Complaint Investigation Report

331880566-1-27-2022-18-AS-JESL-CLNT74-20221130132806

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1650 SPRUCE ST STE 200 MS29-27

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

01/20/2022 and conducted by Evaluator David Cuevas

COMPLAINT CONTROL NUMBER: 18-AS-20220120081209

Staff are administering medication to resident without a prescription.

On 1/27/22 Licensing Program Analysts (LPA) David Cuevas and Licensing Program Manager (LPM) Deborah Mullen arrived at the residence to investigate allegation above. Upon arrival, LPAs met with Licensee, Montano Recinto and explained the purpose of the visit, who allowed entry.

LPA's condcuted resident record review and identify that medication prescription for Resident's #1,#2,#3,#4,and #5 did not have required medication prescription on file. Based on provided evidence allegation will be SUBSTANTIATED. A substantiated finding means that the allegation is valid because the preponderance of evidence standard has been met.

An exit interview was conducted with Licensee, Montano Recinto were this report, LIC 9099D, and appeal rights were reviewed with and provided to Mr. Recinto.