El Cajon Senior Care Home

Type of visit: Annual/Random

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 House Manager, Melissa Cherry. According to the facility’s license, the facility has a maximum capacity of six clients, of whom all may be non-ambulatory and waiver for 3 hospice, updated license pending CCLD. Licensee, Dawn Sasso-Toth arrived at the facility at later time. 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 2 out of 3 showers were in working order. 2 out of the 3 bathrooms need light bulbs to be replaced. Facility pantry items were reviewed and expired items were disposed of. 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 105 degrees F. No pools or bodies of water on the premises. Per House Manager, Melissa Cherry, no firearms or ammunition are kept at the facility. Smoke/carbon monoxide detectors were tested at 11:30AM, emergency lighting, and facility telephone were all working. Fire extinguisher was present. First aid kit is in need of bandaids and are readily accessible. Resident records reviewed had required documentation. Staff records reviewed contained required documentation. An exit interview was conducted with Licensee, Dawn Sasso-Toth, to whom a copy of this report, the Licensee/Appeal Rights, and LIC 809-D were provided during the visit.the state’s words, verbatim · CDSS document, Sep 3, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(e)(6) · Plan of correction due date: Oct 1, 2026

87303 Maintenance and Operation: (e) Water supplies and plumbing fixtures shall be maintained as follows: (6) Toilet, handwashing and bathing facilities shall be maintained in operating condition. Based on LPA observation for 2 of 6 residents, Licensee did not ensure that the bathroom shower was functional which posed a potential health & safety risk to persons in care.the state’s words, verbatim · CDSS document, Sep 3, 2026

Plan of correction: Licensee is to fix shower in bathroom by POC date and provide proof via email.

Allegation investigated: -Licensee unlawfully evicted resident.

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to commence a Complaint Investigation regarding the above allegation. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with House Manager Melissa Cherry. LPA also spoke with Licensee/Administrator Dawn Sasso-Toth via phone during today’s visit. The Complainant alleged that Licensee unlawfully evicted Resident #1 (R1) [See LIC 811 Confidential Names List for a description of select person identifiers used in this report.] CCLD’s investigation involved an unannounced facility tour/welfare check, interviews of relevant staff and multiple outside sources, and review of R1’s care and administrative records. LPA also made a collateral visit to interview R1. [CONTINUED ON LIC 9099-C] Substantiated [CONTINUED FROM LIC 9099] The available records and interviews showed: According to R1’s Admissions Agreement, R1 moved into the facility in September 2024, and R1’s monthly rent was payable to Licensee on the 1st day of each month. Beginning November 2025, R1 stopped making rent payments to Licensee. (R1 still had a past-due balance owed to Licensee as of the filing of this complaint.) Licensee subsequently issued a 30-day-notice / eviction letter to R1. This letter was dated 11/01/2025 and stated that R1 was required to vacate the premises no later than 11/30/2025. However, CCR 87224(a)(1) states that a Licensee may not initiate an eviction action against a resident until there is a balance owed that is more than ten (10) days past due; it was therefore incorrect to date the letter 11/01/2025. Interviews showed that Licensee in practice did not serve this eviction letter to R1’s acting representative until 11/12/2025. The Department also found that the letter did not contain other elements required by law (which will be addressed in a separate Case Management visit report). The totality of available evidence showed that the eviction letter which Licensee served to R1 during November 2025 was invalid. Interviews further showed: On 01/14/2026, R1 was transported from the facility to a hospital emergency room. Hospital staff medically evaluated R1 and determined that R1 was safe and ready to be discharged back to the facility, the same day. However, Licensee told hospital staff that they refused to accept R1 back to the facility, and that R1’s room (still with R1’s personal belongings in it) was no longer reserved for R1. The evidence shows that Licensee, in practice, physically evicted R1 from their facility, against R1’s will, without following the legal process. According to HSC 1569.683(a)(4), “In order to evict a resident who remains in the facility after the effective date of the eviction, the residential care facility for the elderly must file an unlawful detainer action in superior court and receive a written judgment signed by a judge,” and said resident must be served with the summons and complaint. Based on records and interviews, a preponderance of evidence exists to show that Licensee unlawfully evicted R1. The allegation is therefore Substantiated, and one (1) deficiency was cited for it per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D page). A Plan of Correction was jointly developed with the Licensee. An exit interview was conducted with Licensee/Administrator Dawn Sasso-Toth and House Manager Melissa Cherry, to whom a copy of this report, the LIC 809-D page, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Jan 21, 2026 · control 08-AS-20260115100642

