374604544-8-29-2025-08-AS-APAO-DL264E-20250829202837

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604544
Report Date: 08/29/2025
Date Signed: 08/29/2025 01:27:15 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
10/22/2024 and conducted by Evaluator Marisela Garcia-Centeno

COMPLAINT CONTROL NUMBER: 08-AS-20241022162033

FACILITY NAME:	PACIFICA SENIOR LIVING BONITA		FACILITY NUMBER:	374604544
ADMINISTRATOR:	REBECCA TOVES		FACILITY TYPE:	740
ADDRESS:	3434 BONITA ROAD		TELEPHONE:	(619) 476-9444
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91910
CAPACITY:	145	CENSUS: 118	DATE:	08/29/2025
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Resident Services Director, Richard Tibi		TIME COMPLETED:	01:55 PM

ALLEGATION(S):

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Unlawful Eviction

INVESTIGATION FINDINGS:

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On August 29, 2025, Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted a telephone conference with Resident Services Director Richard Tibi to present investigative findings.

The Department’s investigation included a facility tour, record review, and interviews with staff and external sources.

Allegation: Unlawful Eviction
On October 22, 2024, Community Care Licensing (CCL) received a complaint alleging that a resident (R1) had been unlawfully evicted from the facility. Specifically, it was alleged that on October 17, 2024, R1 was transferred to the hospital due to a medical emergency, and that prior to the hospitalization, staff told R1 they needed to vacate their apartment by the end of the month because the facility could no longer meet their needs.
(Continue at LIC9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025

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 3

Control Number 08-AS-20241022162033

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: 08/29/2025

NARRATIVE

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(continue from LIC9099)

Record Review
A review of facility and resident records indicated that R1 was capable of making their own decisions. R1 signed an admission agreement on November 25, 2019, and moved into the facility. Records also showed that R1 was receiving financial assistance from an outside source to help cover monthly room and board fees.

On October 4, 2024, the facility issued R1 a 30-day termination notice and Notice to Quit due to nonpayment of the basic service rate. The notice stated that the admission agreement would terminate effective November 4, 2024, and that R1 had an outstanding balance of $33,400. This amount represented unpaid residency, care, and service fees from June through September 2024.

Billing statements from March through October 2024 and correspondence between R1 and the facility’s business office confirmed that R1 was not current with payments. Handwritten notes from R1 to staff further indicated that R1 was no longer receiving financial support from the outside source and lacked the financial means to continue paying for room and board.

R1 had previously been served a 30-day termination notice on September 4, 2024, when they first became delinquent. However, the facility withdrew that notice when R1 attempted partial payments. Those payments were returned due to insufficient funds, which led to the second 30-day termination notice issued on October 4, 2024.

Resident Placement
Interviews and records showed that on October 21, 2024, R1 was discharged from the hospital to another facility that provided rehabilitation services appropriate for R1’s needs. As of the date of this report, R1 continues to reside at that rehabilitation facility and receive necessary services.

(continue to LIC9099C)

SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 08-AS-20241022162033

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: 08/29/2025

NARRATIVE

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((ontinue from LIC9099C)

Findings
The investigation found no corroborating evidence that R1 was unlawfully evicted from the facility when transported to the hospital by 911 personnel due to a medical emergency. Review of the 30-day termination notice and Notice to Quit was properly served to R1, and it did not indicate any violations of Title 22 regulations.

Conclusion
Based on the investigation, including record reviews and interviews with staff and external sources—there is insufficient evidence to substantiate the allegation of unlawful eviction. Therefore, the allegation is deemed unsubstantiated.

An exit interview was conducted with Resident Services Director, Richard Tibi. A copy of this report, LIC811 Confidential List form and the Licensee Appeal Rights (LIC 9058, 03/22) were provided via email at rsd.bonita@bonitavillaseniorliving.com and ed.bonita@bonitavillaseniorlviging.com. An electronic confirmation of receipt was obtained.

SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025

LIC9099 (FAS) - (06/04)

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