Incident investigation·May 2, 2022

On 05/02/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct a Case Management - Inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Administrator, Pamela Hamilton. The purpose of today's inspection is to follow up on an incident that occurred on 04/18/2022. It was reported that at the beginning of S2's shift, S2 observed a Medication cup with morning medications poured for R1, but the medications were not administered. S1 was did not administer morning medications, however: S1 documented that medications were given to R1. A deficiency is being issued in accordance with the California Code Regulations, Title 22, Division 6 on the attached 809D. An exit interview was conducted and a Plan of Correction was reviewed and developed with Administrator. A copy of this report and appeal rights were discussed and provided to Administrator, Pamela Hamilton, whose signature on this form confirms receipt of these documents.