374603913-8-24-2026-08-AS-SJAB-DXAP2E-20260825105550

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603913
Report Date: 04/16/2026
Date Signed: 08/24/2026 09:03:04 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
04/03/2024 and conducted by Evaluator Manuel Monter

COMPLAINT CONTROL NUMBER: 08-AS-20240403143343

FACILITY NAME:	NOBLE LIVING II LLC		FACILITY NUMBER:	374603913
ADMINISTRATOR:	BUNNELL, DEBRA		FACILITY TYPE:	740
ADDRESS:	505 HILLS LANE DR		TELEPHONE:	(619) 938-4984
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92020
CAPACITY:	6	CENSUS: 6	DATE:	04/16/2026
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Administrator Nora Garcia		TIME COMPLETED:	03:40 PM

ALLEGATION(S):

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Questionable death
Staff did not provide medication assistance to resident in care
Staff did not feed resident in care
Staff did not provide drinking water to resident in care
Staff did not ensure resident's diapering needs were met
Staff did not ensure resident's oxygen administration needs were met
Staff denied visitations to residents in care

INVESTIGATION FINDINGS:

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(This report is being amended on August 20, 2026, to remove confidential information.) Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced investigation visit to deliver the investigation finding via telephone call and met with Administrator Nora Garcia.

On April 3, 2024, the Department received a complaint allegation that a questionable death occurred. It has also been alleged Staff did not provide drinking water to resident in care / Staff did not feed resident in care. It has been alleged that resident R1 was neglected during the months of December 2018 to April 2019, resulting in R1’s death.

On April 5, 2024, Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced visit to open a complaint investigation. During the visit, LPA obtained copies of records. Page 1 Out of 8

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2026

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 8

Control Number 08-AS-20240403143343

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: NOBLE LIVING II LLC	FACILITY NUMBER: 374603913
	VISIT DATE: 04/16/2026

NARRATIVE

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On April 10, 2024, the Department interviewed Administrator (ADM) Nora Garcia. ADM stated every year around April, upon the anniversary of R1’s death, witness W1 posts online about the facility, expressing his/her anger with the facility and the fact that R1 had passed away. ADM stated R1 was on Bridge Hospice and the facility contacted W1 to let him/her know that R1 was transition to his/her end. ADM stated R1 was on hospice and the facility followed R1’s Plan of Care. ADM stated they did not have a copy of R1’s plan of care. ADM stated they were not pushing liquids as R1 was dying and on morphine. ADM stated when R1 first came to the facility on December 02, 2018. ADM stated R1 was sent to the hospital on March 21, 2019 because he/she wasn’t swallowing well and R1 came back on March 29, 2019, where he/she was placed on hospice care. ADM stated R1 was on a pureed diet. ADM stated on April 4, 2019, hospice notified W1 that R1 was transitioning to his/her end. ADM stated W1 came to the facility on April 4, 2019 and canceled hospice care and sent R1 to the hospital, where R1 died on April 7, 2019.

On April 18, 2024, the Department interviewed Witness (W1). W1 stated a care giver, name unknown, neglected R1, which lead to R1’s death. W1 stated he/she went to visit R1 on April 4, 2019 and the care giver, name unknown, had not given R1 his/her morphine. W1 confirmed that R1 was under hospice at the time. W1 stated he/she received a call from hospice, and was informed that R1 wasn’t doing well, and to visit R1. W1 stated when he/she saw R1, it seemed R1 was gasping for air, so W1 asked the care giver to give R1 his/her oxygen mask. W1 stated he/she asked the caregiver about R1’s oxygen and they didn’t seem to care and ignored W1.

W1 stated he/she would visit R1 and the care giver, name unknown, would place his/her water bottle behind R1 so R1 couldn’t reach his/her water bottle. The Department asked W1 how many times he/she saw the water bottle behind R1’s back. W1 could not provide an answer. The Department asked W1 how often he/she visited R1. W1 stated maybe 2 times a week. The Department asked W1 if he/she ever offered R1 water when he/she visited. W1 stated he/she could not recall. The Department asked W1 if R1 would drink water on his/her own. W1 did not know.

