Complaint Investigation Report

Further review of facility records show that S1 signed the Medication Administration Record for 11/21/2025 and 11/22/2025 after the immediate exclusion of S1 was issued to the facility on 11/20/2025. Based on the information gathered, the licensee allowed excluded individual into the facility.

An immediate civil penalty of $500 was issued for Section HSC 1548 for allowing an excluded individual.

The following deficiencies were cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was provided to the facility at the end of this visit along appeals rights.