Incident investigation·April 6, 2021

On 04/06/2021, Licensing Program Analysts (LPA) Leslie Ibo conducted a Case Management with Administrator Kyle Ruth- Islas and Residence Services Director Robyn Mendez, in relation to the incident report received on 03/26/2021, S1 gave R1 un-prescribed medication. LPA explained that due to Shelter in Place Order and directive from management to telework, inspection will be done via phone call. This is continuation of case management conducted on 03/30/2021, LPA conducted interview and records review, based on facility internal investigation document S1 admitted giving medication to R1, but based on medication records and Physician's order the medication was not prescribed to R1. Facility then provided one on one observation to R1 upon receiving the incident report from S2 & S3 . There was no reported side effect from the medication that was given to R1. Law enforcement, ombudsman & R1's family was informed about the incident. S1 was terminated from the facility effected 03/31/2021. Administrator will hire a third party company to provide training for all medication technician. Deficiency was cited from the California Code of Regulations, Title 22. Repeat violation, civil penalty of $250.00 assessed today. Exit interview conducted. Appeal Rights and a copy of this report emailed