Complaint Investigation Report

Furthermore, during interviews with an outside provider, it was disclosed to the LPA that the resident was bedridden which requires a higher level of care needs (See LIC 9099D). LPA reviewed the STD 850 Fire Clearance and observed that the facility is Fire Clearance approved for 4 residents that are Non-Ambulatory and 0 bedridden residents. Facility is not licensed to care for residents that are Bedridden (See LIC 9099D).

Complaint alleges that staff do not administer medications to resident(s) according to physician’s instructions. LPA could not review the Medication Assessment Record (MAR) for Resident #1 because the facility did not retain the MAR for Resident #1 (See LIC 9099D). Furthermore, during an interview conducted on March 27, 2023 (See LIC 812-Interview-Administrator) with the Administrator, LPA learned that the facility did not retain an LIC 602 and the MAR for Resident #1.

Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview was conducted, and a copy of this report was signed and given to the Licensee/Administrator.