275294322-7-28-2022-24-AS-MHON-CGYKGB-20220804075313

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 275294322
Report Date: 07/28/2022
Date Signed: 07/28/2022 11:03:27 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/27/2022 and conducted by Evaluator Melinda Medina

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20220727154723

FACILITY NAME:	PARK LANE, THE		FACILITY NUMBER:	275294322
ADMINISTRATOR:	MONTELLANO, ANTHONY		FACILITY TYPE:	740
ADDRESS:	200 GLENWOOD CIR		TELEPHONE:	(831) 373-0101
CITY:	MONTEREY	STATE: CA	ZIP CODE:	93940
CAPACITY:	160	CENSUS: 85	DATE:	07/28/2022
		UNANNOUNCED	TIME BEGAN:	09:57 AM
MET WITH:	Anthony Montellano		TIME COMPLETED:	11:01 AM

ALLEGATION(S):

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Staff did not ensure the facility was free from vermin

INVESTIGATION FINDINGS:

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On 7/28/22, Licensing Program Analysts (LPAs) M. Medina and V. Gorban conducted an unannounced initial 10-day complaint visit. LPAs introduced themselves and Administrator was notified. LPAs explained purpose of visit with Administrator, Anthony Montellano. LPAs toured the facility, reviewed and received copies of facility records, and conducted interviews.

Based on record review and interviews conducted, it was determined that the facility has had a continuing problem with vermin however through review of records facility is maintaining pest control service monthly to resolve issue.
Based on interviews and records review, this agency has investigated the complaint alleging staff did not ensure the facility was free from vermin. The Department has found that the complaint was UNFOUNDED, therefore we have dismissed the complaint.

An exit interview was conducted and a copy of this report was provided for facility records.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 341-3247
LICENSING EVALUATOR NAME: Melinda Medina	TELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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