Inspection Reports for
Stonewall Gardens Assisted Living

CA, 92262

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Deficiencies (last 6 years)

Deficiencies (over 6 years) 2 deficiencies/year

Deficiencies are regulatory violations found during state inspections.

50% better than California average
California average: 4 deficiencies/year

Deficiencies per year

8 6 4 2 0
2021
2022
2023
2024
2025
2026

Occupancy

Latest occupancy rate 74% occupied

Based on a March 2026 inspection.

This facility has shown a steady increase in demand based on occupancy rates.

Occupancy rate over time

40% 60% 80% 100% Nov 2021 Apr 2023 Jan 2024 May 2024 Aug 2025 Dec 2025 Mar 2026

Inspection Report

Complaint Investigation
Census: 26 Capacity: 35 Deficiencies: 2 Date: Mar 12, 2026

Visit Reason
The inspection was an unannounced case management visit to follow up on a complaint control number 18-AS-20251106134235.

Complaint Details
The visit was triggered by a complaint control number 18-AS-20251106134235. The report does not explicitly state substantiation status.
Findings
The Licensing Program Analyst found no health and safety concerns during the facility tour but identified two deficiencies: Staff #1 worked without criminal record clearance prior to employment, and a physical abuse incident on 08/26/2025 was not reported to Community Care Licensing. Citations were issued for both.

Deficiencies (2)
Staff #1 did not have criminal record clearance prior to employment, posing an immediate health and safety risk.
Physical abuse incident on 08/26/2025 was not reported to Community Care Licensing, posing a potential health and safety risk.
Report Facts
Census: 26 Total Capacity: 35

Employees mentioned
NameTitleContext
Clayshanisha HensonResident Service DirectorMet with Licensing Program Analyst during inspection
Seo JeonLicensing Program AnalystConducted the inspection and authored the report
Brittany CabanasAdministrator/DirectorFacility administrator named in report header

Inspection Report

Complaint Investigation
Census: 26 Capacity: 35 Deficiencies: 2 Date: Mar 12, 2026

Visit Reason
The Licensing Program Analyst conducted an unannounced case management visit to follow up on a complaint control number 18-AS-20251106134235.

Complaint Details
The visit was a follow-up on a complaint. The report does not explicitly state substantiation status.
Findings
The analyst found no health and safety concerns during the facility tour but identified two deficiencies: Staff #1 worked without criminal record clearance prior to employment, and a physical abuse incident on 08/26/2025 was not reported to Community Care Licensing. Citations were issued for both.

Deficiencies (2)
Staff #1 did not have criminal record clearance prior to employment, posing an immediate health and safety risk.
Physical abuse incident on 08/26/2025 was not reported to Community Care Licensing, posing a potential health and safety risk.
Report Facts
Census: 26 Total Capacity: 35

Employees mentioned
NameTitleContext
Clayshanisha HensonResident Service DirectorMet with Licensing Program Analyst during inspection
Seo JeonLicensing Program AnalystConducted the inspection and authored the report
Brittany CabanasAdministrator/DirectorFacility administrator named in the report header

Inspection Report

Complaint Investigation
Census: 26 Capacity: 35 Deficiencies: 1 Date: Mar 12, 2026

Visit Reason
The inspection was an unannounced complaint investigation visit triggered by a complaint received on 2025-11-06 alleging that staff physically assaulted a resident at Stonewall Gardens Assisted Living Facility.

Complaint Details
The complaint investigation was substantiated for the allegation that staff physically assaulted a resident. The allegation that the licensee did not notify relevant parties of the incident was found to be unfounded.
Findings
The investigation substantiated that Staff #1 physically assaulted Resident #1, causing bruising and swelling. The allegation was supported by police reports, interviews with staff, residents, and relevant parties. Another allegation that the licensee did not notify relevant parties of the incident was found to be unfounded.

Deficiencies (1)
Based on interviews conducted and records review, Resident #1 was physically abused by Staff #1. This posed an immediate personal rights risk to residents in care.
Report Facts
Capacity: 35 Census: 26 Deficiency Type A: 1 Plan of Correction Due Date: Mar 19, 2026

Employees mentioned
NameTitleContext
Seo JeonLicensing Program AnalystConducted the complaint investigation and unannounced visit
Clayshanisha HensonResident Service DirectorMet with Licensing Program Analyst during the investigation
Brittany CabanasAdministratorFacility administrator who provided information about the incident and staff termination
Rikesha StampsSupervisorSupervisor overseeing the licensing evaluation

Inspection Report

Annual Inspection
Census: 27 Capacity: 35 Deficiencies: 0 Date: Dec 5, 2025

Visit Reason
Licensing Program Analyst Seo Jeon conducted an unannounced annual required visit to evaluate the facility's compliance with licensing requirements.

