Incident investigation·October 13, 2022

On 10/13/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct a Case Management visit. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Administrator, Erik Schuk The purpose of this visit is to follow up on an incident report that was submitted to the Fresno CCL office. It was reported that on 09/13/2022 a hospice resident received a medication that had been discontinued. A deficiency is being cited in accordance to California Code of Regulations, Title 22, Division 6, on the attached 809D. A civil penalty in the amount of $250 is being assessed for repeat violation. Exit interview 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, Erik V. Schuk, whose signature on this form confirms receipt of this document.