374604300-12-8-2025-08-AS-RCLK-DPU2XQ-20251229164732

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604300
Report Date: 12/08/2025
Date Signed: 12/08/2025 03:54:27 PM

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
07/11/2025 and conducted by Evaluator Rebecca A Borunda

COMPLAINT CONTROL NUMBER: 08-AS-20250711083149

FACILITY NAME:	OCEANSIDE SENIOR LIVING		FACILITY NUMBER:	374604300
ADMINISTRATOR:	JOHNSON, KRISTELANGELICA		FACILITY TYPE:	740
ADDRESS:	5508 AVENIDA PACIFICA WAY		TELEPHONE:	(760) 978-6602
CITY:	OCEANSIDE	STATE: CA	ZIP CODE:	92057
CAPACITY:	165	CENSUS:	DATE:	12/08/2025
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Executive Director Kristel Johnson		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Licensee did not assist resident with transportation

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rebecca Borunda conducted an unannounced complaint visit to conduct follow up and deliver findings regarding the above-mentioned allegation. LPA identified herself to, was greeted by, and explained the purpose of the visit to Executive Director Kristel Johnson.

During today's visit, LPA observed residents in care and interviewed residents.

The Department’s investigation consisted of interviews with residents and staff, records review, and a tour of the facility. It was alleged that the licensee did not assist Resident 1 (R1) with transportation. Interviews with staff and review of transportation documents revealed that the facility provided transportation services for medical appointments on Tuesdays and Thursdays, religious services on Sundays, and recreational outings on Mondays and Wednesdays. Residents were able to register for all types of outings using sign-up sheets located at the front desk.
Continued on LIC9099-C page...

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Rebecca A Borunda
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20250711083149

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: OCEANSIDE SENIOR LIVING	FACILITY NUMBER: 374604300
	VISIT DATE: 12/08/2025

NARRATIVE

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Review of outing sign-up sheets for June and July 2025 showed that the facility offered transportation to multiple different religious services on Sundays. Outing sign-up sheets revealed that R1 signed up for transportation for almost every single recreational outing and religious services in June and July. Interviews with activities staff revealed that the facility owned three vehicles, a bus with a wheelchair lift, a van with a drive-up ramp, and a spare bus given to the facility from a different community. Interviews revealed that the facility’s two buses required repairs, one of which would not be repaired until 7/23/2025. The facility’s van also required smog testing on 7/22/2025 to renew its vehicle registration and facility staff feared that the van would not pass the smog testing. Due to these concerns, the facility had been borrowing a bus from a sister facility when that bus was not already in use by the sister facility.

Interviews with staff revealed that R1 attended all outings and religious services that R1 signed up for except for a religious service on one occasion. Staff stated that R1 and another resident used electric wheelchairs and had both signed up for the same religious service, causing staff to question if the borrowed bus, which was the only available vehicle, could accommodate the size of both wheelchairs. Additionally, interviews with staff revealed that the borrowed bus had a physically smaller wheelchair lift with a lower weight capacity than the facility’s normal bus. Interviews revealed that R1 refused to provide facility management with information on the weight of R1’s wheelchair when asked by staff. Additionally, staff stated that due to the smaller size of the lift, R1’s wheelchair wheels would have hung off the edges of the lift, putting R1 in a very unsafe situation. Interviews did not reveal any other instances where R1 was not able to attend outings.

The Department has investigated the above-mentioned allegation and based on interviews and records review, the preponderance of the evidence has not been met, therefore, this allegation is deemed unsubstantiated.

An exit interview was conducted with Executive Director Kristel Johnson, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 03/22).

SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Rebecca A Borunda
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2025

LIC9099 (FAS) - (06/04)

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