435202959-9-15-2026-26-AS-RMAO-DYS3KL-20261011181918

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202959
Report Date: 09/15/2026
Date Signed: 09/15/2026 10:07:50 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/01/2026 and conducted by Evaluator Simranjit Rai

COMPLAINT CONTROL NUMBER: 26-AS-20260601094912

FACILITY NAME:	BONITA SPRINGS SENIOR LIVING		FACILITY NUMBER:	435202959
ADMINISTRATOR:	CERA, DULCE		FACILITY TYPE:	740
ADDRESS:	1818 SCOTT BLVD		TELEPHONE:	(669) 242-7150
CITY:	SANTA CLARA	STATE: CA	ZIP CODE:	95050
CAPACITY:	32	CENSUS:	DATE:	09/15/2026
		UNANNOUNCED	TIME BEGAN:	08:49 AM
MET WITH:	Staff, Zebiba Hassan		TIME COMPLETED:	10:15 AM

ALLEGATION(S):

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Staff consumes alcohol during work hours, impairing the ability to provide adequate care and supervision, which presents a risk to residents in care.
Staff hit resident in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Simi Rai conducted an unannounced visit to conclude the complaint investigation. LPA Rai met with the Administrator and stated the purpose of today’s visit. LPA Rai spoke with Administrator (ADM) Dulce Cera over the phone. ADM could not be present at the facility. ADM gave verbal authorization for staff Zebiba Hassan to sign today's report after LPA Rai went over the report with ADM over the phone.

On 06/01/2026, the Department received a complaint with the above allegations. On 06/02/2026, the Department conducted an initial investigation at the facility.

Continuation on LIC 9099-C, Page 1 of 3.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Simranjit Rai
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2026

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 3

Control Number 26-AS-20260601094912

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: BONITA SPRINGS SENIOR LIVING	FACILITY NUMBER: 435202959
	VISIT DATE: 09/15/2026

NARRATIVE

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Page 2 of 3.

Staff consumes alcohol during work hours, impairing the ability to provide adequate care and supervision, which presents a risk to residents in care. / Staff hit resident in care.
It was alleged on 05/22/2026, staff (S1) was under the influence of alcohol and poked resident (R1)’s eye making R1 squint from one eye.

On 06/02/2026, LPA Rai interviewed Administrator (ADM) Dulce Cera. ADM stated there is no staff by the name of S1. LPA Rai verified this information with the updated LIC 500 Personnel Report. ADM stated on 05/22/2026, there wasn’t an incident with the staff wherein they consumed alcohol and provided care and supervision to the residents in care. ADM stated she has not heard or seen staff consume alcohol during working hours. ADM stated resident R1 has not suffered an injury to the eye or any other bodily injury. ADM stated resident R1 has not informed the staff about any eye injury.

ADM stated there was an incident on 05/22/2026 wherein resident R1’s family member (F1) came to the facility and was bothering resident R1 by convincing R1 to move out of the facility. R1 has expressed to F1 and facility staff of staying in the facility and did not want to move out of the facility. The facility staff had to call 911 and F1 was placed on 5150 hold. ADM stated this report is retaliating against the facility since the facility staff were protecting R1’s rights to remain a resident of the facility.

On 06/02/2026, LPA Rai interviewed 2 staff (S2-S3). S2 was working at the facility on 05/22/2026 and S2 stated R1 did not complain about eye injury or hurt in the eyes. S2 stated he/she did not observe any change of condition where R1 was complaining of eye pain or was squinting the eyes. Both staff stated they do not consume alcohol when working a shift, where they provide care and supervision to the residents in care. Both staff stated they did not hear or see other staff consume alcohol when working a shift at the facility. Both staff stated they have not seen or heart staff hit residents in care, including R1 nor do they hit the residents in care.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Simranjit Rai
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 26-AS-20260601094912

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: BONITA SPRINGS SENIOR LIVING	FACILITY NUMBER: 435202959
	VISIT DATE: 09/15/2026

NARRATIVE

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Page 3 of 3.

On 06/02/2026, LPA Rai interviewed 4 residents (R1-R4). R1 stated he/she was at the facility on 05/22/2026 and he/she did not have any issues with his/her eyes. R1 stated there were no injuries on his/her eyes and R1 showed LPA Rai his/her eyes during the interview. LPA Rai did not observe any visible injuries to the eyes. 4 Out of 4 residents stated the staff do not consume alcohol when providing his/her care at the facility. 4 Out of 4 residents stated he/she has not seen or heard about the staff drinking alcohol prior to or during their shift at the facility. 4 Out of 4 residents stated they have not seen or heard about staff hitting the residents at the facility.

On 06/02/2026, LPA Rai interviewed 2 witnesses (W1-W2). Both witnesses stated they have not seen or heard of staff consuming alcohol during work hours. Both witnesses stated they have not seen or heard staff physically abusing residents in care. Both witnesses stated they were present at the facility on 05/22/2026 and they not seen resident R1 have any issues with his/her eyes.

Based on review of staff training, 7 out of 7 staff working on 05/22/2026 had received training on resident’s rights and reviewed signed copies of SOC 341A Statement Acknowledging Requirement to Report Suspected Abuse of Dependent Adults and Elders.

The Department has completed the investigation of the above allegations. Based on interviews conducted and record reviews, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis.

No deficiencies cited from California Code of Regulations, Title 22. Exit interview conducted with Administrator and a copy of the report was provided.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Simranjit Rai
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2026

LIC9099 (FAS) - (06/04)

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