374604065-7-9-2026-08-AS-APAO-DWE3P5-20260727182455

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604065
Report Date: 07/09/2026
Date Signed: 07/09/2026 09:42:10 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
04/09/2026 and conducted by Evaluator Ramin Hashemi

COMPLAINT CONTROL NUMBER: 08-AS-20260409121610

FACILITY NAME:	CARLSBAD VILLAGE SENIOR LIVING		FACILITY NUMBER:	374604065
ADMINISTRATOR:	NATALIE CARLBORG		FACILITY TYPE:	740
ADDRESS:	1088 LAGUNA DRIVE		TELEPHONE:	(760) 434-7116
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92008
CAPACITY:	0	CENSUS: 0	DATE:	07/09/2026
		UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Executive Director Brandon Cho		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Staff are not assisting residents in a timely manner
Staff did not ensure resident's room was clean

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ramin Hashemi conducted an unannounced visit to deliver findings regarding the above complaint allegations. LPA introduced themselves and disclosed the purpose of the visit to Executive Director (ED) Brandon Cho.

On 04/16/2026 it was alleged "Staff are not assisting residents in a timely manner." The Department’s investigation consisted of unannounced facility visits, interviews with residents, and records review.

Regarding the allegation, "Staff are not assisting residents in a timely manner.", it was alleged facility staff members do not help residents who need assistance within a reasonable amount of time. In this case, as determined by the investigating LPA, a reasonable amount of time is no longer than fifteen to twenty (15-20) minutes.
(Continued on LIC9099C, Page 2)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026

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-20260409121610

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: CARLSBAD VILLAGE SENIOR LIVING	FACILITY NUMBER: 374604065
	VISIT DATE: 07/09/2026

NARRATIVE

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Resident interviews revealed that residents do not normally wait an unreasonable amount of time to be helped by staff when they engage the signal system or the pendent alert system. Residents told the LPA that on average, facility staff attend to them within five (5) to fifteen (15) minutes.

Records review of the signal system alerts demonstrated that on average, more than eighty (80) percent of calls were responded to in under 15 minutes with an additional ten (10) percent of calls coming in under 20 minutes. This corroborates resident interviews.

On 04/16/2026 it was alleged "Staff did not ensure resident's room was clean." The Department’s investigation consisted of unannounced facility visits, interviews with facility staff, residents, outside sources, and records review.

Regarding the allegation, "Staff did not ensure resident's room was clean", it was alleged facility staff do not clean resident rooms on a regular basis.

Resident interviews revealed that facility staff clean rooms once a week. All interviewed residents stated that they had no issues with getting help from staff to clean rooms. Interviewed resident rooms were clean and sanitary.

Records review revealed that facility staff have assigned rooms to a schedule of cleaning and sign off on the shift that the room was cleaned. Residents whose rooms are not cleaned on their assigned days are given the opportunity for staff to come at a later time to perform cleaning duties.

LPA Observations of rooms in the facility demonstrated that rooms in both the memory care and assisted living portions of the facility were clean and sanitary. This corroborates resident interviews.

Based on interviews, direct LPA observations and records review, a preponderance of evidence does not exist to prove that the alleged violations occurred, therefore the allegations are UNSUBSTANTIATED. An exit interview was conducted with ED Brandon Cho, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026

LIC9099 (FAS) - (06/04)

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