Senior Care Records.

Facility Evaluation Report

Montclair Home, Modesto03/27/2026Licence 502700977

Capacity4
Census4
Date signed03/27/2026 02:41:58 PM
Name of licensing program analystNoel Wolf Petersen
Name of licensing program managerLiza King
The inspector’s account

Licensing Program Analyst, Noel Wolf Petersen arrived unanounced to the facility to conduct a case management related to a annual where the staff files, client files, and administrator files didnt get reviewed. LPA met with Administrator Patrick to explain the purpose of the visit.

Staff files were reviewed for 5 staff, the reviewed included the health screening, fingerprint clearance, first aid, and continuing and initial training. all documents are present and up to date. LPA gave guidance to do the annual training in relaevant topics to the clients in care.

Client files reviewed for 3 residents, the review included the admission agreement, addendums to the admission agreement, house rules, ipp, functional capability assessments. all documents present and up to date.LPA gave guidance to update the needs and services plans of the clients with the knowlege from their experiences, the 602, and the functional capabilities assessment.

LPA reviewed administrator files including the infection control plan, evacuation control plan, facility sketch, and liability insurance. all documents present and up to date.

LPA reviewed 2 clients p+i at random. found to be in agrement between the balance and the physical cash present.

No citations issued as part of this visit ,a copy of the report was read and given to the administrator. exit interview was conducted.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction