Complaint Investigation Report

415601063-12-5-2023-14-AS-KHOS-D2DJW2-20240212062358

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

06/26/2023 and conducted by Evaluator Jaime Vado

COMPLAINT CONTROL NUMBER: 14-AS-20230626083229

- Staff did not provide medications as needed

- Staff did not communicate with authorized representative in a timely manner

On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit in order to deliver findings regarding the allegations above. LPA met with the administrator Stephanine Gaspar and explained the purpose of today's visit.

During the investigation LPA conducted interviews and reviewed documents from the facility. It is discovered that the facility did provide the medications per the prescription provided and through interviews and documentation observed. The medications were prescribed "as needed" and the facility followed as prescribed. In regards to communication with authorized representative, the person on file as was out of the country at the time, so communication to them was received at a delay on their end. The facility did communicate with the additional family members listed due to the authorized representative not being immediately available. These allegations are unsubstantiated.

Based on these observations, the above allegations are UNSUBSTANTIATED.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are unsubstantiated at this time.

Report is reviewed with Stephanine Gaspar.