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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604411
Report Date: 02/26/2026
Date Signed: 02/26/2026 01:21:29 PM

Substantiated


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
09/28/2021 and conducted by Evaluator Ramin Hashemi
COMPLAINT CONTROL NUMBER: 08-AS-20210928124543
FACILITY NAME:LA MAREA SENIOR LIVINGFACILITY NUMBER:
374604411
ADMINISTRATOR:CORNELL, LAUNAFACILITY TYPE:
740
ADDRESS:5592 EL CAMINO REALTELEPHONE:
(442) 325-3510
CITY:CARLSBADSTATE: CAZIP CODE:
92008
CAPACITY:125CENSUS: 117DATE:
02/26/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Executive Director Janet MillerTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Resident in care eloped from facility and sustained multiple injuries
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Ramin Hashemi conducted an unannounced visit to deliver findings regarding the above complaint allegation. LPA introduced themselves and disclosed the purpose of the visit to Executive Director (ED) Janet Miller.

On 09/28/21 it was alleged "Resident in care eloped from facility and sustained multiple injuries." The Department’s investigation consisted of unannounced facility visits, interviews with facility staff, residents, outside sources, and records review.

Regarding the allegation, Resident 1 (R1) eloped from the facility during the night and found their way to the hospital after they sustained injuries (bruises and scratches) after falling during the elopement.

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

DATE: 02/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2026
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 3
Control Number 08-AS-20210928124543
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: LA MAREA SENIOR LIVING
FACILITY NUMBER: 374604411
VISIT DATE: 02/26/2026
NARRATIVE
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(Continued from LIC9099, Page 2)

A records review of the incident showed that both a physician's report dated 08/30/21 and a resident appraisal (no date) diagnosed R1 with Parkinson's disease, insomnia, and gait instability. The physician's report stated that R1 was not able to leave facility unassisted. The Resident Appraisal listed the history of R1 having been hospitalized on three separate occasions: twice due to falling down stairs and once due to insomnia induced hallucinations. On the ISL Base Level of Care Assessment performed on 09/09/2021, it was determined that R1 was a fall risk and required escort services up to three times a day.

Based on relevant interviews and records review, the preponderance of evidence has been met that alleged violation(s) occurred and are therefore substantiated.  Deficiencies are cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D).  A Plan of Correction was jointly developed with ED Miller. An exit interview was conducted with ED Janet Miller, 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: 02/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20210928124543
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: LA MAREA SENIOR LIVING
FACILITY NUMBER: 374604411
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/27/2026
Section Cited
CCR
87464(f)(4)
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87464 Basic Services
"(f) Basic services... include: (4) Personal assistance and care as needed by the resident... indicated in the pre-admission appraisal... such as dressing and assistance with taking prescribed medications..."
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Executive DIrector will show CCLD offices proof of In-service training on appraisals, elopement procedures, and Parkinson's education by 03/27/2026.
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Based on observation and record review, the licensee did not comply with the section cited above in ensuring resident was supervised as needed which posed an immediate health, safety or personal rights risk to 1 of 120 persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3