<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604261
Report Date: 08/03/2026
Date Signed: 08/03/2026 02:56:11 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
05/07/2026 and conducted by Evaluator Janet Ngallo
COMPLAINT CONTROL NUMBER: 08-AS-20260507052039
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: 33DATE:
08/03/2026
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Administrator Susan CaccamTIME COMPLETED:
03:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not prevent a resident from sustaining a fracture while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Janet Ngallo conducted an unannounced subsequent visit to deliver findings regarding the above‑mentioned allegation. LPA identified themselves and met with Administrator Susan Caccam to discuss the purpose of the visit and elements of the complaint.

On 05/07/2026, it was alleged that staff did not prevent a resident(R1) from sustaining a fracture while in care. The department's investigation consisted of interviews and records review.

[Cont. on LIC 9099-C]
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Janet Ngallo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2026
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 2
Control Number 08-AS-20260507052039
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: 08/03/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
[Cont. on LIC 9099]

Regarding the allegation, R1 was sent to the hospital upon the request of their responsible party, and was found to have a displaced femoral fracture. Interviews revealed that since R1 was admitted to the facility, R1 frequently cried, expressed distress, and exhibited facial grimacing as part of their baseline behavior, making it difficult for staff to distinguish baseline emotional behaviors from potential pain. Interviews stated anytime staff asked R1 if they were experiencing any pain or if the behavior was anxiety-related, R1 would respond that they were anxious. Multiple staff stated that R1 did not report any fall, and no fall was witnessed in the days prior to hospitalization and the day of hospitalization. Staff reported that R1 ambulated with both wheelchair and walker depending on preference, and that R1 had no visible injuries or complaints of hip pain prior to the incident. Interviews consistently stated that camera footage was reviewed and showed no fall or incident in monitored areas. Staff stated that R1 spent time in common areas and was monitored regularly.

Staff interviews revealed that when R1 exhibited baseline behavior on the day of hospitalization, emergency services were called at the request of the responsible party. Staff confirmed that R1 had previously been hospitalized from an unrelated health matter days earlier and had continued showing facial expressions that were described as consistent with their baseline. No staff reported observing a fall or any event that could clearly or consistently be associated with a new injury.

Records review revealed that R1’s service plan and medical records documented dementia, anxiety, muscle weakness, and a prior displaced femur fracture before admission to the facility. Records also documented that R1 required assistance with all ADLs and used both a wheelchair and walker.  Records review of the incident report on 05/03/2026 revealed that R1’s responsible party observed R1 to be expressing pain and requested emergency services, and R1 was transported to the hospital and admitted with a displaced right femoral fracture.

Based on interviews and records review, the preponderance of evidence standard has not been met, therefore the above allegation is found to be unsubstantiated. An exit interview was conducted with Administrator Susan Caccam and a copy of this report, along with Licensee/Appeal Rights (LIC 9058 01/16), were provided. Their signature confirms receipts of these documents.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Janet Ngallo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2