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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 371881431
Report Date: 10/11/2023
Date Signed: 10/11/2023 01:16:33 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
08/01/2023 and conducted by Evaluator Venus Mixson
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20230801091504
FACILITY NAME:JOY AND LOVE HOME CARE, LLCFACILITY NUMBER:
371881431
ADMINISTRATOR:SARAPAT, AILA J.FACILITY TYPE:
740
ADDRESS:1178 EVERGREEN LANETELEPHONE:
(661) 754-0261
CITY:VISTASTATE: CAZIP CODE:
92084
CAPACITY:18CENSUS: 13DATE:
10/11/2023
UNANNOUNCEDTIME BEGAN:
12:41 PM
MET WITH:LICENSEE, SIVA MULLAPUDITIME COMPLETED:
01:16 PM
ALLEGATION(S):
1
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9
Staff did not properly destroy resident's medication.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/ 11/2023, Licensing Program Analyst (LPA), Venus Mixson conducted an office visit at 1650 Spruce Street Riverside, and met with the Licensee, Siva Mullapudi. The visit was conducted to provide the findings for the investigation pertaining to the listed allegation. During the course of the investigation, the LPA conducted interviews with staff, residents, and additional Witness. Pertinent documentation was reviewed and observations were made regarding the allegations. The LPA was unable to interview additional witnesses due to a high turnover in staff.

On August 01, 2023, Community Care Licensing (CCL) received information which stated staff did not properly destroy resident's medication. It was reported that facility staff were discarding resident’s medicating in the public trash can. Pictures were provided. Information obtained from administration and staff interviews stated that the facility is under new management and there have been new procedures and policies implemented which will prevent any type of mishandling of unused medications. It was reported that only the Med tech, Facility Nurse, and the Licensee will have access to the locked medication cabinets and will process the proper destruction of any unused or left behind medications, and/or of empty bubble packets. It was also advised that each Hospice Agency Nurse has the responsibility for properly destroying any unused or left behind resident medication for whom they provide hospice services for. Training documents regarding proper destruction and documentation of medication were observed. The LPA was unable to verify that the pictures of the medication in the trash can belonged to any resident placed at the facility or if the trash can belonged to the facility.

Based on interviews, record reviews, and observations the preponderance of evidence standard has not been met. Therefore, the allegation that facility staff did not properly destroy resident’s medication has been deemed as "UNSUBSTANTIATED." An allegation finding of "unsubstantiated" means 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.

An exit interview was conducted. A copy of this report, along with appeal rights were provided to the Licensee, Siva Mullapudi.




Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
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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