Complaint Investigation Report

157209373-8-2-2024-24-AS-SMOA-D7XKZ7-20240808082013

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

This is an official report of an unannounced visit/investigation of a complaint received in our office on

12/20/2023 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20231220104001

Licensee Anthony Barbato, Licensee Legal Representative Iustina Mignea, and Administrator Kala Gibson

Facility staff did not ensure resident received medications as prescribed resulting in hospitalization.

Staff left a resident soiled while in care.

On this date, Licensing Program Analyst (LPA) M. Yang delivered findings for the above allegations. LPA met with Licensee Representative Anthony Barbato.

The Department conducted interviews, reviewed records, and toured the facility. Based on the interviews conducted, records reviewed, and observations made by the LPA on the 12/18/2023 facility visit, the above allegations are Substantiated. R1 was observed soiled while in care. Facility staff did not ensure R2 received his medications to treat his insulin-dependent diabetes condition and did not monitor the resident’s glucose level, which resulted in the resident’s hospitalization and death. Citations were issued on complaint #24-AS-20231228152212 and appeal rights were provided.