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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604645
Report Date: 09/09/2025
Date Signed: 09/09/2025 07:47:16 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
09/09/2025 and conducted by Evaluator Debbie Correia
COMPLAINT CONTROL NUMBER: 08-AS-20250909091101
FACILITY NAME:POWAY GARDENS SENIOR LIVING - THE PALMSFACILITY NUMBER:
374604645
ADMINISTRATOR:SHANNON HUNDLEYFACILITY TYPE:
740
ADDRESS:12708 MONTE VISTA ROADTELEPHONE:
(858) 674-1255
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY:24CENSUS: 13DATE:
09/09/2025
UNANNOUNCEDTIME BEGAN:
10:13 AM
MET WITH:Executive Director (ED) Melissa WatkinsTIME COMPLETED:
02:40 PM
ALLEGATION(S):
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Licensee is not addressing mold at the facility.
Licensee does not ensure that required posters are posted at facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Correia conducted an unannounced visit to commence and conclude a complaint investigation. LPA Correia was met by Executive Director (ED) Melissa Watkins, identified herself, and explained the purpose of the visit.

The Department's investigation included staff and outside source interviews, a facility record review, and a facility tour.

On September 3, 2025, the Department received a complaint alleging the Licensee did not address mold at the facility and the facility is not displaying the required postings. An interview conducted with Outside Source1 (OS1) revealed there was a leak at the facility that affected the area under the kitchen sink, in the facility laundry room, and the hair salon that resulted in mold at the facility.

[Continued on LIC 9099C]
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2025
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-20250909091101
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: POWAY GARDENS SENIOR LIVING - THE PALMS
FACILITY NUMBER: 374604645
VISIT DATE: 09/09/2025
NARRATIVE
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[Continuation of LIC 9099]

An interview conducted with the Executive Director revealed the leak had been fixed on August 15, 2025, and provided a corroborating invoice for repair. A facility tour and staff interview revealed the areas damaged by the leak had been removed in preparation for new installation of dry wall and repairs. The areas affected were all inaccessible to residents in care and there was no food in the surrounding area of the kitchen. The interview with the ED also provided a contractor’s bid and revealed waiting for two more bids for the facility to undergo repair/remodel in the affected areas.

Regarding the allegation that the facility did not have the required posting. An interview with OS1 disclosed that the facility did not have Community Care Licensing (CCL) posting with the Complaint Bureau's contact information, however upon entering the facility the posting was in direct view at the entrance. Pictures were secured for evidentiary purposes.

Based on interviews, record reviews, and a facility tour the above listed allegations were determined to be Unsubstantiated. This finding means the preponderance of evidence standard was not met.



An exit interview was conducted with ED Watkins and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) will be provided at the conclusion of the visit.
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2