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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604273
Report Date: 07/13/2026
Date Signed: 07/13/2026 03:36:23 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
07/07/2026 and conducted by Evaluator Angelica Boyles
COMPLAINT CONTROL NUMBER: 08-AS-20260707113756
FACILITY NAME:CASA MAHALFACILITY NUMBER:
374604273
ADMINISTRATOR:FRAZIER, THERESAFACILITY TYPE:
740
ADDRESS:12631 CASA AVENIDATELEPHONE:
(858) 924-1136
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY:6CENSUS: 5DATE:
07/13/2026
UNANNOUNCEDTIME BEGAN:
12:42 PM
MET WITH:Caregiver Teresita DuclayanTIME COMPLETED:
03:22 PM
ALLEGATION(S):
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Staff do not properly dispose chemicals.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced visit to the facility to deliver investigative findings regarding the above mentioned allegation. LPA identified herself, explained the purpose of the visit and nature of the complaint to Caregiver Teresita Duclayan.

On July 7, 2026 the Department received this complaint which alleged staff do not properly dispose chemicals. The Department’s investigation included a facility tour and interviews with staff and an outside source.

(Continued on LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Angelica Boyles
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2026
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 3
Control Number 08-AS-20260707113756
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: CASA MAHAL
FACILITY NUMBER: 374604273
VISIT DATE: 07/13/2026
NARRATIVE
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(Continued from LIC9099)

An interview with an Outside Source (OS1) reported that facility staff frequently dump water and chemicals against the fence after cleaning and it leaks under the fence. Pictures provided to LPA demonstrated how the water ends up soaking through to the other side of the fence into the neighbor’s backyard. OS1 reported not knowing what the water was but stated it must have been something unsanitary due to observing staff wearing masks and gloves while dumping it. OS1 reported that it smelled of waste and chemicals.

Per LPA interviews with staff, when resident’s clothes or sheets are soaked with urine, they are washed in the backyard by being soaked in a basin filled with water and cleaning agents. Staff reported the laundry is not done in the washing machine because they do not want to contaminate the other laundry with urine. Staff reported the water waste is then dumped against the fence into the plants. Staff reported understanding that the water dumped included urine and cleaning chemicals and it is unsanitary to dump it.

During unannounced visits, LPA observed in the backyard against the fence a small tub where clothing was being soaked. Additionally, during today’s visit LPA observed next to the back sliding door a plastic bag containing soiled incontinence care items which was not properly disposed of. LPA was able to smell the malodor of urine immediately upon opening the sliding back door.

The Department has investigated the allegation that facility staff do not properly dispose of chemicals. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was met to support or corroborate this allegations and therefore deemed substantiated. A deficiency is being cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D page). A plan of correction was jointly developed with Caregiver Teresita Duclayan.

An exit interview was conducted with Caregiver Teresita Duclayan, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided at the conclusion of the visit.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Angelica Boyles
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 08-AS-20260707113756
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: CASA MAHAL
FACILITY NUMBER: 374604273
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/13/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/03/2026
Section Cited
CCR
87303(f)
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Maintenance and Operation (f) All waste shall be located, stored, and disposed of in a manner that will not transmit...diseases or odors, pose a risk to health and safety...
This requirement was not met as evidenced by:
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Staff reported that they will no longer dump waste water in the backyard. Additionally, staff will complete a training on cleaning and disposing of incontinence waste and submit to LPA proof of training by POC due date.
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Per LPA observations and interview with staff, incontinence waste and was not being properly disposed of. This poses a potential health and safety risk to 5 of 5 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.
SUPERVISOR'S NAME: Simon Jacob
LICENSING EVALUATOR NAME: Angelica Boyles
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2026
LIC9099 (FAS) - (06/04)
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