374604232-6-27-2025-08-AS-APAO-DJ5SNQ-20250630140155

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604232
Report Date: 06/27/2025
Date Signed: 06/27/2025 02:11:54 PM

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
06/18/2025 and conducted by Evaluator Ramin Hashemi

COMPLAINT CONTROL NUMBER: 08-AS-20250618161114

FACILITY NAME:	REMINGTON CLUB II		FACILITY NUMBER:	374604232
ADMINISTRATOR:	TERRI BOSTIAN		FACILITY TYPE:	740
ADDRESS:	16922 HIERBA DRIVE		TELEPHONE:	(858) 673-6333
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92128
CAPACITY:	140	CENSUS: 61	DATE:	06/27/2025
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Executive Director, Ryan Golze		TIME COMPLETED:	02:20 PM

ALLEGATION(S):

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Staff did not treat resdient with dignity.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Ramin Hashemi and Nacole Patterson conducted an unannounced visit to initiate a complaint investigation and deliver findings regarding the above complaint allegation. LPAs introduced themselves and disclosed the purpose of the visit to Executive Director, Ryan Golze.

On June 18th, 2025 it was alleged that staff did not treat resident with dignity. The Department’s investigation consisted of an unannounced facility visit, interviews with facility staff, residents, outside sources, records review, and LPA observations.

Staff interviews revealed that staff had not heard of residents being treated without dignity. Staff confirmed that if they were to witness such an event they would immediately report it to management, per protocol. Staff interviews consistently informed the protocol for residents exhibiting behaviors by giving residents time to readjust, change of face, or elevating the situation to management. No Staff indicated that they had observed residents being treated without dignity or respect. Management was not aware of any reports of resident dignity being violated.

(Continued on LIC9099 P2)

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025

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-20250618161114

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: REMINGTON CLUB II	FACILITY NUMBER: 374604232
	VISIT DATE: 06/27/2025

NARRATIVE

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(Continued from LIC9099 P1)

Management informed that any allegation of resident abuse required an internal investigation and administrative leave for the accused staff. Three of four caregiver interviews revealed that Resident 1 (R1) tended to have combative days, which included claiming that they were being hurt even when no staff were nearby or touching them.

Four residents were interviewed, during the investigation including the resident in question. All residents stated staff were nice, treated them well, and respected them. Residents who utilized their pendants stated that staff response times were 15 minutes or less. No residents including R1 stated that staff were rough or treated them without dignity. R1 specifically denied that staff interacted with them roughly or were rude.

An outside source familiar with R1 informed that R1 has good days and bad days, which corroborated staff statements. Attempts were made to contact an additional outside source with no response.

Records review did not corroborate the allegation. R1's Physician’s Report indicated secondary diagnosis of cognitive impairment. No progress or care notes during the time frame of the incident gave evidence to the allegation.

During an unannounced facility visit, LPAs directly observed resident care. LPAs did not observe staff interact with residents in a way that did not honor their dignity or assist residents in a way that was unwelcome.

Based on interviews, direct LPA observations and records review, a preponderance of evidence does not exist to prove that the alleged violation occurred, therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted with Executive Director Ryan Golze, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025

LIC9099 (FAS) - (06/04)

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