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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 277209399
Report Date: 09/02/2026
Date Signed: 09/10/2026 11:38:48 AM

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
08/31/2026 and conducted by Evaluator Vadim Gorban
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20260831091720
FACILITY NAME:DEL MONTE CAREFACILITY NUMBER:
277209399
ADMINISTRATOR:CABUCO, KAYFACILITY TYPE:
740
ADDRESS:1221/1229 DAVID AVETELEPHONE:
(619) 439-8488
CITY:PACIFIC GROVESTATE: CAZIP CODE:
93950
CAPACITY:65CENSUS: 41DATE:
09/02/2026
UNANNOUNCEDTIME BEGAN:
02:22 PM
MET WITH:Administrator Victoria MontoyaTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
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9
Staff did not ensure facility was free from pests
INVESTIGATION FINDINGS:
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2
3
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5
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8
9
10
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13
Licensing Program Analysts (LPAs) V. Gorban and H Vang arrived commence complaint investigation to allegation stated above. LPA explained the purpose of the visit to house manager Victoria Montoya and was allowed entry.
During the course of the investigation, LPA conducted a physical pant inspection, conducted interviews, and reviewed records.
The Department has investigated the allegation: Staff did not ensure facility was free from pests. Based on observation during facility visit LPAs toured random rooms, dining and kitchen. Investigation have not provided sufficient evidence to establish that facility had an ongoing pest infestation or that the facility staff failed to appropriately address reported tests concern. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore above allegation is UNSUBSTANTIATED.

Exit interview conducted, report signed and copy of this report provided for facility records.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Shawna Doucette
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2026
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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