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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604554
Report Date: 07/01/2025
Date Signed: 07/01/2025 05:25:01 PM

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
06/25/2025 and conducted by Evaluator Dang Nguyen
COMPLAINT CONTROL NUMBER: 08-AS-20250625145637
FACILITY NAME:ACORN OAKS MANOR IIIFACILITY NUMBER:
374604554
ADMINISTRATOR:LIMPIN, ALEXANDERFACILITY TYPE:
740
ADDRESS:6209 ACORN STTELEPHONE:
(619) 777-9674
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY:6CENSUS: 5DATE:
07/01/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Supervisor Jamily “Jamila” Hallak and Administrator/Licensee Alexander “Alex” LimpinTIME COMPLETED:
05:45 PM
ALLEGATION(S):
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Licensee did not maintain facility in compliance with its issued fire clearance.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to commence a Complaint Investigation regarding the above allegations. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Supervisor Jamily “Jamila” Hallak. LPA then met with Administrator/Licensee Alexander “Alex” Limpin, who arrived shortly after.

The Complainant alleged that Licensee did not maintain facility in compliance with its issued fire clearance. CCLD’s investigation involved an unannounced facility tour/welfare check, interviews of relevant staff and a deputy fire marshal, and review of pertinent photographs and physical plant records.


[CONTINUED ON LIC 9099-C]
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2025
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 5
Control Number 08-AS-20250625145637
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: ACORN OAKS MANOR III
FACILITY NUMBER: 374604554
VISIT DATE: 07/01/2025
NARRATIVE
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[CONTINUED FROM LIC 9099]

LPA observation and interviews showed: The current facility (Acorn Oaks Manor III) is located at 6209 Acorn Street, San Diego, CA 92115. After this current facility’s licensure, Licensee had built another adjacent building/structure at 6211 Acorn Street. This new adjacent building sat so close to the current facility that it constricted the space just outside the side sliding-glass door of Bedroom #1 (of Acorn Oaks Manor III), creating a narrow hallway. Per San Diego Fire Rescue Department, this constriction was indeed severe enough to impair Bedroom #1’s continued status as a non-ambulatory room, as it was designated in the facility’s prior-approved fire clearance.

By the start of CCLD’s complaint investigation, Licensee had already used a professional contractor to construct a second side-exit door coming out of Bedroom #1 which does not face towards 6211 Acorn Street.

Based on photographs, interviews, and LPA observation, a preponderance of evidence exists to show that during the complaint time frame, Licensee did not maintain facility in compliance with its issued fire clearance. One (1) deficiency was cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D page). A Plan of Correction was jointly developed with the Licensee. Since the deficiency was timely corrected upon Licensee’s constructive knowledge of the problem, and fully resolved by the start of CCLD’s investigation, no civil penalty was assessed/charged.

An exit interview was conducted with Administrator/Licensee Alexander “Alex” Limpin, to whom a copy of this report, the LIC 9099-D page, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 08-AS-20250625145637
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: ACORN OAKS MANOR III
FACILITY NUMBER: 374604554
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/01/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/01/2025
Section Cited
CCR
87202(a)
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87202 Fire Clearance: “(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal.” This requirement was not met, as evidenced by:
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As of the date of deficiency issuance, Licensee had already used a professional contractor to construct a second side-exit door out of Bedroom #1 which does not face towards 6211 Acorn Street. This action resolves the immediate risk. Licensee agreed to E-mail an updated Facility Sketch (showing the presence of the new door coming out of Bedroom #1) to LPA and San Diego Fire Rescue Department by 08/01/2025.
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Based on records and interviews, Licensee did not maintain ongoing compliance with its prior-approved fire clearance. This posed an immediate safety risk to 5 of 5 residents (Resident #1 through Resident #5) in care.
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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: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
06/25/2025 and conducted by Evaluator Dang Nguyen
COMPLAINT CONTROL NUMBER: 08-AS-20250625145637

FACILITY NAME:ACORN OAKS MANOR IIIFACILITY NUMBER:
374604554
ADMINISTRATOR:LIMPIN, ALEXANDERFACILITY TYPE:
740
ADDRESS:6209 ACORN STTELEPHONE:
(619) 777-9674
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY:6CENSUS: 5DATE:
07/01/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Supervisor Jamily “Jamila” Hallak and Administrator/Licensee Alexander “Alex” LimpinTIME COMPLETED:
05:45 PM
ALLEGATION(S):
1
2
3
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5
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9
Licensee did not ensure facility was free of odors from incontinence.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to commence a Complaint Investigation regarding the above allegations. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Supervisor Jamily “Jamila” Hallak. LPA then met with Administrator/Licensee Alexander “Alex” Limpin, who arrived shortly after.

The Complainant alleged that Licensee did not ensure facility was free of odors from incontinence. CCLD’s investigation involved an unannounced facility tour/welfare check to observe residents and the physical plant. The Department also interviewed pertinent staff.

During his 07/01/2025 site visit, LPA inspected every common area, restroom, and resident bedroom of the facility, finding no evidence of urine or fecal odors, or other foul odors. The facility appeared clean.

[CONTINUED ON LIC 9099-C]
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 08-AS-20250625145637
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: ACORN OAKS MANOR III
FACILITY NUMBER: 374604554
VISIT DATE: 07/01/2025
NARRATIVE
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[CONTINUED FROM LIC 9099]

Interviews of multiple facility staff showed they consistently checked residents’ incontinent products roughly every two hours, changing them if wet/soiled, and more often as needed. Caregivers also cleaned the shared restrooms daily and performed routine housekeeping.

Based on records and interviews, a preponderance of evidence does not exist to show that Licensee did not ensure facility was free of odors from incontinence. The allegation is therefore Unsubstantiated, and no deficiency was cited for it.

An exit interview was conducted with Administrator/Licensee Alexander “Alex” Limpin, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5