Casa De Modesto

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Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to conduct 1 year required annual visit. LPA Lund met with Administrator Stephany Issakhani explained the purpose of the visit. Census: 94 LPA Lund & Administrator Stephany Issakhani toured/inspected the physical plant including but not limited to the Assisted Living side and the Memory Care side. LPA Lund also inspected the kitchen, dining room, resident bedrooms, resident bathrooms, medication room, laundry room, activity room, and outside courtyards. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present in the facility. LPA inspected the kitchen was in compliance and sufficient seven- day non-perishable and two- day perishable food supplies. Hot water temperature was measured at 110.5 degrees Fahrenheit in resident bathroom sink, which is within the required range of 105 to 120 degrees. Fire extinguishers (2/9/2026) and smoke detectors are current and in compliance with fire safety. LPA observed centrally stored medications are kept locked and inaccessible to residents. LPA reviewed 9 residents and 7 staff files, including criminal record clearances and was in compliance. The first aid kit was checked and in compliance. No deficiencies were observed or cited during this visit. Exit interview held and a copy of report given.the state’s words, verbatim · CDSS document, Aug 6, 2026

Allegation investigated: Staff did not administer medication as prescribed.

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to complete a complaint investigation regarding the above allegations. LPA Lund met with Program Coordinator Anita Mishra and explained the reason for the visit. Census: 94 Staff did not administer medication as prescribed - LPA Lund reviewed facility records, and interviewed staff. Based on records reviewed, and interviews with staff. LPA Lund reviewed Resident (R1’s) medication log from 12/15/2025 through 03/13/2026 which states R1 doesn’t have any medications that need to be crushed. R1 left the facility on 3/13/2026 and was not able to be interviewed. The facility has guidelines for medications that need to crushed for residents in care for MED TECKS. Unsubstantiated Based on reviewed facility records and interviews with staff on the information provided, it was unclear if staff did not administer medication as prescribed, 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.the state’s words, verbatim · CDSS document, Jul 13, 2026 · control 27-AS-20260222205300

Allegation investigated: 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

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 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. 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.the state’s words, verbatim · CDSS document, Feb 2, 2026 · control 27-AS-20251008103431

Allegation investigated: Staff does not assist residents in a timely manner Staff does not assist residents to the bathroom

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 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.the state’s words, verbatim · CDSS document, Feb 2, 2026 · control 27-AS-20251104114802

Allegation investigated: Staff do not prevent residents from using illegal drugs Staff are not properly cleaning resident bedrooms Staff do not keep resident rooms free from odor Licensee does not ensure enough staff are present to meet the needs of residents Facility staff are leaving residents soiled for an extended period of time Staff are not properly supervising residents who may be a fall risk Staff are not dispensing medication as prescribed Staff are not providing adequate laundry services for residents Staff are not meeting resident bathing needs Staff are not providing adequate food service Staff do not intervene between resident verbal interactions Staff blocks exit doors presenting a hazard to residents

