Complaint Investigation Report

415600358-11-1-2023-14-AS-KHOS-CY2L9R-20231129073357

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

10/27/2023 and conducted by Evaluator Murial Han

COMPLAINT CONTROL NUMBER: 14-AS-20231027125651

Due to staff negligence, medications were accessible to residents

On 11/1/2023, Licensing Program Analyst (LPA) Murial Han conducted a 10-day complaint visit. LPA met with administrator and explained the purpose of today's visit.

Regarding to allegation of- due to staff negligence, medications were accessible to residents, the reporting party report that one cabinet lock was broken and accessible to resident and another cabinet was closed with a lock, however, the key is permanently in the lock.

During the visit, LPA observed the medicine cabinet with two doors, the doors were closed, however, 2 keys were in the lock and both were not lock. In addition, LPA observed resident's medication placed on the counter below the medicine cabinet.

Above observations were acknowledged by the administrator.

In addition, LPA also made other observations during the visit, see LIC 809 and LIC 809 D under case management for the details.

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 Appeal Rights provided.