374604267-4-8-2026-08-AS-APAO-DUE6Q4-20260524210003

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604267
Report Date: 04/08/2026
Date Signed: 04/08/2026 02:36:19 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
03/30/2026 and conducted by Evaluator Janet Ngallo

COMPLAINT CONTROL NUMBER: 08-AS-20260330161726

FACILITY NAME:	CLOISTERS OF THE VALLEY, LLC		FACILITY NUMBER:	374604267
ADMINISTRATOR:	DISHA FRANCES-HALL		FACILITY TYPE:	740
ADDRESS:	4171 CAMINO DEL RIO SOUTH		TELEPHONE:	(619) 283-2226
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92108
CAPACITY:	70	CENSUS: 64	DATE:	04/08/2026
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Resident Service Director Marquette Corbett		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff did not ensure resident's hygiene needs were met.
Staff communicate in an inappropriate manner to residents in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst(LPA) Janet Ngallo conducted an unannounced visit to initiate a complaint investigation and deliver findings regarding the above-mentioned complaint allegations. LPA introduced themselves and disclosed the purpose of the visit and elements of the complaint to Resident Service Director Marquette Corbett.

On 03/30/2026, it was alleged that staff did not ensure resident's hygiene needs were met and that staff communicate in an inappropriate manner to residents in care. The department's investigation consisted of interviews and records review.

(Cont. on LIC 9099-C)

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Janet Ngallo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2026

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-20260330161726

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: CLOISTERS OF THE VALLEY, LLC	FACILITY NUMBER: 374604267
	VISIT DATE: 04/08/2026

NARRATIVE

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(Cont. from LIC 9099)

Regarding staff not ensuring residents’ hygiene needs were met, interviews with residents and staff consistently reported that scheduled showers were frequently missed within the last month, largely due to ongoing staffing shortages and limited availability of caregivers to complete bathing tasks. Resident interviews reported going more than a week without receiving their scheduled showers. Staff interviews acknowledged that they were unable to provide showers when the facility was short-staffed or lacked necessary supplies. Staff further stated that the facility does not have a system in place to document missed showers, only refusals.

Records review revealed that the facility maintained a standard shower schedule for all residents however, no documentation existed to show whether scheduled showers were completed or missed.

Regarding the allegation that staff communicate in an inappropriate manner to residents in care, interviews with both residents and staff consistently reported that certain staff spoke to residents in a rude, harsh, or otherwise inappropriate manner. Resident interviews reported that some caregivers used unpleasant or short tones when interacting with them, and one resident stated they had personally observed disrespectful communication from management staff. Staff interviews further corroborated these accounts, with multiple caregivers confirming they had witnessed or were aware of staff raising their voices, speaking unpleasantly to residents, or making inappropriate comments. Management interviews also confirmed at least one prior incident involving an inappropriate comment made to a resident.

Based on interviews and record review, the preponderance of evidence standard has been met, therefore the above allegations are found to be substantiated. California code of Regulations, Title 22, is being cited on the attached LIC 9099D. An exit interview was conducted with Resident Service Director Marquette Corbett 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: 04/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2026

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20260330161726

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: CLOISTERS OF THE VALLEY, LLC	FACILITY NUMBER: 374604267
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/08/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/24/2026 Section Cited CCR 87468.2(a)(4)	1 2 3 4 5 6 7	(a)In addition to the rights... personal rights: (4)To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers.. needs. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	The licensee agreed to maintain staffing levels sufficient to meet resident hygiene needs and to provide outside vendor training on resident hygiene and care plan requirements. The licensee will also implement and maintain a tracking system to document completed and missed resident showers. Licensee will send proof of training and documentation to LPA by POC due date.
	8 9 10 11 12 13 14	Based on interviews, the licensee did not ensure staff was sufficient in numbers for residents to receive scheduled showers/bathing needs, which posed a potential health, safety and personal rights risk to residents in care.	8 9 10 11 12 13 14
Type B 05/13/2026 Section Cited CCR 87468.1(a)(1)	1 2 3 4 5 6 7	(a)"Residents in all residential care facilities for the elderly shall.. personal rights: (1)To be accorded dignity in their personal relationships with staff, residents, and other persons." This requirement was not met, as evidenced by:	1 2 3 4 5 6 7	Licensee will conduct resident personal rights outside vendor training to review resident personal rights and etiquette for all staff with sign-in sheet and training topic clearly noted by POC due date.
	8 9 10 11 12 13 14	Based on interviews, the facility did not communicate with residents in an appropriate manner. This posed a potential personal rights risk to persons in care.	8 9 10 11 12 13 14

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: Lizzette Tellez
LICENSING EVALUATOR NAME: Janet Ngallo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2026

LIC9099 (FAS) - (06/04)

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