Follow-up·April 22, 2024

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct a case management visit. LPA Moleski met with facility administrator Neal Torres and explained the purpose of the visit. LPA Moleski concluded an investigation regarding medication injections on 4/22/24. During the course of that investigation, LPA Moleski interviewed Torres, three residents (R1-R3), seven medication technicians (S2-S8), and one licensed nurse (S1). According to Torres, four diabetic residents were taking injectable insulin (R1-R4) at the onset of the investigation. LPA Moleski reviewed four months' worth of medication administration records (MARs) for R1-R4’s injectable medications. LPA Moleski compared employee initials in these records to a list of employees and observed that initials for these injectable medications corresponded with the initials of licensed nurses, and with medication technicians. LPA Moleski reviewed LIC 602s for R1-R4. All four have diabetes. R1 is not able to perform R1’s own injections due to dementia, according to the most recent LIC 602, which is dated 5/3/23. However, R1 has a doctor's note on file dated 2/14/24 granting approval for R1 to self-administer injections. R4 "needs assistance" with injections, according to the most recent LIC 602, dated 12/6/23. LPA Moleski requested Torres to seek clarity from R4's doctor with regard to self-administration of injections. No deficiencies were cited during this visit. An exit interview was held and a copy of this report was left with Torres.