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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604425
Report Date: 09/24/2025
Date Signed: 09/24/2025 05:08:53 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
08/06/2025 and conducted by Evaluator Arian Golbakhsh
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20250806161250
FACILITY NAME:LA JOLLA CASA FIESTAFACILITY NUMBER:
374604425
ADMINISTRATOR:FERNANDEZ, JENNIFERFACILITY TYPE:
740
ADDRESS:5426 AVENIDA FIESTATELEPHONE:
(858) 775-6935
CITY:LA JOLLASTATE: CAZIP CODE:
92037
CAPACITY:6CENSUS: 6DATE:
09/24/2025
UNANNOUNCEDTIME 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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Staff are not providing resident with a refund.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced visit to deliver findings regarding the above mentioned complaint allegation. 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 8/6/25, the Department received a complaint where it was alleged that the facility did not refund a former resident (identified as R1) the pro-rated amount for prepaid rent after move out. 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)
Page: 1 of 2
Control Number 08-AS-20250806161250
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]

Multiple staff interviews revealed that R1's move out was around late July, with one who was present during date of move out (1) specifying the date as being 7/17/25, which was corroborated with file review of emails between the facility and R1's responsible party. File review and outside source interviews corroborated that a check for the prorated refund amount was made out to R1's responsible party on 8/16/25. File review of R1's admission agreement contract did not contain conditions for refunds given due to voluntary move out, only refund conditions given due to resident death. However, the contract does state that in the case of voluntary resident move out, the facility would provide reasonable efforts to assist with belongings removal. The facility was not obligated by contract to provide a refund in this circumstance, however, they chose to.

Based on interviews and records review, while the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred – therefore the allegation has 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)
Page: 2 of 2