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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604274
Report Date: 11/05/2025
Date Signed: 11/05/2025 11:26:45 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/17/2023 and conducted by Evaluator Venus Mixson
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20230117113429
FACILITY NAME:VISTA DEL LAGO MEMORY CAREFACILITY NUMBER:
374604274
ADMINISTRATOR:GONZALEZ, JEFFFACILITY TYPE:
740
ADDRESS:1817 AVENIDA DEL DIABLOTELEPHONE:
(760) 741-2888
CITY:ESCONDIDOSTATE: CAZIP CODE:
92029
CAPACITY:96CENSUS: 96DATE:
11/05/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:LICENSEE, MARIA HILLTIME COMPLETED:
11:38 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility has mold.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On November 5, 2025, Licensing Program Analyst (LPA), Venus Mixson arrived unannounced at the facility and met with the Licensee, Maria Hill. LPA explained the reason for the visit was to provide findings for the complaint investigation. During the investigation, LPA conducted interviews, record reviews, and made observations pertaining to the listed allegation.
On January 17, 2023, Community Care Licensing received a complaint alleging Facility has mold. It was reported that there was suspected mold in the activity room and room 20. It was additionally reported that a couple of weeks went by, and the suspected mold was just painted over, and there was no professional called out to test the suspected mold. Information obtained from interview with Licensee; Johnathan Thomas denied the allegation the facility had mold. The Licensee indicated there was simply water damage from the previous rains. Additionally, the Licensee stated there was a professional called out to test the suspected spots for mold. There was no mold detected at the time of the inspection. Information obtained from interviews with staff members indicated there was no information brought to their attention that there was mold detected at any time at the facility. Information received from interviews with Residents indicated they have resided at the facility during the time of the investigation and there was never a time when they were informed of there being any type of mold located in the activity room or in any room in the facility. Due to the complaint being filed anonymously, LPAs were unable to interview and obtain additional information regarding the allegation. LPA’s review of the records confirmed there was no documentation confirming there was any type of mold detected at the facility covering the investigation period. LPA’s observations confirmed there was no water damage found at the facility at the time of the unannounced visit. LPA conducted subsequent interviews with Witness, and they advised that there were no challenges or concerns with mold at the facility. Additional Witness interviewed indicated there were no concerns or issues brought to their attention regarding there being mold located at the facility.
Based on information obtained from interviews, record reviews, observations, and the unavailability of relevant parties, the evidence received pertaining to the allegation, the facility has mold, has been deemed unsubstantiated. An unsubstantiated allegation means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted. A copy of this report was discussed and given to the Licensee, Maria Hill.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
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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