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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374605021
Report Date: 09/08/2026
Date Signed: 09/08/2026 01:42:41 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
08/31/2026 and conducted by Evaluator Natasha Persaud
COMPLAINT CONTROL NUMBER: 08-AS-20260831141810
FACILITY NAME:BARON'S LOVING CARE - UCFACILITY NUMBER:
374605021
ADMINISTRATOR:NORTON, AGNIESZKAFACILITY TYPE:
740
ADDRESS:6860 CONDON DRTELEPHONE:
(858) 558-4772
CITY:SAN DIEGOSTATE: CAZIP CODE:
92122
CAPACITY:6CENSUS: 5DATE:
09/08/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Staff, Esther VillarTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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9
Staff did not administer medications as prescribed
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced visit to commence a complaint investigation. LPA identified herself and was allowed entry into the facility by Staff, Medenio Villar. Staff, Esther Villar arrived during the visit and discussed the allegation.

During the investigation, the facility was briefly toured, records reviewed, and interviews conducted with staff, residents, and outside sources. It was alleged staff did not administer medications as prescribed. It was reported staff were crushing medications and placing them in pudding. A review of medication orders for Resident #1 (R1) indicated only six (6) out of nine (9) medications were allowed to be crushed. Staff confirmed 8 eight (8) out of nine (9) medications were being crushed, due to R1 requesting all medications be crushed. Staff admitted they were aware there was no order on file to crush all medications but it was crushed due to R1 insisting. The facility did not have a Medication Administration Record on file for R1. Continued on LIC 9099C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2026
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 5
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
08/31/2026 and conducted by Evaluator Natasha Persaud
COMPLAINT CONTROL NUMBER: 08-AS-20260831141810

FACILITY NAME:BARON'S LOVING CARE - UCFACILITY NUMBER:
374605021
ADMINISTRATOR:NORTON, AGNIESZKAFACILITY TYPE:
740
ADDRESS:6860 CONDON DRTELEPHONE:
(858) 558-4772
CITY:SAN DIEGOSTATE:CAZIP CODE:
92122
CAPACITY:6CENSUS: 5DATE:
09/08/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Staff, Esther VillarTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not prepare food in consideration of resident's preference
Staff did not keep the facility clean
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced visit to commence a complaint investigation. LPA identified herself and was allowed entry into the facility by Staff, Medenio Villar. Staff, Esther Villar arrived during the visit and discussed the allegations.

During the investigation, the facility was briefly toured, records reviewed, and interviews conducted with staff, residents, and outside sources. It was alleged staff did not prepare food in consideration of resident's preference. It was reported staff were serving Filipino food to residents and did not take into consideration the resident's cultural preferences. Staff stated they do not serve Filipino food. Staff stated they served the following items at meals times: Breakfast: eggs; bacon; sausage; bread; and pancakes; Lunch: meat; vegetables; bread; and potatoes. Dinner: sandwiches; and soup. Residents interviews stated they were served a variety of food and it was good. The facility's sample menu indicated breakfast was coffee, bacon, sausage and bread, eggs fruit were only served some days. Lunch consisted of potatoes, meat, vegetables, but no names of meals were listed, just items. The menu reflected dinner items were soup bread, water, and fruit, but no specific meals were indicated. Continued on LIC 9099C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 08-AS-20260831141810
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: BARON'S LOVING CARE - UC
FACILITY NUMBER: 374605021
VISIT DATE: 09/08/2026
NARRATIVE
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It was also alleged that staff did not keep the facility clean. It was reported the toilet was not kept clean. On 08/30/26, an outside source reported they observed the restrooms at the facility to be clean, including the toilets. On 09/08/26, LPA observed the bathrooms and toilets were clean. In addition, resident interviews revealed the bathrooms and toilets were kept clean. Today, LPA observed lunch being cooked, which consisted on beef stew with green beans, mashed potatoes and ice cream for dessert.

During the course of the investigation, interviews were conducted, and records were reviewed. The allegations may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Staff, Esther Villar whose signature below confirms receipt of these rights.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 08-AS-20260831141810
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: BARON'S LOVING CARE - UC
FACILITY NUMBER: 374605021
VISIT DATE: 09/08/2026
NARRATIVE
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5
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Based on interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation was found to be substantiated. California code of Regulations, Title 22, Division 6 & Chapter 8 was cited on the attached LIC 9099D. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Staff, Esther Villar whose signature below confirms receipt of these rights.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 08-AS-20260831141810
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: BARON'S LOVING CARE - UC
FACILITY NUMBER: 374605021
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/08/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/15/2026
Section Cited
CCR
87465(a)(4)
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Incidental Medical and Dental Care. The licensee shall assist residents with self-administered medications as needed. This requirement is not met as evidenced by:
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All staff that dispense medications will attend medication training through a vendor and provide proof of training by POC due date.
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Based on record review and interviews, the licensee did not administer medications as prescribed for 1 out of 5 residents [R1], which posed a potential health and safety risk to residents 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: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5