Complaint Investigation Report

The reporting party stated that R1 had a refill of the medication on February 14, 2025. A review of medication showed a refill for February 14, 2025, with nine(9) films left in the box and zero refills. Medication is for 30 days at a time. R1 needs multiple prompting for compliance in medication. On March 5, 2025, R1 called emergency services and was taken to the hospital and was hospitalized until March 10, 2025, and returned to the facility on March 10, 2025. R1 called emergency services again on March 10, 2025, and has not been discharged from the hospital's behavioral services. There are no discrepancies in the number of films left in the medication box of nine (9) from February 14, 2025, to March 5, 2025. R1's primary diagnosis is bipolar disorder, secondary ADHD.

Based on the evidence in the investigation, the allegation of staff mishandled a client's medication was deemed unsubstantiated based on the findings. An unsubstantiated finding means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

An exit interview was conducted with Roger Hernandez, Administrator. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided to the Administrator, and his signature on this report confirms receipt of the Licensee Rights.