507203017-3-20-2026-27-AS-LRIS-DSXV57-20260408160729

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 507203017
Report Date: 03/16/2026
Date Signed: 03/20/2026 09:54:04 AM

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
11/03/2025 and conducted by Evaluator Jason Lund

COMPLAINT CONTROL NUMBER: 27-AS-20251103082943

FACILITY NAME:	MODESTO RESIDENTIAL LIVING CENTER, LLC		FACILITY NUMBER:	507203017
ADMINISTRATOR:	PATRICIA A CALLA		FACILITY TYPE:	735
ADDRESS:	1932 EVERGREEN AVE		TELEPHONE:	(209) 530-9300
CITY:	MODESTO	STATE: CA	ZIP CODE:	95350
CAPACITY:	100	CENSUS: 78	DATE:	03/16/2026
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Assistant Administrator Lionel Bazan		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Illegal eviction
Staff did not ensure residents personal property was safely secured
Staff physically abused residents
Staff did not speak to resident in an appropriate manner

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 Assistant Administrator Lionel Bazan and explained the reason for the visit. Census: 78

Illegal eviction-LPA Lund reviewed facility records and interviewed staff, Based on interviews with staff, and reviewed paperwork Client (C1) willing left the facility and moved to a facility in San Francisco. C1’s placement team in San Francisco discharged C1 from Modesto Residential on 6/1/2025.

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2026

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 3

Control Number 27-AS-20251103082943

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: 03/16/2026

NARRATIVE

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Based on interviews with staff and facility records on the information provided, it was unclear if there was a Illegal eviction, therefore the allegation was deemed UNSUBSTANTIATED.

Staff did not ensure residents personal property was safely secured- LPA Lund reviewed facility records, interviewed staff and clients in care. Based on facility records, interviews with staff and clients in care. All client fill out a Client/Resident personal property and valuables (LIC621) when they are admitted to the facility. Clients update the form as needed while staying at the facility. Clients interviewed stated that their property is secure in their rooms and if something comes up missing staff help them try to find it. Staff stated if something comes up missing staff try to help the client find what is missing.

Based on facility paperwork, interviews with staff and clients in care on the information provided, it was unclear if staff did not ensure residents personal property was safely secured, therefore the allegation was deemed UNSUBSTANTIATED.

Staff physically abused residents- LPA Lund reviewed facility paperwork, interviewed staff and clients in care. Based on reviewed paperwork, interviews with staff, and clients in care. All facility staff have training on universal training, reporting requirements and verbal de-escalation training before working with clients in care. Staff interviewed stated that they would report to management immediately if they saw staff get physical with a client in care. Interviewed clients in care stated they have never been physically abused by staff.

Based facility paperwork, interviews with staff and clients in care on the information provided, it was unclear if staff physically abused residents, therefore the allegation was deemed UNSUBSTANTIATED.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2026

LIC9099 (FAS) - (06/04)

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Control Number 27-AS-20251103082943

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: 03/16/2026

NARRATIVE

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Staff did not speak to resident in an appropriate manner- LPA Lund reviewed facility paperwork, interviewed staff and clients in care. Based on reviewed paperwork, interviews with staff, and clients in care. All facility staff have training on universal training, reporting requirements and verbal de-escalation training before working with clients in care. Staff interviewed stated that they would report to management immediately if seen staff speak in appropriate to clients in care. Interviewed clients in care stated they have never been spoken inappropriate while at the facility.

Based on facility paperwork, interviews with staff and clients in care on the information provided, it was unclear if staff did not speak to resident in an appropriate manner, 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: 03/16/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2026

LIC9099 (FAS) - (06/04)

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