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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 507203017
Report Date: 11/07/2024
Date Signed: 11/07/2024 07:11:42 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
08/21/2024 and conducted by Evaluator Jason Lund
COMPLAINT CONTROL NUMBER: 27-AS-20240821093700
FACILITY NAME:MODESTO RESIDENTIAL LIVING CENTER, LLCFACILITY NUMBER:
507203017
ADMINISTRATOR:DENNIS MONTEROSSOFACILITY TYPE:
735
ADDRESS:1932 EVERGREEN AVETELEPHONE:
(209) 530-9300
CITY:MODESTOSTATE: CAZIP CODE:
95350
CAPACITY:100CENSUS: 85DATE:
11/07/2024
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Administrator Lionel BazanTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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9
Staff opened resident’s mail

Facility does not have an administrator
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jason Lund arrived unannounced to complete a complaint investigation regarding the above allegations. LPA Lund met with Administrator Lionel Bazan. and explained the reason for the visit. Census: 85

Staff opened resident’s mail - LPA Lund interviewed staff, reporting party and residents in care. Based on interviews with staff, reporting party, and residents in care. United States Postal Service mail come into the facility around 1 pm, staff will open mail addressed to Modesto Residential facility only. If a resident receives personal mail, staff will get in contact with that resident and give it to them. Staff interviewed stated that only open the mail that is addressed to Modesto Residential only and do not residents’ mails. Residents interviewed stated that their personal mail in not opened when received from the facility staff.
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
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-20240821093700
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: MODESTO RESIDENTIAL LIVING CENTER, LLC
FACILITY NUMBER: 507203017
VISIT DATE: 11/07/2024
NARRATIVE
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Based on interviews with staff, reporting party and residents in care, on the information provided, it was unclear if staff opened resident’s mail, therefore the allegation was deemed UNSUBSTANTIATED.

Facility does not have an administrator - LPA Lund reviewed facility records, interviewed staff, and reporting party. Administrator Dennis Monterosso Effective Date: 9/23/2022 and Expiration Date 9/22/2024. LPA reviewed facility paper and the facility did have an active administrator during the time of the complaint.

Based on reviewed facility records, interviewed staff, and reporting party, on the information provided, it was unclear if facility does not have an administrator, therefore the allegation was deemed UNSUBSTANTIATED.


As a result of this investigation, this Department finds the allegation to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted and report left.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2