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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603339
Report Date: 11/18/2022
Date Signed: 11/18/2022 12:40:22 PM

Unsubstantiated


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
08/09/2022 and conducted by Evaluator Chinwe Nwogene
COMPLAINT CONTROL NUMBER: 18-AS-20220809162428
FACILITY NAME:MERIDIAN AT LAKE SAN MARCOS, THEFACILITY NUMBER:
374603339
ADMINISTRATOR:QUIGLEY, KEVINFACILITY TYPE:
740
ADDRESS:1177 SAN MARINO DR BLDG 1 & 2TELEPHONE:
(760) 510-7500
CITY:SAN MARCOSSTATE: CAZIP CODE:
92078
CAPACITY:170CENSUS: 143DATE:
11/18/2022
UNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Theresa Robert, Resident Services DirectorTIME COMPLETED:
12:50 PM
ALLEGATION(S):
1
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9
Resident was not given medication as prescribed.
INVESTIGATION FINDINGS:
1
2
3
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5
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7
8
9
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11
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13
Licensing Program Analyst (LPA) Chinwe Nwogene conducted an unannounced visit to conclude the complaint investigation into the allegation listed above. LPA met with Theresa Robert who was informed of the purpose of the visit. During the investigation, LPA interviewed Resident, interviewed staff and reviewed resident file.
Regarding the allegation “Resident was not given medication as prescribed”. It was alleged facility did not administer resident’s pain medication as prescribed by the doctor. LPA interviewed staff who stated resident had dental procedure and returned to the facility with three #3 PRN pain medications. Staff stated the medications are administered upon resident’s request. LPA interview with resident revealed, Resident receives the pain medication upon resident request. LPA reviewed resident’s Medication Administration Record (MAR), MAR revealed the three #3 prescribed pain medications are PRN, administered “as needed”.
Based on LPA’s interviews with staff, residents and review of resident file, there is not enough evidence to support the allegation “Resident was not given medication as prescribed”. Although the 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. An exit interview was conducted, and a copy of this report was reviewed with and provided to Theresa Robert.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Chinwe NwogeneTELEPHONE: (951) 202-2066
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2022
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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