134604528-8-5-2026-08-AS-LTEZ-DWZQZK-20260816123652

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 134604528
Report Date: 08/05/2026
Date Signed: 08/05/2026 02:26:25 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
10/20/2025 and conducted by Evaluator David Roman

COMPLAINT CONTROL NUMBER: 08-AS-20251020150354

FACILITY NAME:	SUNSET VILLA ASSISTED LIVING		FACILITY NUMBER:	134604528
ADMINISTRATOR:	GARCIA, SIKLALIC		FACILITY TYPE:	740
ADDRESS:	1203 DRIFTWOOD DRIVE		TELEPHONE:	(760) 592-4001
CITY:	EL CENTRO	STATE: CA	ZIP CODE:	92243
CAPACITY:	0	CENSUS: 0	DATE:	08/05/2026
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Licensee, Quetzali Kahnis		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Questionable death.
Staff are inappropriately administering medication to residents.
Underaged staff providing care to residents.
Staff are not meeting residents laundry needs.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) David Roman conducted an over the phone meeting to deliver findings regarding the above complaint allegations. LPA introduced himself and disclosed the purpose of the phone call to Licensee, Quetzali Kahns.

On October 20, 2025, Community Care Licensing Division (CCLD) received a complaint alleging a questionable death, staff are inappropriately administering medication to residents, underaged staff providing care to residents, and staff are not meeting residents’ laundry needs. The Department’s investigation consisted of unannounced facility visits, interviews with facility staff, and records review.

It was alleged that a resident's cause of death was related to a fall at the facility however, CCLD’s Investigative Bureau identified the resident’s death was due to their underlying health issues.

(Cont. on LIC-9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: David Roman
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

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-20251020150354

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: SUNSET VILLA ASSISTED LIVING	FACILITY NUMBER: 134604528
	VISIT DATE: 08/05/2026

NARRATIVE

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Interviews with facility staff revealed that a DSP was terminated for having accidentally dropped an elderly client, interviews were unsure if the client dropped was the resident in question pertinent to the questionable death. Interviews with facility staff confirmed that medications were appropriately provided to the residents in care. Staff interviews revealed no underage staff was providing care to residents. Staff Interviews also revealed that resident’s laundry needs were being met although washer machines may have been broken the facility had its laundry needs met at their sister facilities.

Records Review revealed that the resident was admitted into the facility on June 23, 2025. The client had a DNR on file. The resident’s Physician’s Assessment identified that the resident was DX of Alzheimer’s/Dementia w/hallucinations w/behavioral disturbances, hypertension, chronic atrial fibrillation, thyroidism, and hypercholesterolemia.

Based on interviews and records review, a preponderance of evidence does not exist to prove that the alleged violations occurred, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted with Licensee, Quetzali Khans, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: David Roman
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

LIC9099 (FAS) - (06/04)

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