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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603237
Report Date: 05/26/2026
Date Signed: 06/04/2026 11:02:49 AM

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
09/05/2025 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20250905085135
FACILITY NAME:ROXIES ELDERLY HOMES IIFACILITY NUMBER:
374603237
ADMINISTRATOR:TERESITA ROXASFACILITY TYPE:
740
ADDRESS:4560 VINYARD STREETTELEPHONE:
(442) 266-2939
CITY:OCEANSIDESTATE: CAZIP CODE:
92057
CAPACITY:6CENSUS: 6DATE:
05/26/2026
UNANNOUNCEDTIME BEGAN:
10:41 AM
MET WITH:Teresita Roxas, AdministratorTIME COMPLETED:
11:10 AM
ALLEGATION(S):
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Staff did not treat resident with dignity
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA)Tiffany Holmes conducted an unannounced complaint visit to the facility to close out a complaint on the above-mentioned allegation. LPA gained access to the facility, identified herself, and met with Teresita Roxas, Administrator to discuss the purpose of the visit.

LPA conducted conducted a tour of the facility, and conducted interviews. It was alleged that staff did not treat resident with dignity. Interviews revealed the staff members at the facility are wonderful and nice, however, there was an interview that revealed sometimes the owner says things like "there's the door" or "you can get out" Other interviews revealed that there are 3 staff members and that they are hard workers and treat the residents well. Interviews also revealed that the facility owner is very curt and won't greet residents or respond when they greet the owner.

Based on the evidence obtained from interviews, the complaint allegation is substantiated. A substantiated finding means the allegation is valid because the preponderance of the evidence standard has been met.

A deficiency is cited per Title 22 California Code of Regulation on the 9099 D page. An exit interview was conducted with Teresita Roxas, Administrator and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) was provided at the conclusion of the visit.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2026
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
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
09/05/2025 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20250905085135

FACILITY NAME:ROXIES ELDERLY HOMES IIFACILITY NUMBER:
374603237
ADMINISTRATOR:TERESITA ROXASFACILITY TYPE:
740
ADDRESS:4560 VINYARD STREETTELEPHONE:
(442) 266-2939
CITY:OCEANSIDESTATE: CAZIP CODE:
92057
CAPACITY:6CENSUS: 6DATE:
05/26/2026
UNANNOUNCEDTIME BEGAN:
10:41 AM
MET WITH:Teresita Roxas, AdministratorTIME COMPLETED:
11:10 AM
ALLEGATION(S):
1
2
3
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9
Meals did not meet residents needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA)Tiffany Holmes conducted an unannounced complaint visit to the facility to close out a complaint on the above-mentioned allegation. LPA gained access to the facility, identified herself, and met with Teresita Roxas, Administrator to discuss the purpose of the visit.

LPA conducted conducted a tour of the facility, and conducted interviews. It was alleged that meals did not meet residents needs. Some interviews revealed there are residents that don't like the food that is being served at the facility. Interviews revealed the food is "not that good". Other interviews revealed that the food is different everyday and the portions are of good size. One interview revealed there is not enough food cooked at the facility. Other interviews revealed that everyone has different tastes in regards to foods and they have had to adapt to the food at the facility. Interviews revealed that the staff serve food, desserts, juice, and milk. Interviews revealed that if they get hungry at any time, they will ask staff for food and they will give them food.

Based on the evidence obtained from interviews, the complaint allegation is unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Teresita Roxas, Administrator and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) was provided at the conclusion of the visit.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20250905085135
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: ROXIES ELDERLY HOMES II
FACILITY NUMBER: 374603237
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/26/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/12/2026
Section Cited
CCR
87468.1(a)(1)
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87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:(1) To be accorded dignity in their personal relationships with staff, residents, and other persons.
This requirement is not met as evidenced by:
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Licensee will have a training by an outside source on personal rights. POC due to CCL by 06/12/2026. Licensee will provide to LPA documentation of training and sign in sheet for all staff
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Based on interviews, the facility failed to treat 6 out of 6 residents with dignity.(R1-R6)

This poses a potential personal rights violation to the clients in care.

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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: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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