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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 300600977
Report Date: 04/18/2026
Date Signed: 04/18/2026 02:36:49 PM

Substantiated


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
12/14/2025 and conducted by Evaluator Kimberly Lyman
COMPLAINT CONTROL NUMBER: 22-AS-20251214233319
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:
04/18/2026
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Cristina Garcia and Kristine SantillianTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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8
9
Staff left a resident soiled for an extended period of time
Staff did not meet a resident's incontinence needs
INVESTIGATION FINDINGS:
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2
3
4
5
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7
8
9
10
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13
Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to continue the 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 interviewed staff and witness as well as reviewed and obtained pertinent documentation such as physician report. Regarding the allegations that staff left a resident soiled for an extended period of time and staff did not meet a resident's incontinence needs, the investigation revealed the following: On 12/10/2025, Resident 1 (R1) had an accident in the resident's room and pulled the pendant for assistance. In the meantime, the resident called family who lives in independent living. The family member arrived and went to look for caregiver assistance as the resident and resident's room needed immediate assistance. Review of pendant call record on 12/10/2025 shows a pendant call at 8:36 AM with a response time of 37 minutes. Two out of two caregiver signed statements indicate the two caregivers responded between 9 and 930 AM. Further review of record shows between 12/07-12/10/2025, there were six calls with response times over 30 minutes. CONTINUED ON LIC 9099C DATED 4/18/2026.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2026
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 5
Control Number 22-AS-20251214233319
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: 04/18/2026
NARRATIVE
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Based on interviews conducted and record review, the preponderance of evidence standard has been met. Therefore, the above allegations are deemed SUBSTANTIATED as per the Title 22, Division 6, Chapter 8 of the California Code of Regulations. Deficiencies are being cited on the attached LIC-9099D.
An exit interview was conducted and a copy of this report as well as the appeal rights were provided at exit.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 22-AS-20251214233319
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/18/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/12/2026
Section Cited
CCR
87464(f)(4)
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7
Basic services shall at a minimum include: Personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal, with those activities of daily living such as dressing, eating, bathing and assistance...This req is not met as evidenced by:
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5
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Licensee to conduct an in-service on providing incontinence care and forward proof to LPA by POC due date.
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Based on interviews conducted and record review, Licensee failed to ensure personal assistance with incontinence care was provided to R1 which poses an immediate health and safety risk to residents in care.
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Type A
04/19/2026
Section Cited
CCR
87468.2(a)(4)
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In addition to the rights.., residents shall have all of the following personal rights: To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient.. to meet their needs. This req is not met as evidenced by:
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Licensee to provide an in-service on responding to pendant calls and forward proof to LPA by POC due date.
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Based on interviews conducted and record review, Licensee failed to ensure R1 was provided timely incontinence care. From 12/07-12/10/ 2025, there are six pendant calls with a response time over 30 minutes which poses an immediate health and safety risk to residents in care.
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9
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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: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
12/14/2025 and conducted by Evaluator Kimberly Lyman
COMPLAINT CONTROL NUMBER: 22-AS-20251214233319

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:
04/18/2026
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Cristina Garcia and Kristine SantillianTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not meet a resident's bathing needs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to continue the investigation into the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit.
During the course of the investigation, LPA interviewed staff and witness as well as reviewed and obtained pertinent documentation such as physician report. Regarding the allegation that staff did not meet a resident's bathing needs, the investigation revealed the following: Two out of two caregivers and family member interviewed stated R1 is receiving showers appropriately. R1's family member states one incident where there was a miscommunication regarding whether or not the family member would shower the resident but claims responsibility for the misunderstanding. Two out of two caregivers interviewed state the resident was receiving showers. LPA unable to review shower log as resident discharged from assisted living to memory care and staff state the record is no longer available. Based on records reviewed and interviews conducted, LPA is unable to corroborate the allegation. CONTINUED ON LIC 9099C DATED 4/18/2026
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2026
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 5
Control Number 22-AS-20251214233319
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: 04/18/2026
NARRATIVE
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Therefore, the allegation is deemed unsubstantiated, meaning that although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation 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: 04/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5