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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565850439
Report Date: 10/28/2025
Date Signed: 10/28/2025 04:16:02 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/24/2025 and conducted by Evaluator Kelly Dulek
COMPLAINT CONTROL NUMBER: 29-AS-20251024100205
FACILITY NAME:RINCON ASSISTED LIVINGFACILITY NUMBER:
565850439
ADMINISTRATOR:SPRING, REBECCAFACILITY TYPE:
740
ADDRESS:67 EAST BARNETT ST.TELEPHONE:
(805) 643-2176
CITY:VENTURASTATE: CAZIP CODE:
93001
CAPACITY:54CENSUS: 50DATE:
10/28/2025
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Lesley Jamon, Facility DesigneeTIME COMPLETED:
04:25 PM
ALLEGATION(S):
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Staff do not prevent residents from smoking in non-designated areas
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced initial complaint visit related to the above allegation. Upon arrival, the LPA met with Facility Designee Irina Zendejas and explained the reason for the visit. Entrance interview conducted.

During today's visit, LPA interviewed management at 12:33PM, toured the facility with management at 01:06PM and took photographs, from 01:27PM to 02:43PM, LPA interviewed five (5) residents and two (2) additional staff. LPA also reviewed and obtained a copy of the facility's house rules. At 03:35PM, the LPA conducted one (1) additional resident interview and facility tour. The following was then determined:

The complaint alleges that residents of the facility smoke outdoors too close to the building and it bothers non-smokers. Interviews with both residents and staff revealed that most of the residents in the facility smoke cigarettes and there are very few non-smokers. Residents interviewed indicated there are four (4) designated
Report Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2025
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 29-AS-20251024100205
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: RINCON ASSISTED LIVING
FACILITY NUMBER: 565850439
VISIT DATE: 10/28/2025
NARRATIVE
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smoking areas. LPA observed outdoor smoking areas to contain shaded seating and have appropriate smoking receptacles. LPA observed there are no smoking signs posted around the outside of the building. LPA reviewed the facility's house rules, which indicate "smoking is not permitted within the interior confines of the facility. It is permitted in designated areas only." Residents interviewed stated they are aware of the designated smoking areas, however, not all residents abide by the facility policies. Staff interviewed indicated they regularly remind residents of the facility's smoking policies, however, there are some residents that repeatedly violate these policies. Residents interviewed stated once staff reminded residents of the where to smoke, the problem has been resolved. Staff indicated they have ordered additional signage to further remind residents of the smoke-free areas. The information obtained during the investigation did not include sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not sufficient evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed UNSUBSTANTIATED at this time.

No citations issued. Exit interview conducted. A copy of today's report was provided.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2