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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 275202817
Report Date: 01/24/2024
Date Signed: 01/28/2024 07:48:02 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/10/2024 and conducted by Evaluator Lisa Salazar
COMPLAINT CONTROL NUMBER: 24-AS-20240110113508
FACILITY NAME:VISTA HARDEN RANCHFACILITY NUMBER:
275202817
ADMINISTRATOR:CARTER, JOYFACILITY TYPE:
740
ADDRESS:290 REGENCY CIRCLETELEPHONE:
(805) 319-7370
CITY:SALINASSTATE: CAZIP CODE:
93906
CAPACITY:83CENSUS: 71DATE:
01/24/2024
UNANNOUNCEDTIME BEGAN:
06:30 PM
MET WITH:Joy TIME COMPLETED:
07:00 PM
ALLEGATION(S):
1
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9
Staff did not follow resident's physician's order regarding medications
INVESTIGATION FINDINGS:
1
2
3
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5
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7
8
9
10
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12
13
On 01/24/24, Licensing Program Analysts (LPAs) L. Salazar and Sarah Hurt arrived to the facility unannounced to deliver findings on the above allegation. LPAs met with Joy Carter via telephone and stated the purpose of the visit.

During the investigation, LPA S. Hurt observed Centrally Stored Medication Destruction (CSMDR) from 04/04/22, which shows the medication in question, was given per the physician's orders. LPA Hurt also observed the active medication list that was faxed from R1's physician on 03/30/22. Facility communication logs show the responsible party (RP) for R1, contacted Staff S1 on 08/17/22 for an update on resident's medication being discontinued. S1 informed RP the facility did not receive any changes for R1's medications to be changed. S1 advised RP to contact R1's physician and request the order of discontinuation be faxed to the facility if medication is discontinued. On 08/18/22, facility received discontinuation order from R1's physician. On 08/18/22, the medication was discontinued on 08/18/22.

Based on the information received, we have found that the complaint is Unfounded, meaning that the allegation is false, could not have happened, and/or is without reasonable basis, therefore, we have dismissed the complaint. Exit interview conducted. A copy of this report was provided at the time of visit. No deficiencies cited.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Lisa SalazarTELEPHONE: (559) 691-0004
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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