Complaint Investigation Report, 10/30/2024 — A & J Assisted Living Facility, Daly City CA

415601066-10-30-2024-14-AS-KHOS-DAQQEX-20241105110704

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SAN BRUNO RO , 851 TRAEGER AVE., SUITE 360

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

10/25/2024 and conducted by Evaluator Komal Charitra

COMPLAINT CONTROL NUMBER: 14-AS-20241025084857

Staff did not ensure centrally stored medication was locked and inaccessible to residents

On October 30, 2024, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced 10-day complaint visit. LPA met with Administrator, Paula Madrigal and explained the purpose of the visit.

Regarding the allegation, staff did not ensure centrally stored medication was locked and inaccessible to residents, according to the reporting party, it was observed that the nurses' station gate was wide open with a clear view and access to residents' medication bottles. In addition, the reporting party indicated that the gate remained unlocked and open for 5-10 minutes until it was brought to a staff members attention.

During the visit, LPA interviewed staff and observed the nurses' station on the first and second floor. Based on observations, LPA observed nurses' station gate on the first floor open and medication unlocked and accessible to residents. Medication bottles, medication in bubble packs, medication for destruction, and other prescribed medications were observed on top of the medication cart on the first floor. LPA observed the second floor nurses' station and observed medication cart to be unlocked with the key on it. In addition, LPA observed medication pills in a cup on top of the medication cart. At the time of the visit, no staff was observed present in the nurses' station on the second floor and the door was open. Furthermore, it was observed that the medication cart on the second floor is in disrepair and does not lock, and the room door stays unlocked at all times.

Based on observations, and interviews during the investigation, the preponderance of evidence standard has been met. Therefore, this allegation is determined to be substantiated. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC9099-D. Failure to correct the deficiencies may result in civil penalties. Report was discussed with Administrator and a copy is provided with appeal rights.