The Department asked W1 if R1 was eating puree or chopped food. W1 did not know. The Department asked W1 if R1 had a swallowing disorder, where someone has a difficult time swallowing. W1 stated he/she didn’t know. The Department asked W1 if hospice had explained to W1 that R1 was at his/her end of life. W1 could not answer the question. Page 2 Out of 8

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 8

Control Number 08-AS-20240403143343

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: NOBLE LIVING II LLC	FACILITY NUMBER: 374603913
	VISIT DATE: 04/16/2026

NARRATIVE

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(This report is being amended on August 20, 2026, to remove confidential information.) On April 23, 2024, the Department interviewed Witness W2. W2 stated he/she never witnessed any neglect at the facility. W2 stated W1 felt the facility wasn’t taking care of R1.

On May 14, 2024, the Department interviewed Witness W3. W3 stated, W1 had alleged that on April 4, 2019, the facility had not given R1 Medication M1. W3 stated he/she wasn’t there and did not witness what W1 told him/her. W3 stated he/she saw R1 at the facility two times. W3 stated he/she didn’t see anything out of the ordinary and cannot verify any information W1 said happened. W3 stated it seemed the care givers were taking good care of R1. The Department asked W3 if there was something he/she saw at the facility that he/she didn’t like or if he/she saw R1 mistreated. W3 stated no.
On May 14, 2024, the Department interviewed resident R2 and R3. R2 stated he/she liked living at the facility. R2 stated he/she likes the food at the facility and gets enough to eat. Due to neurocognitive disorder, R3 was unable to provide relevant information during the interview.
On April 10 and 15, 2026, Licensing Program Analyst Manuel Monter interviewed staff S1-S3. 3 Out of 3 staff (S1-S3) stated residents at the facility were provide meals and water. 3 Out of 3 staff (S1-S3) stated there hasn't been an instance where residents were neglected their meals or water.

Based on a review of all documentation and interviews conducted during the complaint investigation process, it was reported on April 3, 2024, five years after R1 had passed away, that R1 had been neglected by the facility from December 2018 through April 2019, which led to R1’s death. However, R1 was on Uni-Care Home Health for a short time from 12/02/2018 through 01/28/2019, then in Sharp Grossmount Hospital from 03/21/2019 through 03/29/2019, then after R1 was discharged and placed on Bridge Hospice through 04/04/2019. W1 was notified by Bridge Hospice that R1 was transitioning toward the end of his/her life on 04/04/2019. When W1 came to see R1, he/she canceled Bridge Hospice and sent R1 back to Sharp Grossmount Hospital where he/she died on 04/07/2019.

There is not enough corroborating evidence to show Neglect/Lack of Care and Supervision regarding the questionable death of resident R1. The family had placed R1 on comfort care due to his/her poor prognosis and his/her Physician Orders for Life-Sustaining Treatment (POLST) described for comfort-focused treatment, therefore the allegation of Neglect/Lack of Care and Supervision regarding the questionable death is deemed unsubstantiated. Page 3 Out of 8

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 8

Control Number 08-AS-20240403143343

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: NOBLE LIVING II LLC	FACILITY NUMBER: 374603913
	VISIT DATE: 04/16/2026

NARRATIVE

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There is not enough corroborating evidence regarding staff not feeding resident R1 while in the facilities care. Based on investigation there is not enough corroborating evidence find any Neglect/Lack of Care and Supervision of R1 by the facility staff resulting in not feeding R1, therefore, the allegation is deemed Unsubstantiated.

There is not enough corroborating evidence regarding staff not providing drinking water to resident R1. Based on investigation, there is not enough corroborating evidence to find any Neglect/Lack of Care and Supervision of R1 by the facility staff resulting in his/her dehydration, therefore, the allegation is deemed Unsubstantiated.

Staff did not provide medication assistance to resident in care / Staff did not ensure resident's oxygen administration needs were met

On April 3, 2024, the Department received a complaint alleging Staff did not provide medication assistance to resident in care / Staff did not ensure resident's oxygen administration needs were met

On April 5, 2024, Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced visit to open a complaint investigation. During the visit, LPA obtained copies of records.

On April 18, 2024, the Department interviewed Witness W1. W1 stated a care giver (name unknown) neglected R1. W1 stated on April 4, 2019, the care giver (name unknown) had not given R1 his/her Medication M1. W1 stated when he/she went to see R1, it seemed as if R1 was gasping for air, so he/she asked the care giver to give R1 his/her oxygen mask. W1 stated they didn’t seem to care and they ignored W1. W1 stated he/she had to call the doctor and ask if R1 should have his/her oxygen and the doctor said yes.

