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BILL LOCI(YER Attol11ey General of the State of Califon1ia
MARGARET A LAFI(O Supervising Deputy Atton1ey General
JAMES M LEDAI(IS State Bar No 132645 Deputy Atton1ey General
Califon1ia Depaliment of Justice 110 West A Street Suite 1100 San Diego CA 92101
PO Box 85266 San Diego CA 92186-5266 Telephone (619) 645-2105 Facsitnile (619) 645-2061
Atton1eys for COlnplainant
BEFORE THE BOARD OF PHARMACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOME CARE PHARMACY Luis Gaurano president and Valerie Gaurano vice president and owners
Original Phannacy Pennit No PHY 45192
VALE~IJl GAU~NO 2051 Kristi Court Fallbrook CA 92028
Original Phan11acist License No RPH 38852
In the Matter of the Citation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOME CARE PHARMACY Luis Gaurano president and Valerie Gaurano vice president and owners
Original Phannacy Pennit No PHY 45192
Respondent
Accusation Case No 2959
Citation Case CI No 2005-30007
OAH No L-2006070547
STIPULATED SETTLEMENT AND DISCIPLINARY ORDER FOR VALERIE GAURANO
IT IS HEREBY STIPULATED AND AGREED by and between the paliies to the
above-entitled proceedings that the following Inatters are true
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PARTIES
l Patricia F Harris (Colnplainant) is the Executive Officer of the Board of
Phan11acy She brought this action solely in her official capacity and is represented in this Inatter
by Bill Lockyer Atton1ey General of the State of California by Jalnes M Ledakis Deputy
Atton1ey General
2 Respondent Valerie Gaurano is represented in this proceeding by attoll1ey
TiInothy Rutherford whose address is 2368 Second Avenue Suite 1011 San Diego CA 92101
3 On or about April 25 2001 the Board ofPhan11acy issued Phannacy
Pennit No PHY 45192 to RESIDENTIAL CARE HOME FOR YOU INC dba HOME CARE
PHARMACY The Pen11it was in full force and effect at all tiInes relevant to the charges
brought in Accusation No 2959 and will expires on April 1 2007 unless renewed
4 On or about August 23 1984 the Board of Phannacy issued Phannacist
License No RPH 38852 to Valelie Gaurano The License was in full force and effect at all tiInes
relevant to the charges brought in Accusation No 2959 and will expire on April 30 2008 unless
renewed
JURISDICTION
- 5~-AccusaHon No 2959 was filed before the Board and is dunently pending
against Valerie Gaurano The Accusation and all other statutorily required docun1ents were
properly served on Respondent on April 18 2006 Respondent tin1ely filed its Notice of Defense
contesting the Accusation A copy of Accusation No 2959 is attached as exhibit A and
incorporated herein by reference Citation No CT 2005-30007 was filed by the Board and is
currently pending against Valerie Gaurano and HOlne Care Phannacy
ADVISEMENT AND WAIVERS
6 Respondent has carefully read fully discussed with counsel and
understands the charges and allegations in Accusation No 2959 and Citation No CT 2005shy
30007 Respondent has also carefully read fully discussed with counsel and understands the
effects of this Stipulated Settlelnent and Disciplinary Order This stipulation constitutes a full
and final resolution of all n1atters against Respondents herein
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7 Respondent is fully aware of its legal rights in this Inatter including the
right to a hearing on the charges and allegations in the Accusation and Citation the right to be
represented by counsel at its own expense the right to confront and cross-exaInine the witnesses
against them the right to present evidence and to testify on its own behalf the right to the
issuance of subpoenas to cOlnpel the attendance of witnesses and the production of dOC111nents
the right to reconsideration and court review of an adverse decision and all other rights accorded
by the California Administrative Procedure Act and other applicable laws
8 Respondent voluntarily Ia10wingly and intelligently waives and gives up
each and every right set fOlih above
CULP ABILITY
9 Respondent understands and agrees that the charges and allegations in
Accusation No 2959 and Citation No 2005-30007 if proven at a hearing constitute cause for
itnposing discipline upon her Phannacy license no RPH 38852 as well as the Original Phannacy
Pelmit No 45192
10 For the purpose of resolving the Accusation and Citation without the
expense and uncertainty of further proceedings Respondent agrees that at a hearing
COlnplainant could establish a factual basiS for the charges in the AccusatiQn and Citation and
that Respondent hereby gives up its right to contest those charges
11 Respondent agrees that her Phannacist license RPH 38852 and her
Phannacy Pennit No PHY 45192 are subject to discipline and they agree to be bound by the
Boards itnposition of discipline as set forth in the Disciplinary Order below
RESERVATION
12 The adlnissions Inade by Respondent herein are only for the purposes of
this proceeding or any other proceedings in which the Board or other professional licensing
agency is involved and shall not be adlnissible in any other critninal or civil proceeding
CONTINGENCY
13 The paliies understand and agree that facsin1ile copies of this Stipulated
Settlement and Disciplinary Order including facsin1ile signatures thereto shall have the SaIne
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force and effect as the originals
14 In consideration of the foregoing adlnissions and stipulations the parties
agree that the Board Inay without further notice or fonnal proceeding issue and enter the
following Disciplinary Order
DISCIPLINARY ORDER
IT IS HEREBY ORDERED that Valerie Gaurano s Original Phan11acist License
No RPH 38852 is revoked however the revocation is stayed and the Respondent is placed on
two (2) years probation on the following tenns and conditions
1 Obey All Laws Respondent shall obey all state and federal laws and
regulations substantially related to or goven1ing the practice of phan11acy
Respondent shall report any of the following occun-ences to the Board in writing
within 72 hours of such occun-ence
bull an an-est or issuance of a crin1inal cOlnplaint for violation of any provision of the
Pham1acy Law state and federal food and drug laws or state and federal
controlled substances laws
bull a plea of guilty or nolo contendere in any state or federal criIninal proceeding to
any criIninal cOlnplaintinfonnationor indictn1ent
bull a conviction of any crilne
bull discipline citation or other adlninistrative action filed by any state and federal
agency which involves Respondents license or which is related to the practice
of phannacy or the Inanufacturing obtaining handling or distribution or billing
or charging for any drug device or controlled substance
2 Reporting to the Board Respondent shall report to the Board
qUaIierly The report shall be Inade either in person or in writing as directed Respondent
shall state under penalty of peljury whether there has been cOlnpliance with all the tenns and
conditions of probation If the final probation report is not made as directed probation shall
be extended autOlnatically until such tiIne as the final repoli is Inade and accepted by the
Board
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3 Interview with the Board Upon receipt of reasonable notice
Respondent shall appear in person for interviews with the Board upon request at various
intervals at a location to be determined by the Board Failure to appear for a scheduled
interview without plior notification to Board staff shall be considered a violation of probation
4 Cooperation with Board Staff Respondent shall cooperate with the
Boards inspectional prograln and in the Boards Inonitoling and investigation of Respondents
cOlnpliance with the tenns and conditions of their probation Failure to cOlnply shall be
considered a violation of probation
5 Continuing Education Respondent shall provide evidence of effolis
to maintain skill and I010wledge as a phannacist as directed by the Board
6 Notice to Employers Respondent shall notify all present and
prospective elnployers of the decision in case nun1ber 2959 and the tenns conditions and
restrictions itnposed on Respondent by the decision Within 30 days of the effective date of
this decision and within 15 days of Respondent undertaking new elnploYlnent Respondent
shall cause their direct supervisor phannacist-in-charge andor owner to report to the Board in
wliting acla10wledging the elnployer has read the decision in case nUlnber 2959
If Respondent works for oris etnpfoyed-by or through a phannacy elnployment
service Respondent n1ust notify the direct supervisor pharmacist-in-charge andor owner at
every phan11acy of the and tenns conditions of the decision in case nUlnber 2959 in advance of
the Respondent cOlnlnencing work at each phalmacy
ElnploYlnent within the Ineaning of this provision shall include any full-titne partshy
titne telnporary relief or phannacy Inanagelnent service as a phannacist whether the
Respondent is considered an elnployee or independent contractor
7 No Preceptorships Supervision of Interns Being Pharmacist-in-
Charge (PIC) or Serving as a Consultant Respondent shall not supervise any inten1
phannacist or perfonn any of the duties of a preceptor nor shall Respondent be the
phannacist-in-charge of any entity licensed by the Board unless otherwise specified in this
order
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8 Reimbursement of Board Costs None
9 Payment of Fines Valerie Gaurano shall pay a fine of $5000000 in
order to resolve the current outstanding Citation CI 2005 30007 as pati of this global
stipulated settlement Respondent shall pay the Board the $2500000 on or before Decelnber
12 2007 and $2500000 on or before December 122008 Failure to timely pay the fine shall
constitute a violation of probation
10 Probation Monitoring Costs Respondent shall pay the costs
associated with probation monitoring as determined by the Board each and every year of
probation Such costs shall be payable to the Board at the end of each year of probation
Failure to pay such costs shall be considered a violation of probation
11 Status of License Respondent shall at all tiInes while on probation
Inaintain an active current license with the Board including any period during which
suspension or probation is tolled
If Respondents license expires or is canceled by operation of law or otherwise
upon renewal or reapplication Respondents license shall be subject to all tenns and
conditions of this probation not previously satisfied
12 License Surrender while on Prob-ationSuspensiori Following the
effective date of this decision should Respondent cease practice due to retireinent or health
or be otherwise unable to satisfy the tenns and conditions of probation Respondent Inay
tender their license to the Board for surrender The Board shall have the discretion whether to
grant the request for surrender or take any other action it deelns appropriate and reasonable
Upon fonnal acceptance of the surrender of the license Respondent will no longer be subject
to the tenns and conditions of probation
Upon acceptance of the surrender Respondent shall relinquish their pocket
license to the Board within 10 days of notification by the Board that the surrender is accepted
Respondent n1ay not reapply for any license froin the Board for three years frOln the effective
date of the surrender Respondent shall meet all requireinents applicable to the license sought
as of the date the application for that license is sublnitted to the Board
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13 Notification of EmploymentMailing Address Change Respondent
shall notify the Board in writing within 10 days of any change of elnploYlnent Said
notification shall include the reasons for leaving andor the address of the new employer
supervisor or owner and work schedule if known Respondent shall notify the Board in
writing within 10 days of a change in natne In ailing address or phone nmnber
14 Tolling of Probation Should Respondent regardless of residency for
any reason cease practicing phannacy for a Ininimum of 40 hours per calendar Inonth in
Califon1ia Respondent Inust notify the Board in writing within 10 days of cessation of the
practice ofphannacy or the resuInption of the practice ofphannacy Such periods oftiIne
shall not apply to the reduction of the probation period It is a violation of probation for
Respondents probation to reinain tolled pursuant to the provisions of this condition for a
period exceeding three years
Cessation of practice Ineans any period of tin1e exceeding 30 days in which
Respondent is not engaged in the practice of phannacy as defined in Section 4052 of the
Business and Professions Code
15 Violation of Probation If Respondent violates probation in any
respect the Board after giving Respondent notice and an 0ppoliuni-ty fo be heard Ii1ay
revoke probation and carry out the disciplinary order which was stayed If a petition to revoke
probation or an accusation is filed against Respondent during probation the Board shall have
continuing jurisdiction and the period of probation shall be extended until the petition to
revoke probation or accusation is heard and decided
If R~spondent has not complied with any tenn or condition of probation the
Board shall have continuing jurisdiction over Respondent and probation shall autoinatically
be extended until all tenns and conditions have been satisfied or the Board has taken other
action as deelned appropriate to treat the failure to cOlnply as a violation of probation to
tenninate probation and to iinpose the penalty which was stayed
16 Completion of Probation Upon successful con1pletion of probation
Respondents license will be fully restored
I 0 D e r I 11 I YII 111 n u LU U O~ f J Jr IVIII
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17 No o anhip ofPreatHS Respondent shall not OWQ uwe any logal
or beneficial inttfe9t in~ or serve as 11 managcr~ administrator member offioer director
psociate or p~r ofany bUsiness fihJl plUtllersbip OJ corporation cu~tly or het~Dafter licensed by the Board Respondent shall sell or transfer poundiny Iega or twmeii cia inleret in any
entity licensfJd by the 80ard within 90 day follcwing the offective dat~ of this deciJion and
shall immediately tbereaftet ptovide written proofthereof to the BONd
AC(CJPTampNct
1havf1 carefully read the ~bove Stipu181ed Settlement and Diseplinery Order
and hAve fully discussed it with my attorney Timothy lu1herford 1understand the stip)l1ation
rmd the effect it will have on my Original Phannaeisr License No 38852 1enter into thig
Stipulated ScttlentMt and Discipl~aty Order voluntarilY1 knoWingly and intelUSettly and
Dgree to be bOlnd by the Dech~i()n and cm1a ofthe SQard
DATEDJl- Lt - famp i
~Iwafnt 1hale read and fully discussed with Itesponclent VALElUE Gallano the lemu
and corulitio and other maIt~ conrained In the above 8tipul41eO S~lcmerU and rw DiseiplilWY Order 1approve its fonn ~d content
OATBD
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17 No Ownership of Premises Respondent shall not own have any legal
or beneficial interest in or serve as a Inanager adIninistrator Inember officer director
associate or patiner of any business finn patinership or corporation currently or hereinafter
licensed by the Board Respondent shall sell or transfer any legal or beneficial interest in any
entity licensed by the Board within 90 days following the effective date of this decision and
shall in1n1ediately thereafter provide written proof thereof to the Board
ACCEPTANCE
I have carefully read the ~bove Stipulated Settlelnent and Disciplinary Order
and have fully discussed it with Iny atton1ey Titnothy Rutherford I understand the stipulation
and the effect it will have on my Original Phannacist License No 38852 I enter into this
Stipulated Settlelnent and Disciplinary Order voluntarily la10wingly and intelligently and
agree to be bound by the Decision and Order of the Board
DATED
VALERIE GAURANO Respondent
I have read and fully discussed with Respondent VALERIE Gaurano the tenns
and conditions and other Inatters contained in the above Stipulated Settlel11ent and
Disciplinary Order I approve its fonn and content
DATED
TIMOTHY RUTHERFORD Attorney for Valerie Gaurano
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DOJ Matter ID SD2005800399
80 1 05464wpd
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ENDORSEMENT
The foregoing Stipulated Settlelnent and Disciplinary Order is hereby
respectfully sublnitted for consideration by the Board
DATED ~4 UJtJb BILL LOCKYER Atton1ey General of the State of California
Atton1eys for COlnplainant
BEFORE THE BOARD OF PHARMACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOME CARE PHARMACY Luis Gaurano president and Valerie Gaurano vice president and owners
Original Phanllacy Pennit No PHY 45192
VALERIE Gaurano 2051 Kristi COllli Fallbrook CA 92028
Original Phannacist License No RPH 38852
Respondent
Accusation No 2959
Citation No CT 2005-30007
OAH No L-2006070547
DECISION AND ORDER
The attached Stipulated Settlenlent and Disciplinary Order for Valerie Gaurano
is hereby adopted by the Board as its Decision in this Inatter
This Decision shall becOlne effective on February 21 2007
It is so 0 RD ERED __Jarr----u=ar=--y--22=-z~2~00~7---__
BOARD OF PHARMACY DEP ARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
By WILLIAM POWERS Board President
Exhibit A
Accusation No 2959
Citation No CT 2005-30007
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BILL LOCKyBR Attorney Genera of the State of CalifoTI1ia
JAIIES M LEDAKIS State Bar No 132645 Deputy AttoTI1ey General
CalifoTI1ia Depmin1ent of Justice 110 West A II Street Suite 1100 San Diego CA 92101
PO Box 85266 San Diego CA 92186-5266 Telephone 619-645-2105 Facsin1ile 619-645-2061
AttOTI1eys for COll1plainant
BEFORE THE BOARD OF PHARl1ACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOl1E CARE PHARMACY Luis Gaurano President and Valerie Gaurano Vice President and Owners
11711 Sterling Avenue Suite E Riverside CA 92503
Oliginal Phan11acy Pennit No PHY 45192
VALERIE GAURANO Pharmacist-in Charge at HOl1E CARE PI-IARMACY
2051 Krist1 Ct FallBrook CA 92028
Original Phanl1acist License No RPH 38852
ANNE R CABRERA Pharmacist-in-Charge at I-IOME CARE PI-IARMACY
31921 Old Hickory Road Trabuco Canyon CA 92679
Origina] Pharn1acist Ljcense No RPH 40776
Respondents
Case No 2959
OAHNo
ACCUSATION
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C0111plainant alleges
PARTIES
1 (Co111plail1ant) Patricia p Banis brings this Accusation solely in her
official capacity as tIle Executive Offlcer for the Califonlia State Board of Ph an11ElCY Department
of Consul11er Affairs
2 On or about April 252001 the Board ofPharnlacy issued Original
Pban11acy Pernlit NL111lber PEY 45192 to Residential Care Honle For You Inc dba Honle
Care Phanl1Clcy The license Nil] expire on April 1 2006 unless renewed
3 On or about August 23 1984 the Board of Phan1lacy issued Original
Phanl1acist license nq 38852 to Valerie Reyes Gaurano aka Va]elie Arme Abani1 Reyes Sbe
was the phanl1acist in charge at HOlvlE CARE PHARlvlACY froll1 IvIarch26 2004 through
August 23 2004 Her license will expire on April 1 2006 unless renewed
4 On or about March 17 1986 the Board of Phanl1acy issued Oliginal
Pharmacist license no 40776 to Am1e Roberto Cabrera She was the phanl1acist in charge at
HOIvIE CARE PHARlvlACY froll1 August 23 2004 to the present Her license vvi11 expire on
ILl1y 31 ( 2096 unless renewed
JURISDICTION
5 This Accusation is brought before the California State Board of Phm111acy
(Board) Depmin1ent of COnSU111er Affairs under the authority of the following laws AlJ section
references are to the Business and Professions Code unless otherwise indicated
6 Section 4059 (a) of the Code states in pertinent part that a person l1lay not
furnisl1 any dangerous drug except upon t11e prescription of a pl1ysician dentist podiat1ist
opton1ehist or veterinarian A person n1ay not fUr11is11 any dangerous device except llpon the
prescription of a pbyslcian dentist podiatrist opt0111etrist or veterinarian
7 Section 4070 (a) of tbe Code entitl ed Oral or electroni c data trans111issl011
prescripbon reduction to writing states Except as provided in Section 4019 and subdivision (b)
an ora1 or an electronic data tra118111issio11 prescription as defined in subdivision (c) of Section
4040 shal1 as soon as practicab1e be reduced to writing by the phanl1aclst and sha1] be filled by
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or under the direction of the phar111acist The phanl1acist need n01 reduce to ~lri1ing the address
telephone l1U111ber license classification federal registry nU111ber of the prescriber or the address
of the patj ent or pati ents if the infor111ation is readily retrievable in tbe pharn1ucy
Section 4081 of the Code states
(a) All records of 111anufacture and of sale acquisition or disposition of dangerous drugs or dangerous devices shal1 be at al] tinles during business hours open 10 inspection by authorized officers oft11e ImN and shall be preserved for at least three years frOlTI the date of l11aking A CUlTent inventory shall be kept by every 111cmufacturer vholesaler phan111lcy veterinary food-anin1al drug retaileT physician dentist podiatrist veterinarian laboratory clinic hospital institution or establish111ent holding a currently valid andmuevoked certificate license pen11it registration or exe111ption under Division 2 (co111111encing with Section 1200) of the Health and Safety Code or under Part 4 (conlnlencing Nith Section 16000) of Division 9 of the Welfare and Institutions Code who 111aintains a stock of dangerous drugs or dangerous devices
(b) The owner officer and pminer of any phanl1acy wholesaler or veterinary food-ani111al dnlg retailer shall be jointly responsible witl1 the phannacist-in-charge or exenlptee for n1aintaining the records and inventory described in this section
(c) The phan11acist-in-charge or exen1ptee shall not be crin1inally responsible for acts of the owner officer partner or en1ployee that violate this section and of vlhich the phanl1acist-in-charge or exen1ptee had no knowledge or in which he or she did not lQl0wingly participate
9 Section 4105 of the Code states
(a) All records or other dOCUlTIentation of the acquisition and disposjtion of dangerous dnlgB and dangerous devices by any entity liGen_~ed by the bQard sha11 be retained on the licensed prenlises in a readily retrievable fOD11
(b) The l1censee 111ay ielTIOVe the original records or docun1entation fro111 the licensed pre111ises on a tell1porary basis for license-related PU1lJoses Hovever a duplicate set of those records Of other docu111entation shan be retained on the licensed pren11ses
(c) The records reqllired by this section shall be retained on the 1icensed prenlises for a period oftlu-ee years fro111 the date of 111aking
(c1) Any records that are ll1aintained el ectronicany shall be ll1aintained so that the pharn1acist-in-charge the pha1111acist on duty if tIl e pharmacist-in-charge is not on duty or in the case of a veterinary food-anin1al drug retailer or wholesa1er the exenlptee sha1l at all tillles during which the licensed pren1ises are open for business be able to produce a hard copy and electronic copy of al] records of aCClllisition or disposition or otber drug or dispensing-related records nluintained electronical1y
(e)(l) Notwithstanding subdivisions (a) (b) and (c) the board nlaY upon written request grant to a licensee a waiver of the requirenlents that tl1e records described in subdivisions (a) (b) and (c) be kept on the licensed ])reJl1ises
(2) A waiver granted pursuant to tbis sllbdi-vislol1 shal] not affect tl1e boards authority under this section or any otber provision of this c11apter
10 Section 4301 of the Code states
The board s11al1 take action against any holder of a license who is b1l1i1ty of unprofessional conduct or whose l1cense has been procured by fraud or J11isrepresentation or issued by n1istake Unprofessional conduct shal] include but is not linlited to any of
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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2
PARTIES
l Patricia F Harris (Colnplainant) is the Executive Officer of the Board of
Phan11acy She brought this action solely in her official capacity and is represented in this Inatter
by Bill Lockyer Atton1ey General of the State of California by Jalnes M Ledakis Deputy
Atton1ey General
2 Respondent Valerie Gaurano is represented in this proceeding by attoll1ey
TiInothy Rutherford whose address is 2368 Second Avenue Suite 1011 San Diego CA 92101
3 On or about April 25 2001 the Board ofPhan11acy issued Phannacy
Pennit No PHY 45192 to RESIDENTIAL CARE HOME FOR YOU INC dba HOME CARE
PHARMACY The Pen11it was in full force and effect at all tiInes relevant to the charges
brought in Accusation No 2959 and will expires on April 1 2007 unless renewed
4 On or about August 23 1984 the Board of Phannacy issued Phannacist
License No RPH 38852 to Valelie Gaurano The License was in full force and effect at all tiInes
relevant to the charges brought in Accusation No 2959 and will expire on April 30 2008 unless
renewed
JURISDICTION
- 5~-AccusaHon No 2959 was filed before the Board and is dunently pending
against Valerie Gaurano The Accusation and all other statutorily required docun1ents were
properly served on Respondent on April 18 2006 Respondent tin1ely filed its Notice of Defense
contesting the Accusation A copy of Accusation No 2959 is attached as exhibit A and
incorporated herein by reference Citation No CT 2005-30007 was filed by the Board and is
currently pending against Valerie Gaurano and HOlne Care Phannacy
ADVISEMENT AND WAIVERS
6 Respondent has carefully read fully discussed with counsel and
understands the charges and allegations in Accusation No 2959 and Citation No CT 2005shy
30007 Respondent has also carefully read fully discussed with counsel and understands the
effects of this Stipulated Settlelnent and Disciplinary Order This stipulation constitutes a full
and final resolution of all n1atters against Respondents herein
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7 Respondent is fully aware of its legal rights in this Inatter including the
right to a hearing on the charges and allegations in the Accusation and Citation the right to be
represented by counsel at its own expense the right to confront and cross-exaInine the witnesses
against them the right to present evidence and to testify on its own behalf the right to the
issuance of subpoenas to cOlnpel the attendance of witnesses and the production of dOC111nents
the right to reconsideration and court review of an adverse decision and all other rights accorded
by the California Administrative Procedure Act and other applicable laws
8 Respondent voluntarily Ia10wingly and intelligently waives and gives up
each and every right set fOlih above
CULP ABILITY
9 Respondent understands and agrees that the charges and allegations in
