Complaint Investigation Report

157209516-9-3-2025-24-AS-AWAN-DMUVCR-20251027161935

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

08/25/2025 and conducted by Evaluator Daiquiri Boyd

COMPLAINT CONTROL NUMBER: 24-AS-20250825180500

Resident ingested another residents medication due to staff leaving medication accessible to other residents in care

Licensing Program Analysts (LPAs) Daiquiri Boyd and Shawna Doucette conducted the 10 Day complaint investigation visit to the facility. During the course of this complaint investigation visit, LPAs interviewed staff and obtained and/or reviewed resident and facility records. It was determined based on the Incident Report submitted by the facility and records review that the above allegation is SUBSTANTIATED. Facility staff left medication accessible, allowing a resident (R1) access to another residents (R2) medications, and as a result R1 then injested medication that was prescribed for R2, requiring medical attention for R1. Based on LPAs records review and submitted reports, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

California Code of Regulations, (Title 22, Division 6, Chapter 8), is being cited on the attached LIC 9099D.