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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 300600977
Report Date: 10/28/2025
Date Signed: 10/28/2025 04:17:02 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
08/20/2025 and conducted by Evaluator Jessica Cho
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250820170219
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: DATE:
10/28/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Sara Modugno, RN, BSN- Director of Resident ServicesTIME COMPLETED:
04:35 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not meeting residents’ care needs due to lack of staff.

INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jessica Cho made an unannounced subsequent visit to continue the investigation into the above allegation. LPA met with Director of Resident Services (DRS) Sara Modugno and stated the purpose of the visit.

On August 20, 2025, the Department received a complaint, and the complaint investigation was initiated by LPA Cho on August 26, 2025 which was continued on today's date. During the course of the investigation, LPA interviewed seven Memory Care (MC) residents/MC staff, and obtained the following documentation: Resident Rosters, Personnel Report, Staff Contacts, (AM/PM/Noc) Shift Schedules/Time Cards for August 13, 15, 16, 2025, Face Sheets, Physician's Reports, and Service Plans.

The investigation is as follows: It is alleged that the Staff are not meeting the residents' care needs due to lack of staff, affecting the residents' care in the Memory Care (MC) unit.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2025
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 7
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
08/20/2025 and conducted by Evaluator Jessica Cho
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250820170219

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: DATE:
10/28/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Sara Modugno, RN, BSN- Director of Resident ServicesTIME COMPLETED:
04:35 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not have access to supplies for residents.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jessica Cho made an unannounced subsequent visit to continue the investigation into the above allegation. LPA met with Director of Resident Services (DRS) Sara Modugno and stated the purpose of the visit.

On August 20, 2025, the Department received a complaint, and the complaint investigation was initiated by LPA Cho on August 26, 2025. During the course of the investigation, LPA inspected six MC apartment units, interviewed seven MC residents/MC staff, and obtained the following documentation: Resident Rosters, Personnel Report, Staff Contacts, (AM/PM/Noc) Shift Schedules/Time Cards for August 13, 15, 16, 2025, Face Sheets, Physician's Reports, and Service Plans.

The investigation is as follows: It is alleged that the Staff do not have access to supplies for residents, such as briefs.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 22-AS-20250820170219
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: 10/28/2025
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
On August 20th, LPA inspected six MC apartment units and observed ample supply of briefs in the cabinets of the resident units. LPA observed donation hygiene supplies in the janitor's room which was secured. Seven out of the seven staff interviewed confirmed that the lead caregiver is in possession of the janitor's room key and found no issues with obtaining the key. Five out of the seven residents confirmed that the hygiene supplies are in their respective units. The remaining two residents could not be qualified due to their medical condition.

Therefore, this agency has investigated the complaint and based on the observations made and the interviews which were conducted the following allegation: Staff do not have access to supplies for residents is deemed UNFOUNDED. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

An exit interview was conducted with Director of Resident Services Sara Modugno, and a copy of this report was provided at exit.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 7
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
08/20/2025 and conducted by Evaluator Jessica Cho
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250820170219

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: DATE:
10/28/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Sara Modugno, RN, BSN- Director of Resident ServicesTIME COMPLETED:
04:35 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is in disrepair.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jessica Cho made an unannounced subsequent visit to continue the investigation into the above allegation. LPA met with Director of Resident Services (DRS) Sara Modugno and stated the purpose of the visit.

On August 20, 2025, the Department received a complaint, and the complaint investigation was initiated by LPA Cho on August 26, 2025. During the visit conducted on August 26th, LPA inspected the two patio doors on the first floor in the Memory Care unit accompanied by DRS Madugno. LPA and DRS observed that the keypad for both patio doors were functioning properly. The patio doors were operational and would open and close automatically. However, there was a delay in response time via the walkie-talkie between 2-3 minutes. Title 22 regulation indicates that the facility be in "good repair at all times" which also ensures that the walkie-talkie system is fully fucitional as it is critical for staff communication to prevent any unforseeable incidents.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 7
Control Number 22-AS-20250820170219
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: 10/28/2025
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
Based on LPA's observations, the preponderance of evidence standard has been met, therefore the following allegation, Facility is in disrepair, is deemed SUBSTANTIATED as per the Title 22, Division 6, Chapter 8 of the California Code of Regulations. A deficiency is being cited on the attached LIC-9099D.

An exit interview was conducted with Director of Resident Services Sara Modugno, and a copy of this report including the LIC9099-D and the appeal rights were provided at exit.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 7
Control Number 22-AS-20250820170219
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/03/2025
Section Cited
CCR
87303(a)
1
2
3
4
5
6
7
87303 Maintenance and Operation (a) The facility shall be... in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
This requirement was not met as evidenced by:
1
2
3
4
5
6
7
RSD stated that the walkie-talkie was replaced and will provide a written procedure ensuring to secure an extra budget for obtaining facility equipments as well as ensuring that the walkie talkies are fuctional movring forward to LPA by POC due date.
8
9
10
11
12
13
14
Based on observation accompanied by RSD Madugno, the walkie-talkie experienced a dealy in alert between 2-3mins when the two patio doors were opened which poses a potential Health and Safety risk to persons in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 22-AS-20250820170219
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: 10/28/2025
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
Based on the interviews, two out of seven residents denied the allegation while the remaining three residents indicated that staff assistance is not needed due to their independence with their Activities of Daily Living (ADLs), and the remaining two residents interviews could not be qualified due to their medical conditions. Based on the review of the shift schedule and time cards for the month of August 2025, three sample days were reviewed: August 13, 15, and 16, 2025. On Wednesday, August 13th, there were 8 caregivers working the AM shift (6:30am-2:30pm); 7 in the PM shift (2:00pm-10:30pm); and 6 noc shift (10:00pm-6:30am). On Friday, August 15th, 7 caregivers were working the AM/PM shifts and 4 in the noc shift. On Saturday, August 16th, there were 7 caregivers working the AM/PM shifts and 6 in the noc shift. In addition to the full time caregivers mentioned above, there are leads/medication technicians that also assist during breaks and when additional staff are needed upon request which was corroborated by six out of seven staff.

The investigation revealed that there was insufficient corroborating evidence to support the allegation of not meeting the resident's needs due to lack of staff, therefore, the investigation is deemed UNSUBSTANTIATED.

An exit interview was conducted with Director of Resident Services Sara Modugno, and a copy of this report was provided at exit.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2025
LIC9099 (FAS) - (06/04)
Page: 7 of 7