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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435202100
Report Date: 03/06/2025
Date Signed: 03/06/2025 01:16:03 PM

Document Has Been Signed on 03/06/2025 01:16 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:MASTEN CARE HOMEFACILITY NUMBER:
435202100
ADMINISTRATOR/
DIRECTOR:		JHANELLE GUICOFACILITY TYPE:
735
ADDRESS:375 FITZGERALD AVE.TELEPHONE:
(408) 846-8985
CITY:SAN MARTINSTATE: CAZIP CODE:
95046
CAPACITY: 6CENSUS: 5DATE:
03/06/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:10 PM
MET WITH:Jhanelle GuicoTIME VISIT/
INSPECTION COMPLETED:
01:20 PM
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Licensing Program Analyst (LPA) Christine Kabariti arrived at the facility unannounced to conduct a case management – other visit. LPA met with Administrator Jhanelle Guico.

The purpose of the visit is to hand deliver an immediate exclusion letter for a staff member (S1) who the Department determined engaged in conduct inimical.

The immediate exclusion letter for S1 was handed to the Administrator.

Administrator confirmed S1 does not currently work for the facility. The Administrator was informed to remove S1 from any contact with clients and not allow S1 to be physically present in the facility.

LPA advised to separate S1 from the facility roster.

No deficiencies were cited per California Code of Regulations, Title 22.

This report was reviewed with Administrator Jhanelle Guico and a copy of the report was provided.
SUPERVISORS NAME: Jackie Jin
LICENSING EVALUATOR NAME: Christine Kabariti
LICENSING EVALUATOR SIGNATURE: DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2025
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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