Accusation No 2959 and Citation No 2005-30007 if proven at a hearing constitute cause for
itnposing discipline upon her Phannacy license no RPH 38852 as well as the Original Phannacy
Pelmit No 45192
10 For the purpose of resolving the Accusation and Citation without the
expense and uncertainty of further proceedings Respondent agrees that at a hearing
COlnplainant could establish a factual basiS for the charges in the AccusatiQn and Citation and
that Respondent hereby gives up its right to contest those charges
11 Respondent agrees that her Phannacist license RPH 38852 and her
Phannacy Pennit No PHY 45192 are subject to discipline and they agree to be bound by the
Boards itnposition of discipline as set forth in the Disciplinary Order below
RESERVATION
12 The adlnissions Inade by Respondent herein are only for the purposes of
this proceeding or any other proceedings in which the Board or other professional licensing
agency is involved and shall not be adlnissible in any other critninal or civil proceeding
CONTINGENCY
13 The paliies understand and agree that facsin1ile copies of this Stipulated
Settlement and Disciplinary Order including facsin1ile signatures thereto shall have the SaIne
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force and effect as the originals
14 In consideration of the foregoing adlnissions and stipulations the parties
agree that the Board Inay without further notice or fonnal proceeding issue and enter the
following Disciplinary Order
DISCIPLINARY ORDER
IT IS HEREBY ORDERED that Valerie Gaurano s Original Phan11acist License
No RPH 38852 is revoked however the revocation is stayed and the Respondent is placed on
two (2) years probation on the following tenns and conditions
1 Obey All Laws Respondent shall obey all state and federal laws and
regulations substantially related to or goven1ing the practice of phan11acy
Respondent shall report any of the following occun-ences to the Board in writing
within 72 hours of such occun-ence
bull an an-est or issuance of a crin1inal cOlnplaint for violation of any provision of the
Pham1acy Law state and federal food and drug laws or state and federal
controlled substances laws
bull a plea of guilty or nolo contendere in any state or federal criIninal proceeding to
any criIninal cOlnplaintinfonnationor indictn1ent
bull a conviction of any crilne
bull discipline citation or other adlninistrative action filed by any state and federal
agency which involves Respondents license or which is related to the practice
of phannacy or the Inanufacturing obtaining handling or distribution or billing
or charging for any drug device or controlled substance
2 Reporting to the Board Respondent shall report to the Board
qUaIierly The report shall be Inade either in person or in writing as directed Respondent
shall state under penalty of peljury whether there has been cOlnpliance with all the tenns and
conditions of probation If the final probation report is not made as directed probation shall
be extended autOlnatically until such tiIne as the final repoli is Inade and accepted by the
Board
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3 Interview with the Board Upon receipt of reasonable notice
Respondent shall appear in person for interviews with the Board upon request at various
intervals at a location to be determined by the Board Failure to appear for a scheduled
interview without plior notification to Board staff shall be considered a violation of probation
4 Cooperation with Board Staff Respondent shall cooperate with the
Boards inspectional prograln and in the Boards Inonitoling and investigation of Respondents
cOlnpliance with the tenns and conditions of their probation Failure to cOlnply shall be
considered a violation of probation
5 Continuing Education Respondent shall provide evidence of effolis
to maintain skill and I010wledge as a phannacist as directed by the Board
6 Notice to Employers Respondent shall notify all present and
prospective elnployers of the decision in case nun1ber 2959 and the tenns conditions and
restrictions itnposed on Respondent by the decision Within 30 days of the effective date of
this decision and within 15 days of Respondent undertaking new elnploYlnent Respondent
shall cause their direct supervisor phannacist-in-charge andor owner to report to the Board in
wliting acla10wledging the elnployer has read the decision in case nUlnber 2959
If Respondent works for oris etnpfoyed-by or through a phannacy elnployment
service Respondent n1ust notify the direct supervisor pharmacist-in-charge andor owner at
every phan11acy of the and tenns conditions of the decision in case nUlnber 2959 in advance of
the Respondent cOlnlnencing work at each phalmacy
ElnploYlnent within the Ineaning of this provision shall include any full-titne partshy
titne telnporary relief or phannacy Inanagelnent service as a phannacist whether the
Respondent is considered an elnployee or independent contractor
7 No Preceptorships Supervision of Interns Being Pharmacist-in-
Charge (PIC) or Serving as a Consultant Respondent shall not supervise any inten1
phannacist or perfonn any of the duties of a preceptor nor shall Respondent be the
phannacist-in-charge of any entity licensed by the Board unless otherwise specified in this
order
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8 Reimbursement of Board Costs None
9 Payment of Fines Valerie Gaurano shall pay a fine of $5000000 in
order to resolve the current outstanding Citation CI 2005 30007 as pati of this global
stipulated settlement Respondent shall pay the Board the $2500000 on or before Decelnber
12 2007 and $2500000 on or before December 122008 Failure to timely pay the fine shall
constitute a violation of probation
10 Probation Monitoring Costs Respondent shall pay the costs
associated with probation monitoring as determined by the Board each and every year of
probation Such costs shall be payable to the Board at the end of each year of probation
Failure to pay such costs shall be considered a violation of probation
11 Status of License Respondent shall at all tiInes while on probation
Inaintain an active current license with the Board including any period during which
suspension or probation is tolled
If Respondents license expires or is canceled by operation of law or otherwise
upon renewal or reapplication Respondents license shall be subject to all tenns and
conditions of this probation not previously satisfied
12 License Surrender while on Prob-ationSuspensiori Following the
effective date of this decision should Respondent cease practice due to retireinent or health
or be otherwise unable to satisfy the tenns and conditions of probation Respondent Inay
tender their license to the Board for surrender The Board shall have the discretion whether to
grant the request for surrender or take any other action it deelns appropriate and reasonable
Upon fonnal acceptance of the surrender of the license Respondent will no longer be subject
to the tenns and conditions of probation
Upon acceptance of the surrender Respondent shall relinquish their pocket
license to the Board within 10 days of notification by the Board that the surrender is accepted
Respondent n1ay not reapply for any license froin the Board for three years frOln the effective
date of the surrender Respondent shall meet all requireinents applicable to the license sought
as of the date the application for that license is sublnitted to the Board
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13 Notification of EmploymentMailing Address Change Respondent
shall notify the Board in writing within 10 days of any change of elnploYlnent Said
notification shall include the reasons for leaving andor the address of the new employer
supervisor or owner and work schedule if known Respondent shall notify the Board in
writing within 10 days of a change in natne In ailing address or phone nmnber
14 Tolling of Probation Should Respondent regardless of residency for
any reason cease practicing phannacy for a Ininimum of 40 hours per calendar Inonth in
Califon1ia Respondent Inust notify the Board in writing within 10 days of cessation of the
practice ofphannacy or the resuInption of the practice ofphannacy Such periods oftiIne
shall not apply to the reduction of the probation period It is a violation of probation for
Respondents probation to reinain tolled pursuant to the provisions of this condition for a
period exceeding three years
Cessation of practice Ineans any period of tin1e exceeding 30 days in which
Respondent is not engaged in the practice of phannacy as defined in Section 4052 of the
Business and Professions Code
15 Violation of Probation If Respondent violates probation in any
respect the Board after giving Respondent notice and an 0ppoliuni-ty fo be heard Ii1ay
revoke probation and carry out the disciplinary order which was stayed If a petition to revoke
probation or an accusation is filed against Respondent during probation the Board shall have
continuing jurisdiction and the period of probation shall be extended until the petition to
revoke probation or accusation is heard and decided
If R~spondent has not complied with any tenn or condition of probation the
Board shall have continuing jurisdiction over Respondent and probation shall autoinatically
be extended until all tenns and conditions have been satisfied or the Board has taken other
action as deelned appropriate to treat the failure to cOlnply as a violation of probation to
tenninate probation and to iinpose the penalty which was stayed
16 Completion of Probation Upon successful con1pletion of probation
Respondents license will be fully restored
I 0 D e r I 11 I YII 111 n u LU U O~ f J Jr IVIII
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17 No o anhip ofPreatHS Respondent shall not OWQ uwe any logal
or beneficial inttfe9t in~ or serve as 11 managcr~ administrator member offioer director
psociate or p~r ofany bUsiness fihJl plUtllersbip OJ corporation cu~tly or het~Dafter licensed by the Board Respondent shall sell or transfer poundiny Iega or twmeii cia inleret in any
entity licensfJd by the 80ard within 90 day follcwing the offective dat~ of this deciJion and
shall immediately tbereaftet ptovide written proofthereof to the BONd
AC(CJPTampNct
1havf1 carefully read the ~bove Stipu181ed Settlement and Diseplinery Order
and hAve fully discussed it with my attorney Timothy lu1herford 1understand the stip)l1ation
rmd the effect it will have on my Original Phannaeisr License No 38852 1enter into thig
Stipulated ScttlentMt and Discipl~aty Order voluntarilY1 knoWingly and intelUSettly and
Dgree to be bOlnd by the Dech~i()n and cm1a ofthe SQard
DATEDJl- Lt - famp i
~Iwafnt 1hale read and fully discussed with Itesponclent VALElUE Gallano the lemu
and corulitio and other maIt~ conrained In the above 8tipul41eO S~lcmerU and rw DiseiplilWY Order 1approve its fonn ~d content
OATBD
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17 No Ownership of Premises Respondent shall not own have any legal
or beneficial interest in or serve as a Inanager adIninistrator Inember officer director
associate or patiner of any business finn patinership or corporation currently or hereinafter
licensed by the Board Respondent shall sell or transfer any legal or beneficial interest in any
entity licensed by the Board within 90 days following the effective date of this decision and
shall in1n1ediately thereafter provide written proof thereof to the Board
ACCEPTANCE
I have carefully read the ~bove Stipulated Settlelnent and Disciplinary Order
and have fully discussed it with Iny atton1ey Titnothy Rutherford I understand the stipulation
and the effect it will have on my Original Phannacist License No 38852 I enter into this
Stipulated Settlelnent and Disciplinary Order voluntarily la10wingly and intelligently and
agree to be bound by the Decision and Order of the Board
DATED
VALERIE GAURANO Respondent
I have read and fully discussed with Respondent VALERIE Gaurano the tenns
and conditions and other Inatters contained in the above Stipulated Settlel11ent and
Disciplinary Order I approve its fonn and content
DATED
TIMOTHY RUTHERFORD Attorney for Valerie Gaurano
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DOJ Matter ID SD2005800399
80 1 05464wpd
9
ENDORSEMENT
The foregoing Stipulated Settlelnent and Disciplinary Order is hereby
respectfully sublnitted for consideration by the Board
DATED ~4 UJtJb BILL LOCKYER Atton1ey General of the State of California
Atton1eys for COlnplainant
BEFORE THE BOARD OF PHARMACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOME CARE PHARMACY Luis Gaurano president and Valerie Gaurano vice president and owners
Original Phanllacy Pennit No PHY 45192
VALERIE Gaurano 2051 Kristi COllli Fallbrook CA 92028
Original Phannacist License No RPH 38852
Respondent
Accusation No 2959
Citation No CT 2005-30007
OAH No L-2006070547
DECISION AND ORDER
The attached Stipulated Settlenlent and Disciplinary Order for Valerie Gaurano
is hereby adopted by the Board as its Decision in this Inatter
This Decision shall becOlne effective on February 21 2007
It is so 0 RD ERED __Jarr----u=ar=--y--22=-z~2~00~7---__
BOARD OF PHARMACY DEP ARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
By WILLIAM POWERS Board President
Exhibit A
Accusation No 2959
Citation No CT 2005-30007
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BILL LOCKyBR Attorney Genera of the State of CalifoTI1ia
JAIIES M LEDAKIS State Bar No 132645 Deputy AttoTI1ey General
CalifoTI1ia Depmin1ent of Justice 110 West A II Street Suite 1100 San Diego CA 92101
PO Box 85266 San Diego CA 92186-5266 Telephone 619-645-2105 Facsin1ile 619-645-2061
AttOTI1eys for COll1plainant
BEFORE THE BOARD OF PHARl1ACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOl1E CARE PHARMACY Luis Gaurano President and Valerie Gaurano Vice President and Owners
11711 Sterling Avenue Suite E Riverside CA 92503
Oliginal Phan11acy Pennit No PHY 45192
VALERIE GAURANO Pharmacist-in Charge at HOl1E CARE PI-IARMACY
2051 Krist1 Ct FallBrook CA 92028
Original Phanl1acist License No RPH 38852
ANNE R CABRERA Pharmacist-in-Charge at I-IOME CARE PI-IARMACY
31921 Old Hickory Road Trabuco Canyon CA 92679
Origina] Pharn1acist Ljcense No RPH 40776
Respondents
Case No 2959
OAHNo
ACCUSATION
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C0111plainant alleges
PARTIES
1 (Co111plail1ant) Patricia p Banis brings this Accusation solely in her
official capacity as tIle Executive Offlcer for the Califonlia State Board of Ph an11ElCY Department
of Consul11er Affairs
2 On or about April 252001 the Board ofPharnlacy issued Original
Pban11acy Pernlit NL111lber PEY 45192 to Residential Care Honle For You Inc dba Honle
Care Phanl1Clcy The license Nil] expire on April 1 2006 unless renewed
3 On or about August 23 1984 the Board of Phan1lacy issued Original
Phanl1acist license nq 38852 to Valerie Reyes Gaurano aka Va]elie Arme Abani1 Reyes Sbe
was the phanl1acist in charge at HOlvlE CARE PHARlvlACY froll1 IvIarch26 2004 through
August 23 2004 Her license will expire on April 1 2006 unless renewed
4 On or about March 17 1986 the Board of Phanl1acy issued Oliginal
Pharmacist license no 40776 to Am1e Roberto Cabrera She was the phanl1acist in charge at
HOIvIE CARE PHARlvlACY froll1 August 23 2004 to the present Her license vvi11 expire on
ILl1y 31 ( 2096 unless renewed
JURISDICTION
5 This Accusation is brought before the California State Board of Phm111acy
(Board) Depmin1ent of COnSU111er Affairs under the authority of the following laws AlJ section
references are to the Business and Professions Code unless otherwise indicated
6 Section 4059 (a) of the Code states in pertinent part that a person l1lay not
furnisl1 any dangerous drug except upon t11e prescription of a pl1ysician dentist podiat1ist
opton1ehist or veterinarian A person n1ay not fUr11is11 any dangerous device except llpon the
prescription of a pbyslcian dentist podiatrist opt0111etrist or veterinarian
7 Section 4070 (a) of tbe Code entitl ed Oral or electroni c data trans111issl011
prescripbon reduction to writing states Except as provided in Section 4019 and subdivision (b)
an ora1 or an electronic data tra118111issio11 prescription as defined in subdivision (c) of Section
4040 shal1 as soon as practicab1e be reduced to writing by the phanl1aclst and sha1] be filled by
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or under the direction of the phar111acist The phanl1acist need n01 reduce to ~lri1ing the address
telephone l1U111ber license classification federal registry nU111ber of the prescriber or the address
of the patj ent or pati ents if the infor111ation is readily retrievable in tbe pharn1ucy
Section 4081 of the Code states
(a) All records of 111anufacture and of sale acquisition or disposition of dangerous drugs or dangerous devices shal1 be at al] tinles during business hours open 10 inspection by authorized officers oft11e ImN and shall be preserved for at least three years frOlTI the date of l11aking A CUlTent inventory shall be kept by every 111cmufacturer vholesaler phan111lcy veterinary food-anin1al drug retaileT physician dentist podiatrist veterinarian laboratory clinic hospital institution or establish111ent holding a currently valid andmuevoked certificate license pen11it registration or exe111ption under Division 2 (co111111encing with Section 1200) of the Health and Safety Code or under Part 4 (conlnlencing Nith Section 16000) of Division 9 of the Welfare and Institutions Code who 111aintains a stock of dangerous drugs or dangerous devices
(b) The owner officer and pminer of any phanl1acy wholesaler or veterinary food-ani111al dnlg retailer shall be jointly responsible witl1 the phannacist-in-charge or exenlptee for n1aintaining the records and inventory described in this section
(c) The phan11acist-in-charge or exen1ptee shall not be crin1inally responsible for acts of the owner officer partner or en1ployee that violate this section and of vlhich the phanl1acist-in-charge or exen1ptee had no knowledge or in which he or she did not lQl0wingly participate
9 Section 4105 of the Code states
(a) All records or other dOCUlTIentation of the acquisition and disposjtion of dangerous dnlgB and dangerous devices by any entity liGen_~ed by the bQard sha11 be retained on the licensed prenlises in a readily retrievable fOD11
(b) The l1censee 111ay ielTIOVe the original records or docun1entation fro111 the licensed pre111ises on a tell1porary basis for license-related PU1lJoses Hovever a duplicate set of those records Of other docu111entation shan be retained on the licensed pren11ses
(c) The records reqllired by this section shall be retained on the 1icensed prenlises for a period oftlu-ee years fro111 the date of 111aking
(c1) Any records that are ll1aintained el ectronicany shall be ll1aintained so that the pharn1acist-in-charge the pha1111acist on duty if tIl e pharmacist-in-charge is not on duty or in the case of a veterinary food-anin1al drug retailer or wholesa1er the exenlptee sha1l at all tillles during which the licensed pren1ises are open for business be able to produce a hard copy and electronic copy of al] records of aCClllisition or disposition or otber drug or dispensing-related records nluintained electronical1y
(e)(l) Notwithstanding subdivisions (a) (b) and (c) the board nlaY upon written request grant to a licensee a waiver of the requirenlents that tl1e records described in subdivisions (a) (b) and (c) be kept on the licensed ])reJl1ises
(2) A waiver granted pursuant to tbis sllbdi-vislol1 shal] not affect tl1e boards authority under this section or any otber provision of this c11apter
10 Section 4301 of the Code states
The board s11al1 take action against any holder of a license who is b1l1i1ty of unprofessional conduct or whose l1cense has been procured by fraud or J11isrepresentation or issued by n1istake Unprofessional conduct shal] include but is not linlited to any of
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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7 Respondent is fully aware of its legal rights in this Inatter including the
right to a hearing on the charges and allegations in the Accusation and Citation the right to be
represented by counsel at its own expense the right to confront and cross-exaInine the witnesses
against them the right to present evidence and to testify on its own behalf the right to the
issuance of subpoenas to cOlnpel the attendance of witnesses and the production of dOC111nents
the right to reconsideration and court review of an adverse decision and all other rights accorded
by the California Administrative Procedure Act and other applicable laws
8 Respondent voluntarily Ia10wingly and intelligently waives and gives up
each and every right set fOlih above
CULP ABILITY
9 Respondent understands and agrees that the charges and allegations in
Accusation No 2959 and Citation No 2005-30007 if proven at a hearing constitute cause for
itnposing discipline upon her Phannacy license no RPH 38852 as well as the Original Phannacy
Pelmit No 45192
10 For the purpose of resolving the Accusation and Citation without the
expense and uncertainty of further proceedings Respondent agrees that at a hearing
COlnplainant could establish a factual basiS for the charges in the AccusatiQn and Citation and
that Respondent hereby gives up its right to contest those charges
11 Respondent agrees that her Phannacist license RPH 38852 and her
Phannacy Pennit No PHY 45192 are subject to discipline and they agree to be bound by the
Boards itnposition of discipline as set forth in the Disciplinary Order below
RESERVATION
12 The adlnissions Inade by Respondent herein are only for the purposes of
this proceeding or any other proceedings in which the Board or other professional licensing
agency is involved and shall not be adlnissible in any other critninal or civil proceeding
CONTINGENCY
13 The paliies understand and agree that facsin1ile copies of this Stipulated
Settlement and Disciplinary Order including facsin1ile signatures thereto shall have the SaIne
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force and effect as the originals
14 In consideration of the foregoing adlnissions and stipulations the parties
agree that the Board Inay without further notice or fonnal proceeding issue and enter the
following Disciplinary Order
DISCIPLINARY ORDER
IT IS HEREBY ORDERED that Valerie Gaurano s Original Phan11acist License
No RPH 38852 is revoked however the revocation is stayed and the Respondent is placed on
two (2) years probation on the following tenns and conditions
1 Obey All Laws Respondent shall obey all state and federal laws and
regulations substantially related to or goven1ing the practice of phan11acy
Respondent shall report any of the following occun-ences to the Board in writing
within 72 hours of such occun-ence
bull an an-est or issuance of a crin1inal cOlnplaint for violation of any provision of the
Pham1acy Law state and federal food and drug laws or state and federal
controlled substances laws
bull a plea of guilty or nolo contendere in any state or federal criIninal proceeding to
any criIninal cOlnplaintinfonnationor indictn1ent
bull a conviction of any crilne
bull discipline citation or other adlninistrative action filed by any state and federal
agency which involves Respondents license or which is related to the practice
of phannacy or the Inanufacturing obtaining handling or distribution or billing
or charging for any drug device or controlled substance
2 Reporting to the Board Respondent shall report to the Board
qUaIierly The report shall be Inade either in person or in writing as directed Respondent
shall state under penalty of peljury whether there has been cOlnpliance with all the tenns and
conditions of probation If the final probation report is not made as directed probation shall
be extended autOlnatically until such tiIne as the final repoli is Inade and accepted by the
Board
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3 Interview with the Board Upon receipt of reasonable notice
Respondent shall appear in person for interviews with the Board upon request at various
intervals at a location to be determined by the Board Failure to appear for a scheduled
interview without plior notification to Board staff shall be considered a violation of probation
4 Cooperation with Board Staff Respondent shall cooperate with the
Boards inspectional prograln and in the Boards Inonitoling and investigation of Respondents
cOlnpliance with the tenns and conditions of their probation Failure to cOlnply shall be
considered a violation of probation
5 Continuing Education Respondent shall provide evidence of effolis
to maintain skill and I010wledge as a phannacist as directed by the Board
6 Notice to Employers Respondent shall notify all present and
prospective elnployers of the decision in case nun1ber 2959 and the tenns conditions and
restrictions itnposed on Respondent by the decision Within 30 days of the effective date of
this decision and within 15 days of Respondent undertaking new elnploYlnent Respondent
shall cause their direct supervisor phannacist-in-charge andor owner to report to the Board in
wliting acla10wledging the elnployer has read the decision in case nUlnber 2959
If Respondent works for oris etnpfoyed-by or through a phannacy elnployment
service Respondent n1ust notify the direct supervisor pharmacist-in-charge andor owner at
every phan11acy of the and tenns conditions of the decision in case nUlnber 2959 in advance of
the Respondent cOlnlnencing work at each phalmacy
ElnploYlnent within the Ineaning of this provision shall include any full-titne partshy
titne telnporary relief or phannacy Inanagelnent service as a phannacist whether the
Respondent is considered an elnployee or independent contractor
7 No Preceptorships Supervision of Interns Being Pharmacist-in-
Charge (PIC) or Serving as a Consultant Respondent shall not supervise any inten1
phannacist or perfonn any of the duties of a preceptor nor shall Respondent be the
phannacist-in-charge of any entity licensed by the Board unless otherwise specified in this
order
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8 Reimbursement of Board Costs None
9 Payment of Fines Valerie Gaurano shall pay a fine of $5000000 in
order to resolve the current outstanding Citation CI 2005 30007 as pati of this global
stipulated settlement Respondent shall pay the Board the $2500000 on or before Decelnber
12 2007 and $2500000 on or before December 122008 Failure to timely pay the fine shall
constitute a violation of probation
10 Probation Monitoring Costs Respondent shall pay the costs
associated with probation monitoring as determined by the Board each and every year of
probation Such costs shall be payable to the Board at the end of each year of probation
Failure to pay such costs shall be considered a violation of probation
11 Status of License Respondent shall at all tiInes while on probation
