La Jolla Casa Fiesta

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Janet Ngallo conducted an unannounced, required Annual Inspection. The facility file and personnel report was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Caregiver Laura Aguayo. Licensee Gus Fernandez later joined the visit. The facility's license shows a maximum capacity of six (6) non-ambulatory residents, one (1) of which may be bedridden. Bedridden resident may reside in bedroom #1 only. Additionally, the facility is approved for two (2) hospice waivers. During today’s inspection there were three(3) residents in care. LPA and Caregiver Aguayo 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, screens, toilets, and showers were in working order. Hot water temperature at taps accessible to residents were all compliant. 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 two (2) days of perishable food, and at least seven (7) days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, as required, and stored in locked areas. [Cont. on LIC 809-C] [Cont. from LIC 809] No pools or bodies of water on the premises. Per Licensee, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and reviewed multiple staff and client records/files. LPA interviews did not raise any licensing concerns. The files which LPA reviewed contained required documents. Confidential records were stored in locked areas. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Licensee Gus Fernandez 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, Aug 24, 2026

Allegation investigated: Licensee did not follow reporting requirements regarding pending facility sale. Licensee did not provide enough food to meet the needs of residents. Licensee did not ensure infection control requirments are followed. Licensee did not treat pests.

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced visit to deliver findings regarding the above mentioned complaint allegations. LPA was welcomed by, identified themselves to, and discussed the purpose of their visit to Caregiver Laura Aguayo and House Manager Linda Gonzalez. LPA also spoke with Administrator Jennifer Fernandez over the phone to inform them of their visit. On 4/9/25, the Department received a complaint where it was alleged that the facility was listed for sale and that residents or their responsible parties were not notified, that the facility is not supplying food for the residents, that there is a lack of hygienic items such as gloves, and that there are pest control issues. The complaint specified that a non-specified resident's family member as well as care staff were supplying food for the home. The Department’s investigation consisted of unannounced facility visits, records review, and interviews with staff, residents, and outside sources. [Continued on LIC 9099-C] Unsubstantiated [Continued from LIC 9099] Regarding the allegation of lack of notification to appropriate parties regarding listing of the property, based on interviews with administrative staff, the facility was only listed onto the market and no actual sale or offer has been made. Per online review of the listing site, Zillow, the home was listed for sale February 2025. While it may be a best practice to inform residents and/or their responsible parties of the facility's interest or intent for sale, as there was no actual transfer of property that took place, the facility is not required to provide notification at this stage, therefore there is no indication of a violation at this time. The facility also notified the Department via email on 4/21/25 that the facility has been listed for sale. Regarding the allegation of lack of food at the facility, staff interviews revealed mixed sentiments about the grocery provisions for the facility. Some staff interviewed revealed that the grocery list would never be provided in full, only a few items at a time and that the food items that were brought in were close to expiration. It was revealed that a resident's family member has been supplying food for their respective resident and all those items were labeled to indicate so. Additional staff interviews revealed that groceries were purchased by the Administrator about every week to two weeks. One also mentioned that though groceries were not always brought in full, there was no shortage of food in the home. Another staff member interviewed revealed no concerns about food and denied any grocery shortages at the facility. Outside sources interviewed revealed no concerns about the quality or supply of food. Residents interviewed revealed no concerns about food, aside from one who stated that they found the food provided to be "alright," but clarified that there was no shortage of food and they were well fed. File review of grocery purchase receipts for the facility revealed that groceries were purchased about 2-3 times a month and receipts show a variety of foods purchased. [Continued on LIC 9099-C] [Continued from LIC 9099-C page] In regards to the allegation of lack of hygiene items, staff interviews again revealed conflicting statements in regards to the facility's supply of Personal Protective Equipment (PPE) for staff. Some staff members interviewed revealed that there was an overall shortage of gloves and paper goods supplies (toilet paper, paper towels, personal wipes, etc.) and that staff are having to bring their own supplies. Additional staff interviewed revealed no concerns of gloves and paper goods shortages, revealing that when supplies are running low, administrative staff are notified and supplies are replenished. Resident interviews revealed no concerns about the use of PPE by staff, with two (2) revealing that staff regularly use gloves to assist residents and that they have not heard staff voice concerns about them being low in supply. During LPA's visit on 4/24/25, two (2) boxes of 100 gloves along with multiple boxes of adult briefs were observed in the storage area of the facility's garage. File review of PPE and hygiene items invoices from December 2024 through July 2025 reveal that gloves were purchased on 12/9, 1/15, 4/1, 4/25, 6/10, and 7/28 in the amount of 1-2 cases (10 boxes per case). Finally, in regards to the allegation of lack of pest control, interviews and file review corroborate that the facility arranged for pest control treatment. Four staff members interviewed all revealed that there have been pests observed at the facility, but that pest control technicians come out regularly for treatment and prevention. Resident interviews revealed that pests have not been observed by them at all, with one (1) noting that staff clean daily. One (1) outside source interviewed noted that they have not observed any pests at the facility and felt that the facility was very clean. File review of pest control invoices revealed that services were rendered roughly on a monthly basis from August 2024 through June 2025. During LPA's initial visit to the facility (4/15/25) roaches were observed, but on subsequent visits (4/24/25 and 8/14/25), LPA noted none. Based on interviews and records review, while the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred – therefore the allegations have been determined to be UNSUBSTANTIATED. An exit interview was conducted with House Manager Gonzalez to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Sep 24, 2025 · control 08-AS-20250409123908

