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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604648
Report Date: 02/11/2026
Date Signed: 02/11/2026 09:54:56 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
12/31/2025 and conducted by Evaluator Debbie Correia
COMPLAINT CONTROL NUMBER: 08-AS-20251231143359
FACILITY NAME:POWAY GARDENS SENIOR LIVING - MAGNOLIASFACILITY NUMBER:
374604648
ADMINISTRATOR:SHANNON HUNDLEYFACILITY TYPE:
740
ADDRESS:12735 MONTE VISTA ROADTELEPHONE:
(658) 674-1255
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY:6CENSUS: 6DATE:
02/11/2026
UNANNOUNCEDTIME BEGAN:
02:31 PM
MET WITH:Executive Director (ED) WatkinsTIME COMPLETED:
05:10 PM
ALLEGATION(S):
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Staff did not allow resident visitation at the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Correia conducted an unannounced visit to conclude a complaint investigation. LPA Correia was greeted by Executive Director (ED) Watkins, identified herself, and explained the purpose of the visit.

On December 31, 2025, the Department received a complaint alleging that the Licensee did not allow visitation with Resident 1 (R1). The Department’s investigation included interviews with staff, residents, and outside sources, as well as a review of resident records.

It was alleged that facility staff restricted Outside Source 1 (OS1) from visiting R1 for approximately three weeks following R1’s admission.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
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 3
Control Number 08-AS-20251231143359
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: POWAY GARDENS SENIOR LIVING - MAGNOLIAS
FACILITY NUMBER: 374604648
VISIT DATE: 02/11/2026
NARRATIVE
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A review of R1’s records revealed that their Power of Attorney (POA) was Outside Source 2 (OS2) for both health and fiduciary matters; however, R1 was not conserved. Interviews with outside sources (OS1, OS2, and OS3) corroborated that, at the time of admission, OS2 requested staff to prohibit OS1’s visitation with R1. An interview with OS2 confirmed this request, stating that R1 was still acclimating to the new environment and that OS1’s visits appeared to upset R1. Additionally, OS1 reported being denied visitation on two occasions by facility staff, who stated they were following management’s directive. OS3 also corroborated that OS1 was denied visitation by facility staff [see LIC 811 for confidential names list].Allegation Findings:

Based on interviews and record review, the allegation that the Licensee did not allow visitation with R1 is SUBSTANTIATED.

An exit interview was conducted with Health Services Director (HSD) Anding, A copy of this reports (LIC 9099/LIC 9099D) and the Licensee Rights (LIC 9058) will be provided at the conclusion of the visit. Signature below confirms receipt of these documents.
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20251231143359
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: POWAY GARDENS SENIOR LIVING - MAGNOLIAS
FACILITY NUMBER: 374604648
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/11/2026
Section Cited
CCR
87468.1(a)11
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Personal Rights. To have their visitors..., permitted....provided that the rights of other residents are not infringed upon.

This requirement was not met as evidenced by:
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The Licensee and staff agreed to take a CCL approved vendorized training on Personal Rights.

Certification of completion will be submitted to CCL by the POC due date.
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Based on interviews and record reviews, it was determined that staff did not allow visitation for Resident 1 (R1) at the request of R1’s Power of Attorney (POA).

This posed a potential personal rights risk to one out of six resdients 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: Robyn Clark
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3