Inaintain an active current license with the Board including any period during which
suspension or probation is tolled
If Respondents license expires or is canceled by operation of law or otherwise
upon renewal or reapplication Respondents license shall be subject to all tenns and
conditions of this probation not previously satisfied
12 License Surrender while on Prob-ationSuspensiori Following the
effective date of this decision should Respondent cease practice due to retireinent or health
or be otherwise unable to satisfy the tenns and conditions of probation Respondent Inay
tender their license to the Board for surrender The Board shall have the discretion whether to
grant the request for surrender or take any other action it deelns appropriate and reasonable
Upon fonnal acceptance of the surrender of the license Respondent will no longer be subject
to the tenns and conditions of probation
Upon acceptance of the surrender Respondent shall relinquish their pocket
license to the Board within 10 days of notification by the Board that the surrender is accepted
Respondent n1ay not reapply for any license froin the Board for three years frOln the effective
date of the surrender Respondent shall meet all requireinents applicable to the license sought
as of the date the application for that license is sublnitted to the Board
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13 Notification of EmploymentMailing Address Change Respondent
shall notify the Board in writing within 10 days of any change of elnploYlnent Said
notification shall include the reasons for leaving andor the address of the new employer
supervisor or owner and work schedule if known Respondent shall notify the Board in
writing within 10 days of a change in natne In ailing address or phone nmnber
14 Tolling of Probation Should Respondent regardless of residency for
any reason cease practicing phannacy for a Ininimum of 40 hours per calendar Inonth in
Califon1ia Respondent Inust notify the Board in writing within 10 days of cessation of the
practice ofphannacy or the resuInption of the practice ofphannacy Such periods oftiIne
shall not apply to the reduction of the probation period It is a violation of probation for
Respondents probation to reinain tolled pursuant to the provisions of this condition for a
period exceeding three years
Cessation of practice Ineans any period of tin1e exceeding 30 days in which
Respondent is not engaged in the practice of phannacy as defined in Section 4052 of the
Business and Professions Code
15 Violation of Probation If Respondent violates probation in any
respect the Board after giving Respondent notice and an 0ppoliuni-ty fo be heard Ii1ay
revoke probation and carry out the disciplinary order which was stayed If a petition to revoke
probation or an accusation is filed against Respondent during probation the Board shall have
continuing jurisdiction and the period of probation shall be extended until the petition to
revoke probation or accusation is heard and decided
If R~spondent has not complied with any tenn or condition of probation the
Board shall have continuing jurisdiction over Respondent and probation shall autoinatically
be extended until all tenns and conditions have been satisfied or the Board has taken other
action as deelned appropriate to treat the failure to cOlnply as a violation of probation to
tenninate probation and to iinpose the penalty which was stayed
16 Completion of Probation Upon successful con1pletion of probation
Respondents license will be fully restored
I 0 D e r I 11 I YII 111 n u LU U O~ f J Jr IVIII
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17 No o anhip ofPreatHS Respondent shall not OWQ uwe any logal
or beneficial inttfe9t in~ or serve as 11 managcr~ administrator member offioer director
psociate or p~r ofany bUsiness fihJl plUtllersbip OJ corporation cu~tly or het~Dafter licensed by the Board Respondent shall sell or transfer poundiny Iega or twmeii cia inleret in any
entity licensfJd by the 80ard within 90 day follcwing the offective dat~ of this deciJion and
shall immediately tbereaftet ptovide written proofthereof to the BONd
AC(CJPTampNct
1havf1 carefully read the ~bove Stipu181ed Settlement and Diseplinery Order
and hAve fully discussed it with my attorney Timothy lu1herford 1understand the stip)l1ation
rmd the effect it will have on my Original Phannaeisr License No 38852 1enter into thig
Stipulated ScttlentMt and Discipl~aty Order voluntarilY1 knoWingly and intelUSettly and
Dgree to be bOlnd by the Dech~i()n and cm1a ofthe SQard
DATEDJl- Lt - famp i
~Iwafnt 1hale read and fully discussed with Itesponclent VALElUE Gallano the lemu
and corulitio and other maIt~ conrained In the above 8tipul41eO S~lcmerU and rw DiseiplilWY Order 1approve its fonn ~d content
OATBD
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17 No Ownership of Premises Respondent shall not own have any legal
or beneficial interest in or serve as a Inanager adIninistrator Inember officer director
associate or patiner of any business finn patinership or corporation currently or hereinafter
licensed by the Board Respondent shall sell or transfer any legal or beneficial interest in any
entity licensed by the Board within 90 days following the effective date of this decision and
shall in1n1ediately thereafter provide written proof thereof to the Board
ACCEPTANCE
I have carefully read the ~bove Stipulated Settlelnent and Disciplinary Order
and have fully discussed it with Iny atton1ey Titnothy Rutherford I understand the stipulation
and the effect it will have on my Original Phannacist License No 38852 I enter into this
Stipulated Settlelnent and Disciplinary Order voluntarily la10wingly and intelligently and
agree to be bound by the Decision and Order of the Board
DATED
VALERIE GAURANO Respondent
I have read and fully discussed with Respondent VALERIE Gaurano the tenns
and conditions and other Inatters contained in the above Stipulated Settlel11ent and
Disciplinary Order I approve its fonn and content
DATED
TIMOTHY RUTHERFORD Attorney for Valerie Gaurano
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DOJ Matter ID SD2005800399
80 1 05464wpd
9
ENDORSEMENT
The foregoing Stipulated Settlelnent and Disciplinary Order is hereby
respectfully sublnitted for consideration by the Board
DATED ~4 UJtJb BILL LOCKYER Atton1ey General of the State of California
Atton1eys for COlnplainant
BEFORE THE BOARD OF PHARMACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOME CARE PHARMACY Luis Gaurano president and Valerie Gaurano vice president and owners
Original Phanllacy Pennit No PHY 45192
VALERIE Gaurano 2051 Kristi COllli Fallbrook CA 92028
Original Phannacist License No RPH 38852
Respondent
Accusation No 2959
Citation No CT 2005-30007
OAH No L-2006070547
DECISION AND ORDER
The attached Stipulated Settlenlent and Disciplinary Order for Valerie Gaurano
is hereby adopted by the Board as its Decision in this Inatter
This Decision shall becOlne effective on February 21 2007
It is so 0 RD ERED __Jarr----u=ar=--y--22=-z~2~00~7---__
BOARD OF PHARMACY DEP ARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
By WILLIAM POWERS Board President
Exhibit A
Accusation No 2959
Citation No CT 2005-30007
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1
BILL LOCKyBR Attorney Genera of the State of CalifoTI1ia
JAIIES M LEDAKIS State Bar No 132645 Deputy AttoTI1ey General
CalifoTI1ia Depmin1ent of Justice 110 West A II Street Suite 1100 San Diego CA 92101
PO Box 85266 San Diego CA 92186-5266 Telephone 619-645-2105 Facsin1ile 619-645-2061
AttOTI1eys for COll1plainant
BEFORE THE BOARD OF PHARl1ACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOl1E CARE PHARMACY Luis Gaurano President and Valerie Gaurano Vice President and Owners
11711 Sterling Avenue Suite E Riverside CA 92503
Oliginal Phan11acy Pennit No PHY 45192
VALERIE GAURANO Pharmacist-in Charge at HOl1E CARE PI-IARMACY
2051 Krist1 Ct FallBrook CA 92028
Original Phanl1acist License No RPH 38852
ANNE R CABRERA Pharmacist-in-Charge at I-IOME CARE PI-IARMACY
31921 Old Hickory Road Trabuco Canyon CA 92679
Origina] Pharn1acist Ljcense No RPH 40776
Respondents
Case No 2959
OAHNo
ACCUSATION
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C0111plainant alleges
PARTIES
1 (Co111plail1ant) Patricia p Banis brings this Accusation solely in her
official capacity as tIle Executive Offlcer for the Califonlia State Board of Ph an11ElCY Department
of Consul11er Affairs
2 On or about April 252001 the Board ofPharnlacy issued Original
Pban11acy Pernlit NL111lber PEY 45192 to Residential Care Honle For You Inc dba Honle
Care Phanl1Clcy The license Nil] expire on April 1 2006 unless renewed
3 On or about August 23 1984 the Board of Phan1lacy issued Original
Phanl1acist license nq 38852 to Valerie Reyes Gaurano aka Va]elie Arme Abani1 Reyes Sbe
was the phanl1acist in charge at HOlvlE CARE PHARlvlACY froll1 IvIarch26 2004 through
August 23 2004 Her license will expire on April 1 2006 unless renewed
4 On or about March 17 1986 the Board of Phanl1acy issued Oliginal
Pharmacist license no 40776 to Am1e Roberto Cabrera She was the phanl1acist in charge at
HOIvIE CARE PHARlvlACY froll1 August 23 2004 to the present Her license vvi11 expire on
ILl1y 31 ( 2096 unless renewed
JURISDICTION
5 This Accusation is brought before the California State Board of Phm111acy
(Board) Depmin1ent of COnSU111er Affairs under the authority of the following laws AlJ section
references are to the Business and Professions Code unless otherwise indicated
6 Section 4059 (a) of the Code states in pertinent part that a person l1lay not
furnisl1 any dangerous drug except upon t11e prescription of a pl1ysician dentist podiat1ist
opton1ehist or veterinarian A person n1ay not fUr11is11 any dangerous device except llpon the
prescription of a pbyslcian dentist podiatrist opt0111etrist or veterinarian
7 Section 4070 (a) of tbe Code entitl ed Oral or electroni c data trans111issl011
prescripbon reduction to writing states Except as provided in Section 4019 and subdivision (b)
an ora1 or an electronic data tra118111issio11 prescription as defined in subdivision (c) of Section
4040 shal1 as soon as practicab1e be reduced to writing by the phanl1aclst and sha1] be filled by
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or under the direction of the phar111acist The phanl1acist need n01 reduce to ~lri1ing the address
telephone l1U111ber license classification federal registry nU111ber of the prescriber or the address
of the patj ent or pati ents if the infor111ation is readily retrievable in tbe pharn1ucy
Section 4081 of the Code states
(a) All records of 111anufacture and of sale acquisition or disposition of dangerous drugs or dangerous devices shal1 be at al] tinles during business hours open 10 inspection by authorized officers oft11e ImN and shall be preserved for at least three years frOlTI the date of l11aking A CUlTent inventory shall be kept by every 111cmufacturer vholesaler phan111lcy veterinary food-anin1al drug retaileT physician dentist podiatrist veterinarian laboratory clinic hospital institution or establish111ent holding a currently valid andmuevoked certificate license pen11it registration or exe111ption under Division 2 (co111111encing with Section 1200) of the Health and Safety Code or under Part 4 (conlnlencing Nith Section 16000) of Division 9 of the Welfare and Institutions Code who 111aintains a stock of dangerous drugs or dangerous devices
(b) The owner officer and pminer of any phanl1acy wholesaler or veterinary food-ani111al dnlg retailer shall be jointly responsible witl1 the phannacist-in-charge or exenlptee for n1aintaining the records and inventory described in this section
(c) The phan11acist-in-charge or exen1ptee shall not be crin1inally responsible for acts of the owner officer partner or en1ployee that violate this section and of vlhich the phanl1acist-in-charge or exen1ptee had no knowledge or in which he or she did not lQl0wingly participate
9 Section 4105 of the Code states
(a) All records or other dOCUlTIentation of the acquisition and disposjtion of dangerous dnlgB and dangerous devices by any entity liGen_~ed by the bQard sha11 be retained on the licensed prenlises in a readily retrievable fOD11
(b) The l1censee 111ay ielTIOVe the original records or docun1entation fro111 the licensed pre111ises on a tell1porary basis for license-related PU1lJoses Hovever a duplicate set of those records Of other docu111entation shan be retained on the licensed pren11ses
(c) The records reqllired by this section shall be retained on the 1icensed prenlises for a period oftlu-ee years fro111 the date of 111aking
(c1) Any records that are ll1aintained el ectronicany shall be ll1aintained so that the pharn1acist-in-charge the pha1111acist on duty if tIl e pharmacist-in-charge is not on duty or in the case of a veterinary food-anin1al drug retailer or wholesa1er the exenlptee sha1l at all tillles during which the licensed pren1ises are open for business be able to produce a hard copy and electronic copy of al] records of aCClllisition or disposition or otber drug or dispensing-related records nluintained electronical1y
(e)(l) Notwithstanding subdivisions (a) (b) and (c) the board nlaY upon written request grant to a licensee a waiver of the requirenlents that tl1e records described in subdivisions (a) (b) and (c) be kept on the licensed ])reJl1ises
(2) A waiver granted pursuant to tbis sllbdi-vislol1 shal] not affect tl1e boards authority under this section or any otber provision of this c11apter
10 Section 4301 of the Code states
The board s11al1 take action against any holder of a license who is b1l1i1ty of unprofessional conduct or whose l1cense has been procured by fraud or J11isrepresentation or issued by n1istake Unprofessional conduct shal] include but is not linlited to any of
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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force and effect as the originals
14 In consideration of the foregoing adlnissions and stipulations the parties
agree that the Board Inay without further notice or fonnal proceeding issue and enter the
following Disciplinary Order
DISCIPLINARY ORDER
IT IS HEREBY ORDERED that Valerie Gaurano s Original Phan11acist License
No RPH 38852 is revoked however the revocation is stayed and the Respondent is placed on
two (2) years probation on the following tenns and conditions
1 Obey All Laws Respondent shall obey all state and federal laws and
regulations substantially related to or goven1ing the practice of phan11acy
Respondent shall report any of the following occun-ences to the Board in writing
within 72 hours of such occun-ence
bull an an-est or issuance of a crin1inal cOlnplaint for violation of any provision of the
Pham1acy Law state and federal food and drug laws or state and federal
controlled substances laws
bull a plea of guilty or nolo contendere in any state or federal criIninal proceeding to
any criIninal cOlnplaintinfonnationor indictn1ent
bull a conviction of any crilne
bull discipline citation or other adlninistrative action filed by any state and federal
agency which involves Respondents license or which is related to the practice
of phannacy or the Inanufacturing obtaining handling or distribution or billing
or charging for any drug device or controlled substance
2 Reporting to the Board Respondent shall report to the Board
qUaIierly The report shall be Inade either in person or in writing as directed Respondent
shall state under penalty of peljury whether there has been cOlnpliance with all the tenns and
conditions of probation If the final probation report is not made as directed probation shall
be extended autOlnatically until such tiIne as the final repoli is Inade and accepted by the
Board
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3 Interview with the Board Upon receipt of reasonable notice
Respondent shall appear in person for interviews with the Board upon request at various
intervals at a location to be determined by the Board Failure to appear for a scheduled
interview without plior notification to Board staff shall be considered a violation of probation
4 Cooperation with Board Staff Respondent shall cooperate with the
Boards inspectional prograln and in the Boards Inonitoling and investigation of Respondents
cOlnpliance with the tenns and conditions of their probation Failure to cOlnply shall be
considered a violation of probation
5 Continuing Education Respondent shall provide evidence of effolis
to maintain skill and I010wledge as a phannacist as directed by the Board
6 Notice to Employers Respondent shall notify all present and
prospective elnployers of the decision in case nun1ber 2959 and the tenns conditions and
restrictions itnposed on Respondent by the decision Within 30 days of the effective date of
this decision and within 15 days of Respondent undertaking new elnploYlnent Respondent
shall cause their direct supervisor phannacist-in-charge andor owner to report to the Board in
wliting acla10wledging the elnployer has read the decision in case nUlnber 2959
If Respondent works for oris etnpfoyed-by or through a phannacy elnployment
service Respondent n1ust notify the direct supervisor pharmacist-in-charge andor owner at
every phan11acy of the and tenns conditions of the decision in case nUlnber 2959 in advance of
the Respondent cOlnlnencing work at each phalmacy
ElnploYlnent within the Ineaning of this provision shall include any full-titne partshy
titne telnporary relief or phannacy Inanagelnent service as a phannacist whether the
Respondent is considered an elnployee or independent contractor
7 No Preceptorships Supervision of Interns Being Pharmacist-in-
Charge (PIC) or Serving as a Consultant Respondent shall not supervise any inten1
phannacist or perfonn any of the duties of a preceptor nor shall Respondent be the
phannacist-in-charge of any entity licensed by the Board unless otherwise specified in this
order
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8 Reimbursement of Board Costs None
9 Payment of Fines Valerie Gaurano shall pay a fine of $5000000 in
order to resolve the current outstanding Citation CI 2005 30007 as pati of this global
stipulated settlement Respondent shall pay the Board the $2500000 on or before Decelnber
12 2007 and $2500000 on or before December 122008 Failure to timely pay the fine shall
constitute a violation of probation
10 Probation Monitoring Costs Respondent shall pay the costs
associated with probation monitoring as determined by the Board each and every year of
probation Such costs shall be payable to the Board at the end of each year of probation
Failure to pay such costs shall be considered a violation of probation
11 Status of License Respondent shall at all tiInes while on probation
Inaintain an active current license with the Board including any period during which
suspension or probation is tolled
If Respondents license expires or is canceled by operation of law or otherwise
upon renewal or reapplication Respondents license shall be subject to all tenns and
conditions of this probation not previously satisfied
12 License Surrender while on Prob-ationSuspensiori Following the
effective date of this decision should Respondent cease practice due to retireinent or health
or be otherwise unable to satisfy the tenns and conditions of probation Respondent Inay
tender their license to the Board for surrender The Board shall have the discretion whether to
grant the request for surrender or take any other action it deelns appropriate and reasonable
Upon fonnal acceptance of the surrender of the license Respondent will no longer be subject
to the tenns and conditions of probation
Upon acceptance of the surrender Respondent shall relinquish their pocket
license to the Board within 10 days of notification by the Board that the surrender is accepted
Respondent n1ay not reapply for any license froin the Board for three years frOln the effective
date of the surrender Respondent shall meet all requireinents applicable to the license sought
as of the date the application for that license is sublnitted to the Board
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13 Notification of EmploymentMailing Address Change Respondent
shall notify the Board in writing within 10 days of any change of elnploYlnent Said
notification shall include the reasons for leaving andor the address of the new employer
supervisor or owner and work schedule if known Respondent shall notify the Board in
writing within 10 days of a change in natne In ailing address or phone nmnber
14 Tolling of Probation Should Respondent regardless of residency for
any reason cease practicing phannacy for a Ininimum of 40 hours per calendar Inonth in
Califon1ia Respondent Inust notify the Board in writing within 10 days of cessation of the
practice ofphannacy or the resuInption of the practice ofphannacy Such periods oftiIne
shall not apply to the reduction of the probation period It is a violation of probation for
Respondents probation to reinain tolled pursuant to the provisions of this condition for a
period exceeding three years
Cessation of practice Ineans any period of tin1e exceeding 30 days in which
Respondent is not engaged in the practice of phannacy as defined in Section 4052 of the
Business and Professions Code
15 Violation of Probation If Respondent violates probation in any
respect the Board after giving Respondent notice and an 0ppoliuni-ty fo be heard Ii1ay
revoke probation and carry out the disciplinary order which was stayed If a petition to revoke
probation or an accusation is filed against Respondent during probation the Board shall have
continuing jurisdiction and the period of probation shall be extended until the petition to
revoke probation or accusation is heard and decided
If R~spondent has not complied with any tenn or condition of probation the
Board shall have continuing jurisdiction over Respondent and probation shall autoinatically
be extended until all tenns and conditions have been satisfied or the Board has taken other
action as deelned appropriate to treat the failure to cOlnply as a violation of probation to
tenninate probation and to iinpose the penalty which was stayed
16 Completion of Probation Upon successful con1pletion of probation
Respondents license will be fully restored
I 0 D e r I 11 I YII 111 n u LU U O~ f J Jr IVIII
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17 No o anhip ofPreatHS Respondent shall not OWQ uwe any logal
or beneficial inttfe9t in~ or serve as 11 managcr~ administrator member offioer director
psociate or p~r ofany bUsiness fihJl plUtllersbip OJ corporation cu~tly or het~Dafter licensed by the Board Respondent shall sell or transfer poundiny Iega or twmeii cia inleret in any
entity licensfJd by the 80ard within 90 day follcwing the offective dat~ of this deciJion and
shall immediately tbereaftet ptovide written proofthereof to the BONd
AC(CJPTampNct
1havf1 carefully read the ~bove Stipu181ed Settlement and Diseplinery Order
and hAve fully discussed it with my attorney Timothy lu1herford 1understand the stip)l1ation
rmd the effect it will have on my Original Phannaeisr License No 38852 1enter into thig
Stipulated ScttlentMt and Discipl~aty Order voluntarilY1 knoWingly and intelUSettly and
Dgree to be bOlnd by the Dech~i()n and cm1a ofthe SQard
DATEDJl- Lt - famp i
~Iwafnt 1hale read and fully discussed with Itesponclent VALElUE Gallano the lemu
and corulitio and other maIt~ conrained In the above 8tipul41eO S~lcmerU and rw DiseiplilWY Order 1approve its fonn ~d content
OATBD
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17 No Ownership of Premises Respondent shall not own have any legal
or beneficial interest in or serve as a Inanager adIninistrator Inember officer director
associate or patiner of any business finn patinership or corporation currently or hereinafter
licensed by the Board Respondent shall sell or transfer any legal or beneficial interest in any
entity licensed by the Board within 90 days following the effective date of this decision and
shall in1n1ediately thereafter provide written proof thereof to the Board
ACCEPTANCE
I have carefully read the ~bove Stipulated Settlelnent and Disciplinary Order
and have fully discussed it with Iny atton1ey Titnothy Rutherford I understand the stipulation
and the effect it will have on my Original Phannacist License No 38852 I enter into this
Stipulated Settlelnent and Disciplinary Order voluntarily la10wingly and intelligently and
agree to be bound by the Decision and Order of the Board
DATED
VALERIE GAURANO Respondent
I have read and fully discussed with Respondent VALERIE Gaurano the tenns
and conditions and other Inatters contained in the above Stipulated Settlel11ent and
Disciplinary Order I approve its fonn and content
DATED
TIMOTHY RUTHERFORD Attorney for Valerie Gaurano
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DOJ Matter ID SD2005800399
80 1 05464wpd
9
ENDORSEMENT
The foregoing Stipulated Settlelnent and Disciplinary Order is hereby
respectfully sublnitted for consideration by the Board
DATED ~4 UJtJb BILL LOCKYER Atton1ey General of the State of California
Atton1eys for COlnplainant
BEFORE THE BOARD OF PHARMACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOME CARE PHARMACY Luis Gaurano president and Valerie Gaurano vice president and owners
Original Phanllacy Pennit No PHY 45192
VALERIE Gaurano 2051 Kristi COllli Fallbrook CA 92028
Original Phannacist License No RPH 38852
Respondent
Accusation No 2959
Citation No CT 2005-30007
OAH No L-2006070547
DECISION AND ORDER
The attached Stipulated Settlenlent and Disciplinary Order for Valerie Gaurano
is hereby adopted by the Board as its Decision in this Inatter
This Decision shall becOlne effective on February 21 2007
It is so 0 RD ERED __Jarr----u=ar=--y--22=-z~2~00~7---__
BOARD OF PHARMACY DEP ARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
By WILLIAM POWERS Board President
Exhibit A
Accusation No 2959
Citation No CT 2005-30007
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BILL LOCKyBR Attorney Genera of the State of CalifoTI1ia
JAIIES M LEDAKIS State Bar No 132645 Deputy AttoTI1ey General
CalifoTI1ia Depmin1ent of Justice 110 West A II Street Suite 1100 San Diego CA 92101
PO Box 85266 San Diego CA 92186-5266 Telephone 619-645-2105 Facsin1ile 619-645-2061
AttOTI1eys for COll1plainant
BEFORE THE BOARD OF PHARl1ACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOl1E CARE PHARMACY Luis Gaurano President and Valerie Gaurano Vice President and Owners
11711 Sterling Avenue Suite E Riverside CA 92503
Oliginal Phan11acy Pennit No PHY 45192
VALERIE GAURANO Pharmacist-in Charge at HOl1E CARE PI-IARMACY
2051 Krist1 Ct FallBrook CA 92028
Original Phanl1acist License No RPH 38852
ANNE R CABRERA Pharmacist-in-Charge at I-IOME CARE PI-IARMACY
31921 Old Hickory Road Trabuco Canyon CA 92679
Origina] Pharn1acist Ljcense No RPH 40776
Respondents
Case No 2959
OAHNo
ACCUSATION
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C0111plainant alleges
