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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603136
Report Date: 09/02/2025
Date Signed: 09/02/2025 10:55:15 AM

Unsubstantiated


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
06/09/2025 and conducted by Evaluator Natasha Persaud
COMPLAINT CONTROL NUMBER: 08-AS-20250609134506
FACILITY NAME:CORONADO RETIREMENT VILLAGEFACILITY NUMBER:
374603136
ADMINISTRATOR:ELIZABETH REYESFACILITY TYPE:
740
ADDRESS:299 PROSPECT PLACETELEPHONE:
(619) 437-1777
CITY:CORONADOSTATE: CAZIP CODE:
92118
CAPACITY:120CENSUS: 77DATE:
09/02/2025
UNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Executive Director, Rajni KharbandaTIME COMPLETED:
10:50 AM
ALLEGATION(S):
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Staff did not accord resident safe accommodations
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Natasha Persaud contacted the facility via telephone, to conclude the complaint investigation regarding the above-mentioned allegation. LPA spoke with Executive Director, Rajni Kharbanda.

During the investigation, the facility was briefly toured, records reviewed, and interviews conducted with staff, residents, and outside sources. It was alleged that staff did not accord resident safe accommodation. It was reported that on 06/08/25, Resident #1 (R1) was lying on their bed fully clothed with shoes on and a pillow over their face. R1 had a medical condition that required medical attention. Staff called 911 and R1 was transported to the hospital. R1 also has a Major Neurocognitive Disorder and didn’t recall the incident, when interviewed. R1 confirmed they sleep in their bed, on top of their covers, fully clothed, and wearing shoes. R1 also confirmed they do not sleep with a pillow over their face or feel they are in harm. Continued on an LIC 9099C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025
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 2
Control Number 08-AS-20250609134506
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: CORONADO RETIREMENT VILLAGE
FACILITY NUMBER: 374603136
VISIT DATE: 09/02/2025
NARRATIVE
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Staff interviewed confirmed that R1 was not found with the pillow over R1’s face but to the side of R1’s face, very close, but not to interfere with R1’s breathing. There are no corroborating statements or evidence to support the allegation.

During the course of the investigation, interviews were conducted, and records were reviewed. Investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegation. The allegation was deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were emailed to Executive Director, Rajni Kharbanda.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2