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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 370808582
Report Date: 11/21/2025
Date Signed: 11/21/2025 10:36:08 PM

Substantiated


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
12/31/2024 and conducted by Evaluator Debbie Correia
COMPLAINT CONTROL NUMBER: 08-AS-20241231075959
FACILITY NAME:RUBIA'S FACILITY CARE HOMEFACILITY NUMBER:
370808582
ADMINISTRATOR:MERCEDES RUBIAFACILITY TYPE:
735
ADDRESS:12443 OLD POMERADO ROADTELEPHONE:
(858) 397-3030
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY:6CENSUS: 2DATE:
11/21/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Licensee MercedesTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Licensee did not prevent pests.
Facility was not sanitary.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced subsequent visit to deliver findings regarding the above allegation(s). LPA was greeted by Licensee Rubia to whom LPA identified herself and discussed the purpose of the visit.

The Department's investigation consisted of LPA observations, interviews with facility staff, residents, and outside sources, as well as a review of facility records.

It was alleged that the licensee did not prevent pests. Specifically, it was reported that Outside Source1 (OS1) pests were observed in the refrigerator located in the kitchen. Through interviews with OS1, the Licensee, and facility staff, it was confirmed that pests were observed in the refrigerator on 12/16/2024. The Licensee also informed LPA that the facility did not previously have a pest control company providing regular service.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025
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 3
Control Number 08-AS-20241231075959
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: RUBIA'S FACILITY CARE HOME
FACILITY NUMBER: 370808582
VISIT DATE: 11/21/2025
NARRATIVE
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The Licensee stated that a new refrigerator had been purchased. During LPA observations on 01/08/2024, it was confirmed that a new refrigerator had been installed and was clean and sanitary.

Additionally, it was alleged that the facility was not maintained in a sanitary condition. Specifically, it was reported that dog feces were present on the walkways in the facility’s backyard. Interviews with outside sources, staff, and the Licensee confirmed that on 12/16/2024, there was an abundance of dog feces on the backyard walkways. During an inspection conducted by LPA on 01/08/2024, it was observed that the backyard had been cleaned, and no dog feces were present.

Based on review interviews with staff and outside sources, and direct observations, the preponderance of evidence standard has been met. Therefore, the above allegations are determined to be SUBSTANTIATED. Deficiencies are cited per California Code of Regulations, Title 22, Division 6, on the attached LIC 9099-D.

An exit interview was conducted, and a copy of this report, the LIC 9099-D, and the Licensee Appeal Rights (LIC 9058 03/22) were reviewed with and provided to Licensee Mercedes at the conclusion of the visit. Signature below confirms receipt of the reports.
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20241231075959
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: RUBIA'S FACILITY CARE HOME
FACILITY NUMBER: 370808582
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/24/2025
Section Cited
CCR
80087(a))(1)
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The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.The licensee shall take measures to keep the facility free of flies and other insects.

This regulation was not met as evidenced by:
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Licensee shall ensure that the facility remains free of pests by contracting with a licensed pest control company to provide regular service.
Proof of service agreement shall be submitted to the Department by the POC due date.
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Based on a records review from OS1, pests were observed inside the facility refrigerator in the kitchen. The Licensee acknowledged that the facility did not have a pest control service in place at the time.

This posed a potential personal rights and health risk to 2 out of 2 residents in care
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Type B
11/24/2025
Section Cited
CCR
80087(a)
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The facility shall be clean, safe, sanitary, and in good repair at all times for the safety and well-being of clients, employees, and visitors.

This regulation was not met as evidenced by:
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Licensee stated they will implement a written cleaning schedule to ensure the backyard remains free of dog feces. A copy of the cleaning schedule and documentation of staff training on the new procedure shall be submitted to the Department by the POC due date.
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On 12/16/2024, it was reported by OS1 and confirmed through interviews and observations that there was an abundance of dog feces on the walkways in the backyard of the facility.

This posed a potential personal rights and health risk to 2 out of 2 residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3