Post-licensing visit·April 30, 2025

On 04/30/2025 at 09:30 am, Licensing Program Analyst (LPA) Lorena Casillas conducted an announced Post-Licensing Inspection with Licensee Arlen Shahverdian and Administrator Artisha Hickman. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on 05/09/2024. A fire clearance was approved on 8/20/2024, for four (4) non-ambulatory residents and two (2) ambulatory residents for a total capacity of six (6). The purpose of today’s visit is to inspect the facility to ensure that it maintains compliance under California Code of Regulations, Title 22, Division 6. A tour of the physical plant was initiated at 10:30 am and the following was observed: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven and sink. There was an adequate supply of two (2) day perishable and seven (7) day nonperishable foods. LPA observed the kitchen to be clean and clear of clutter. All appliances were operative. Cleaning solutions are locked under the sink. Knives are kept locked in a kitchen cabinet inaccessible to residents. BEDROOMS: The facility has three (3) bedrooms for resident use. Bedroom #1 and Bedroom #3 are designated for two (2) non ambulatory residents each. Bedroom #2 is designated for two (2) ambulatory residents. The bedrooms are furnished with beds, nightstands, chairs, dresser, bedding and linens. All rooms had sufficient lighting. Continued on LIC809-C BATHROOMS: The facility has two (2) bathrooms. All bathrooms were observed to have the proper fixtures, and non-skid mats. The hot water delivered in the bathrooms measured 116.9 degrees F. COMMON AREAS: These included the living room and dining room areas, which are equipped with living room furniture, a television, tables, and chairs. The dining room table is large enough to accommodate up to six (6) residents. There were no visible immediate hazards. The smoke alarms are hard wired and inter-connected. The carbon monoxide detector is functional. The facility has one fire extinguisher that was purchased on 10/18/2024 and is fully charged that is located in the kitchen. LAUNDRY ROOM: Laundry room has washer and dryer. Cleaning detergents and supplies are locked in the garage. MEDICATIONS: Medications and first aid kit are stored in a locked cabinet in the hallway closet. GARAGE: The garage is used for storage. There is a refrigerator used for extra food and water. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. The backyard of the facility has a patio and backyard furniture. The facility backyard has sufficient yard space to accommodate outdoor activities. There is no swimming pool or bodies of water. STAFF FILES : LPA conducted a file review of staff records at 12:00 pm. RESIDENT FILES : LPA conducted a file review of resident records at 1:00 pm. Exit Interview was conducted, and a copy of this report was given to applicant.