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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604441
Report Date: 05/14/2026
Date Signed: 05/14/2026 05:22:15 PM

Unsubstantiated


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
05/13/2026 and conducted by Evaluator Dang Nguyen
COMPLAINT CONTROL NUMBER: 08-AS-20260513163917
FACILITY NAME:MONTE VISTA VILLAGE SENIOR LIVINGFACILITY NUMBER:
374604441
ADMINISTRATOR:ADRIAN GUILLENFACILITY TYPE:
740
ADDRESS:2211 MASSACHUSETTS AVENUETELEPHONE:
(619) 465-1331
CITY:LEMON GROVESTATE: CAZIP CODE:
91945
CAPACITY:219CENSUS: 115DATE:
05/14/2026
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Executive Director Adrian GuillenTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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-Licensee unlawfully evicted resident.
-Licensee did not refund full amount owed to resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to commence a Complaint Investigation regarding the above allegations. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Executive Director Adrian Guillen.

The Complainant alleged that Licensee unlawfully evicted Resident #1 (R1), and that Licensee did not refund the full amount of money owed to R1. [See LIC 811 Confidential Names List for a description of select person identifiers used in this report.] CCLD’s investigation involved an unannounced facility tour/welfare check and interviews of pertinent facility staff and outside sources. The Department also reviewed R1’s facility admissions agreement, billing ledger, and written correspondence.

The Complainant said that R1, who was receiving treatment at an offsite skilled-nursing facility, was not allowed to return to their room at Monte Vista Village Senior Living, per a 04/24/2026 conversation that facility manager Staff #1 (S1) had with R1’s responsible person (RP). [CONTINUED ON LIC 9099-C]
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026
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 2
Control Number 08-AS-20260513163917
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: MONTE VISTA VILLAGE SENIOR LIVING
FACILITY NUMBER: 374604441
VISIT DATE: 05/14/2026
NARRATIVE
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[CONTINUED FROM LIC 9099] The Complainant also said R1 was owed a refund of prepaid rent fees from 04/25/2026 through 05/31/2026, but Licensee agreed to only refund RP/R1 for the prepaid rent fees from 05/04/2026 though 05/31/2026.

However, in their own interview, S1 presented a different account of their conversation with the RP. S1 said they advised the RP that additional costs (related to increased care) would be necessarily charged upon R1’s return, in spite of the RP’s protest that they could not afford the increased fees; S1 said R1 was never expressly prohibited from returning to their room at the facility. LPA also interviewed other two other facility managers plus a credible third-party/outside source, all who interacted with both S1 and RP during this time period. These interviews and the available written correspondence more showed that the RP chose for R1 to not return to the facility due to the anticipation of increased costs which were not financially sustainable, rather than R1 being prohibited by S1 from returning to their room at the facility.

Per the facility's admissions agreement contract: Licensee reserves the right to reassess a resident upon any observed change in condition, and to immediately charge the care level (according to the disclosed schedule of fees) that the resident requires for their safety. Also, billing ends only after a resident has fully moved out, which is defined as both the resident departing and also vacating their room of personal property.

Interviews of all parties unanimously showed: The RP had prepaid R1’s rent through 05/31/2026, and that the RP in practice fully-vacated R1’s room of personal belongings on 05/03/2026. R1 is thus owed a prorated refund of $2,619.35, which Licensee has agreed to issue. Per regulation, RCFE licensees have up to “15 days after the personal property is removed” to refund owed prepaid rent following a move out (which in this case comes out to 05/18/2026). As of the commencement of CCLD’s investigation, Licensee was still in compliance with this deadline.

Based on records and interviews, a preponderance of evidence did not exist to show that Licensee unlawfully evicted R1, or that Licensee did not refund the full amount of money owed to R1. Both allegations are therefore Unsubstantiated, and no deficiencies were cited for them.

An exit interview was conducted with Executive Director Adrian Gullien, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026
LIC9099 (FAS) - (06/04)
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