Crestview Manor

Allegation investigated: Staff do not ensure facility is free of hazards Facility is in disrepair

This is a amended document on July 17, 2026. Licensing Program Analyst (LPA), Robert Campbell conducted an unannounced visit to investigate the above allegations. LPA met with Brendan Nailon/Fire Inspector/Investigator, Mark Poulsen/Administrator and explained the purpose of the visit and assisted LPA with today’s visit. During the visit LPA toured the facility and made observations pertaining to the allegations. LPA observed the following during the tour there was wiring exposed in an outdoor box (photo taken), one large basement was filled with combustible material but was mostly removed today by six trucks according to the Administrator, a portion of the ceiling is compromised, and you can see the bathtub from the basement (photos taken). LPA observed burn marks on wood beams by water piping (photos taken), and there is open electrical wiring (photos taken) that creates fire hazards to the residents in care according to the Fire Inspector. LPA issued Type B deficiencies to the facility under Title 22 87303(a) on an LIC9099D form.Therefore, based on observations and interviews, the allegations Staff do not ensure facility is free of hazards, and Facility is in disrepair is SUBSTANTIATED. Substantiated Continued.... LPA advised that at this time additional time is needed, follow-up visits and or telephone calls are necessary before reaching investigation findings, further investigation is needed. An exit interview was conducted, and a copy of this report was discussed and given to Mark Poulsen/Administrator.the state’s words, verbatim · CDSS document, May 13, 2026 · control 18-AS-20260512104707

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Jun 9, 2026

(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. Not met evidenced by the following: LPA observed the following during the tour there was wiring exposed in an outdoor box (photo taken), one large basement was filled with combustible material but was mostly removed today by six trucks according to the Administrator,(photos taken) more exposed wiring, loose beam, exposed ceiling.the state’s words, verbatim · CDSS document, May 13, 2026

Plan of correction: Licensee will have all repairs done by a professional with permits in place, submit all corrections by email to the LPA on the POC date.

Type of visit: Prelicensing

Licensing Program Analysts (LPAs) Armando Perez and Abdoulaye Zerbo, conducted an announced visit for the purpose of conducting the pre licensing inspection. LPAs met with Administrator Audra Bristol for the visit. The applicant is seeking a change in ownership with residents in care for a residential care facility for the elderly, ages 60 and up. The facility is a single-story triplex compound with a capacity for 38 residents with 5 bedridden approved. On 07/08/24 the Fire Department of City of Escondido approved a fire clearance. LPAs toured the facility and observed the following: LPAs inspected a sample of resident bedrooms and bathrooms. Resident bedrooms have the required bedding and furniture; such as clean mattresses, night stands, storage space, and sufficient lighting. Room temperatures were comfortable for residents in care. LPAs inspected a sample of resident bathrooms; the bathroom appliances were operating in safe and sanitary conditions. Showers contained non-slip surface and access to grab bars in the showers and next to toilets. LPAs measured the hot water temperature in the sampled bathrooms and measured within regulation. Bedrooms were equipped with a signal system to notify staff of any emergencies. LPAs toured the kitchen and dining area. The facility kitchen is locked and accessible only to staff. LPAs observed sharps and knives stored in an unlocked cabinet. Pantry was stocked with sufficient food to meet the required 2-day supply of perishable and 7-day supply of non-perishable food items. The facility had a menu posted and available for review. Dishes, glasses, and utensils were in good condition. LPAs observed two outdoor patio areas with each having a covering and sufficient seating for residents. The facility's main office is the centralized storage area where resident files, personnel files and medications are to be stored, locked, and inaccessible to the residents in care. LPAs verified the applicants Administrator Certification, with an expiration date of December 02, 2025 and the CPR certification, with the expiration date of March 21, 2026. LPAs observed required postings including the visitation polices, emergency/disaster plans, complaint procedures, employee rights, personal rights and the Long-Term Care Ombudsman poster. Facility contains emergency supplies and first aid kits with the required items. The facility has working telephone for clients' use. LPAs observed several smoke detectors and carbon monoxide alarms throughout the facility. The facility has an emergency disaster plan and approved infection control training plan on file. The buildings and grounds were free from hazards. Outdoor and indoor passageways were kept free of obstruction. No bodies of water or firearms are being kept in the facility. The facility has satisfied all requirements in accordance with Title 22, California Code of Regulations. An exit interview was conducted, and this report was discussed and provided to Administrator Audra Bristol.the state’s words, verbatim · CDSS document, Oct 2, 2024

The state marks this report as 5 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Office

COMP II by CAB successfully completed Method: Phone Call at CAB Applicant/administrator participated in COMP II at CAB telephone call with analyst at CAB. Identification of the applicant and administrator was verified by presenting photo ID via phone. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Staff qualifications and responsibilities 3. Applicant and Administrator qualifications 4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions 5. Grievances, Complaints, Community resources 6. Physical plant, food service 7. Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of propertythe state’s words, verbatim · CDSS document, Aug 23, 2024