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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604371
Report Date: 06/27/2025
Date Signed: 06/27/2025 09:59:55 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
04/04/2025 and conducted by Evaluator Renita Hall
COMPLAINT CONTROL NUMBER: 08-AS-20250404130608
FACILITY NAME:LEXINGTON HOUSEFACILITY NUMBER:
374604371
ADMINISTRATOR:ARCELI B SONGCOFACILITY TYPE:
740
ADDRESS:180 W. LEXINGTON AVE.TELEPHONE:
(619) 401-7528
CITY:EL CAJONSTATE: CAZIP CODE:
92020
CAPACITY:6CENSUS: 6DATE:
06/27/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Ann Cunanan, CaregiverTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Facility staff allowed resident to remain in soiled diaper overnight
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Renita Hall conducted an unannounced visit to deliver findings regarding the allegation mentioned above. LPA was allowed entry the caregiver. LPA identified herself and disclosed the purpose of the visit and elements of the complaint to the caregiver.

LPA conducted a facility tour and observed no concerns related to resident hygiene or incontinence care practices. LPA conducted interviews with facility staff, residents, and attempted interviews with outside sources and Resident 1 (R1). LPA spoke with the Administrator, who confirmed that R1 is no longer at the facility and has been relocated to a Skilled Nursing Facility (SNF) after being discharged from the hospital.

R1 was able to communicate their needs and did not have a cognitive impairment, although occasional forgetfulness was noted. Interviewed with R1’s primary caregiver Staff 2 (S2) revealed that R1 had access to a call bell, and staff responded to calls.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
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-20250404130608
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: LEXINGTON HOUSE
FACILITY NUMBER: 374604371
VISIT DATE: 06/27/2025
NARRATIVE
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S2 also confirmed that routine incontinence checks were performed per facility protocol. Per the LIC 602 dated March 7, 2025, R1 is medically stable at their baseline and requires minimal assistance with transfers. R1 experiences frequent episodes of incontinence; however, there is no documentation of current skin breakdown. R1 has episodes of forgetfulness, but no formal cognitive impairment is documented. She required set-up assistance with grooming and feeding, minimal assistance with bathing, and maximum assistance with toileting needs.

Additional interviews were conducted with residents who all stated they did not have any incontinence issues and were able to handle their own toileting needs. LPA attempted to interview an outside source with no success due to the hostile interaction.

Based on the information gathered through interviews, observations, and record reviews, the allegation is unsubstantiated. There was insufficient evidence to support the allegation that R1 was left in a soiled diaper overnight. A finding that is unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

An exit interview was conducted with the Caregiver. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided to the Caregiver, and her signature on this report confirms receipt of the Licensee Rights.
SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2