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(a)(20) · Plan of correction due date: Feb 21, 2026

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities: “(a) …residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (20) To be protected from involuntary transfers, discharges, and evictions. A licensee shall not involuntarily transfer or evict residents for reasons other than those permitted by state law or regulations and shall comply with all eviction and relocation protections for residents…” This requirement was not met, as evidenced by: Based on records and interviews, Licensee did not ensure that 1 of 6 residents (R1) in their privately operated residential care facility for the elderly was protected from involuntary eviction. This posed a potential health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jan 21, 2026

Plan of correction: Based LPA observation and interviews, R1 was discharged from the hospital to a skilled nursing facility (SNF) on a short-term basis, and R1’s representative is seeking another care facility for R1. Licensee agreed to have the facility administrator [Staff #1 (S1)] complete retraining on correct eviction procedures for RCFE, led by a third-party instructor (preferably a CEU education vendor already approved by CCLD). Licensee agreed to E-mail the proof of training completion to LPA, by 02/21/2026.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Case Management Visit to cite a deficiencies which were identified during a separate complaint investigation. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with House Manager Melissa Cherry. LPA also spoke with Licensee/Administrator Dawn Sasso-Toth via phone during today’s visit. During LPA's 01/21/2026 site visit, Licensee/Administrator was not physically present at the facility. LPA asked the House Manager (who was the acting administrator) for Staff #2’s (S2) personnel file. [See LIC811 Confidential Names List for a description of select person identifiers used in this report.] However, Licensee’s staff were unable to timely produce it during LPA’s visit, which occurred during normal business hours, and which lasted several hours. CCR 87412(f) states, “All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours.” Interview of administrator and multiple care staff showed S2 worked on the facility’s overnight NOC shift. Review of CCLD’s Guardian Database showed that S2 did not possess an active criminal record clearance with CCLD, which was required before S2 can work. [Licensee immediately pulled S2 off the work schedule and arranged coverage to backfill their shifts. Licensee agreed to not employ S2 again, until S2 is cleared and associated the facility’s employee roster in Guardian.] [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] The available records and interviews showed: According to R1’s Admissions Agreement, R1 moved into the facility in September 2024, and R1’s monthly rent was payable to Licensee on the 1st day of each month. Beginning November 2025, R1 stopped making rent payments to Licensee. (R1 still had a past-due balance owed to Licensee as of the date of this report.) Licensee subsequently issued a 30-day-notice / eviction letter to R1. This letter was dated 11/01/2025 and stated that R1 was required to vacate the premises no later than 11/30/2025. The letter was served to R1’s acting representative on 11/12/2025. CCLD reviewed a copy of this letter, finding: The notice to quit did not include, “Resources available to assist in identifying alternative housing and care options which include, but are not limited to, the following: 1. Referral services that will aid in finding alternative housing. 2. Case management organizations which help manage individual care and service,” as required. The notice to quit did not include a statement informing the resident of “their right to file a complaint with the licensing agency, as specified in Section 87468, subsection (a)(4), including the name, address and telephone number of the licensing office with whom the licensee normally conducts business, and the State Long Term Care Ombudsman office,” as required. The notice to quit also did not include the following required paragraph: “In order to evict a resident who remains in the facility after the effective date of the eviction, the residential care facility for the elderly must file an unlawful detainer action in superior court and receive a written judgment signed by a judge. If the facility pursues the unlawful detainer action, you must be served with a summons and complaint. You have the right to contest the eviction in writing and through a hearing.” Lastly, neither a written report nor a copy of R1’s eviction letter was sent to CCLD within the required five (5) days. Six (6) deficiencies were cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D pages). Since one of these deficiencies was regarding a staff background clearance, and immediate civil penalty of $500 was assessed (refer to the LIC421-BG page). Plans of Correction was jointly developed with the Licensee. An exit interview was conducted with House Manager Melissa Cherry. A copy of this report, the LIC 809-D pages, the LIC421-BG page, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided to Cherry, and a duplicate set was E-mailed to Licensee/Administrator Dawn-Sasso Toth.the state’s words, verbatim · CDSS document, Jan 21, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(2) · Plan of correction due date: Jan 21, 2026

87355 Criminal Record Clearance: "(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (2) Obtain a California clearance or a criminal record exemption as required by the Department…” This requirement was not met, as evidenced by: Based on record review and manager interviews, Licensee did not ensure that 1 of 9 staff (S2) obtained a California clearance or a criminal record exemption as required by the Department, prior to working in the licensed facility. This posed an immediate safety risk to 5 of 5 residents (Resident #2 through Resident #6) in care.the state’s words, verbatim · CDSS document, Jan 21, 2026

Plan of correction: S2 was not on duty during LPA’s visit. Licensee took immediate steps to completely remove S2 from the work schedule. This action resolved the immediate risk. Licensee agreed to not employ S2 at the facility again, unless S2 subsequently achieves a CCLD criminal record clearance/exemption and becomes associated to the facility’s employee roster in Guardian.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87412(f) · Plan of correction due date: Feb 21, 2026

87412 Personnel Records: “(f) All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours.” This requirement was not met, as evidenced by: Based on LPA observation and staff interviews, for 9 of 9 staff (S1 through S9), Licensee did not ensure that their personnel records were available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. This posed a potential safety risk to persons in care.the state’s words, verbatim · CDSS document, Jan 21, 2026

Plan of correction: Licensee agreed to provide a set of keys to the staff who act as the administrator on duty (such keys will remain in a safe spot or with a safe person, at the facility) which provide them controlled access to staff records/files. Licensee agreed to send LPA a photograph of said key(s), by the POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(d)(1)(B) · Plan of correction due date: Feb 21, 2026

87224 Eviction Procedures : “(d)(1) The notice to quit shall include the following information: (B) Resources available to assist in identifying alternative housing and care options…” This requirement was not met, as evidenced by: Based on records review, in the notice to quit regarding 1 of 6 residents (R1), Licensee did not include resources available to assist in identifying alternative housing and care options, to include referral services and case management organizations. This posed a potential personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jan 21, 2026

Plan of correction: Based LPA observation and interviews, R1 was discharged from the hospital to a skilled nursing facility (SNF) on a short-term basis, and R1’s representative is seeking another care facility for R1. Licensee agreed to have the facility administrator [Staff #1 (S1)] complete retraining on correct eviction procedures for RCFE, led by a third-party instructor (preferably a CEU education vendor already approved by CCLD). Licensee agreed to E-mail the proof of training completion to LPA, by the POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87224(d)(1)(C) · Plan of correction due date: Feb 21, 2026

87224 Eviction Procedures : “(d)(1) The notice to quit shall include the following information: (C) A statement informing residents of their right to file a complaint with the licensing agency, as specified in Section 87468, subsection (a)(4), including the name, address and telephone number of the licensing office with whom the licensee normally conducts business, and the State Long Term Care Ombudsman office.” This requirement was not met, as evidenced by: Based on records review, in the notice to quit regarding 1 of 6 residents (R1), Licensee did not include a statement informing residents of their right to file a complaint with the licensing agency, as specified in Section 87468, subsection (a)(4), including the name, address and telephone number of the licensing office with whom the licensee normally conducts business, and the State Long Term Care Ombudsman office. This posed a potential personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jan 21, 2026

