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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604544
Report Date: 02/20/2025
Date Signed: 02/24/2025 01:09:52 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
06/18/2024 and conducted by Evaluator Alyssa Ramirez
COMPLAINT CONTROL NUMBER: 08-AS-20240618085911
FACILITY NAME:PACIFICA SENIOR LIVING BONITAFACILITY NUMBER:
374604544
ADMINISTRATOR:REBECCA TOVESFACILITY TYPE:
740
ADDRESS:3434 BONITA ROADTELEPHONE:
(619) 476-9444
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:145CENSUS: 130DATE:
02/20/2025
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Dining Services Director Abraham BotelloTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff abandoned residents.
Staff did not have transportation for resident after hospital visit.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alyssa Ramirez conducted an unannounced complaint visit to deliver findings on the above allegations. LPA met with Dining Services Director Abraham Botello and discussed the purpose of the visit and elements of the complaint.

Community Care Licensing (CCL) has investigated the above allegations. The investigation consisted of records review, interviews with facility staff and outside sources.

It was reported to CCL that staff abandoned resident and staff did not have transportation for resident after hospital visit.

Regarding the allegation, staff abandoned resident, it was reported that resident (R1) was transported to the hospital for unknown reasons. It was reported that hospital contacted the facility to pick up R1 but facility refused. It was reported that R1 was still at the hospital.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Alyssa Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
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-20240618085911
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: PACIFICA SENIOR LIVING BONITA
FACILITY NUMBER: 374604544
VISIT DATE: 02/20/2025
NARRATIVE
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Interview with reporting party (RP) revealed that R1 had started to develop exit seeking behaviors and memory care unit at facility was full. RP said that facility had explained that they were not a locked facility and were not equipped to care for a resident with exit seeking behaviors. RP said that facility staff informed hospital staff of the exit seeking behaviors that R1 was exhibiting and hospital social worker had R1 moved to another facility. Records review revealed that on 4/15/24, a 30 day eviction notice was given to R1 due to R1 needing a higher level of care. Interview’s with facility staff revealed that facility had sent out R1 to the hospital and was in communication with hospital social worker about concerns for the need for a higher level of care. Interview with facility staff revealed that R1’s responsible party had passed away and there was no relatives willing to assist in re-locating R1. Interview with outside source (OS2) revealed that they were aware of the situation and was involved in trying to locate a responsible party for R1. OS2 reported that the facility is at no fault and did all they could. OS2 stated that there was no concern for facility abandoning R1.

Regarding the allegation, staff did not have transportation for resident after hospital visit, it was reported that resident (R2) was admitted to the hospital due to chest pain. It was reported that on 5/18/24, R2 was released from hospital but facility did not pick R2 up. It was reported that facility did not have transportation and R2 remained at the hospital and passed away. Interview’s with facility staff revealed that the facility utilizes a van from their other property for transportation services. Staff reported that if van is not available and a resident needs transportation services then facility will pay for an Uber. Staff reported that residents have never been denied transportation. Staff reported that when R2 was at the hospital they were in contact with hospital social worker and was never told that R2 was ready for discharge. Staff reported that R2 passed away at the hospital. Interview with outside source (OS2) revealed that there was no concern for lack of transportation at the facility. Interview’s with other resident’s revealed that residents have returned to the facility via ambulance, facility van or Uber paid for by facility. No concern for lack of transportation from residents.

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 allegations are not valid. No deficiencies were cited today.



An exit interview was conducted with Botello. A copy of this report along with licensee rights (LIC 9058, 3/22) was provided to Botello whose signature below verifies receipt of these rights.

SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Alyssa Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2