336423469-7-13-2020-18-AS-RLAY-BTNP3V-20200921105809

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336423469
Report Date: 07/13/2020
Date Signed: 07/13/2020 01:11:05 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/22/2020 and conducted by Evaluator Pauline Beschorner

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20200522165909

FACILITY NAME:	NEW DISCOVERY RESIDENTIAL SERVICES #4		FACILITY NUMBER:	336423469
ADMINISTRATOR:	CLARDY, GEORGE		FACILITY TYPE:	735
ADDRESS:	903 UNION ST.		TELEPHONE:	(951) 797-3933
CITY:	BEAUMONT	STATE: CA	ZIP CODE:	92223
CAPACITY:	4	CENSUS: 4	DATE:	07/13/2020
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Erika Reyes		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff administering medications that are not prescribed to resident's.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pauline Beschorner spoke telephonically with facility Administrator Erika Reyes. This investigation was conducted via telephone and via facetime, video conference due to Covid-19 precautions. The purpose of this investigation call is to conclude this agency's investigation into the above mentioned allegations.

During the investigation LPA received and reviewed staff training records, medication records, prescriptions for residents (R1, R2, R3, and R4), interviewed staff (S1, S2 and S3,) and observed via facetime all medications. Residents were unable to be interviewed due to disabilities which impair their verbal communication skills.

It is alleged, staff is administering medications that are not prescribed to residents. A review of employee training records showed staff are trained in the areas of Medication Recording, Virtual Medical Dispensing, First-Aid/CPR, Blood Pressure training, Glucose and Insulin Monitoring, Medication Dispensing, Documentation by Golden Elite Pharmacy.
CONTINUED ON NEXT PAGE

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Pauline Beschorner	TELEPHONE: (951) 897-7936
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2020

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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Control Number 18-AS-20200522165909

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: NEW DISCOVERY RESIDENTIAL SERVICES #4	FACILITY NUMBER: 336423469
	VISIT DATE: 07/13/2020

NARRATIVE

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Two out of three staff interviewed denied residents receiving medication that was not prescribed to them, however one staff stated another caregiver had given residents medication that was not prescribed to them, to make them sleep at night.

Although the above allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED at this time. A copy of this report was reviewed with and furnished to the facility Administrator Erika Reyes via email.

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Pauline Beschorner	TELEPHONE: (951) 897-7936
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2020

LIC9099 (FAS) - (06/04)

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