PARTIES
1 (Co111plail1ant) Patricia p Banis brings this Accusation solely in her
official capacity as tIle Executive Offlcer for the Califonlia State Board of Ph an11ElCY Department
of Consul11er Affairs
2 On or about April 252001 the Board ofPharnlacy issued Original
Pban11acy Pernlit NL111lber PEY 45192 to Residential Care Honle For You Inc dba Honle
Care Phanl1Clcy The license Nil] expire on April 1 2006 unless renewed
3 On or about August 23 1984 the Board of Phan1lacy issued Original
Phanl1acist license nq 38852 to Valerie Reyes Gaurano aka Va]elie Arme Abani1 Reyes Sbe
was the phanl1acist in charge at HOlvlE CARE PHARlvlACY froll1 IvIarch26 2004 through
August 23 2004 Her license will expire on April 1 2006 unless renewed
4 On or about March 17 1986 the Board of Phanl1acy issued Oliginal
Pharmacist license no 40776 to Am1e Roberto Cabrera She was the phanl1acist in charge at
HOIvIE CARE PHARlvlACY froll1 August 23 2004 to the present Her license vvi11 expire on
ILl1y 31 ( 2096 unless renewed
JURISDICTION
5 This Accusation is brought before the California State Board of Phm111acy
(Board) Depmin1ent of COnSU111er Affairs under the authority of the following laws AlJ section
references are to the Business and Professions Code unless otherwise indicated
6 Section 4059 (a) of the Code states in pertinent part that a person l1lay not
furnisl1 any dangerous drug except upon t11e prescription of a pl1ysician dentist podiat1ist
opton1ehist or veterinarian A person n1ay not fUr11is11 any dangerous device except llpon the
prescription of a pbyslcian dentist podiatrist opt0111etrist or veterinarian
7 Section 4070 (a) of tbe Code entitl ed Oral or electroni c data trans111issl011
prescripbon reduction to writing states Except as provided in Section 4019 and subdivision (b)
an ora1 or an electronic data tra118111issio11 prescription as defined in subdivision (c) of Section
4040 shal1 as soon as practicab1e be reduced to writing by the phanl1aclst and sha1] be filled by
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or under the direction of the phar111acist The phanl1acist need n01 reduce to ~lri1ing the address
telephone l1U111ber license classification federal registry nU111ber of the prescriber or the address
of the patj ent or pati ents if the infor111ation is readily retrievable in tbe pharn1ucy
Section 4081 of the Code states
(a) All records of 111anufacture and of sale acquisition or disposition of dangerous drugs or dangerous devices shal1 be at al] tinles during business hours open 10 inspection by authorized officers oft11e ImN and shall be preserved for at least three years frOlTI the date of l11aking A CUlTent inventory shall be kept by every 111cmufacturer vholesaler phan111lcy veterinary food-anin1al drug retaileT physician dentist podiatrist veterinarian laboratory clinic hospital institution or establish111ent holding a currently valid andmuevoked certificate license pen11it registration or exe111ption under Division 2 (co111111encing with Section 1200) of the Health and Safety Code or under Part 4 (conlnlencing Nith Section 16000) of Division 9 of the Welfare and Institutions Code who 111aintains a stock of dangerous drugs or dangerous devices
(b) The owner officer and pminer of any phanl1acy wholesaler or veterinary food-ani111al dnlg retailer shall be jointly responsible witl1 the phannacist-in-charge or exenlptee for n1aintaining the records and inventory described in this section
(c) The phan11acist-in-charge or exen1ptee shall not be crin1inally responsible for acts of the owner officer partner or en1ployee that violate this section and of vlhich the phanl1acist-in-charge or exen1ptee had no knowledge or in which he or she did not lQl0wingly participate
9 Section 4105 of the Code states
(a) All records or other dOCUlTIentation of the acquisition and disposjtion of dangerous dnlgB and dangerous devices by any entity liGen_~ed by the bQard sha11 be retained on the licensed prenlises in a readily retrievable fOD11
(b) The l1censee 111ay ielTIOVe the original records or docun1entation fro111 the licensed pre111ises on a tell1porary basis for license-related PU1lJoses Hovever a duplicate set of those records Of other docu111entation shan be retained on the licensed pren11ses
(c) The records reqllired by this section shall be retained on the 1icensed prenlises for a period oftlu-ee years fro111 the date of 111aking
(c1) Any records that are ll1aintained el ectronicany shall be ll1aintained so that the pharn1acist-in-charge the pha1111acist on duty if tIl e pharmacist-in-charge is not on duty or in the case of a veterinary food-anin1al drug retailer or wholesa1er the exenlptee sha1l at all tillles during which the licensed pren1ises are open for business be able to produce a hard copy and electronic copy of al] records of aCClllisition or disposition or otber drug or dispensing-related records nluintained electronical1y
(e)(l) Notwithstanding subdivisions (a) (b) and (c) the board nlaY upon written request grant to a licensee a waiver of the requirenlents that tl1e records described in subdivisions (a) (b) and (c) be kept on the licensed ])reJl1ises
(2) A waiver granted pursuant to tbis sllbdi-vislol1 shal] not affect tl1e boards authority under this section or any otber provision of this c11apter
10 Section 4301 of the Code states
The board s11al1 take action against any holder of a license who is b1l1i1ty of unprofessional conduct or whose l1cense has been procured by fraud or J11isrepresentation or issued by n1istake Unprofessional conduct shal] include but is not linlited to any of
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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3 Interview with the Board Upon receipt of reasonable notice
Respondent shall appear in person for interviews with the Board upon request at various
intervals at a location to be determined by the Board Failure to appear for a scheduled
interview without plior notification to Board staff shall be considered a violation of probation
4 Cooperation with Board Staff Respondent shall cooperate with the
Boards inspectional prograln and in the Boards Inonitoling and investigation of Respondents
cOlnpliance with the tenns and conditions of their probation Failure to cOlnply shall be
considered a violation of probation
5 Continuing Education Respondent shall provide evidence of effolis
to maintain skill and I010wledge as a phannacist as directed by the Board
6 Notice to Employers Respondent shall notify all present and
prospective elnployers of the decision in case nun1ber 2959 and the tenns conditions and
restrictions itnposed on Respondent by the decision Within 30 days of the effective date of
this decision and within 15 days of Respondent undertaking new elnploYlnent Respondent
shall cause their direct supervisor phannacist-in-charge andor owner to report to the Board in
wliting acla10wledging the elnployer has read the decision in case nUlnber 2959
If Respondent works for oris etnpfoyed-by or through a phannacy elnployment
service Respondent n1ust notify the direct supervisor pharmacist-in-charge andor owner at
every phan11acy of the and tenns conditions of the decision in case nUlnber 2959 in advance of
the Respondent cOlnlnencing work at each phalmacy
ElnploYlnent within the Ineaning of this provision shall include any full-titne partshy
titne telnporary relief or phannacy Inanagelnent service as a phannacist whether the
Respondent is considered an elnployee or independent contractor
7 No Preceptorships Supervision of Interns Being Pharmacist-in-
Charge (PIC) or Serving as a Consultant Respondent shall not supervise any inten1
phannacist or perfonn any of the duties of a preceptor nor shall Respondent be the
phannacist-in-charge of any entity licensed by the Board unless otherwise specified in this
order
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8 Reimbursement of Board Costs None
9 Payment of Fines Valerie Gaurano shall pay a fine of $5000000 in
order to resolve the current outstanding Citation CI 2005 30007 as pati of this global
stipulated settlement Respondent shall pay the Board the $2500000 on or before Decelnber
12 2007 and $2500000 on or before December 122008 Failure to timely pay the fine shall
constitute a violation of probation
10 Probation Monitoring Costs Respondent shall pay the costs
associated with probation monitoring as determined by the Board each and every year of
probation Such costs shall be payable to the Board at the end of each year of probation
Failure to pay such costs shall be considered a violation of probation
11 Status of License Respondent shall at all tiInes while on probation
Inaintain an active current license with the Board including any period during which
suspension or probation is tolled
If Respondents license expires or is canceled by operation of law or otherwise
upon renewal or reapplication Respondents license shall be subject to all tenns and
conditions of this probation not previously satisfied
12 License Surrender while on Prob-ationSuspensiori Following the
effective date of this decision should Respondent cease practice due to retireinent or health
or be otherwise unable to satisfy the tenns and conditions of probation Respondent Inay
tender their license to the Board for surrender The Board shall have the discretion whether to
grant the request for surrender or take any other action it deelns appropriate and reasonable
Upon fonnal acceptance of the surrender of the license Respondent will no longer be subject
to the tenns and conditions of probation
Upon acceptance of the surrender Respondent shall relinquish their pocket
license to the Board within 10 days of notification by the Board that the surrender is accepted
Respondent n1ay not reapply for any license froin the Board for three years frOln the effective
date of the surrender Respondent shall meet all requireinents applicable to the license sought
as of the date the application for that license is sublnitted to the Board
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13 Notification of EmploymentMailing Address Change Respondent
shall notify the Board in writing within 10 days of any change of elnploYlnent Said
notification shall include the reasons for leaving andor the address of the new employer
supervisor or owner and work schedule if known Respondent shall notify the Board in
writing within 10 days of a change in natne In ailing address or phone nmnber
14 Tolling of Probation Should Respondent regardless of residency for
any reason cease practicing phannacy for a Ininimum of 40 hours per calendar Inonth in
Califon1ia Respondent Inust notify the Board in writing within 10 days of cessation of the
practice ofphannacy or the resuInption of the practice ofphannacy Such periods oftiIne
shall not apply to the reduction of the probation period It is a violation of probation for
Respondents probation to reinain tolled pursuant to the provisions of this condition for a
period exceeding three years
Cessation of practice Ineans any period of tin1e exceeding 30 days in which
Respondent is not engaged in the practice of phannacy as defined in Section 4052 of the
Business and Professions Code
15 Violation of Probation If Respondent violates probation in any
respect the Board after giving Respondent notice and an 0ppoliuni-ty fo be heard Ii1ay
revoke probation and carry out the disciplinary order which was stayed If a petition to revoke
probation or an accusation is filed against Respondent during probation the Board shall have
continuing jurisdiction and the period of probation shall be extended until the petition to
revoke probation or accusation is heard and decided
If R~spondent has not complied with any tenn or condition of probation the
Board shall have continuing jurisdiction over Respondent and probation shall autoinatically
be extended until all tenns and conditions have been satisfied or the Board has taken other
action as deelned appropriate to treat the failure to cOlnply as a violation of probation to
tenninate probation and to iinpose the penalty which was stayed
16 Completion of Probation Upon successful con1pletion of probation
Respondents license will be fully restored
I 0 D e r I 11 I YII 111 n u LU U O~ f J Jr IVIII
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17 No o anhip ofPreatHS Respondent shall not OWQ uwe any logal
or beneficial inttfe9t in~ or serve as 11 managcr~ administrator member offioer director
psociate or p~r ofany bUsiness fihJl plUtllersbip OJ corporation cu~tly or het~Dafter licensed by the Board Respondent shall sell or transfer poundiny Iega or twmeii cia inleret in any
entity licensfJd by the 80ard within 90 day follcwing the offective dat~ of this deciJion and
shall immediately tbereaftet ptovide written proofthereof to the BONd
AC(CJPTampNct
1havf1 carefully read the ~bove Stipu181ed Settlement and Diseplinery Order
and hAve fully discussed it with my attorney Timothy lu1herford 1understand the stip)l1ation
rmd the effect it will have on my Original Phannaeisr License No 38852 1enter into thig
Stipulated ScttlentMt and Discipl~aty Order voluntarilY1 knoWingly and intelUSettly and
Dgree to be bOlnd by the Dech~i()n and cm1a ofthe SQard
DATEDJl- Lt - famp i
~Iwafnt 1hale read and fully discussed with Itesponclent VALElUE Gallano the lemu
and corulitio and other maIt~ conrained In the above 8tipul41eO S~lcmerU and rw DiseiplilWY Order 1approve its fonn ~d content
OATBD
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17 No Ownership of Premises Respondent shall not own have any legal
or beneficial interest in or serve as a Inanager adIninistrator Inember officer director
associate or patiner of any business finn patinership or corporation currently or hereinafter
licensed by the Board Respondent shall sell or transfer any legal or beneficial interest in any
entity licensed by the Board within 90 days following the effective date of this decision and
shall in1n1ediately thereafter provide written proof thereof to the Board
ACCEPTANCE
I have carefully read the ~bove Stipulated Settlelnent and Disciplinary Order
and have fully discussed it with Iny atton1ey Titnothy Rutherford I understand the stipulation
and the effect it will have on my Original Phannacist License No 38852 I enter into this
Stipulated Settlelnent and Disciplinary Order voluntarily la10wingly and intelligently and
agree to be bound by the Decision and Order of the Board
DATED
VALERIE GAURANO Respondent
I have read and fully discussed with Respondent VALERIE Gaurano the tenns
and conditions and other Inatters contained in the above Stipulated Settlel11ent and
Disciplinary Order I approve its fonn and content
DATED
TIMOTHY RUTHERFORD Attorney for Valerie Gaurano
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DOJ Matter ID SD2005800399
80 1 05464wpd
9
ENDORSEMENT
The foregoing Stipulated Settlelnent and Disciplinary Order is hereby
respectfully sublnitted for consideration by the Board
DATED ~4 UJtJb BILL LOCKYER Atton1ey General of the State of California
Atton1eys for COlnplainant
BEFORE THE BOARD OF PHARMACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOME CARE PHARMACY Luis Gaurano president and Valerie Gaurano vice president and owners
Original Phanllacy Pennit No PHY 45192
VALERIE Gaurano 2051 Kristi COllli Fallbrook CA 92028
Original Phannacist License No RPH 38852
Respondent
Accusation No 2959
Citation No CT 2005-30007
OAH No L-2006070547
DECISION AND ORDER
The attached Stipulated Settlenlent and Disciplinary Order for Valerie Gaurano
is hereby adopted by the Board as its Decision in this Inatter
This Decision shall becOlne effective on February 21 2007
It is so 0 RD ERED __Jarr----u=ar=--y--22=-z~2~00~7---__
BOARD OF PHARMACY DEP ARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
By WILLIAM POWERS Board President
Exhibit A
Accusation No 2959
Citation No CT 2005-30007
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BILL LOCKyBR Attorney Genera of the State of CalifoTI1ia
JAIIES M LEDAKIS State Bar No 132645 Deputy AttoTI1ey General
CalifoTI1ia Depmin1ent of Justice 110 West A II Street Suite 1100 San Diego CA 92101
PO Box 85266 San Diego CA 92186-5266 Telephone 619-645-2105 Facsin1ile 619-645-2061
AttOTI1eys for COll1plainant
BEFORE THE BOARD OF PHARl1ACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOl1E CARE PHARMACY Luis Gaurano President and Valerie Gaurano Vice President and Owners
11711 Sterling Avenue Suite E Riverside CA 92503
Oliginal Phan11acy Pennit No PHY 45192
VALERIE GAURANO Pharmacist-in Charge at HOl1E CARE PI-IARMACY
2051 Krist1 Ct FallBrook CA 92028
Original Phanl1acist License No RPH 38852
ANNE R CABRERA Pharmacist-in-Charge at I-IOME CARE PI-IARMACY
31921 Old Hickory Road Trabuco Canyon CA 92679
Origina] Pharn1acist Ljcense No RPH 40776
Respondents
Case No 2959
OAHNo
ACCUSATION
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C0111plainant alleges
PARTIES
1 (Co111plail1ant) Patricia p Banis brings this Accusation solely in her
official capacity as tIle Executive Offlcer for the Califonlia State Board of Ph an11ElCY Department
of Consul11er Affairs
2 On or about April 252001 the Board ofPharnlacy issued Original
Pban11acy Pernlit NL111lber PEY 45192 to Residential Care Honle For You Inc dba Honle
Care Phanl1Clcy The license Nil] expire on April 1 2006 unless renewed
3 On or about August 23 1984 the Board of Phan1lacy issued Original
Phanl1acist license nq 38852 to Valerie Reyes Gaurano aka Va]elie Arme Abani1 Reyes Sbe
was the phanl1acist in charge at HOlvlE CARE PHARlvlACY froll1 IvIarch26 2004 through
August 23 2004 Her license will expire on April 1 2006 unless renewed
4 On or about March 17 1986 the Board of Phanl1acy issued Oliginal
Pharmacist license no 40776 to Am1e Roberto Cabrera She was the phanl1acist in charge at
HOIvIE CARE PHARlvlACY froll1 August 23 2004 to the present Her license vvi11 expire on
ILl1y 31 ( 2096 unless renewed
JURISDICTION
5 This Accusation is brought before the California State Board of Phm111acy
(Board) Depmin1ent of COnSU111er Affairs under the authority of the following laws AlJ section
references are to the Business and Professions Code unless otherwise indicated
6 Section 4059 (a) of the Code states in pertinent part that a person l1lay not
furnisl1 any dangerous drug except upon t11e prescription of a pl1ysician dentist podiat1ist
opton1ehist or veterinarian A person n1ay not fUr11is11 any dangerous device except llpon the
prescription of a pbyslcian dentist podiatrist opt0111etrist or veterinarian
7 Section 4070 (a) of tbe Code entitl ed Oral or electroni c data trans111issl011
prescripbon reduction to writing states Except as provided in Section 4019 and subdivision (b)
an ora1 or an electronic data tra118111issio11 prescription as defined in subdivision (c) of Section
4040 shal1 as soon as practicab1e be reduced to writing by the phanl1aclst and sha1] be filled by
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or under the direction of the phar111acist The phanl1acist need n01 reduce to ~lri1ing the address
telephone l1U111ber license classification federal registry nU111ber of the prescriber or the address
of the patj ent or pati ents if the infor111ation is readily retrievable in tbe pharn1ucy
Section 4081 of the Code states
(a) All records of 111anufacture and of sale acquisition or disposition of dangerous drugs or dangerous devices shal1 be at al] tinles during business hours open 10 inspection by authorized officers oft11e ImN and shall be preserved for at least three years frOlTI the date of l11aking A CUlTent inventory shall be kept by every 111cmufacturer vholesaler phan111lcy veterinary food-anin1al drug retaileT physician dentist podiatrist veterinarian laboratory clinic hospital institution or establish111ent holding a currently valid andmuevoked certificate license pen11it registration or exe111ption under Division 2 (co111111encing with Section 1200) of the Health and Safety Code or under Part 4 (conlnlencing Nith Section 16000) of Division 9 of the Welfare and Institutions Code who 111aintains a stock of dangerous drugs or dangerous devices
(b) The owner officer and pminer of any phanl1acy wholesaler or veterinary food-ani111al dnlg retailer shall be jointly responsible witl1 the phannacist-in-charge or exenlptee for n1aintaining the records and inventory described in this section
(c) The phan11acist-in-charge or exen1ptee shall not be crin1inally responsible for acts of the owner officer partner or en1ployee that violate this section and of vlhich the phanl1acist-in-charge or exen1ptee had no knowledge or in which he or she did not lQl0wingly participate
9 Section 4105 of the Code states
(a) All records or other dOCUlTIentation of the acquisition and disposjtion of dangerous dnlgB and dangerous devices by any entity liGen_~ed by the bQard sha11 be retained on the licensed prenlises in a readily retrievable fOD11
(b) The l1censee 111ay ielTIOVe the original records or docun1entation fro111 the licensed pre111ises on a tell1porary basis for license-related PU1lJoses Hovever a duplicate set of those records Of other docu111entation shan be retained on the licensed pren11ses
(c) The records reqllired by this section shall be retained on the 1icensed prenlises for a period oftlu-ee years fro111 the date of 111aking
(c1) Any records that are ll1aintained el ectronicany shall be ll1aintained so that the pharn1acist-in-charge the pha1111acist on duty if tIl e pharmacist-in-charge is not on duty or in the case of a veterinary food-anin1al drug retailer or wholesa1er the exenlptee sha1l at all tillles during which the licensed pren1ises are open for business be able to produce a hard copy and electronic copy of al] records of aCClllisition or disposition or otber drug or dispensing-related records nluintained electronical1y
(e)(l) Notwithstanding subdivisions (a) (b) and (c) the board nlaY upon written request grant to a licensee a waiver of the requirenlents that tl1e records described in subdivisions (a) (b) and (c) be kept on the licensed ])reJl1ises
(2) A waiver granted pursuant to tbis sllbdi-vislol1 shal] not affect tl1e boards authority under this section or any otber provision of this c11apter
10 Section 4301 of the Code states
The board s11al1 take action against any holder of a license who is b1l1i1ty of unprofessional conduct or whose l1cense has been procured by fraud or J11isrepresentation or issued by n1istake Unprofessional conduct shal] include but is not linlited to any of
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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8 Reimbursement of Board Costs None
9 Payment of Fines Valerie Gaurano shall pay a fine of $5000000 in
order to resolve the current outstanding Citation CI 2005 30007 as pati of this global
stipulated settlement Respondent shall pay the Board the $2500000 on or before Decelnber
12 2007 and $2500000 on or before December 122008 Failure to timely pay the fine shall
constitute a violation of probation
10 Probation Monitoring Costs Respondent shall pay the costs
associated with probation monitoring as determined by the Board each and every year of
probation Such costs shall be payable to the Board at the end of each year of probation
Failure to pay such costs shall be considered a violation of probation
11 Status of License Respondent shall at all tiInes while on probation
Inaintain an active current license with the Board including any period during which
suspension or probation is tolled
If Respondents license expires or is canceled by operation of law or otherwise
upon renewal or reapplication Respondents license shall be subject to all tenns and
conditions of this probation not previously satisfied
12 License Surrender while on Prob-ationSuspensiori Following the
effective date of this decision should Respondent cease practice due to retireinent or health
or be otherwise unable to satisfy the tenns and conditions of probation Respondent Inay
tender their license to the Board for surrender The Board shall have the discretion whether to
grant the request for surrender or take any other action it deelns appropriate and reasonable
Upon fonnal acceptance of the surrender of the license Respondent will no longer be subject
to the tenns and conditions of probation
Upon acceptance of the surrender Respondent shall relinquish their pocket
license to the Board within 10 days of notification by the Board that the surrender is accepted
Respondent n1ay not reapply for any license froin the Board for three years frOln the effective
date of the surrender Respondent shall meet all requireinents applicable to the license sought
as of the date the application for that license is sublnitted to the Board
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13 Notification of EmploymentMailing Address Change Respondent
shall notify the Board in writing within 10 days of any change of elnploYlnent Said
notification shall include the reasons for leaving andor the address of the new employer
supervisor or owner and work schedule if known Respondent shall notify the Board in
writing within 10 days of a change in natne In ailing address or phone nmnber
14 Tolling of Probation Should Respondent regardless of residency for
any reason cease practicing phannacy for a Ininimum of 40 hours per calendar Inonth in
Califon1ia Respondent Inust notify the Board in writing within 10 days of cessation of the
practice ofphannacy or the resuInption of the practice ofphannacy Such periods oftiIne
shall not apply to the reduction of the probation period It is a violation of probation for
Respondents probation to reinain tolled pursuant to the provisions of this condition for a
period exceeding three years
Cessation of practice Ineans any period of tin1e exceeding 30 days in which
Respondent is not engaged in the practice of phannacy as defined in Section 4052 of the
Business and Professions Code
15 Violation of Probation If Respondent violates probation in any
respect the Board after giving Respondent notice and an 0ppoliuni-ty fo be heard Ii1ay
revoke probation and carry out the disciplinary order which was stayed If a petition to revoke
probation or an accusation is filed against Respondent during probation the Board shall have
continuing jurisdiction and the period of probation shall be extended until the petition to
revoke probation or accusation is heard and decided
If R~spondent has not complied with any tenn or condition of probation the
Board shall have continuing jurisdiction over Respondent and probation shall autoinatically
be extended until all tenns and conditions have been satisfied or the Board has taken other
action as deelned appropriate to treat the failure to cOlnply as a violation of probation to
tenninate probation and to iinpose the penalty which was stayed
16 Completion of Probation Upon successful con1pletion of probation
Respondents license will be fully restored
I 0 D e r I 11 I YII 111 n u LU U O~ f J Jr IVIII
