complaint·July 25, 2025

The reporting party stated resident was given more medications than what should be given and medications were given late. Two out of 3 staff interviewed stated that it could happen that a resident is given a certain number of medications day prior and may be given different number of medications the succeeding days if there's a change in doctor's order. One of the residents interviewed stated this resident was given 11 medications in the morning of 02/19/2022 when this resident should be given only 9. This same resident was given 9 medications 02/27/2022. Review of doctor's order of medications dated 01/26/2022 and discontinued order of medications dated 01/26/2022 showed this resident has a total of 9 of the regular prescribed medications in tablet and capsule forms listed. Although notes in the MAR showed this resident was given medications on time, MAR for 02/2022 showed this resident was given one of the medications 1 1/2 tablets of the 10 mg tablet when prescription showed 10 mg only. MAR also showed only 6 medications in tablets and capsule forms listed of which 1 were administered at 5:00 pm on 02/2022. These findings were discussed with the ED. Based on review of records and interviews, the preponderance of evidence standard has been met, therefore, the allegation is substantiated. Deficiency is cited from Title 22 California Code of Regulations and listed on 9099D. Failure to submit proof of correction by plan of correction due date and any repeat violation within 12 month period may result in civil penalty. Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.