El Cajon Elder Care

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Angelica Boyles 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 Caregiver Wilma Castagnola. Co-Administrator Jenny Sequeira later later joined the visit. According to the facility’s license, the facility serves residents age 60 and over and has a maximum capacity of 6 residents. All residents may be non-ambulatory, of which 1 may be bedridden in bedroom #6. LPA, accompanied by caregiver, 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. Resident bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. 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, fireplaces, or open-faced heaters accessible to clients. Medications were labeled, as required, and stored in locked areas. (CONTINUED ON LIC 809C) (CONTINUED FROM LIC 809) No pools or bodies of water were observed on the premises. Per Co-Administrator, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed multiple staff and resident records/files. The reviewed files contained required documents. Confidential records were stored in locked areas. Proof of current/active business liability insurance was presented. No deficiencies were observed or cited on today's visit. An exit interview was conducted with Co-Administrator Jenny Sequeira, 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, Apr 16, 2026

Allegation investigated: Facility did not issue refund

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced visit to the facility to deliver investigative findings regarding the above mentioned allegation. LPA identified herself, explained the purpose of the visit and nature of the complaint to Caregiver Wilma Castagnola. On January 7, 2026 the Department received this complaint which alleged the facility did not issue a refund. The Department’s investigation included a review of the facility’s records as well as interviews with staff. (Continued on LIC9099-C) Unsubstantiated (Continued from LIC9099) Records reviewed revealed that Resident #1 (R1) lived at the facility from 9/25/24 through 11/8/24. [See LIC811 Confidential Name List for a description of select person identifiers used in this report.] Per the Admission Agreement, signed by the Administrator and R1’s Representative on 9/23/24, it is stated that if the resident leaves the facility for any reason during the second month of residency, the resident shall be entitled to a refund of at least 60 percent of the preadmission fee amount in excess of five hundred dollars ($600). Records reviewed revealed that facility staff did issue a refund in the correct amount of $600 on 11/12/24 addressed to R1’s Representative, however, due to a clerical error the check was mailed to the wrong address. The Department has investigated the above-mentioned allegation. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was not met to support or corroborate this allegation and therefore deemed unsubstantiated. An exit interview was conducted with Caregiver Wilma Castagnola, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided.the state’s words, verbatim · CDSS document, Jan 16, 2026 · control 08-AS-20260107160939

Allegation investigated: Staff did not follow resident's doctor orders, resulting in dehydration Staff forced resident to drink water

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced visit to the facility to deliver investigative findings regarding the above mentioned allegation. LPA identified herself, explained the purpose of the visit and nature of the complaint to Caregiver Wilma Castagnola. On October 18, 2025 the Department received this complaint which alleged staff did not follow Resident’s #1’s (R1) doctor orders, resulting in dehydration and staff forced R1 to drink water. [See LIC811 Confidential Name List for a description of select person identifiers used in this report.] The Department’s investigation included a facility tour, record reviews, as well as interviews with staff, residents, and outside sources. (Continued on LIC9099-C) Unsubstantiated (Continued from LIC9099) Regarding the allegation that staff did not follow resident’s doctor orders resulting in dehydration, records reviewed did not reveal any diagnosis of dehydration for R1. Interviews with two outside sources familiar with the facility reported not having any concerns regarding staff not following doctor’s orders. Interviews with staff reported following the doctor orders and reported honoring residents’ rights to refuse medications. A record review of the Medication Administration Record (MAR) for R1 accurately reflects doctor orders. LPA unannounced visits and review of residents’ MARs did not raise any concerns. Regarding the allegation that staff forced resident to drink water, interviews with staff reported never forcing R1 to drink more than R1 wanted and emphasized residents’ rights. Interviews with residents reported never being forced to drink water or witnessing other resident’s being forced to drink water. Interviews with two outside sources familiar with the facility did not report any concerns regarding staff forcing residents to drink water. Further, LPA observations during unannounced visits did not raise any concerns. The Department has investigated the above-mentioned allegations. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was not met to support or corroborate these allegations and therefore deemed unsubstantiated. An exit interview was conducted with Caregiver Wilma Castagnola, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided.the state’s words, verbatim · CDSS document, Nov 13, 2025 · control 08-AS-20251008153813

Allegation investigated: Staff do not provide adequate supervision resulting in resident being sexually assaulted by another resident.

