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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 300600977
Report Date: 03/19/2025
Date Signed: 03/19/2025 04:17:34 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/12/2025 and conducted by Evaluator Jenifer Tirre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250312162740
FACILITY NAME:TOWN & COUNTRYFACILITY NUMBER:
300600977
ADMINISTRATOR:SARA MODUGNOFACILITY TYPE:
741
ADDRESS:555 E. MEMORY LANETELEPHONE:
(714) 547-7581
CITY:SANTA ANASTATE: CAZIP CODE:
92706
CAPACITY:328CENSUS: 121DATE:
03/19/2025
UNANNOUNCEDTIME BEGAN:
07:20 AM
MET WITH:Executive Director Sara ModugnoTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff are not meeting residents needs
Staff do not have access to supplies for residents
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jenifer Tirre met with Executive Director Sara Modugno for the purpose of delivering findings for the above allegations. The complaint consisted of observations and interviews.
On March 12, 2025 the department received allegations that staff are not meeting residents needs and staff do not have access to supplies for residents. The investigation was completed by the Department and revealed the following:

Regarding allegation “Staff are not meeting resident’s needs”, during visit LPA toured facility and observed staff assisting residents with meals, medications, changing of linens inside bedrooms and assisting residents with toileting needs. LPA also observed several staff members answering resident questions.
During investigation LPA Tirre conducted interviews with residents and staff. Based on investigation interviews the following was revealed: six of seven residents stated that facility staff meet their care needs. Six Residents interviewed stated that staff provide assistance with showering, toileting, medications,
CONTINUED ON 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jenifer Tirre
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025
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 2
Control Number 22-AS-20250312162740
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: TOWN & COUNTRY
FACILITY NUMBER: 300600977
VISIT DATE: 03/19/2025
NARRATIVE
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meals and respond to their pendant calls in a timely manner. Seven of seven residents stated that they feel safe at facility and are not in any danger.

Based off interviews with staff, Ten of ten staff members stated that they feel they are meeting the care needs of residents. Based off Staff interviews, staff stated they are providing residents with assistance in Activities of Daily Living (ADL’s) and stated that they have not had any complaints from residents or family members on the level of care being provided.

Regarding allegation “Staff do not have access to supplies for residents”, during visit, LPA observed that residents have supply of diapers, wipes, toilet paper, under pads, towels and linens inside resident rooms. During tour LPA Tirre observed storage closets that had extra over flow of diapers, under pads, wipes, incontinence products and gloves that are secured. LPA Tirre observed additional overflow of supplies readily available to staff near hydration stations as well as personal laundry room cabinets inside memory care wing.

Based off interviews with seven residents, no residents stated they have been short supplied on items. Based on interviews with Staff members, ten of ten staff stated that residents have supplies of diapers, wipes, toilet paper, and towels readily available inside resident rooms. Nine of ten staff stated that facility has overflow of supplies inside storage closets which Director, Coordinators, Nurses and Med Technicians have keys to open for staff to access. Nine of ten staff interviews confirmed that residents under hospice care are being provided products from hospice agencies and residents not on hospice that require diapers, wipes and under pads are being supplied products from responsible parties. Staff interviews reveal that if ever an emergency need and resident does not have supply, staff will pull from overflow storage. Interview with Executive Director Modugno confirmed that facility started labeling supplies for each resident that requires incontinence supplies and that since, facility has not ran out of supplies for residents.

Based on observations made and interviews conducted, LPA is unable to corroborate allegations made that staff not meeting residents needs and staff do not have access to supplies therefore although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are deemed UNSUBSTANTIATED.

An exit interview was conducted with Executive Director Sara Modugno, and a copy of this report was provided during this visit.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jenifer Tirre
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2