La Costa Coastal Care

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced Case Management visit in regards to updates made to the facility layout/floor plan. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to caregivers Eleanor Weber and Oscar Rosario. LPA also spoke with Licensee/Administrator Luka Subotic over the phone. The facility had notified the Department on 2/5/26 of construction completed to add two (2) more bedrooms to the home, changing the number of designated resident bedrooms from four (4) to six (6). No changes to facility capacity or ambulatory status capacity were requested. A new fire inspection was requested by the Department to review the proposed floor plan and determine if the new rooms were ready for occupancy. Community Care Licensing received an approved fire clearance on February 26th, 2026, approving the new floor plan. The facility is approved for a capacity of six (6) residents, all of which may be non-ambulatory. Additionally, the facility has a hospice waiver for four (4). Currently, the facility has no approval for bedridden residents. During today's visit, LPA conducted a tour of the facility and confirmed that the updated facility sketch was consistent with the current layout of the facility. The new rooms were furnished and one already occupied. No immediate health and/or safety concerns were observed during today's visit. The updated facility sketch will be forwarded to management for final review/approval. An exit interview was conducted with caregiver Rosario to whom a copy of this report was provided. Their signature below confirms receipt of this document.the state’s words, verbatim · CDSS document, Apr 16, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Caregivers Ida Mendoza and Oscar Rosario. The facility's license shows a maximum capacity of six non-ambulatory residents, age 60 and over. Hospice waiver approved for 4 residents. During today’s inspection there were 5 residents in care. LPA and Licensee Luka Subotic 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 contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Licensee Luka Subotic, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and clients, and reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Licensee Luka Subotic to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Oct 30, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Nacole Patterson and Arian Golbakhsh conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPAs were welcomed by and discussed the purpose of the visit to Licensee Luka Subotic. The facility's license shows a maximum capacity of six (6) ambulatory and non-ambulatory residents, ages 60 and over, with a hospice waiver for four (4) residents. During today’s inspection there were 5 residents in care. LPAs and Licensee Luka Subotic 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, and 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 contained at least 2 days of perishable food, and at least 7 days non-perishable food, which were all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Licensee Luka Subotic, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and clients, and reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Licensee Luka Subotic to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Nov 6, 2024

Allegation investigated: Neglect/ Lack of supervision resulted is resident being sexually abused.

Licensing Program Analyst (LPA) Tiffany Holmes conducted an unannounced visit to deliver findings for a complaint investigation regarding the above-mentioned allegation. LPA identified herself and met with Ida Mendoza, Caregiver, to discuss the purpose of the visit and elements of the complaint. The Department's investigation included interviews and a review of pertinent records. It was alleged that Neglect/ Lack of supervision resulted in resident being sexually abused. Resident 1 (R1) was diagnosed with Malignant neoplasm of central portion of the left breast. The cancer had also metastasized to the bone and their right lung. R1 was admitted from their residence to La Costa Coastal on 02/24/2023. Hospice of the North Coast was being provided to R1 prior to being admitted to La Costa Coastal. On or about 03/22/23 – 03/23/23 R1 reported to their daughter that they had been sexually assaulted by Staff 1 (S1) between late evening-early morning between 03/22/23 and 03/23/23. R1s health had declined from the cancer, and they were requiring assistance transferring from their bed to the bedside commode. According to interviews Staff 1 (S1) was the overnight caregiver assigned to assist R1 during their shifts. After R1 disclosed their abuse to their Responsible Party (RP) they notified the hospice nurse about the allegation. Unsubstantiated Interviews revealed R1 was medically evaluated by a hospice nurse who found no injuries or signs of abuse. Interviews revealed the hospice nurse and social worker evaluated R1 and asked them questions about the abuse. Interviews revealed that R1 was unable to provide clear statements. Interviews with outside sources revealed R1 was confused and unable to provide any details regarding the incident. Interviews with S1 revealed them denying the allegation of engaging in sexual misconduct with R1. On 04/09/23, interviews with R1s RP revealed they do not believe S1 was inappropriate with R1. Interviews with RP revealed that R1s health declined rapidly and R1 was making delusional statements prior to passing away. There is not enough information to support the allegation of Neglect/ Lack of supervision resulted in resident being sexually abused. Therefore, the allegation is unsubstantiated. This finding means although the allegation may have happened or could be valid, there is not a preponderance of evidence to prove that the alleged violations occurred. An exit interview was conducted with Ida Mendoza, Caregiver. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided and their signature on this report confirms receipt of the Licensee Rights.the state’s words, verbatim · CDSS document, Mar 12, 2024 · control 08-AS-20230323154855

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Administrator Luka Subotic. The facility's license shows a maximum capacity of six (6) ambulatory and/or non-ambulatory residents. During today’s inspection there were 5 residents in care. LPA and 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. Facility contained 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. No toxic chemicals/poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per licensee, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and clients, and reviewed staff and client records/files. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Administrator Luka Subotic to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Nov 22, 2023