<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 445202356
Report Date: 02/02/2025
Date Signed: 03/16/2025 11:09:28 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
Lookup Error,
, CA
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/23/2024 and conducted by Evaluator Arielle Pascua
PUBLIC
COMPLAINT CONTROL NUMBER: 26-AS-20241123104336
FACILITY NAME:MONTECITO MANORFACILITY NUMBER:
445202356
ADMINISTRATOR:JOLENE SICLEYFACILITY TYPE:
740
ADDRESS:311 MONTECITO AVE.TELEPHONE:
(831) 724-3055
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:85CENSUS: 53DATE:
02/02/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Ivonne Sanchez TIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff inappropriately touched resident in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 02/02/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct a complaint visit. LPA met with Facility Designated Administrator (FDA), Ivonne Sanchez and explained the purpose of the visit. The purpose of this visit was to deliver complaint findings for the allegations above.
Current census was 53. A brief interview with FDR Sanchez was conducted.
It was alleged that facility staff inappropriately touched resident in care. During the course of this investigation, LPA conducted interviews and reviewed facilty records. Based on interviews conducted it was denied by 4 out 4 staff members that they have seen or inappropriately touched a resident in care. It was also learned through interviews that it was alleged that a male inappropriately touched a resident. However it was learned through facility records that the facility does not have any staff members who are male at this time. In addition, an interview with 8 residents were conducted who deny that they have been inappropriately touched by a staff member.
Based on the information gathered it is unclear if a staff member inappropriately touched a resident in care.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Arielle Pascua
LICENSING EVALUATOR SIGNATURE:

DATE: 02/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2025
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 26-AS-20241123104336
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
Lookup Error,
, CA
FACILITY NAME: MONTECITO MANOR
FACILITY NUMBER: 445202356
VISIT DATE: 02/02/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
As a result of this investigation, this Department found the allegations to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegations may have happened or was valid, there was not a preponderance of the evidence to prove that the alleged violation occurred.

There were no deficiencies observed or cited at this time. An exit interview was conducted, a copy of the 9099 and 9099-C was provided to the facility.

SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Arielle Pascua
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2