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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604261
Report Date: 12/04/2025
Date Signed: 12/04/2025 01:27:07 PM

Substantiated


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
10/08/2025 and conducted by Evaluator Arian Golbakhsh
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20251008141157
FACILITY NAME:AVANTGARDE SENIOR LIVING OF LA JOLLAFACILITY NUMBER:
374604261
ADMINISTRATOR:ESCOBAR, AGUSTINFACILITY TYPE:
740
ADDRESS:6211 LA JOLLA HERMOSA AVETELEPHONE:
(818) 692-5284
CITY:LA JOLLASTATE: CAZIP CODE:
92037
CAPACITY:45CENSUS: 37DATE:
12/04/2025
UNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Activities Director Gabriela Ortiz and Administrator Susan CaccamTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Unlawful Eviction
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced visit for a complaint investigation and delivered findings regarding the above mentioned allegation. LPA was welcomed by, identified themselves to, and discussed the purpose of their visit to Activities Director Gabriela Ortiz. Administrator Susan Caccam arrived later during the visit.

On 10/08/2025, the Department received a complaint where it was alleged that the facility issued a 30-day notice to a resident, identified as R1, for the reason of failure to comply with house rules. Additionally, the complaint alleges the eviction also listed supplemental reasons for eviction as R1's inability to operate their wheelchair and leaving a hospital stay early. The Department’s investigation consisted of unannounced facility visits, records review, and interviews with staff, residents, and outside sources.

[Continued on LIC 9099-C]
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 08-AS-20251008141157
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: AVANTGARDE SENIOR LIVING OF LA JOLLA
FACILITY NUMBER: 374604261
VISIT DATE: 12/04/2025
NARRATIVE
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[Continued from LIC 9099]

R1 is a non-ambulatory resident at the facility who utilizes a motorized wheelchair. Per R1's physician's report, they are able to leave the facility unassisted and have no diagnosis of Mild Cognitive Impairment (MCI) or Dementia.

On 10/7/25 the facility issued a 30-day notice to R1, and a copy was shared to the Department. Per review of the notice, it was discovered that the a phone number on the notice for appeals information was incorrect. LPA informed the facility of the technicality and that the notice was now invalid. On 11/10/25, the facility issued a new and corrected 30-day notice to R1, the reasons remaining the same: 1. Failure to comply with the house rules and policies of the facility 2. Engaging in behavior which is a threat to the mental and/or physical safety of others in the facility 3. Noncompliant with recommended medical treatment 4. Methamphetamine abuse per discharge papers for a hospital stay in September 2025 5. Suspected camera in R1's room 6. Resident cannot operate well in their electric wheelchair.

Per the notice, sections 11 (house rules/policies) and 20 (conditions for eviction) of R1's admissions agreement contract were specified. Review of R1's admissions agreement revealed that under section 20 (conditions for eviction), subsection (D)(1): " The reasons relied upon for the eviction, with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons." Additionally, under section 11 (house rules/policies) it is noted that "failure to comply may result in a written warning. After sufficient warning, a notice of eviction will be given to the resident and/or responsible person."

The notice itself did not supply specific incidents or information regarding the reasons for eviction. Per interview with administrative staff, it was revealed that no written documentation of incidents or previous meetings with R1 regarding their alleged misbehavior/facility concerns were held. It was revealed that verbal warnings were issued, but no documentation of such was able to be provided. An outside source interviewed revealed that they had received no supporting documentation from the facility for the reasoning for eviction. Another outside source interviewed revealed concerns that there was no substantial basis for the eviction in the first place, labeling it "suspicious."

[Continued on LIC 9099-C]
SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 08-AS-20251008141157
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: AVANTGARDE SENIOR LIVING OF LA JOLLA
FACILITY NUMBER: 374604261
VISIT DATE: 12/04/2025
NARRATIVE
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[Continued from LIC 9099-C]

Per interviews with administrative staff, the main reasoning for the eviction was drug use, R1 leaving the facility and coming back "late at night," R1 having a camera in their room, and concerns about R1's ability to operate their wheelchair properly. Per review of medical discharge papers for R1's hospital stay in September 2025, one of the discharge diagnoses was "methamphetamine abuse." However, review of facility rules do not include anything against the use of drugs in the facility, only that smoking must be done outside the facility and in designated areas. One (1) staff member interviewed revealed that they have observed R1 smoking outdoors and down the street. Interview with R1 also corroborated that they smoke outside of the facility.

In regards to coming and going from the facility, file review of R1's physician's report reveal that R1 is able to leave the facility unassisted, therefore the facility cannot necessarily restrict R1 from coming and going as they please. Additionally, staff interviews and file review of resident sign-in/out records corroborated that R1 does inform staff when they leave and that they sign out at the front desk. While multiple staff interviews corroborated that R1 does often return late at night, R1 is not disruptive when they return. However some staff interviews revealed that R1 does return appearing intoxicated at times. Several staff members interviewed revealed that R1 was in possession of the secured door code and is able to let themselves in at night, which again is not specifically outlined in the admissions agreement to be against house rules/policies.
In regards to R1 having a camera in their room, again the facility rules do not include rules or policies regarding a resident setting a personal camera in their room. Staff interviews revealed concern for the privacy of R1's roommate. Interview with R1's roommate revealed that they were alright with the presence of the camera so long they were not included in the frame. Interview with R1 revealed the camera only records video and not audio, thus complying with applicable California State laws. Additionally, a notice was placed outside R1's room, providing notice of recording in progress inside.

[Continued on LIC 9099-C]
SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 08-AS-20251008141157
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: AVANTGARDE SENIOR LIVING OF LA JOLLA
FACILITY NUMBER: 374604261
VISIT DATE: 12/04/2025
NARRATIVE
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[Continued from LIC 9099-C]

Regarding concerns with R1's ability to utilize their wheelchair, per R1's admissions agreement, all residents with motorized wheelchairs must have a doctor's note certifying the resident can operate it safely. Administrative staff confirmed R1 had a doctors note certifying approval upon move in. Staff interviews revealed mixed sentiments regarding R1's wheelchair use. While most acknowledged R1 has bumped and scraped doorways and corners with their wheelchair, two (2) stated that damages were not done on purpose, mentioning that R1 does try to be careful but that their wheelchair is wide, leading to occasional scrapes when navigating. Another two (2) staff interviewed revealed they believed the damages to be attributed to R1 being intoxicated and thus unable to steer correctly. File review of photos documented by the facility of property damage depict horizontal scrapes/markings on the lower half of R1's unit door. One additional photo of the exit door near R1's room also to have several scrapes, less in amount than shown on R1's door.
Based on LPA's review of records, interviews with staff, residents, and outside sources, the preponderance of evidence standard has been met, therefore the above allegation of unlawful eviction is found to be SUBSTANTIATED. A deficiency is being cited per California Code of Regulations, Title 22, Division 6 on the attached 9099D. An exit interview was conducted with Administrator Caccam to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.
SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 08-AS-20251008141157
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: AVANTGARDE SENIOR LIVING OF LA JOLLA
FACILITY NUMBER: 374604261
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/24/2025
Section Cited
CCR
87224(a)
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87224(a): "The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5).Thirty (30) days written notice to the resident is required [...]"
This requirement was not met as evidenced by:
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Licensee agreed to conduct training/review with staff on eviction procedures and submit proof to LPA by POC due date.
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Based on records review and
interviews the licensee did not comply with the section cited above as R1 was not issued a lawful eviction notice which posed a potential personal rights risk to one (1) out of thirty-seven (37) residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5