Gate Manor

Type of visit: Office

An office meeting was held in the San Diego Adult and Senior Care Regional office. The following people were present at the meeting: RM Jerry Romero, LPM Simon Jacob, LPM Lizzette Tellez, LPA Angelica Boyles, Chuck Thomas and Suolang “Julie” Quzchen. The purpose of this meeting was to gather information regarding the operations of of Gate Manor, Gate Manor II, and Gate Manor III. Translation services approved by the Department were used during this office meeting. This report was mailed to Licensee, as licensee left.the state’s words, verbatim · CDSS document, Jun 3, 2026

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Debbie Correia made an unannounced visit to the facility to conduct a continuation of the annual licensing inspection. LPA identified herself to Administrator Ambalada and was granted entry and explained the purpose of the visit. Gate Manor is licensed to serve six (6) residents, all of whom may be non-ambulatory. The facility may serve up to four (4) residents receiving Hospice services and one (1) bedridden resident. As documented on the LIC 9099 dated February 25, 2026, during the time of visits, the current census was 5 residents that consisted of three (3) non-ambulatory residents and two (2) receiving hospice services. The facility was operating within its licensed capacity and conditions. LPA also verified that the facility’s lease agreement for all three properties, and the facility's liability and administrator certification were current. Staff records showed all employees were fingerprint cleared through Live Scan and had completed the required ongoing training. The facility maintains documentation of on-going weekly staff training conducted by a Medical Professional. Additionally, LPA Correia, accompanied by Administrator Ambalada , conducted a tour of the facility of the facility. Similarly, to Gate Manor II and Gate Manor III, based on today’s review, resident records were complete and up to date. During the facility tour, LPA observed that smoke detectors, carbon monoxide detectors, and fire extinguishers were present and operable, and/or had current inspections. [Continued on 9099] [Continuation of LIC 9099] Required postings were properly displayed, and the facility had a functional landline telephone. Sharps, toxins, and medications were locked and inaccessible to residents in care No deficiencies were cited during today’s visit. This report was reviewed with Administrator Ambalada. A copy of the report and Licensee Rights (01/2016) will be provided at the conclusion of the visit. Signature on this form acknowledges receipt of both the rights and this reportthe state’s words, verbatim · CDSS document, Feb 27, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Debbie Correia made an unannounced visit to the facility to conduct an annual licensing inspection. LPA identified herself to Administrator Thomas of Gate Manor, was granted entry, and explained the purpose of the visit. Gate Manor is licensed to serve six (6) residents, all of whom may be non-ambulatory. The facility may serve up to four (4) residents receiving Hospice Services and one (1) bedridden resident. During today’s visit, the current census was five (5) residents: three (3) non-ambulatory, and two (2) receiving hospice services. The facility was operating within its licensed capacity and conditions. An overall inspection of the facility began today; however, due to time constraints, LPA was unable to complete the visit and will return at a later time to conduct the remaining portion of the inspection. No deficiencies were cited during today’s visit. This report was discussed with Administrator Ambalada. A copy of the report and Licensee Rights (01/2016) will be provided at the conclusion of the visit, and signature on this form acknowledges receipt of both the rights and this report.the state’s words, verbatim · CDSS document, Feb 25, 2026

Allegation investigated: Staff provided discontinued medication to resident.

Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced visit to open a complaint investigation into the above listed allegation. LPA met with Administrator Maniza Ambalada, to whom LPA disclosed the reason for the visit. During the visit, it was determined Resident1 (R1) did not reside at the facility, therefore the complaint was determined unfounded and dismissed. An exit interview was conducted with Administrator Ambalada, and copies of this report and Licensee Rights (LIC 9058 01/16) were provided at the conclusion of the visit. Signature on this form acknowledges receipt of these rights and a copy of this report. Unfoundedthe state’s words, verbatim · CDSS document, Jan 15, 2026 · control 08-AS-20260108095949

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced case management visit to confirm records of qualifications and credentials to process a change of Administrator. LPA Correia was greeted by Administrator Ambalada, met with Administrator Thomas, identified herself and explained the purpose of the visit. During the visit, LPA ensured documentation of credentials and qualifications for Administrator Thomas and processed a change in Administrator. An exit interview was conducted with Administrator Ambalada. A copy of this report and the Licensee’s Rights were provided via hard copy.the state’s words, verbatim · CDSS document, Oct 23, 2025

Allegation investigated: Staff hit resident.

Licensing Program Analyst (LPA) Correia conducted an unannounced visit to commence and conclude a complaint investigation. LPA Correia was met by Administrator Chuck Thomas, identified herself, and explained the purpose of the visit. During today’s visit LPA conducted staff, resident, and Outside source interviews, and a resident records review. On September 15, 2025, the Department received a complaint alleging that Staff1 (S1) hit Resident1 (R1). A review of R1’s facility records revealed they were admitted to the facility on February 5, 2022, with diagnoses of schizophrenia, bi-polar disorder, and emphysema. An interview conducted with Outside Source1 (OS1) revealed R1 notified them that S1 had hit their arm. OS1 also revealed they had a meeting with R1 and R1’s Power of Attorney (POA) to discuss the incident. OS1 revealed both they nor the POA saw any bruising or marks on R1. [Continued on LIC 9099C] Unsubstantiated [Continuation from LIC 9099] The interview with OS1 also disclosed S1 denied ever hitting R1, and stated they were trying to assist R1 change as their clothing was soiled and R1 began yelling and screaming at them. An interview conducted with the Administrator revealed no knowledge of the incident but has noticed R1’s behaviors seemed to have increased, and R1 was very disrespectful towards staff. An interview conducted with S2 revealed they were not present, however S1 had told them they were trying to assist S1 with changing their clothes and they became agitated and swatted S1’s hands away and began yelling at them. An interview with S3 revealed they were a live-in caregiver and corroborated that R1 would have outbursts of behaviors. All staff interviews revealed never witnessing S1 hit a resident in care. An interview conducted with R1 revealed that S1 punched them in the head and hit their arm but didn’t know why, and R1 yelled at them and called them names. Interviews conducted with R2 and R3 both revealed the staff at the facility were great, and they were very happy, and neither had been mistreated by staff nor witnessed other residents be mistreated by staff. The interview with R2 also corroborated that R1 yells at the staff, is testy, and can go off their rails at times. [See LIC 811 for confidential names] Based on interviews and record reviews the above listed allegation was determined Unsubstantiated. This finding means the preponderance of evidence standard was not met. An exit interview was conducted with Administrator Thomas and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) will be provided at the conclusion of the visit. Signature below confirms receipt of the reports.the state’s words, verbatim · CDSS document, Sep 25, 2025 · control 08-AS-20250915155310

