Incident investigation·July 6, 2023

On 7/6/2023, Licensing Program Analyst (LPA) Grace Donato conducted a case management visit concerning an incident report received. LPA met with Lead Staff (LS) Veronica Rozario. LPA explained the purpose of today's visit. On 7/5/2023, facility submitted an incident report concerning resident a resident (R1) was given a wrong medication. During today's visit, LPA observed medications to be locked and inaccessible to residents. Residents were at the living room watching a movie. In regard to the incident, LS stated that on the day the incident occurred, the staff (S1) was on NOC shift. S1 was giving out medication in the morning and accidentally gave the wrong set of medication to R1. R1 already ingested the medication so S1 called administrator to report and then poison control was called for advice. S1 is currently not allowed to give out medications. S1 has medication training. Facility staff members will have training again in regard to resident medications. Deficiency is cited today as the facility did not ensure that correct medications is given to residents. Deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. Report was discussed with lead staff, Veronica Rozario. A copy of this report and the Appeal Rights are provided.