complaint·November 20, 2023

Interviews revealed that staff have found medication on the facility floor multiple times within the last six months. Interviews also revealed that staff did not receive medication order from pharmacy for Resident 1 (R1) until a few days after it was prescribed. During facility inspection on 11/20/23, LPA Strong observed three resident rooms with medication on the floor. Interviews revealed that staff could not confirm which resident the medication belonged to. Outside source interviews corroborated that residents have not received medications as prescribed. Based on interviews, and records reviewed, a preponderance of evidence exists to support the allegations. Deficiencies are being cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). An exit interview was conducted with Executive Director Jared Green, to whom a copy of this report, LIC 9099-C, LIC 9099-D, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided to.