Monarch Cottages la Jolla.

Licensing Program Analyst (LPA) Janet Ngallo conducted a case management – Incident visit in response to an incident that occurred at the facility on 08/09/2026. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Executive Director Risa Jester. According to the Executive Director, a fire occurred at approximately 4:40 PM on 08/09/2026. The facility contacted the fire department, which responded and extinguished the fire. As a result of the fire, the facility’s sprinkler system activated and caused flooding on the first floor. The second floor of the facility was not affected. Due to the fire and resulting flood, the facility initiated resident relocations. A total of twenty (20) residents were relocated to nearby facilities and other safe locations. Two residents were transported to the hospital as a precaution due to smoke inhalation and/or medical needs. The remaining residents were relocated among neighboring facilities that had available capacity, as the facility’s designated temporary relocation sites listed in the Emergency Disaster Plan had no availability at the time of the incident. The Executive Director reported that one resident is expected to be discharged to a facility after precautionary evaluation, and another resident remains at a hospital due to existing medical conditions and is anticipated to be discharged back to the facility when operations resume. The facility anticipates a temporary relocation timeline of 48–72 hours. The Executive Director stated that there was no damage to the facility kitchen and shared that both the fire department and the Department of Public Health have cleared the facility to resume operations. [Cont. on LIC 809-C] 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 [Cont. from LIC 809] LPA conducted a tour of the facility, including areas impacted by the incident. No additional health or safety concerns were observed during the visit. An exit interview conducted with Executive Director Risa Jester, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058), were provided. Their signature below confirms receipt of these documents.

Licensing Program Analyst (LPA) Liliana Silveira, made an unannounced visit to conduct the required Annual Inspection to ensure substantial compliance with Title 22 regulations. LPA Silveira was granted entry into the facility by Cognitive Enrichment Director Karen Moran, after identifying herself and stating the purpose of the inspection. The facility serves 52 non-ambulatory residents, age 60 and above, of which 8 may be bedridden. There is an approved Hospice Waiver for 12 residents. This is a two-story complex, equipped with delayed egress and secured perimeters. Currently, there are 18 residents living in the facility. LPA, accompanied by Karen, toured of the facility. The tour was conducted inside and out and included a sample of resident units, the dining area, recreation rooms, and food storage areas. The last disaster drill was conducted on December 18, 2025. No bodies of water are on the premises. Passageways were free from obstructions. According to Karen, there are no weapons and/or ammunition stored on the premises. Signal Systems was available in each resident unit and LPA observed functionality of said system. Delayed Egress and secured perimeter doors were also tested for functionality. Resident's room temperatures were within a comfortable range. Each resident had clean and sufficient bed linens. All extra linens, towels, and washcloth inventory was kept in each resident’s room. All residents’ rooms were equipped with required furnishings. Lighting was present in the bedrooms. Residents’ bathrooms were observed to be sanitary and operational. Toilets and showers were equipped with grab bars. Hot water temperature in residents’ bathrooms were compliant. [CONTINUED ON LIC 809-C] 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 [CONTINUED FROM LIC 809] Facility has a two-day supply of perishable foods and a seven-day supply of nonperishable food items. Food was observed to be properly stored and labeled. Food menus and activities schedule were posted. Chemicals and cleaning supplies were stored in a locked closet. The medication room is secured and has a locked medication cart, emergency supplies, and medications were labeled and kept in compliance with label instructions. Staff records review verified that all staff records were complete and compliant. Staff records review verified that all staff have a current First Aid certificate and at least one staff member, per shift, has a First Aide/CPR certificate. Resident records were reviewed and confirmed compliant. Administrator’s certification is current. LPA also interviewed staff and spoke briefly to residents. No deficiencies were cited at the time of visit. LPA observed that residents were being treated with dignity by staff, and there were sufficient staff on duty to meet the residents needs. An exit interview was conducted and this report was discussed with Karen Moran. A copy of the report, along with Licensee/Appeal Rights (LIC 9058 01/2106) were provided to Karen via email. Signature on this form acknowledges receipt of the documents.

