Inspection Report Summary
Most inspections found deficiencies related to safety and regulatory compliance, with several civil penalties issued for issues such as unsecured medications and chemicals, insufficient overnight staffing, and over-capacity of bedridden residents. The most recent report from October 16, 2025, showed that while some earlier deficiencies involving staff health screening and scheduling were corrected, a key fire clearance issue for bedridden residents remained unresolved, resulting in an immediate civil penalty. Earlier reports cited immediate safety risks from unsecured cleaning chemicals and medications, lack of proper staff background checks, and inadequate administrator presence. Several complaint investigations were unsubstantiated or related to other facilities, but one substantiated complaint in November 2024 found no overnight staff supervision, leading to a fine. The facility’s record shows ongoing challenges with compliance, though some improvements were made over time, especially in staff health screening and scheduling.
Deficiencies per Year
4
3
2
1
0
High
Moderate
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Plan of Correction
Census: 6
Capacity: 6
Deficiencies: 3
Oct 16, 2025
Visit Reason
The visit was a plan of correction (POC) inspection to verify if deficiencies issued on 9/22/2025, 9/25/2025, and 10/2/2025 had been corrected by the licensee.
Findings
The licensee corrected deficiencies 87411(f) regarding staff health screening and tuberculosis test, and 87415(a)(1) regarding staff schedule showing 24/7 coverage. However, deficiency 87158(a) related to fire clearance for bedridden residents and eviction notice was not corrected, resulting in an immediate civil penalty.
Deficiencies (3)
| Description |
|---|
| Deficiency 87158(a) related to failure to submit updated LIC200 and facility sketch requesting fire clearance for two bedridden residents or a 30-day eviction for one bedridden resident. |
| Deficiency 87411(f) regarding staff health screening and tuberculosis test. |
| Deficiency 87415(a)(1) regarding staff schedule showing 24/7 staff coverage. |
Report Facts
Civil penalty amount: 1400
Capacity: 6
Census: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Rebecca Borunda | Licensing Program Analyst | Conducted the plan of correction visit and verified deficiencies. |
| Zayden Chen | Licensee | Met with Licensing Program Analyst during inspection and named in findings. |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 2
Oct 2, 2025
Visit Reason
An unannounced annual continuation visit was conducted to continue the annual inspection started on 2025-09-22, to evaluate compliance with licensing requirements.
Findings
The facility was found to be clean, safe, and in good repair with no pathway obstructions. However, deficiencies were cited for over-capacity of bedridden residents and insufficient administrator presence. A civil penalty of $500 was assessed for over-capacity of bedridden residents.
Severity Breakdown
Type A: 1
Type B: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Facility is licensed for one bedridden resident but two residents were bedridden, posing an immediate safety risk to all residents. | Type A |
| Administrator was not present at the facility enough hours to oversee its operation, posing a potential safety and personal rights risk to all residents. | Type B |
Report Facts
Civil penalty amount: 500
Plan of Correction due date: Oct 3, 2025
Plan of Correction due date: Oct 17, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Rebecca A Borunda | Licensing Program Analyst | Conducted the inspection and signed the report |
| Lynn Drummond | Administrator | Named in deficiency for insufficient presence at the facility |
| Roy Antes | Caregiver | Met with Licensing Program Analyst during inspection |
| Raymond Abedoza | Caregiver | Participated in exit interview and provided information about facility |
| Sabel Martinez | Licensing Program Manager | Named on report |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 1
Sep 25, 2025
Visit Reason
An unannounced case management visit was conducted to continue the required 1-year annual inspection visit from 09/22/2025.
Findings
The inspection found unsecured cleaning chemicals stored under the sink in a common bathroom accessible to residents, posing an immediate health and safety risk. The caregiver relocated the chemicals to locked storage during the visit. A repeat violation from 10/16/2024 resulted in a $250 civil penalty. The annual inspection was not completed due to time constraints and requires a return visit.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Unsecured cleaning chemicals stored under the sink in a common bathroom accessible to residents. | Type A |
Report Facts
Civil penalty amount: 250
Number of residents in care: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Rebecca A Borunda | Licensing Program Analyst | Conducted the inspection and authored the report. |
| Raymond Abedoza | Caregiver | Facility staff member who relocated cleaning chemicals during the visit. |
| Lynn Drummonn | Administrator/Director | Facility administrator/director named in the report header. |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 2
Sep 22, 2025
Visit Reason
An unannounced Required 1-Year visit was conducted to evaluate the facility's compliance with licensing requirements.
Findings
The inspection found deficiencies including unsecured medications stored in the kitchen refrigerator and a staff member working without completing a required health screening. A civil penalty was issued for a repeat violation related to unsecured medications.
