<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603565
Report Date: 03/07/2025
Date Signed: 03/11/2025 12:14:01 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
02/10/2025 and conducted by Evaluator Iby Strong
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20250210153551
FACILITY NAME:LA VIDA REALFACILITY NUMBER:
374603565
ADMINISTRATOR:GARCIA, KIMBERLYFACILITY TYPE:
740
ADDRESS:11588 VIA RANCHO SAN DIEGOTELEPHONE:
(619) 660-5778
CITY:EL CAJONSTATE: CAZIP CODE:
92019
CAPACITY:177CENSUS: 120DATE:
03/07/2025
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Executive Director Kimberly GarciaTIME COMPLETED:
04:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not ensure residents call buttons are answered in a timely manner.
Staff allow residents to be left in soiled clothing for extended periods of time.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Iby Strong conducted an unannounced visit to continue an investigation in the above-mentioned complaint allegations. LPA identified herself and discussed the purpose of the visit with Executive Director Kimberly Garcia.

On February 10, 2025, Community Care Licensing (CCL) received a complaint alleging staff do not answer call buttons in a timely manner and staff allow residents to be left in soiled clothing for an extended period. During investigation, LPA Strong collected pertinent facility records, conducted interviews, and completed a facility inspection.

According to the first allegation, on February 9, 2025 at an undisclosed time, Resident 1 (R1) was requesting medication for pain and pressed their call button, after twenty minutes no staff appeared so family proceeded to find a Medication Technician to assist. Records collected revealed that R1’s button was pressed on February 9, 2025, one time at 3:00pm and not cleared by staff until 8:47pm.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2025
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 5
Control Number 08-AS-20250210153551
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: LA VIDA REAL
FACILITY NUMBER: 374603565
VISIT DATE: 03/07/2025
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
Interview with staff revealed that medication was issued to R1 when requested but the call button was not cleared by error. Medication administration records reviewed revealed that R1 was issued pain medication at 1:48pm and an anxiety medication at 2:59pm on the same date. According to pain medication prescription, medication can only be issued up to every two hours. Interview with an outside source did not confirm that R1’s call button was not answered in a timely manner.

It was also alleged that staff allow R2 to be left in urine-soaked clothing for an extended period. On February 18, 2025, LPA Strong interviewed R2 and found that R2 can change own clothing and can go to the bathroom independently. Interview with staff revealed that R2 does not like using incontinence pads and often does not use them. Interview former Director of Memory Care revealed that R2 must be convinced to receive incontinence assistance and their bedding is changed multiple times per day. Records revealed that R2 is incontinent of the bladder/bowel.

Based on multiple interviews and record reviews there is not a preponderance of evidence to prove alleged violations occurred, therefore the allegations are unsubstantiated. An exit interview was conducted with Executive Director Kimberly Garcia to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
02/10/2025 and conducted by Evaluator Iby Strong
COMPLAINT CONTROL NUMBER: 08-AS-20250210153551

FACILITY NAME:LA VIDA REALFACILITY NUMBER:
374603565
ADMINISTRATOR:GARCIA, KIMBERLYFACILITY TYPE:
740
ADDRESS:11588 VIA RANCHO SAN DIEGOTELEPHONE:
(619) 660-5778
CITY:EL CAJONSTATE: CAZIP CODE:
92019
CAPACITY:177CENSUS: 120DATE:
03/07/2025
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Executive Director Kimberly GarciaTIME COMPLETED:
04:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not ensure the facility is kept free of mal odors
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Iby Strong conducted an unannounced visit to continue an investigation in the above-mentioned complaint allegation. LPA identified herself and discussed the purpose of the visit with Executive Director Kimberly Garcia.

On February 10, 2025, Community Care Licensing (CCL) received a complaint alleging staff do not ensure facility is kept free of mal odors. During investigation, LPA Strong collected pertinent facility records, conducted interviews, and completed a facility inspection.

According to the allegation, there is a strong urine smell coming from Resident 1 (R1)'s room. On February 18, 2025, LPA Strong entered R1's bedroom and spoke with R1. R1 had no concerns of the care received and states bedroom is cleaned often by staff. R1's room had a strong urine malodor throughout the room. It appeared resident had clean bed linen, clothing and fresh chuck pads lining the bed.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 08-AS-20250210153551
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: LA VIDA REAL
FACILITY NUMBER: 374603565
VISIT DATE: 03/07/2025
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
 According to R1's Physician Report, R1 is diagnosed with a major neurocognitive disorder and has bowel and bladder incontinence.

Based on observations and records reviewed, there is a preponderance of evidence that exists to prove licensee did not keep facility free of mal odors. Deficiencies are being cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). An exit interview was conducted with Executive Director Kimberly Garcia, to whom a copy of this report, LIC 9099-C, LIC 9099-D, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided to.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 08-AS-20250210153551
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: LA VIDA REAL
FACILITY NUMBER: 374603565
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/21/2025
Section Cited
CCR
87625(b)(3)
1
2
3
4
5
6
7

Managed Incontinence- b).... the licensee shall be responsible for the following (3) Ensuring that incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence.This requirement was not met as in evidence:
1
2
3
4
5
6
7
Licensee agrees to make R1's room clear of any urine odors by POC date.
8
9
10
11
12
13
14
Based on observations and records reviewed the licensee did not did not keep R1's room free of odors from incontinence in 1 of 120 persons in care which poses a potential personal rights risk.

8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5