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to complete a complaint investigation regarding the above allegations. LPA Lund met with Program Coordinator Anita Mishra and explained the reason for the visit. Census: 90 Staff do not prevent residents from using illegal drugs - LPA Lund reviewed facility records, interviewed staff, and residents in care. Based on facility records reviewed, interviews with staff, and residents in care. LPA Lund has made fourteen unannounced visits to the facility from 2/12/2024 through 8/21/2025 has never observed any residents in care using illegal drugs. Staff interviewed stated that they never observed any residents in care using illegal drugs and if observed would notify management immediately. Residents interviewed stated that they never seen any residents in care using illegal drugs. Unsubstantiated Based on reviewed facility records, interviews with staff, and residents in care, on the information provided, it was unclear if staff do not prevent residents from using illegal drugs, therefore the allegation was deemed UNSUBSTANTIATED. Staff are not properly cleaning resident bedrooms - LPA Lund reviewed facility records and observed residents’ rooms, interviewed staff, and residents in care. LPA Lund reviewed housekeeper schedules and housekeepers work at the facility from 6:00 am through 6:30 pm throughout the week. Housekeeper clean memory care rooms daily and assisted side weekly in less needed. LPA Lund observed rooms in memory care and in assisted care to be clean and in compliance. Staff interviewed stated if a resident’s room needs attention either housekeeping or care staff will clean the room. Residents interviewed stated that their rooms are cleaned with the help of staff. Based on reviewed facility records, interviews with staff and residents in care, on the information provided, it was unclear if staff are not properly cleaning resident bedrooms, therefore the allegation was deemed UNSUBSTANTIATED. Staff do not keep resident rooms free from odor – LPA Lund reviewed facility records and observed residents’ rooms, interviewed staff, and residents in care. LPA Lund reviewed housekeeper schedules and housekeepers work at the facility from 6:00 am through 6:30 pm throughout the week. Housekeeper clean memory care rooms daily and assisted side weekly in less needed. LPA Lund observed rooms in memory care and in assisted care to be free from odor and in compliance. Staff interviewed stated if a resident’s room needs attention either housekeeping or care staff will clean the room. Residents interviewed stated that their rooms are cleaned with the help of staff. Based on reviewed facility records, interviews with staff and residents in care, on the information provided, it was unclear if Staff do not keep resident rooms free from odor, therefore the allegation was deemed UNSUBSTANTIATED. Licensee does not ensure enough staff are present to meet the needs of residents – LPA Lund reviewed facility records, interviewed staff, and residents in care. Based on staff schedules from 3/30/25 through 8/20/25 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. Facility staff are leaving residents soiled for an extended period of time- 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. 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 facility staff are leaving residents soiled for an extended period of time, therefore the allegation was deemed UNSUBSTANTIATED. Staff are not properly supervising residents who may be a fall risk- LPA Lund reviewed facility records, interviewed staff, and residents in care. Staff have had an in-service training (Preventing falls in facilities) dated 4/16/2025. The facility does two-hour bedroom checks and sooner if needed for all residents in care. Staff interviewed stated they have been trained in how to help prevent residents in care from falling. Residents interviewed stated that staff are great about reminders about using the restroom and if they needed help with getting up. Based on reviewed facility records, interviews staff and residents in care, on the information provided, it was unclear if staff are not properly supervising residents who may be a fall risk, therefore the allegation was deemed UNSUBSTANTIATED. Staff are not dispensing medication as prescribed- LPA Lund reviewed facility records, interviewed staff, and residents in care. Based on reviewed facility paperwork each Med Tech takes ten courses 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. Residents interviewed stated that they take the medications that staff provide to them. Based on facility records reviewed, interviews with staff, and residents in care, on the information provided, it was unclear if staff are not dispensing medication as prescribed, therefore the allegation was deemed UNSUBSTANTIATED. Staff are not providing adequate laundry services for residents- LPA Lund reviewed facility records, interviewed staff, and residents in care. Based on reviewed facility paperwork each resident in care has laundry days. Staff interviewed stated if a resident in care needs something washed before their laundry day staff will wash it. Residents interviewed stated that their laundry is done by staff and has had no problems. Based on facility records reviewed, interviews with staff, and residents in care, on the information provided, it was unclear if staff are not providing adequate laundry services for residents, therefore the allegation was deemed UNSUBSTANTIATED. Staff are not meeting resident bathing needs- Based on facility records review, interviews with staff, and residents in care. Facility records indicate that residents did get their scheduled showers if they need the help of staff, if a resident is independent they can take showers when they want to. Each resident who needs assistance has a scheduled shower day that staff will assist them with. Staff interviewed state that residents in the care get showers twice a week or as necessary. Residents interviewed, state they did get showers twice a week or as necessary. Based on facility records review, interviews with staff and residents in care, the information provided; it was unclear if staff are not meeting resident bathing needs, therefore the allegation was deemed UNSUBSTANTIATED. Staff are not providing adequate food service- LPA Lund reviewed facility records, interviewed staff, and residents in care. Based on review of the facility menu March 3, 2025, through May 17, 2025. LPA’s Lund observation of 2- day supply of perishable food and 7- day supply of non-perishable food is in compliance. Residents interviewed stated that they the facility is providing adequate food for them. Staff interviewed stated that residents have not complained about the food being served at the facility. Based on records reviewed, interviews with staff, and residents in care, on the information provided, it was unclear if facility staff are not providing adequate food service, therefore the allegation was deemed UNSUBSTANTIATED. Staff do not intervene between resident verbal interactions- LPA Lund reviewed facility records, interviewed staff, and residents in care. Staff have had, in-service training (Challenging Behaviors and dementia) along with the initial 6 hour and 40 minutes with Care Academy training on how to work with the residents in care. Staff interviewed stated that when residents are have a disagreement they intervene with asking them a question and if that doesn’t work they notify management immediately to help. Residents interviewed stated that staff are great and help them when they need it. Based on reviewed facility records, interviews with staff, and residents in care, on the information provided, it was unclear if staff do not intervene between resident verbal interactions, therefore the allegation was deemed UNSUBSTANTIATED. Staff blocks exit doors presenting a hazard to residents- LPA Lund reviewed facility records and interviewed staff. Based on facility records reviewed and interviews with staff. LPA Lund has made fourteen unannounced visits to the facility from 2/12/2024 through 8/21/2025 has never observed any exit doors being blocked. Staff interviewed stated that they never observed exit doors being blocked. Based on reviewed facility records and interviews with staff, on the information provided, it was unclear if staff blocks exit doors presenting a hazard to 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.the state’s words, verbatim · CDSS document, Aug 21, 2025 · control 27-AS-20250523150712

