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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604675
Report Date: 08/27/2025
Date Signed: 08/27/2025 05:15:14 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
01/30/2025 and conducted by Evaluator Amy Rodgers
COMPLAINT CONTROL NUMBER: 08-AS-20250130141917
FACILITY NAME:GROSSMONT GARDENS SENIOR LIVINGFACILITY NUMBER:
374604675
ADMINISTRATOR:JONES, REGINALDFACILITY TYPE:
740
ADDRESS:5480 MARENGO AVETELEPHONE:
(619) 463-0281
CITY:LA MESASTATE: CAZIP CODE:
91942
CAPACITY:425CENSUS: 362DATE:
08/27/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Administrator Lynn TorinoTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff did not assist resident with incontinence care
Staff did not assist resident with showers
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced visit to initiate a complaint investigate and deliver findings. LPA was met by and granted entry into the facility by Administrator Lynn Torino, with whom the purpose of the visit was discussed.

On January 30, 2025, the Community Care Licensing Division (CCLD) received a complaint alleging that staff failed to assist Resident #1 (R1) with incontinence care and showers. The investigation included staff and resident interviews, records review, and relevant documentation review.

(Continued on LIC 9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2025
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-20250130141917
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: GROSSMONT GARDENS SENIOR LIVING
FACILITY NUMBER: 374604675
VISIT DATE: 08/27/2025
NARRATIVE
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(Continued from LIC9099)

The Department interviewed R1 and they stated they do not require assistance with toileting or showers, reporting no concerns with staff and asserting they manage their own hygiene. However, their statements conflicted with staff interviews and documentation, which indicated that R1 does require assistance and has a history of refusing hygiene care.

Staff confirmed that R1 was placed back on the facility’s shower schedule following her discharge from hospice. They reported that R1 frequently refuses showers and incontinence care, often stating she has already bathed or can manage independently. No staff reported observing wounds, skin breakdown, or other signs of neglect. An outside source (OS1) confirmed that R1 had been receiving hospice services, during which hospice staff provided showers. OS1 reported no hygiene concerns during their most recent visit.

Interviews with other residents on R1’s floor revealed no concerns regarding hygiene or incontinence care. Residents reported receiving appropriate assistance, and no one observed others in soiled briefs or with poor hygiene. The department also observed adequate hygiene supplies in the shower rooms. A review of the shower schedule confirmed that R1 was assigned designated shower days consistent with facility policy following her hospice discharge.

Based on interviews, and records review and department observations there is not a preponderance of evidence to prove alleged violations occurred, therefore the allegations are unsubstantiated.

An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Administrator Lynn Torino whose signature below confirms receipt of these rights. [See LIC 811 Confidential Names List to identify Resident #1]
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2