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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 502701450
Report Date: 02/02/2026
Date Signed: 02/06/2026 11:24:19 AM

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
10/08/2025 and conducted by Evaluator Jason Lund
COMPLAINT CONTROL NUMBER: 27-AS-20251008103431
FACILITY NAME:CASA DE MODESTOFACILITY NUMBER:
502701450
ADMINISTRATOR:ISSAKHANI, STEPHANYFACILITY TYPE:
740
ADDRESS:1745 ELDENA WAYTELEPHONE:
(925) 594-1122
CITY:MODESTOSTATE: CAZIP CODE:
95350
CAPACITY:160CENSUS: 88DATE:
02/02/2026
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Administrator Stephany Issakhani TIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Facility staff are not administering medication as prescribed
Facility staff are not ordering medication in a timely manner
Unqualified staff administering medication
Facility staff are not meeting residents needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jason Lund arrived unannounced to complete a complaint investigation regarding the above allegations. LPA Lund met with Administrator Stephany Issakhani and explained the reason for the visit. Census: 88

Facility staff are not administering medication as prescribed - LPA Lund reviewed facility records, interviewed staff, and residents in care. Based on eight reviewed Medication Administration Records (MARS) from 10/1/2025 through 11/30/2025 residents in care were getting medications as prescribed. LPA interviewed MED TECKS (Staff) who stated that they give medications to residents in care and have procedures if residents refuse their medications. Residents interviewed stated that they take the medications that are given by staff.
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:

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

DATE: 02/02/2026
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 3
Control Number 27-AS-20251008103431
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: CASA DE MODESTO
FACILITY NUMBER: 502701450
VISIT DATE: 02/02/2026
NARRATIVE
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Based on reviewed facility records, interviews with staff, and residents in care, on the information provided, it was unclear if facility staff are not administering medication as prescribed, therefore the allegation was deemed UNSUBSTANTIATED.

Facility staff are not ordering medication in a timely manner - LPA Lund interviewed staff who stated that they order medications on Sunday night shift and Wednesday night shift. About 90 of the medications are ordered through one pharmacy for residents in care. The others have mail orders and have families order medications for the residents in care. LPA Lund received samples of how the MED TECKS order medications for the residents in care.

Based on reviewed facility records, staff interviewed, on the information provided, it was unclear if facility staff are not ordering medication in a timely manner, therefore the allegation was deemed UNSUBSTANTIATED.

Unqualified staff administering medication– LPA Lund reviewed facility records, and interviewed staff. Based on reviewed facility paperwork each Med Tech takes ten hours of training from Advanced Healthcare studies on how to work with medications for the facility. Each staff member must have this training before working with residents’ medications. Staff interviewed stated that they have procedures on how to work with residents regarding medications and no untrained staff give medications.

Based on reviewed facility records and interviewed staff, on the information provided, it was unclear if unqualified staff administering medication, therefore the allegation was deemed UNSUBSTANTIATED.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:

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

DATE: 02/02/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20251008103431
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: CASA DE MODESTO
FACILITY NUMBER: 502701450
VISIT DATE: 02/02/2026
NARRATIVE
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Facility staff are not meeting residents needs – LPA Lund reviewed facility records, interviewed staff, and residents in care. Based on staff schedules from 10/01/25 through 11/30/25 the revealed staff to be consistently residents in care on duty. LPA Lund interviewed residents in care who stated that their needs are being met. Staff interviewed stated that there is adequate staff to meet the needs of the residents in care.

Based on facility records reviewed, interviews with staff, and residents in care, on the information provided, it was unclear if licensee does not ensure enough staff are present to meet the needs of residents, therefore the allegation was deemed UNSUBSTANTIATED.

As a result of this investigation, this Department finds the allegation to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted and report left.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:

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

DATE: 02/02/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3