374604675-11-21-2025-08-AS-SJAB-DP3UYR-20251205150021

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604675
Report Date: 11/21/2025
Date Signed: 11/21/2025 04:31:05 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
01/13/2025 and conducted by Evaluator Amy Rodgers

COMPLAINT CONTROL NUMBER: 08-AS-20250113154056

FACILITY NAME:	GROSSMONT GARDENS SENIOR LIVING		FACILITY NUMBER:	374604675
ADMINISTRATOR:	JONES, REGINALD		FACILITY TYPE:	740
ADDRESS:	5480 MARENGO AVE		TELEPHONE:	(619) 463-0281
CITY:	LA MESA	STATE: CA	ZIP CODE:	91942
CAPACITY:	425	CENSUS: 382	DATE:	11/21/2025
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Administrator/Asstistant Executive Director Lane Hermosillo		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Lack of supervision resulting in resident injury

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rodgers, conducted an unannounced visit to futher invistigate and deliver findings regarding the above complaint allegation. LPA introduced themselves and disclosed the purpose of the visit to Administrator/Asstistant Executive Director Lane Hermosillo.

The Department’s investigation consisted of unannounced facility visits, interviews with facility staff, residents, outside sources, and records review.

On 01/12/25, it was alleged that a lack of supervision resulted in a physical altercation between Resident #1 (R1) and Resident #2 (R2), causing injury to R1. Staff interviews revealed that R1 was escorted to the smoking area where R2 was already present. After verbal exchanges, staff separated the residents and observed no further issues. Approximately 30 minutes later, R1 returned with a bleeding hand. Staff responded by calling emergency services and providing first aid. Staff described both residents as verbally expressive but not previously physically aggressive. (Continued on LIC9099C)

Resident interviews were inconsistent. R1 had limited recall but stated R2 scratched them. R2 stated R1 initiated the altercation after being told not to touch R2’s lighter. R2 admitted to swinging back and believed their fingernail may have caused the injury.

Outside sources (R1’s financial contact and R2’s sister) were unaware of prior issues and described the incident as surprising.

Records review confirmed staff response, hospital transport, and police involvement. R1 was relocated to a different floor post-incident to prevent further contact.

LPA observations confirmed both residents remain at the facility with no further incidents. The smoking area has a partial divider but is not fully enclosed.

Conclusion:
Based on interviews, direct LPA observations, and records review, a preponderance of evidence does not exist to prove that the alleged violation occurred. Staff responded appropriately, and the incident appears to have been spontaneous and unforeseeable.

Therefore, the allegation is UNSUBSTANTIATED.

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

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025

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-20250113154056

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: GROSSMONT GARDENS SENIOR LIVING	FACILITY NUMBER: 374604675
	VISIT DATE: 11/21/2025

NARRATIVE

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(Continued form LIC9099)

Resident interviews were inconsistent when trying to recall the incident.. R1 had limited recall but stated R2 scratched them. R2 stated R1 initiated the altercation after being told not to touch R2’s lighter. R2 admitted to swinging back and believed their fingernail may have caused the injury. Outside sources were unaware of prior issues and described the incident as surprising. Records review confirmed staff response, hospital transport, and police involvement. R1 was relocated to a different floor post-incident to prevent further contact. LPA observations confirmed both residents remained at the facility after the incident with no further incidents. The smoking area has a partial divider but is not fully enclosed.

Based on interviews, direct LPA observations, and records review, a preponderance of evidence does not exist to prove that the alleged violation occurred. Staff responded appropriately, and the incident appears to have been spontaneous and unforeseeable. Therefore, the allegation is UNSUBSTANTIATED.

An exit interview was conducted with Administrator/Assistant Executive Director Lane Hermosillo, 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: 11/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025

LIC9099 (FAS) - (06/04)

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