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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 507202944
Report Date: 05/13/2025
Date Signed: 05/13/2025 12:37:55 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/06/2025 and conducted by Evaluator Arielle Pascua
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250506142627
FACILITY NAME:TOJINO GUEST HOMEFACILITY NUMBER:
507202944
ADMINISTRATOR:TOJINO, MARISAFACILITY TYPE:
735
ADDRESS:2516 MANOR OAKTELEPHONE:
(209) 765-9735
CITY:MODESTOSTATE: CAZIP CODE:
95355
CAPACITY:6CENSUS: 5DATE:
05/13/2025
UNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Marisa Tojino TIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not keeping an accurate record of personal property for clients
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 05/13/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived unannouced to this facility to conduct a complaint visit. LPA met with Facility Designated Administrator (FDA), Marisa Tojino and explained the purpose of the visit. The purpose of the visit was to inform the facility and its representative that a complaint has been filed against it at this time.

Current Census was 5. 4 out 5 residents were out of their respective day program at this time.

During the course of this investigation reviewed (5) resident files to review for completed inventory sheets. Based reviews of all resident records, it was observed that 5 out 5 resident files had inventory sheets upon admission and dated at the appropriate time. In addition, LPA reviewed 5 resident Personal and Incidental Funds, which show an accurate and updated record of the residents funds at this time.
Based on the information gathered, there is not sufficient evidence to prove that the staff are not keeping an accurate record of personal property for the residents in care.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Arielle Pascua
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025
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 27-AS-20250506142627
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: TOJINO GUEST HOME
FACILITY NUMBER: 507202944
VISIT DATE: 05/13/2025
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: Lisa Rios
LICENSING EVALUATOR NAME: Arielle Pascua
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2