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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604441
Report Date: 09/04/2026
Date Signed: 09/07/2026 01:02:56 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
01/24/2025 and conducted by Evaluator Amy Rodgers
COMPLAINT CONTROL NUMBER: 08-AS-20250124092730
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: DATE:
09/04/2026
UNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Executive Director Adrian GuillenTIME COMPLETED:
04:45 PM
ALLEGATION(S):
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Licensee pursued unlawful eviction of resident.
Licensee retaliated against a resident.
Licensee overcharged resident for services.
Licensee did not serve food at correct temperature.
Licensee did not employ enough staff.
Licensee did not accommodate resident’s personal preferences.
Licensee did not address a potential safety hazard.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced visit on June 5, 2026, to further invistigate and deliver findings regarding the above complaint allegations. LPA introduced herself and disclosed the purpose of the visit to the Executive Director Adrian Guillen

On January 24, 2025, Community Care Licensing Division (CCLD) received allegations involving the above- mentioned concerns. The Department’s investigation included an unannounced facility visit, interviews with the Reporting Party (RP), interviews with residents, interviews with staff, and a review of available records.

Regarding the allegation that the licensee pursued an unlawful eviction of a resident, it was reported that Resident #1 (R1) was evicted for an amount disputed by the RP. Staff interviews confirmed that a 30- day eviction notice was issued due to non payment. Interviews and documentation indicated that R1’s responsible party had an outstanding balance, and elected to move R1 out prior to the end of the notice period. Billing records provided to the responsible party supported the facility’s claim of delinquent payment. Based on the information gathered, the eviction notice was determined to be valid.Therefore, the eviction notice was valid.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2026
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-20250124092730
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: 09/04/2026
NARRATIVE
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(Continued from LIC9099)

Regarding the allegation of retaliation. More specifically, RP alleged staff were instructed not to speak to her and that facility actions were retaliatory. Resident interviews revealed normal interactions with staff, and no records indicated restricted communication with R1's POA. Department records review reveal facility care notes for R1 that addressed concerns regarding the R1's POA’s behavior toward staff. Department records review reveal a letter addressed to R1’s POA documented that harassment would not be tolerated per facility policy and that efforts had been made to accommodate POA requests.
Regarding the allegation that the facility overcharged for services, it was alleged that Resident #1 (R1) was billed for services not requested or provided. Interviews with staff and residents, along with a review of narrative care notes, showed that R1’s assessed care needs and level-of-care plan matched the services documented in the notes. Billing records listed services consistent with the care needs identified in R1’s assessments. No documentation or witness statements were found showing that services were billed that were not part of R1’s assessed care needs.
Regarding the allegation that facility had Incorrect food temperature. More specifically, RP alleged food was left out long after meal service.Some residents noted that their plates may not always be picked up right away after they finish eating. No concerns related to food temperature were observed during the LPA’s visit. Photo evidence was provided; however, the time stamp showed the photo was taken after meal service had concluded, and the plate was located in R1’s room.
Regarding the allegation of insufficient staffing, it was alleged that staffing levels were not adequate to meet resident needs. During Department interviews, residents stated that their needs were met in a timely manner, including when using their call buttons to request assistance. A review of narrative charting showed regular and consistent check-ins with Resident #1 (R1) throughout shifts, including extended supervision related to R1’s behaviors when taking medication. The Department’s review of staffing levels at or around the time of the allegation did not show staff shortages.
Regarding the allegation that staff failed to accommodate preferences. More specifically, it was alleged staff refused R1’s clothing preferences and wake up schedule. Department Interviews with other residents did not support this concern. Department records review revealed there was a conflict between the POA’s preferences and R1’s personal preferences. No documentation indicated refusal by the facility.Regarding the allegation of a safety hazard. More specifically, RP alleged water was found on the resident’s floor near electrical cords. Records review revealed no maintenance reports or photographs regarding the cord. Interviews with staff denied observing water near cords. Resident interviews indicated housekeeping responds within a reasonable amount of time when called. No hazards were observed during the LPA visit.
Regarding the allegation that staff failed to follow personal/dietary preferences. More specifically, RP alleged the facility did not follow R1’s care plan and diet preferences. Records revealed the care plan was updated to a higher level on January 16, 2025, per charting. Further records reviews records contained diet preferences, no prescribed diets (“RX diet”). Department resident interviews revealed many residents have dietary preferences (e.g., no spicy food), and the facility accommodates their needs. A secondary menu is always available if residents do not like what is being served.

During the course of the investigation, interviews were conducted and records were reviewed. The investigation revealed inconsistent statements, and the information obtained did not present a preponderance of evidence to support or corroborate the allegations. Therefore, the allegations are deemed unsubstantiated.
An exit interview was conducted, and a copy of this report along with Licensee Rights (LIC 9058, 03/22) was provided to Executive Director Adrian Guillen , whose signature below confirms receipt of these rights. ]
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2