502701450-2-6-2026-27-AS-LRIS-DR8UBW-20260212142700

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 502701450
Report Date: 02/02/2026
Date Signed: 02/06/2026 10:51:41 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
11/04/2025 and conducted by Evaluator Jason Lund

COMPLAINT CONTROL NUMBER: 27-AS-20251104114802

FACILITY NAME:	CASA DE MODESTO		FACILITY NUMBER:	502701450
ADMINISTRATOR:	ISSAKHANI, STEPHANY		FACILITY TYPE:	740
ADDRESS:	1745 ELDENA WAY		TELEPHONE:	(925) 594-1122
CITY:	MODESTO	STATE: CA	ZIP CODE:	95350
CAPACITY:	160	CENSUS: 88	DATE:	02/02/2026
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Administrator Stephany Issakhani		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff does not assist residents in a timely manner

Staff does not assist residents to the bathroom

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

Staff does not assist residents in a timely manner - LPA Lund reviewed facility records, interviewed staff, and residents in care. Based on records reviewed, interviews with staff, and residents in care. LPA Lund reviewed Medication Administration Records (MARS) from 10/1/2025 through 11/30/2025 for Resident (R1) did receive medication when R1 asked for it. R1 stated that staff have given medication when R1 asked for it.

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)

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Control Number 27-AS-20251104114802

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 staff does not assist residents in a timely manner, therefore the allegation was deemed UNSUBSTANTIATED.

Staff does not assist residents to the bathroom - LPA Lund reviewed facility records, interviewed staff and residents in care. Staff are trained to ask residents in care about bathroom checks every two hours in less residents in care need to be checked sooner. LPA Lund reviewed Needs and Services plan which state what residents need help with toileting. Staff interviewed stated they have sufficient time to make sure that residents in care are changed. Residents interviewed stated that staff ask about bathroom needs and help when needed.

Based on reviewed facility records, interviews with staff, and residents in care, on the information provided, it was unclear if staff does not assist residents to the bathroom, 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)

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