complaint·February 22, 2022

Continued LIC9099 page 2 LPA Bunker requested pertinent documentation regarding the above allegation. (Physician's Report, Medical Administration Record, Admission agreement, Appraisal/Needs and Services Plan, Personnel Report, Resident's Roster, Special Incident Report, Corrective Action Memo, and Ongoing In-Service Medication Training) Allegation: Medication error Investigation revealed the following: Interviews were conducted with the staff 1-3 (S1-3), and residents 1-6 (R1-R6). The Administrator stated that it is true that one of the Med Techs accidentally gave R1's wife one bottle of Risperidone 1 MG Tab medication that was for R2 when R1 went home with his wife for a weekend visit. Staff stated R1 did not take R2's medication. R1's wife brought R2 medication back to the facility. R2 did not miss taking any of his medications. R2 had an extra supply of medications, VA provides residents with three (3) monthly supplies of medications. Administrator Gwen Craig self-reported the Special Incident Report to all the appropriate agencies in a timely manner within Title 22 Regulations required time frame prior to the complaint allegation. Ms. Craig stated the Med Tech was given a Corrective Action Memo and received ongoing In-Service Medication Training. The Residents interviewed stated they were happy and staff is providing them with the necessary care and supervision, their daily needs are being met and they had no problems at the facility. Residents stated the Med Techs always dispense their medications according to their physician's directions. Based on LPA’s observations, interviews that were conducted, and records reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, Title 22, Division 6, and Chapter 8 are being cited on the attached LIC9099-D. Appeal Rights were discussed, and copies of the Complaint Investigation Report LIC9099, LIC9099-C, and LIC9099-D Confidential Names LIC 811 were provided to Administrator Gwen Craig. Exit interview conducted.