It was further alleged that staff did not respond timely to Resident 2’s (R2) call button in a timely manner. The investigation revealed that the facility care providers all have radios and they check with each other to see who is available to provide care when a call button is pushed. The MedTech on duty is responsible for monitoring the situation and will respond if all care providers are assisting other residents. It was also revealed that almost all calls are responded to from immediately to 10 minutes. On a rare occasion when all caregivers and the MedTech are busy assisting other residents, it might be 15 minutes before care can be delivered. No records were available to confirm response times. “Timely manner” is not specifically defined, however the preponderance of evidence revealed during the investigation did not confirm that response times are of regular concern or that any specific incident was egregious or endangered any resident’s wellbeing. This allegation is Unsubstantiated. It was lastly alleged that the facility did not provide adequate incontinence care for R2. Interviews with internal and external sources revealed that residents are checked every two hours to assess their toileting needs. Excluding the above allegation no concerns regarding resident incontinence care were revealed during the investigation. A review of documents did not reveal any skin breakdown for R1, or other indications of inadequate incontinence care. This allegation is Unsubstantiated. Based on the evidence obtained during the complaint investigation, the above allegations are UNSUBSTANTIATED, meaning the preponderance of evidence standard was not met. An exit interview was conducted with Risa Jester, Executive Director ; a copy of this report and Licensee's Rights (LIC9058) were provided.

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection. The LPA introduced himself and disclosed the purpose of the visit to Cognitive Enrichment Director Alycia Prichard. The facility was licensed for a capacity of fifty two (52) non-ambulatory residents, of which eight (8) may be bedridden. The facility also had a hospice waiver approved for twelve (12) residents, and approved delayed egress throughout the facility. The LPA, accompanied by staff, toured the interior and exterior of the facility. The facility was clean, sanitary, and in good repair. Pathways were free of obstructions and slip hazards. Bedrooms contained the required furnishing and lighting was observed throughout. The signal/call buttons and delayed egress was tested and observed to be operational. 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. The were no toxic chemicals accessible to residents and medications were labeled and locked No pools, nor bodies of water were observed on the premises. Per staff, no firearms nor ammunition were kept at the facility. Fire extinguisher(s) were present. Required licensing postings were observed in visible areas of the facility. The LPA conducted interviews and reviewed facility records. No deficiencies were cited during today's annual inspection. An exit interview was conducted with Cognitive Enrichment Director Alycia Prichard, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058), were provided.

Licensing Program Analyst (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 Director Risa Bishop, after identifying herself and stating the purpose of the inspection. The facility serves 52 non-ambulatory residents, age 60 and above, of which 8 may be bedridden. There is an approved Hospice Waiver for 12 residents. This is a two-story complex, equipped with delayed egress and secured perimeters. LPA was accompanied Director Bishop during a tour of the facility. Tour was conducted inside and out and included a sample of resident units, the dining area, recreation rooms, and food storage areas. The last disaster drill was conducted on December 21, 2023. No bodies of water are on premises. Passageways were free from obstructions. According to Director Bishop, there are no weapons and/or ammunition stored on the premises. Signal Systems was available in each resident unit and LPA observed functionality of said system. Delayed Egress and secured perimeter doors were also tested for functionality. Resident's room temperatures were within a comfortable range. Each resident had clean and sufficient bed linens. All extra linens, towels, and washcloth inventory was kept in each resident’s room. All residents’ rooms were equipped with required furnishings. Lighting was present in the bedrooms. Residents’ bathrooms were observed to be sanitary and operational. Toilets and showers were equipped with grab bars. Hot water temperature in residents’ bathrooms were compliant. [CONTINUED ON LIC 809-C] 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 [CONTINUED FROM LIC 809] Facility has a two-day supply of perishable food and a seven-day supply of nonperishable food items. Food supply is replenished frequently by outside vendors. Food was observed to be properly stored and labeled. Food menus and activities schedule were posted. Chemicals and cleaning supplies were stored in a locked closet and outside storage area. The medication room is secured and has a locked medication cart, emergency supplies, and medications were labeled and kept in compliance with label instructions. Staff records review verified that all staff records were complete and compliant. Staff records review verified that all staff have a current First Aid certificate and at least one staff member, per shift, has a First Aide/CPR certificate. 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 interviews with Director Bishop confirm residences are provided with assistance necessary for medical and dental appointments. LPA reviewed the theft and loss policy and procedures. No deficiencies were cited at the time of visit. LPA observed that residents were being treated with dignity by staff, and there were sufficient staff on duty to meet resident’s needs. An exit interview was conducted, this report was discussed with Director Bishop, a copy along with Licensee/Appeal Rights (LIC 9058 01/2106), and their signature on this form acknowledges receipt and a copy of the report was given to the Director Bishop.