392700640-6-18-2024-27-AS-LRIS-D7ET4D-20240722142343

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392700640
Report Date: 06/17/2024
Date Signed: 06/18/2024 09:22:45 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/29/2024 and conducted by Evaluator Albert Johnson

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20240429123705

FACILITY NAME:	COURTYARD AT RIO LAS PALMAS, THE		FACILITY NUMBER:	392700640
ADMINISTRATOR:	GUERRERO, LIZETH		FACILITY TYPE:	740
ADDRESS:	877 EAST MARCH LANE		TELEPHONE:	(209) 957-4711
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95207
CAPACITY:	80	CENSUS: 59	DATE:	06/17/2024
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	L. Guerrero		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Facility staff are not dispensing medication as prescribed.

INVESTIGATION FINDINGS:

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On 6/17/2024, LPA Johnson made an unannounced visit to deliver findings for the allegation listed. LPA met with Admininstrator.

Allegation: Facility staff are not dispensing medication as prescribed.
Based on records reviewed, visual inspection of the controlled medication and interviews with the staff, The department was able to confirmed that the facility has an established check and balance for medications . The facility also provides random inspections of the medication carts and medication logs. There has been no record or report of any medication missing or medication not being dispensed as prescribed. LPA was able to review and inspect the carts and logs. As a result the department was unable to identify that the facility is not dispensing medication as prescribed. The allegation is unsubstantiated.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Albert Johnson	TELEPHONE: (916) 217-1390
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2024

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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