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17 No o anhip ofPreatHS Respondent shall not OWQ uwe any logal
or beneficial inttfe9t in~ or serve as 11 managcr~ administrator member offioer director
psociate or p~r ofany bUsiness fihJl plUtllersbip OJ corporation cu~tly or het~Dafter licensed by the Board Respondent shall sell or transfer poundiny Iega or twmeii cia inleret in any
entity licensfJd by the 80ard within 90 day follcwing the offective dat~ of this deciJion and
shall immediately tbereaftet ptovide written proofthereof to the BONd
AC(CJPTampNct
1havf1 carefully read the ~bove Stipu181ed Settlement and Diseplinery Order
and hAve fully discussed it with my attorney Timothy lu1herford 1understand the stip)l1ation
rmd the effect it will have on my Original Phannaeisr License No 38852 1enter into thig
Stipulated ScttlentMt and Discipl~aty Order voluntarilY1 knoWingly and intelUSettly and
Dgree to be bOlnd by the Dech~i()n and cm1a ofthe SQard
DATEDJl- Lt - famp i
~Iwafnt 1hale read and fully discussed with Itesponclent VALElUE Gallano the lemu
and corulitio and other maIt~ conrained In the above 8tipul41eO S~lcmerU and rw DiseiplilWY Order 1approve its fonn ~d content
OATBD
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17 No Ownership of Premises Respondent shall not own have any legal
or beneficial interest in or serve as a Inanager adIninistrator Inember officer director
associate or patiner of any business finn patinership or corporation currently or hereinafter
licensed by the Board Respondent shall sell or transfer any legal or beneficial interest in any
entity licensed by the Board within 90 days following the effective date of this decision and
shall in1n1ediately thereafter provide written proof thereof to the Board
ACCEPTANCE
I have carefully read the ~bove Stipulated Settlelnent and Disciplinary Order
and have fully discussed it with Iny atton1ey Titnothy Rutherford I understand the stipulation
and the effect it will have on my Original Phannacist License No 38852 I enter into this
Stipulated Settlelnent and Disciplinary Order voluntarily la10wingly and intelligently and
agree to be bound by the Decision and Order of the Board
DATED
VALERIE GAURANO Respondent
I have read and fully discussed with Respondent VALERIE Gaurano the tenns
and conditions and other Inatters contained in the above Stipulated Settlel11ent and
Disciplinary Order I approve its fonn and content
DATED
TIMOTHY RUTHERFORD Attorney for Valerie Gaurano
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DOJ Matter ID SD2005800399
80 1 05464wpd
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ENDORSEMENT
The foregoing Stipulated Settlelnent and Disciplinary Order is hereby
respectfully sublnitted for consideration by the Board
DATED ~4 UJtJb BILL LOCKYER Atton1ey General of the State of California
Atton1eys for COlnplainant
BEFORE THE BOARD OF PHARMACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOME CARE PHARMACY Luis Gaurano president and Valerie Gaurano vice president and owners
Original Phanllacy Pennit No PHY 45192
VALERIE Gaurano 2051 Kristi COllli Fallbrook CA 92028
Original Phannacist License No RPH 38852
Respondent
Accusation No 2959
Citation No CT 2005-30007
OAH No L-2006070547
DECISION AND ORDER
The attached Stipulated Settlenlent and Disciplinary Order for Valerie Gaurano
is hereby adopted by the Board as its Decision in this Inatter
This Decision shall becOlne effective on February 21 2007
It is so 0 RD ERED __Jarr----u=ar=--y--22=-z~2~00~7---__
BOARD OF PHARMACY DEP ARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
By WILLIAM POWERS Board President
Exhibit A
Accusation No 2959
Citation No CT 2005-30007
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1
BILL LOCKyBR Attorney Genera of the State of CalifoTI1ia
JAIIES M LEDAKIS State Bar No 132645 Deputy AttoTI1ey General
CalifoTI1ia Depmin1ent of Justice 110 West A II Street Suite 1100 San Diego CA 92101
PO Box 85266 San Diego CA 92186-5266 Telephone 619-645-2105 Facsin1ile 619-645-2061
AttOTI1eys for COll1plainant
BEFORE THE BOARD OF PHARl1ACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOl1E CARE PHARMACY Luis Gaurano President and Valerie Gaurano Vice President and Owners
11711 Sterling Avenue Suite E Riverside CA 92503
Oliginal Phan11acy Pennit No PHY 45192
VALERIE GAURANO Pharmacist-in Charge at HOl1E CARE PI-IARMACY
2051 Krist1 Ct FallBrook CA 92028
Original Phanl1acist License No RPH 38852
ANNE R CABRERA Pharmacist-in-Charge at I-IOME CARE PI-IARMACY
31921 Old Hickory Road Trabuco Canyon CA 92679
Origina] Pharn1acist Ljcense No RPH 40776
Respondents
Case No 2959
OAHNo
ACCUSATION
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C0111plainant alleges
PARTIES
1 (Co111plail1ant) Patricia p Banis brings this Accusation solely in her
official capacity as tIle Executive Offlcer for the Califonlia State Board of Ph an11ElCY Department
of Consul11er Affairs
2 On or about April 252001 the Board ofPharnlacy issued Original
Pban11acy Pernlit NL111lber PEY 45192 to Residential Care Honle For You Inc dba Honle
Care Phanl1Clcy The license Nil] expire on April 1 2006 unless renewed
3 On or about August 23 1984 the Board of Phan1lacy issued Original
Phanl1acist license nq 38852 to Valerie Reyes Gaurano aka Va]elie Arme Abani1 Reyes Sbe
was the phanl1acist in charge at HOlvlE CARE PHARlvlACY froll1 IvIarch26 2004 through
August 23 2004 Her license will expire on April 1 2006 unless renewed
4 On or about March 17 1986 the Board of Phanl1acy issued Oliginal
Pharmacist license no 40776 to Am1e Roberto Cabrera She was the phanl1acist in charge at
HOIvIE CARE PHARlvlACY froll1 August 23 2004 to the present Her license vvi11 expire on
ILl1y 31 ( 2096 unless renewed
JURISDICTION
5 This Accusation is brought before the California State Board of Phm111acy
(Board) Depmin1ent of COnSU111er Affairs under the authority of the following laws AlJ section
references are to the Business and Professions Code unless otherwise indicated
6 Section 4059 (a) of the Code states in pertinent part that a person l1lay not
furnisl1 any dangerous drug except upon t11e prescription of a pl1ysician dentist podiat1ist
opton1ehist or veterinarian A person n1ay not fUr11is11 any dangerous device except llpon the
prescription of a pbyslcian dentist podiatrist opt0111etrist or veterinarian
7 Section 4070 (a) of tbe Code entitl ed Oral or electroni c data trans111issl011
prescripbon reduction to writing states Except as provided in Section 4019 and subdivision (b)
an ora1 or an electronic data tra118111issio11 prescription as defined in subdivision (c) of Section
4040 shal1 as soon as practicab1e be reduced to writing by the phanl1aclst and sha1] be filled by
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or under the direction of the phar111acist The phanl1acist need n01 reduce to ~lri1ing the address
telephone l1U111ber license classification federal registry nU111ber of the prescriber or the address
of the patj ent or pati ents if the infor111ation is readily retrievable in tbe pharn1ucy
Section 4081 of the Code states
(a) All records of 111anufacture and of sale acquisition or disposition of dangerous drugs or dangerous devices shal1 be at al] tinles during business hours open 10 inspection by authorized officers oft11e ImN and shall be preserved for at least three years frOlTI the date of l11aking A CUlTent inventory shall be kept by every 111cmufacturer vholesaler phan111lcy veterinary food-anin1al drug retaileT physician dentist podiatrist veterinarian laboratory clinic hospital institution or establish111ent holding a currently valid andmuevoked certificate license pen11it registration or exe111ption under Division 2 (co111111encing with Section 1200) of the Health and Safety Code or under Part 4 (conlnlencing Nith Section 16000) of Division 9 of the Welfare and Institutions Code who 111aintains a stock of dangerous drugs or dangerous devices
(b) The owner officer and pminer of any phanl1acy wholesaler or veterinary food-ani111al dnlg retailer shall be jointly responsible witl1 the phannacist-in-charge or exenlptee for n1aintaining the records and inventory described in this section
(c) The phan11acist-in-charge or exen1ptee shall not be crin1inally responsible for acts of the owner officer partner or en1ployee that violate this section and of vlhich the phanl1acist-in-charge or exen1ptee had no knowledge or in which he or she did not lQl0wingly participate
9 Section 4105 of the Code states
(a) All records or other dOCUlTIentation of the acquisition and disposjtion of dangerous dnlgB and dangerous devices by any entity liGen_~ed by the bQard sha11 be retained on the licensed prenlises in a readily retrievable fOD11
(b) The l1censee 111ay ielTIOVe the original records or docun1entation fro111 the licensed pre111ises on a tell1porary basis for license-related PU1lJoses Hovever a duplicate set of those records Of other docu111entation shan be retained on the licensed pren11ses
(c) The records reqllired by this section shall be retained on the 1icensed prenlises for a period oftlu-ee years fro111 the date of 111aking
(c1) Any records that are ll1aintained el ectronicany shall be ll1aintained so that the pharn1acist-in-charge the pha1111acist on duty if tIl e pharmacist-in-charge is not on duty or in the case of a veterinary food-anin1al drug retailer or wholesa1er the exenlptee sha1l at all tillles during which the licensed pren1ises are open for business be able to produce a hard copy and electronic copy of al] records of aCClllisition or disposition or otber drug or dispensing-related records nluintained electronical1y
(e)(l) Notwithstanding subdivisions (a) (b) and (c) the board nlaY upon written request grant to a licensee a waiver of the requirenlents that tl1e records described in subdivisions (a) (b) and (c) be kept on the licensed ])reJl1ises
(2) A waiver granted pursuant to tbis sllbdi-vislol1 shal] not affect tl1e boards authority under this section or any otber provision of this c11apter
10 Section 4301 of the Code states
The board s11al1 take action against any holder of a license who is b1l1i1ty of unprofessional conduct or whose l1cense has been procured by fraud or J11isrepresentation or issued by n1istake Unprofessional conduct shal] include but is not linlited to any of
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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13 Notification of EmploymentMailing Address Change Respondent
shall notify the Board in writing within 10 days of any change of elnploYlnent Said
notification shall include the reasons for leaving andor the address of the new employer
supervisor or owner and work schedule if known Respondent shall notify the Board in
writing within 10 days of a change in natne In ailing address or phone nmnber
14 Tolling of Probation Should Respondent regardless of residency for
any reason cease practicing phannacy for a Ininimum of 40 hours per calendar Inonth in
Califon1ia Respondent Inust notify the Board in writing within 10 days of cessation of the
practice ofphannacy or the resuInption of the practice ofphannacy Such periods oftiIne
shall not apply to the reduction of the probation period It is a violation of probation for
Respondents probation to reinain tolled pursuant to the provisions of this condition for a
period exceeding three years
Cessation of practice Ineans any period of tin1e exceeding 30 days in which
Respondent is not engaged in the practice of phannacy as defined in Section 4052 of the
Business and Professions Code
15 Violation of Probation If Respondent violates probation in any
respect the Board after giving Respondent notice and an 0ppoliuni-ty fo be heard Ii1ay
revoke probation and carry out the disciplinary order which was stayed If a petition to revoke
probation or an accusation is filed against Respondent during probation the Board shall have
continuing jurisdiction and the period of probation shall be extended until the petition to
revoke probation or accusation is heard and decided
If R~spondent has not complied with any tenn or condition of probation the
Board shall have continuing jurisdiction over Respondent and probation shall autoinatically
be extended until all tenns and conditions have been satisfied or the Board has taken other
action as deelned appropriate to treat the failure to cOlnply as a violation of probation to
tenninate probation and to iinpose the penalty which was stayed
16 Completion of Probation Upon successful con1pletion of probation
Respondents license will be fully restored
I 0 D e r I 11 I YII 111 n u LU U O~ f J Jr IVIII
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17 No o anhip ofPreatHS Respondent shall not OWQ uwe any logal
or beneficial inttfe9t in~ or serve as 11 managcr~ administrator member offioer director
psociate or p~r ofany bUsiness fihJl plUtllersbip OJ corporation cu~tly or het~Dafter licensed by the Board Respondent shall sell or transfer poundiny Iega or twmeii cia inleret in any
entity licensfJd by the 80ard within 90 day follcwing the offective dat~ of this deciJion and
shall immediately tbereaftet ptovide written proofthereof to the BONd
AC(CJPTampNct
1havf1 carefully read the ~bove Stipu181ed Settlement and Diseplinery Order
and hAve fully discussed it with my attorney Timothy lu1herford 1understand the stip)l1ation
rmd the effect it will have on my Original Phannaeisr License No 38852 1enter into thig
Stipulated ScttlentMt and Discipl~aty Order voluntarilY1 knoWingly and intelUSettly and
Dgree to be bOlnd by the Dech~i()n and cm1a ofthe SQard
DATEDJl- Lt - famp i
~Iwafnt 1hale read and fully discussed with Itesponclent VALElUE Gallano the lemu
and corulitio and other maIt~ conrained In the above 8tipul41eO S~lcmerU and rw DiseiplilWY Order 1approve its fonn ~d content
OATBD
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17 No Ownership of Premises Respondent shall not own have any legal
or beneficial interest in or serve as a Inanager adIninistrator Inember officer director
associate or patiner of any business finn patinership or corporation currently or hereinafter
licensed by the Board Respondent shall sell or transfer any legal or beneficial interest in any
entity licensed by the Board within 90 days following the effective date of this decision and
shall in1n1ediately thereafter provide written proof thereof to the Board
ACCEPTANCE
I have carefully read the ~bove Stipulated Settlelnent and Disciplinary Order
and have fully discussed it with Iny atton1ey Titnothy Rutherford I understand the stipulation
and the effect it will have on my Original Phannacist License No 38852 I enter into this
Stipulated Settlelnent and Disciplinary Order voluntarily la10wingly and intelligently and
agree to be bound by the Decision and Order of the Board
DATED
VALERIE GAURANO Respondent
I have read and fully discussed with Respondent VALERIE Gaurano the tenns
and conditions and other Inatters contained in the above Stipulated Settlel11ent and
Disciplinary Order I approve its fonn and content
DATED
TIMOTHY RUTHERFORD Attorney for Valerie Gaurano
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DOJ Matter ID SD2005800399
80 1 05464wpd
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ENDORSEMENT
The foregoing Stipulated Settlelnent and Disciplinary Order is hereby
respectfully sublnitted for consideration by the Board
DATED ~4 UJtJb BILL LOCKYER Atton1ey General of the State of California
Atton1eys for COlnplainant
BEFORE THE BOARD OF PHARMACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOME CARE PHARMACY Luis Gaurano president and Valerie Gaurano vice president and owners
Original Phanllacy Pennit No PHY 45192
VALERIE Gaurano 2051 Kristi COllli Fallbrook CA 92028
Original Phannacist License No RPH 38852
Respondent
Accusation No 2959
Citation No CT 2005-30007
OAH No L-2006070547
DECISION AND ORDER
The attached Stipulated Settlenlent and Disciplinary Order for Valerie Gaurano
is hereby adopted by the Board as its Decision in this Inatter
This Decision shall becOlne effective on February 21 2007
It is so 0 RD ERED __Jarr----u=ar=--y--22=-z~2~00~7---__
BOARD OF PHARMACY DEP ARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
By WILLIAM POWERS Board President
Exhibit A
Accusation No 2959
Citation No CT 2005-30007
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1
BILL LOCKyBR Attorney Genera of the State of CalifoTI1ia
JAIIES M LEDAKIS State Bar No 132645 Deputy AttoTI1ey General
CalifoTI1ia Depmin1ent of Justice 110 West A II Street Suite 1100 San Diego CA 92101
PO Box 85266 San Diego CA 92186-5266 Telephone 619-645-2105 Facsin1ile 619-645-2061
AttOTI1eys for COll1plainant
BEFORE THE BOARD OF PHARl1ACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOl1E CARE PHARMACY Luis Gaurano President and Valerie Gaurano Vice President and Owners
11711 Sterling Avenue Suite E Riverside CA 92503
Oliginal Phan11acy Pennit No PHY 45192
VALERIE GAURANO Pharmacist-in Charge at HOl1E CARE PI-IARMACY
2051 Krist1 Ct FallBrook CA 92028
Original Phanl1acist License No RPH 38852
ANNE R CABRERA Pharmacist-in-Charge at I-IOME CARE PI-IARMACY
31921 Old Hickory Road Trabuco Canyon CA 92679
Origina] Pharn1acist Ljcense No RPH 40776
Respondents
Case No 2959
OAHNo
ACCUSATION
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C0111plainant alleges
PARTIES
1 (Co111plail1ant) Patricia p Banis brings this Accusation solely in her
official capacity as tIle Executive Offlcer for the Califonlia State Board of Ph an11ElCY Department
of Consul11er Affairs
2 On or about April 252001 the Board ofPharnlacy issued Original
Pban11acy Pernlit NL111lber PEY 45192 to Residential Care Honle For You Inc dba Honle
Care Phanl1Clcy The license Nil] expire on April 1 2006 unless renewed
3 On or about August 23 1984 the Board of Phan1lacy issued Original
Phanl1acist license nq 38852 to Valerie Reyes Gaurano aka Va]elie Arme Abani1 Reyes Sbe
was the phanl1acist in charge at HOlvlE CARE PHARlvlACY froll1 IvIarch26 2004 through
August 23 2004 Her license will expire on April 1 2006 unless renewed
4 On or about March 17 1986 the Board of Phanl1acy issued Oliginal
Pharmacist license no 40776 to Am1e Roberto Cabrera She was the phanl1acist in charge at
HOIvIE CARE PHARlvlACY froll1 August 23 2004 to the present Her license vvi11 expire on
ILl1y 31 ( 2096 unless renewed
JURISDICTION
5 This Accusation is brought before the California State Board of Phm111acy
(Board) Depmin1ent of COnSU111er Affairs under the authority of the following laws AlJ section
references are to the Business and Professions Code unless otherwise indicated
6 Section 4059 (a) of the Code states in pertinent part that a person l1lay not
furnisl1 any dangerous drug except upon t11e prescription of a pl1ysician dentist podiat1ist
opton1ehist or veterinarian A person n1ay not fUr11is11 any dangerous device except llpon the
prescription of a pbyslcian dentist podiatrist opt0111etrist or veterinarian
7 Section 4070 (a) of tbe Code entitl ed Oral or electroni c data trans111issl011
prescripbon reduction to writing states Except as provided in Section 4019 and subdivision (b)
an ora1 or an electronic data tra118111issio11 prescription as defined in subdivision (c) of Section
4040 shal1 as soon as practicab1e be reduced to writing by the phanl1aclst and sha1] be filled by
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or under the direction of the phar111acist The phanl1acist need n01 reduce to ~lri1ing the address
telephone l1U111ber license classification federal registry nU111ber of the prescriber or the address
of the patj ent or pati ents if the infor111ation is readily retrievable in tbe pharn1ucy
Section 4081 of the Code states
(a) All records of 111anufacture and of sale acquisition or disposition of dangerous drugs or dangerous devices shal1 be at al] tinles during business hours open 10 inspection by authorized officers oft11e ImN and shall be preserved for at least three years frOlTI the date of l11aking A CUlTent inventory shall be kept by every 111cmufacturer vholesaler phan111lcy veterinary food-anin1al drug retaileT physician dentist podiatrist veterinarian laboratory clinic hospital institution or establish111ent holding a currently valid andmuevoked certificate license pen11it registration or exe111ption under Division 2 (co111111encing with Section 1200) of the Health and Safety Code or under Part 4 (conlnlencing Nith Section 16000) of Division 9 of the Welfare and Institutions Code who 111aintains a stock of dangerous drugs or dangerous devices
(b) The owner officer and pminer of any phanl1acy wholesaler or veterinary food-ani111al dnlg retailer shall be jointly responsible witl1 the phannacist-in-charge or exenlptee for n1aintaining the records and inventory described in this section
(c) The phan11acist-in-charge or exen1ptee shall not be crin1inally responsible for acts of the owner officer partner or en1ployee that violate this section and of vlhich the phanl1acist-in-charge or exen1ptee had no knowledge or in which he or she did not lQl0wingly participate
9 Section 4105 of the Code states
(a) All records or other dOCUlTIentation of the acquisition and disposjtion of dangerous dnlgB and dangerous devices by any entity liGen_~ed by the bQard sha11 be retained on the licensed prenlises in a readily retrievable fOD11
(b) The l1censee 111ay ielTIOVe the original records or docun1entation fro111 the licensed pre111ises on a tell1porary basis for license-related PU1lJoses Hovever a duplicate set of those records Of other docu111entation shan be retained on the licensed pren11ses
(c) The records reqllired by this section shall be retained on the 1icensed prenlises for a period oftlu-ee years fro111 the date of 111aking
(c1) Any records that are ll1aintained el ectronicany shall be ll1aintained so that the pharn1acist-in-charge the pha1111acist on duty if tIl e pharmacist-in-charge is not on duty or in the case of a veterinary food-anin1al drug retailer or wholesa1er the exenlptee sha1l at all tillles during which the licensed pren1ises are open for business be able to produce a hard copy and electronic copy of al] records of aCClllisition or disposition or otber drug or dispensing-related records nluintained electronical1y
(e)(l) Notwithstanding subdivisions (a) (b) and (c) the board nlaY upon written request grant to a licensee a waiver of the requirenlents that tl1e records described in subdivisions (a) (b) and (c) be kept on the licensed ])reJl1ises
(2) A waiver granted pursuant to tbis sllbdi-vislol1 shal] not affect tl1e boards authority under this section or any otber provision of this c11apter
10 Section 4301 of the Code states
The board s11al1 take action against any holder of a license who is b1l1i1ty of unprofessional conduct or whose l1cense has been procured by fraud or J11isrepresentation or issued by n1istake Unprofessional conduct shal] include but is not linlited to any of
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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17 No o anhip ofPreatHS Respondent shall not OWQ uwe any logal
or beneficial inttfe9t in~ or serve as 11 managcr~ administrator member offioer director
psociate or p~r ofany bUsiness fihJl plUtllersbip OJ corporation cu~tly or het~Dafter licensed by the Board Respondent shall sell or transfer poundiny Iega or twmeii cia inleret in any
entity licensfJd by the 80ard within 90 day follcwing the offective dat~ of this deciJion and
shall immediately tbereaftet ptovide written proofthereof to the BONd
AC(CJPTampNct
1havf1 carefully read the ~bove Stipu181ed Settlement and Diseplinery Order
and hAve fully discussed it with my attorney Timothy lu1herford 1understand the stip)l1ation
rmd the effect it will have on my Original Phannaeisr License No 38852 1enter into thig
Stipulated ScttlentMt and Discipl~aty Order voluntarilY1 knoWingly and intelUSettly and
Dgree to be bOlnd by the Dech~i()n and cm1a ofthe SQard
DATEDJl- Lt - famp i
~Iwafnt 1hale read and fully discussed with Itesponclent VALElUE Gallano the lemu
and corulitio and other maIt~ conrained In the above 8tipul41eO S~lcmerU and rw DiseiplilWY Order 1approve its fonn ~d content
OATBD
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17 No Ownership of Premises Respondent shall not own have any legal
or beneficial interest in or serve as a Inanager adIninistrator Inember officer director
associate or patiner of any business finn patinership or corporation currently or hereinafter
licensed by the Board Respondent shall sell or transfer any legal or beneficial interest in any
entity licensed by the Board within 90 days following the effective date of this decision and
shall in1n1ediately thereafter provide written proof thereof to the Board
ACCEPTANCE
I have carefully read the ~bove Stipulated Settlelnent and Disciplinary Order
and have fully discussed it with Iny atton1ey Titnothy Rutherford I understand the stipulation
and the effect it will have on my Original Phannacist License No 38852 I enter into this
Stipulated Settlelnent and Disciplinary Order voluntarily la10wingly and intelligently and
agree to be bound by the Decision and Order of the Board
DATED
VALERIE GAURANO Respondent
I have read and fully discussed with Respondent VALERIE Gaurano the tenns
and conditions and other Inatters contained in the above Stipulated Settlel11ent and
Disciplinary Order I approve its fonn and content
DATED
TIMOTHY RUTHERFORD Attorney for Valerie Gaurano
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DOJ Matter ID SD2005800399
80 1 05464wpd
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ENDORSEMENT
The foregoing Stipulated Settlelnent and Disciplinary Order is hereby
respectfully sublnitted for consideration by the Board
DATED ~4 UJtJb BILL LOCKYER Atton1ey General of the State of California
Atton1eys for COlnplainant
BEFORE THE BOARD OF PHARMACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOME CARE PHARMACY Luis Gaurano president and Valerie Gaurano vice president and owners
Original Phanllacy Pennit No PHY 45192
VALERIE Gaurano 2051 Kristi COllli Fallbrook CA 92028
Original Phannacist License No RPH 38852
Respondent
Accusation No 2959
Citation No CT 2005-30007
OAH No L-2006070547
DECISION AND ORDER
The attached Stipulated Settlenlent and Disciplinary Order for Valerie Gaurano
is hereby adopted by the Board as its Decision in this Inatter
This Decision shall becOlne effective on February 21 2007
It is so 0 RD ERED __Jarr----u=ar=--y--22=-z~2~00~7---__
BOARD OF PHARMACY DEP ARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
By WILLIAM POWERS Board President
Exhibit A
Accusation No 2959
Citation No CT 2005-30007
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BILL LOCKyBR Attorney Genera of the State of CalifoTI1ia
JAIIES M LEDAKIS State Bar No 132645 Deputy AttoTI1ey General
CalifoTI1ia Depmin1ent of Justice 110 West A II Street Suite 1100 San Diego CA 92101
PO Box 85266 San Diego CA 92186-5266 Telephone 619-645-2105 Facsin1ile 619-645-2061
AttOTI1eys for COll1plainant
