Complaint·May 25, 2021

Licensing Program Analyst (LPA) Adam Hamer conducted an unannounced complaint investigation visit on today's date. LPA identified himself, spoke with Caregiver Ma Guinto and discussed the purpose of the visit, which was to conduct a complaint investigation visit for the above allegations. Licensee Benito Encabo arrived at the facility later and met with LPA. The Department’s investigation included LPA observations and interviews with staff and residents. Facility records were also obtained by the Department and reviewed for pertinent evidence. The Department received a complaint on May 19, 2021 alleging that the facility did not securely store resident's medications and that cleaning supplies were accessible to the residents in care. After arrival at the facilty, LPA observed one (1) resident (R1) who was ambulatory and in the living area adjacent to the kitchen and three (3) residents in their rooms with their doors open (R2, R3 and R4)(see LIC 811 - Confidential Names List). In the kitchen area, medications were stored in an open, unlocked cabinet next to the refrigerator and in a partially open drawer underneath the kitchen counter. In the drawer, there were pills in three (3) unlabeled, open containers; other resident medications in bubble packs and in a bag; and a resident medication in a small, labeled pharmacy container. Interviews with staff (S1 and S2) revealed that the medicine drawer and cabinet next to the refrigerator were kept open throughout the day and residents' pills were distributed to each resident from the open pill containers. There was no medication administration record at the facility to document what medications were being given to the residents at different times. With regard to the storage of cleaning supplies, LPA observed several containers of various cleaning supplies underneath the sink in the residents' bathroom, which was unlocked and had no door handle. LPA also observed in the unlocked garage, on top of the washer, bleach and other cleaning supply items and, in an area near the washer, other accessible cleaning supply items. Interviews with S2 revealed that the bathroom door is kept open with a rope and has not had a lock on it for at least a week or so. Interviews with S1 revealed that the door leading to the garage was always propped open with a door stopper, which LPA observed propping the door open when he entered the garage. Based on the evidence obtained during the complaint investigation, the allegations that facility did not securely store resident's medications and that cleaning supplies were accessible to residents are found to be SUBSTANTIATED, as there is a preponderance of the evidence to prove that the allegations occurred. Citations are being issued in accordance with California Code of Regulations, Title 22, are listed on the LIC9099D, and a plan of correction was developed by the Licensee.