Plan of correction: Based LPA observation and interviews, R1 was discharged from the hospital to a skilled nursing facility (SNF) on a short-term basis, and R1’s representative is seeking another care facility for R1. Licensee agreed to have the facility administrator [Staff #1 (S1)] complete retraining on correct eviction procedures for RCFE, led by a third-party instructor (preferably a CEU education vendor already approved by CCLD). Licensee agreed to E-mail the proof of training completion to LPA, by the POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(d)(1)(D) · Plan of correction due date: Feb 21, 2026

87224 Eviction Procedures : “(d)(1) The notice to quit shall include the following information: (D) The following exact statement as specified in Health and Safety Code Section 1569.683(a)(4): ‘In order to evict a resident who remains in the facility after the effective date of the eviction, the residential care facility for the elderly must file an unlawful detainer action in superior court and receive a written judgment signed by a judge. If the facility pursues the unlawful detainer action, you must be served with a summons and complaint. You have the right to contest the eviction in writing and through a hearing.’” This requirement was not met, as evidenced by: Based on records review, in the notice to quit regarding 1 of 106 residents (R1), Licensee did not include the following exact statement as specified in Health and Safety Code Section 1569.683(a)(4): “In order to evict a resident who remains in the facility after the effective date of the eviction, the residential care facility for the elderly must file an unlawful detainer action in superior court and receive a written judgment signed by a judge. If the facility pursues the unlawful detainer action, you must be served with a summons and complaint. You have the right to contest the eviction in writing and through a hearing.” This posed a potential personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jan 21, 2026

Plan of correction: Based LPA observation and interviews, R1 was discharged from the hospital to a skilled nursing facility (SNF) on a short-term basis, and R1’s representative is seeking another care facility for R1. Licensee agreed to have the facility administrator [Staff #1 (S1)] complete retraining on correct eviction procedures for RCFE, led by a third-party instructor (preferably a CEU education vendor already approved by CCLD). Licensee agreed to E-mail the proof of training completion to LPA, by the POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87224(f) · Plan of correction due date: Feb 21, 2026

87224 Eviction Procedures: “(f) A written report of any eviction shall be sent to the licensing agency within five (5) days.” This requirement was not met, as evidenced by: Based on records review, Licensee did not send a written report of eviction regarding 1 of 6 residents (R1) to the licensing agency within five (5) days. This posed a potential personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jan 21, 2026

Plan of correction: Based LPA observation and interviews, R1 was discharged from the hospital to a skilled nursing facility (SNF) on a short-term basis, and R1’s representative is seeking another care facility for R1. Licensee agreed to have the facility administrator [Staff #1 (S1)] complete retraining on correct eviction procedures for RCFE, led by a third-party instructor (preferably a CEU education vendor already approved by CCLD). Licensee agreed to E-mail the proof of training completion to LPA, by the POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Iby Strong conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with House Manager Melissa Cherry. According to the facility’s license, the facility has a maximum capacity of six residents. Administrator arrived at the end of the inspection. 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. Water temperature was measured at 112.5 degrees F. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water present. Per Melissa, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher was present. First aid kit was complete and readily accessible. Resident records reviewed had required documentation. Staff records reviewed contained required documentation. Hospice resident with full bed rail had medical documentation. No residents were active on oxygen. No deficiencies were cited on todays visit. An exit interview was conducted with Melissa, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Jun 13, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Iby Strong conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with House Manager Melissa Cherry. Administrator Dawn Sasso-Toth arrived shortly after. According to the facility’s license, the facility has a maximum capacity of six residents. 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 residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water present. Per Rose, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Resident records reviewed had required documentation. Staff records reviewed contained required documentation. No deficiencies were cited on todays visit. An exit interview was conducted with Administrator, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Jun 4, 2024