BEFORE THE BOARD OF PHARl1ACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOl1E CARE PHARMACY Luis Gaurano President and Valerie Gaurano Vice President and Owners
11711 Sterling Avenue Suite E Riverside CA 92503
Oliginal Phan11acy Pennit No PHY 45192
VALERIE GAURANO Pharmacist-in Charge at HOl1E CARE PI-IARMACY
2051 Krist1 Ct FallBrook CA 92028
Original Phanl1acist License No RPH 38852
ANNE R CABRERA Pharmacist-in-Charge at I-IOME CARE PI-IARMACY
31921 Old Hickory Road Trabuco Canyon CA 92679
Origina] Pharn1acist Ljcense No RPH 40776
Respondents
Case No 2959
OAHNo
ACCUSATION
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C0111plainant alleges
PARTIES
1 (Co111plail1ant) Patricia p Banis brings this Accusation solely in her
official capacity as tIle Executive Offlcer for the Califonlia State Board of Ph an11ElCY Department
of Consul11er Affairs
2 On or about April 252001 the Board ofPharnlacy issued Original
Pban11acy Pernlit NL111lber PEY 45192 to Residential Care Honle For You Inc dba Honle
Care Phanl1Clcy The license Nil] expire on April 1 2006 unless renewed
3 On or about August 23 1984 the Board of Phan1lacy issued Original
Phanl1acist license nq 38852 to Valerie Reyes Gaurano aka Va]elie Arme Abani1 Reyes Sbe
was the phanl1acist in charge at HOlvlE CARE PHARlvlACY froll1 IvIarch26 2004 through
August 23 2004 Her license will expire on April 1 2006 unless renewed
4 On or about March 17 1986 the Board of Phanl1acy issued Oliginal
Pharmacist license no 40776 to Am1e Roberto Cabrera She was the phanl1acist in charge at
HOIvIE CARE PHARlvlACY froll1 August 23 2004 to the present Her license vvi11 expire on
ILl1y 31 ( 2096 unless renewed
JURISDICTION
5 This Accusation is brought before the California State Board of Phm111acy
(Board) Depmin1ent of COnSU111er Affairs under the authority of the following laws AlJ section
references are to the Business and Professions Code unless otherwise indicated
6 Section 4059 (a) of the Code states in pertinent part that a person l1lay not
furnisl1 any dangerous drug except upon t11e prescription of a pl1ysician dentist podiat1ist
opton1ehist or veterinarian A person n1ay not fUr11is11 any dangerous device except llpon the
prescription of a pbyslcian dentist podiatrist opt0111etrist or veterinarian
7 Section 4070 (a) of tbe Code entitl ed Oral or electroni c data trans111issl011
prescripbon reduction to writing states Except as provided in Section 4019 and subdivision (b)
an ora1 or an electronic data tra118111issio11 prescription as defined in subdivision (c) of Section
4040 shal1 as soon as practicab1e be reduced to writing by the phanl1aclst and sha1] be filled by
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or under the direction of the phar111acist The phanl1acist need n01 reduce to ~lri1ing the address
telephone l1U111ber license classification federal registry nU111ber of the prescriber or the address
of the patj ent or pati ents if the infor111ation is readily retrievable in tbe pharn1ucy
Section 4081 of the Code states
(a) All records of 111anufacture and of sale acquisition or disposition of dangerous drugs or dangerous devices shal1 be at al] tinles during business hours open 10 inspection by authorized officers oft11e ImN and shall be preserved for at least three years frOlTI the date of l11aking A CUlTent inventory shall be kept by every 111cmufacturer vholesaler phan111lcy veterinary food-anin1al drug retaileT physician dentist podiatrist veterinarian laboratory clinic hospital institution or establish111ent holding a currently valid andmuevoked certificate license pen11it registration or exe111ption under Division 2 (co111111encing with Section 1200) of the Health and Safety Code or under Part 4 (conlnlencing Nith Section 16000) of Division 9 of the Welfare and Institutions Code who 111aintains a stock of dangerous drugs or dangerous devices
(b) The owner officer and pminer of any phanl1acy wholesaler or veterinary food-ani111al dnlg retailer shall be jointly responsible witl1 the phannacist-in-charge or exenlptee for n1aintaining the records and inventory described in this section
(c) The phan11acist-in-charge or exen1ptee shall not be crin1inally responsible for acts of the owner officer partner or en1ployee that violate this section and of vlhich the phanl1acist-in-charge or exen1ptee had no knowledge or in which he or she did not lQl0wingly participate
9 Section 4105 of the Code states
(a) All records or other dOCUlTIentation of the acquisition and disposjtion of dangerous dnlgB and dangerous devices by any entity liGen_~ed by the bQard sha11 be retained on the licensed prenlises in a readily retrievable fOD11
(b) The l1censee 111ay ielTIOVe the original records or docun1entation fro111 the licensed pre111ises on a tell1porary basis for license-related PU1lJoses Hovever a duplicate set of those records Of other docu111entation shan be retained on the licensed pren11ses
(c) The records reqllired by this section shall be retained on the 1icensed prenlises for a period oftlu-ee years fro111 the date of 111aking
(c1) Any records that are ll1aintained el ectronicany shall be ll1aintained so that the pharn1acist-in-charge the pha1111acist on duty if tIl e pharmacist-in-charge is not on duty or in the case of a veterinary food-anin1al drug retailer or wholesa1er the exenlptee sha1l at all tillles during which the licensed pren1ises are open for business be able to produce a hard copy and electronic copy of al] records of aCClllisition or disposition or otber drug or dispensing-related records nluintained electronical1y
(e)(l) Notwithstanding subdivisions (a) (b) and (c) the board nlaY upon written request grant to a licensee a waiver of the requirenlents that tl1e records described in subdivisions (a) (b) and (c) be kept on the licensed ])reJl1ises
(2) A waiver granted pursuant to tbis sllbdi-vislol1 shal] not affect tl1e boards authority under this section or any otber provision of this c11apter
10 Section 4301 of the Code states
The board s11al1 take action against any holder of a license who is b1l1i1ty of unprofessional conduct or whose l1cense has been procured by fraud or J11isrepresentation or issued by n1istake Unprofessional conduct shal] include but is not linlited to any of
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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17 No Ownership of Premises Respondent shall not own have any legal
or beneficial interest in or serve as a Inanager adIninistrator Inember officer director
associate or patiner of any business finn patinership or corporation currently or hereinafter
licensed by the Board Respondent shall sell or transfer any legal or beneficial interest in any
entity licensed by the Board within 90 days following the effective date of this decision and
shall in1n1ediately thereafter provide written proof thereof to the Board
ACCEPTANCE
I have carefully read the ~bove Stipulated Settlelnent and Disciplinary Order
and have fully discussed it with Iny atton1ey Titnothy Rutherford I understand the stipulation
and the effect it will have on my Original Phannacist License No 38852 I enter into this
Stipulated Settlelnent and Disciplinary Order voluntarily la10wingly and intelligently and
agree to be bound by the Decision and Order of the Board
DATED
VALERIE GAURANO Respondent
I have read and fully discussed with Respondent VALERIE Gaurano the tenns
and conditions and other Inatters contained in the above Stipulated Settlel11ent and
Disciplinary Order I approve its fonn and content
DATED
TIMOTHY RUTHERFORD Attorney for Valerie Gaurano
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DOJ Matter ID SD2005800399
80 1 05464wpd
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ENDORSEMENT
The foregoing Stipulated Settlelnent and Disciplinary Order is hereby
respectfully sublnitted for consideration by the Board
DATED ~4 UJtJb BILL LOCKYER Atton1ey General of the State of California
Atton1eys for COlnplainant
BEFORE THE BOARD OF PHARMACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOME CARE PHARMACY Luis Gaurano president and Valerie Gaurano vice president and owners
Original Phanllacy Pennit No PHY 45192
VALERIE Gaurano 2051 Kristi COllli Fallbrook CA 92028
Original Phannacist License No RPH 38852
Respondent
Accusation No 2959
Citation No CT 2005-30007
OAH No L-2006070547
DECISION AND ORDER
The attached Stipulated Settlenlent and Disciplinary Order for Valerie Gaurano
is hereby adopted by the Board as its Decision in this Inatter
This Decision shall becOlne effective on February 21 2007
It is so 0 RD ERED __Jarr----u=ar=--y--22=-z~2~00~7---__
BOARD OF PHARMACY DEP ARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
By WILLIAM POWERS Board President
Exhibit A
Accusation No 2959
Citation No CT 2005-30007
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1
BILL LOCKyBR Attorney Genera of the State of CalifoTI1ia
JAIIES M LEDAKIS State Bar No 132645 Deputy AttoTI1ey General
CalifoTI1ia Depmin1ent of Justice 110 West A II Street Suite 1100 San Diego CA 92101
PO Box 85266 San Diego CA 92186-5266 Telephone 619-645-2105 Facsin1ile 619-645-2061
AttOTI1eys for COll1plainant
BEFORE THE BOARD OF PHARl1ACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOl1E CARE PHARMACY Luis Gaurano President and Valerie Gaurano Vice President and Owners
11711 Sterling Avenue Suite E Riverside CA 92503
Oliginal Phan11acy Pennit No PHY 45192
VALERIE GAURANO Pharmacist-in Charge at HOl1E CARE PI-IARMACY
2051 Krist1 Ct FallBrook CA 92028
Original Phanl1acist License No RPH 38852
ANNE R CABRERA Pharmacist-in-Charge at I-IOME CARE PI-IARMACY
31921 Old Hickory Road Trabuco Canyon CA 92679
Origina] Pharn1acist Ljcense No RPH 40776
Respondents
Case No 2959
OAHNo
ACCUSATION
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C0111plainant alleges
PARTIES
1 (Co111plail1ant) Patricia p Banis brings this Accusation solely in her
official capacity as tIle Executive Offlcer for the Califonlia State Board of Ph an11ElCY Department
of Consul11er Affairs
2 On or about April 252001 the Board ofPharnlacy issued Original
Pban11acy Pernlit NL111lber PEY 45192 to Residential Care Honle For You Inc dba Honle
Care Phanl1Clcy The license Nil] expire on April 1 2006 unless renewed
3 On or about August 23 1984 the Board of Phan1lacy issued Original
Phanl1acist license nq 38852 to Valerie Reyes Gaurano aka Va]elie Arme Abani1 Reyes Sbe
was the phanl1acist in charge at HOlvlE CARE PHARlvlACY froll1 IvIarch26 2004 through
August 23 2004 Her license will expire on April 1 2006 unless renewed
4 On or about March 17 1986 the Board of Phanl1acy issued Oliginal
Pharmacist license no 40776 to Am1e Roberto Cabrera She was the phanl1acist in charge at
HOIvIE CARE PHARlvlACY froll1 August 23 2004 to the present Her license vvi11 expire on
ILl1y 31 ( 2096 unless renewed
JURISDICTION
5 This Accusation is brought before the California State Board of Phm111acy
(Board) Depmin1ent of COnSU111er Affairs under the authority of the following laws AlJ section
references are to the Business and Professions Code unless otherwise indicated
6 Section 4059 (a) of the Code states in pertinent part that a person l1lay not
furnisl1 any dangerous drug except upon t11e prescription of a pl1ysician dentist podiat1ist
opton1ehist or veterinarian A person n1ay not fUr11is11 any dangerous device except llpon the
prescription of a pbyslcian dentist podiatrist opt0111etrist or veterinarian
7 Section 4070 (a) of tbe Code entitl ed Oral or electroni c data trans111issl011
prescripbon reduction to writing states Except as provided in Section 4019 and subdivision (b)
an ora1 or an electronic data tra118111issio11 prescription as defined in subdivision (c) of Section
4040 shal1 as soon as practicab1e be reduced to writing by the phanl1aclst and sha1] be filled by
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or under the direction of the phar111acist The phanl1acist need n01 reduce to ~lri1ing the address
telephone l1U111ber license classification federal registry nU111ber of the prescriber or the address
of the patj ent or pati ents if the infor111ation is readily retrievable in tbe pharn1ucy
Section 4081 of the Code states
(a) All records of 111anufacture and of sale acquisition or disposition of dangerous drugs or dangerous devices shal1 be at al] tinles during business hours open 10 inspection by authorized officers oft11e ImN and shall be preserved for at least three years frOlTI the date of l11aking A CUlTent inventory shall be kept by every 111cmufacturer vholesaler phan111lcy veterinary food-anin1al drug retaileT physician dentist podiatrist veterinarian laboratory clinic hospital institution or establish111ent holding a currently valid andmuevoked certificate license pen11it registration or exe111ption under Division 2 (co111111encing with Section 1200) of the Health and Safety Code or under Part 4 (conlnlencing Nith Section 16000) of Division 9 of the Welfare and Institutions Code who 111aintains a stock of dangerous drugs or dangerous devices
(b) The owner officer and pminer of any phanl1acy wholesaler or veterinary food-ani111al dnlg retailer shall be jointly responsible witl1 the phannacist-in-charge or exenlptee for n1aintaining the records and inventory described in this section
(c) The phan11acist-in-charge or exen1ptee shall not be crin1inally responsible for acts of the owner officer partner or en1ployee that violate this section and of vlhich the phanl1acist-in-charge or exen1ptee had no knowledge or in which he or she did not lQl0wingly participate
9 Section 4105 of the Code states
(a) All records or other dOCUlTIentation of the acquisition and disposjtion of dangerous dnlgB and dangerous devices by any entity liGen_~ed by the bQard sha11 be retained on the licensed prenlises in a readily retrievable fOD11
(b) The l1censee 111ay ielTIOVe the original records or docun1entation fro111 the licensed pre111ises on a tell1porary basis for license-related PU1lJoses Hovever a duplicate set of those records Of other docu111entation shan be retained on the licensed pren11ses
(c) The records reqllired by this section shall be retained on the 1icensed prenlises for a period oftlu-ee years fro111 the date of 111aking
(c1) Any records that are ll1aintained el ectronicany shall be ll1aintained so that the pharn1acist-in-charge the pha1111acist on duty if tIl e pharmacist-in-charge is not on duty or in the case of a veterinary food-anin1al drug retailer or wholesa1er the exenlptee sha1l at all tillles during which the licensed pren1ises are open for business be able to produce a hard copy and electronic copy of al] records of aCClllisition or disposition or otber drug or dispensing-related records nluintained electronical1y
(e)(l) Notwithstanding subdivisions (a) (b) and (c) the board nlaY upon written request grant to a licensee a waiver of the requirenlents that tl1e records described in subdivisions (a) (b) and (c) be kept on the licensed ])reJl1ises
(2) A waiver granted pursuant to tbis sllbdi-vislol1 shal] not affect tl1e boards authority under this section or any otber provision of this c11apter
10 Section 4301 of the Code states
The board s11al1 take action against any holder of a license who is b1l1i1ty of unprofessional conduct or whose l1cense has been procured by fraud or J11isrepresentation or issued by n1istake Unprofessional conduct shal] include but is not linlited to any of
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
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forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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DOJ Matter ID SD2005800399
80 1 05464wpd
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ENDORSEMENT
The foregoing Stipulated Settlelnent and Disciplinary Order is hereby
respectfully sublnitted for consideration by the Board
DATED ~4 UJtJb BILL LOCKYER Atton1ey General of the State of California
Atton1eys for COlnplainant
BEFORE THE BOARD OF PHARMACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOME CARE PHARMACY Luis Gaurano president and Valerie Gaurano vice president and owners
Original Phanllacy Pennit No PHY 45192
VALERIE Gaurano 2051 Kristi COllli Fallbrook CA 92028
Original Phannacist License No RPH 38852
Respondent
Accusation No 2959
Citation No CT 2005-30007
OAH No L-2006070547
DECISION AND ORDER
The attached Stipulated Settlenlent and Disciplinary Order for Valerie Gaurano
is hereby adopted by the Board as its Decision in this Inatter
This Decision shall becOlne effective on February 21 2007
It is so 0 RD ERED __Jarr----u=ar=--y--22=-z~2~00~7---__
BOARD OF PHARMACY DEP ARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
By WILLIAM POWERS Board President
Exhibit A
Accusation No 2959
Citation No CT 2005-30007
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1
BILL LOCKyBR Attorney Genera of the State of CalifoTI1ia
JAIIES M LEDAKIS State Bar No 132645 Deputy AttoTI1ey General
CalifoTI1ia Depmin1ent of Justice 110 West A II Street Suite 1100 San Diego CA 92101
PO Box 85266 San Diego CA 92186-5266 Telephone 619-645-2105 Facsin1ile 619-645-2061
AttOTI1eys for COll1plainant
BEFORE THE BOARD OF PHARl1ACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOl1E CARE PHARMACY Luis Gaurano President and Valerie Gaurano Vice President and Owners
11711 Sterling Avenue Suite E Riverside CA 92503
Oliginal Phan11acy Pennit No PHY 45192
VALERIE GAURANO Pharmacist-in Charge at HOl1E CARE PI-IARMACY
2051 Krist1 Ct FallBrook CA 92028
Original Phanl1acist License No RPH 38852
ANNE R CABRERA Pharmacist-in-Charge at I-IOME CARE PI-IARMACY
31921 Old Hickory Road Trabuco Canyon CA 92679
Origina] Pharn1acist Ljcense No RPH 40776
Respondents
Case No 2959
OAHNo
ACCUSATION
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C0111plainant alleges
PARTIES
1 (Co111plail1ant) Patricia p Banis brings this Accusation solely in her
official capacity as tIle Executive Offlcer for the Califonlia State Board of Ph an11ElCY Department
of Consul11er Affairs
2 On or about April 252001 the Board ofPharnlacy issued Original
Pban11acy Pernlit NL111lber PEY 45192 to Residential Care Honle For You Inc dba Honle
Care Phanl1Clcy The license Nil] expire on April 1 2006 unless renewed
3 On or about August 23 1984 the Board of Phan1lacy issued Original
Phanl1acist license nq 38852 to Valerie Reyes Gaurano aka Va]elie Arme Abani1 Reyes Sbe
was the phanl1acist in charge at HOlvlE CARE PHARlvlACY froll1 IvIarch26 2004 through
August 23 2004 Her license will expire on April 1 2006 unless renewed
4 On or about March 17 1986 the Board of Phanl1acy issued Oliginal
Pharmacist license no 40776 to Am1e Roberto Cabrera She was the phanl1acist in charge at
HOIvIE CARE PHARlvlACY froll1 August 23 2004 to the present Her license vvi11 expire on
ILl1y 31 ( 2096 unless renewed
JURISDICTION
5 This Accusation is brought before the California State Board of Phm111acy
(Board) Depmin1ent of COnSU111er Affairs under the authority of the following laws AlJ section
references are to the Business and Professions Code unless otherwise indicated
6 Section 4059 (a) of the Code states in pertinent part that a person l1lay not
furnisl1 any dangerous drug except upon t11e prescription of a pl1ysician dentist podiat1ist
opton1ehist or veterinarian A person n1ay not fUr11is11 any dangerous device except llpon the
prescription of a pbyslcian dentist podiatrist opt0111etrist or veterinarian
7 Section 4070 (a) of tbe Code entitl ed Oral or electroni c data trans111issl011
prescripbon reduction to writing states Except as provided in Section 4019 and subdivision (b)
an ora1 or an electronic data tra118111issio11 prescription as defined in subdivision (c) of Section
4040 shal1 as soon as practicab1e be reduced to writing by the phanl1aclst and sha1] be filled by
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or under the direction of the phar111acist The phanl1acist need n01 reduce to ~lri1ing the address
telephone l1U111ber license classification federal registry nU111ber of the prescriber or the address
of the patj ent or pati ents if the infor111ation is readily retrievable in tbe pharn1ucy
Section 4081 of the Code states
(a) All records of 111anufacture and of sale acquisition or disposition of dangerous drugs or dangerous devices shal1 be at al] tinles during business hours open 10 inspection by authorized officers oft11e ImN and shall be preserved for at least three years frOlTI the date of l11aking A CUlTent inventory shall be kept by every 111cmufacturer vholesaler phan111lcy veterinary food-anin1al drug retaileT physician dentist podiatrist veterinarian laboratory clinic hospital institution or establish111ent holding a currently valid andmuevoked certificate license pen11it registration or exe111ption under Division 2 (co111111encing with Section 1200) of the Health and Safety Code or under Part 4 (conlnlencing Nith Section 16000) of Division 9 of the Welfare and Institutions Code who 111aintains a stock of dangerous drugs or dangerous devices
(b) The owner officer and pminer of any phanl1acy wholesaler or veterinary food-ani111al dnlg retailer shall be jointly responsible witl1 the phannacist-in-charge or exenlptee for n1aintaining the records and inventory described in this section
(c) The phan11acist-in-charge or exen1ptee shall not be crin1inally responsible for acts of the owner officer partner or en1ployee that violate this section and of vlhich the phanl1acist-in-charge or exen1ptee had no knowledge or in which he or she did not lQl0wingly participate
9 Section 4105 of the Code states
(a) All records or other dOCUlTIentation of the acquisition and disposjtion of dangerous dnlgB and dangerous devices by any entity liGen_~ed by the bQard sha11 be retained on the licensed prenlises in a readily retrievable fOD11
(b) The l1censee 111ay ielTIOVe the original records or docun1entation fro111 the licensed pre111ises on a tell1porary basis for license-related PU1lJoses Hovever a duplicate set of those records Of other docu111entation shan be retained on the licensed pren11ses
(c) The records reqllired by this section shall be retained on the 1icensed prenlises for a period oftlu-ee years fro111 the date of 111aking
(c1) Any records that are ll1aintained el ectronicany shall be ll1aintained so that the pharn1acist-in-charge the pha1111acist on duty if tIl e pharmacist-in-charge is not on duty or in the case of a veterinary food-anin1al drug retailer or wholesa1er the exenlptee sha1l at all tillles during which the licensed pren1ises are open for business be able to produce a hard copy and electronic copy of al] records of aCClllisition or disposition or otber drug or dispensing-related records nluintained electronical1y
(e)(l) Notwithstanding subdivisions (a) (b) and (c) the board nlaY upon written request grant to a licensee a waiver of the requirenlents that tl1e records described in subdivisions (a) (b) and (c) be kept on the licensed ])reJl1ises
(2) A waiver granted pursuant to tbis sllbdi-vislol1 shal] not affect tl1e boards authority under this section or any otber provision of this c11apter
10 Section 4301 of the Code states
The board s11al1 take action against any holder of a license who is b1l1i1ty of unprofessional conduct or whose l1cense has been procured by fraud or J11isrepresentation or issued by n1istake Unprofessional conduct shal] include but is not linlited to any of
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
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II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
BEFORE THE BOARD OF PHARMACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOME CARE PHARMACY Luis Gaurano president and Valerie Gaurano vice president and owners
Original Phanllacy Pennit No PHY 45192
VALERIE Gaurano 2051 Kristi COllli Fallbrook CA 92028
Original Phannacist License No RPH 38852
Respondent
Accusation No 2959
Citation No CT 2005-30007
OAH No L-2006070547
DECISION AND ORDER
The attached Stipulated Settlenlent and Disciplinary Order for Valerie Gaurano
is hereby adopted by the Board as its Decision in this Inatter
This Decision shall becOlne effective on February 21 2007
It is so 0 RD ERED __Jarr----u=ar=--y--22=-z~2~00~7---__
BOARD OF PHARMACY DEP ARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
By WILLIAM POWERS Board President
Exhibit A
Accusation No 2959
Citation No CT 2005-30007
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1
BILL LOCKyBR Attorney Genera of the State of CalifoTI1ia
JAIIES M LEDAKIS State Bar No 132645 Deputy AttoTI1ey General
CalifoTI1ia Depmin1ent of Justice 110 West A II Street Suite 1100 San Diego CA 92101
PO Box 85266 San Diego CA 92186-5266 Telephone 619-645-2105 Facsin1ile 619-645-2061
AttOTI1eys for COll1plainant
BEFORE THE BOARD OF PHARl1ACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOl1E CARE PHARMACY Luis Gaurano President and Valerie Gaurano Vice President and Owners
11711 Sterling Avenue Suite E Riverside CA 92503
Oliginal Phan11acy Pennit No PHY 45192
VALERIE GAURANO Pharmacist-in Charge at HOl1E CARE PI-IARMACY
2051 Krist1 Ct FallBrook CA 92028
Original Phanl1acist License No RPH 38852
ANNE R CABRERA Pharmacist-in-Charge at I-IOME CARE PI-IARMACY
31921 Old Hickory Road Trabuco Canyon CA 92679
Origina] Pharn1acist Ljcense No RPH 40776
Respondents
Case No 2959
OAHNo
ACCUSATION
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C0111plainant alleges
PARTIES
1 (Co111plail1ant) Patricia p Banis brings this Accusation solely in her
official capacity as tIle Executive Offlcer for the Califonlia State Board of Ph an11ElCY Department
of Consul11er Affairs
2 On or about April 252001 the Board ofPharnlacy issued Original
Pban11acy Pernlit NL111lber PEY 45192 to Residential Care Honle For You Inc dba Honle
Care Phanl1Clcy The license Nil] expire on April 1 2006 unless renewed
3 On or about August 23 1984 the Board of Phan1lacy issued Original
Phanl1acist license nq 38852 to Valerie Reyes Gaurano aka Va]elie Arme Abani1 Reyes Sbe
was the phanl1acist in charge at HOlvlE CARE PHARlvlACY froll1 IvIarch26 2004 through
August 23 2004 Her license will expire on April 1 2006 unless renewed
4 On or about March 17 1986 the Board of Phanl1acy issued Oliginal
Pharmacist license no 40776 to Am1e Roberto Cabrera She was the phanl1acist in charge at
HOIvIE CARE PHARlvlACY froll1 August 23 2004 to the present Her license vvi11 expire on
ILl1y 31 ( 2096 unless renewed
JURISDICTION
5 This Accusation is brought before the California State Board of Phm111acy
(Board) Depmin1ent of COnSU111er Affairs under the authority of the following laws AlJ section
references are to the Business and Professions Code unless otherwise indicated
6 Section 4059 (a) of the Code states in pertinent part that a person l1lay not
furnisl1 any dangerous drug except upon t11e prescription of a pl1ysician dentist podiat1ist
opton1ehist or veterinarian A person n1ay not fUr11is11 any dangerous device except llpon the
prescription of a pbyslcian dentist podiatrist opt0111etrist or veterinarian
