Complaint Investigation Report

415600657-4-16-2025-14-AS-KHOS-DH9LKA-20250602084914

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

03/14/2025 and conducted by Evaluator Jaime Vado

COMPLAINT CONTROL NUMBER: 14-AS-20250314094640

- Unqualified staff are administering medications to residents in care

On 04/16/2025, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigaiton visit to deliver findings regarding the allegations received. LPA met with administrators Ante and Nediljka Buljan and explained the purpose of today's visit.

During the course of the investigation, LPA conducted interviews, conducted research, and reviewed pertinent documents related to the allegations. According to interviews and documentation reviewed, staff were trained by hospice to administer medication such as morphine to those residents who may need it. Per interviews, R1 was never given morphine during her time at the facility. This allegation 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.