Routine inspection·May 1, 2025

On 05/01/2025 at 10:00 AM, Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced annual inspection visit at the Montoak One Facility. LPA Calderon was allowed entry into the facility by Administrator Najma Shaheen. The licensee has a license to serve (6) elderly residents ages 59 and older. Currently, there are (6) residents residing in the facility age 59 or older. LPA Calderon explained to Administrator Najma Shaheen, the purpose of the one-year Annual Inspection visit, and escorted LPA Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Calderon reviewed: Six (6) client service records, six (6) client medication records, three (3) staff records, and inspected the inside facility and outside grounds. The facilities’ last fire drill was conducted on 04/10/2025 . The one-story residential home consists of five (5) client bedrooms, two (2) client bathrooms, living room, dining room, kitchen, staff room, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored in the premises. Kitchen was inspected and observed to be clean and operational. A two-day supply perishable and seven-day supply of non-perishable foods are present in the facility. Emergency Water Storage is in the kitchen area. LPA Calderon observed that all facility rooms are clean and in good repair. A comfortable temperature was observed, and the facility has central air and heating. LPA Calderon observed the following during inspection of client’s rooms: mattresses are in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. All bedrooms contain furniture, lighting fixtures and personal storage space as required, all beds have the required amount of linen and mattress covers, LPA Calderon observed fully stocked closet with bedding, towels, and toiletries supplies . Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats and grab bars. LPA Calderon observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 108 degrees Fahrenheit, and bathroom #2 hot water temperature properly measured at 109 degrees Fahrenheit. Kitchen hot water temperature properly measured at 113 degrees Fahrenheit. Facility one (1) Carbon Monoxide and seven (7) Smoke Detectors hard wired and connected were tested and are working properly. The facility one (1) Fire Extinguishers was checked and found to be fully charged and accessible . All exit doors in the facility have alarm systems. All toxins and knifes are locked/secured and inaccessible to clients. Medications are centrally stored and in a locked storage cabinet. Facility first aid kit is fully stocked with manual was checked and in order. A working landline phone was operational. Outside grounds were toured and no bodies of water were observed. All Exits/ Walkways around the home were free of debris and hazards. Outside patio accessible to clients. Six (6) client files were reviewed and found to be complete. LPA Calderon reviewed six (6) resident medications, and they were all found to be administered according to doctor's orders. Three (3) staff files were checked and have the required documents. LPA Calderon noted the Administrator Najma Shaheen Certification # 6043760740 expiration date of 04/12/2025 was NOT valid at time of visit. The facility does NOT handle client's money/cash resources, and a NO Surety bond is needed. Commercial General Liability Policy #001519281 policy period from 01/30/2025 to 01/30/2026 underwritten by James River Insurance Company, coverage 1,000,000/3,000,000 is valid at time of inspection. Administrator Najma Shaheen to email LPA Calderon a full copy of the commercial insurance policy including all endorsements no later than 05/10/2025 . All the required documents are posted in the facility in a clearly visible area. LPA Calderon advised the Administrator Najma Shaheen to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing Provider Informational Notices (PIN) for any updates relating to COVID-19 guidance. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA Calderon did not observe any deficiencies therefore no citations were issued at this time. Annual Licensing Fee is CURRENT. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Administrator Najma Shaheen.