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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604620
Report Date: 06/29/2026
Date Signed: 07/03/2026 05:45:11 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
03/13/2026 and conducted by Evaluator Angelica Boyles
COMPLAINT CONTROL NUMBER: 08-AS-20260313103839
FACILITY NAME:LAKE CANYON HOME CAREFACILITY NUMBER:
374604620
ADMINISTRATOR:NOEMI VAZQUEZFACILITY TYPE:
735
ADDRESS:9460 LAKE CANYON RDTELEPHONE:
(619) 495-5187
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY:4CENSUS: 4DATE:
06/29/2026
UNANNOUNCEDTIME BEGAN:
11:44 AM
MET WITH:Administrator Noemi VasquezTIME COMPLETED:
03:05 PM
ALLEGATION(S):
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Resident was under the influence of fentanyl due to staff neglect
Staff are not meeting resident's incontinence needs
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 allegations. LPA identified herself, explained the purpose of the visit and nature of the complaint to Administrator Noemi Vasquez.

On March 13, 2026 the Department received this complaint which alleged Resident #1 (R1) was under the influence of fentanyl due to staff neglect and staff are not meeting R1’s incontinence needs. [See LIC811 Confidential Name List for a description of select person identifiers used in this report.] The Department’s investigation included a facility tour, record reviews, as well as interviews with residents, staff and outside sources.

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

DATE: 06/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026
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 2
Control Number 08-AS-20260313103839
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: LAKE CANYON HOME CARE
FACILITY NUMBER: 374604620
VISIT DATE: 06/29/2026
NARRATIVE
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(Continued from LIC9099)

Regarding the allegation that R1 was under the influence of fentanyl due to staff neglect in an interview with LPA, R1 denied the use of using fentanyl. Interviews with facility staff and an Outside Source (OS1) who interacts with R1 frequently reported R1 not having a history of illicit drug use. Additionally, R1 cannot leave the facility unassisted and there were no instances of R1 leaving the facility unattended leading up to the alleged incident. Per interviews, R1's whereabouts are minimal to the facility and their Day Program, where they are also supervised. A follow up drug screening done on March 17, 2026 showed negative results for fentanyl. There is no evidence to support R1 used fentanyl due to facility staff neglect.

Regarding the allegation that staff are not meeting R1’s incontinence needs, an interview with R1 reported that staff care for their incontinence needs. Further, an interview with OS1 reported no concern regarding R1’s incontinence needs being met by facility staff. During unannounced facility visits, LPA did not observe anything to raise concern regarding incontinence needs being unmet.

The Department has investigated the above mentioned allegations. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was not met to support or corroborate these allegations and therefore deemed unsubstantiated.

An exit interview was conducted with Administrator Noemi Vasquez, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided.

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

DATE: 06/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026
LIC9099 (FAS) - (06/04)
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