374604441-10-2-2025-08-AS-SJAB-DMGU6F-20251015151813

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604441
Report Date: 10/02/2025
Date Signed: 10/02/2025 11:33:25 AM

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
06/29/2023 and conducted by Evaluator Amy Rodgers

COMPLAINT CONTROL NUMBER: 08-AS-20230629152942

FACILITY NAME:	MONTE VISTA VILLAGE SENIOR LIVING		FACILITY NUMBER:	374604441
ADMINISTRATOR:	MARKOVICH, PAUL		FACILITY TYPE:	740
ADDRESS:	2211 MASSACHUSETTS AVENUE		TELEPHONE:	(619) 465-1331
CITY:	LEMON GROVE	STATE: CA	ZIP CODE:	91945
CAPACITY:	219	CENSUS:	DATE:	10/02/2025
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Executive Director Adrian Guillen.		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Licensee did not protect resident
Unlawful eviction
Neglect resulted in resident on resident abuse

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced visit to deliver findings regarding the above complaint allegations. LPA introduced themselves and disclosed the purpose of the visit to Executive Director Adrian Guillen.

On June 29, 2023 it was alleged licensee did not protect resident, unlawful eviction, and neglect resulted in resident on resident abuse. The Department’s investigation consisted of unannounced facility visits, interviews with facility staff, residents, outside sources, and records review.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:	DATE: 10/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2025

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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Control Number 08-AS-20230629152942

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: MONTE VISTA VILLAGE SENIOR LIVING	FACILITY NUMBER: 374604441
	VISIT DATE: 10/02/2025

NARRATIVE

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(continued from LIC 9099)

It was further alleged that the licensee failed to protect R1 from another resident. More specifically, RP alleged that the facility did not take appropriate action to ensure R1’s safety despite ongoing conflict with R2, including the existence of a restraining order. Staff interviews confirmed that the facility was aware of the interpersonal conflict and had informed staff during meetings to monitor the situation and report any violations. There was no evidence that the facility failed to intervene or respond to concerns. R1 had a documented history of verbal and physical aggression toward staff and residents.

It was alleged that the facility neglected Resident #1 (R1), resulting in resident-on-resident abuse. More specifically, the Reporting Party (RP) alleged that another resident, identified as Resident #2 (R2), physically assaulted R1 on multiple occasions, causing injury. RP stated there were no witnesses to the incidents, and R1 did not report them to staff. A review of facility records revealed no incident reports or documentation supporting the claim that R2 physically assaulted R1. Staff and resident interviews did not corroborate the allegation. A narrative charting entry dated 5/30/2023 documented that R2 sustained a skin tear while defending himself during an altercation involving R1, and police were contacted. R2’s records showed no history of aggressive behavior.

It was further alleged that the facility issued an unlawful eviction notice to R1. More specifically, RP alleged that the eviction was retaliatory and followed the issuance of a protective order in favor of R1. A review of the eviction notice confirmed that it was issued in writing with a stated reason and followed Title 22 requirements. Facility documentation showed that R1 had violated house rules through repeated verbal aggression and a physical altercation. There was no evidence that the eviction was retaliatory or procedurally improper.

Based on interviews and records review, a preponderance of evidence does not exist to prove that the alleged violations occurred; therefore, the allegations are UNSUBSTANTIATED.

An exit interview was conducted with Executive Director Adrian Guillen to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058 03/22) were provided.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:	DATE: 10/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2025

LIC9099 (FAS) - (06/04)

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