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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 277209241
Report Date: 07/30/2025
Date Signed: 07/31/2025 10:44:28 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/09/2025 and conducted by Evaluator Vadim Gorban
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20250509160506
FACILITY NAME:PACIFIC GROVE SENIOR LIVINGFACILITY NUMBER:
277209241
ADMINISTRATOR:JESSICA SANCHEZFACILITY TYPE:
741
ADDRESS:551 GIBSON AVENUETELEPHONE:
(831) 657-5200
CITY:PACIFIC GROVESTATE: CAZIP CODE:
93950
CAPACITY:150CENSUS: 75DATE:
07/30/2025
UNANNOUNCEDTIME BEGAN:
11:11 AM
MET WITH:administrator Jessica SanchezTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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9
Licensee does not ensure that a qualified administrator is present at the facility
Licensee does not ensure enough staff are available to meet resident needs during meal times
INVESTIGATION FINDINGS:
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2
3
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5
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13
On 07/30/2025, Licensing Program Analyst (LPA) V. Gorban arrived unannounced to deliver findings on a complaint investigation. LPA explained the purpose of the visit to administrator Jessica Sanchez.
During the course of the investigation, LPA conducted a facility tour, conducted interviews, and reviewed records.
The Department has investigated the allegation: Licensee does not ensure that a qualified administrator is present at the facility. Based on interviews and records review, when the Administrator is not in the facility, there is a designated substitute who is responsible and accountable for the management of the facility, therefore the allegation is UNSUBSTANTIATED.
The department has investigated the allegation: Licensee does not ensure enough staff are available to meet resident needs during mealtimes. Based on observations, interviews conducted, and records review, there are two staff members present during each shift that are available to serve meals in the dining area to residents in care, therefore the allegation is UNSUBSTANTIATED.
No deficiencies issued.
Exit interview conducted. Report signed on-site, copy of this report provided to administrator.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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