Complaint Investigation Report

507206802-4-29-2022-27-AS-SDOB-CE4K4E-20220504073412

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 2525 NATOMAS PARK DR. STE.270

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

04/19/2022 and conducted by Evaluator Victoria Brown

COMPLAINT CONTROL NUMBER: 27-AS-20220419085726

Facility staff gave resident wrong medications

Facility did not report medication error to licensing

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to investigate the above mentioned allegations on 4/29/22 at 2:20pm. LPA was met by Linda Aguilar and stated the purpose of the visit. The Administrator Voica Matias was made aware of the complaint as well. LPA observed the locked medication cabinet and the containers for each resident. LPA observed the Medication Administration Record (MAR), and the Tablets-Capsules-Ampules Log. LPA interviewed staff #1 (S1-S3) during this visit. LPA did not observe the use of 7-day pill box during this visit.

Based on interviews, observation and lack of evidence the preponderance of evidence standards has not been met; therefore, the above allegation(s) is found to be UNSUBSTANTIATED.

A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies cited. An exit interview was conducted, and a copy of this report was provided.