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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374600026
Report Date: 04/15/2026
Date Signed: 04/15/2026 10:37:52 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/13/2023 and conducted by Evaluator Antonine Richard
COMPLAINT CONTROL NUMBER: 18-AS-20230413163957
FACILITY NAME:SILVERGATE SAN MARCOS RETIREMENT RESIDENCEFACILITY NUMBER:
374600026
ADMINISTRATOR:JOAN RINK-CARROLLFACILITY TYPE:
740
ADDRESS:1550/1560 SECURITY PLACETELEPHONE:
(760) 744-4484
CITY:SAN MARCOSSTATE: CAZIP CODE:
92078
CAPACITY:160CENSUS: 48DATE:
04/15/2026
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Joan Rink CarrollTIME COMPLETED:
10:37 AM
ALLEGATION(S):
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Facility staff member who is not an appropriately skilled professional removed a fecal impaction from a resident.
INVESTIGATION FINDINGS:
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On April 15, 2026, the California Department of Social Services/Community Care Licensing (CDSS/CCL) Licensing Program Analyst (LPA), Antonine Richard, conducted an unannounced follow-up complaint visit. The LPA met with the Administrator (A1), Joan Rink Carroll, and explained that the purpose of the visit was to correct the wording of the allegation on LIC9099, as stated in LIC802.


The investigation consisted of collecting records and observing the facility. On April 7, 2026, the Department obtained various documents, including the Personnel Report LIC 500 (dated 04/07/26), the Resident Roster (dated 04/07/26), the Registered Nursing License dated September 30, 2025, and the Living Nurse Certificates dated June 30, 2026. The department interviewed Administrator A1, an RN, a Licensed Vocational Nurse (LVN), and six residents (R1-R6).
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 18-AS-20230413163957
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: SILVERGATE SAN MARCOS RETIREMENT RESIDENCE
FACILITY NUMBER: 374600026
VISIT DATE: 04/15/2026
NARRATIVE
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Allegation #1: Facility staff member who is not an appropriately skilled professional removed a fecal impaction from a resident.

The complaint alleged that a resident pressed the call button in the bathroom and required assistance. Facility staff member, who is not an appropriately skilled professional removed a fecal impaction from a resident. On April 7, 2026, the department interviewed the administrator (A1), who denied the allegations and stated that the facility had never experienced such incidents. A1 also stated that no staff member by that name was employed at the facility.

During the same investigation, the department interviewed the registered nurse (RN), who clarified that a physician's order is required before a nurse can remove a fecal impaction due to the risks to residents. The RN indicated that if a resident requires this procedure, the facility either contacts the physician or calls the Medical Emergency team for assistance.

Additionally, an interview was conducted with the licensed vocational nurse (LVN), who confirmed that a physician's order is indeed required before performing a fecal impaction removal for any resident. If the order is not available, the facility will contact the Medical Emergency team or send the resident to the hospital.

The department also interviewed six residents (R1-R6) on April 7, 2026, all of whom denied ever needing this type of procedure and were unaware of any other residents who had undergone it. Furthermore, a review of the facility roster and the Community Care Licensing Division’s Licensing Information System confirmed that no staff members by that name were listed.

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20230413163957
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: SILVERGATE SAN MARCOS RETIREMENT RESIDENCE
FACILITY NUMBER: 374600026
VISIT DATE: 04/15/2026
NARRATIVE
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Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation (s) did or did not occur, therefore the allegation is unsubstantiated.

No deficiencies were cited.

An exit interview was conducted. A copy of this report was provided to the Administrator Joan Rink-Carroll.

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3