374604083-7-11-2025-08-AS-SJAB-DJULBR-20250723083711

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604083
Report Date: 07/10/2025
Date Signed: 07/11/2025 11:24:09 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
01/13/2025 and conducted by Evaluator Amy Domingo

COMPLAINT CONTROL NUMBER: 08-AS-20250113095614

FACILITY NAME:	MONTERA, THE		FACILITY NUMBER:	374604083
ADMINISTRATOR:	EMILY TURNER		FACILITY TYPE:	740
ADDRESS:	5740 LAKE MURRAY BLVD		TELEPHONE:	(619) 832-2599
CITY:	LA MESA	STATE: CA	ZIP CODE:	91942
CAPACITY:	225	CENSUS: 179	DATE:	07/10/2025
		UNANNOUNCED	TIME BEGAN:	01:14 PM
MET WITH:	Cathy Allen Executive Director		TIME COMPLETED:	01:50 PM

ALLEGATION(S):

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Staff are not observing residents for changes in condition

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Amy Domingo conducted an unannounced visit to deliver findings regarding the above complaint allegation. LPA introduced herself and disclosed the purpose of the visit to Cathy Allen, Executive Director.

The Department’s investigation consisted of interviews with staff and outside sources, and a review of relevant documents pertinent to this investigation.

On January 13, 2025, Community Care Licensing (CCL) received a complaint alleging that the staff are not observing residents for changes in condition.

(Continued on LIC9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Domingo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025

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-20250113095614

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: MONTERA, THE	FACILITY NUMBER: 374604083
	VISIT DATE: 07/10/2025

NARRATIVE

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(Continued from LIC9099)

LPA reviewed medical records for Resident 1 (R1), and the records revealed R1's medical provider was updated and previously notified of R1’s change in mental condition, such that R1 was exhibiting increased wandering behavior and increased confusion with agitation. R1 did have a care plan conference held when the increase in wandering, confusion, and agitation was observed by staff.

Interview with Staff 1 (S1) revealed that there was communication between the licensee and the medical provider regarding observed changes in R1’s behavior.

Interview with Staff 2 (S2) revealed Outside source 1 (OS1) was aware of R1’s changes, and a plan was in place to move R1 into the Memory Unit because of the increase in R1’s behaviors. There were documents to support the plan of care, with the medical provider and the responsible party.

Interview with Staff 3 (S3) revealed that they were updated on R1's plan of care and provided redirection as needed during the transition to the memory unit.

This agency has investigated the complaint alleging that staff are not observing residents for changes in condition. The Department has found that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is UNSUBSTANTIATED.

An exit interview was conducted, and a copy of this report, (LIC 9058 03/22). Executive Director, Cathy Allen's signature on this form confirms receipt of these rights.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Domingo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025

LIC9099 (FAS) - (06/04)

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