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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374600103
Report Date: 11/18/2025
Date Signed: 11/18/2025 02:59:28 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/10/2025 and conducted by Evaluator Liliana Silveira
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20251110131049
FACILITY NAME:GROVEVIEW BOARD AND CAREFACILITY NUMBER:
374600103
ADMINISTRATOR:TERESITA PEDROSOFACILITY TYPE:
740
ADDRESS:2204 GROVEVIEW ROADTELEPHONE:
(619) 512-1262
CITY:SAN DIEGOSTATE: CAZIP CODE:
92139
CAPACITY:6CENSUS: 6DATE:
11/18/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Care Staff Sherell KremerTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Licensee does not ensure facility is free of pests.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced visit to conduct a complaint investigation visit and to deliver findings. LPA Silveira introduced themselves, disclosed the purpose of the visit and was granted entry into the facility by caregiver Sherell Kremer. Licensee Teresita Pedrozo arrived a short time after.

The Department’s investigation consisted of observations and interviews. On November 10, 2025, it was alleged that
The Licensee did not ensure the facility is free of pests. A Department health and safety tour conducted on November 18, 2025 revealed that the facility was clean, including communal areas, bathrooms and resident bedrooms. During the inspection, no cockroaches were observed in those areas of the facility, but were observed in the kitchen, on the countertop next to the refrigerator.
(CONTINUED ON NEXT PAGE, LIC 9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
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 08-AS-20251110131049
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: GROVEVIEW BOARD AND CARE
FACILITY NUMBER: 374600103
VISIT DATE: 11/18/2025
NARRATIVE
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(CONTINUED FROM PAGE 1, LIC 9099)
A Department interview with an Outside Source (OS) revealed that a visit to the facility was conducted the week of November 9 to 15, 2025 and the OS also observed cockroaches in the same location- on the kitchen countertop next to the stove. Interviews with (3) residents revealed that residents have not witnessed cockroaches in any communal areas, bedrooms or bathrooms, but have observed them in the kitchen.

An interview with Care Staff #1 (CS1) revealed that the problem started about a month ago in a small section of the kitchen near the stove, and CS1 placed traps behind the refrigerator and stove. An interview with Resident #1 (R1) corroborated that R1 witnessed traps in the kitchen. Staff also placed traps on the counters near the kitchen appliances. Interviews with CS1, the Licensee and R1 revealed that the facility was fumigated approximately one year ago and all residents had to relocate.

Based on the evidence obtained from observations and interviews, the complaint allegation is substantiated. A substantiated finding means the allegation is valid because the preponderance of the evidence standard has been met.

A deficiency is cited per Title 22 California Code of Regulation. LPA Silveira conducted an exit interview with Sherell, to whom a copy of this report, the LIC 9099-D, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided. Signature below confirms receipt of the reports.
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20251110131049
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: GROVEVIEW BOARD AND CARE
FACILITY NUMBER: 374600103
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/18/2025
Section Cited
CCR
87303(a)
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87303(a)The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors as evidenced by:
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Licensee conducted a deep cleaning, removed hot appliances and has placed traps/chemicals in area where pests are concentrated. Licensee will communicate with CCLD regarding progress-they are currently searching for professional pest control if needed. Due date is 12/18/25.
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Based on observations and interviews, the Licensee did not provide a clean or sanitary environment due to evidence of pests in the kitchen. This poses a potential health risk to 5 of 5 clients in care.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3