374604727-10-24-2025-08-AS-SJAB-DMRUSP-20251024155041

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604727
Report Date: 10/23/2025
Date Signed: 10/24/2025 01:50:28 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
07/07/2025 and conducted by Evaluator Tiffany Holmes

COMPLAINT CONTROL NUMBER: 08-AS-20250707113955

FACILITY NAME:	LANCE PLACE		FACILITY NUMBER:	374604727
ADMINISTRATOR:	MASONER, EVA		FACILITY TYPE:	735
ADDRESS:	10056 ROTHGARD RD		TELEPHONE:	(858) 262-3057
CITY:	SPRING VALLEY	STATE: CA	ZIP CODE:	91977
CAPACITY:	4	CENSUS: 3	DATE:	10/23/2025
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Eva Masoner, Administrator		TIME COMPLETED:	01:55 PM

ALLEGATION(S):

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Staff mismanaged resident's medications.
Staff did not accord resident privacy.
Staff wrongfully evicted resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA)Tiffany Holmes contacted the facility to deliver findings for a complaint investigation via tele-virtual. LPA identified herself to, and explained the purpose of the visit and the basic elements of the complaint with Eva Masoner, Administrator

LPA previously conducted interviews with residents, staff, and outside sources, made observations, and obtained and reviewed pertinent records. LPA conducted the initial visit on July 15, 2025 and conducted a tour of the facility.

On July 7, 2025, Community Care Licensing (CCL) received a complaint alleging that staff mismanaged resident's medications, staff did not accord resident privacy and
staff wrongfully evicted resident. Interviews revealed that Client one (C1) leaves the facility and goes home on the weekends with their family. Interviews revealed that there have not been any instances where a medication error occurred. Interviews with outside sources revealed there havent been any medication issues with any of the clients. Interviews also revealed that Staff 1 (S1) denied mismanaging the clients medications. Interviews revealed that C1s father assists with their medication as well as the facility staff. S1 denies the allegation of staff mismanaged resident's medications.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025

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-20250707113955

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: LANCE PLACE	FACILITY NUMBER: 374604727
	VISIT DATE: 10/23/2025

NARRATIVE

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(continue from LIC9099)

It was alleged that staff did not accord resident privacy. Interviews revealed that staff allow the clients their privacy in their rooms if their doors are closed and around the facility if they are on the phone having conversations. Interviews revealed the clients can talk in their rooms, the living room and outside in the back yard or the front yard. The clients don't go into each others rooms. Interviews revealed that most clients will go into their room if they need to talk privately. S1 denies the allegation of not according the client with privacy. Interviews with an outside stated they have not heard of any complaints of any of the clients not being accorded privacy.

It was alleged that staff wrongfully evicted resident. Interviews revealed that a review of C1’s medical records indicated that C1 has been diagnosed with a moderate intellectual disability. Despite this, C1 is considered independent, highly functional, and employed full-time. C1 resided with their parents until moving into the facility on May 24, 2025. Interviews revealed the family is very active in C1s life. Interviews revealed that C1 is disruptive and very loud around the facility. Interviews revealed that C1 plays their television loud and their radio. Interviews also revealed that C1 is deaf in one ear. Interviews revealed that C1 was given a 30 day notice to find another home that could meet their needs due to the clients behaviors. Interviews with outside sources stated the client was given the 30 days legally. S1 denied the allegation of wrongfully evicting the client.

The Department has investigated the above-mentioned allegations and based on interviews, LPA observations, and records review, it was determined that the complaint allegations are Unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Eva Masoner via face time and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) was provided via email. An electronic email read receipt confirms the documents were received.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025

LIC9099 (FAS) - (06/04)

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