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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 370800394
Report Date: 12/09/2025
Date Signed: 12/09/2025 11:33:28 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
07/28/2025 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20250728153034
FACILITY NAME:COVENANT LIVING AT MOUNT MIGUELFACILITY NUMBER:
370800394
ADMINISTRATOR:RICHARD MILLERFACILITY TYPE:
741
ADDRESS:325 KEMPTON STREETTELEPHONE:
(619) 479-4790
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:435CENSUS: 352DATE:
12/09/2025
UNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Ron Alamario, AdministratorTIME COMPLETED:
11:35 AM
ALLEGATION(S):
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Licensee did not ensure staff followed proper infection control protocols.
Licensee did not ensure sufficient staffing to assist residents with medication needs.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Tiffany Holmes conducted an unannounced complaint visit to deliver findings on the above-mentioned allegations. LPA met with Ron Alamario, Assisted Living Director and we discussed the allegation.

LPA conducted interviews, made observations, and obtained and reviewed pertinent records. It was alleged that the licensee did not ensure staff followed proper infection control protocols. Interviews revealed that the facility is supplied with plenty of Personal Protective Equipment (PPE). Interviews revealed that when a resident has tested positve for covid and is put on isolation that the facility staff provides a PPE box outside of their door for the staff. Interviews and LPA observations revealed there were masks, gloves, gowns and shields inside of the drawers of the PPE boxes. Interviews revealed there is sanitizer on top of the PPE boxes for staff to use as soon as they take their gloves off. Interviews revealed the staff denied not ensuring the staff are not following proper infection control protocols.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2025
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-20250728153034
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: COVENANT LIVING AT MOUNT MIGUEL
FACILITY NUMBER: 370800394
VISIT DATE: 12/09/2025
NARRATIVE
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It was alleged that the licensee did not ensure sufficient staffing to assist residents with medication needs. Interviews revealed that the staff are med tech's as well as caregivers. On every shift there are med tech's. Interviews revealed that staff are hired to do both jobs as needed. Interviews revealed the caregivers and CNAs can do medication for the residents and the caregiving. There are CNAs on every shift. Interviews revealed that there are 5 staff in the mornings that work from 6am -230 pm. There are 5 staff in the evenings from 215 pm- 1045 pm then there are 4 staff that work overnight from 1030 pm -7am and they all can do medications.

The Department has investigated the above-mentioned allegations and based on interviews, LPA observations, and records review, it was determined that the complaint allegations are Unsubstantiated. The allegations may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted, and a copy of this report was left at the facility with Ron Alamario Assisted Living Director and was provided a copy of the Appeal Rights (LIC 9058 3/22) and their signature on this form acknowledges receipt of these rights.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2