Severity Breakdown
Type A: 1
Type B: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Medication was stored in the unsecured refrigerator located in the kitchen, posing an immediate health and safety risk to all 6 residents. | Type A |
| Staff 1 did not complete a health screening and tuberculosis test prior to working in the facility, posing a potential health risk to all 6 residents. | Type B |
Report Facts
Civil penalty amount: 250
Residents in care: 6
Facility capacity: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Rebecca A Borunda | Licensing Program Analyst | Conducted the inspection and authored the report |
| Lynn Drummonn | Administrator/Director | Facility administrator named in the report |
| Raymond Abedoza | Caregiver | Met during inspection and involved in relocating medications |
| Carmelita Twite | Caregiver | Met during inspection |
Inspection Report
Census: 6
Capacity: 6
Deficiencies: 0
Aug 28, 2025
Visit Reason
An unannounced Case Management visit was conducted by the Regional Manager and Licensing Program Manager to tour the facility, interview staff, and review records.
Findings
No immediate health and safety concerns were observed and no deficiencies were cited during the visit.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Raymond Abedoza | Staff | Met with during the visit and exit interview. |
| Jerry Romero | Regional Manager | Conducted the unannounced Case Management visit. |
| Sabel Martinez | Licensing Program Manager | Conducted the unannounced Case Management visit. |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 0
Jul 7, 2025
Visit Reason
An unannounced collateral visit was conducted to interview a staff member regarding a complaint investigation filed at another facility licensed by Community Care Licensing.
Findings
The Licensing Program Analyst conducted an unannounced collateral visit, interviewed a staff member for a complaint investigation related to another facility, and completed an exit interview with the caregiver. No specific deficiencies or violations were detailed in the report.
Complaint Details
The visit was related to a complaint investigation filed at another facility licensed by Community Care Licensing. No substantiation status or further details were provided.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Rebecca Borunda | Licensing Program Analyst | Conducted the unannounced collateral visit and interview. |
| Raymond Abedoza | Caregiver | Interviewed during the visit and participated in the exit interview. |
| Lynn Drummonn | Administrator/Director | Named as facility administrator/director. |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 1
Nov 19, 2024
Visit Reason
An unannounced complaint investigation was conducted due to an allegation that the licensee did not ensure the facility was staffed at night.
Findings
The investigation found that the facility did not have staff present overnight to provide care and supervision, posing an immediate safety risk to all 6 residents. The allegation was substantiated based on interviews, record reviews, and observations.
Complaint Details
The complaint alleged that the licensee did not ensure the facility was staffed at night. The allegation was substantiated based on interviews with residents and staff, review of incident reports, and staff schedules. It was found that overnight staff were not awake or present, and residents had no assistance from approximately 8:00pm to 7:00am on weekdays and 8:00pm to 6:00am on weekends. A civil penalty of $500 was assessed for lack of supervision.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to have a qualified person on call on the premises overnight in a facility caring for less than sixteen residents, posing an immediate safety risk to 6 of 6 residents. | Type A |
Report Facts
Civil penalty amount: 500
Residents affected: 6
Deficiency count: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Rebecca A Ruiz | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Lynn Drummond | Administrator | Facility administrator involved in the investigation and exit interview |
| Raymond Abedoza | Caregiver | Met with Licensing Program Analyst during investigation and involved in exit interview |
| Zayden Chen | Licensee | Spoke with Licensing Program Analyst by telephone during investigation |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 1
Oct 30, 2024
Visit Reason
An unannounced Case Management - Annual Continuation visit was conducted to review the facility file, observe residents, interview staff, and assess compliance with licensing requirements.
Findings
A deficiency was cited for a staff member (S1) working without a valid criminal background clearance, posing an immediate safety risk to all 6 residents. The annual inspection could not be completed due to time constraints, requiring a return visit.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Staff member S1 has been working at the facility since August 2024 without a valid criminal background clearance, posing an immediate safety risk to 6 residents. | Type A |
Report Facts
Civil penalty amount: 500
Residents at risk: 6
Plan of Correction Due Date: Nov 4, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Rebecca A Ruiz | Licensing Program Analyst | Conducted the inspection and cited the deficiency |
| Lynn Drummond | Administrator | Facility administrator involved in the exit interview and plan of correction |
| Raymond Abedoza | Caregiver | Met with Licensing Program Analyst during the visit |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 2
Oct 16, 2024
Visit Reason
Licensing Program Analyst Rebecca Ruiz conducted an unannounced Required 1-Year visit to evaluate the facility's compliance with licensing regulations.
Findings
The inspection found unsecured cleaning chemicals, knives, scissors, and medications prescribed to a previous resident stored in unsecured locations, posing immediate safety risks. The annual inspection was not completed due to time constraints and requires a return visit.
