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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604806
Report Date: 09/11/2026
Date Signed: 09/11/2026 11:04:44 AM

Substantiated


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
09/02/2026 and conducted by Evaluator Iby Strong
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20260902123632
FACILITY NAME:EVEREST AT OCEANSIDEFACILITY NUMBER:
374604806
ADMINISTRATOR:MCBRIDE, FERLINAFACILITY TYPE:
740
ADDRESS:3500 LAKE BLVD.TELEPHONE:
(760) 414-9411
CITY:OCEANSIDESTATE: CAZIP CODE:
92056
CAPACITY:175CENSUS: 111DATE:
09/11/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Executive Director Brandon Cho and Matia Grochowiak Assistant Executive DirectorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Facility did not follow procedures to protect food items.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Iby Strong conducted an unannounced visit to initiate a complaint investigation on the above allegation. LPA identified herself and discussed the purpose of the visit with Executive Director Brandon Cho and Matia Grochowiak Assistant Executive Director.

On September 2, 2026, Community Care Licensing (CCL) receas a complaint alleging facility is not following procedures to protect food items. During investigation, LPA Strong conducted interviews and made observations.
According to allegation, facility staff were collecting resident specimens and storing it in refrigerators meant for medication/resident snacks. Photographic evidence collected shows a filled urine sample in a medical cup within a plastic bag stored in a refrigerator with fruit cups, protein shakes and pudding. Interview with multiple staff revealed that at times, resident samples may be stored in these refrigerators. Interviews also revealed that there is no specific refrigeration system meant for storage of human specimen.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2026
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 3
Control Number 08-AS-20260902123632
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: EVEREST AT OCEANSIDE
FACILITY NUMBER: 374604806
VISIT DATE: 09/11/2026
NARRATIVE
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Based on interviews, and observations, a preponderance of evidence exists to support the allegation. Deficiencies are being cited by the California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). An exit interview was conducted with Executive Director Brandon Cho and Matia Grochowiak Assistant Executive Director. to whom a copy of this report, LIC 9099-C, LIC 9099-D, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided to.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20260902123632
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: EVEREST AT OCEANSIDE
FACILITY NUMBER: 374604806
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/18/2026
Section Cited
CCR
87555(b)(9)
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87555 General Food Service Requirements b) The following food service requirements shall apply: (9) Procedures which protect the safety, acceptability ... of food shall be observed in food storage... This requirement was not met, as evidenced by:
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Licensee agrees to establish a system for human specimen storage that does not affect food storage by POC date and provide proof to LPA via email.
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Based on interviews and records the licensee did not have procedures in place to protect the safety of resident food which posed a potential Safety risk to persons in care.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3