Findings
The facility was found to be clean, well-maintained, and compliant with infection control, physical plant, food service, and disaster preparedness standards. No deficiencies were cited during the visit.

Report Facts
Staff present: 3 Resident files reviewed: 4 Staff files reviewed: 4 Fire drill date: Sep 10, 2025 Hot water temperature: 118 Fire marshal inspection date: May 20, 2025

Employees mentioned
NameTitleContext
Brittany CabanasAdministratorFacility Administrator present during inspection
Seo JeonLicensing Program AnalystConducted the inspection
Nisha HensonCare DirectorGreeted Licensing Program Analyst upon entry

Inspection Report

Complaint Investigation
Census: 27 Capacity: 35 Deficiencies: 0 Date: Nov 20, 2025

Visit Reason
The inspection was an unannounced complaint investigation visit conducted to investigate allegations including unqualified staff providing medical care and staff testing positive for COVID.

Complaint Details
The complaint included allegations that unqualified staff were providing medical care and that a staff member tested positive for COVID and was asked not to disclose it to other staff. Both allegations were found to be unsubstantiated due to lack of preponderance of evidence.
Findings
The investigation found insufficient evidence to substantiate the allegations. Staff certifications and training were verified, and the facility's COVID mitigation plan was confirmed. No deficiencies were cited during the visit.

Report Facts
Capacity: 35 Census: 27 Staff interviewed: 5 Residents interviewed: 3 Staff files reviewed: 4

Employees mentioned
NameTitleContext
Nisha HensonResidential Care CoordinatorInterviewed and denied allegations during the investigation
Allen BoeddekerAdministratorFacility administrator mentioned in relation to COVID test handling
Deborah LeeLicensing EvaluatorConducted the complaint investigation
Eva M AlvarezSupervisorSupervisor overseeing the investigation

Inspection Report

Complaint Investigation
Census: 27 Capacity: 35 Deficiencies: 0 Date: Nov 20, 2025

Visit Reason
The inspection was an unannounced complaint investigation visit conducted to investigate allegations of unqualified staff providing medical care and staff testing positive for COVID at Stonewall Gardens Assisted Living Facility.

Complaint Details
The complaint included allegations that unqualified staff were providing medical care and that a staff member tested positive for COVID and was asked not to disclose it to other staff. Both allegations were found to be unsubstantiated due to lack of sufficient evidence.
Findings
The investigation found insufficient evidence to substantiate the allegations. Staff certifications and training were verified, and interviews with staff and residents supported that medical care was provided by qualified personnel. The facility had a COVID mitigation plan and maintained confidentiality regarding positive COVID tests. No deficiencies were cited during the visit.

Report Facts
Capacity: 35 Census: 27 Staff interviewed: 5 Residents interviewed: 3 Staff files reviewed: 4

Employees mentioned
NameTitleContext
Nisha HensonResidential Care CoordinatorInterviewed and denied allegations during the complaint investigation
Allen BoeddekerAdministratorFacility administrator mentioned in the report
Deborah LeeLicensing EvaluatorConducted the complaint investigation
Eva M AlvarezSupervisorSupervisor overseeing the investigation

Inspection Report

Complaint Investigation
Census: 26 Capacity: 35 Deficiencies: 0 Date: Aug 18, 2025

Visit Reason
The inspection was an unannounced Case Management visit regarding a death report received on 2025-08-15.

Complaint Details
The visit was triggered by a death report complaint received on 2025-08-15. No deficiencies were found or cited.
Findings
The Licensing Program Analyst conducted a tour of the facility for health and safety and did not find any health and safety concerns at the time of the visit. No deficiencies were cited.

Employees mentioned
NameTitleContext
Brittany CabanasExecutive DirectorMet with Licensing Program Analyst during the inspection and provided pertinent documentation.
Seo JeonLicensing Program AnalystConducted the unannounced Case Management visit and facility tour.
Rikesha StampsLicensing Program ManagerNamed as Licensing Program Manager on the report.

