374604722-4-14-2026-08-AS-APAO-DUER4V-20260525124209

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604722
Report Date: 04/14/2026
Date Signed: 04/14/2026 11:32:51 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
04/13/2026 and conducted by Evaluator Debbie Correia

COMPLAINT CONTROL NUMBER: 08-AS-20260413114921

FACILITY NAME:	NOVELLUS CLAIREMONT LLC		FACILITY NUMBER:	374604722
ADMINISTRATOR:	LEWIS, ERNEST		FACILITY TYPE:	740
ADDRESS:	5219 CLAIREMONT MESA BLVD.		TELEPHONE:	(858) 292-8044
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92117
CAPACITY:	214	CENSUS: 86	DATE:	04/14/2026
		UNANNOUNCED	TIME BEGAN:	11:14 AM
MET WITH:	Executive Director (ED) Ernest Lewis		TIME COMPLETED:	06:00 PM

ALLEGATION(S):

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Staff did not answer call button in a timely manner.
Staff did not ensure that resident's incontinence needs were met.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced visit to commence and conclude a complaint investigation. LPA was greeted by Concierge Alex Garcia, identified herself, and met with Executive Director (ED) Lewis to discuss the purpose of the visit.

The investigation included staff and resident interviews, along with a review of facility and resident records. On April 13, 2026, the Department received a complaint alleging the facility did not provide timely attention to a pendant call and that staff did not provide incontinent care to Resident 1 (R1).

A review of R1’s resident record revealed R1 was admitted to the facility on August 31, 2025. Records showed that at the time of admission, R1 was independent with all activities of daily living (ADLs), able to self-administer medications, and required the use of a walking device or wheelchair. In addition, an interview with the ED confirmed that R1 drove their own vehicle and transported their mobility devices independently.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2026

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-20260413114921

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: NOVELLUS CLAIREMONT LLC	FACILITY NUMBER: 374604722
	VISIT DATE: 04/14/2026

NARRATIVE

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Records also noted R1 was diagnosed with COPD, diabetes, Parkinson’s, GERD, arthritis, and HIV at the time of admission. R1’s records further disclosed that R1 did not require incontinence care, although they occasionally experienced urgency.

A review of R1’s records and staff interviews showed no change of condition or decline in ADLs prior to R1’s voluntary relocation. At the time of the visit, it was confirmed that R1 had voluntarily relocated to another facility on March 31, 2026. The ED also disclosed that prior to relocating, R1 began displaying behavioral and mental health concerns, such as hitting themselves in the head, although no previous behavioral concerns were documented in R1’s facility records.

Additional review of resident records confirmed R1 was assessed at a care level of “0,” requiring no care, consistent with their medical records maintained at the facility. Interviews with staff revealed they had no knowledge of R1 being incontinent, nor was incontinence care included in R1’s care plan. Interviews with other residents corroborated that they were unaware of R1 experiencing incontinence. LPA attempted to contact R1 multiple times but was unsuccessful. Additional staff interviews confirmed R1 was independent with all ADLs, including toileting. Regarding the allegation that staff did not respond in a timely manner to a pendant pull from R1, a review of the facility’s pendant call logs from March through April showed no pendant pulls initiated by R1. Interviews with residents (R2–R4) revealed no concerns with staff response time. One resident (R2), who lived directly next door to R1 and had regular communication with them, reported that R1 frequently expressed feelings that others were “out to get them” and tended to have “a chip on their shoulder.” Residents interviewed expressed satisfaction with staff and the services provided. R2 stated that “staff have been nothing but good to them.[See LIC 811 for confidential names list]

Based on record review and interviews, the allegations that the facility did not provide timely attention to a pendant call and that staff failed to provide incontinence care to R1 were determined to be Unsubstantiated. An exit interview was conducted with ED Lewis who was notified a copy of the report will be provided at the conclusion of the visit. Signature below confirms receipt of the reports

*LPA took a lunch break during the visit.

SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2026

LIC9099 (FAS) - (06/04)

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