Acorn Oaks Manor III

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Amy Domingo, made an unannounced visit to conduct the required One-Year Inspection to ensure substantial compliance with Title 22 regulations. LPA Domingo was granted entry after identifying herself and stating the purpose of the inspection Community Manager Maria Williams. Later Licensee/Administrator Alex Limpin joined the visit. A tour of the facility was conducted which included a sample of resident units, the dining area, common gathering areas, and food storage areas. There are no water features on site. Each resident had clean and sufficient bed linens. All residents’ rooms were equipped with the required furnishings. Residents’ bathrooms were observed to be sanitary and operational. Showers were equipped with grab bars. Hot water temperature in residents’ bathrooms were compliant. The facility is operating in accordance with their fire clearance. The smoke and carbon monoxide alarms were hard wired and present in each building. Emergency lighting, and facility telephone were all working. First aid kit was complete and readily accessible in the kitchen area. Required licensing postings were observed in visible areas of the facility. PPE supplies are on site. Indoor passageways were free from obstructions. Food was observed to be properly labeled. All food is prepared on the common property and delivered to the home or residents can visit the common dining area for a meal. The food service area was observed to be neat and clean. Food menus and activities schedule were posted. Centrally stored medications were properly stored and locked in medication carts. Medications were labeled and kept in compliance with label instructions. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] Resident records were reviewed and confirmed compliant. Administrator’s certification is current. LPA reviewed the theft and loss policy and procedures. LPA conducted a review of In-service training procedures. LPA interviewed Administrator Alex Limpin was assured transportation procedures as well as outside medical and dental assistance procedure are compliant. There is large common rooms used for dining and activities. LPA observed that residents were being treated with dignity by staff, and there were sufficient staff on duty to meet resident’s needs. LPA interviewed staff and clients. LPA interviews did not raise any licensing concerns. LPA reviewed multiple staff and client records/files. Files reviewed contained required documents. Confidential records were stored in locked areas. the administrator presented proof of current/active business liability insurance. LPA observed that residents were being treated with dignity by staff, and there were sufficient staff on duty to meet resident’s needs. No deficiencies were cited at the time of visit. An exit interview was conducted with Licensee/Administrator Alex Limpin 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, Jun 2, 2026

Allegation investigated: Licensee did not maintain facility in compliance with its issued fire clearance.

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to commence a Complaint Investigation regarding the above allegations. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Supervisor Jamily “Jamila” Hallak. LPA then met with Administrator/Licensee Alexander “Alex” Limpin, who arrived shortly after. The Complainant alleged that Licensee did not maintain facility in compliance with its issued fire clearance. CCLD’s investigation involved an unannounced facility tour/welfare check, interviews of relevant staff and a deputy fire marshal, and review of pertinent photographs and physical plant records. [CONTINUED ON LIC 9099-C] Substantiated [CONTINUED FROM LIC 9099] LPA observation and interviews showed: The current facility (Acorn Oaks Manor III) is located at 6209 Acorn Street, San Diego, CA 92115. After this current facility’s licensure, Licensee had built another adjacent building/structure at 6211 Acorn Street. This new adjacent building sat so close to the current facility that it constricted the space just outside the side sliding-glass door of Bedroom #1 (of Acorn Oaks Manor III), creating a narrow hallway. Per San Diego Fire Rescue Department, this constriction was indeed severe enough to impair Bedroom #1’s continued status as a non-ambulatory room, as it was designated in the facility’s prior-approved fire clearance. By the start of CCLD’s complaint investigation, Licensee had already used a professional contractor to construct a second side-exit door coming out of Bedroom #1 which does not face towards 6211 Acorn Street. Based on photographs, interviews, and LPA observation, a preponderance of evidence exists to show that during the complaint time frame, Licensee did not maintain facility in compliance with its issued fire clearance. One (1) deficiency was cited 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. Since the deficiency was timely corrected upon Licensee’s constructive knowledge of the problem, and fully resolved by the start of CCLD’s investigation, no civil penalty was assessed/charged. An exit interview was conducted with Administrator/Licensee Alexander “Alex” Limpin, to whom a copy of this report, the LIC 9099-D page, and the Licensee/Appeal Rights (LIC9058 03/22) were provided. [CONTINUED FROM LIC 9099] Interviews of multiple facility staff showed they consistently checked residents’ incontinent products roughly every two hours, changing them if wet/soiled, and more often as needed. Caregivers also cleaned the shared restrooms daily and performed routine housekeeping. Based on records and interviews, a preponderance of evidence does not exist to show that Licensee did not ensure facility was free of odors from incontinence. The allegation is therefore Unsubstantiated, and no deficiency was cited for it. An exit interview was conducted with Administrator/Licensee Alexander “Alex” Limpin, 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 1, 2025 · control 08-AS-20250625145637

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a) · Plan of correction due date: Jul 1, 2025

87202 Fire Clearance: “(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal.” This requirement was not met, as evidenced by: Based on records and interviews, Licensee did not maintain ongoing compliance with its prior-approved fire clearance. This posed an immediate safety risk to 5 of 5 residents (Resident #1 through Resident #5) in care.the state’s words, verbatim · CDSS document, Jul 1, 2025

Plan of correction: As of the date of deficiency issuance, Licensee had already used a professional contractor to construct a second side-exit door out of Bedroom #1 which does not face towards 6211 Acorn Street. This action resolves the immediate risk. Licensee agreed to E-mail an updated Facility Sketch (showing the presence of the new door coming out of Bedroom #1) to LPA and San Diego Fire Rescue Department by 08/01/2025.