Inspection Report

Annual Inspection
Census: 24 Capacity: 35 Deficiencies: 0 Date: Dec 4, 2024

Visit Reason
An unannounced annual required visit was conducted to evaluate the facility's compliance with licensing and regulatory requirements.

Findings
The facility was found to be clean, well-maintained, and compliant with infection control, physical plant, food service, care and supervision, and disaster preparedness requirements. No deficiencies were cited during the visit.

Report Facts
Staff members present: 6 Resident files reviewed: 3 Staff files reviewed: 6 Fire drill date: Nov 14, 2024 Hot water temperature: 106

Employees mentioned
NameTitleContext
Brittany HolmAdministratorMet with Licensing Program Analyst during inspection
Seo JeonLicensing Program AnalystConducted the inspection visit
Rikesha StampsLicensing Program ManagerNamed in report as Licensing Program Manager
Lauren KabakoffAdministrator/DirectorFacility Administrator/Director named in report header

Inspection Report

Complaint Investigation
Census: 22 Capacity: 35 Deficiencies: 0 Date: May 17, 2024

Visit Reason
An unannounced complaint investigation visit was conducted in response to allegations that staff did not supervise a resident resulting in multiple falls and that a resident's money was stolen.

Complaint Details
The complaint investigation was unsubstantiated. Allegations included lack of supervision leading to multiple falls and theft of resident's money. Evidence did not support the claims, and the resident was confirmed to be a fall risk with regular monitoring.
Findings
The investigation found insufficient evidence to substantiate the allegations. Interviews, observations, and record reviews indicated that the resident was a fall risk with regular checks and that there was no corroboration of theft of the resident's money. Therefore, the allegations were deemed unsubstantiated.

Report Facts
Capacity: 35 Census: 22

Employees mentioned
NameTitleContext
Brian TroutMarketing and Resident Enrichment DirectorMet with Licensing Program Analyst during investigation and provided information regarding allegations
Kathleen BanrasavongLicensing Program AnalystConducted the complaint investigation visit
Allen BoeddekerAdministratorProvided information regarding resident's fall risk and supervision

Inspection Report

Complaint Investigation
Census: 20 Capacity: 35 Deficiencies: 0 Date: Mar 27, 2024

Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 2024-02-12 regarding staff not transporting residents to medical appointments, insufficient administrator presence, failure to follow residents' dietary plans, and lack of nurse availability.

Complaint Details
The complaint was unsubstantiated after investigation. Allegations included staff not transporting residents to medical appointments, insufficient administrator hours, failure to follow dietary plans, and no nurse availability. Interviews and records did not support these claims.
Findings
The investigation included observations, interviews, and record reviews. The allegations were found to be unsubstantiated due to lack of preponderance of evidence. Residents and staff reported no issues with transportation, administrator presence, dietary plans, or nurse availability. The facility has six med techs covering all shifts.

Report Facts
Facility capacity: 35 Census: 20 Number of med techs: 6

Employees mentioned
NameTitleContext
Kathleen BanrasavongLicensing Program AnalystConducted the complaint investigation
Lauren KabakoffAdministratorFacility administrator involved in investigation
Brian LebeufKitchen Manager / Head ChefInterviewed regarding dietary plan allegations
Brian TroutMarketing & Resident Enrichment DirectorProvided information about med tech staffing
Lauren VincentExecutive DirectorSpoke with Licensing Program Analyst by phone during investigation

Inspection Report

Complaint Investigation
Census: 20 Capacity: 35 Deficiencies: 0 Date: Mar 27, 2024

Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation that the facility was illegally evicting a resident without following proper eviction guidelines.

Complaint Details
The complaint alleged illegal eviction of a resident without proper 30-day notice and lack of assistance in finding alternative housing. The complaint was found to be unfounded based on observations, interviews, and record reviews.
Findings
The investigation found that the resident was properly served with two 30-day eviction notices and was provided resources to find alternative housing. The complaint was determined to be unfounded and dismissed.

