Routine inspection·August 29, 2025

On August 29, 2025, at 8:45 AM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Administrator (ADMIN) Saleem Moosani and explained the purpose of the visit. The facility is licensed to operate for four (4) ambulatory residents and two (2) non-ambulatory residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident bedrooms, one (1) Staff bedroom, two (2) bathrooms, living area, family area, dining area, kitchen, attached 3-car garage, swimming pool, and an outside covered patio area. LPA Kim toured indoor and outdoor of the physical plant with ADMIN Moosani. There are no obstructions on premises. There is a swimming pool located in the backyard that is enclosed with a fence which makes it inaccessible for the residents. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. All bedrooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, and Resident Room 4. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured between 116.7 degrees F and 119.3 degrees F. A comfortable temperature of 75 degrees F was maintained in the facility. LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. Evaluation Report Continues on LIC 809-C The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food and emergency water is stored in the kitchen pantry. A working telephone (714-660-9268) remains available. First Aid Kit contained all the necessary elements. During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). LPA conducted an audit of resident files (R1-R6), staff files (S1-S8) and medication and medication administration review. S1 did not have background clearance. S2 and S3 were missing health screening and first aid training. S4 and S5 were missing training hours for 2025. LPA Kim conducted 1 staff interview and 3 resident interviews. LPA Kim observed R1 and R2 had full bed rails and were not on hospice. Deficiencies were cited during this inspection visit according to the California Code of Regulations (Title 22, Division 6 Chapter 8). S1 did not have background clearance for the facility. S2's and S3's health screening and first aid training were not in their files. S4 and S5 were missing training hours for 2025. LPA Kim observed R1 and R2 had full bed rails and were not on hospice. A civil penalty was assessed for S1 not having background clearance. An exit interview was conducted, and a copy of this report, LIC811, LIC421BG, and the appeal rights were provided to Administrator Saleem Moosani