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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604441
Report Date: 09/17/2026
Date Signed: 09/18/2026 02:22:42 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
09/14/2026 and conducted by Evaluator Angelica Boyles
COMPLAINT CONTROL NUMBER: 08-AS-20260914145707
FACILITY NAME:MONTE VISTA VILLAGE SENIOR LIVINGFACILITY NUMBER:
374604441
ADMINISTRATOR:ADRIAN GUILLENFACILITY TYPE:
740
ADDRESS:2211 MASSACHUSETTS AVENUETELEPHONE:
(619) 465-1331
CITY:LEMON GROVESTATE: CAZIP CODE:
91945
CAPACITY:219CENSUS: 117DATE:
09/17/2026
UNANNOUNCEDTIME BEGAN:
08:43 AM
MET WITH:Executive Director Adrian GuillenTIME COMPLETED:
12:01 PM
ALLEGATION(S):
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Facility in disrepair
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced visit to the facility to initiate a complaint investigation regarding the above mentioned allegation. LPA identified herself, explained the purpose of the visit and nature of the complaint to Executive Director Adrian Guillen.

On September 14, 2026 the Department received this complaint which alleged the facility is in disrepair. Specifically, the Reporting Party alleged sewage issues in the women’s restroom in the dining room. The Department’s investigation included a facility tour, record reviews, as well as interviews with staff and residents.

(Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Angelica Boyles
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2026
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-20260914145707
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: MONTE VISTA VILLAGE SENIOR LIVING
FACILITY NUMBER: 374604441
VISIT DATE: 09/17/2026
NARRATIVE
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(Continued from LIC9099)

During an unannounced visit to the facility, LPA observed the women’s restroom in the dining room with a sign on the door saying, “Out of service we apologize for the inconvenience”. LPA entered the restroom and observed the sinks filled with brown water and was malodorous. LPA did not observe this affecting the dining room area. Records reviewed revealed that a plumbing service was contacted for this plumbing issue and a quote was given and signed for on 9/16/26. During LPA’s visit, the plumbing services came and LPA observed them working in the women’s restroom in the dining room. Interviews with residents confirmed that the restrooms in their own rooms are operational and have not been impacted.

The Department has investigated the allegations that the facility is in disrepair. Based upon the information obtained during this investigation, facility staff took appropriate and timely steps to address the plumbing issue. It is therefore determined that the preponderance of evidence was not met to support this allegation and deemed unsubstantiated.

An exit interview was conducted with Executive Director Adrian Guillen, to whom a copy of this report and the Licensee’s Rights (LIC9058 3/22) were provided.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Angelica Boyles
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2026
LIC9099 (FAS) - (06/04)
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