Complaint Investigation Report

415600980-4-4-2023-14-AS-CSMH-CQVTZ8-20230414150956

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SF COASTAL AC/SC , 851 TRAEGER AVE., SUITE 360

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

11/09/2022 and conducted by Evaluator Jaime Vado

COMPLAINT CONTROL NUMBER: 14-AS-20221109113420

On this day, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit to deliver findings regarding the allegations received. LPA met with administrator Freddie Fullon and explained the purpose of today's visit.

During the course of the investigation it was discovered that the time period in question, around June 2022, there was a COVID outbreak which impacted staffing. With the administrator, LPA Vado reviewed medication logs, and discussed staffing issues due to COVID. It was confirmed that in the morning hours of a day in June 2022 there were no available med techs due to them calling out the morning at the start of their work shifts due to COVID symptoms. Administrator confirmed that memory care residents did not receive medications until back up staff arrived later that morning. Other staff were in place so there was not a lack of supervision. This allegation is substantiated.

Based on LPA interviews and items letters received, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, are being cited on the attached LIC9099D. Report is reviewed with administrator.