Complaint Investigation Report

During the investigation, LPA reviewed facility records, including incident reports, medication records, and interviewed staff. The investigation revealed that the facility self-reported two medication errors. On 03/16/2026, the facility submitted an incident report documenting that a resident received the wrong medication. A second self-reported incident dated 05/22/2026 documented another medication administration error in which staff administered an incorrect medication during the medication pass.

Based on the facility's self-reported incident reports, staff interviews, and records reviewed, LPA obtained sufficient evidence to support the allegation that staff mismanaged residents' medications. Therefore, this allegation is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiencies, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Exit interview conducted. Copy of report, LIC9099D (Deficiency Page), Plan of Corrections, and Appeal Rights discussed and provided to Executive Director. Signature on form confirms receipt of documents.