Incident investigation·July 8, 2021

Licensing Program Analysts (LPAs) David Sicairos and Luis Mora conducted an unannounced case management visit in regards to a Special Incident Report that was submitted to Licensing on 06/21/21. LPAs met with Selene Rangel and explained the reason for the visit. Per Incident Report on 06/17/21, Staff #1 (S1) - Staff #2 (S2) noted that the medication in the medication card did not match the stated medication on the label. Upon further assessment it was noted that various medication cards had been tampered with. Cards appeared to have been cut and taped, visible only when held against the light. Azusa Police Department was called and an investigation was opened. On 06/30/21, Detective informed Administrator and Director of Care Health Services that there are two persons of interest (Staff #3 - Staff #4). Both employees have been suspended from facility pending investigation. Door codes and locks on medication carts have been changed and police investigation is still ongoing. LPA advised Administrator and Director of Health Care Services to keep Licensing informed of the police investigation findings. LPA also requested copy of the Police Report when it becomes available. No deficiencies were cited during today's visit. Exit interview held and a copy of this report was provided.