complaint·September 15, 2023

12 pills remain in the bottle, indicating only 18 doses were administered over the 36 day period. Medication Administration Record (MAR) reviewed did not indicate any medications were refused and contained blank spaces or x marked on different dates, instead of initials indicating the staff administered the medication. R1's medication ripseriDONE 2mg tablet originally contained 60 pills and 38 remain in the bottle during today's count. The MAR indicates the bottle was opened on 08/19/2023 and 20 days elapsed from that date to R1's hospitalization. RisperiDONE is ordered twice a day, therefore 39 doses should have been administered from the start date, but only 22 doses were utilized. Again, MAR was missing staff initials and had x marked on various dates, but no doses marked as refused. R1's Divalproex Sodium 125mg TBEC originally contained 240 capsules and during today's count 176 capsules remain. This medication is ordered 4 capsules to be administered twice a day. Start date is marked on the MAR as 08/18/2023 and on the bottle as 08/19/2023, so either 20 or 21 days have elapsed since the start date to the time of R1's hospitalization, so if the medication was administered as ordered, either 160 or 168 capsules should have been used. However, only 64 capsules were used. Again, R1's MAR has blank spaces or x marked on various dates but no refusals indicated. Based on interview and medication review, there is sufficient evidence to support the allegation, therefore, the allegation that " Licensee did not assist resident with self-administration of medications as prescribed" is deemed SUBSTANTIATED at this time. The following deficiency was observed (See LIC 9099-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. As this is a repeat violation, civil penalty issued in the amount of $250. Failure to correct the deficiency may result in additional civil penalties. Exit interview conducted. A copy of the report, civil penalty and appeal rights were provided.