374602972-5-7-2026-08-AS-APAO-DVZ37F-20260714175948

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374602972
Report Date: 05/07/2026
Date Signed: 05/07/2026 03:58:23 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
02/12/2026 and conducted by Evaluator Jose DeLaCruz

COMPLAINT CONTROL NUMBER: 08-AS-20260212151743

FACILITY NAME:	PLAZA VILLAGE SENIOR LIVING		FACILITY NUMBER:	374602972
ADMINISTRATOR:	MEGAN AMY		FACILITY TYPE:	740
ADDRESS:	950 L AVE		TELEPHONE:	(619) 289-8798
CITY:	NATIONAL CITY	STATE: CA	ZIP CODE:	91950
CAPACITY:	85	CENSUS: 58	DATE:	05/07/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Facility Director Megan Moore		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Staff did not meet resident's hygiene care needs
Facility not meeting dietary needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jose De La Cruz conducted an unannounced visit regarding the above mentioned allegations. LPA was greeted and granted entry by Facility Director Megan Moore, to whom he identified himself and explained the purpose of the visit.

The Reporting Party (RP) alleged that the facility failed to meet Resident 1’s (R1) dietary and hygiene needs. According to RP, during a meeting with R1, the resident had dried feces on their body. RP also stated that R1 expressed pronounced hunger and ate offered food rapidly. RP expressed concern that the facility was not adequately monitoring R1’s food intake, especially given R1’s cognitive impairment, which limits their ability to recall whether they have eaten.

[CONTINUED ON LIC9099-C]

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Jose DeLaCruz
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026

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 08-AS-20260212151743

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: PLAZA VILLAGE SENIOR LIVING	FACILITY NUMBER: 374602972
	VISIT DATE: 05/07/2026

NARRATIVE

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[CONTINUED FROM LIC9099]

LPA interviewed RP on 02/19/2026, who acknowledged that R1’s intake may not have seemed optimal, but also noted that R1 gained 4.8 pounds between February 10 and February 19, 2026. RP further clarified that based on their own assessments, R1 was capable of using the restroom independently.

On February 19, 2026, LPA conducted a site visit and reviewed R1’s records. LPA observed that since July 2025, R1 had been diagnosed with severe malnutrition associated with mild to moderate oropharyngeal dysphagia, which results in impaired swallow strength. Records indicated that R1 experienced sadness and reduced appetite related to feelings of loneliness. R1’s pre placement appraisal, dated January 5, 2026, documented that R1 was able to use the restroom independently.

During the visit, LPA interviewed Staff 1 (S1), the Resident Care Director. S1 reported that R1 was admitted in early January 2026 and initially appeared shy and unwilling to eat. According to S1, R1 was prescribed a pureed diet but was selective about the types of food they would accept, requiring staff to try different options. S1 further explained that R1 would not eat when being observed, so staff would place food within reach and step away to allow R1 to eat independently.

On April 14, 2026, LPA interviewed an outside source familiar with R1 (OS1). OS1 stated that due to cognitive impairment, R1 is often unaware of their surroundings. OS1 reported that R1 frequently assumed food had to be purchased and, because they did not have money, avoided requesting meals out of fear they could not pay. OS1 also noted that R1 has experienced significant decline over the past year due to multiple relocations. According to OS1, R1 does not require toileting assistance and wears adult diapers only to prevent potential accidents. OS1 stated that R1 typically refuses assistance when it is offered.

Based on records reviewed, LPA observations, and interviews conducted with RP, outside source and staff, the preponderance of evidence standard has not been met, and the allegation is deemed unsubstantiated. No deficiencies were cited in accordance with the California Code of Regulations.

Report and Appeal Rights discussed with and provided to Licensee. Signature below confirms receipt.

SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Jose DeLaCruz
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026

LIC9099 (FAS) - (06/04)

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