On April 23, 2024, the Department interviewed Witness W2. W2 stated he/she never witnessed any neglect. W2 stated W1 felt R1 wasn’t getting his/her Medication M1. W2 stated one time he/she went there, and R1 seemed to be in pain and the caregiver said he/she could not administer the morphine and W1 had to call the doctor in order for the facility to give R1 the M1. Page 4 Out of 8

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2026

LIC9099 (FAS) - (06/04)

Page: 4 of 8

Control Number 08-AS-20240403143343

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: NOBLE LIVING II LLC	FACILITY NUMBER: 374603913
	VISIT DATE: 04/16/2026

NARRATIVE

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On May 14, 2024, the Department interviewed Witness W3. W3 stated, W1 had alleged that on April 4, 2019, the facility had not given R1 Medication M1. W3 stated he/she wasn’t there and did not witness what W1 told him/her. W3 stated he/she saw R1 at the facility two times. W3 stated he/she didn’t see anything out of the ordinary and cannot verify any information W1 said happened. W13 stated it seemed the care givers were taking good care of R1. The Department asked W3 if there was something he/she saw at the facility that he/she didn’t like or if he/she saw R1 mistreated. W3 stated no.

On May 14, 2024, the Department interviewed resident R2 and R3. R2 stated he/she liked living at the facility. Due to neurocognitive disorder, R2 and R3 were unable to provide relevant information during the interview.

On April 30, 2026, Licensing Program Analyst Manuel Monter interviewed Administrator Nora Garcia. ADM stated she thinks she knows where and what the context is regarding the allegation that the facility was not administering medication originates from. ADM stated sometime several years ago, there was an incident where W1 was upset, claiming R1 needed M1, stating R1 was in pain. ADM stated R1 had already given M1. ADM stated W1 had contacted the doctor asking for R1 to have more M1. ADM stated she remembers W1 and the hospice nurse discussing the M1 and the hospice nurse explaining to W1 that R1 had already been given M1 that day. ADM stated there hasn’t been a time when R1 was not assisted with his/her oxygen.

On April 3, 2026, Licensing Program Analyst Manuel Monter interviewed Witness W1. W1 stated he/she isn’t aware how many times or when R1 was not administered medication M1. W1 stated a staff member he/she can’t identify didn’t give R1’s M1 and stated that staff member couldn’t find it. LPA asked W1 if he/she knew if R1 had already been administered M1, before he/she arrived at the facility that day. W1 stated he/she doesn’t know if R1 had been given a dose of M1 prior to him/her arriving to the facility that day.

W1 stated he/she doesn’t think the oxygen was ever given. W1 stated he/she doesn’t know who is supposed to administer the oxygen. LPA asked W1 if he/she spoke with the hospice agency when he/she had concerns about the oxygen and M1. W1 stated he/she did call them but doesn’t know if he/she discussed the M1 or oxygen. Page 5 Out of 8

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2026

LIC9099 (FAS) - (06/04)

Page: 5 of 8

Control Number 08-AS-20240403143343

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: NOBLE LIVING II LLC	FACILITY NUMBER: 374603913
	VISIT DATE: 04/16/2026

NARRATIVE

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On April 10 and 15, 2026, Licensing Program Analyst Manuel Monter interviewed staff S1-S3. 3 Out of 3 staff (S1-S3) stated they have never observed or are aware of any instance where a resident was provided their medications. 3 Out of 3 staff (S1-S3) stated they have never observed residents being neglected their oxygen needs or assistance with their oxygen needs.

Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur.

Staff did not ensure resident's diapering needs were met

On April 5, 2024, Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced visit to open a complaint investigation. During the visit, LPA obtained copies of records.

On April 23, 2024, the Department interviewed Witness W2. W2 stated he/she never witnessed any neglect.

On May 14, 2024, the Department interviewed Witness W3. W3 stated he/she saw R1 at the facility two times. W3 stated he/she didn’t see anything out of the ordinary and cannot verify any information W1 said happened. W3 stated it seemed the care givers were taking good care of R1. The Department asked W3 if there was something he/she saw at the facility that he/she didn’t like or if he/she saw R1 mistreated. W3 stated no.

On May 14, 2024, the Department interviewed resident R2 and R3. R2 stated he/she liked living at the facility. Due to neurocognitive disorder, Residents R2 and R3 were unable to provide relevant information during the interview.