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced visit to the facility to deliver investigative findings regarding the above mentioned allegation. LPA identified herself, explained the purpose of the visit and nature of the complaint to Caregiver Wilma Castagnola. On July 11, 2025 the Department received this complaint which alleged staff did not provide adequate supervision resulting in Resident #1 (R1) being sexually assaulted by another resident. [See LIC811 Confidential Name List for a description of select person identifiers used in this report.] The Department’s investigation included unannounced facility visits/health and safety checks, record reviews, as well as interviews with residents and staff. (Continued on LIC9099-C) Unsubstantiated (Continued from LIC9099) According to R1’s most recent Physician’s Report R1’s primary diagnoses include schizophrenia and paranoia with a history of delusions and mild cognitive impairment. The Physician’s Report also notes R1’s confused and disoriented mental conditions. During an interview with the Department, R1’s responses were incoherent and R1 did not report ever being harmed by a resident or anyone else at the facility. An interview with facility staff revealed the alleged resident R1 named in the allegation is not someone who has ever been a resident at the facility, nor the name of any staff or visitors. A review of Resident Roster, Staff Roster, and Visitor’s Log corroborated this information. Further, observations made by the Department during unannounced facility visits did not raise any concerns regarding lack of supervision. The Department has investigated the allegations that staff do not provide adequate supervision resulting in resident being sexually assaulted by another resident. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was not met to support or corroborate this allegation and therefore deemed unsubstantiated. An exit interview was conducted with Caregiver Wilma Castagnola, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided.the state’s words, verbatim · CDSS document, Sep 11, 2025 · control 08-AS-20250711104741

Allegation investigated: Licensee's staff physically/sexually abused 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 Caregiver Armando Guido-Manjarrez. LPA then met and discussed the purpose of the visit with Licensee/Administrator Jenifer Sequeira, who arrived shortly after. The Complainant alleged that Licensee’s staff physically/sexually abused Resident #1 (R1). [See LIC 811 Confidential Names List for a description of R1.] CCLD’s investigation involved an unannounced facility tour/welfare check and interviews of R1, multiple fellow residents/housemates, multiple pertinent facility staff, and neutral outside sources. LPA also reviewed relevant care records for R1. According to R1’s latest LIC602 Physician’s Report, R1’s primary diagnoses included Schizoaffective Disorder Bipolar Type, Major Depressive Disorder, Insomnia due to Mental Disorder, and Mild Cognitive Impairment (MCI), among others. [CONTINUED ON LIC 9099-C] Unsubstantiated [CONTINUED FROM LIC 9099] Their doctor wrote that while R1 was able to follow instructions and able to communicate their needs, R1 was also confused/disoriented. R1 was non-ambulatory and relied on staff assistance with dressing, bathing, and changing their incontinence briefs. The Complainant did not have direct knowledge of the allegation but rather relied on R1’s statements. In their own interview with LPA, R1 was disoriented to time and displayed repeated non-tangential thinking. There were also significant inconsistencies/contradictions and reversals in R1’s narrative of the incident. Nonetheless, R1 was able to say a male facility staff had kissed them repeatedly on the cheek, then groped their breasts under their shirt while they were in bed at the facility. R1 could not say if this occurred once, or more than once. R1 initially declined to identify their perpetrator by name, but answered questions about the perpetrator’s physical appearance characteristics. R1 subsequently provided a name to LPA. Review of the staff and resident rosters, corroborated by manager and caregiver interviews, showed: There were no staff or residents matching the name which R1 provided. There were also no staff or residents who resembled the physical appearance profile which R1 provided. Staff who were interviewed unanimously reported that R1 was sometimes very confused and that they had never seen any coworker kiss, grope, or physically/sexually abuse any resident in care. They also denied abusing any resident, themselves. LPA also interviewed 3 of 6 housemates who were present at the facility (the other two residents were at the hospital), finding no evidence/suggestion that R1 or any resident had been physically/sexually abused by facility staff. Residents were complimentary of the care they received. Prior to CCLD’s involvement, the Long-Term Care Ombudsman’s office independently investigated the same allegation involving R1, determining that it was unsubstantiated. Based on records and interviews, a preponderance of evidence does not exist to show that Licensee's staff physically/sexually abused resident. The allegation is therefore Unsubstantiated, and no deficiency was cited. An exit interview was conducted with Licensee/Administrator Jenifer Sequeira, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Jul 31, 2025 · control 08-AS-20250723091306