7 Section 4070 (a) of tbe Code entitl ed Oral or electroni c data trans111issl011
prescripbon reduction to writing states Except as provided in Section 4019 and subdivision (b)
an ora1 or an electronic data tra118111issio11 prescription as defined in subdivision (c) of Section
4040 shal1 as soon as practicab1e be reduced to writing by the phanl1aclst and sha1] be filled by
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or under the direction of the phar111acist The phanl1acist need n01 reduce to ~lri1ing the address
telephone l1U111ber license classification federal registry nU111ber of the prescriber or the address
of the patj ent or pati ents if the infor111ation is readily retrievable in tbe pharn1ucy
Section 4081 of the Code states
(a) All records of 111anufacture and of sale acquisition or disposition of dangerous drugs or dangerous devices shal1 be at al] tinles during business hours open 10 inspection by authorized officers oft11e ImN and shall be preserved for at least three years frOlTI the date of l11aking A CUlTent inventory shall be kept by every 111cmufacturer vholesaler phan111lcy veterinary food-anin1al drug retaileT physician dentist podiatrist veterinarian laboratory clinic hospital institution or establish111ent holding a currently valid andmuevoked certificate license pen11it registration or exe111ption under Division 2 (co111111encing with Section 1200) of the Health and Safety Code or under Part 4 (conlnlencing Nith Section 16000) of Division 9 of the Welfare and Institutions Code who 111aintains a stock of dangerous drugs or dangerous devices
(b) The owner officer and pminer of any phanl1acy wholesaler or veterinary food-ani111al dnlg retailer shall be jointly responsible witl1 the phannacist-in-charge or exenlptee for n1aintaining the records and inventory described in this section
(c) The phan11acist-in-charge or exen1ptee shall not be crin1inally responsible for acts of the owner officer partner or en1ployee that violate this section and of vlhich the phanl1acist-in-charge or exen1ptee had no knowledge or in which he or she did not lQl0wingly participate
9 Section 4105 of the Code states
(a) All records or other dOCUlTIentation of the acquisition and disposjtion of dangerous dnlgB and dangerous devices by any entity liGen_~ed by the bQard sha11 be retained on the licensed prenlises in a readily retrievable fOD11
(b) The l1censee 111ay ielTIOVe the original records or docun1entation fro111 the licensed pre111ises on a tell1porary basis for license-related PU1lJoses Hovever a duplicate set of those records Of other docu111entation shan be retained on the licensed pren11ses
(c) The records reqllired by this section shall be retained on the 1icensed prenlises for a period oftlu-ee years fro111 the date of 111aking
(c1) Any records that are ll1aintained el ectronicany shall be ll1aintained so that the pharn1acist-in-charge the pha1111acist on duty if tIl e pharmacist-in-charge is not on duty or in the case of a veterinary food-anin1al drug retailer or wholesa1er the exenlptee sha1l at all tillles during which the licensed pren1ises are open for business be able to produce a hard copy and electronic copy of al] records of aCClllisition or disposition or otber drug or dispensing-related records nluintained electronical1y
(e)(l) Notwithstanding subdivisions (a) (b) and (c) the board nlaY upon written request grant to a licensee a waiver of the requirenlents that tl1e records described in subdivisions (a) (b) and (c) be kept on the licensed ])reJl1ises
(2) A waiver granted pursuant to tbis sllbdi-vislol1 shal] not affect tl1e boards authority under this section or any otber provision of this c11apter
10 Section 4301 of the Code states
The board s11al1 take action against any holder of a license who is b1l1i1ty of unprofessional conduct or whose l1cense has been procured by fraud or J11isrepresentation or issued by n1istake Unprofessional conduct shal] include but is not linlited to any of
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
Exhibit A
Accusation No 2959
Citation No CT 2005-30007
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1
BILL LOCKyBR Attorney Genera of the State of CalifoTI1ia
JAIIES M LEDAKIS State Bar No 132645 Deputy AttoTI1ey General
CalifoTI1ia Depmin1ent of Justice 110 West A II Street Suite 1100 San Diego CA 92101
PO Box 85266 San Diego CA 92186-5266 Telephone 619-645-2105 Facsin1ile 619-645-2061
AttOTI1eys for COll1plainant
BEFORE THE BOARD OF PHARl1ACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOl1E CARE PHARMACY Luis Gaurano President and Valerie Gaurano Vice President and Owners
11711 Sterling Avenue Suite E Riverside CA 92503
Oliginal Phan11acy Pennit No PHY 45192
VALERIE GAURANO Pharmacist-in Charge at HOl1E CARE PI-IARMACY
2051 Krist1 Ct FallBrook CA 92028
Original Phanl1acist License No RPH 38852
ANNE R CABRERA Pharmacist-in-Charge at I-IOME CARE PI-IARMACY
31921 Old Hickory Road Trabuco Canyon CA 92679
Origina] Pharn1acist Ljcense No RPH 40776
Respondents
Case No 2959
OAHNo
ACCUSATION
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C0111plainant alleges
PARTIES
1 (Co111plail1ant) Patricia p Banis brings this Accusation solely in her
official capacity as tIle Executive Offlcer for the Califonlia State Board of Ph an11ElCY Department
of Consul11er Affairs
2 On or about April 252001 the Board ofPharnlacy issued Original
Pban11acy Pernlit NL111lber PEY 45192 to Residential Care Honle For You Inc dba Honle
Care Phanl1Clcy The license Nil] expire on April 1 2006 unless renewed
3 On or about August 23 1984 the Board of Phan1lacy issued Original
Phanl1acist license nq 38852 to Valerie Reyes Gaurano aka Va]elie Arme Abani1 Reyes Sbe
was the phanl1acist in charge at HOlvlE CARE PHARlvlACY froll1 IvIarch26 2004 through
August 23 2004 Her license will expire on April 1 2006 unless renewed
4 On or about March 17 1986 the Board of Phanl1acy issued Oliginal
Pharmacist license no 40776 to Am1e Roberto Cabrera She was the phanl1acist in charge at
HOIvIE CARE PHARlvlACY froll1 August 23 2004 to the present Her license vvi11 expire on
ILl1y 31 ( 2096 unless renewed
JURISDICTION
5 This Accusation is brought before the California State Board of Phm111acy
(Board) Depmin1ent of COnSU111er Affairs under the authority of the following laws AlJ section
references are to the Business and Professions Code unless otherwise indicated
6 Section 4059 (a) of the Code states in pertinent part that a person l1lay not
furnisl1 any dangerous drug except upon t11e prescription of a pl1ysician dentist podiat1ist
opton1ehist or veterinarian A person n1ay not fUr11is11 any dangerous device except llpon the
prescription of a pbyslcian dentist podiatrist opt0111etrist or veterinarian
7 Section 4070 (a) of tbe Code entitl ed Oral or electroni c data trans111issl011
prescripbon reduction to writing states Except as provided in Section 4019 and subdivision (b)
an ora1 or an electronic data tra118111issio11 prescription as defined in subdivision (c) of Section
4040 shal1 as soon as practicab1e be reduced to writing by the phanl1aclst and sha1] be filled by
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or under the direction of the phar111acist The phanl1acist need n01 reduce to ~lri1ing the address
telephone l1U111ber license classification federal registry nU111ber of the prescriber or the address
of the patj ent or pati ents if the infor111ation is readily retrievable in tbe pharn1ucy
Section 4081 of the Code states
(a) All records of 111anufacture and of sale acquisition or disposition of dangerous drugs or dangerous devices shal1 be at al] tinles during business hours open 10 inspection by authorized officers oft11e ImN and shall be preserved for at least three years frOlTI the date of l11aking A CUlTent inventory shall be kept by every 111cmufacturer vholesaler phan111lcy veterinary food-anin1al drug retaileT physician dentist podiatrist veterinarian laboratory clinic hospital institution or establish111ent holding a currently valid andmuevoked certificate license pen11it registration or exe111ption under Division 2 (co111111encing with Section 1200) of the Health and Safety Code or under Part 4 (conlnlencing Nith Section 16000) of Division 9 of the Welfare and Institutions Code who 111aintains a stock of dangerous drugs or dangerous devices
(b) The owner officer and pminer of any phanl1acy wholesaler or veterinary food-ani111al dnlg retailer shall be jointly responsible witl1 the phannacist-in-charge or exenlptee for n1aintaining the records and inventory described in this section
(c) The phan11acist-in-charge or exen1ptee shall not be crin1inally responsible for acts of the owner officer partner or en1ployee that violate this section and of vlhich the phanl1acist-in-charge or exen1ptee had no knowledge or in which he or she did not lQl0wingly participate
9 Section 4105 of the Code states
(a) All records or other dOCUlTIentation of the acquisition and disposjtion of dangerous dnlgB and dangerous devices by any entity liGen_~ed by the bQard sha11 be retained on the licensed prenlises in a readily retrievable fOD11
(b) The l1censee 111ay ielTIOVe the original records or docun1entation fro111 the licensed pre111ises on a tell1porary basis for license-related PU1lJoses Hovever a duplicate set of those records Of other docu111entation shan be retained on the licensed pren11ses
(c) The records reqllired by this section shall be retained on the 1icensed prenlises for a period oftlu-ee years fro111 the date of 111aking
(c1) Any records that are ll1aintained el ectronicany shall be ll1aintained so that the pharn1acist-in-charge the pha1111acist on duty if tIl e pharmacist-in-charge is not on duty or in the case of a veterinary food-anin1al drug retailer or wholesa1er the exenlptee sha1l at all tillles during which the licensed pren1ises are open for business be able to produce a hard copy and electronic copy of al] records of aCClllisition or disposition or otber drug or dispensing-related records nluintained electronical1y
(e)(l) Notwithstanding subdivisions (a) (b) and (c) the board nlaY upon written request grant to a licensee a waiver of the requirenlents that tl1e records described in subdivisions (a) (b) and (c) be kept on the licensed ])reJl1ises
(2) A waiver granted pursuant to tbis sllbdi-vislol1 shal] not affect tl1e boards authority under this section or any otber provision of this c11apter
10 Section 4301 of the Code states
The board s11al1 take action against any holder of a license who is b1l1i1ty of unprofessional conduct or whose l1cense has been procured by fraud or J11isrepresentation or issued by n1istake Unprofessional conduct shal] include but is not linlited to any of
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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1
BILL LOCKyBR Attorney Genera of the State of CalifoTI1ia
JAIIES M LEDAKIS State Bar No 132645 Deputy AttoTI1ey General
CalifoTI1ia Depmin1ent of Justice 110 West A II Street Suite 1100 San Diego CA 92101
PO Box 85266 San Diego CA 92186-5266 Telephone 619-645-2105 Facsin1ile 619-645-2061
AttOTI1eys for COll1plainant
BEFORE THE BOARD OF PHARl1ACY
DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA
In the Matter of the Accusation Against
RESIDENTIAL CARE HOME FOR YOU INC dha HOl1E CARE PHARMACY Luis Gaurano President and Valerie Gaurano Vice President and Owners
11711 Sterling Avenue Suite E Riverside CA 92503
Oliginal Phan11acy Pennit No PHY 45192
VALERIE GAURANO Pharmacist-in Charge at HOl1E CARE PI-IARMACY
2051 Krist1 Ct FallBrook CA 92028
Original Phanl1acist License No RPH 38852
ANNE R CABRERA Pharmacist-in-Charge at I-IOME CARE PI-IARMACY
31921 Old Hickory Road Trabuco Canyon CA 92679
Origina] Pharn1acist Ljcense No RPH 40776
Respondents
Case No 2959
OAHNo
ACCUSATION
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C0111plainant alleges
PARTIES
1 (Co111plail1ant) Patricia p Banis brings this Accusation solely in her
official capacity as tIle Executive Offlcer for the Califonlia State Board of Ph an11ElCY Department
of Consul11er Affairs
2 On or about April 252001 the Board ofPharnlacy issued Original
Pban11acy Pernlit NL111lber PEY 45192 to Residential Care Honle For You Inc dba Honle
Care Phanl1Clcy The license Nil] expire on April 1 2006 unless renewed
3 On or about August 23 1984 the Board of Phan1lacy issued Original
Phanl1acist license nq 38852 to Valerie Reyes Gaurano aka Va]elie Arme Abani1 Reyes Sbe
was the phanl1acist in charge at HOlvlE CARE PHARlvlACY froll1 IvIarch26 2004 through
August 23 2004 Her license will expire on April 1 2006 unless renewed
4 On or about March 17 1986 the Board of Phanl1acy issued Oliginal
Pharmacist license no 40776 to Am1e Roberto Cabrera She was the phanl1acist in charge at
HOIvIE CARE PHARlvlACY froll1 August 23 2004 to the present Her license vvi11 expire on
ILl1y 31 ( 2096 unless renewed
JURISDICTION
5 This Accusation is brought before the California State Board of Phm111acy
(Board) Depmin1ent of COnSU111er Affairs under the authority of the following laws AlJ section
references are to the Business and Professions Code unless otherwise indicated
6 Section 4059 (a) of the Code states in pertinent part that a person l1lay not
furnisl1 any dangerous drug except upon t11e prescription of a pl1ysician dentist podiat1ist
opton1ehist or veterinarian A person n1ay not fUr11is11 any dangerous device except llpon the
prescription of a pbyslcian dentist podiatrist opt0111etrist or veterinarian
7 Section 4070 (a) of tbe Code entitl ed Oral or electroni c data trans111issl011
prescripbon reduction to writing states Except as provided in Section 4019 and subdivision (b)
an ora1 or an electronic data tra118111issio11 prescription as defined in subdivision (c) of Section
4040 shal1 as soon as practicab1e be reduced to writing by the phanl1aclst and sha1] be filled by
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or under the direction of the phar111acist The phanl1acist need n01 reduce to ~lri1ing the address
telephone l1U111ber license classification federal registry nU111ber of the prescriber or the address
of the patj ent or pati ents if the infor111ation is readily retrievable in tbe pharn1ucy
Section 4081 of the Code states
(a) All records of 111anufacture and of sale acquisition or disposition of dangerous drugs or dangerous devices shal1 be at al] tinles during business hours open 10 inspection by authorized officers oft11e ImN and shall be preserved for at least three years frOlTI the date of l11aking A CUlTent inventory shall be kept by every 111cmufacturer vholesaler phan111lcy veterinary food-anin1al drug retaileT physician dentist podiatrist veterinarian laboratory clinic hospital institution or establish111ent holding a currently valid andmuevoked certificate license pen11it registration or exe111ption under Division 2 (co111111encing with Section 1200) of the Health and Safety Code or under Part 4 (conlnlencing Nith Section 16000) of Division 9 of the Welfare and Institutions Code who 111aintains a stock of dangerous drugs or dangerous devices
(b) The owner officer and pminer of any phanl1acy wholesaler or veterinary food-ani111al dnlg retailer shall be jointly responsible witl1 the phannacist-in-charge or exenlptee for n1aintaining the records and inventory described in this section
(c) The phan11acist-in-charge or exen1ptee shall not be crin1inally responsible for acts of the owner officer partner or en1ployee that violate this section and of vlhich the phanl1acist-in-charge or exen1ptee had no knowledge or in which he or she did not lQl0wingly participate
9 Section 4105 of the Code states
(a) All records or other dOCUlTIentation of the acquisition and disposjtion of dangerous dnlgB and dangerous devices by any entity liGen_~ed by the bQard sha11 be retained on the licensed prenlises in a readily retrievable fOD11
(b) The l1censee 111ay ielTIOVe the original records or docun1entation fro111 the licensed pre111ises on a tell1porary basis for license-related PU1lJoses Hovever a duplicate set of those records Of other docu111entation shan be retained on the licensed pren11ses
(c) The records reqllired by this section shall be retained on the 1icensed prenlises for a period oftlu-ee years fro111 the date of 111aking
(c1) Any records that are ll1aintained el ectronicany shall be ll1aintained so that the pharn1acist-in-charge the pha1111acist on duty if tIl e pharmacist-in-charge is not on duty or in the case of a veterinary food-anin1al drug retailer or wholesa1er the exenlptee sha1l at all tillles during which the licensed pren1ises are open for business be able to produce a hard copy and electronic copy of al] records of aCClllisition or disposition or otber drug or dispensing-related records nluintained electronical1y
(e)(l) Notwithstanding subdivisions (a) (b) and (c) the board nlaY upon written request grant to a licensee a waiver of the requirenlents that tl1e records described in subdivisions (a) (b) and (c) be kept on the licensed ])reJl1ises
(2) A waiver granted pursuant to tbis sllbdi-vislol1 shal] not affect tl1e boards authority under this section or any otber provision of this c11apter
10 Section 4301 of the Code states
The board s11al1 take action against any holder of a license who is b1l1i1ty of unprofessional conduct or whose l1cense has been procured by fraud or J11isrepresentation or issued by n1istake Unprofessional conduct shal] include but is not linlited to any of
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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C0111plainant alleges
PARTIES
1 (Co111plail1ant) Patricia p Banis brings this Accusation solely in her
official capacity as tIle Executive Offlcer for the Califonlia State Board of Ph an11ElCY Department
of Consul11er Affairs
2 On or about April 252001 the Board ofPharnlacy issued Original
Pban11acy Pernlit NL111lber PEY 45192 to Residential Care Honle For You Inc dba Honle
Care Phanl1Clcy The license Nil] expire on April 1 2006 unless renewed
3 On or about August 23 1984 the Board of Phan1lacy issued Original
Phanl1acist license nq 38852 to Valerie Reyes Gaurano aka Va]elie Arme Abani1 Reyes Sbe
was the phanl1acist in charge at HOlvlE CARE PHARlvlACY froll1 IvIarch26 2004 through
August 23 2004 Her license will expire on April 1 2006 unless renewed
4 On or about March 17 1986 the Board of Phanl1acy issued Oliginal
Pharmacist license no 40776 to Am1e Roberto Cabrera She was the phanl1acist in charge at
HOIvIE CARE PHARlvlACY froll1 August 23 2004 to the present Her license vvi11 expire on
ILl1y 31 ( 2096 unless renewed
JURISDICTION
5 This Accusation is brought before the California State Board of Phm111acy
(Board) Depmin1ent of COnSU111er Affairs under the authority of the following laws AlJ section
references are to the Business and Professions Code unless otherwise indicated
6 Section 4059 (a) of the Code states in pertinent part that a person l1lay not
furnisl1 any dangerous drug except upon t11e prescription of a pl1ysician dentist podiat1ist
opton1ehist or veterinarian A person n1ay not fUr11is11 any dangerous device except llpon the
prescription of a pbyslcian dentist podiatrist opt0111etrist or veterinarian
7 Section 4070 (a) of tbe Code entitl ed Oral or electroni c data trans111issl011
prescripbon reduction to writing states Except as provided in Section 4019 and subdivision (b)
an ora1 or an electronic data tra118111issio11 prescription as defined in subdivision (c) of Section
4040 shal1 as soon as practicab1e be reduced to writing by the phanl1aclst and sha1] be filled by
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or under the direction of the phar111acist The phanl1acist need n01 reduce to ~lri1ing the address
telephone l1U111ber license classification federal registry nU111ber of the prescriber or the address
of the patj ent or pati ents if the infor111ation is readily retrievable in tbe pharn1ucy
Section 4081 of the Code states
(a) All records of 111anufacture and of sale acquisition or disposition of dangerous drugs or dangerous devices shal1 be at al] tinles during business hours open 10 inspection by authorized officers oft11e ImN and shall be preserved for at least three years frOlTI the date of l11aking A CUlTent inventory shall be kept by every 111cmufacturer vholesaler phan111lcy veterinary food-anin1al drug retaileT physician dentist podiatrist veterinarian laboratory clinic hospital institution or establish111ent holding a currently valid andmuevoked certificate license pen11it registration or exe111ption under Division 2 (co111111encing with Section 1200) of the Health and Safety Code or under Part 4 (conlnlencing Nith Section 16000) of Division 9 of the Welfare and Institutions Code who 111aintains a stock of dangerous drugs or dangerous devices
(b) The owner officer and pminer of any phanl1acy wholesaler or veterinary food-ani111al dnlg retailer shall be jointly responsible witl1 the phannacist-in-charge or exenlptee for n1aintaining the records and inventory described in this section
(c) The phan11acist-in-charge or exen1ptee shall not be crin1inally responsible for acts of the owner officer partner or en1ployee that violate this section and of vlhich the phanl1acist-in-charge or exen1ptee had no knowledge or in which he or she did not lQl0wingly participate
9 Section 4105 of the Code states
(a) All records or other dOCUlTIentation of the acquisition and disposjtion of dangerous dnlgB and dangerous devices by any entity liGen_~ed by the bQard sha11 be retained on the licensed prenlises in a readily retrievable fOD11
(b) The l1censee 111ay ielTIOVe the original records or docun1entation fro111 the licensed pre111ises on a tell1porary basis for license-related PU1lJoses Hovever a duplicate set of those records Of other docu111entation shan be retained on the licensed pren11ses
(c) The records reqllired by this section shall be retained on the 1icensed prenlises for a period oftlu-ee years fro111 the date of 111aking
(c1) Any records that are ll1aintained el ectronicany shall be ll1aintained so that the pharn1acist-in-charge the pha1111acist on duty if tIl e pharmacist-in-charge is not on duty or in the case of a veterinary food-anin1al drug retailer or wholesa1er the exenlptee sha1l at all tillles during which the licensed pren1ises are open for business be able to produce a hard copy and electronic copy of al] records of aCClllisition or disposition or otber drug or dispensing-related records nluintained electronical1y
(e)(l) Notwithstanding subdivisions (a) (b) and (c) the board nlaY upon written request grant to a licensee a waiver of the requirenlents that tl1e records described in subdivisions (a) (b) and (c) be kept on the licensed ])reJl1ises
(2) A waiver granted pursuant to tbis sllbdi-vislol1 shal] not affect tl1e boards authority under this section or any otber provision of this c11apter
10 Section 4301 of the Code states
The board s11al1 take action against any holder of a license who is b1l1i1ty of unprofessional conduct or whose l1cense has been procured by fraud or J11isrepresentation or issued by n1istake Unprofessional conduct shal] include but is not linlited to any of
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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or under the direction of the phar111acist The phanl1acist need n01 reduce to ~lri1ing the address
telephone l1U111ber license classification federal registry nU111ber of the prescriber or the address
of the patj ent or pati ents if the infor111ation is readily retrievable in tbe pharn1ucy
Section 4081 of the Code states
(a) All records of 111anufacture and of sale acquisition or disposition of dangerous drugs or dangerous devices shal1 be at al] tinles during business hours open 10 inspection by authorized officers oft11e ImN and shall be preserved for at least three years frOlTI the date of l11aking A CUlTent inventory shall be kept by every 111cmufacturer vholesaler phan111lcy veterinary food-anin1al drug retaileT physician dentist podiatrist veterinarian laboratory clinic hospital institution or establish111ent holding a currently valid andmuevoked certificate license pen11it registration or exe111ption under Division 2 (co111111encing with Section 1200) of the Health and Safety Code or under Part 4 (conlnlencing Nith Section 16000) of Division 9 of the Welfare and Institutions Code who 111aintains a stock of dangerous drugs or dangerous devices
(b) The owner officer and pminer of any phanl1acy wholesaler or veterinary food-ani111al dnlg retailer shall be jointly responsible witl1 the phannacist-in-charge or exenlptee for n1aintaining the records and inventory described in this section
(c) The phan11acist-in-charge or exen1ptee shall not be crin1inally responsible for acts of the owner officer partner or en1ployee that violate this section and of vlhich the phanl1acist-in-charge or exen1ptee had no knowledge or in which he or she did not lQl0wingly participate
9 Section 4105 of the Code states
(a) All records or other dOCUlTIentation of the acquisition and disposjtion of dangerous dnlgB and dangerous devices by any entity liGen_~ed by the bQard sha11 be retained on the licensed prenlises in a readily retrievable fOD11
(b) The l1censee 111ay ielTIOVe the original records or docun1entation fro111 the licensed pre111ises on a tell1porary basis for license-related PU1lJoses Hovever a duplicate set of those records Of other docu111entation shan be retained on the licensed pren11ses
(c) The records reqllired by this section shall be retained on the 1icensed prenlises for a period oftlu-ee years fro111 the date of 111aking
(c1) Any records that are ll1aintained el ectronicany shall be ll1aintained so that the pharn1acist-in-charge the pha1111acist on duty if tIl e pharmacist-in-charge is not on duty or in the case of a veterinary food-anin1al drug retailer or wholesa1er the exenlptee sha1l at all tillles during which the licensed pren1ises are open for business be able to produce a hard copy and electronic copy of al] records of aCClllisition or disposition or otber drug or dispensing-related records nluintained electronical1y
(e)(l) Notwithstanding subdivisions (a) (b) and (c) the board nlaY upon written request grant to a licensee a waiver of the requirenlents that tl1e records described in subdivisions (a) (b) and (c) be kept on the licensed ])reJl1ises
(2) A waiver granted pursuant to tbis sllbdi-vislol1 shal] not affect tl1e boards authority under this section or any otber provision of this c11apter
10 Section 4301 of the Code states
The board s11al1 take action against any holder of a license who is b1l1i1ty of unprofessional conduct or whose l1cense has been procured by fraud or J11isrepresentation or issued by n1istake Unprofessional conduct shal] include but is not linlited to any of
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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the fol1ovving
(c) Gross negligence U) The c0111111i8sion of any act involving 1110ra1 tUllJltude dishonesty
