502701290-10-23-2025-27-AS-LRIS-DNMNHT-20251121092913

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 502701290
Report Date: 10/23/2025
Date Signed: 10/23/2025 09:40:18 PM

Unsubstantiated

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
07/21/2025 and conducted by Evaluator Jason Lund

COMPLAINT CONTROL NUMBER: 27-AS-20250721101848

FACILITY NAME:	CARVER CARE RESIDENTIAL		FACILITY NUMBER:	502701290
ADMINISTRATOR:	ASHLEY M GUDINO		FACILITY TYPE:	735
ADDRESS:	1009 CARVER ROAD		TELEPHONE:	(209) 204-5157
CITY:	MODESTO	STATE: CA	ZIP CODE:	95350
CAPACITY:	70	CENSUS: 51	DATE:	10/23/2025
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Administrator Gena Garibay		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff do not provide resident with a diet according to resident’s health needs

Staff force residents to eat their meals

Staff speak inappropriately while in the presence of residents

Staff are overmedicating resident

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to complete a complaint investigation. LPA Lund met with Administrator Gena Garibay and explained the reason for the visit. Census:51

Staff do not provide resident with a diet according to resident’s health needs- Based on records reviewed, interviews with staff, reporting party, and clients. LPA Lund reviewed facility records which state that the facility has a list of clients in care with Dietary Restrictions/Diabetics which as of 10/14/2025 client (C1) is not on.

Based on records review, interviews with clients, reporting party, and staff information provided, it was unclear if staff do not provide resident with a diet according to resident’s health needs, therefore the allegation was deemed UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025

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 27-AS-20250721101848

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: CARVER CARE RESIDENTIAL	FACILITY NUMBER: 502701290
	VISIT DATE: 10/23/2025

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

Staff force residents to eat their meals- Based on records reviewed, interviews with clients, reporting party, and staff. LPA Lund reviewed facility records which state that the facility has a list of clients in care with Dietary Restrictions/Diabetics which as of 10/14/2025 client (C1) is not on. Clients interviewed stated that they are not forced to eat food they do not want.

Based on records review, interviews with clients, reporting party, and staff the information provided, it was unclear if staff forced residents to eat their meals, therefore the allegation was deemed UNSUBSTANTIATED.

Staff speak inappropriately while in the presence of residents -LPA Lund reviewed facility records, interviewed staff, and residents in care. Based on facility records review, interviews with staff, and clients in care. Clients interviewed stated that never have never seen illegal drugs at the facility and would notify management if seen. Staff interviewed stated that they have never witnessed any staff speak inappropriately in the presence of residents in care. All staff interviewed know that they are mandated reporters. All staff have initial training on how to report suspected adults and elderly abuse before working with clients in care. Residents in care stated that Staff do not speak inappropriately around residents.

Based on facility records review, interviews with staff, and clients in care, on the information provided, it was unclear if staff speak inappropriately while in the presence of residents, therefore the allegation was deemed UNSUBSTANTIATED.

Staff are overmedicating resident- Based on records reviewed, interviews with clients, reporting party, and staff. LPA Lund reviewed facility Medication Administration Records (MARS) for client (C1) from July 1, 2025, through September 30, 2025. Review of C1’s MARS indicate that C1 was taking C1’s medication as prescribed.

Based on records review, interviews with clients, reporting party, and staff the information provided, it was unclear if staff are overmedicating resident, therefore the allegation was deemed UNSUBSTANTIATED.

The Department (CCLD) has found the allegations. Unsubstantiated.

A finding that the complaint allegation(s) are UNSUBSTANTIATED means that although the allegation(s) may have happened or is valid, there is not a

preponderance of the evidence to prove that the alleged violation(s) occurred. Exit interview was conducted with and report left.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 2