Report Facts
Outstanding balance due: Resident had unpaid rent fees from September 2022 through March 2024 Eviction notices served: 2

Employees mentioned
NameTitleContext
Kathleen BanrasavongLicensing Program AnalystConducted the complaint investigation and authored the report
Lauren VincentExecutive DirectorSpoke with Licensing Program Analyst during investigation and assisted resident with housing resources
Brian LebeufKitchen ManagerMet with Licensing Program Analyst during the investigation and signed report

Inspection Report

Complaint Investigation
Census: 20 Capacity: 35 Deficiencies: 0 Date: Mar 27, 2024

Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that staff did not ensure a resident attended medical appointments, did not meet dietary needs, mismanaged medication, falsified records, and that the administrator was not present enough.

Complaint Details
The complaint investigation was unsubstantiated. The allegations included failure to ensure resident medical appointments, dietary needs, medication mismanagement, falsification of records, and insufficient administrator presence. Interviews and reviews did not support these claims.
Findings
Based on observations, record reviews, and interviews with staff and residents, the allegations were found to be unsubstantiated due to lack of preponderance of evidence. Residents and staff reported no issues with medical appointments, dietary needs, medication management, or falsification of records, and the administrator's presence was deemed sufficient.

Report Facts
Capacity: 35 Census: 20

Employees mentioned
NameTitleContext
Kathleen BanrasavongLicensing Program AnalystConducted the complaint investigation
Lauren KabakoffAdministratorNamed as administrator and involved in investigation
Brian LebeufKitchen ManagerMet with during investigation and received report
Lauren VincentExecutive DirectorInterviewed by phone regarding allegations
Brian TroutMarketing & Resident Enrichment DirectorInterviewed regarding allegations and denied falsification
Nisha HensonMed TechStated no issues with medication administration
Jazmond D HarrisLicensing Program ManagerNamed in report header and signature

Inspection Report

Complaint Investigation
Census: 24 Capacity: 35 Deficiencies: 0 Date: Jan 30, 2024

Visit Reason
An unannounced complaint investigation visit was conducted to investigate allegations that a resident sustained unexplained bruising while in care and that staff did not safeguard the resident's personal property.

Complaint Details
The complaint was unsubstantiated. Allegations included unexplained bruising on Resident One and loss of Resident One's wallet and glasses. Interviews and record reviews did not provide sufficient evidence to prove the allegations.
Findings
The investigation found insufficient information to substantiate the allegations regarding unexplained bruising and loss of the resident's wallet and glasses. The complaint was deemed unsubstantiated due to lack of evidence.

Report Facts
Capacity: 35 Census: 24

Employees mentioned
NameTitleContext
Stephanie MartinezLicensing Program AnalystConducted the complaint investigation visit
Lauren KabakoffInterim AdministratorMet with Licensing Program Analyst during the investigation
Allen BoeddekerAdministratorInterviewed regarding resident bruising allegation

Inspection Report

Annual Inspection
Census: 23 Capacity: 35 Deficiencies: 0 Date: Dec 11, 2023

Visit Reason
Licensing Program Analyst Janira Arreola conducted a required annual unannounced visit to evaluate the facility's compliance with regulations.

Findings
The facility was found to be in good condition with no deficiencies cited. Observations included proper infection control measures, a clean and safe physical plant, adequate food service supplies, complete staff and client records, proper medication storage and labeling, and an up-to-date emergency and disaster plan.

Report Facts
Fire drill date: Sep 21, 2023 Hot water temperature: 108.3 Food supply duration: 2 Food supply duration: 7

Employees mentioned
NameTitleContext
Lauren KabakoffAdministratorMet with Licensing Program Analyst during inspection and named in report
Janira ArreolaLicensing Program AnalystConducted the annual inspection visit
Rikesha StampsLicensing Program ManagerNamed in report as Licensing Program Manager

Inspection Report

Complaint Investigation
Census: 17 Capacity: 35 Deficiencies: 5 Date: Apr 20, 2023

Visit Reason
An unannounced complaint investigation visit was conducted following a complaint received on 2023-04-12. The investigation addressed multiple allegations including lack of a current emergency disaster plan, facility vehicle disrepair, uncleared adults working at the facility, inaccurate resident and employee records, and inadequate staff training.

