Complaint Investigation Report

342700936-9-26-2022-27-AS-KHOS-CJWU3F-20221005151327

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 2525 NATOMAS PARK DR. STE.270

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

07/08/2022 and conducted by Evaluator Christina Valerio

COMPLAINT CONTROL NUMBER: 27-AS-20220708172342

Facility not following resident's ipp plan

Licensing Program Analyst (LPA) Christina Valerio arrived at the facility unannounced to deliver complaint investigation findings. LPA met with Administrator Pearl Ofodire, and explained the purpose of the visit.

Based on records review, Alta Regional Center made an unannounced visit on 06/15/22. They observed 2 medications that were dispensed on 04/29/22 and 06/06/22 were not listed on the Centrally Stored Medication Record. Records show the administrator was to ensure medications were logged in the Centrally Stored Log by 07/05/222. The facility was also to submit a plan to implement a double-check system. This has been completed LPA observed the Centrally Stored Log for resident 1, which was up to date.

Based on interviews and records review, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. CCR (Title 22, Division 6, Chapter 8) are being cited on the attached LIC-9099D. Failure to correct the deficiency may result in civil penalties. Appeal rights were provided. An exit interview was conducted with Administrator Pearl Ofodire, and a copy of the report was left.