Complaint Investigation Report

486803806-10-29-2024-21-AS-KMOA-DARPWB-20241106104028

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1450 NEOTOMAS AVENUE, STE. 100

This is an official report of an unannounced visit/investigation of a complaint received in our office on

10/18/2024 and conducted by Evaluator David Leibert

COMPLAINT CONTROL NUMBER: 21-AS-20241018104643

VILLAGE AT RANCHO SOLANO ASSISTED LIVING, THE

Staff did not ensure reporting requirements were followed

Licensing Program Analyst Leibert arrived unannounced for the purpose of delivering findings on this complaint. During the course of this investigation, statements were taken and documents reviewed. Complainant has alleged that Facility did not follow reporting requirements. A medication error occurred on 10/14/2024 and discovered on 10/15/24. An incident report (SIR) was created by the facility on 10/18 which was received by this Department on 10/21/2024, which is within the required time frame. The report indicates that the Responsible Person and this Department were notified. Based on statements and documents, this complaint is deemed UNFOUNDED, meaning that it is false and/or, without a reasonable basis. The complaint is DISMISSED.