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Amy Rodgers, made an unannounced visit to conduct the required One-Year Inspection to ensure substantial compliance with Title 22 regulations. LPA Rodgers was granted entry after identifying herself and stating the purpose of the inspection Community Manager Jamila Hallak. Later Licensee/Administrator Alex Limpin joined the visit. A tour of the facility was conducted which included a sample of resident units, the dining area, common gathering areas, and food storage areas. There are no water features on site. Each resident had clean and sufficient bed linens. All residents’ rooms were equipped with the required furnishings. Residents’ bathrooms were observed to be sanitary and operational. Showers were equipped with grab bars. Hot water temperature in residents’ bathrooms were compliant. The facility is operating in accordance with their fire clearance. The smoke and carbon monoxide alarms were hard wired and present in each building. Emergency lighting, and facility telephone were all working. First aid kit was complete and readily accessible in the kitchen area. Required licensing postings were observed in visible areas of the facility. PPE supplies are on site. Indoor passageways were free from obstructions. Food was observed to be properly labeled. All food is prepared on the common property and delivered to the home or residents can visit the common dining area for a meal. The food service area was observed to be neat and clean. Food menus and activities schedule were posted. Centrally stored medications were properly stored and locked in medication carts. Medications were labeled and kept in compliance with label instructions. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] Resident records were reviewed and confirmed compliant. Administrator’s certification is current. LPA reviewed the theft and loss policy and procedures. LPA conducted a review of In-service training procedures. LPA interviewed Administrator Alex Limpin was assured transportation procedures as well as outside medical and dental assistance procedure are compliant. There is large common rooms used for dining and activities. LPA observed that residents were being treated with dignity by staff, and there were sufficient staff on duty to meet resident’s needs. LPA interviewed staff and clients. LPA interviews did not raise any licensing concerns. LPA reviewed multiple staff and client records/files. Files reviewed contained required documents. Confidential records were stored in locked areas. the administrator presented proof of current/active business liability insurance. LPA observed that residents were being treated with dignity by staff, and there were sufficient staff on duty to meet resident’s needs. No deficiencies were cited at the time of visit. An exit interview was conducted with Licensee/Administrator Alex Limpin 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, May 7, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Amy Rodgers, made an unannounced visit to conduct the required One-Year Inspection to ensure substantial compliance with Title 22 regulations. LPA Rodgers was granted entry into the facility by Med Tech Ivana Porras, after identifying herself and stating the purpose of the inspection House Manager Jamily Hallak and Care Coordinator Maria Williams joined the visit. A tour of the facility was conducted which included a sample of resident units, the dining area, common gathering areas, and food storage areas. There are no water features on site. Each resident had clean and sufficient bed linens. All residents’ rooms were equipped with the required furnishings. Residents’ bathrooms were observed to be sanitary and operational. Showers were equipped with grab bars. Hot water temperature in residents’ bathrooms were compliant. The facility is operating in accordance with their fire clearance. The smoke and carbon monoxide alarms were present in each building. Emergency lighting, and facility telephone were all working. First aid kit was complete and readily accessible in the kitchen area. Required licensing postings were observed in visible areas of the facility. PPE supplies are on site. Indoor passageways were free from obstructions. Food was observed to be properly labeled. All food is prepared on the property and delivered to the home or residents can visit the common dining area for a meal. The food service area was observed to be neat and clean. Food menus and activities schedule were posted. Centrally stored medications were properly stored and locked in medication carts. Medications were labeled and kept in compliance with label instructions. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] Resident records were reviewed and confirmed compliant. Administrator’s certification is current. LPA reviewed the theft and loss policy and procedures. LPA conducted a review of In-service training procedures. LPA interviewed Houses Manager Jamily Hallak and was assured transportation procedures as well as outside medical and dental assistance procedure are compliant. There is large common rooms used for dining and activities. LPA observed that residents were being treated with dignity by staff, and there were sufficient staff on duty to meet resident’s needs. LPA interviewed staff and clients. LPA interviews did not raise any licensing concerns. LPA reviewed multiple staff and client records/files. Files reviewed contained required documents. Confidential records were stored in locked areas. House Manager Jamily Hallak presented proof of current/active business liability insurance. An exit interview was conducted over the Licensee Alex Limpon and with House Manager Jamily Hallak 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, Mar 27, 2024