Routine inspection·April 13, 2026

At 9:10 AM, Licensing Program Analyst (LPA), Huma Rahimi conducted an unannounced required annual inspection and met with the staff Liana Babaian who granted access to the facility. The staff contacted the Administrator via a telephone and LPA explained the reason for the visit. Today's site visit consisted of LPA touring the physical plant inside and outside and observed the following: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, oven, and a sink. Stove was observed in a good working condition. At 9:20 AM, LPA did not observe a seven day supply of non-perishable food and a two day supply of perishable foods. LPA observed almost empty (one cup remaining) gallon of milk, two eggs, opened and rotten fish container, two cauliflowers, and a quarter gallon of orange juice. Staff informed LPA that two residents did not have their breakfast yet. During the visit, at around 12:00 pm, LPA observed that Resident #6 (R6) requested for a glass of milk and the staff was unable to provide. Additionally, LPA observed a knife, a scissor, and staff's medication in one of the drawers in the kitchen unlocked and accessible to residents in care. LPA also observed that residents' medication were kept in the kitchen in two cabinets (upper & lower) of which the upper one was observed locked and the lower one was unlocked and accessible to residents in care. LPA observed another drawer in the kitchen where the rest of the sharps/knives were kept locked. LPA observed a Fire Extinguisher and was last purchased on 04/13/2026. Continue on LIC 809C MEDICATION ROOM: The centrally stored medication were observed in two upper and lower cabinets of the kitchen and the upper cabinet was observed locked and the lower cabinet was unlocked and accessible to residents in care. LPA observed the residents and staff files locked in a locked cabinet in the living room. BEDROOMS: There are three (3) bedrooms designated for residents use. All bedrooms are shared. LPA observed that all bedrooms are furnished with beds, dressers and required bedding and linen. The bedrooms have sufficient closet space and have sufficient lighting. Auditory alarms were tested and were observed to be operational. Furthermore, LPA observed the emergency exit in bedroom #2 (Bedridden room) to be completely blocked by a resident bed. Additionally, LPA observed resident medication to be unlocked to residents in bedroom #2 (bedridden). LPA observed Resident #1 (R1) with half bedrail and LPA asked the Administrator if there is a physician order and the Administrator stated that he did not know that he was supposed to have it. The facility has an awake staff. BATHROOMS: There are three (3) bathrooms at the facility of which two are for residents' use and one for staff use. LPA observed the staff bathroom unlocked and accessible to residents in care with clorox on the top of the toilet tank, drain clog remover, disinfectant spray next to the toilet. L PA observed all bathrooms are clean and in good repair. Properly supplied with toilet papers, soap and paper towels. LPA observed appropriate grab bar and had non-skid mat The water temperature was noted at 112.5°. In one of the residents' bathroom, LPA observed under the sink cabinet to have a Clorox gallon and Awesome Bleach gallon and was observed unlocked and accessible to residents in care. Additionally, LPA observed A+D treat & heal cream in the bathroom drawer unlocked and accessible to residents in care. LAUNDRY ROOM: The laundry room is located in the kitchen and all cleaning supplies and laundry detergents were observed tol be locked in standing closet by the laundry machines inaccessible to residents in care. The washer/dryer appear to be in good working condition. Continue on LIC 809C COMMON AREAS: The facility maintains a comfortable temperature at 73°F. The living room and dining area appeared clean and were properly furnished and has a television. Additionally, self-closing fire door was altered by taking out the door handle and was plastered completely and placed a air freshener spray in the middle of the door to prevent from closing during the emergency. The Administrator stated that he did not know and LPA explained the reason why the fire door is not supposed to be blocked or altered. No any other obstructions and or tripping hazards throughout the facility. LPA observed a working telephone for the facility. SURROUNDING GROUNDS: The facility has sufficient backyard space. LPA did observe appropriate outdoor furniture in the backyard of the facility that can accommodate six (6) residents, LPA observe a covered shaded area for residents. There is no swimming pool or any bodies of water at the facility. The exit was free of any obstruction or hazard. Garage/Storage: The facility does not have an extra space or a garage. SMOKE DETECTORS/CARBON MONOXIDE. Smoke detectors and carbon monoxide were located throughout the facility. At 9:35 AM, they were tested and observed to be operational. Between 11:30 AM to 1:15 PM, LPA reviewed records of six (6) residents and three (3) staff. LPA observed that Resident #1's (R1's) records were missing a TB test results and consent forms, Resident #2 (R2) records had a partially completed Appraisal Needs and Services Plan (LIC 625), Resident #3 (R3) records were missing a Physician report, TB test results, consent forms, and LIC 625, Resident #5 (R5) records were missing LIC 625 and TB test results, and Resident #6 (R6) records were missing ID information, consent forms, and LIC 625. During the staff file review, LPA observed that Staff #1 (S1) records were missing 1st Aid and CPR training, and in-service training. Staff #2 (S2) records were missing TB test results, 1st Aid and CPR training, in-service training and health screening form (LIC 503). Upon LPA's request for the Administrator facility file, the Administrator asked LPA if the Administrator is also supposed to have a facility file available for review. During the visit, LPA observed that the Administrator lacked knowledge of the title 22 regulations and rules and stated that he did not know. Administrative: LPA collected LIC500. Deficiencies issued during today's visit. Appeal rights explained. Exit interview conducted and copy this report signed and delivered.