374603724-6-4-2025-08-AS-SJAB-DJ5N6J-20250630101109

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603724
Report Date: 06/04/2025
Date Signed: 06/04/2025 11:58:00 AM

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
05/27/2025 and conducted by Evaluator Arian Golbakhsh

COMPLAINT CONTROL NUMBER: 08-AS-20250527152121

FACILITY NAME:	MONARCH COTTAGES LA JOLLA		FACILITY NUMBER:	374603724
ADMINISTRATOR:	JESTER, RISA		FACILITY TYPE:	740
ADDRESS:	7630 FAY AVENUE		TELEPHONE:	(858) 924-8530
CITY:	LA JOLLA	STATE: CA	ZIP CODE:	92037
CAPACITY:	52	CENSUS: 23	DATE:	06/04/2025
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Executive Director Risa Jester		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Staff did not seek medical attention for resident

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Arian Golbakhsh and Iby Strong conducted an unannounced visit to open a complaint investigation and delivered findings regarding the above mentioned allegation. LPAs were welcomed by, identified themselves to, and discussed the purpose of their visit to Executive Director Risa Jester.

On 05/27/2025, the Department received a complaint allegation where it was alleged that a resident at the facility identified as (R1) sustained a fall and did not receive medical care. No timeline was provided in the complaint regarding when R1 had fallen. The Department’s investigation consisted of an unannounced facility visit, records review, and interviews with staff, residents, and outside sources.

[Continued on LIC 9099-C]

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025

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-20250527152121

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: MONARCH COTTAGES LA JOLLA	FACILITY NUMBER: 374603724
	VISIT DATE: 06/04/2025

NARRATIVE

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[Continued from LIC 9099]

Interviews with residents did not reveal any concerns regarding timeliness of care received and arrangement of necessary and/or incidental medical attention. Interviews with outside sources indicated that resident medical needs were responded to quickly by the facility. Interviews with staff reveal an established plan for responding to and reporting resident falls. Additionally, staff interviewed did not recall any residents, including R1, having any recent falls. File review of records and outside source medical records corroborated communication with R1's medical providers and contained response plans for R1's care.

Based on interviews and records review, there is not a preponderance of the evidence, therefore the allegation have been determined to be UNSUBSTANTIATED. An exit interview was conducted with Executive Director Jester to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025

LIC9099 (FAS) - (06/04)

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