Allegation investigated: Staff physically abused resident

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced visit to the facility to deliver investigative findings regarding the above mentioned allegation. LPA identified herself, explained the purpose of the visit and nature of the complaint to Caregiver Wilma Castagnola. On April 29, 2025 the Department received this complaint which alleged staff physically abused Resident #1 (R1) [See LIC811 Confidential Name List for a description of select person identifiers used in this report] specifically that R1 was being spanked. The Department’s investigation included a facility tour, record reviews, as well as interviews with residents, staff and outside sources. (Continued on LIC9099-C) Unsubstantiated (Continued from LIC9099) During LPA interview with R1, R1 did not report being spanked by staff and reported feeling safe and well taken care of at the facility. Per the reporting party, R1 was unable to provide any details regarding the alleged spanking such as when it happened or who did it. Records reviewed revealed that R1 has mild cognitive impairment and may often exhibit confused and/or disoriented mental conditions. Interviews with other residents and outside sources who are familiar with the facility and frequently visit revealed there have been no witnesses to staff spanking R1. None of the interviewed residents and outside sources reported any concerns regarding how staff treat the residents. The Department has investigated the allegation that staff physically abused resident. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was not met to support or corroborate this allegation and therefore deemed unsubstantiated. An exit interview was conducted with Caregiver Wilma Castagnola, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided.the state’s words, verbatim · CDSS document, May 22, 2025 · control 08-AS-20250429152030

Allegation investigated: Staff restrained resident Staff handles resident in a rough manor

Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced visit to the facility to deliver investigative findings regarding the above mentioned allegation. LPA identified herself, explained the purpose of the visit and nature of the complaint to Co-Administrator Jenny Sequeiralater. On February 27, 2025 the Department received this complaint which alleged staff restrained Resident #1 (R1) [See LIC811 Confidential Name List for a description of select person identifiers used in this report.] and staff handles R1 in a rough manor. The Department’s investigation included a facility tour, record reviews, as well as interviews with residents, staff and outside sources. (Continued on LIC9099-C) Unsubstantiated (Continued from LIC9099) Regarding the allegation of facility staff restraining resident, during LPA interview with R1, R1 was unable to provide any details of the event including when it happened or which staff allegedly restrained them. Records reviewed revealed that R1 has mild cognitive impairment and may often exhibit confused and/or disoriented mental conditions. Per interviews with other residents and outside sources who are familiar with the facility and frequently visit, there have been no witnesses to R1 or any other residents being restrained in any manner. Regarding the allegation of facility staff handling resident in a rough manor, during LPA interview, R1 did not report ever being treated roughly by staff and reported feeling safe at the facility. LPA observed R1 having good rapport with facility staff. Further, interviews with other residents and outside sources familiar with the facility revealed no witnesses to staff treating R1 or any resident in a rough manner. The Department has investigated the allegations that staff restrained resident and staff handles resident in a rough manor. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was not met to support or corroborate these allegations and therefore deemed unsubstantiated. An exit interview was conducted with Co-Administrator Jenny Sequeiralater, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided.the state’s words, verbatim · CDSS document, Apr 24, 2025 · control 08-AS-20250227152404

