374604318-8-12-2026-08-AS-SMAZ-DY7P5V-20260923110121

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604318
Report Date: 08/12/2026
Date Signed: 08/12/2026 03:38:53 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
08/03/2026 and conducted by Evaluator Arian Golbakhsh

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20260803111826

FACILITY NAME:	WESTMONT OF ENCINITAS		FACILITY NUMBER:	374604318
ADMINISTRATOR:	BENJIE DOCTOLERO		FACILITY TYPE:	740
ADDRESS:	1920 SOUTH EL CAMINO REAL		TELEPHONE:	(760) 452-6037
CITY:	ENCINITAS	STATE: CA	ZIP CODE:	92024
CAPACITY:	101	CENSUS: 94	DATE:	08/12/2026
		UNANNOUNCED	TIME BEGAN:	08:57 AM
MET WITH:	Executive Director Donelle Williams		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Licensee did not respond to resident grievance in a timely manner

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced visit to open 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 Executive Director Donelle Williams. Note, LPA did step out for lunch from 12-1pm.

On 08/03/2026, the Department received a complaint where it was alleged that the facility did not provide a timely response to a grievance presented to the facility. The Department’s investigation consisted of an unannounced facility visit, 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: 08/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2026

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-20260803111826

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: WESTMONT OF ENCINITAS	FACILITY NUMBER: 374604318
	VISIT DATE: 08/12/2026

NARRATIVE

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[Continued from LIC 9099]

Per the complaint, a grievance was presented to the facility via email in June 2026 requesting updates to the facility's policies on video surveillance devices in resident units. Per the grievance, the current policy does not allow for residents to implement their own surveillance devices of any kind in their units, and residents would like the policy amended to allow for their own video surveillance devices, should they wish to use any. Per the complaint, as of the beginning of August 2026, an official response to the grievance had not yet been received, although the facility had been giving verbal updates in the meantime. Additionally, it was shared that the facility's corporate office had undergone a major position change, which was causing a delay in review of grievance at a corporate level.

On 8/6/26, LPA received an email from the facility with a copy of the facility's written response to the grievance, in which the facility agreed to update its policies on the topic. LPA was also sent a copy of the proposed amendment to the facility's resident admissions contract to reflect the change.

Per interview with the Executive Director of the facility, they had met with resident council members a few times a week to give verbal updates on the grievance proceedings, corroborating that there were major organizational changes that affected the timeliness of an official response in writing. In addition, it was shared that the proposed policy updates would affect all the company's facility locations, not just this one, hence the need for extended review. Interview with an outside source from the county Long-Term Care Ombudsmans office corroborated this information and the timeline from grievance filing to response, as well.

Interviews with residents revealed that the Executive Director did give verbal updates in response to the grievance prior to the official final resolution. Resident interviews also revealed that resident concerns are generally handled promptly and communication between residents and management was great.

[Continued on LIC 9099-C]

SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2026

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20260803111826

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: WESTMONT OF ENCINITAS	FACILITY NUMBER: 374604318
	VISIT DATE: 08/12/2026

NARRATIVE

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[Continued from LIC 9099-C]

File review of the facility's agreement contract and grievance procedures policy revealed that the facility shall respond in writing within 14 calendar days of any action or inaction taken in response to the grievances and/or recommendations submitted. Review of the facility's grievance log revealed documentation of receipt of the grievance, and documentation of verbal communication with resident council members was done same day and the grievance was elevated. Date of official written response for the grievance resolution is well over two (2) weeks (14 days) from date of the grievance having been received.

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 that the facility did not respond to the grievance in a timely manner is found to be SUBSTANTIATED. A deficiency is being cited per California Code of Regulations, Title 22, Division 6 on the attached LIC 9099D. An exit interview was conducted with Executive Director Williams 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: 08/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2026

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20260803111826

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: WESTMONT OF ENCINITAS	FACILITY NUMBER: 374604318
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/12/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/26/2026 Section Cited CCR 87468.2(a)(9)	1 2 3 4 5 6 7	87468.2(a): "In addition to the rights listed in Section 87468.1 [...] residents [...] shall have all of the following personal rights: (9) [...] The licensee shall respond to residents’ grievances and recommendations promptly." This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee issued a written response to the grievance. POC was cleared during the visit.
	8 9 10 11 12 13 14	Based on LPA file review and interviews, the licensee did not comply with the section cited above in ensuring resident grievances were responded to in a timely manner as outlined in the facility's operating procedures, which poses a potential personal rights risk to all persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2026

LIC9099 (FAS) - (06/04)

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