Severity Breakdown
Type A: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Unsecured medications belonging to a previous resident were stored in the facility fridge, posing an immediate safety risk. | Type A |
| Cleaning chemicals, knives, and other sharps were not locked, posing an immediate safety risk. | Type A |
Report Facts
Capacity: 6
Census: 6
Plan of Correction Due Date: Nov 15, 2024
Plan of Correction Due Date: Oct 16, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Raymond Abedoza | Caregiver | Observed relocating unsecured medications and hazardous items to secured locations during the inspection |
| Rebecca Ruiz | Licensing Program Analyst | Conducted the inspection and documented findings |
| Lynn Drummond | Administrator | Facility administrator with pending certificate |
Inspection Report
Follow-Up
Census: 5
Capacity: 6
Deficiencies: 0
Oct 3, 2024
Visit Reason
An unannounced case management visit was conducted to follow up regarding an incident report about Resident 1 who had moved out of the facility.
Findings
The Licensing Program Analyst confirmed that Resident 1 was no longer present at the facility and no personal belongings remained. No deficiencies were cited during this visit.
Report Facts
Eviction notice duration: 30
Census: 5
Total capacity: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Rebecca Ruiz | Licensing Program Analyst | Conducted the unannounced case management visit |
| Lynn Drummond | Administrator | Facility administrator present during the visit |
| Raymond Abedoza | Caregiver | Met with Licensing Program Analyst during the visit |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 0
Nov 9, 2023
Visit Reason
The visit was conducted in response to an SOC341 Report of Suspected Dependent Adult/Elder Abuse, which the licensee self-submitted to the CCLD San Diego Regional Office involving Resident #1.
Findings
No deficiencies were observed or cited during the unannounced Case Management - Incident visit. The Licensing Program Analyst performed a facility tour, welfare check, reviewed pertinent records, and interviewed the resident and relevant staff.
Complaint Details
The visit was triggered by a report of suspected dependent adult/elder abuse involving Resident #1. The licensee self-submitted the report. No deficiencies were found during the investigation.
Report Facts
Capacity: 6
Census: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Raymond Abedoza | Caregiver | Met with Licensing Program Analyst during the visit |
| Zayden Chen | Licensee | Spoken to via phone during the visit |
| Dang Nguyen | Licensing Program Analyst | Conducted the unannounced Case Management - Incident visit |
| Lizzette Tellez | Licensing Program Manager | Named in the report header |
Inspection Report
Original Licensing
Census: 5
Capacity: 6
Deficiencies: 0
Sep 29, 2023
Visit Reason
An announced Pre-Licensing visit was conducted to observe the facility’s physical plant for compliance with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code.
Findings
The facility was found clean, sanitary, and in good repair with compliant ambient temperature and hot water temperatures. All safety equipment was operational, and the facility passed the pre-licensing inspection with no deficiencies noted.
Report Facts
Facility capacity: 6
Current census: 5
Hot water temperature: 109.6
Hot water temperature: 117.4
Hot water temperature: 119
Hot water temperature: 116.4
Hot water temperature: 117.8
Kitchen refrigerator temperature: 39
Kitchen freezer temperature: 0
Garage refrigerator temperature: 36
Garage freezer temperatures: -2
Garage freezer temperatures: 0
Medication refrigerator temperature: 40
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dang Nguyen | Licensing Program Analyst | Conducted the pre-licensing inspection and authored the report |
| Materesa Derafera | Administrator | Facility administrator named in the report |
| Zayden Chen | Applicant's Representative | Met with Licensing Program Analyst during the visit |
| Lizzette Tellez | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Original Licensing
Census: 4
Capacity: 6
Deficiencies: 0
Aug 28, 2023
Visit Reason
An announced Pre-Licensing visit was conducted to observe the facility’s physical plant for compliance with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code.
Findings
The applicant did not pass the pre-licensing inspection due to items requiring correction for regulatory compliance, and a return visit will be required.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Dang Nguyen | Licensing Program Analyst | Conducted the announced Pre-Licensing visit and authored the report. |
| Materesa Derafera | Facility Administrator and applicant’s representative present during the visit. | |
| Zayden Chen | Applicant’s representative present during the visit. |
Inspection Report
Census: 3
Capacity: 6
Deficiencies: 0
Aug 11, 2023
Visit Reason
The visit was an office evaluation involving a telephone interview with the applicant and administrator to verify identification and confirm understanding of community care facility licensing laws.
Findings
The applicant and administrator participated in COMP II, confirming their knowledge of licensing laws and providing required documentation including signed LIC 809 and photo ID.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tessa Derafera | Administrator | Participated in COMP II and interview |
| Zayden Chen | Applicant | Participated in COMP II and interview |
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