374604300-1-22-2026-08-AS-APAO-DTMT8X-20260430143105

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604300
Report Date: 01/22/2026
Date Signed: 01/22/2026 03:46:11 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
01/16/2026 and conducted by Evaluator Rebecca A Borunda

COMPLAINT CONTROL NUMBER: 08-AS-20260116172340

FACILITY NAME:	OCEANSIDE SENIOR LIVING		FACILITY NUMBER:	374604300
ADMINISTRATOR:	JOHNSON, KRISTEL ANGELA		FACILITY TYPE:	740
ADDRESS:	5508 AVENIDA PACIFICA WAY		TELEPHONE:	(760) 978-6602
CITY:	OCEANSIDE	STATE: CA	ZIP CODE:	92057
CAPACITY:	165	CENSUS: 95	DATE:	01/22/2026
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Executive Director Kristel Johnson		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

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Unlawful Eviction

INVESTIGATION FINDINGS:

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

During today’s visit, LPA toured the facility, observed residents in care, reviewed and obtained copies of facility records, and interviewed residents and staff. LPA was away from the facility for approximately one hour between 12:15pm and 1:15pm.

The Department’s investigation consisted of interviews with residents, staff, and outside sources, records review, and a tour of the facility. It was alleged that the Licensee unlawfully evicted Resident 1 (R1).

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: 01/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2026

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-20260116172340

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: 01/22/2026

NARRATIVE

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Interviews and reviews of R1’s financial ledgers revealed that in May 2025, R1 stopped submitting payments for basic services and care rates. Interviews and review of assessment records from April and May 2025 revealed that R1 was declining cognitively and was moved into the facility’s memory care in late May 2025. Review of email exchanges between R1’s responsible party and facility management starting in late July 2025 revealed that both parties were in communications regarding managing R1’s finances and bringing R1’s balance in good standing. On August 1, 2025, the facility hand delivered an eviction notice to R1 regarding failure to pay for fees issued between May 2025 and July 2025 and mailed and emailed a written copy to R1’s responsible party. After not receiving any payment prior to the eviction notice’s effective date of September 1, 2025, the facility filed for an unlawful detainer with the San Diego County Superior Court on September 4, 2025. Email communications between R1’s responsible party and facility management documented that R1’s responsible party was in the process of having R1’s long term care insurance cover R1’s future basic rate and care fees starting in May 2025. Emails showed that R1’s responsible party mailed multiple physical checks to the facility, however, issues with dates and not covering the full amount of R1's outstanding balance caused the checks to be unable to be cashed. The facility did not receive any other payments until mid-January 2026, when the facility received and cashed a check which almost covered R1’s existing balance at that time. Interviews and review of a Notice to Vacate revealed that R1 was issued a notice to vacate by the San Diego Sheriff and R1 would be physically evicted on January 22, 2026. Interviews revealed that R1's responsible party submitted payments to the facility in January 2026, which settled R1's outstanding balance. Interviews with facility management revealed that the eviction through the local Sheriff was cancelled during LPA’s visit, and LPA Borunda verified that R1 remained at the facility and had not been evicted as of the end of today’s visit.

The Department has investigated the above-mentioned allegation and based on interview 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: 01/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2026

LIC9099 (FAS) - (06/04)

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