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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604919
Report Date: 09/16/2026
Date Signed: 09/16/2026 02:48:40 PM

Substantiated


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
09/16/2026 and conducted by Evaluator Jose DeLaCruz
COMPLAINT CONTROL NUMBER: 08-AS-20260916093319
FACILITY NAME:MAILE ALOHA CARE HOMEFACILITY NUMBER:
374604919
ADMINISTRATOR:RAMIREZ, HEATHERFACILITY TYPE:
740
ADDRESS:3636 CHRISTINE STREETTELEPHONE:
(858) 274-0921
CITY:SAN DIEGOSTATE: CAZIP CODE:
92117
CAPACITY:14CENSUS: 8DATE:
09/16/2026
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:TIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Main exit from a resident's room is partially obstructed
The main door handdle does not work properly to exit the facility
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jose De La Cruz conducted an unannounced visit regarding the above mentioned allegations. LPA was greeted by Staff 1 (S1), to whom he identified himself and explained the purpose of the visit.

On September 9, 2026, the Reporting Party (RP) alleged that the facility hallway was obstructed, blocking emergency access for a resident. RP also reported that the main door’s exit handle was not working properly.

On September 16, 2026, LPA contacted RP, who reiterated the allegations. On the same day, LPA visited the facility, interviewed staff and a resident, and reviewed facility records. LPA toured the facility and observed an Air Conditioning Unit placed in the hallway corner near one resident’s (R1) exit door. LPA also observed two wheelchairs placed near a different exit leading to the outside of the facility.

[CONTINUED ON LIC9099-C]
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Jose DeLaCruz
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2026
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 4
Control Number 08-AS-20260916093319
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: MAILE ALOHA CARE HOME
FACILITY NUMBER: 374604919
VISIT DATE: 09/16/2026
NARRATIVE
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[CONTINUED FROM LIC9099]


LPA informed Staff 2 (S2) that these items may obstruct residents’ exit paths. S2 disagreed but moved R1’s wheelchair out of the room.

While touring the facility, LPA attempted to open the main door from the inside, and the handle detached. S2 observed this and explained that it was due to a previous resident who was not permitted to leave the facility unsupervised. Specifically, that the handle had been reversed so that a resident with dementia could not get out of the facility; all other residents and staff were aware of how to operate the lock. Since this, the lock was broken due to individuals attempting to turn it incorrectly. LPA advised that this condition posed an immediate risk to emergency evacuation in the facility. Staff acknowledged the concern and repaired the door handle.

Based on record reviews and interviews, the preponderance of evidence standard has been met for both allegations. Two deficiencies were cited in accordance with the California Code of Regulations.

Report and Appeal Rights were discussed with and provided to the Licensee. The Licensee’s signature below confirms receipt.
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Jose DeLaCruz
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 08-AS-20260916093319
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: MAILE ALOHA CARE HOME
FACILITY NUMBER: 374604919
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/16/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/17/2026
Section Cited
CCR
87303(a)
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87303(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
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Staff will change the entrance door handle.
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Based on observation, the licensee did not comply with the section cited above in one out of one main entrance door handle, which posed a health and safety risk to eight out of eight persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Robyn Clark
LICENSING EVALUATOR NAME: Jose DeLaCruz
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 08-AS-20260916093319
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: MAILE ALOHA CARE HOME
FACILITY NUMBER: 374604919
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/16/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/30/2026
Section Cited
CCR
87307(d)(6)
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87307(d)(6) All outdoor and indoor passageways and stairways shall be kept free of obstruction.
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Staff will remove the objects on the hallway.
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Based on interviews and observations, the licensee did not comply with the section cited above in three out of three items in the hallway, which posed a health and safety risk to eight out of eight persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Robyn Clark
LICENSING EVALUATOR NAME: Jose DeLaCruz
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4