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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 277209241
Report Date: 03/20/2026
Date Signed: 03/20/2026 08:53:47 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
09/16/2025 and conducted by Evaluator Vadim Gorban
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20250916085905
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: 86DATE:
03/20/2026
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:administrator Jessica SanchezTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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9
Staff do not ensure kitchen is cleaned properly
Staff do not ensure food is at proper temperature
INVESTIGATION FINDINGS:
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2
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7
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9
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13
On 03/20/2026, Licensing Program Analyst (LPA) V Gorban visited the facility regarding complaint investigation and deliver findings. LPA met with administrator and explain the purpose of the visit.

During multiple visits of this complaint investigation, LPA conducted a tour of the facility, interior and exterior to ensure there is no potential or immediate health and safety risk at the facility, documents were reviewed, interviews conducted, and information gathered.
Allegation: Staff do not ensure kitchen is cleaned properly and Staff do not ensure food is at proper temperature. Based on observation during facility visits on 09/16/ and 12/30/25 LPA interviewed staff, administrator, and residents which revealed the above allegation is Unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or disprove that the allegations occurred.
Exit interview conducted, report signed and copy of this report provided to administrator for facility records.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2026
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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