Complaint Investigation Report

9 out of the 9 staff members did not agree with the allegation. Although S1 stated that the facility has a system in place to ensure that medications are given to residents in care, S1-S5 were not able to explain why the medications for S1-S3 were unaccounted for. LPA observations revealed the following: On 07/25/2025, R1-R3 residents bubble pack medications were popped on incorrect days with no document to explain the reasons. R1 and R2’s medication for 07/26/2025 and R3’s medication for 07/31/2025 were unaccounted for without documentation or explanation. Records review revealed the following: The July 2025 medication administration records (MAR) for R1-R2 did not indicate that R1 and R2’s medication for 07/26/2025 and R3’s medication for 07/31/2025 were given. Based on interviews, observation and records reviews the preponderance of evidence standard has been met. Therefore, the above allegation is found to be Substantiated. California Code of Regulations, Title twenty-two (22), Division six (6), is being cited, please see attached LIC-9099D. A Civil penalty is being assessed for repeat violation please see LIC421RP.

An exit interview was conducted, plans of corrections were developed and appeals rights were provided to Catherine Dacara .