Complaint Investigation Report

277209489-4-17-2026-24-AS-SMOA-DTCSQS-20260421140514

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

01/15/2026 and conducted by Evaluator Vadim Gorban

COMPLAINT CONTROL NUMBER: 24-AS-20260115090814

Staff are not documenting residents medication

Staff are not meeting resident's hygiene needs

Unqualified staff are administering medications

On 04/16/2026 Licensing Program Analyst (LPA) Gorban unannounced visited the facility to commence complaint investigation. LPA introduced self and met by Administrator; LPA stated purpose of the visit and was allowed entry.

During the complaint investigation LPA toured the facility conducting health and safety checks, reviewed records, and interviews.

Allegations: Staff are not documenting residents’ medication, Staff are not meeting resident's hygiene needs, and Unqualified staff are administering medications. Based records reviews resident’s medications record confirmed medication records confirmed proper documentation. Based on staff interviews, resident will maintain own dental hygiene. Based on records review and staff interviews, training on medication administration provided to staff that have access to med cart. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is Unsubstantiated.