Incident investigation·August 2, 2022

Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced at Village at Rancho Solano Assisted Living for the purpose of following-up on an incident report that was forwarded to the Regional Office (RO) on July 18, 2022. LPA was greeted at the door by Administrator, Josef Dunham and was granted access into the facility. CCL received an incident report indicating a medication error. The error occurred on July 12, 2022 while Med Tech was counting medication. R1 was given the wrong dosage during medication passing on July 12, 2022 (See LIC 809D) . Responsible Party and prescribing doctor were notified of the medication error. LPA obtained copies of the fax to the Primary Care Physician, the Medication List for Resident #1 (R1) indicating dosages for R1, discharge paperwork and the Medication Assessment Record (MAR) for R1 on July 12, 2022. Deficiencies are cited from the California Code of Regulations (CCRs), Title 22, Division 6, Chapter 8 and the Health and Safety Code. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview was conducted with the Administrator and appeal rights were given to the Administrator.