<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 134604528
Report Date: 05/21/2026
Date Signed: 05/21/2026 04:55:51 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/24/2025 and conducted by Evaluator David Roman
COMPLAINT CONTROL NUMBER: 08-AS-20250624144211
FACILITY NAME:SUNSET VILLA ASSISTED LIVINGFACILITY NUMBER:
134604528
ADMINISTRATOR:GARCIA, SIKLALICFACILITY TYPE:
740
ADDRESS:1203 DRIFTWOOD DRIVETELEPHONE:
(760) 592-4001
CITY:EL CENTROSTATE: CAZIP CODE:
92243
CAPACITY:12CENSUS: 0DATE:
05/21/2026
UNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Quetzali KhanisTIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not provide assistance to resident in care resulting in a fall.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) David Roman conducted a phone call contact to deliver findings in the above complaint allegation to the Licensee, Quetzalli Kahnis. LPA identified himself and discussed the purpose of the call with Facility Licensee, Quetzalli Kahnis.

On June 24, 2025, Community Care Licensing Division (CCLD) received a complaint alleging facility staff did not provide assistance to resident in care resulting in a fall. During the investigation, LPA D. Roman reviewed pertinent facility records, conducted interviews with residents, staff, and outside sources. Resident interviews revealed contradicting information regarding the ratio of staff at the facility. Staff interviews revealed that the facility was understaffed. Caregivers reported multiple incidents in which their ratio was (1) one staff caring for (12) twelve residents for at least two hours.

(Cont. on LIC9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: David Roman
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 08-AS-20250624144211
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SUNSET VILLA ASSISTED LIVING
FACILITY NUMBER: 134604528
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/21/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/21/2026
Section Cited
CCR
87411(a)
1
2
3
4
5
6
7
87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs.
1
2
3
4
5
6
7
The facility has been closed as of 12/05/2025.
8
9
10
11
12
13
14
 This regulation was not met as evidenced by LPA record review, observations and interviews. Licensee did not meet staffing regulations which threatened the physical, emotional or health & safety of 12 of 12 residents in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: David Roman
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20250624144211
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: SUNSET VILLA ASSISTED LIVING
FACILITY NUMBER: 134604528
VISIT DATE: 05/21/2026
NARRATIVE
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
Based on the evidence obtained, the preponderance of evidence standard was met, therefore, the allegation was Substantiated. The deficiency is cited in accordance with California Code of Regulations, Title 22, Division 6, Chapter 8 and is noted on the attached LIC 9099-D.

An exit interview was conducted with Facility Licensee, Quetzalli Kahnis, to whom a copy of this report and Licensee/Appeals Rights (LIC 9058) were provided via email.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: David Roman
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3