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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604722
Report Date: 12/08/2025
Date Signed: 12/10/2025 10:05:59 AM

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
11/21/2025 and conducted by Evaluator Debbie Correia
COMPLAINT CONTROL NUMBER: 08-AS-20251121091920
FACILITY NAME:NOVELLUS CLAIREMONT LLCFACILITY NUMBER:
374604722
ADMINISTRATOR:LEWIS, ERNESTFACILITY TYPE:
740
ADDRESS:5219 CLAIREMONT MESA BLVD.TELEPHONE:
(858) 292-8044
CITY:SAN DIEGOSTATE: CAZIP CODE:
92117
CAPACITY:214CENSUS: 89DATE:
12/08/2025
UNANNOUNCEDTIME BEGAN:
02:53 PM
MET WITH:Executive Director (ED) Ernest LewisTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff did not provide resident with a refund.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Correia conducted an unannounced visit to commence and conclude a complaint investigation. LPA Correia was met by Concierge Angele Reyes, identified herself, and subsequently met with Business Office Coordinator (BOC) Vanessa Padilla to whom it was explained the purpose of the visit.

The Department’s investigation consisted of a review of R1’s facility records and a review of outside source records, a tour of R1’s room, and outside source interviews.

On November 21, 2025, the Department received a complaint that alleged the facility would not provide a refund for the number of pre-paid days after R1 had relocated.

This is an amended version of the original complaint delivered on December 8, 2025.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2025
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-20251121091920
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: NOVELLUS CLAIREMONT LLC
FACILITY NUMBER: 374604722
VISIT DATE: 12/08/2025
NARRATIVE
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Outside Source (OS1) interview revealed R1 gave the Executive Director (ED) verbal notice they were going to vacate the facility on October 14, 2025. Although there was no documentation of written notice to vacate on October 14, 2025, records were secured dated October 16, 2025, that confirmed the ED had received R1’s notice. However, on October 18, 2025, a record review revealed R1 asked the ED to put a hold on their 30-day notice to vacate after encountering an issue with their new location, in which the ED agreed and on November 3, 2025, the ED sent out a notice to the corporate office that R1 would be resuming their place at the facility.

Subsequently, on November 11, 2025, a record review revealed R1 notified the ED that they would not be returning to the facility, and on November 17, 2025, a moving company picked up R1’s belongings and removed them from the facility. Although there were 13 days of unused prepaid (November 18th through November 30th) days of rent, due to R1 recanting their notice to vacate on November 11, 2025, the facility held R1’s room with an expectation of their return and did not seek a new admit.

During LPA Correia’s initial visit on December 1, 2025, she conducted an inspection of R1’s room at the facility. LPA observed the room to be vacant, and readily available to house a new resident.

Based on the interviews and reviews of records the Department’s investigation determined the allegation to be Unsubstantiated. An unsubstantiated finding means there was not a preponderance of evidence to prove the violation occurred.

An exit interview was conducted with ED Lewis. A copy of this report (LIC 9099), and the Licensee Rights (LIC 9058) was provided to ED Lewis. Signature below confirms receipt of the reports.
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2