374604176-4-13-2025-18-AS-KLOZ-DFTSGY-20250417135240

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604176
Report Date: 04/13/2025
Date Signed: 04/13/2025 01:54:18 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/25/2024 and conducted by Evaluator Martha Arroyo

COMPLAINT CONTROL NUMBER: 18-AS-20240625154351

FACILITY NAME:	ALTA VISTA SENIOR LIVING		FACILITY NUMBER:	374604176
ADMINISTRATOR:	ALSPACH, DAVID		FACILITY TYPE:	740
ADDRESS:	2041 W VISTA WAY		TELEPHONE:	(760) 941-3233
CITY:	VISTA	STATE: CA	ZIP CODE:	92083
CAPACITY:	98	CENSUS: 81	DATE:	04/13/2025
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Beatrice Soliven - Memory Care Director		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Unlawful eviction

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Martha Arroyo conducted a subsequent complaint visit to the above facility. The purpose of the visit is to deliver findings for the above allegation. The initial complaint visit was conducted on 07/03/2024 by LPAs Venus Mixson and Kathleen Banrasavong and a subsequent complaint visit was conducted on 04/12/2025 by LPA M. Arroyo. On today’s visit, LPA Arroyo met with Memory Care Director, Beatrice Soliven. Entrance interview.

During the initial visit on 07/03/2024, LPAs Mixson and Banrasavong toured the facility and requested and received pertinent documents. On 04/12/2025, LPA Arroyo conducted interviews with one staff, conducted a plant tour starting at 9:20am, and conducted a resident file review and obtained copies of pertinent documents.

Report Continued on LIC 9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) -59-4347
LICENSING EVALUATOR NAME: Martha Arroyo	TELEPHONE: (818) 421-6459
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2025

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 18-AS-20240625154351

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: ALTA VISTA SENIOR LIVING	FACILITY NUMBER: 374604176
	VISIT DATE: 04/13/2025

NARRATIVE

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Report Continued from LIC 9099...

It was alleged that facility issued an unlawful eviction notice to Resident #1 (R1) in December 2023 and again in January 2024, citing nonpayment as the reason for eviction. Records reviewed and interviews conducted revealed that R1 had a Power of Attorney (POA) who was responsible for paying R1’s living expenses at the facility. However, due to the POA’s inability to make payments, the facility issued eviction notices to both R1 and the POA. Interviews with staff confirmed that the eviction notices were issued due to nonpayment. Staff stated that they attempted to contact R1’s POA multiple times without receiving a response resulting in eviction notice. Additionally, the facility proceeded to search for an alternative placement for R1 after issuing eviction notice. Furthermore, law enforcement had an approved Eviction Restoration Notice authorizing the removal of R1 from the facility on July 3, 2024.

Based on the information obtained and reviewed during the investigation, the Department found insufficient evidence to support the allegation of “unlawful eviction.” Therefore, the allegation is deemed Unsubstantiated at this time.

Exit interview conducted. Report was reviewed and copy provided.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) -59-4347
LICENSING EVALUATOR NAME: Martha Arroyo	TELEPHONE: (818) 421-6459
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2025

LIC9099 (FAS) - (06/04)

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