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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604407
Report Date: 11/19/2025
Date Signed: 11/19/2025 03:43:11 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
08/13/2025 and conducted by Evaluator Ramin Hashemi
COMPLAINT CONTROL NUMBER: 08-AS-20250813123358
FACILITY NAME:BAYSHIRE CARLSBADFACILITY NUMBER:
374604407
ADMINISTRATOR:DAYNES, THOMASFACILITY TYPE:
741
ADDRESS:3140 EL CAMINO REALTELEPHONE:
(760) 720-9898
CITY:CARLSBADSTATE: CAZIP CODE:
92008
CAPACITY:125CENSUS: 113DATE:
11/19/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Pamela Talamentes, Resident Services DIrectorTIME COMPLETED:
04:10 PM
ALLEGATION(S):
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Lack of supervision resulted in resident elopement.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Ramin Hashemi conducted an unannounced visit to deliver findings regarding the above complaint allegation(s). LPA introduced themselves and disclosed the purpose of the visit to Pamela Talamentes, Resident Services Director.

On 08/12/2025, it was alleged that lack of supervision resulted in resident elopement. The Department’s investigation consisted of an unannounced facility visit, review of facility and outside source records, interviews with facility staff, outside sources, and LPA direct observations.

(Continued on Page 2 LIC9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
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-20250813123358
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: BAYSHIRE CARLSBAD
FACILITY NUMBER: 374604407
VISIT DATE: 11/19/2025
NARRATIVE
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(Continued from Page 1 LIC9099)

Staff interviews revealed that Resident 1 (R1) was alert, oriented, and independent with daily tasks. Staff 1 (S1) stated that as a result of the continued elopements, the facility arranged 1:1 caregiver support, used an Apple AirTag for monitoring, and held care conferences with the responsible party and healthcare providers. Despite these efforts, R1 often refused assistance and continued to leave the facility independently. Staff followed protocol by notifying the responsible party and law enforcement when R1 left and sought guidance from the Community Care Licensing Department regarding how to proceed. Staff also noted that R1 expressed a strong desire to live independently and had a history of returning from elopement safely.

Outside source interviews revealed that R1 was described as cognitively intact, capable of making informed decisions, and able to manage personal affairs such as finances and medical care. Outside Source 1 (OS1) confirmed as Power of Attorney that the facility made efforts to supervise R1 and responded appropriately to elopement concerns. Outside Source 2 (OS2), a psychiatric nurse practitioner, stated that R1 retained reasoning, safety awareness, and the ability to plan and carry out their own departure. Both sources agreed that R1 was not at risk to themself when leaving the facility.

Records review revealed that the facility documented R1’s behaviors, coordinated with healthcare providers, and implemented interventions in response to elopement concerns. R1's preplacement appraisal supported the assessment that R1 was not a harm to themselves or others and was mentally alert and oriented. Progress and Care notes indicate an almost daily log of ongoing supervision and concern for solutions to R1's eloping and independence. There was no evidence of harm or injury resulting from R1’s departure, and the facility’s actions were consistent with regulatory expectations.

Based on relevant interviews and records review, a preponderance of evidence does not support that the alleged violation occurred. Therefore, the allegation is determined to be: UNSUBSTANTIATED.

An exit interview was conducted with Pamela Talamentes, Resident Services Director, 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: 11/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2