Complaint Investigation Report

--- Reporting guidelines were not followed.

It was alleged that there was a lack of incident reporting about the medication errors . To investigate this allegation, on 05/16/2022, LPA interviewed staff from 10:30 AM - 11:30 AM and conducted a record review. Interviews and record review revealed that the facility did not submit an incident report timely.

Based on the information revealed during interviews and record review, the allegation is SUBSTANTIATED at this time.

An exit interview was conducted, and a Plan of Correction was reviewed and developed with the

Administrator. A copy of this report, LIC 9099-D, and Appeal Rights were discussed and provided to

Administrator, whose signature on this form confirm receipt of these documents.