On March 30, 2026, Licensing Program Analyst Manuel Monter interviewed Administrator Nora Garcia. ADM stated the staff check and change all the residents, including R1 every 2 hours. ADM stated she is not aware of any instance where the residents changing needs were neglected. Page 6 Out of 8

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2026

LIC9099 (FAS) - (06/04)

Page: 6 of 8

Control Number 08-AS-20240403143343

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: NOBLE LIVING II LLC	FACILITY NUMBER: 374603913
	VISIT DATE: 04/16/2026

NARRATIVE

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On April 3, 2026, Licensing Program Analyst Manuel Monter interviewed Witness W1. W1 stated he/she believes the facility wasn’t changing R1. W1 stated after R1 had passed, he/she had a conversation with a friend who stated, maybe R1 was not feed / given liquids so they wouldn’t need to change his/her diaper. W1 stated because he/she thinks R1 wasn’t feed and given liquids, its leads him/her to believe R1 was not fed to avoid changing diapers. LPA ask W1 if he/she ever found R1 was not changed or left soiled for an extended period. W1 stated he/she doesn’t know.

On April 10 and 15, 2026, Licensing Program Analyst Manuel Monter interviewed staff S1-S3. 3 Out of 3 staff (S1-S3) stated they are not aware of any instance where a residents changing needs were neglected.

Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur.

Staff denied visitations to residents in care

On April 5, 2024, Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced visit to open a complaint investigation. During the visit, LPA obtained copies of records.

On April 18, 2024, the Department interviewed Witness W1. W1 stated the facility had limited his/her visiting hours on when he/she could visit R1.

On May 14, 2024, the Department interviewed resident R2 and R3. R2 stated he/she liked living at the facility. Due to neurocognitive disorder, Residents R2 and R3 were unable to provide relevant information during the interview.

On March 30, 2026, LPA Manuel Monter interviewed Administrator Nora Garcia. ADM stated they never denied family from visiting. ADM stated the visiting hours for the facility is 9am-7pm. ADM stated visiting family members can stay as long as possible as long as it doesn’t disturb others. ADM stated if a resident is in the last weeks of their life, the family members can stay as long as they like. Page 7 Out of 8

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2026

LIC9099 (FAS) - (06/04)

Page: 7 of 8

Control Number 08-AS-20240403143343

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: NOBLE LIVING II LLC	FACILITY NUMBER: 374603913
	VISIT DATE: 04/16/2026

NARRATIVE

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ADM stated one time she did tell the W1, that he/she would need to leave because he/she was screaming and yelling, about R1 not being fed. ADM stated he/she came to the facility and told W1 to calm down, if he/she didn’t calm down, he/she would need to leave. ADM stated she told W1 that he/she is causing a ruckus and disturbing the other residents.

On April 3, 2026, Licensing Program Analyst Manuel Monter interviewed Witness W1. W1 stated at an unknown date/ time, there was a resident in hospice that was crying, stating his/her family were not allowed to visit. W1 stated he/she thought it was mean this was happening. W1 stated he/she doesn’t know the name of that resident. W1 stated the visiting hours are from 7:00pm – 7:30pm. W1 stated he/she didn’t know about this occurring to W2 or W3. W1 stated there were no incidents of him/her raising his/her voice in the facility. W1 stated he/she didn’t have any problems with the home.

On April 10, 2026, Licensing Program Analyst Manuel Monter interviewed Witness W2. W2 stated regarding visiting R1, that he/she wasn’t personally denied from visiting. W2 stated he/she would visit around 4:30pm.

On April 10 and 15, 2026, Licensing Program Analyst Manuel Monter interviewed staff S1-S3. 3 Out of 3 staff (S1-S3) stated the staff has never bared visitors from visiting. S1 and S2 stated if the families want to visit past 7, they can visit as well. S1 and S2 stated if a resident is in there last days before passing, then the families can come at all hours of the day.

Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur.

This Report was reviewed with Administrator Nora Garcia. LPA Monter informed Administrator Nora Garcia that a PDF copy of the signed report by LPA Monter will be emailed to ADM's for her signature and a signed copy returned to LPA Monter. ADM stated she will send the signed original report to the San Diego Regional Office. Page 8 Out of 8 End Of Report.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2026

LIC9099 (FAS) - (06/04)

Page: 8 of 8