Type of visit: POC

Licensing Program Analyst (LPA) David Roman conducted an unannounced Plan Of Correction inspection visit to physically observe the facilities compliance to Title 22. LPA D. Roman identified himself, was greeted by and discussed the purpose of the visit with Supervisor, Maniza Ambadala. . During the visit, LPA toured the interior and exterior of the facility along with facility staff. LPA D. Roman reviewed the CPR training certificates and observed the completion of an Infection Control Plan for the facility. An exit interview was conducted with Program Supervisor, Maniza Ambadala. A copy of this report and the Licensee’s Rights were provided via hard copy.the state’s words, verbatim · CDSS document, Apr 17, 2025

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) David Roman conducted an unannounced case management visit to deliver an amended report for a visit conducted on 1/15/2025. LPA D. Roman identified himself, was greeted by and discussed the purpose of the visit with Supervisor, Maniza Ambalada. During the visit, LPA obtained Maniza Ambalada’s signature on the amended report. An exit interview was conducted with Supervisor Maniza Ambalada. A copy of this report and the Licensee’s Rights were provided via hard copy.the state’s words, verbatim · CDSS document, Apr 17, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) David Roman conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Administrator, Ma Niza Ambalada. According to the facility’s license, the facility has a maximum capacity of six clients, of whom all may be non-ambulatory and one of which may be bedridden. LPA toured the interior and exterior of the facility and inspected each room. The facility was sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to client. Medications were labeled, as required, and stored in locked areas. Water temperature was measured at 120 degrees F. No pools or bodies of water on the premises. Per Ma Niza Ambalada, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguishers were present. First aid kits were complete and readily accessible. Resident records reviewed had required documentation. Staff records reviewed first aid certificates expired on 01/09/2024. Two (2) deficiencies were cited today for expired CPR certificate and no Infection Control Plan. An exit interview was conducted with Administrator, Ma Niza Ambalada, to whom a copy of this report and the Licensee/Appeal Rights, were provided during the visit.the state’s words, verbatim · CDSS document, Jan 15, 2025

The state marks this report as 9 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Allegation investigated: Facility is understaffed Staff were unable to communicate with residents

Licensing Program Analyst (LPA)Tiffany Holmes conducted an unannounced complaint visit to start an investigation on the above-mentioned allegations. LPA gained access to the facility, identified herself, and met with Ma.Niza Ambalada, Administrator to discuss the purpose of the visit. LPA conducted interviews, made observations, and obtained and reviewed pertinent records. It was alleged that the facility is understaffed. Interviews revealed there are 3 staff that work at the facility and a floater that works between the three facilities. Interviews revealed there is a cook, a floater and two caregivers. Interviews with staff revealed they are comfortable with the set up of the staff and feel as though they have enough staff. Interviews revealed that the facility could possibly be understaffed but the staff rely on the floater and that the floater helps out a lot. Interviews revealed that it wouldnt hurt to have another staff so the floater is not between all three facilities. There were no complaints from the staff about being understaffed. Unsubstantiated It was also alleged that the staff were unable to communicate with residents. Interviews revealed that all staff are able to speak english to all the residents and they all understand english. Interviews with staff revealed they are able to communicate with residents and their families. LPA observations revealed all staff spoke english to LPA and residents. Interviews revealed all staff speak Tagalog and English. Interviews with residents revealed they have no issues with communicating with the staff. There were no complaints from the residents that staff is not able to communicate with residents. Based on the evidence obtained from interviews and records review, the complaint allegations are unsubstantiated. An exit interview was conducted with Ma.Niza Ambalada, Administrator and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) was provided at the conclusion of the visitthe state’s words, verbatim · CDSS document, Jan 23, 2024 · control 08-AS-20240116150335

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Tiffany Holmes conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was greeted and allowed entry into the facility by Ma.Niza Ambalada, Administrator to whom LPA discussed the purpose of the visit. According to the facility’s license, the facility has a maximum capacity of six (6) elderly residents. During today’s inspection, six (6) were at the facility. LPA, accompanied by the Administrator, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility’s ambient internal temperature was comfortable. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, or open-faced heaters accessible to clients. Medications were labeled, as required, and stored in locked areas. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] No pools or bodies of water on the premises. Per Ma.Niza Ambalada, Administrator, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher has been serviced. First aid kits were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff present. LPA reviewed multiple staff and client records/files. Files reviewed contained required documents. Confidential records were stored in locked areas. Administrator presented proof of current/active business liability insurance and surety bond. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Ma.Niza Ambalada, Administrator to whom copies of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jan 23, 2024