565850439-2-12-2026-29-AS-KHEN-DSKVSL-20260327164143

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565850439
Report Date: 02/12/2026
Date Signed: 02/12/2026 03:53:02 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
12/15/2025 and conducted by Evaluator Kelly Dulek

COMPLAINT CONTROL NUMBER: 29-AS-20251215154626

FACILITY NAME:	RINCON ASSISTED LIVING		FACILITY NUMBER:	565850439
ADMINISTRATOR:	SPRING, REBECCA		FACILITY TYPE:	740
ADDRESS:	67 EAST BARNETT ST.		TELEPHONE:	(805) 643-2176
CITY:	VENTURA	STATE: CA	ZIP CODE:	93001
CAPACITY:	54	CENSUS: 50	DATE:	02/12/2026
		UNANNOUNCED	TIME BEGAN:	12:10 PM
MET WITH:	Lesley Jamon, Program Manager		TIME COMPLETED:	04:00 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 designee at 12:12PM, Program Manager at 12:43PM, toured the facility with Program Manager at 02:03PM, and LPA interviewed six (6) residents from 02:20PM to 03:15PM. LPA reviewed and obtained copies of relevant documents. During an initial complaint visit conducted on 12/19/2025, LPA interviewed designee at 12:22PM, toured the facility with designee at 12:49PM, and LPA attempted to call Resident #1 (R1) at 01:01PM. LPA requested copies of the LIC 500 and the resident roster be sent via email. Throughout the course of the investigation, LPA reviewed all documents obtained. The following was then determined:

Report Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20251215154626

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: 02/12/2026

NARRATIVE

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The complaint alleges that residents continue to smoke in non-designated areas, close to the facility doors and windows, which allows smoke to enter the facility. During both the initial and subsequent complaint visit, LPA observed designated smoking areas in the back of the facility, a sufficient distance from the facility entrances. LPA observed residents utilizing the designated smoking areas appropriately. Interview with staff and residents revealed that there are designated smoking areas which are used regularly for residents who smoke. However, sometimes residents do violate the rules and are observed smoking in a non-designated areas, usually in an outdoor courtyard in the back of the facility. When staff see a resident smoking in an unapproved area, staff ask the resident to move to a designated smoking area. The staff do give verbal warnings to all residents who are caught in violation of the house rules related to smoking. Staff interviewed indicated that for repeat offenders, the facility would follow their policies for all house rules violations, which includes verbal warnings and if continuing to re-offend, residents may be issued written warnings and possibly an eviction notice if warranted. At this time, only verbal warnings have been issued to various residents. Residents interviewed are aware of the facility's policies related to smoking only in designated areas, but admitted that sometimes they break the rules and staff do verbally warn them when in violation. 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.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2026

LIC9099 (FAS) - (06/04)

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