Rancho Penasquitos Senior Living.

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced Case Management Visit.  LPA was greeted by and met with Executive Director Heather Myers to discuss the purpose of the visit. Today's visit is in response to the facility's self report regarding memory care Resident 1 (R1) becoming lost on a hike after being signed out of the facility by a friend. LPA collected records, conducted interviews and health and safety check for R1. Interviews and records revealed that Law enforcement and facility staff arrived on scene to search for R1 and R1's family was notified. R1 was found by law enforcement approximately 3.5 hours after R1 was identified to be missing. R1 was assessed by paramedics and placed on 48 hour alert charting for monitoring. R1 did not suffer any injuries from the incident. The facility consulted R1's family and friend regarding R1 leaving the facility. Training is to be provided to the friend for future visits, including when R1 is signed out of the facility. Additionally, R1 will be provided with a location tracker to monitor their location when away from the facility. Executive Director will provide information regarding the training provided to R1's friend, as well as any updated procedures for when R1 leaves the facility. No health or safety issues were identified. No deficiencies were cited or observed on this date. An exit interview was conducted with Executive Director Heather Myers, who was provided with a copy of this report and Appeal Rights (LIC9056 03/22). Their signature confirms receipt of these documents.

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced Plan of Correction (POC) visit regarding a deficiency that was cited on December 23rd, 2025. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Receptionist Hayley Josten, Memory Care Director Cristina Coronado, and Executive Director Heather Myers. On 12/23/25 LPA cited a deficiency for not meeting reporting requirement timelines. The POC due date was set for January 5th, 2026. Licensee designated representative sent LPA an email 1/7/26 notifying LPA that POC would be submitted the following day, 1/8/26. Licensee submitted proof of correction to LPA via email on 1/8/26, and POC was cleared. Licensee 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 1/6/26 to 1/8/26 for a total of $300.00. An exit interview was conducted with Executive Director Myers 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.

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced Case Management visit to follow up on an incident reported to Community Care Licensing. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Memory Care Director Cristina Coronado. Executive Director (ED) Heather Myers arrived later during the visit. Community Care Licensing received an Incident Report on 12/22/25 in which it was reported that on 12/9/25, a Resident (identified as R1), fell out of their wheelchair due to uneven concrete when being assisted by a staff member down a ramp at the facility. Per the report, the resident hit their knees and head on the ground. Emergency services were contacted and resident was transported to the hospital where no injuries were found. Per the report, resident returned to the facility with no new orders. R1's responsible party and primary care physician were notified. During today's visit, LPA conducted interviews and file review. Additionally, LPA attempted to conduct a health and safety visit with R1, however R1 was being assisted by staff. LPA attempted again later during the visit, but R1 was attending lunch and LPA did not want to disturb their meal. Due to time constraints, LPA was unable to complete a determination regarding this case management visit, and additional visits may be necessary to complete review of this incident. At this time, LPA observed no health and/or safety concerns and no deficiencies were cited during today's visit. An exit interview was conducted with ED Myers to whom a copy of this report was provided. Their signature below confirms receipt of this document.

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced Case Management visit to follow up on an incident reported to Community Care Licensing. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Business Office Manager Kamryn Finchum. Community Care Licensing received an Incident Report on 5/19/25 in which it was reported that Resident #1 (R1) was found unresponsive by care staff while sitting out in the patio area of the facility. Per the report, other residents present at the time stated R1 was out there for about an hour. Emergency services were contacted and R1 was taken to the hospital where they were treated for heat exhaustion. R1's Responsible Party (RP) and Primary Care Physician (PCP) were notified. During today's visit, LPA conducted file review, a health and safety visit with R1, and provided consultation with Business Office Manager Finchum. No Deficiencies were cited during the visit. An exit interview was conducted with Business Office Manager Finchum to whom a copy of this report was provided. Their signature below confirms receipt of this document.

