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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603669
Report Date: 01/15/2026
Date Signed: 01/15/2026 03:33:37 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
10/21/2025 and conducted by Evaluator Angelica Boyles
COMPLAINT CONTROL NUMBER: 08-AS-20251021081133
FACILITY NAME:HABILITATIVE HOMES RESIDENTIAL CARE FACILITYFACILITY NUMBER:
374603669
ADMINISTRATOR:DAVID LARSONFACILITY TYPE:
735
ADDRESS:11775 WALNUT ROADTELEPHONE:
(619) 938-4007
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY:6CENSUS: 6DATE:
01/15/2026
UNANNOUNCEDTIME BEGAN:
08:28 AM
MET WITH:David Larson - Administrator TIME COMPLETED:
03:31 PM
ALLEGATION(S):
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Staff spoke inappropriately to resident
Staff did not prevent residents from engaging in a physical altercation
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced visit to the facility to deliver investigative findings regarding the above mentioned allegation. LPA identified herself, explained the purpose of the visit and nature of the complaint to Administrator David Larson.

On October 21, 2025 the Department received this complaint which alleged staff spoke inappropriately to Resident #1 (R1) and staff did not prevent residents from engaging in a physical altercation. [See LIC811 Confidential Name List for a description of select person identifiers used in this report]. The Department’s investigation included a facility tour, record reviews, as well as interviews with residents, staff and outside sources.

(Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Angelica Boyles
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
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 5
Control Number 08-AS-20251021081133
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: HABILITATIVE HOMES RESIDENTIAL CARE FACILITY
FACILITY NUMBER: 374603669
VISIT DATE: 01/15/2026
NARRATIVE
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(Continued from LIC9099)

Regarding the allegation that staff spoke inappropriately to R1, interviews with other residents in care did not report observing staff speaking inappropriately to R1, nor did they report staff speaking inappropriately to them. Interviews with outside sources who work with residents regularly did not report concerns regarding staff speaking inappropriately to the residents in care. During unannounced visits, LPA observed staff treating residents with dignity and respect.

Regarding the allegation that staff did not prevent residents from engaging in a physical altercation, interviews with residents in care did not report residents getting into physical altercations. Interviews with outside sources who work with residents regularly did not report concerns about residents engaging in physical altercations. Interviews with staff reported that the residents in care do not have aggressive behaviors and do not get into physical altercations with each other.

The Department has investigated the above mentioned allegations. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was not met to support or corroborate these allegations and therefore deemed unsubstantiated. An exit interview was conducted with Administrator David Larson, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Angelica Boyles
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
LIC9099 (FAS) - (06/04)
Page: 5 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
10/21/2025 and conducted by Evaluator Angelica Boyles
COMPLAINT CONTROL NUMBER: 08-AS-20251021081133

FACILITY NAME:HABILITATIVE HOMES RESIDENTIAL CARE FACILITYFACILITY NUMBER:
374603669
ADMINISTRATOR:DAVID LARSONFACILITY TYPE:
735
ADDRESS:11775 WALNUT ROADTELEPHONE:
(619) 938-4007
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY:6CENSUS: 6DATE:
01/15/2026
UNANNOUNCEDTIME BEGAN:
08:28 AM
MET WITH:David Larson - AdministratorTIME COMPLETED:
03:31 PM
ALLEGATION(S):
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Illegal eviction
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced visit to the facility to deliver investigative findings regarding the above mentioned allegation. LPA identified herself, explained the purpose of the visit and nature of the complaint to Administrator David Larson.

On October 21, 2025 the Department received this complaint which alleged an illegal eviction notice was given to Resident #1 (R1). [See LIC811 Confidential Name List for a description of select person identifiers used in this report]. The Department’s investigation included a review of records and interviews with staff.

(Continued on LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Angelica Boyles
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 08-AS-20251021081133
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: HABILITATIVE HOMES RESIDENTIAL CARE FACILITY
FACILITY NUMBER: 374603669
VISIT DATE: 01/15/2026
NARRATIVE
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(Continued from LIC9099-A)

A review of the 30 day written notice provided to R1 was dated 10/16/25 and did not state the reason for eviction. Interviews with staff and records reviewed revealed that this notice was rescinded on 10/23/25. As of today's visit, R1 still resides at the facility. However, the 30 day written notice given to R1 was unlawful as it did not contain the required element of providing specific facts supporting the reason for the eviction.

The Department has investigated the above mentioned allegation. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was met to support or corroborate this allegation and therefore deemed substantiated. A deficiency is being cited per Title 22 California Code of Regulations (see attached 9099-D). An exit interview was conducted with Administrator David Larson, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Angelica Boyles
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 08-AS-20251021081133
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: HABILITATIVE HOMES RESIDENTIAL CARE FACILITY
FACILITY NUMBER: 374603669
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/15/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/16/2026
Section Cited
CCR
80068.5(c)
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80068.5 Eviction Procedures (c)The notice to quit shall state the reasons for the eviction, with specific facts supporting the reason for the eviction...
This requirement is not met as evidenced by:
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Licensee agreed to attend training on Evictions and provide proof of training by POC due date.
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Based on record review licensee did not issue a lawful 30 day notice for 1 out of 6 residents in care (R1) which posed a potential personal rights violation.
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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: Simon Jacob
LICENSING EVALUATOR NAME: Angelica Boyles
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5