374604986-5-22-2026-08-AS-APAO-DW97YE-20260722220434

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604986
Report Date: 05/22/2026
Date Signed: 05/22/2026 03:12:34 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
05/13/2026 and conducted by Evaluator Arian Golbakhsh

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20260513095615

FACILITY NAME:	BLISS ASSISTED LIVING & MEMORY CARE		FACILITY NUMBER:	374604986
ADMINISTRATOR:	AMEY, MEGAN		FACILITY TYPE:	740
ADDRESS:	950 L AVENUE		TELEPHONE:	(619) 474-4844
CITY:	NATIONAL CITY	STATE: CA	ZIP CODE:	91950
CAPACITY:	85	CENSUS: 56	DATE:	05/22/2026
		UNANNOUNCED	TIME BEGAN:	09:22 AM
MET WITH:	Concierge Glynda Rotoni, RSD Anita Crickenberger, and Administrator Megan Amey		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Facility not helping resident obtain medical care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced visit to conduct a complaint investigation and delivered findings regarding the above mentioned allegation. LPA was welcomed by, identified themselves to, and discussed the purpose of their visit to Resident Services Director Anita Crickenberger. Administrator Megan Amey arrived later during the visit. Note, LPA did step out for lunch from 12:30-1:30pm.

On 05/13/2026, the Department received a complaint where it was alleged that facility staff had not arranged for medical care for a resident (identified as R1) after R1 had been requesting to go to the hospital for a period of five (5) days (May 4th through 8th) due to feeling unwell and having shortness of breath. The Department’s investigation consisted of an unannounced facility visit, records review, and interviews with staff, residents, and outside sources.

[Continued on LIC 9099-C]

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2026

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-20260513095615

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: BLISS ASSISTED LIVING & MEMORY CARE	FACILITY NUMBER: 374604986
	VISIT DATE: 05/22/2026

NARRATIVE

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[Continued from LIC 9099]

R1 is a resident at the facility currently receiving hospice services for an end stage health condition affecting their lungs. Per review of R1's Physician's Assessment, dated for March 2026, R1 does not have any diagnosis of Dementia or Mild Cognitive Impairment (MCI). Per staff interviews, R1 has a documented history of anxiety and a repeated behavior of seeking admission to the hospital with no apparent reason. Per staff interviews, it is believed the anxiety may be connected to R1's hospice diagnosis, which causes the breathing symptoms/issues R1 experiences and often claims they need hospitalization for and that the facility would respect and oblige to R1's wish for being sent out. Additional staff interview revealed that R1 would often complain of shortness of breath, but once they were accompanied by staff, they would suddenly be ok. Interview with an outside source part of R1's hospice team corroborated that R1 has increased anxiety and routinely attempts to seek hospitalization for the "normal" symptoms of their hospice diagnosis and finds comfort in the hospital setting. It was also revealed that hospice was working with R1 on anxiety reducing activities. Interviews with residents did not reveal any concerns with care by the facility or response times for calls for assistance.

File review of R1's records show members of R1's hospice team having made visits with R1 daily from May 1st through the 8th. A note from a hospice worker who visited on the 7th noted that they had addressed concerns of R1's agitation and panic during their visit. A note from a visit conducted today (5/22/26) noted that R1 was experiencing "agitation, anxiety, SOB [shortness of breath] wanting to go to hospital." Facility progress notes for R1 indicate that the facility regularly took note of and updated R1's hospice agency of R1's reported symptoms. Per progress notes, R1 was hospitalized somewhere between May 5th and returned to the facility on May 12th. Per interview with Administrative staff, R1 requested to be sent out to the hospital on May 8th and was. Progress notes also highlight that R1 was hospitalized at least six (6) times since the end of January 2026 through today (5/22/26) due to symptoms associated with their condition despite being on hospice.

Based on interviews and records review, while the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred – therefore the allegation has been determined to be UNSUBSTANTIATED. An exit interview was conducted with Administrator Amey to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.

SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2026

LIC9099 (FAS) - (06/04)

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