374604407-7-23-2026-08-AS-LTEZ-DWMUB5-20260804152548

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604407
Report Date: 07/23/2026
Date Signed: 07/23/2026 02:33:52 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
07/07/2026 and conducted by Evaluator Ramin Hashemi

COMPLAINT CONTROL NUMBER: 08-AS-20260707152857

FACILITY NAME:	BAYSHIRE CARLSBAD		FACILITY NUMBER:	374604407
ADMINISTRATOR:	DAYNES, THOMAS		FACILITY TYPE:	741
ADDRESS:	3140 EL CAMINO REAL		TELEPHONE:	(760) 720-9898
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92008
CAPACITY:	125	CENSUS: 115	DATE:	07/23/2026
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Resident Services Director Pam Talamantes		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Staff did not allow resident to return to the facility

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ramin Hashemi conducted an unannounced visit to deliver findings for the complaint investigation regarding the above-mentioned allegation. LPA identified themselves and met with Resident Services Director Pam Talamantes to discuss the purpose of the visit and elements of the complaint.

It was alleged on 07/07/26, "Staff did not allow resident to return to the facility" meaning that staff did not allow Resident 1 (R1) to return to the facility following discharge from the skilled nursing facility (SNF). The Department’s investigation consisted of unannounced facility visits, interviews with facility staff, outside sources, and records review.

(Continued on LIC9099C, Page 2)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026

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-20260707152857

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: BAYSHIRE CARLSBAD	FACILITY NUMBER: 374604407
	VISIT DATE: 07/23/2026

NARRATIVE

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(Continued from LIC9099, Page 1)

Interviews with staff revealed that staff unanimously stated they did not issue an eviction notice to R1. Staff 1 (S1) and Staff 2 (S2) stated that the facility had not refused R1’s return and stated that R1 could not initially return due to the SNF orders indicating daily wound care requirements; exceeding the facility’s licensed scope of care. Staff documented reassessments of R1 to find reasonable accommodations for the resident to return to the facility with the help of outside agencies in order to remain in compliance.

Interviews with Outside Sources revealed that Outside Source 1 (OS1) believed facility staff were delaying R1’s return and questioned whether concerns about past refusals of care influenced the facility’s decision-making. OS1 stated that they did not think the wound care orders were a requirement for R1 to return. The LPA asked OS1 if R1 was currently receiving wound care to which they confirmed that R1 was receiving those services at the SNF.

Records review revealed that R1 required a higher level of daily wound care than the facility could provide per the SNF physician's orders. Review of email correspondences between the facility and R1's family demonstrated clear communication of the circumstances in which R1 would/would not be able to return to the facility. This corroborates staff interviews stating they did not refuse the return of R1 outside the scope of their responsibilities.

Based on interviews and records review, a preponderance of evidence does not exist to prove that the alleged violation occurred, therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted with Resident Services Director Pam Talamantes, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Ramin Hashemi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026

LIC9099 (FAS) - (06/04)

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