Allegation investigated: Staff are not providing resident with a refund.

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced visit to deliver findings regarding the above mentioned complaint allegation. LPA was welcomed by, identified themselves to, and discussed the purpose of their visit to Caregiver Laura Aguayo and House Manager Linda Gonzalez. LPA also spoke with Administrator Jennifer Fernandez over the phone to inform them of their visit. On 8/6/25, the Department received a complaint where it was alleged that the facility did not refund a former resident (identified as R1) the pro-rated amount for prepaid rent after move out. The Department’s investigation consisted of unannounced facility visits, records review, and interviews with staff, residents, and outside sources. [Continued on LIC 9099-C] Unsubstantiated [Continued from LIC 9099] Multiple staff interviews revealed that R1's move out was around late July, with one who was present during date of move out (1) specifying the date as being 7/17/25, which was corroborated with file review of emails between the facility and R1's responsible party. File review and outside source interviews corroborated that a check for the prorated refund amount was made out to R1's responsible party on 8/16/25. File review of R1's admission agreement contract did not contain conditions for refunds given due to voluntary move out, only refund conditions given due to resident death. However, the contract does state that in the case of voluntary resident move out, the facility would provide reasonable efforts to assist with belongings removal. The facility was not obligated by contract to provide a refund in this circumstance, however, they chose to. Based on interviews and records review, while the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred – therefore the allegation has been determined to be UNSUBSTANTIATED. An exit interview was conducted with House Manager Gonzalez to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Sep 24, 2025 · control 08-AS-20250806161250

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced, required Annual Inspection. The facility file and personnel report was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Caregiver Mila Flotildes and Licensee Gus Fernandez. The facility's license shows a maximum capacity of six (6) non-ambulatory residents, one (1) of which may be bedridden. Bedridden resident may reside in bedroom #1 only. Additionally, the facility is approved for two (2) hospice waivers. During today’s inspection there were six (6) residents in care. LPA and Licensee Fernandez 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. Hot water temperature at taps accessible to clients were all compliant: Common bathroom sink in hall restroom was 107.2F and common bathroom sink in the restroom adjacent to the garage measured at 115.7F. 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 two (2) days of perishable food, and at least seven (7) days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. As LPA was shown the drawer where knives are stored, LPA noted that the lock mechanism was broken, rendering the drawer accessible to residents in care. Staff immediately moved the knives in the drawer to a locked storage room. As a staff member was present and working in the kitchen from when LPA arrived to when the broken lock was noted, a Type B citation was issued as opposed to a Type A for the accessible knives. [Continued on LIC 809-C] [Continued from LIC 809] 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 Fernandez, no firearms or ammunition are kept at the facility. Smoke and carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguishers were serviced within the last 12 months. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed three (3) staff and zero (0) clients, and interviews did not reveal any licensing or regulatory concerns. LPA reviewed facility records. Staff records were offsite due to updating documents and Licensee will send remaining required staff documents to LPA via email. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. One Deficiency was cited during the inspection for the accessible knives. An exit interview was conducted with Licensee Fernandez to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Aug 29, 2025

