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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604907
Report Date: 05/14/2026
Date Signed: 05/14/2026 03:57:11 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
03/19/2026 and conducted by Evaluator Natasha Persaud
COMPLAINT CONTROL NUMBER: 08-AS-20260319113207
FACILITY NAME:PSALM 23 ASSISTED LIVING IIFACILITY NUMBER:
374604907
ADMINISTRATOR:LACONSAY, IRMAFACILITY TYPE:
740
ADDRESS:10176 EMBASSY WAYTELEPHONE:
(858) 610-8455
CITY:SAN DIEGOSTATE: CAZIP CODE:
92126
CAPACITY:6CENSUS: 5DATE:
05/14/2026
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Licensee, Irma LaconsayTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Staff did not provide incontinence supplies
Satff did not provide the necessary food quantity to meet the resident needs
Staff unable to communicate with resident due to language barrier
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Natasha Persaud conducted a telephonic complaint investigation regarding the above mentioned allegations. LPA met with Licensee, Irma Laconsay and discussed the investigation.

During the investigation, the facility was briefly toured, records reviewed, and interviews conducted with staff, residents, and outside sources. It was alleged staff did not provide incontinent supplies, It was reported Resident #1 (R1) had an incontinent accident last week due to not having a liner that goes inside their brief/diaper, and their clothes became soiled with urine. It was reported R1 was not receiving their wipes and liners at the facility. An outside source (OS) reported R1 had sufficient incontinence supplies but R1 didn’t like the type of briefs/diapers and or liners. However, the facility provided necessary incontinent supplies. In addition, the OS reported they bought the diapers/liners R1 preferred and the issue was resolved. On 03/23/26 and 05/11/26, R1’s incontinent supplies were observed at the facility and were sufficient. Also, incontinent supplies were observed with resident names written on the outside of the supplies to identify the correct resident with the correct product. Continued on LIC 9099C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026
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 2
Control Number 08-AS-20260319113207
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: PSALM 23 ASSISTED LIVING II
FACILITY NUMBER: 374604907
VISIT DATE: 05/14/2026
NARRATIVE
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Furthermore, R1 had additional incontinent supplies stored in their room. R1 stated their family member purchased the incorrect size and they were too big, causing it to leak. R1 confirmed they now have the correct size and the issue was resolved. Staff confirmed there are no issues with R1’s briefs/diapers, and/or liners and they have a sufficient supply.

It was also reported that R1 was provided with very small portions of food. Outside sources were interviewed and reported not observing food being served at the facility. However, they have observed food being cooked. R1 stated they were served the quantity necessary at the facility but didn’t like the food. R1 eats breakfast and lunch at their day program and eats dinner at the facility. On 03/23/26, lunch was observed that consisted of four (4) crackers, bowl of soup and a bowl of Jello. On 05/11/26, LPA observed residents eating lunch, which consisted of fried chicken, mashed potatoes, and vegetables. LPA also observed the residents dinner, which was half of a sandwich, salad and pudding for dessert. The staff showed LPA they prepared a different meal option for R1, which was Menudo, rice, and pudding for dessert. The food portion served to residents was observed as the quantity necessary to meet the resident’s needs. The facility has a menu posted. However, staff reported it’s not followed often, as they provide variety to the residents. The licensee reported they reduced the portion size of the food due to waste. The residents were made aware they can have more if needed. However, they finish their plate and are content. Other residents interviews confirmed they received the food quantity necessary.

Lastly, it was alleged staff were unable to communicate with residents due to language barrier. It was reported staff do not speak Spanish and there was a communication barrier with R1. OS reported R1 can understand enough English to communicate their basic needs. Upon admission to the facility, there was knowledge R1 was Spanish speaking, and it was determined there were no issues. Additional interviews confirmed staff have access to R1’s responsible party to interpret if needed. Further staff interviews confirmed the interpretation application was used by the licensee but not the staff due to R1 communicating their needs. R1 reported staff do not understand them. However, R1 confirmed the staff are meeting their needs and they were able to communicate their needs to staff.

During the course of the investigation, interviews were conducted, and records were reviewed. Investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegations. The allegations are deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Licensee, Irma Laconsay whose signature below confirms receipt of these rights.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2