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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604421
Report Date: 04/24/2025
Date Signed: 04/24/2025 12:17:23 PM

Unfounded


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
04/16/2025 and conducted by Evaluator Arian Golbakhsh
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20250416112406
FACILITY NAME:LA JOLLA VISTAFACILITY NUMBER:
374604421
ADMINISTRATOR:FERNANDEZ, GUSFACILITY TYPE:
740
ADDRESS:5720 DESERT VIEW DRTELEPHONE:
(858) 775-6935
CITY:LA JOLLASTATE: CAZIP CODE:
92037
CAPACITY:6CENSUS: 0DATE:
04/24/2025
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Administrator Jennifer FernandezTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
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7
8
9
Licensee did not follow reporting requirments regarding pending facility sale.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Arian Golbakhsh conducted a complaint investigation regarding the above mentioned allegation. LPA was welcomed by, identified themselves to, and discussed the purpose of their visit to Co-owner Jennifer Fernandez.

LPA's visit consisted of touring the facility to ensure there were no residents in care, in addition to conducting interviews and file review. LPA verified there were no residents on the premises. Per Co-owner Fernandez, the facility was vacated on March 26th after the only resident passed.

The agency has investigated the complaint alleging the licensee did not follow reporting requirements regarding pending facility sale. We have determined that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have dismissed the complaint. An exit interview was conducted with Co-owner Jennifer Fernandez to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
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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