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Continuation Annual Inspection visit. The LPA introduced himself and disclosed the purpose of the visit to Business Office Manager Jenny Flores. The facility was licensed for a capacity of one hundred twenty (120) non-ambulatory residents, of which ten (10) may be bedridden. The facility also had an approved hospice care waiver for fifteen (15) residents, and the facility's first floor was approved for delayed egress. During today's visit the LPA conducted interviews and reviewed facility records. There were no deficiencies cited on today's date. An exit interview was conducted with Flores, to whom a copy of this report, and Licensee Rights (LIC 9058), were provided via email. An email read receipt confirms the documents were received by Flores.

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection visit. The LPA introduced himself and disclosed the purpose of the visit to Executive Director Wes Hebner. Maintenance Director Mathew Gomez and Business Office Manager Jenny Flores assisted the LPA during visit. The facility was licensed for a capacity of one hundred twenty (120) non-ambulatory residents, of which ten (10) may be bedridden. The facility also had an approved hospice care waiver for fifteen (15) residents, and the facility's first floor was approved for delayed egress. During today's visit, the LPA conducted a tour of the interior and exterior of the facility. The facility was clean sanitary and in good repair. Resident bedrooms contained the required furnishings, and the call pendants/signal system tested were operational. Faucets tested delivered water within the required range. Carbon monoxide detectors were tested at random and were also operational. 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. All pathways were free of obstructions and slip hazards. Review of facility records was initiated, but due to time constraints, an additional visit on a subsequent day in necessary to complete the annual inspection. An exit interview was conducted with Executive Director Wes Hebner, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058), were provided via email. An email read receipt confirms the documents were received by the Executive Director.

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 Executive Director Austin Irwin, identifying herself and stating the purpose of the inspection. This facility serves one-hundred twenty non-ambulatory residents, 60 and above. Approved for Hospice waiver for 15. First floor is approved for delayed egress. A tour of the facility was conducted which included a sample of resident units, the dining area, recreation rooms, and food storage areas. This a three story building with three courtyards on the property. There are no water features on the property. Each resident had clean and sufficient bed linens. 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 and non-skid mats. Hot water temperature in residents’ bathrooms were compliant. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. The facility is operating in accordance with their fire clearance. First aid kit(s) were complete and readily accessible in the medication room. Required licensing postings were observed in visible areas of the facility. PPE supplies are onsite. Passageways were free from obstructions. [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. The food service area was observed to be neat and clean. Food menus and activities schedule were posted. Chemicals and cleaning supplies were stored in a locked closed area not assessable to residents. Centrally stored medications were properly stored and locked in medication carts and cabinets. Medication logs and medications reviewed were current and medications appear to be administered according to the label instructions. Staff records review verified that all staff records were complete and compliant. 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 Irwin and was assured transportation procedures as well as outside medical and dental assistance procedure are compliant. There are two designated activity areas used for such activities as exercise, game activities, arts/crafts, and current events. There are also gathering areas throughout the facility. At the time of visit, LPA observed one large group activities in which many residents were participating. 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 issued at the time of visit. An exit interview was conducted with Executive Director Austin Irwin to whom copies of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit.

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Case Management - Incident visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Executive Director Austin Irwin. Today's visit was in response to an LIC624 Incident Report, which licensee self-submitted to the CCLD San Diego Regional Office (received on 11/10/2023), involving Resident #1 (R1) on 11/06/2023. [See LIC 811 Confidential Names List for a description of person identifiers used in this report]. During today’s visit, LPA performed a brief facility tour and welfare check, verifying that R1 was safe. LPA reviewed and collected copies of pertinent care records. LPA also interviewed R1 and relevant staff. No deficiencies were observed or cited during today's visit. An exit interview was conducted with Irwin, to whom a copy of this report, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.

