Incident investigation·February 9, 2023

On 02/09/2023, Licensing Program Analyst (LPA) Bains arrived at the facility to conduct a Case Management visit regarding an incident that occurred on 01/29/23 for resident (R1) for medication error. LPA met with staff Alma Caniedo and explained reason for visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms and contacted facility and completed a facility risk assessment. LPA ensured to apply hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn surgical mask. After staff interviews and records reviewed, it was determined that, staff (S1) dispensed the wrong medication to a resident in care. LPA Bains had initially received an incident report on a LIC624 on 02/02/23 regarding the medication error involving resident R1 for date- 01/29/23. Through documentation reviewed, it was determined S1 distributed medication, Levothyroxine, 50 mcg to R1 in error which was not belong to R1. The facility documented the medication error and did seek medical observation and treatment for R1 following the medication error. Deficiency is cited per California Code of Regulations, Title 22, and listed on LIC 809D. Failure to submit Proof of Correction (POC) by Plan of Correction date may result in civil penalties. Exit interview conducted. Appeal rights provided. Copy of the report left at facility.