Pacific Coast Assisted Living

Allegation investigated: Staff had sexual relations with resident The facility is not providing adequate meals The facility is not providing resident with anything to drink

Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced complaint visit to deliver complaint findings. LPA introduced himself and disclosed the purpose of the visit with Caregiver America Cisneros. LPA also spoke with Licensees Ray and Aleena Cruz via telephone. Community Care Licensing (CCL) has investigated the above allegations. The investigation consisted of LPA observations, records review, interviews with staff, residents and outside sources. On 02/13/2026, Community Care Licensing (CCL) received a complaint containing three allegations regarding the facility: (1) staff had sexual relations with a resident, (2) the facility is not providing adequate meals, and (3) the facility is not providing the resident with anything to drink. The resident identified in the complaint is Resident 1 (R1). Unsubstantiated On 02/12/2026, it was reported that R1 stated they had been sexually assaulted by the facility’s manager approximately two weeks earlier. It was also reported that R1 stated they were not being fed well and were not receiving anything to drink. Documentation indicates that R1 has made various allegations in the past, though none involving sexual assault. Following the report, R1 refused to return to the facility and was placed on a 5150 psychiatric hold. R1 also expressed a desire for their out of state family member to pick them up. Documentation from an outside agency shows that R1 provided conflicting statements regarding when the alleged incident occurred, stating it happened two weeks ago and also stating it occurred around Halloween of 2025. R1 has documented cognitive impairments and a history of making false statements. R1 described the alleged event as the facility manager entering their room, pushing them to the floor, and assaulting them. R1’s family member was contacted and reported that R1 has made similar types of allegations in the past when attempting to leave the facility. R1’s family member stated they did not believe the accused staff member would commit such an act. During a subsequent conversation, R1 stated they wanted to leave the facility to live with their out of state family member. When informed this was not possible, R1 became upset and stated they would leave the facility on their own if returned there. The staff member identified by R1 was interviewed and denied the allegation. They stated that R1 has made untrue claims previously. Staff further reported that R1 shares a room with another resident, and that the facility maintains an open door policy, which they stated would make it difficult for such an event to occur without being observed. Another individual familiar with R1’s care was interviewed and stated they believed R1 was again attempting to leave the facility. They confirmed that R1’s roommate does not have cognitive impairments and has not reported seeing or hearing anything unusual. They also stated that R1 is provided appropriate care at the facility. A review of R1’s facility records shows diagnoses of dementia, episodes of confusion, and a history of making false allegations. R1 also has several medical conditions, including frailty, malnutrition, mild cognitive impairment, anxiety, and depression. R1 was admitted to the facility on 03/09/2025. To investigate the remaining allegations regarding meals and hydration, LPA conducted resident and staff interviews and made in facility observations. Resident 2 (R2), who has lived at the facility for 4–5 months, stated their experience has been “good.” R2 reported that staff provide them with three meals a day and snacks upon request. R2 stated the meals are substantial and they “get enough to eat.” R2 also reported that staff provide them with drinks throughout the day or whenever they request them. Resident 3 (R3), who has lived at the facility for 3–4 months, stated their experience at the facility has been “pretty good.” When asked what they liked about the facility, R3 immediately stated “the food,” describing it as good. R3 confirmed they are provided three meals per day, the meals contain “enough food,” and that staff always provide “enough fluids” throughout the day. Staff 2 (S2), who has worked at the facility for over one year, stated that residents are provided three full meals a day and snacks. S2 reported that meals are generally sugar free and/or heart healthy. Staff stated the menu is changed daily to avoid repetition. Staff also reported that each resident has a water bottle in their room that is refilled two to three times per day. During resident interviews, the LPA observed that each resident had a water bottle on a table near them. Based on interviews, record reviews, and observations, there is not sufficient evidence to support the allegation that staff had sexual relations with a resident, nor the allegations that the facility failed to provide adequate meals or fluids. Therefore, all three allegations are unsubstantiated. The report was discussed, and an exit interview was conducted with America Cisneros. A copy of this report along with Licensee/Appeal Rights (LIC9058 3/22) were provided to America Cisneros at the conclusion of the visit. The signature below confirms the receipt of these documents.the state’s words, verbatim · CDSS document, May 12, 2026 · control 08-AS-20260213091516

