374604441-2-23-2026-08-AS-APAO-DRL8UU-20260223215008

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604441
Report Date: 02/18/2026
Date Signed: 02/23/2026 11:17:11 AM

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
12/02/2025 and conducted by Evaluator Amy Domingo

COMPLAINT CONTROL NUMBER: 08-AS-20251202131425

FACILITY NAME:	MONTE VISTA VILLAGE SENIOR LIVING		FACILITY NUMBER:	374604441
ADMINISTRATOR:	ADRIAN GUILLEN		FACILITY TYPE:	740
ADDRESS:	2211 MASSACHUSETTS AVENUE		TELEPHONE:	(619) 465-1331
CITY:	LEMON GROVE	STATE: CA	ZIP CODE:	91945
CAPACITY:	219	CENSUS: 104	DATE:	02/18/2026
		UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Adrian Guillen Administrator		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Facility staff are not following proper eviction procedures

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Amy Domingo conducted an unannounced visit to deliver the findings in the above-mentioned complaint allegations. LPA Domingo identified herself and discussed the purpose of the visit with Administrator Adrian Guillen.

During the investigation, LPA Domingo collected pertinent resident records as well as facility documentation and conducted interviews with staff, residents, and outside sources.

On 12/02/25, the department received a complaint alleging the Facility staff are not following proper eviction procedures. Staff 1 (S1) was interviewed and stated that the facility did not follow the proper eviction procedures by not informing the department of the 30 day eviction notice given to Resident 1 (R1).S1 confirmed that the notices did not include the reason for eviction or information about appeal rights.They explained that the decision was made due to financial concerns. S1 stated they are now aware of the proper process and will ensure corrective measures are implemented immediately.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Domingo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026

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-20251202131425

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: MONTE VISTA VILLAGE SENIOR LIVING	FACILITY NUMBER: 374604441
	VISIT DATE: 02/18/2026

NARRATIVE

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(Continued from LIC9099)

Outside source 1 (OS1) revealed that the facility did not follow proper procedures when giving R1 the eviction notice. OS1 reported that the facility did not provide documentation explaining the reason for eviction, or the resident’s right to appeal. OS1 expressed concern that the lack of written notice made it difficult to arrange alternative placement and understand the process. They confirmed that no discharge plan or assistance was offered by the facility and stated that they expected proper notice in compliance with regulations.

During the investigation, the LPA reviewed facility records, including eviction notices, communication logs, and resident files. The review revealed that R1 was asked to leave the facility without receiving the required 30-day written notice. Notices lacked clear reasons for eviction and did not include information about appeal rights, as required by Title 22. Additionally, there was no evidence of discharge planning or coordination to ensure safe relocation for affected residents.

Based on relevant interviews and records review, the preponderance of evidence has been met that alleged violation 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 the licensee. An exit interview was conducted with Administrator Adrian Guillen, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Domingo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20251202131425

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: MONTE VISTA VILLAGE SENIOR LIVING	FACILITY NUMBER: 374604441
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/18/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/06/2026 Section Cited CCR 87224(d)	1 2 3 4 5 6 7	87224 Eviction Procedures: “(d) The licensee shall set forth in the notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons.” This requirement was not met, as evidenced by:	1 2 3 4 5 6 7	Administrator agrees to complete a training with an outside source. This training was completed by January 2, 2026
	8 9 10 11 12 13 14	Licensee issued 1 of 104 residents (R1) a notice to quit (i.e. a written eviction letter), but the notice did not include specific facts to permit determination of the date, place, witnesses, and circumstances concerning the reason(s) for eviction. This posted a potential personal rights risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Simon Jacob
LICENSING EVALUATOR NAME: Amy Domingo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026

LIC9099 (FAS) - (06/04)

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