Complaint Investigation Report

547201356-1-17-2024-24-AS-SMOA-D23LUN-20240202080413

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

10/30/2023 and conducted by Evaluator Kamaldeep Kaur

COMPLAINT CONTROL NUMBER: 24-AS-20231030162407

Staff are serving the residents expired food

Staff are mishandling the resident's medications

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.

Based on observations the facility had expired food. Medication audit revealed residents’ medication was not logged in the Centrally Stored Medication and Destruction Record (CSMDR). The preponderance of evidence standard has been met; therefore, the above allegations are found to be SUBSTANTIATED. See citations on the attached LIC9099D. Civil penalty issued due to repeat violation.

Exit interview was conducted with Administrator and appeal rights were provided.