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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374600431
Report Date: 12/23/2025
Date Signed: 01/09/2026 09:17:49 AM

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
12/18/2025 and conducted by Evaluator Ramin Hashemi
COMPLAINT CONTROL NUMBER: 08-AS-20251218090559
FACILITY NAME:EMERALD GUEST HOMEFACILITY NUMBER:
374600431
ADMINISTRATOR:PETRONILA ECHEVARRIAFACILITY TYPE:
740
ADDRESS:2558 MOBLEY STREETTELEPHONE:
(858) 384-6800
CITY:SAN DIEGOSTATE: CAZIP CODE:
92123
CAPACITY:3CENSUS: 3DATE:
12/23/2025
UNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Licensee Petronila EchevarriaTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff did not ensure that the facility was kept free of rodents
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Ramin Hashemi conducted an unannounced visit to open an investigation and deliver findings regarding the above complaint allegation(s). LPA introduced themselves and disclosed the purpose of the visit to Licensee Petronila Echevarria.

On 12/18/2025 it was alleged Staff did not ensure that the facility was kept free of rodents. The Department’s investigation consisted of unannounced facility visits, review of facility and outside source records, interviews with facility staff, residents, and LPA direct observations.

Regarding the allegation, "Staff did not ensure that the facility was kept free of rodents", it was alleged that there are rodents in the facility and that the facility refused pest control services due to cost.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
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 5
Control Number 08-AS-20251218090559
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: EMERALD GUEST HOME
FACILITY NUMBER: 374600431
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/23/2025
Section Cited
CCR
87303(a)
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87303 Maintenance and Operation“(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.This requirement was not met, as evidenced by:
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Licensee and staff will provide CCLD offices invoices of the requested services for pest control by 01/16/25. Licensee will continue to provide updates to CCLD Offices when outside pest control services are initiated.
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Based on records review and interviews, licensee did not accord safe, healthful accommodations to 3 out of 3 residents. This posed a potential health and personal rights risk to persons 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: Lizzette Tellez
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 08-AS-20251218090559
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: EMERALD GUEST HOME
FACILITY NUMBER: 374600431
VISIT DATE: 12/23/2025
NARRATIVE
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Staff interviews revealed that Staff 1 (S1) Staff 2 (S2) were aware of the rodent infestation within the facility. S1 required help from S2 and an Outside Source 1 (OS1) to help set up pest control appointments. According to staff, there were independent contractors hired to come and set up rodent traps as well as fix and install patchwork to prevent access of rodents in the facility.

Resident Interviews revealed that Resident 1 (R1) had witnessed several occurrences of rodents scurrying around; specifically near the bathroom and on the outside near the garage and patio. R1 also reported hearing rodents in the walls.

Outside Source Interviews revealed that OS1 helped facility staff to set up appointments for a pest control company to come and set down rodent traps and patch holes in the attic. OS1 confirmed that the initial pest control company was too expensive for the services they offered and instead decided to hire independent contractors at a later date to take care of the rodent issues.

LPA observations revealed that there were several spots inside of the garage and around the premises that had pockets of rodent droppings and a urine smell. LPA acquired photographic evidence of the observations. Coincidentally on the day of the visit from licensing, while the LPA was present, the aforementioned independent contractor visited the facility and provided assistance and advice on the pest control issue.

Based on relevant interviews and records review, the preponderance of evidence has been met that alleged violation(s) occurred and are therefore substantiated.  Deficiencies are cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D).  A Plan of Correction was jointly developed with the licensee. An exit interview was conducted with Licensee, to whom a copy of this report, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
12/18/2025 and conducted by Evaluator Ramin Hashemi
COMPLAINT CONTROL NUMBER: 08-AS-20251218090559

FACILITY NAME:EMERALD GUEST HOMEFACILITY NUMBER:
374600431
ADMINISTRATOR:PETRONILA ECHEVARRIAFACILITY TYPE:
740
ADDRESS:2558 MOBLEY STREETTELEPHONE:
(858) 384-6800
CITY:SAN DIEGOSTATE: CAZIP CODE:
92123
CAPACITY:3CENSUS: 3DATE:
12/23/2025
UNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Licensee Petronila EchevarriaTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Meals provided to residents in care do not consist of an appropriate variety of foods
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Ramin Hashemi conducted an unannounced visit to deliver findings regarding the above complaint allegations. LPA introduced themselves and disclosed the purpose of the visit to Licensee Petronila Echevarria.

On 12/18/25 it was alleged meals provided to residents in care do not consist of an appropriate variety of foods. The Department’s investigation consisted of unannounced facility visits, interviews with facility staff, residents, outside sources, and records review.

Regarding the allegation, "Meals provided to residents in care do not consist of an appropriate variety of foods", it was alleged that the food the facility provided does not have enough fruits and vegetables.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 08-AS-20251218090559
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: EMERALD GUEST HOME
FACILITY NUMBER: 374600431
VISIT DATE: 12/23/2025
NARRATIVE
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Staff interviews revealed that Staff 2 (S2) often provides meals to residents and ensures that there is always a side of fruit or vegetables available to residents. S2 also stated that residents can get fruit like bananas, apples, or oranges if they want a snack in-between meals.

Resident interviews revealed that Resident 1 (R1) was able to provide many examples of recent meals that included a side of vegetables or fruit for breakfast, lunch, and dinner. R1 thought the portions should be bigger but acknowledged they have access to fruits and vegetables as snacks.

Records review revealed menus in the facility are not up to date or contain any indicators of when they were last updated. The menus consisted of planned meals for one week. The menus that were provided did indicate an appropriate amount of variety of the foods offered and included fruits and vegetables.

LPA observations revealed there were a large and diverse amount of fresh and frozen fruits and vegetables in the fridge/freezer. Fruits were accessible to residents and could be provided upon request. Leftover meals in the refrigerator included vegetables. LPA Observations corroborated resident and staff interviews.

Based on interviews, direct LPA observations and records review, a preponderance of evidence does not exist to prove that the alleged violation occurred, therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted with Licensee, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5