<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604454
Report Date: 05/28/2026
Date Signed: 05/28/2026 01:41:30 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
08/31/2022 and conducted by Evaluator Becky Kennedy
COMPLAINT CONTROL NUMBER: 08-AS-20220831114557
FACILITY NAME:HUNTINGTON MANORFACILITY NUMBER:
374604454
ADMINISTRATOR:DERAFERA, TESSFACILITY TYPE:
740
ADDRESS:14755 BUDWIN LNTELEPHONE:
(619) 625-6886
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY:21CENSUS: DATE:
05/28/2026
UNANNOUNCEDTIME BEGAN:
12:48 PM
MET WITH:Lynn DrummondTIME COMPLETED:
01:19 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not answer resident's call button in a timely manner.
Staff did not clean resident's room as often as needed.
Staff spoke disrespectfully about resident.
Facility has not provided a written statement of rate increases.
Facility has not provided a copy of the updated admissions agreement.
Facility did not meet resident's dietary needs.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Becky Kennedy conducted an unannounced complaint investigation visit to the facility in order to deliver findings on the above allegations. LPA was granted entry to the facility by Lynn Drummond, Cheif Operating Officer, after identifying herself and explaining the reason for the visit.

It was alleged regarding Resident 1 (R1) that:
• Staff did not answer resident's call button in a timely manner.
• Staff did not clean resident's room as often as needed.
• Staff spoke disrespectfully about resident.
• Facility did not meet resident's dietary needs.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jerry Romero
LICENSING EVALUATOR NAME: Becky Kennedy
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2026
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 2
Control Number 08-AS-20220831114557
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: HUNTINGTON MANOR
FACILITY NUMBER: 374604454
VISIT DATE: 05/28/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The Department’s investigation consisted of a tour of the facility, a review of facility records, and interviews of facility staff.

The investigation revealed that the facility has no record of R1 residing at the facility. Staff members interviewed who worked at the facility at the time of the allegations have no recollection of R1.
Interviews revealed that when a resident activates their call button, staff respond immediately to resident or as soon as possible, resident’s rooms are cleaned daily, and deep cleaning is done weekly. Interviews did not reveal any concerns about residents being treated disrespectfully. Interviews with staff revealed that dietary concerns are accommodated at the facility. These allegations are Unsubstantiated.

It was further alleged that:
• Facility has not provided a written statement of rate increases.
• Facility has not provided a copy of the updated admissions agreement.

The allegations regarding the lack of written statement of rate increases and an updated admission agreement are also unsubstantiated as no records could be reviewed regarding R1

Based on the evidence obtained during the complaint investigation, the allegations above are UNSUBSTANTIATED, meaning there isn’t enough evidence to prove a violation occurred.

An exit interview was conducted with Martha Villalvazo, Assistant to the Administrator; a copy of this report and Licensee's Rights (LIC9058) were provided.
SUPERVISORS NAME: Jerry Romero
LICENSING EVALUATOR NAME: Becky Kennedy
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2