Pre-licensing visit·November 18, 2025

On 11.18.2025 Licensing Program Analyst (LPA) Leslie Ngo-Castaneda arrived at facility at 9:00 AM to conduct a pre-licensing inspection with the administrator. Sarina Shaghaghi (administrator) was greeted upon entering the facility. An application to operate a Residential Care Facility for Elderly (RCFE) was received by Community Care Licensing (CCL) on 10.19.2025. A fire clearance was approved on 09.05.2025 for one (1) bedridden, four (4) non-ambulatory, and one (1) ambulatory residents for a total capacity of six (6). At 9:43 AM, the smoke alarms and carbon monoxide detector were tested, they are hard wired and inter-connected. The facility has two (2) new fire extinguishers that was purchased on 7.24.2025. Located in the facility kitchen and another one in between the dining table and bedroom #1. A tour of the physical plant was initiated at approximately 9:27 AM and the following was observed: KITCHEN: The facility has a kitchen area that is equipped with a refrigerator, microwave oven, and sink. There were adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6). LPA inspected the kitchen and observed gas stove and refrigerator to be clean and working. Knives and sharps are stored in a locked cabinet. Cleaning agents are also stored under the sink with a locking mechanism. BEDROOMS: There are four (4) bedrooms designated for residents use. Bedroom #1 and room #3 are cleared to be private rooms. Bedrooms # 2 and bedroom #4 are shared. The applicant furnished the resident bedrooms with beds, night stand, dresser, bedding, and linen. The bedrooms have sufficient lighting and closet space. The linens were stored in the storage space in each residents bedrooms. Continue to LIC 809-C BATHROOMS: The facility has two (2) bathrooms. Residents bathroom is located in between bedroom #2 and bedroom #3. The bathroom were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water delivered in the bathrooms measured at 116.8 degrees Fahrenheit. Bathroom #2 is located inside bedroom #4. Hot water delivered in the bathroom measured at 117.2 degrees Fahrenheit. COMMON AREAS: The common areas were appropriately furnished these included the living and dining room area. The living room was equipped with couch, tables and chairs. The LPA observed entertainment equipment and games for activities. The dining table is large enough to seat six (6) individuals. The facility has maintained a temperature of 70 degrees Fahrenheit. There were no visible immediate hazards. Water and emergency kits are stored in a cabinet in the kitchen. LAUNDRY ROOM: The laundry room is located by the kitchen beside the exit. The washer and dryer are observed to be operational. All chemicals were stored and locked under the kitchen sink. MEDICATIONS: The medications will be located in the kitchen. It has a locking mechanism. OFFICE/STAFF WORKSTATION: The facility has a staff workstation that is in the living room by the dining table. The first-aid kit is complete. Designated files will be stored in the cabinet by the living room. SURROUNDING GROUNDS: The passageways and entrance to the home was clear of obstruction. All entry and exit doors have a functional auditory alert when the doors open. There is sufficient outdoor space with seating and a shaded area with proper furniture for outdoor use. There are no bodies of water on the premises. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment appears to be compliant and ready for licensee. CAB will be advised, and a copy of this report provided. No health and safety hazard were noted during this visit. Licensee shall contact LPA once the first resident is admitted. Exit interview was conducted and a copy of report was issued. In addition to the pre-licensing inspection, a Component III power point presentation was also held.