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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604029
Report Date: 09/10/2026
Date Signed: 09/10/2026 04:24:14 PM

Substantiated


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
08/31/2026 and conducted by Evaluator Jose DeLaCruz
COMPLAINT CONTROL NUMBER: 08-AS-20260831115347
FACILITY NAME:HILLSIDE HAVEN GUEST HOMEFACILITY NUMBER:
374604029
ADMINISTRATOR:JARDIN, LEONAFACILITY TYPE:
740
ADDRESS:9141 SPICE STREETTELEPHONE:
(619) 741-3473
CITY:LA MESASTATE: CAZIP CODE:
91941
CAPACITY:6CENSUS: 6DATE:
09/10/2026
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Licensee Leona JardinTIME COMPLETED:
04:35 PM
ALLEGATION(S):
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Staff do not assist with arranging medical care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jose De La Cruz conducted an unannounced visit regarding the above allegation. LPA was greeted by Licensee Leona Jardin, to whom he identified himself and explained the purpose of the visit.

On August 31, 2026, the Reporting Party (RP) alleged that the facility did not assist a resident (R1) with arranging medical care. RP stated that R1 experiences back pain and requires a specific treatment that the facility was not helping R1 obtain.

On September 10, 2026, LPA contacted RP, who reiterated the allegation and stated that R1 has not received the treatment that helps prevent back pain.

[CONTINUED ON LIC9099-C]
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Jose DeLaCruz
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
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-20260831115347
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: HILLSIDE HAVEN GUEST HOME
FACILITY NUMBER: 374604029
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/11/2026
Section Cited
CCR
87465(a)(1)
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87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care… shall encourage routine medical … care …by compliance with the following: (1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents.
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Licensee shall reach out to the residents primary care physician by due date and make an appointment with the required professional as soon as posible, sending screenshot as proof of correction to LPA.
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Based on interviews and records review, the licensee did not comply with the section cited above in one out of six residents which posed a health and personal rights risk to one person in care.
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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.
SUPERVISOR'S NAME: Robyn Clark
LICENSING EVALUATOR NAME: Jose DeLaCruz
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
LIC9099 (FAS) - (06/04)
Page: 4 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
08/31/2026 and conducted by Evaluator Jose DeLaCruz
COMPLAINT CONTROL NUMBER: 08-AS-20260831115347

FACILITY NAME:HILLSIDE HAVEN GUEST HOMEFACILITY NUMBER:
374604029
ADMINISTRATOR:JARDIN, LEONAFACILITY TYPE:
740
ADDRESS:9141 SPICE STREETTELEPHONE:
(619) 741-3473
CITY:LA MESASTATE:CAZIP CODE:
91941
CAPACITY:6CENSUS: 6DATE:
09/10/2026
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Licensee Leona JardinTIME COMPLETED:
04:35 PM
ALLEGATION(S):
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Resident was admitted without their consent.
Resident phone calls are being monitored.
Staff do not assist resident with toileting needs.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jose De La Cruz conducted an unannounced visit regarding the above allegation. LPA was greeted by Licensee Leona Jardin, to whom he identified himself and explained the purpose of the visit.

The reporting party (RP) alleged a resident (R1) was admitted without their consent and that their phone calls were being monitored. Furthermore, RP stated that the staff was not assisting residents with toileting needs.

LPA contacted RP over the phone on September 9, 2026. RP reiterated the allegations, mentioning that R1 calls were being restricted and monitored by staff, and that they were being cut after 5 minutes.


[CONTINUED ON LIC9099-C]
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Jose DeLaCruz
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
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-20260831115347
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: HILLSIDE HAVEN GUEST HOME
FACILITY NUMBER: 374604029
VISIT DATE: 09/10/2026
NARRATIVE
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Furthermore, RP stated that residents had to go to bed at a specific time. RP stated that R1 did not agree to live at the facility, and that they were there without consent. RP also stated that R1 requests for help regarding toileting had been ignored.

On the same day, LPA visited the facility, interviewed staff and clients and reviewed facility records. During the visit, LPA was able to see the residents, including R1, interacting with staff and outside services in the living room. The interactions looked amicable, including jokes, laughs and other comments.

Interviews with staff and residents suggested that there is no limit regarding phone calls, or a bed time. A resident (R2) stated that they “love living at the facility, I go to bed whenever I want and I get up as late as I want”.

An interview with R1, mentioned that even though they’d rather be at their own place, they and their outside source (OS1) agreed that they needed help due to age, and could not live on their own. R1 also mentioned that the staff and the facility are the next-best thing after living at their house. R1 stated that staff are respectful and professional and do their best to help them.

R1 specifically denied that the staff monitored their calls or that requests for help have been denied and reiterated that they agreed to live at the facility for their own well-being.

Based on records reviewed, LPA observations, and interviews conducted with R1, residents, and staff, the preponderance of evidence standard has not been met, and the allegation is deemed unsubstantiated. No deficiencies were cited in accordance with the California Code of Regulations.

Report and Appeal Rights discussed with and provided to licensee Leona Jardin. Signature below confirms receipt.
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Jose DeLaCruz
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 08-AS-20260831115347
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: HILLSIDE HAVEN GUEST HOME
FACILITY NUMBER: 374604029
VISIT DATE: 09/10/2026
NARRATIVE
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[CONTINUED FROM LIC9099]

That same day, LPA visited the facility, interviewed staff and residents, and reviewed facility records. R1’s medical records indicate a condition that results in back pain. Interviews with staff, the facility administrator, and R1 confirmed that the facility was aware R1 was experiencing and reporting back pain.

In an interview, R1 stated they continue to experience back pain “at the same time and in the same area.” R1 reported that the day prior they were taken to a physical appointment with their outside source (OS1). According to R1, their regular physician was unavailable, but another physician at the same location evaluated them. An appointment was scheduled for treatment in three weeks; however, R1 stated that they require the treatment as soon as possible due to significant nighttime pain.

Interviews with staff confirmed that the facility has been providing R1’s prescribed medications. Staff also indicated they have not arranged medical appointments because OS1 is currently managing R1’s medical care.

On September 10, 2026, LPA contacted R1’s physician (OS2). According to OS2’s assistant, OS2 has not seen R1 since July 17, 2026, and no upcoming medical appointments for the requested treatment were found in R1’s file.

Based on record review, observations, and interviews, the preponderance of evidence standard has been met for the allegation that the facility did not arrange necessary medical care for a resident. One deficiency was cited in accordance with the California Code of Regulations [see attached LIC 9099(d)].

Report and Appeal Rights were discussed with and provided to the Licensee. The Licensee’s signature below confirms receipt.
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Jose DeLaCruz
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5