Complaint Investigation Report

415601039-11-8-2024-14-AS-KHOS-DAXJKA-20241112060650

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

10/07/2024 and conducted by Evaluator Jaime Vado

COMPLAINT CONTROL NUMBER: 14-AS-20241007215642

On 11/08/2024, Licensing Program Analyst (LPA) Jaime Vado conducted an unannonced complaint investigation visit in order to deliver findings regarding the received allegation. LPA met with Joan Newman and explained the purpose of today's visit.

During the investigation, LPA conducted interviews and reviewed pertinent documentation. It was discovered that the facility did not provide a medication to a resident that is prescribed. The medication was stopped being given to the resident without an order on file from the physician. The medication was stopped around February 18, 2024 through April 7, 2024. It was started again after the discovery of it not being given, but then again was stopped around April 27, 2024 thorugh August 17, 2024. The prescription for the medication was not discontinued by the physician at any point. The dosage was decreased per records reviewed, and per interviews, this may have also caused issues with the facility maintaining the medication on their medication records. The medication was not given although it was prescribed by the physician due to facility error. 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.