Licensing Program Analyst (LPA) Riza Alvarez conducted an unannounced Case Management visit. LPA identified herself and was welcomed by Concierge staff Kimberly Rios, with whom the purpose of the visit was discussed. Rios called Memory Care Unit and staff Karinna Acosta met with LPA. LPA informed Acosta that today's visit was in response to an LIC624 Incident Report dated 08/08/2023 submitted by the facility and received by CCLD on 08/09/2023. According to the LIC624: on 08/07/2023, the courtyard door alarm went off. Facility staff initiated a head count. A systematic search of the outside property was performed. Resident #1 (R1) was found walking on the street curb, was redirected back into the facility with no visible injuries noted. [See LIC 811 Confidential Names List for a description of R1.] Facility staff notified R1's physician and daughter. According to R1’s latest LIC602 Physician’s Report signed and dated 09/15/2022: R1's primary diagnosis is Alzheimer's, Dementia. R1's mental condition indicates wandering behavior, sundowning behavior, but is able to follow instructions and communicate needs. There is no confusion, inappropriate or aggressive behavior. Physician determined that R1 has severe/advance Dementia, and should be escorted by staff when leaving the facility. R1's Narrative Charting (7/27 - 8/9): 8/7 1:43 PM - R1 was found on the street, care staff (Staff #1 [S1]) assisted resident back into the facility. No visible injuries noted and denies pain. Primary physician and daughter notified. 8/7 8:09 PM - R1 doing good until around 6:00 PM when R1 tried to open doors again around the patio. R1 was successfully redirected. R1's daughter visited later that evening. No issues reported since 8/8. R1 is scheduled for re-assessment today, 8/9. [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] LPA visited R1 at the Memory Care Unit's dining area, where R1 was having breakfast. R1 responded appropriately to LPA's greetings and question - "is the breakfast good?" R1 was in good physical condition, well groomed, and appeared to be enjoying breakfast in the company of other residents. LPA interviewed S1. S1 found R1 sitting on a street curb approximately 20 (uphill) steps from the exit door. LPA performed a brief facility tour with S1. S1 stated that on 8/7, lunch was served at 12:10 PM. Residents like to take their time while dining. There were 3 exit doors from the dining area, but only one exit door (courtyard) leads to the street. When S1 found R1, R1 said "Hi". Per S1, from R1's facial expression, R1 appeared to know that they did something they should not have. R1 is a sweet person. Memory Care Director Giovanni Arguello arrived at the facility at around 9:45 AM and showed LPA the facility's Absentee Notification Plan (Clinical 10 - Elopement dated 06/18/2021). The Elopement Plan provides “Should an elopement occur, an immediate systemic search of the property and surrounding neighborhood will take place. The responsible party shall be notified. a) Law enforcement will be notified of the elopement within 30 minutes, should the resident not be located. b) Once the resident is located, the resident's family/responsible party shall be notified, and the resident shall receive a physical examination and physician consult. c) The elopement will be documented. d) The resident will be reevaluated to determine if the resident is appropriate to be retained in the Community, and if so, Service Plan adjustments should be immediately undertaken to prevent further elopements." There does not exist a preponderance of evidence to show that facility staff did not provide needed care and supervision of R1, or that facility staff did not try to mitigate R1's AWOL (Absence With Out Leave), or that facility staff did not follow the facility’s Elopement Plan. No deficiencies were cited for the above incident, and no deficiencies were observed during today’s site visit. An exit interview was conducted with Memory Care Unit Director Giovanni Arguello, to whom a copy of this report, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit.

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to the facility to conduct a Plan of Correct (POC) visit to confirm that a citation which was issued on 04/28/2023 has been corrected. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Resident Services Coordinator Giovanni Arguello and Maintenance Director Singh "Andy" Wong. The following citations were reviewed during today's visit: 87303(i)(1)(A) Maintenance and Operation : On 06/22/2023, Licensee E-mailed LPA to inform him that the signal devices in the memory care unit were operational and ready to be inspected, meeting the POC deadline. On 07/06/2023, LPA inspected and tested these devices during a site visit, finding them satisfactory. No new deficiencies were identified or cited during today's visit. An exit interview was conducted with Arguello, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.