complaint·September 5, 2023

Continued..... During the course of the investigation, it was discovered that Resident (R1) was given an additional dose of medication that was in excess of R1’s physician’s order. Interviews with staff revealed that the facilities computer system alerted staff that a discontinued dose of the medication was due when it had been discontinued resulting in a second dose being administered. Based on LPA's observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8 is being cited on the attached LIC 9099D. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties.