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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604738
Report Date: 12/30/2025
Date Signed: 12/30/2025 03:35:47 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
11/19/2025 and conducted by Evaluator Rebecca A Borunda
COMPLAINT CONTROL NUMBER: 08-AS-20251119162238
FACILITY NAME:BLUE SKIES OF THE VALLEYFACILITY NUMBER:
374604738
ADMINISTRATOR:GAMAB, LAURICEFACILITY TYPE:
740
ADDRESS:4676 MARBLEHEAD BAY DR.TELEPHONE:
(619) 208-7869
CITY:OCEANSIDESTATE: CAZIP CODE:
92057
CAPACITY:6CENSUS: 6DATE:
12/30/2025
UNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Caregiver William PuntaTIME COMPLETED:
11:50 AM
ALLEGATION(S):
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Licensee did not meet resident's hygiene needs
Resident was confined to their room
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Rebecca Borunda conducted an unannounced complaint visit to conduct follow up and deliver findings regarding the above mentioned allegations. LPA was greeted by, identified herself to, and explained the purpose of the visit to Caregiver William Punta.

During today’s visit, LPA observed residents in care and interviewed staff. The Department’s investigation consisted of interviews with residents and staff, records review, and a tour of the facility. It was alleged that the Licensee did not meet resident’s hygiene needs and Resident 1 (R1) was confined to their room.


Continued on LIC9099-C page...
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Rebecca A Borunda
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2025
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-20251119162238
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: BLUE SKIES OF THE VALLEY
FACILITY NUMBER: 374604738
VISIT DATE: 12/30/2025
NARRATIVE
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Review of assessment records for R1 revealed that R1 required assistance with bathing and hygiene care, and further assessment of the other resident’s assessment records revealed that a total of four of six residents requires assistance with hygiene and bathing care. Interviews with residents did not reveal any concerns that staff did not assist residents with showering and residents were pleased about the frequency of staff assistance with showers. Interviews with staff showed that coordination between facility staff and outside agencies allowed residents to receive showers as often as every other calendar day. Interviews with staff did reveal that at least one resident was resistant to receiving shower assistance by staff of the opposite gender, however, staffing schedules allowed for the resident to receive showers by their preferred staff. LPA observations during on-site visits did not reveal any noticeable odors or concerns that residents were not well groomed or appropriately dressed. Additionally, LPA observed that staff assisted residents with incontinence care and ensured that residents were well groomed and absent from noticeable odors following the incontinence care.

Additionally, interviews with staff and residents did not reveal concerns that residents were not able to move about the facility as they wished, including entering the facility’s backyard. Interviews with R1 did not reveal any concerns that R1 was not able to leave their room if they wished. LPA observed during on-site visits that residents, including R1, were able to leave their rooms as desired. However, there was some evidence that residents were not allowed to enter the facility’s kitchen during certain times. Interviews with staff revealed that residents were not allowed to enter a portion of the kitchen where locked cabinets containing sharps and/or other hazardous items were stored. On-site visits confirmed that those items were kept in locked storage as required.

The Department has investigated the above-mentioned allegations and based on observation, interviews, and records review, the preponderance of the evidence has not been met, therefore, these allegations are deemed unsubstantiated.

An exit interview was conducted with Caregiver William Punta, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 03/22).
SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Rebecca A Borunda
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2