fraud deceit or COlTUptlOl1 vhether tbe ac1 is c01111Tlitted ill the course of relations as a bcensee or otherwise and Ihether tbe act is a felony or 111isde111eanor or 110t
(j) The violation of any of the statutes of this state or of the United States regllating contro11ed substances anc1 dangerous drugs
(0) Violating or atten1pting to violate directly or indirectly or assisting in or abetting the violation of or conspiring to violate any provision or tern1 of this chapter or of the applicable federal and state laws and regulations goven1ing pharmacy including regulabons established by the board
(q) Engaging in any conduct that subverts or atten1pts to subvert an investigation of the board
11 Section 4333 of the Code states in peliinent part that all prescliptions
filled by a pharn1acy and all other records required by Section 4081 shall be 111aintained on the
pre111ises and available for inspection by authorized officers of the law for a period of at least
tlTIee years In cases vhere the pha1111acy discontinues business these records shall be
lnaintained in a board-licensed facility for at 1east tluee years
12 0ection 48q states in pertinent pmi
(a) A board 111ay deny a license regulated by this code on the fjTonncls that the applicant has one of the following
(2) Done any act involving dishonesty fraud or deceit witb the intent to substantially benefit hin1self or another or substantially injure another or
(3) Done any act iVhi ch if done by a Ii centiate of the business or profession in qllestion would be grounds for suspension or revocation of license
13 SecUon J 18 subcbvision (b) oftbe Code provides that the
suspenslonexpirationsurrendercancel1atioll of a license shall not deplive tl1c Board of
jurisdiction to proceed vith a disciplinary acUoll during the period II1th1n which the license may
be rene~ed restored reissued or reinstated
14 Ca1ifornia Code of Regulations title 16 section] 7] 7 states
(c) Pr01l1pt]y upon receipt of an orally trans111itLed prescription the pharmacist shall reduce it to writing and initial it and jdentify it as an orally trallS111itted prescriptlon If the prescription is then dispensed by another phalll1aclst t11e dispensing
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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phanl1Clcisi shall also initial the prescription to identify hin1 or herself All orally transnlitted prescriptions shal1 be received and transcribed by EI
phan11acisi prior to C0111pounding) filling dispensing or fUI11ishing Chart orders as defined in Section 4019 of the Business and Professions
Code are not subject to the provis10ns o1thi8 subsection
15 California Code of Regulations section 17 J 5 enbtled Self-Assessment of
a Pbanl1acy by tbe Phanl1Clcist-in-Charge states
(a) The pbanl1Clcist-in-charge of each pharnlltcy as defined under section 4029 or section 4037 of the Business and Professions Code shal1 c0111plete a self-assessnlCnt of tbe pha1l11acys c0111pliance iVitb federa1 and state phCU111CJCY law The aSSeSS1Ylent s11a11 be perfol111ed before July 1 of every odd-l1l1111bered year The prinlary purpose of the self-assessll1ent is to proll10te C0111pliance through self-exanlination and education
(b) In addition to the self-assessll1ent required in subdivision (a) of this section the phanllacist-in-charge shall c0111plete a self-assess111ent ithin 30 days whenever
(1) A new phanl1acy peI111it has been issued or (2) There is a change in the phannacist-in-charge and he or she becoDles tbe new
phan11acist-in-charge of a phanl1acy (c) The cODlponents ofthi8 asseSS111ent shal1 be on Fonl1 17M-13 (Rev 105)
entitled Co1111nunity Phanl1acy amp Hospital Outpatient PhalTIlacy Self-Assessn1ent or Form 17M-14 (Rev 105) entitled Hospital Phannacy Self-Assessll1ent which are hereby incorporated by reference to evaluate cOll1pliance with federal and state laws and regulations
(d) Each se1f-assessl11ent shall be kept on file in the pharn1acy for thJee years afier it is perfonned
16 California Code of Regu1ations section 17931 states
Only a phan11acist or an intern pharn1acist acting under the supervision of a pballnacist ll1ay
(a) Receive E1 new prescriptioll order orally fro1l1 a prescriber or other persoll authorized by law
17 Tit1e 2] Code of Federal Regu1ations section 130411 (a) and c) states in
pali as fol1ows
(a) Genera1 rec]uirenlents Eacb inventory shaD contain a conlp1 ete and accurate recorel of al1 control] ed substances all band 011 tbe elate tbe inventory is taken and shall be 1l1aintained 1n wrHten typewritten or printed form at the registereellocation An inventory taken by use of an oral recording device 111USl be p1o111pOy transcribed Controlled substances shall be deen1ed to be on hand jf they are in the possession of or under the control of the registrant including substances retu1l1ed by a custoll1er ordered by a CustOJl1er but not yet invoiced stored in a warehouse on behalf of the registrant and substances in tIle possesslon of en1ployees of the registrant and intended for distrihLllion as conlplill1entary sanlples A separate inventory shal1 be nlade for eacb registered location and eacb independent activity registered except as provided in paragraph (e)( 4) of this section In the event controlled substances in the possession or under the control of the registrant are stored ai a location for whlcb heshe is not registered) tbe substances shall be included in the inventory of the registered location to whicll they are subject to contro] or to which the person possesslng the substance is responsible The inventory may
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
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916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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be taken either as of opening of business or as of the close of business on the inventory date and i1 shall be indicated on the inventory
(c) Bjennial inventory date Afier the initial inventory is taken the registrant shaD take a nev inventoTY of all stocks of controJ] ed substances on hand at least every two years The bi elulia1 inventory 1118Y be taken on any date vhi cll is within two years of the previous bielulial inventory date
FACTS
18 On July 232004 the Board filed an accusation against phanllElcist Cesar
Cabrera resulting fromiddotm his conviction for possession of dangerous drugs Following Cesar
CabreraS conviction and subsequent stipulated settlenlent the Board placed Cabrera 011 Dve
years probation ordered hi111 to serve 90 days suspension and to enter the Phanl1acists Recovery
Pro graIn Cabreras sLlspensi on was to be served fTon1 11arch 5 2005 througb June 4 2005
19 On March 8 2005 Cabrera nlet with the Inspector KJlight as part of a
probation conference to go over the conditions of his probation Cabrera ac1ul0Nledged that he
was suspended for 90 days that he could not be elnployed where a relative was el11ployed and
that he had to c0111plete the paper work to get prior approval for a vork site 1110nito1 in order to
work at a phanl1acy Cabrera was e111ployed at H0111e Care PhanTlacy where his wife AIUle R
Cabrera was the phanl1acist in charge Cablera signeda declaration that he understood the ten11s
of his probation and suspensio11
20 On J1ay 25 2005 Nlaxin1us representatjve Don Fenster111aI1 the ll1anager
for tbe Pharnlacists Recovery Probrram (PRP) 111et with Cabrera and discussed the tenns of the
phan11acists recovery progranl treatInent contract witb him Thereafier on JLlne 10 2005
Cabrera signed the contract and agreed to be bound by tbe tenl1S and conc1jtions
21 The fol1owing are S0111e of the pertinent conditions of PRP recovery
progran1 that Cabrera contractua11y agreed to
A 11ot ork in a pharmacy middotwhere a fall11]Y member is enlp10yed or wbere a falllily nlenlber has a beneficial interest
B Be supervised 7500 of eacb vork veek by another phanl1acist C Not supervise others) act as a phannacisl in charge phan11acy ll1anager
or as a preceptor to inten1s or ne enlp1oyees D Understand thal11e could be tenl1inated from the probTmn for failure to
c01l1ply witb the contract Agree to abstain from the use of a)coflol and all other Inind altering
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
14
916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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drugs except as prescribed by Cl physician F AgTee to report all relCl])ses to Ivlaxinlus in1111ediately and to cease
practice upon relapse
22 On July 62005 lv1axinlus notiued the Board that CElbrerEl hus relapsed
and verbally suspended CElbrers from practicing pharmacy and told him to leave J-10111e Care
Pl1a1111acy vhere he was working ldaxin1LIS advised Cabrera that he had not completed the
work site Inonitor paper work that he did no1 have a work site 111011itor in place and thai he was
working at Houle Care Phannacy where his wife Anlle R Cabrera was the pharn1Clcist in charge
and bence he violated tbe tenl1S of his recovery progra111 J1axin1us notified Cabrera of the
aforenlentiollec1 violations in writing on July 62005 lvlaxinlus oTdered Cabrera to cease
practice and to enter into a residential inpatient chenlicaJ dependency treatnlcnt progranl on or
before July 132005 and to conlplete a 30 day treatulent
23 On July 12 2005 the Board condl1cted an inspection of the Honle Care
Phanllacy and d~scovered that Cabrera was the only phanl1acist on duty There were two
phanl1acy technicians a clerk and a ll1anager 11s Marian Rano vho was in her office next to
the phanl1acy
24 - _ The Board jnspector noted violatjolls at Ho~ne Care Phannacy that were
the direct responsibility of the phanl1acist in charge in this case Anl1e R CElbrera H0111e Care
Pbanl1acy phanl1acist in charge Al1Jle R Cabrera failed to 1)laintai11 a DEA inventory which
required a11 schedules to be faxed to the Board The phall11acist in charge a110wed a suspended
pharmacist to possess a key to the phanllC1cy The Phmll1Clcyphanl1acist in charge failed to
projde a current self asseSS111ent and fax it to the Board The phanl1Clcypharmacist in charge
al10wed ]vlr Cabrera to work at H01l1e Care Phanl1acy and fail ed to inc1l1cle tl1e initials of tIle
receiving pharmacist on all ora11y tranS1witted prescriptions The Phanl1acypharmacist in charge
fail ed to fax the required corrections to the Board as requested
25 On Ju]y 12 2005 tl1e pharnlacy inspector confhmted ]vlr Cabrera who
adnlitted that he knew that be was 1101 Sllpposed to be Ivorking because of the l1aximus
suspension Additiona] inspection of the prescriptions verdled that 1lr Cabrera had been filling
and dispensing prescriptions from at least July 8) 2005 througl1 July] 2 2005) as evidenced by
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
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1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
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FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
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disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
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FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
14
916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
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his initials IICC on the prescriptions lvir Cabrera adnlitted to having a key to the phannacy
The inspector told Iv1r Cabrera and the nlanager Marian Rano and a 111an representing himself
as the pending owner of the phaffi1acy Richard Lacson that Mr Cabrera could not have a key to
the phanl1acy and that he could not work as a phanl1acist at I-Ion1e Care Phannacy while on
suspensIon The inspector adInonished Mr Cabrera to stop working at the pharnlacy
26 On July 132005 Maxinlus notified the Board that Mr Cabrera had been
tenninated fr0111 the PRP for the following reasons
A Tested positive for alcohol on 6-27-05 and again on 7-05-05 B Retullled to work without a work site 111011itor agreelnent in place C Returned to work where a relative (wife Alule) also works D Failed to enter inpatient chenlical dependency treatment E Retunled to work after relapse F Returned to work after suspension by Maxinlus G Non cOlnpliance with his PRP contact
27 On July 132005 Maximus notified Mr Cabrera in writing that he was
tenninated fr01n the phannacist recovery prograrn On July 14 2005 the Board sent Mr Cabrera
a certified letter infonlling hin1 that his license was suspended due to his tenninatiol1 fro111 the
PRP as per his stipulated settlelnent and the decision of the Board The letter adInonished Mr
Cabrera that he was not allow~d to enter Ol~ work at any phannacy or have access to or control of -
controlled substances On July 20 2005 Mr Cabrera signed for receipt of the Boards celiified
letter placing hin1 011 disciplinary suspension
28 On October 6 2005 the Board conducted a follow up inspection at HOll1e
Care Phannacy Again Mr Cabrera was the only phan11acist on duty There was one technician
and a biller in the front office Again Iv1r Cabrera ad111itted to working but had no excuse for
vjolating his suspension hllposed by the both the Board and Maxin1us Mr Cabrera again had a
key to the phanllacy which he adnlitted to taking He also adn1itted to continuing working at
HOlne Care Phanl1acy after the Boards July 12 2005 inspecti011 in defiance of his suspension
29 On October 6 2005 the Boards inspection confinlled that none of the
prior July 12 2005 conections had been c01npleted For exan1ple there was no c0111pleted DEA
inventory no quality assurance and no CUlTent pharmacy self asseSSInent on the prenlises
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30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
9
2
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4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
10
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
] 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
-16
17
18
19
20
21
22
23
24
25
26
27
28
disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
12
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
] 3
5
10
15
20
25
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3
4
6
7
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SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
14
916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
30 The inspector asked 11r Cabrera to get his vvife (phall11acist in charge) on
the telephone for the inspector to speak with 11rs Cabrera denied receiving a copy of the
Boards prior July 12 2005 cOlTection notice She adnlitted to IG10wing that her husbands
license was suspended The inspector adnlonished Mrs Cabrera that her husband was suspended
and could not work and that he should not have a key to the phanl1acy vvhere she is the
phanl1acist in charge The inspector renlinded Mrs Cabrera that as the phanllacist in charge she
was responsible for cOl11pliance with all the rules and l~egulations pertaining to phanl1acy at
HODle Care Pharnlacy The inspector requested that Alule R Cabrera fax a conlpleted copy of
the cOlTections to her as soon as possible As ofNovenlber 42005 1v1rs Cabrera has not faxed
the cOlTections as requested
31 Following the te1ephone call to Mrs Cabrera the inspector continued to
look through prescliption evidence The inspector found and docUll1ented prescriptions filled by
Mr Cabrera during the til11e of the Board il11posed suspension on his license that is March 5
2005 through June 42005 Mr Cabrera initially denied working during the 90 suspension but
later admitted to the inspector that he had worked during the suspension period The prescription
dates filled by Mr Cabrera CC weJe fi~Qln _Ia11uary2~ 2005 tIllOugh October 6 200 which
confilm that he worked as a phan11acist after suspension fro111 the PRP Mr Cabrera adl11itted to
the inspector that he allowed technicians to receive and transClibe prescriptions vlhich is against
the Board regulations Mr Cabrera told the inspector that he was unaware of that regulation
32 The inspector asked Mr Cabrera for Honle Care Pharmacys recent dnlg
purchases Mr Cabrera staled that none of the invoices for the purchases were at the phanllElcy
as required by regulations but were at the house of a purported new owner Richard Lacsol1 The
inspector re111inded Mr Cabrera that all acquisition and disposition records had to be kept in the
phall11acy accessible to the Board
33 On October 25 2005 written letters were sent by the Board to the owners
and the phan11acist in charge notifying thenl of the violations found dUling the October
inspection
9
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
10
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
] 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
-16
17
18
19
20
21
22
23
24
25
26
27
28
disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
12
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
] 3
5
10
15
20
25
2
3
4
6
7
8
9
11
12
13
14
16
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18
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21
22
23
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26
27
28
SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
14
916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
1 Violations bv Residential Honle Care For You Inc dha Home Care Pharmacv its
o)vners Luis Gaurano and Valerie Gaurano license no RPH 38852 and Pharnlacist in
Charge hereinafter Bonle Care Pharmacy
FIRST CAUSE FOR DISCIPLINE
(No DEA Inventory)
34 Respondent BOl1le Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and Title 21 Code of Federal Regulations section 130411 (a) and c) for
failing to have a BimIDual DEA Inventory at H0111e Care Phan1lacy as set forth in paragraphs 18
tluough 33 above
SECOND CAUSE FOR DISCIPLINE
(No Phannacy Self Assesslnent)
35 Respondent Borne Care Phannacy is subject to disciplinary action under
section 4301 U) (0) and California Code of Regulations section 1715 for failing to have a CUlTent
pharnlacy self aSSeSSl1lent on the premises at Home Care Phannacy as set forth in paragraphs 18
through 33 above
THIRD CAUSE FOR DISCIPLINE - Q
(Phannacists Initials Readily Retrievable)
36 Respondent BOl1le Care Phan11acy is subject to disciplinary action under
section 4301 U) (0) and Califon11a Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescliptions readily available at HOl1le Care Phanl1acy upon
request by the Board as set forth i11 paragraphs 18 through 33 above
FOURTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prel11ises)
37 Respondent H011le Care Phanllacy is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have al] records of acquisition and
disposition of dangerous drugs on the prelnises of Hon1e Care Phan11acy upon request by the
Board as set fmih in paragraphs 18 through 33 above
10
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
] 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
-16
17
18
19
20
21
22
23
24
25
26
27
28
disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
12
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
] 3
5
10
15
20
25
2
3
4
6
7
8
9
11
12
13
14
16
17
18
19
21
22
23
24
26
27
28
SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
14
916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
FIFTH CAUSE FOR DISCIPLINE
(Failure to I-iave Quality Assurance PrObTf811l Records)
38 Respondent H011le Care Pharn1acy is subject to disciplinary action under
section 4125 and California Code of Regulatiolls section 1715 for failing to have the quality
assurance records at HOlne Care Phannacy available upon request by the Board as set forth in
paragraphs 18 througb 33 above
SIXTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
39 Respondent HOlne Care Phanl1acy is subj ect to disciplinary action under
section 4301 U) (0) 4070 and Califonlia Code of Regulations section 17931 (a) and 1 717 (c)
for allowing non-phanllacists to receive and transclibe orally translnitted prescriptions at HOlne
Care Phannacy as set forth in paragraphs 18 through 33 above
SEVENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phannacist to Work as Phannacist)
40 Respondent HOlne Care Phanl1acy is subject to disciplinary action under
section 4301 (c) (f) (0) and (q) for allowing phannacist C~saI~abrera to w~rk a~ HOIne Care
Pharnlacy while on suspension without regard to public health or safety as set fOlih in
paragraphs 18 tluough 33 above
EIGHTH CAUSE FOR DISCIPLINE
(Allowing Non-Phanl1acist to Receive Drug Orders)
41 Respondent HODle Care Phanl1acy is subj ect to disciplinary action under
section 4301 (j) (0) and 40595 (a) for allowing non-pharnlacists specifical1y pharnlacy
technicians to receive drug wholesale orders at Honle Care Phan11acy as set fmih in paragraphs
1 8 tluough 33 above
II Violations by Pharmacist-in-Charge Anne R Cabrera
NINTH CAUSE FOR DISCIPLINE
(No DEA Inventory)
42 Respondent Phannacist-in-Charge (PIC) Alme R Cabrera is subject to
] 1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
-16
17
18
19
20
21
22
23
24
25
26
27
28
disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
12
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
] 3
5
10
15
20
25
2
3
4
6
7
8
9
11
12
13
14
16
17
18
19
21
22
23
24
26
27
28
SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
14
916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
2
3
4
5
6
7
8
9
10
11
12
13
14
15
-16
17
18
19
20
21
22
23
24
25
26
27
28
disciplinary action under section 4301 (j) (0) and Title 21 Code of Federal Regulations section
] 304 11 (a) and c) for failing to have a Bimu1ual DEA Inventory at H011le Care Phannacy as set
forth in paragraphs 18 tIuough 33 above
TENTH CAUSE FOR DISCIPLINE
(No Phan11acy Self Assessnlent)
43 Respondent (PIC) Alu1e R Cabrera is subject to disciplinary action under
section 4301 U) (0) and Califoll1ia Code of Regulations section 1 715 for failing to have a current
phanllacy self asseSS111ent on the prenlises at H0111e Care Phall11acy as set forth in paragraphs 18
tluough 33 above
ELEVENTH CAUSE FOR DISCIPLINE
(PhalTI1acists Initials Readily Retrievable)
44 Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
section 4301 (j) (0) and Califoll1ia Code of Regulations section 1717 (c) for failing to have the
initials of the phannacist filling the prescriptions readily available at HOlne Care Phallnacy upon
request by the Board as set fOlih in paragraphs 18 through 33 above
TWELFTH CAUSE FOR DISCIPLINE
(Failure to have Records on Licensed Prelnises)
45 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4301 U) (0)4081 (a) 4105 and 4333 for failing to have all records of acquisition and
disposition of dangerous drugs on the pren1ises of HOlne Care Phallnacy upon request by the
Board as set forth in paragraphs 18 tluough 33 above
THIRTEENTH CAUSE FOR DISCIPLINE
(Failure to Have Quality Assurance Progran1 Records)
46 Respondent PIC Alu1e R Cabrera is subj ect to disciplinary action under
section 4125 and Califon1ia Code of Regulations section 1715 for failing to have the quality
assurance records at Hon1e Care Phan11acy available upon request by the Board as set fmih in
paragraphs 18 tIuough 33 above
12
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
] 3
5
10
15
20
25
2
3
4
6
7
8
9
11
12
13
14
16
17
18
19
21
22
23
24
26
27
28
SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
14
916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
FOURTEENTH CAUSE FOR D1SCIPLINE
(Allowing N on-Phannacist to Receive Drug Orders)
47 Respondent PIC Alu1e R Cabrera is subject to disciplinary action ll11der
section 4301 (j) (0) and 40595 (a) for allowing non-phan11acists specifical1y phan11acy
tecbnicians to receive drug wholesale orders at HOll1e Care Phannacy as set forth in paragraphs
18 tluough 33 above
FIFTEENTH CAUSE FOR DISCIPLINE
(Non-Phannacists Received and Transcribed Prescriptions)
48 Respondent PIC Alule R Cabrera is subject to disciplinary action under
section 4301 (j) (0) 40595 4070 (a) and CalifoD1ia Code of Regulations section 17931 (a) and
171 7 ( c) for allowing non-phannacists to receive and transcribe oral1y transnlitted prescriptions
at Honle Care Phanllacy as set fOlih in paragraphs 18 through 33 above
SIXTEENTH CAUSE FOR DISCIPLINE
(Allowing Suspended Phamlacist to Work as Phan11acist)
49middot Respondent PIC Alu1e R Cabrera is subject to disciplinary action under
sectfon 4301 (c)~f) (0) and (q) for allowingphannacist Cesar Cabrera to work atHo1)leCare
Pharnlacy while on suspension lArithout regard to public health or safety as set forth in
paragraphs 18 tluough 33 above
PRAYER
WHEREFORE COlnplainant requests that a hearing be held on the nlatters herein
alleged and that following the hearing the Board of Phanllacy issue a decision
1middot Revoking or suspending Original Phanl1acist License NU111ber RPH 38852
issued to VALERIE REYES GAURANO aka VALERIE ANNE ABANIL REYE owner and
vice president of Residential Care Honle For You Inc dba HOlne Care Phannacy
2 Revoking or suspending Original Phm111acy Pennlt NU111ber PHY 45192
issued to Residential Care Horne For You Inc dba HOlne Care Phan11acy
3 Revoking or suspending Origina1 Pbannacist License NU111ber RPH 40776
issued to Anne Robelio Cabrera
] 3
5
10
15
20
25
2
3
4
6
7
8
9
11
12
13
14
16
17
18
19
21
22
23
24
26
27
28
SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
14
916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
5
10
15
20
25
2
3
4
6
7
8
9
11
12
13
14
16
17
18
19
21
22
23
24
26
27
28
SD2005800399
ACCUSATION 4wpd
4 Ordering AIu1e Roberto Cabrera and or VALERIE GAURANO to pay the
Board of Phan11acy the reasonable costs of the investigation and enforcen1ent of this case
pursuant to Business and Professlons Code section 1253
5 Taking such other and ftuiher action as deen1ed necessary and proper
DATED +3 D~
P ahicia F HatTis Executive Officer Board of Phal1nacy Departll1entof Consul11er Affairs State of Califo111ia COlnplainant
14
916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy
916 57 SE 1= DEC-OB-200B 0944 C OARD (W PHARMACY
916574 8618 P001
BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS
STATE OF CALIFORNIA
CITATION AND FINE
Citation Number Name License No CI 2005 30007 Home Care Pharmacy PHY 45192
JURISDICTION 8us amp Prof Code sect 4005 CCR1 title 16 sect 1775 Bus amp Prof Code sect 4301 SUbd (0)
VIOLATION CODE SECTION OFFENSE AMT OF FINE
Furnishing Dangerous Drugs by PharmacyBus ampProf Code sect 41265 subd $8100000Authorized recipientsResale of PreferentiaUy(a)Bus amp Prof Code sect 4380
Priced Drugs Prohibition Exceptions Resale ofsubd (a)fTitle 15 USC sect 13 subd drugs acquired per Nonprofit Institutions(c)
ActDIscrimination in price services or facilities Payment or acceptance of commission brokerage
or other compensation
CONDUCT
During 2095 at Home Cre Pharmacy PHY 45192 while under the supervision of Pharmacist-In-Cnarge Anne Roberto Cabrera RPH 40776 in eighty-one transactions preferentially priced drugs were transferred to a wholesaler not authorized to receive the drugs from Home Care Pharmacy