374603439-7-30-2026-08-AS-LTEZ-DWNSSU-20260805140830

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603439
Report Date: 07/30/2026
Date Signed: 07/30/2026 03:34:27 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
07/23/2026 and conducted by Evaluator Janet Ngallo

COMPLAINT CONTROL NUMBER: 08-AS-20260723132831

FACILITY NAME:	CASA DE MANANA		FACILITY NUMBER:	374603439
ADMINISTRATOR:	MARIVEL JOHNSON		FACILITY TYPE:	740
ADDRESS:	849 COAST BLVD		TELEPHONE:	(858) 456-4268
CITY:	LA JOLLA	STATE: CA	ZIP CODE:	92037
CAPACITY:	249	CENSUS: 209	DATE:	07/30/2026
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Executive Director Marivel Johnson, Director of Health Services Ada Navarrete		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not provide the resident with appropriate sleeping accommodations.
Staff did not prevent the spread of scabies for residents in care.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Janet Ngallo conducted an unannounced visit to initiate a complaint investigation and deliver findings regarding the above-mentioned allegations. LPA identified themselves and met with Executive Director Marivel Johnson to discuss the purpose of the visit and elements of the complaint.

On 07/23/2026, it was alleged that staff did not provide the resident with appropriate sleeping accommodations, and that staff did not prevent the spread of scabies for residents in care. The department's investigation consisted of interviews, records review, and LPA observations.

[Cont. on LIC 9099-C]

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Janet Ngallo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2026

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-20260723132831

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: CASA DE MANANA	FACILITY NUMBER: 374603439
	VISIT DATE: 07/30/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

[Cont. from LIC 9099]

Regarding the allegation that staff did not provide the resident, (R1) with appropriate sleeping accommodations, R1 had an unconfirmed contagious skin condition, and the facility took precaution under physician recommendation by following infection control protocols, including accommodating the request for R1's mattress to be washed. interviews reported that temporary beds are available on site and are typically set up by housekeeping or maintenance staff. Staff interviews indicated that R1 was offered multiple options for temporary accommodations while their bedding was being cleaned, including relocation to another furnished room, which R1 declined. Staff reported that the temporary bed was provided while R1’s mattress was being cleaned and dried, and no concerns were raised by R1 at the time. Interviews could not confirm who exactly set up R1's temporary bed. Additional staff interviews reported knowledge of how to properly setup the temporary bed.

LPA, accompanied by the Executive Director, observed a storage room with multiple roll away beds for temporary use. LPA observed Executive Director and housekeeping staff demonstrate the setup of the temporary beds, and LPA observed the bed with a mattress, and black cot. The cot appeared sturdy and properly assembled, with no safety concerns observed.

Regarding the allegation that staff did not prevent the spread of scabies for residents in care, more specifically, that residents were not notified of the potential outbreak, interviews revealed that several residents experienced symptoms within the same timeframe, however, no confirmed outbreak was identified by public health, and cases were treated based on visual assessment by medical providers. Staff interviews confirmed that environmental cleaning, laundering of clothing, bagging of linens, use of Personal Protective Equipment (PPE), and disinfection procedures were conducted according to guidance provided by public health and medical providers. Maintenance and housekeeping staff confirmed following protocols, including bagging items for the recommended duration and witnessing cleaning companies assist with environmental disinfection.

Interviews with residents reported receiving notifications in their mailboxes informing them of potential cases, preventive steps, and cleaning schedules.
[Cont. on LIC 9099-C pg. 1]

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Janet Ngallo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 08-AS-20260723132831

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: CASA DE MANANA	FACILITY NUMBER: 374603439
	VISIT DATE: 07/30/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

[Cont. from LIC 9099-C]

Records review revealed that the facility submitted an incident report to the department regarding the potential outbreak and consulted with public health, which determined no additional follow-up was required unless a significant increase in cases occurred. Records also confirmed that two written notifications were provided to all residents, advising them of potential cases, cleaning plans, and prevention measures.
Invoices reviewed showed professional cleaning services for affected apartments and common areas, and records review revealed orders of mite-control spray. Review of the facility’s infection control plan showed established procedures for outbreak response, PPE use, and environmental cleaning.

LPA observed PPE supply carts available at the facility containing infection control items such as gloves, gowns, shoe covers, hand sanitizers, and masks.

Based on interviews, records review, and LPA observations, the preponderance of evidence standard has not been met, therefore, these allegations are found to be unsubstantiated. An exit interview was conducted with Director of Health Services Ada Navarrete and a copy of this report, along with Licensee/Appeal Rights (LIC 9058 01/16), were provided. Their signature confirms receipts of these documents.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Janet Ngallo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 3