Type of visit: POC

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced Plan of Correction (POC) visit regarding a deficiency that was cited on 4/15/25. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to caregiver Mila Flotildes. Administrator Jennifer Fernandez arrived later in the visit. On 4/15/25 LPA cited a deficiency for the lack of a fireplace screen in the facility. The POC due date was set for 4/18/25. Licensee submitted proof of correction to LPA via email on 4/22/25 and did not communicate LPA prior to the POC due date for additional time. As the Licensee failed to correct the deficiency and notify LPA by the due date, LPA conducted a POC visit to verify correction and to assess a Civil Penalty Violation for Failure to Correct. A Civil Penalty of $100.00 a day has been assessed from 4/19/25 to 4/22/25 for a total of $400.00. An exit interview was conducted with Administrator Fernandez to whom a copy of this report, the POC Clearance letter, the LIC 421FC, and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Apr 24, 2025

Type of visit: Case Management - Deficiencies

On 4/15/25, Licensing Program Analyst (LPA) Arian Golbakhsh conducted a Case Management visit at the facility. LPA was welcomed by, identified themselves to, and discussed the purpose of their visit to Caregiver Laura Aguayo. While entering the sitting area, LPA observed the fireplace had no protective screen in front of it. Per file review conducted prior to the visit, it was noted that the Licensee had received a Technical Assistance on 7/23/24 for not having a fireplace protective screen. A deficiency was cited per California Code of Regulations 87307(e)(1)(A). An exit interview was conducted with Caregiver Laura Aguayo to whom a copy of this report, the LIC 809-D, and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Apr 15, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87307(e)(1)(A) · Plan of correction due date: Apr 18, 2025

87307(e)(1)(A): when residents are in proximity to . . . ovens, heaters, fireplaces . . . Heating devices shall have protective mechanisms or other measures to prevent access . . . in order to reduce the risk of burns or fire. This requirement is not met as evidenced by: Based on LPA observation and record review, the Licensee did not ensure that the fireplace had a protective screen, creating a potential health and safety risk to 4 out of 4 residents in care.the state’s words, verbatim · CDSS document, Apr 15, 2025

Plan of correction: Licensee will submit proof of a inserted fire place protective screen to LPA by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection. The LPA introduced himself and disclosed the purpose of the visit to House Manager Hermelinda Gonzalez. The facility was licensed for a capacity of six (6) non-ambulatory residents, of which one (1) may be bedridden in room # 1. The facility also had a hospice waiver for two (2) residents. The LPA, accompanied by House Manager, 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 obstructions and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, 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 toxic chemicals/poisons accessible to clients. Medications were labeled, and stored in a locked area. No pools, nor bodies of water were observed on the premises. Per staff, no firearms, nor ammunition were kept at the facility. Carbon monoxide detector, and facility telephone were all working. A fire extinguisher was present. Required licensing postings were observed in visible areas of the facility. The LPA interviewed staff and reviewed multiple staff and client records/files. The LPA provided Technical Advise to the house manger. No deficiencies were cited on today's date. An exit interview was conducted with House Manager Gonzalez, to whom a copy of this report,, and the Licensee/Appeal Rights (LIC9058), were provided.the state’s words, verbatim · CDSS document, Jul 23, 2024