374604143-7-3-2026-08-AS-SJAB-DVSV2C-20260708160251

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604143
Report Date: 07/03/2026
Date Signed: 07/03/2026 10:29:55 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
06/24/2021 and conducted by Evaluator Tiffany Holmes

COMPLAINT CONTROL NUMBER: 08-AS-20210624152727

FACILITY NAME:	OCEAN HILLS ASSISTED LIVING & MEMORY CARE		FACILITY NUMBER:	374604143
ADMINISTRATOR:	JOHNSTON, SHERYL		FACILITY TYPE:	740
ADDRESS:	4500 CANNON RD		TELEPHONE:	(760) 295-8515
CITY:	OCEANSIDE	STATE: CA	ZIP CODE:	92056
CAPACITY:	123	CENSUS: 119	DATE:	07/03/2026
		UNANNOUNCED	TIME BEGAN:	10:16 AM
MET WITH:	Erica Rebollar, Memory Care Director		TIME COMPLETED:	10:35 AM

ALLEGATION(S):

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Licensee did not accord resident with safe and healthful accomodations
Licensee did not meet resident care needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA)Tiffany Holmes contacted the facility to deliver findings for a complaint investigation via tele-virtual. LPA identified herself to, and explained the purpose of the visit and the basic elements of the complaint with Erica Rebollar, Memory Care Director.

LPA previously conducted interviews with residents, staff, and outside sources, made observations, and obtained and reviewed pertinent records. LPA Ryan conducted the initial visit on July 1, 2021 and LPA Ruiz conducted another visit on 11/01/2024, 11/14/2024 and 03/17/2025 and conducted a tour of the facility.

It was alleged that the licensee did not accord resident with safe and healthful accommodations. Interviews with the staff revealed the usual response to pushing the pendant is about 5- 15 minutes. Interviews revealed if it is after 5pm, the response would be closer to 10 minutes. Another interview revealed the pendant is like a watch and that the response time is good. Interviews revealed the facility staff respond to their pendant in 15 minutes or less. Interviews revealed that all residents in AL have a pendant and there were only 5 residents in Memory Care that had a pendant. Interviews revealed that the resident care director and LVN does pendant training for residents and staff. Interviews revealed that the pendant will vibrate and turn red when pushed and the call will go on every few seconds until it gets disabled.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2026

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-20210624152727

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: OCEAN HILLS ASSISTED LIVING & MEMORY CARE	FACILITY NUMBER: 374604143
	VISIT DATE: 07/03/2026

NARRATIVE

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Interviews with staff revealed that at the time the complaint came in there wasn’t a time that the response to the call bell has taken more than 20 minutes. Interviews also revealed that the staff are wonderful and helpful. Interviews also reported that they haven't had any issues with staff being rude, disrespectful or that they felt rushed when interacting with staff.

It was alleged that the licensee did not meet resident care needs. Interviews revealed that on or around June 2020, ants were coming in from the residents' first-floor patio door and ants were coming in from the courtyard. Interviews revealed that it was probably because of all the construction around the facility. Interviews revealed that once staff were advised that there were ants in their room, the facility hired a professional to come out and spray shortly afterwards. Other interviews revealed there were "no problems, no ants" and no issues with pests. Interviews with residents revealed that they have seen pest management in the building. Interviews revealed the facility staff hired a company that came out and sprayed. They sprayed the private patio areas, the facility and the rooms. Interviews revealed that in 2021 the staff observed ant and laid down ant powder and ant traps. The facility hired a pest control company to address the ant problem. Interviews revealed that after they sprayed the facility, the ants did not come back.

The investigation did not produce supporting evidence to prove the staff did not treat residents with dignity and staff did not assist resident with toileting needs. The complaint allegations are unsubstantiated.

An exit interview was conducted with Erica Rebollar, Memory Care Director and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) was provided at the conclusion of the visit.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2026

LIC9099 (FAS) - (06/04)

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