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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604893
Report Date: 08/31/2026
Date Signed: 08/31/2026 04:55:53 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
05/18/2026 and conducted by Evaluator Angelica Boyles
COMPLAINT CONTROL NUMBER: 08-AS-20260518140319
FACILITY NAME:MELROSE 34FACILITY NUMBER:
374604893
ADMINISTRATOR:MENDOZA, JUSTINFACILITY TYPE:
740
ADDRESS:14534 GARDEN RDTELEPHONE:
(702) 776-0689
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY:6CENSUS: 4DATE:
08/31/2026
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Administrator Justin MendozaTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff neglect resulting in resident death
Washing machine was not maintained in good repair
Poor food quality provided to residents
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced visit to the facility to deliver investigative findings regarding the above mentioned allegations. LPA identified herself, explained the purpose of the visit and nature of the complaint to Administrator Justin Mendoza.

On May 18, 2026 the Department received this complaint which alleged staff neglect resulted in resident death, the washing machine was not maintained in good repair, and poor food quality was provided to residents. The Department’s investigation included a facility tour, record reviews, and interviews with staff.

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

DATE: 08/31/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2026
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-20260518140319
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: MELROSE 34
FACILITY NUMBER: 374604893
VISIT DATE: 08/31/2026
NARRATIVE
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(Continued from LIC9099)

Regarding the allegation that staff neglect resulted in resident death the Reporting Party specified neglect resulted in death for Resident #1 (R1). Per the Certificate of Death, R1's cause of death was cardiac arrest, systolic heart failure, unspecified acuity, and human immunodeficiency virus. R1 passed away under hospice care at the facility on 5/17/25. There are no hospice notes indicative that R1’s cause of death was a result of staff neglect.

Regarding the allegation that the washing machine was not maintained in good repair, during unannounced visits LPA observed washing machines to be operable and in good repair. The facility sits on a property where there are five sister facilities. The laundry is centralized in Melrose 48 where there are two sets of washing machines and dryers and Melrose 30 where there is another washer and dryer set.

Regarding the allegation that poor food quality was being provided to residents, during unannounced visits LPA observed meals served to residents to be well balanced and of good quality. LPA did not observe any food in the fridge or pantry to be expired or observe any reason that the food could not be provided to residents.

The Department has investigated the above mentioned allegations. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was not met to support or corroborate these allegations and therefore deemed unsubstantiated.

An exit interview was conducted with Administrator Justin Mendoza, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided.

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

DATE: 08/31/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2