374604425-9-24-2025-08-AS-SMAZ-DLZVKK-20250930163029

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604425
Report Date: 09/24/2025
Date Signed: 09/24/2025 05:08:05 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
04/09/2025 and conducted by Evaluator Arian Golbakhsh

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20250409123908

FACILITY NAME:	LA JOLLA CASA FIESTA		FACILITY NUMBER:	374604425
ADMINISTRATOR:	FERNANDEZ, JENNIFER		FACILITY TYPE:	740
ADDRESS:	5426 AVENIDA FIESTA		TELEPHONE:	(858) 775-6935
CITY:	LA JOLLA	STATE: CA	ZIP CODE:	92037
CAPACITY:	6	CENSUS: 6	DATE:	09/24/2025
		UNANNOUNCED	TIME BEGAN:	03:35 PM
MET WITH:	Caregiver Laura Aguayo and House Manager Linda Gonzalez		TIME COMPLETED:	05:10 PM

ALLEGATION(S):

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Licensee did not follow reporting requirements regarding pending facility sale.
Licensee did not provide enough food to meet the needs of residents.
Licensee did not ensure infection control requirments are followed.
Licensee did not treat pests.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced visit to deliver findings regarding the above mentioned complaint allegations. LPA was welcomed by, identified themselves to, and discussed the purpose of their visit to Caregiver Laura Aguayo and House Manager Linda Gonzalez. LPA also spoke with Administrator Jennifer Fernandez over the phone to inform them of their visit.

On 4/9/25, the Department received a complaint where it was alleged that the facility was listed for sale and that residents or their responsible parties were not notified, that the facility is not supplying food for the residents, that there is a lack of hygienic items such as gloves, and that there are pest control issues. The complaint specified that a non-specified resident's family member as well as care staff were supplying food for the home. The Department’s investigation consisted of unannounced facility visits, records review, and interviews with staff, residents, and outside sources.

[Continued on LIC 9099-C]

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2025

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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Control Number 08-AS-20250409123908

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 JOLLA CASA FIESTA	FACILITY NUMBER: 374604425
	VISIT DATE: 09/24/2025

NARRATIVE

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[Continued from LIC 9099]

Regarding the allegation of lack of notification to appropriate parties regarding listing of the property, based on interviews with administrative staff, the facility was only listed onto the market and no actual sale or offer has been made. Per online review of the listing site, Zillow, the home was listed for sale February 2025. While it may be a best practice to inform residents and/or their responsible parties of the facility's interest or intent for sale, as there was no actual transfer of property that took place, the facility is not required to provide notification at this stage, therefore there is no indication of a violation at this time. The facility also notified the Department via email on 4/21/25 that the facility has been listed for sale.

Regarding the allegation of lack of food at the facility, staff interviews revealed mixed sentiments about the grocery provisions for the facility. Some staff interviewed revealed that the grocery list would never be provided in full, only a few items at a time and that the food items that were brought in were close to expiration. It was revealed that a resident's family member has been supplying food for their respective resident and all those items were labeled to indicate so. Additional staff interviews revealed that groceries were purchased by the Administrator about every week to two weeks. One also mentioned that though groceries were not always brought in full, there was no shortage of food in the home. Another staff member interviewed revealed no concerns about food and denied any grocery shortages at the facility. Outside sources interviewed revealed no concerns about the quality or supply of food. Residents interviewed revealed no concerns about food, aside from one who stated that they found the food provided to be "alright," but clarified that there was no shortage of food and they were well fed. File review of grocery purchase receipts for the facility revealed that groceries were purchased about 2-3 times a month and receipts show a variety of foods purchased.

[Continued on LIC 9099-C]

SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2025

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20250409123908

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 JOLLA CASA FIESTA	FACILITY NUMBER: 374604425
	VISIT DATE: 09/24/2025

NARRATIVE

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[Continued from LIC 9099-C page]

In regards to the allegation of lack of hygiene items, staff interviews again revealed conflicting statements in regards to the facility's supply of Personal Protective Equipment (PPE) for staff. Some staff members interviewed revealed that there was an overall shortage of gloves and paper goods supplies (toilet paper, paper towels, personal wipes, etc.) and that staff are having to bring their own supplies. Additional staff interviewed revealed no concerns of gloves and paper goods shortages, revealing that when supplies are running low, administrative staff are notified and supplies are replenished. Resident interviews revealed no concerns about the use of PPE by staff, with two (2) revealing that staff regularly use gloves to assist residents and that they have not heard staff voice concerns about them being low in supply. During LPA's visit on 4/24/25, two (2) boxes of 100 gloves along with multiple boxes of adult briefs were observed in the storage area of the facility's garage. File review of PPE and hygiene items invoices from December 2024 through July 2025 reveal that gloves were purchased on 12/9, 1/15, 4/1, 4/25, 6/10, and 7/28 in the amount of 1-2 cases (10 boxes per case).

Finally, in regards to the allegation of lack of pest control, interviews and file review corroborate that the facility arranged for pest control treatment. Four staff members interviewed all revealed that there have been pests observed at the facility, but that pest control technicians come out regularly for treatment and prevention. Resident interviews revealed that pests have not been observed by them at all, with one (1) noting that staff clean daily. One (1) outside source interviewed noted that they have not observed any pests at the facility and felt that the facility was very clean. File review of pest control invoices revealed that services were rendered roughly on a monthly basis from August 2024 through June 2025. During LPA's initial visit to the facility (4/15/25) roaches were observed, but on subsequent visits (4/24/25 and 8/14/25), LPA noted none.

Based on interviews and records review, while the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred – therefore the allegations have been determined to be UNSUBSTANTIATED. An exit interview was conducted with House Manager Gonzalez to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.

SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2025

LIC9099 (FAS) - (06/04)

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