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Complaint Investigation

Golden Modesto Care Center

August 21, 2025 · Modesto, CA · 1900 Coffee Road
Citations 3
CMS Rating 2/5
Beds 120
Provider ID 056301
Healthcare Facility
Golden Modesto Care Center
Modesto, CA  ·  View full profile →
Inspection Summary

GOLDEN MODESTO CARE CENTER in MODESTO, CA — inspection on August 21, 2025.

Found 3 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

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Inspection Findings

FF0557
Resident Rights Deficiencies
Potential for More Than Minimal Harm

grooming and showering.During a concurrent interview and record review on 8/21/25 at 1:12 p.m. with CNA 3, Resident 7's, Point of Care (POC)-Showers, dated 7/1/25-7/31/25, was reviewed.

The POC indicated there were no documented refusals or changes in Resident 7's schedule to move showers to a different date, shift or time. CNA 3 stated the facility process was to give all resident showers on the scheduled date, document the shower, refusal to shower or any changes in the schedule on the residents POC. CNA 3 validated Resident 7 had not received a scheduled shower on 7/18/25, 7/25/25 and 7/29/25. CNA 3 stated all residents have the right to shower and live with dignity and respect.During a concurrent interview and record review on 8/21/25 at 1:40 p.m. with the director of staff development (DSD), Resident 7's, CNA Shower Review Forms, dated 7/15/25 and 7/22/25, were reviewed.

The forms indicated Resident 7 received a total of two showers for the month of July.

The forms indicated Resident 7 had not received a scheduled shower on 7/18/25, 7/25/25, and 7/29/25.

The DSD stated the facility expectation was for the CNAs to follow the shower schedule for each resident and to document the showers, baths or refusals on the POC and notify the nurse.

The DSD stated it was not acceptable to have a resident refuse a shower and not document it to alert the nurse and other staff.

The DSD stated Resident 7 had not received a shower on 7/18/25, 7/25/25 and 7/29/25 after review of all CNA documentation.

During an interview on 8/21/25 at 2:12 p.m. with the director of nursing (DON), the DON stated the facility expectation was for all residents to receive their scheduled showers on the scheduled dates.

The DON stated if the resident was refusing the showers, the CNA should have alerted the nurse and completed documentation in the POC and on the shower forms.

The DON stated, the facility did not have a policy and procedure (P&P) on showers or Activity of Daily Living (ADL).During a review of the facility's policy and procedure (P&P) titled, Notice of Resident Rights, dated 7/2015, the P&P indicated, .

Each resident of a skilled nursing facility has the rights.

The Center will seek to ensure that those rights are not violated.

The Center will establish and implement written policies and procedures that include these rights and will make a copy of these policies available to the Resident, Resident's Representatives, or the public upon request.

General rights. To be encouraged and assisted throughout the period of stay to exercise rights as a resident. To be treated with consideration, respect and full recognition of dignity and individuality, including privacy in treatment and in care of personal needs.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/21/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Golden Modesto Care Center

1900 Coffee Road Modesto, CA 95355

SUMMARY STATEMENT OF DEFICIENCIES

(DON), the DON stated there was no expectation for the facility staff to initiate a baseline care plan.

The DON stated the baseline care plan should not have included every diagnosis residents had upon admission if the diagnosis was being treated with medications or other services.

The DON stated the baseline care plan should have consisted of new diagnosis or changes in condition while in the facility.During a review of the facility's policy and procedure (P&P) titled, Baseline Care Plan, dated 7/2025, the P&P indicated, .A baseline plan of care (BPOC) is developed and provided to each resident and/or his/her Representative, following admission.

The facility develops the baseline plan of care for each resident, within 48 hours of admission.

The baseline plan of care includes information regarding care and services sufficient to promote safe delivery of care.

The baseline plan of care consists of the following, Physician Orders, Dietary Orders, Therapy Services, Applicable Social Services Intervention, Applicable PASARR Recommendations, Initial Goals.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/21/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Golden Modesto Care Center

1900 Coffee Road Modesto, CA 95355

SUMMARY STATEMENT OF DEFICIENCIES

During a review of a professional reference publication titled, Nutrition Care of the Older Adult from the Academy of Nutrition and Dietetics, dated 2016, indicated, .

The goal of Medical Nutrition Therapy is to maintain or restore the individual's usual body weight .

Facility ID:

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in MODESTO, CA, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from GOLDEN MODESTO CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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