Complaint Investigation Report

547201356-1-18-2023-24-AS-SMOA-CPL2JN-20230303162635

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

12/05/2022 and conducted by Evaluator Kamaldeep Kaur

COMPLAINT CONTROL NUMBER: 24-AS-20221205101506

Staff are mismanaging resident's medications.

Licensing Program Analyst (LPA) K. Kaur arrived at the facility unannounced for a subsequent inspection.

LPA discussed the purpose of the visit and the elements of the allegations with administrator. LPA Interviewed

The Department has interviewed staff and Administrator, toured the facility, and reviewed records. Based on a sample review of medication that was conducted, and files reviewed. R1 and R2 medication review revealed that medication was missed and or not properly handled. The department received a self- reported incident report from the facility regarding R3 Medication doses being incorrectly given.

The preponderance of evidence standard has been met, therefore the above allegations are found to be

SUBSTANTIATED. See citations on the attached LIC9099D. Exit interview was conducted and appeal rights