Complaint Investigation Report

Review of the facility’s Centrally Stored Medication and Destruction Records for June 2021 revealed C1’s prescription for Medication#1 (M1) was filled 6/30/21. However, review of Special Incident Report dated 6/25/21, documented by Licensee Upchurch, indicated C1 had been discharged from the hospital on 6/24/21 with a prescription for pain medication. Therefore, the prescription was not filled until six (6) days later. The MARs also indicated only one dosage of M1 was signed as given on July 1, 2021.

Based on interviews conducted and records reviewed, the preponderance of evidence standard has been met, therefore the above allegations are found to be substantiated. California Code of Regulations (Title 22, Division 6, Chapter 8), are cited on the attached LIC 9099-D.

An exit interview was conducted, and a copy of this report was provided along with Appeal Rights and LIC811- Confidential Names list.