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Angelica Boyles 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 Caregiver Wilma Castagnola. Co-Administrator Jenny Sequeira later later joined the visit. According to the facility’s license, the facility serves residents age 60 and over and has a maximum capacity of 6 residents. All residents can be non-ambulatory, of which 1 may be bedridden. LPA, accompanied by Co-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 and 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. 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, fireplaces, or open-faced heaters accessible to clients. Medications were labeled, as required, and stored in locked areas. [CONTINUED ON LIC 809C] [CONTINUED FROM LIC 809] No pools or bodies of water were observed on the premises. Per Co-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(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 residents. LPA reviewed multiple staff and client records/files. The interviews did not raise any significant licensing concerns. The reviewed files contained required documents. Confidential records were stored in locked areas. Proof of current/active business liability insurance was presented. No deficiencies were observed or cited on today's visit. An exit interview was conducted with Co-Administrator Jenny Sequeiralater, 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, Apr 24, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Liliana Silveira conducted an announced Pre-Licensing inspection. The inspection included review of Component III, as well as a walk through of the facility’s physical plant for compliance with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code. LPA was greeted at the front entrance by Jennifer Sequeira and Nikita Desai and was granted entry after identifying themselves and disclosing the purpose of the visit. This is a new facility. The fire clearance was approved on 02/21/24 and reflected that the facility was approved for 6 residents for a Residential Care Facility for the Elderly (RCFE). 5 of the residents may be non-ambulatory and which 1 may be bedridden. As of today's visit, there were 5 residents in care. The submitted facility sketch was consistent the current layout of the facility. During today’s visit, LPA, accompanied by Jennifer and Nikita conducted an overall inspection of the internal and external areas of the facility. The facility was clean, sanitary and in good repair. Required licensing postings were observed in visible areas of the facility. The facility has sufficient space and equipment to facilitate laundry, visitation, meetings, and resident activities. All outdoor and indoor pathways were free from obstruction and slip hazards. Smoke and carbon monoxide detectors, emergency lighting, and facility telephone were present and operational. Fire extinguishers were serviced within the last 12 months and affixed with current tags. There is 1 (one) fire extinguisher that is in compliance with regulations. All toxic substances/poisons, chemicals were stored in a locked area inaccessible to residents. Fireplaces, and/or open-faced heaters were inaccessible to residents. (CONTINUED ON NEXT PAGE LIC 809-C) Resident bedrooms allowed for easy passage with no obstruction and contained the required furnishings. Each window had a screen which was in good condition. The facility has all the required furnishings, linens and personal hygiene items. Resident bedrooms allowed for easy passage with no obstruction and contained the required furnishings. There are 3 bathrooms for residents to use. Bathrooms are equipped with grab bars and non-skid mats or stickers. Toilets, sinks, and showers were in working order. The facility’s ambient internal temperature was compliant at 72 degrees F. There were 6 resident bedrooms that measured hot water that are in compliance with regulation. The facility kitchen was stocked with appropriate cooking items. The facility has locked areas for storage of sharp objects- knives were locked in a secure cabinet which is inaccessible to residents. A seven (7) day supply of non-perishable and two (2) day supply of perishable food items were present. Medications were secured in a locked cabinet which is inaccessible to residents. A first aid kit and manual were present and located in each of the med rooms and the front entrance. Resident and staff files were also in a locked cabinet. The facility has no pools or bodies of water that were observed on the facility premises. Per Jennifer Sequeira, no firearms or ammunition are or will be stored on the facility premise. LPA discussed continuing operation requirements, record keeping, reporting requirements and physical plant compliance with the applicant. The items reviewed were complaint with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code. The Pre-Licensing and Component III was completed during today’s visit. The applicant was advised that the facility is ready for licensure pending management final review and approval. An exit interview was conducted with applicant Jennifer Sequiera to whom a copy of this report and Licensee Appeal Rights (LIC 9058 01/16) were provided at the conclusion of the visit. The signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, May 1, 2024