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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604101
Report Date: 03/18/2025
Date Signed: 03/19/2025 07:11:57 AM

Document Has Been Signed on 03/19/2025 07:11 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:MONTON RESIDENTIAL FACILITY INCFACILITY NUMBER:
374604101
ADMINISTRATOR/
DIRECTOR:		MONTON, LOIDAFACILITY TYPE:
735
ADDRESS:12323 JULIAN AVETELEPHONE:
(619) 749-4130
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY: 6CENSUS: 4DATE:
03/18/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Licensee MontonTIME VISIT/
INSPECTION COMPLETED:
03:50 PM
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Licensing Program Analyst (LPA) Correia conducted an unannounced required Annual Inspection. The facility file was reviewed prior to the visit. LPA Correia identified herself, was granted entry by Assistant Administrator/Caregiver Erlinda Samiano. LPA discussed the purpose of the visit with Assistant Administrator/Caregiver Samiano. Licensee Loida Monton later arrived and joined the visit.

According to the facility’s license, there may be a maximum of six (6) clients all of whom may be ambulatory, of which four (4) may be non-ambulatory in at any given time at the facility site. During today’s inspection, the facility’s current census is four (4) clients. There were two (2) clients present at the facility site during the inspection.

LPA, accompanied by Licensee Monton, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and activities.

The facility’s ambient internal temperature was comfortable and compliant, at 69 degrees Fahrenheit (F). Hot water temperature at taps used by clients measured between 106.3 and 110.0 degrees F. There was at least 2 days of perishable food, and at least 7 days of non-perishable food present. Cooking/dining equipment and utensils were present, and all safely stored. There were no toxic chemicals/poisons accessible to clients. Medications were properly labeled, as required, and stored in a locked cabinet in the kitchen. The facility maintained Medication Administration Records (MARs) for client medications, that were complete and accurate. The facility’s last disaster drill was on March 2, 2025, and are held monthly.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: MONTON RESIDENTIAL FACILITY INC
FACILITY NUMBER: 374604101
VISIT DATE: 03/18/2025
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[CONTINUED FROM LIC 809]

No pools or bodies of water were observed on the premises. Per Licensee Monton, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and the facility’s telephone were all working. Fire extinguisher(s) were present (01) and was last serviced on February 21, 2025. A First Aid kit and manual were complete and readily accessible. The facility's liability insurance was current, and the facility maintains a Surety Bond. Personal and Incidentals (P&I) funds for clients were appropriately documented and accurate. Staff and client records were complete and current.

During today's visit there were no deficiencies cited. An exit interview was conducted with Licensee Loida Monton to whom a copy of this report along with the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit. The signature below confirms the documents were received.

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2025
LIC809 (FAS) - (06/04)
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