335530023-9-11-2023-56-AS-KCLS-CWHTLA-20231011144914

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 335530023
Report Date: 09/11/2023
Date Signed: 09/11/2023 11:24:22 AM

Unfounded

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
, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/05/2023 and conducted by Evaluator Bernadette Allen

COMPLAINT CONTROL NUMBER: 56-AS-20230905113939

FACILITY NAME:	COMPASSION HOME 1		FACILITY NUMBER:	335530023
ADMINISTRATOR:	WRIGHT-ILORI, ROSE		FACILITY TYPE:	740
ADDRESS:	825 CHALLENGE AVENUE		TELEPHONE:	(614) 394-5674
CITY:	BEAUMONT	STATE: CA	ZIP CODE:	92223
CAPACITY:	6	CENSUS: 6	DATE:	09/11/2023
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Rose Wright-Llori-Administrator		TIME COMPLETED:	11:35 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff dispensed medication not prescribed to resident

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Bernadette Allen an conducted an unannounced visit to initiate and deliver findings for the allegation above. LPA Allen met with Rose Wright- Llori who was informed of the purpose of the visit.

The investigation consisted of interviews and record review. LPA Allen interviewed the administrator Rose who stated residents are only given medications that are prescribed by their physicians. LPA Allen reviewed six (6) residents files and LPA observed that residents in care have only been given medications that have been prescribed by their physicians. LPA Allen reviewed hospital discharge documentation that confirm staff members did not give resident 1(R1) medication that was not prescribed by their physician.

Based on interviews and documentation the above finding is Unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.
An exit interview was conducted and a copy this report was provided to Rose Wright-Llori with appeal rights at the conclusion of the visit.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3