372004738-2-26-2025-08-AS-LTEZ-DEB47G-20250227175106

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 372004738
Report Date: 02/26/2025
Date Signed: 02/26/2025 01:25:04 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
05/20/2024 and conducted by Evaluator Sabel Martinez

COMPLAINT CONTROL NUMBER: 08-AS-20240520114334

FACILITY NAME:	CANYON VILLAS		FACILITY NUMBER:	372004738
ADMINISTRATOR:	BOLLER, VONDA		FACILITY TYPE:	740
ADDRESS:	4282 BALBOA AVENUE		TELEPHONE:	(858) 273-1306
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92117
CAPACITY:	133	CENSUS: 96	DATE:	02/26/2025
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Executive Director Vonda Boller		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff did not ensure food provided was of good quality
Staff did not provide sufficient food
Staff did not provide activities
Licensee did not follow admissions agreement

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced follow up complaint investigation visit, and delivered complaint findings. The LPA introduced himself and disclosed the purpose of the visit to Housekeeping Director Emy Rivera. Executive Director Vonda Boller arrived during the visit and assisted the LPA.

Throughout the investigation, the Department secured records and conducted interviews with external and internal sources, including staff and residents.

It was alleged staff did not ensure food provided was of good quality. Interviews with internal and external sources revealed contradicting statements regarding the quality of the food provided. Some sources disclosed the food was of good quality, that staff provided options, and that staff were receptive to feedback. Other sources reported the food was mediocre, but still of good quality. These sources had not address this with staff.

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025

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 08-AS-20240520114334

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: CANYON VILLAS	FACILITY NUMBER: 372004738
	VISIT DATE: 02/26/2025

NARRATIVE

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On multiple visits to the facility, the LPA observed the facility’s dining service, and inspected the facility’s food supply. There were no immediate concerns with the quality of food observed by the LPA during these visits.

It was alleged Staff did not provide sufficient food. Interviews with staff and residents revealed the amount of food provided was sufficient. Prior to serving the food, staff would confirm with each resident the portion size desired. Residents were able to request additional servings and there was no concern with lack of food. Interviews also revealed there were snacks placed throughout the facility and were accessible to the residents. During multiple visits to the facility, the LPA inspected the facility’s food supply and determined there were no concerns with the amount of food at the facility. The LPA also toured the facility and witnessed mini fridges with yogurts, parfaits, fruit, snack bars, and bottled water readily available to the residents in care.

It was alleged the licensee did not provide activities. Interviews with staff and residents confirmed the facility had scheduled in-house and off-site activities for all residents to attend. Interviews with staff, residents, and the executive director, confirmed the facility had replaced transportation vehicles and the new transportation vehicle was not able to accommodate for residents in electric scooters, or wheelchairs. These interviews also revealed the facility would assist residents who wanted to participate in off-site activities in arranging Metropolitan Transit System (MTS) services. During multiple visits, the LPA witnessed activities schedules posted throughout the facility.

It was alleged the licensee did not follow an admissions agreement. It was reported to the Department the facility declined to provide transportation to medical appointments as agreed in Resident # 1’s (R1) admission agreement. Interviews with several sources, including R1, staff, and residents, denied the facility ever refusing to assist residents in arranging transportation to medical appointments. The facility scheduled transports to medical appointments on Tuesdays. Residents who used Ambulatory Assistive Devices (ADDs) were assisted with arranging transportation with MTS, or other providers able to accommodate ADDs. Review of R1’s admission agreement noted the facility would assist in arranging transport and providing transport on one designated day per week.

Based on the evidence obtained, there was not enough evidence to prove the alleged violations occurred, therefore, the allegations were Unsubstantiated. An exit interview was conducted with Executive Director Vonda Boller, to whom a copy of this report and Licensee/Appeals Rights (LIC 9058), were provided.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025

LIC9099 (FAS) - (06/04)

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