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jose De La Cruz made an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with Administrator Aleena Cruz. The facility's license shows a maximum capacity of six (6) residents, ages 60 and over non-ambulatory with a waiver granted for hospice care for the six of them.. LPA arrived at 7:40 am. Facility looks clean and in good repair, in the interior and exterior. At 7:50 am LPA requested residents’ files, and at 8:40 am started reviewing the staff files At 10:00 am, LPA and Administrator toured the facility, the interior and exterior and inspected three residents’ rooms, two bathrooms and kitchen. Around 10:10 am, emergency services were called regarding a resident not feeling well. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings and were personalized by the clients. Doors, windows, screens, toilets, and showers were in working order. Extra linen and hygiene supplies were present, as well as Personal Protective Equipment which was stored along with the medication. 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 of non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. Toxic chemicals or poisons were locked and not accessible to clients. Medications were labeled, as required, and stored in locked areas. No bodies of water or fireplaces on the premises. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC809] Per Administrator, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguishers were serviced within the last 12 months. 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 and no Civil Penalties were assessed. An exit interview was conducted with Licensee and Administrator, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today’s visit.the state’s words, verbatim · CDSS document, Nov 11, 2025

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Allegation investigated: Unlawful Eviction

Licensing Program Analyst (LPA) Iby Strong conducted an unannounced visit to initiate a complaint investigation on the above allegation. LPA identified herself and discussed the purpose of the visit with Caregiver Julie Felix. Administrators Ray Cruz, Aleena Cruz and Vanessa Nunez arrived shortly after. On May 5, 2025, Community Care Licensing (CCL) received a complaint alleging Licensee conducted an unlawful eviction. During investigation, LPA Strong collected pertinent resident records and conducted interviews. Based on Resident 1 (R1) Physician’s Report dated April 2, 2025, R1 is diagnosed with a Major Neurocognitive Disorder with behavior disturbances. Additionally, R1’s Preplacement Appraisal shows R1 needs assistance with all activities of daily living. Substantiated According to the allegation, R1 was admitted to the hospital on May 4, 2025, medically cleared to return home on May 5, 2025, but Licensee refused to allow R1 to return home. Outside source records confirmed R1 was medically cleared to return home on May 5, 2025. Interview with an outside source close to R1 revealed R1 was not issued an eviction notice at any time. Facility file reviewed did not reveal that the Licensee submitted a three day eviction request to the Department. Lastly, interview with the Licensee revealed the information was reported to the Department on May 5, 2025, and Licensee followed instructions from an outside government agency but no three day eviction request was submitted for review. Based on interviews, and records reviewed, a preponderance of evidence exists to support the allegation. Deficiencies are being cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). An exit interview was conducted with Administrators, to whom a copy of this report, LIC 9099-C, LIC 9099-D, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided to.the state’s words, verbatim · CDSS document, May 13, 2025 · control 08-AS-20250505141943

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(a)(20) · Plan of correction due date: May 27, 2025

Additional Personal Rights of Residents in Privately Operated Facilities(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. For purposes of this paragraph, "involuntary" means a transfer, discharge, or eviction that is initiated by the licensee, not by the resident. Based on interviews and records the licensee did not protect resident from an involutary eviction in 1 of 6 residents in care which posed a potential Personal Rights risk to persons in carethe state’s words, verbatim · CDSS document, May 13, 2025

Plan of correction: Adminsitrator states they will provide LPA with a written understanding of eviction procedures by POC date.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Alyssa Ramirez conducted an announced Pre-Licensing visit to observe the facility’s physical plant for compliance with Title 22, Division 6 of the California Code of Regulations and Health & Safety Code. LPA was greeted by, identified herself to, and explained the purpose of the visit to applicants Vanessa Nunez, Ray Cruz & Aleen Cruz. The facility fire clearance was granted on 11/18/2024 and reflects that the facility was approved for six (6) non-ambulatory residents. During today’s visit, LPA, accompanied by the applicant, toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Bedrooms contained the required furnishings. Water temperature was in compliance. The facility has enough linens, hygiene supplies and dining supplies for future client use.The facility has locked areas for storage of medication and confidential client and staff records. Facility has an empty jacuzzi on the grounds that is kept empty and locked. No other pools or bodies of water were observed on the premises. There were no toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. Per the applicant, no firearms or ammunition are or will be stored at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all operational. Fire extinguishers and first aid kits were present. Required licensing postings were observed in visible areas of the facility. The items reviewed were complaint with Title 22, Division 6 of California Code of Regulations and Health & Safety Code. The applicant passed the pre-licensing inspection. LPA also provided the Component III Training during today’s visit. Applicant was advised that the facility’s application is pending management final review and approval. An exit interview was conducted with the applicant, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Dec 16, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): COMP II Participants: Vanessa Nunez (A) & Ray Cruz (C) Interview Method: Telephone interview On November 22, 2024, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. License type, client/resident populations, and program 2. Staffing/Medications/Activities 3. Pre Licensing readiness/inspectionthe state’s words, verbatim · CDSS document, Nov 22, 2024