Complaint·February 3, 2026

LPA gave guidance that the reason for refusal should be documented as outlined in regulation, PRN response fields of documentation should be completed timely, any staffing concerns should be raised in the internal grievance process, and documentation should be filled out with the goal to reduce reliance on verbal reporting not to make it mandatory. Based on LPAs observations and interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, is being cited on the attached LIC 9099D. citations issued, a copy of the appeal rights was left with the administrator. a copy of the report was read and given to the administrator. Exit interview conducted. documented, or with the client refusing or accepting a medication. Over three med pass observations, LPA did not witness the staff withold a medication, based on the blood pressure reading or not. By interview with staff/clients, and a record review of MARs and the facility menu, and meal observation, it was learned that medication is confiscated by staff when they arrive to the facility if it is not on the medication orders list. In at least one instance, a client reported the staff taking a medication perscribed to her and not dispersing it. It was learned from the mar that a discontinue order for that medication was issued 2 days before the client arrived. The facility staff do not have a response as to what happened to the medication after it was confiscated, if it was destroyed, if it was kept secure as property of the client. LPA gave guidance that kind of confiscation policy should be more obvious to the incoming clients in the form of an addendum to the admission agreement and the issue should be resolved internally as a loss of property if it cannot be produced by the facility. As a related issue, some clients (a mixed population of nonassisted living, and assisted living) report not being given the option of adequately nutritious alternatives if they have a perscribed alternative diet. LPA reviewed the menu and observed the lunch service on two occasions, the lunch service is meeting the nutritional requirement of 1/3 of servings of the various groups in the regular and alternative meals, LPA is concerned about anybody repeatedly choosing the house salad option not getting an adequate amount of protein. LPA gave guidance that the salad can easily have servings of nuts, cheese, eggs, or chicken added to it to shore up any nutritional concerns and improve the variety for the hypertensive/diabetic folks. cheese cant be used as a source of protien if its also being used as a source of dairy for the purposes of menu design. by interview with staff/clients, it was learned that holds are given of the clients medication. some clients report unease with the facility issuing medication in general and specificly the practice of holding the medication. The staff report that they do not give out medication belonging to other residents, or give out medication that is ordered by a doctor to be withheld, and destroy medications as necessary when a client has a new order/leaves the facility permanently. The practice of holding medication is specificly for unplanned absences from the facility. LPA gave guidance that medication is the clients property and should go with the client if they have a planned absense from the facility, they or a responsible party (as applicible) can sign out their medication with a affidavit that they will adhere to the schedule of the medication. The facility has a responsibility to take measures to ensure medications are delivered on schedule, and medications are not to be used to restrict th e movement of the clients. Although the allegation(s) may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiat ed. no citation issued, A copy of the report was read and given to the administrator, appeal rights provided . exit interview conducted