Routine inspection·September 19, 2025

Licensing Program Analyst (LPA) Hanna Gough arrived at the facility to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with facility designated Administrator (AD) Ali Naghibi and discussed the purpose of the visit. The facility currently has five residents in care. The facility is a one story home with six resident bedrooms, one staff bedroom, eight bathrooms, kitchen, living room, dining room, laundry room and attached two car garage. The facility appears clean, safe and sanitary. LPA observed the residents napping and watching tv in their bedrooms. LPA observed all resident bedrooms had the required components and furnishings. LPA observed the restrooms to be stocked with toilet paper, paper towels and nonslip mats in the shower. LPA tested the hot water to be between 120.2 and 120.7 degrees Fahrenheit. LPA observed AD turn the water heater down. LPA observed the kitchen to be clean and free of vermin. LPA observed a fire extinguisher in the kitchen charged and with a purchase date of March 7, 2025. LPA observed the knives to be locked and inaccessible to residents in care. LPA observed the toxins and chemicals to be locked making them inaccessible to residents in care. LPA observed a two day perishable and seven day nonperishable food supply on hand. LPA observed the centrally stored medication to be in a locked cabinet located in the laundry room making them inaccessible to residents in care. LPA observed the emergency food supply to be stored in the garage. LPA observed the backyard to have a shaded seating area for resident use. LPA observed the backyard to be free of debris and obstructions. LPA and AD tested the carbon monoxide detectors and they were found to be operational. Continue on LIC 809C LPA reviewed staff files and no discrepancies were observed. LPA reviewed 4 resident files and 3 of 4 residents do not have updated needs and services plans. 2 of 4 residents do not have a tb test. 1 of 4 residents do not have a medical assessment. LPA reviewed resident medication and R1 has 2 over the counter medications that do not have a prescription from a physician and R3 has 6 over the counter medications that do not have prescriptions. Due to the facility Administrator being out and at an appointment. LPA requested liability insurance and fire drills to be emailed to LPA by COB September 19, 2025. Based on today’s observations deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with facility designated AD Ali Naghibi and a copy of this report along with LIC809D, LIC858, LIC9102 and appeal rights were left at the facility.