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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 300600977
Report Date: 08/13/2025
Date Signed: 08/13/2025 03:01:31 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/11/2025 and conducted by Evaluator Kimberly Lyman
COMPLAINT CONTROL NUMBER: 22-AS-20250811172747
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: 108DATE:
08/13/2025
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Christina Garcia and Sara ModugnoTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff does not ensure that the facility is free of pests
Staff are not meeting residents' hygiene needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to initiate an investigation into the above allegations. LPA was greeted and granted entry into the facility and explained the reason for the visit.

During the course of the investigation, LPA toured the facility and interviewed staff as well as reviewed and obtained pertinent documentation such as extermination records. Regarding the allegations that staff does not ensure that the facility is free of pests and staff are not meeting residents' hygiene needs, the investigation revealed the following: Facility provided documentation of pest extermination services provided by Skyline Pest Control on 06/03/2025, 07/01/2025, and 08/04/2025. Four out of four staff deny seeing pests inside the facility. LPA toured the memory care unit and did not observe any pests. Per physician correspondence, two residents are being treated for rashes with Elimite for Scabies and Clobetasol for fungal infections. There is no diagnosis of either Scabies or a fungal infection by physician. Four out of four staff state residents are receiving showers and needs are being met. CONTINUED ON LIC 9099C DATED 08/13/2025
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025
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-20250811172747
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: TOWN & COUNTRY
FACILITY NUMBER: 300600977
VISIT DATE: 08/13/2025
NARRATIVE
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Facility provided documentation showing when residents refuse showers. Staff state residents are observed every 15 minutes and incontinence care is provided at a minimum 3-4 times per shift. LPA observed residents relaxing in the facility and all appeared clean. Facility staffing levels are as follows: 6-8 caregivers/ 2 med techs/ lead and an LVN on 1st and second shifts and 5 caregivers/ med tech or LVN on NOC shift. Interviews with staff confirm staffing levels. LPA observed ample staffing during the visit. Based on observations made and interviews conducted, LPA is unable to corroborate the allegations. Therefore, the allegations are deemed unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. Exit interview was conducted and copy of the report was provided to the facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2