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to conduct one year required annual visit. LPA Lund met with Program Coordinator Anita Mishra explained the purpose of the visit. Census: 90 LPA Lund & Program Coordinator Anita Mishra toured/inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms, resident bathrooms, medication room, laundry room, activity room, and outside courtyards. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present in the facility. LPA observed sufficient seven- day non-perishable and two- day perishable food supplies. Hot water temperature was measured at 109.5 degrees Fahrenheit in resident bathroom sink, which is within the required range of 105 to 120 degrees. Fire extinguishers (2/12/2025) and smoke detectors are current and in compliance with fire safety. LPA observed centrally stored medications are kept locked and inaccessible to residents. LPA reviewed 8 residents and 5 staff files, including criminal record clearances. The reviewed filles were in compliance. The first aid kit was checked and in compliance. No deficiencies were observed or cited during this visit. Exit interview held and a copy of report given.the state’s words, verbatim · CDSS document, Aug 20, 2025

Allegation investigated: Staff forced a resident to sign documents Staff disposed of resident's bank cards Staff yelled at a resident in care

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: 70 Staff forced a resident to sign documents - LPA Lund reviewed facility records, interviewed staff, reporting party, witness and residents in care. Based on records reviewed, interviews with staff, reporting party, and residents in care. Resident (R1) signed Residential Agreement on 9/5/2024 with verbal consent from another family. LPA Lund interviewed R1 who stated that R1 was not forced to sign anything. LPA Lund interviewed staff and witness who stated that R1 willing signed the Residential Agreement on 9/5/2024. Unsubstantiated Based on reviewed facility records, interviews with staff, reporting party, witness and residents in care, on the information provided, it was unclear if staff forced a resident to sign documents, therefore the allegation was deemed UNSUBSTANTIATED. Staff disposed of resident's bank cards - LPA Lund reviewed facility records, interviewed staff, reporting party, witness and residents in care. Staff along with verbal consent with another family member, the facility set up automatic payments for Resident (R1) care at the facility. Based on reviewed facility records, interviewed staff, reporting party, witness and residents in care, on the information provided, it was unclear if staff disposed of resident's bank cards, therefore the allegation was deemed UNSUBSTANTIATED. Staff yelled at a resident in care – LPA Lund reviewed facility records, interviewed staff, reporting party and residents in care. Staff have had, in-service training (Challenging Behaviors and dementia) along with the initial 6 hour and 40 minutes with Care Academy training on how to work with the residents in care. Staff interviewed stated that they have never seen any staff yell at a resident if so, would notify management immediately. Residents interviewed stated that staff have not ever yelled at them. Based on reviewed facility records, interviewed staff, reporting party and residents in care, on the information provided, it was unclear if staff yelled at a resident in care, 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.the state’s words, verbatim · CDSS document, Feb 10, 2025 · control 27-AS-20241114093243

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to conduct post-licensing visit. LPA Lund met with Licensee Rani Dhillon explained the purpose of the visit. Census: 54 LPA Lund & Licensee Rani Dhillon toured/inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms, resident bathrooms, medication room, laundry room, activity room, and outside courtyards. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present in the facility. LPA observed sufficient seven- day non-perishable and two- day perishable food supplies. Hot water temperature was measured at 108.7 degrees Fahrenheit in resident bathroom sink, which is within the required range of 105 to 120 degrees. Fire extinguishers (2/12/2024) and smoke detectors are current and in compliance with fire safety. LPA observed centrally stored medications are kept locked and inaccessible to residents. LPA reviewed 5 resident and 3 staff files, including criminal record clearances. First aid kit was checked and is complete. No deficiencies were observed and cited during this visit. Exit interview held and a copy of report given.the state’s words, verbatim · CDSS document, Nov 18, 2024

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Albert Johnson arrived unannounced to conduct an pre-licensing visit. LPA Lund met with Administrator Stephany Issakhani explained the purpose of the visit. Census:48 LPA Lund & Administrator Stephany Issakhani toured/inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms, resident bathrooms, medication room, laundry room, activity room, and outside courtyards. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present in the facility. LPA observed sufficient seven- day non-perishable and two- day perishable food supplies. Hot water temperature was measured at 108.3 degrees Fahrenheit in resident bathroom sink, which is within the required range of 105 to 120 degrees. Fire extinguishers (2/12/2024) and smoke detectors are current and in compliance with fire safety. LPA observed centrally stored medications are kept locked and inaccessible to residents. LPA reviewed 4 resident and 4 staff files, including criminal record clearances. All staff are Fingerprint cleared and associated to the facility. First aid kit was checked and is complete. Fire drill completed 4/2024. Comp 111 was completed for Administrator Stephany Issakhani. No deficiencies were observed and cited during this visit. Exit interview held and a copy of report given.the state’s words, verbatim · CDSS document, Aug 26, 2024

Type of visit: Office

COMP II by CAB successfully completed Applicant/administrator participated in COMP II at CAB telephone call with analyst at CAB. Identification of the applicant and administrator was verified by presenting photo ID via phone. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Staff qualifications and responsibilities 3. Applicant and Administrator qualifications 4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions 5. Grievances, Complaints, Community resources 6. Physical plant, food service 7. Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of propertythe state’s words, verbatim · CDSS document, Aug 7, 2024