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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604474
Report Date: 05/12/2025
Date Signed: 05/12/2025 10:41:28 AM

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
05/06/2025 and conducted by Evaluator Amy Rodgers
COMPLAINT CONTROL NUMBER: 08-AS-20250506112345
FACILITY NAME:VISTA SERENO RCFEFACILITY NUMBER:
374604474
ADMINISTRATOR:MASE, DOMINIQUEFACILITY TYPE:
740
ADDRESS:2725 VISTA SERENO CT.TELEPHONE:
(619) 405-3586
CITY:LEMON GROVESTATE: CAZIP CODE:
91945
CAPACITY:4CENSUS: 4DATE:
05/12/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Care Giver Felimon RaturatTIME COMPLETED:
11:10 AM
ALLEGATION(S):
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Licensee submitted an application and other attachments that were not true or correct
Licensee did not confirm adequate food for residents in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Amy Rodgers, conducted an unannounced visit to conclude a complaint investigation at the facility. LPA was greeted by Care Giver Felimon Raturat , identified herself, was granted entry, and explained the purpose of the visit.

The Department's investigation included a facility file and outside source records reviews, interviews conducted with the Licensee and an Outside Source, and a brief tour of the facility.

It was alleged the Licensee submitted false information on the facility license application regarding the percentage of ownership not being equal (50%, each) between two applicants. Based on a file review the facility's Administration Organization documents (LIC 309), was processed at 70% for Applicant #1(AP1) and 30% For Applicant #2(AP2). The operating Agreement for Vista Serena RCFE LLC confirms the percentages and signatures for both AP1 and AP2 are present on the document.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2025
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-20250506112345
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: VISTA SERENO RCFE
FACILITY NUMBER: 374604474
VISIT DATE: 05/12/2025
NARRATIVE
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(continued from LIC 9099)

It was also alleged the Licensee did not ensure residents in care received adequate food. An interview conducted with Licensee and facility tour confirmed the facility had four (4) clients. A department facility inspection was conducted October 9, 2024 and May 12, 2025 of the kitchen as well as food storage areas There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored Cooking/dining equipment and utensils were present. Interviews with Resident #1 (R1) confirmed thee are no issues in the home with food shortages.

Based upon the foregoing, the above listed allegations are unsubstantiated. This finding means that the preponderance of the evidence standard has not been met and the allegation is not valid.

An exit interview was conducted with Care Giver Felimon Raturat. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided emailed to the address provided by Care Giver Raturat and his signature on this report confirms receipt of the Licensee Rights.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2