Complaint Details
The complaint investigation was substantiated for allegations including lack of a current emergency disaster plan, facility vehicle disrepair, uncleared adults working at the facility, incomplete resident and employee records, and inadequate staff training. Other allegations such as improper storage of flammable liquids, insufficient administrator presence, cleanliness issues, excess trash, and unsafe environment were unsubstantiated.
Findings
The investigation substantiated several allegations: the facility did not have a current emergency disaster plan, the facility vehicle was in disrepair (fire extinguisher unsecured), uncleared adults were working without proper fingerprint clearance, resident and employee records were incomplete or inaccurate, and staff training documentation was insufficient with some expired CPR/First Aid certifications. Other allegations such as improper storage of flammable liquids, administrator presence, cleanliness, excess trash, and unsafe environment were unsubstantiated.

Deficiencies (5)
Facility did not have a current emergency disaster plan with updated forms and accurate staff listings.
Facility vehicle fire extinguisher was not secured and could roll around.
An employee (S1) worked without obtaining proper fingerprint clearance.
Staff files lacked documentation of required training; CPR/First Aid certification expired for one staff member.
Personnel records were incomplete and missing verification of required staff training and orientation.
Report Facts
Facility capacity: 35 Census: 17 Staff files reviewed: 5 Resident files reviewed: 7 Total staff: 15 Volunteers: 10 Plan of Correction due dates: 2023

Employees mentioned
NameTitleContext
Lauren KabakoffExecutive DirectorMet with during inspection; involved in escorting uncleared staff off premises
Shannon HundleyLVN/Assistant Executive DirectorGreeted Licensing Program Analyst and involved in escorting uncleared staff off premises
Javina GeorgeLicensing Program AnalystConducted the complaint investigation
Joel EsquivelLicensing Program ManagerNamed as Licensing Program Manager on report

Inspection Report

Complaint Investigation
Census: 23 Capacity: 35 Deficiencies: 1 Date: Jun 22, 2022

Visit Reason
The inspection visit was an unannounced investigation of a complaint (#18-AS-20220621091121) regarding the facility's licensing compliance.

Complaint Details
Complaint #18-AS-20220621091121 was investigated and substantiated by the observation of overdue licensing fees. No other health and safety issues were found.
Findings
The Licensing Program Analyst observed that the facility had overdue licensing fees totaling $1,857.00 for the year 2021, including late fees. No other health and safety concerns were noted during the inspection.

Deficiencies (1)
Failure to pay all applicable and accrued licensing fees and civil penalties, constituting grounds for denial or forfeiture of a license.
Report Facts
Overdue licensing fees: 1857 Deficiencies cited: 1

Employees mentioned
NameTitleContext
James DunningAdministratorNamed in relation to the deficiency and exit interview
Crystal ColvinLicensing Program AnalystConducted the inspection and cited the deficiency

Inspection Report

Complaint Investigation
Census: 23 Capacity: 35 Deficiencies: 1 Date: Jun 22, 2022

Visit Reason
An unannounced visit was conducted to investigate a complaint regarding overdue licensing fees at the facility.

Complaint Details
Complaint #18-AS-20220621091121 was investigated. The deficiency related to overdue licensing fees was substantiated.
Findings
The inspection found that the facility had overdue licensing fees totaling $1,857.00 for the year 2021 and subsequent late fees. No other health and safety concerns were observed during the inspection.

Deficiencies (1)
Failure to pay all applicable and accrued licensing fees, including annual fees and late fees for 2021, constituting grounds for denial or forfeiture of a license.
Report Facts
Overdue licensing fees: 1857 Census: 23 Total capacity: 35

Employees mentioned
NameTitleContext
James DunningAdministratorNamed in relation to the deficiency and exit interview.
Crystal ColvinLicensing Program AnalystConducted the inspection and cited the deficiency.
Joel EsquivelLicensing Program ManagerSupervisor overseeing the inspection.

Inspection Report

Annual Inspection
Census: 23 Capacity: 35 Deficiencies: 0 Date: Nov 9, 2021

Visit Reason
Licensing Program Analyst Jesse Gardner made an unannounced visit to the facility to conduct an annual inspection with an emphasis on infection control.

Findings
The inspection found sufficient hand hygiene supplies, cleaning and disinfecting provisions, and proper use of face coverings. The facility has a designated infection control lead responsible for tracking COVID-19 cases, maintaining PPE supplies, and staff training on infection control.

Report Facts
COVID-19 positive cases in quarantine: 1

Employees mentioned
NameTitleContext
Nisha HensonMedical TechnicianMet with Licensing Program Analyst during inspection and discussed infection control practices
Jesse GardnerLicensing Program AnalystConducted the annual inspection

Report

March 12, 2026

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