Complaint Investigation Report

547201356-4-10-2023-24-AS-SMOA-CQUL38-20230413082330

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

02/01/2023 and conducted by Evaluator Kamaldeep Kaur

COMPLAINT CONTROL NUMBER: 24-AS-20230201161921

Medication records are not properly documented.

Licensing Program Analyst (LPA) K. Kaur arrived at the facility unannounced for subsequent complaint inspection. LPA discussed the purpose of the visit and the elements of the allegations with administrator. LPA delivered the following findings.

The Department investigated the allegations listed above. Based on observation and record review a medication was not documented in the centrally stored prescription medications list.

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 with Administrator