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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700473
Report Date: 12/24/2025
Date Signed: 12/30/2025 01:23:55 PM

Substantiated


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
12/17/2025 and conducted by Evaluator Charlie Yang
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20251217131604
FACILITY NAME:MANTECA RTRMT COM-HAPPY LVNG BY COGIR/COGIR MANTECFACILITY NUMBER:
392700473
ADMINISTRATOR:JAMES HALLFACILITY TYPE:
740
ADDRESS:430 NORTH UNION RDTELEPHONE:
(209) 823-0164
CITY:MANTECASTATE: CAZIP CODE:
95337
CAPACITY:84CENSUS: 71DATE:
12/24/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:James HallTIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not keep the facility free from infestation

Staff are not following proper food handling techniques
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Unannounced complaint visit made out to this facility on 12/24/2025 by Licensing Program Analyst, LPA, Charlie Yang who was met by the facility designated Administrator James Hall. A brief interview was conducted with the facility designated Administrator at this time.
Current census was 71 residents.
The purpose of this visit was to inform this facility, and it's representative, about the findings to this complaint investigation.
Based on forms and documents gathered and reviewed during this investigation, it was learned that there were issues identified with holes and entry points being present in the kitchen area which allowed access points for pests to be able to enter into this area. It was learned that this facility was ordered to fix and repair these access points in the kitchen area in order to deny access and possibly eliminate the presence of possible pests.
Based on forms and documents gathered and reviewed during this investigation, it was learned that there were issues identified with how this facility, and its staff, were handling and storing food products.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 12/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/24/2025
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 3
Control Number 27-AS-20251217131604
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: MANTECA RTRMT COM-HAPPY LVNG BY COGIR/COGIR MANTEC
FACILITY NUMBER: 392700473
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/24/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/29/2025
Section Cited
CCR
87555(b)(9)
1
2
3
4
5
6
7
General Food Service Requirements
Procedures which protect the safety, acceptability and nutritive values of food shall be observed in food storage, preparation and service.
This facility was found to be deficient as evidenced by the presence of food items
1
2
3
4
5
6
7
The facility designated Administrator stated that all food items will always be stored in a proper manner at all times. A statement of correction, along with updated photos of the facility refrigerator/freezer floors will be captured, completed and submitted into CCL by the due date.
8
9
10
11
12
13
14
being stored on the floors of the facility refrigerator and freezer floors which posed an immediate threat to the Health, Safety, and Personal Rights of the residents in care.
8
9
10
11
12
13
14
Type A
12/29/2025
Section Cited
CCR
87555(b)(27)
1
2
3
4
5
6
7
General Food Service Requirements
All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects.
This facility was found to be deficient as evidenced by the presence of holes around the sink areas in the kitchen area posing a immediate threat to the Health, Safety, and
1
2
3
4
5
6
7
The facility designated Administrator stated that all holes in the kitchen area will be repaired/replaced to remove them all in order to prevent access to potential pests and vermin from entering into this facility.
A statement of correction, along with receipts of contracted work, will be completed and
8
9
10
11
12
13
14
Personal Rights of the residents in care.
8
9
10
11
12
13
14
submitted into CCL by the due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 12/24/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/24/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20251217131604
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: MANTECA RTRMT COM-HAPPY LVNG BY COGIR/COGIR MANTEC
FACILITY NUMBER: 392700473
VISIT DATE: 12/24/2025
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
It was learned that due to the presence of rodent droppings in the facility food storage areas, several food products were improperly being stored together. In addition, food items were improperly being stored on the refrigerator/freezer floors.

As a result of this investigation, this LPA found the allegations to be SUBSTANTIATED - A finding that the complaint was Substantiated meant that the allegations were valid because the preponderance of the evidence standard had been met.

The following deficiencies were observed and cited on the following LIC 9099-D pursuant to Title 22 Rules and Regulations, Division 6 and Health and Safety Codes.

Appeal rights were printed and a copy was left with the facility designated Administrator at this time.

Exit Interview
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 12/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/24/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3