Routine inspection·September 23, 2025

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation using the CARE Inspection Tool. LPA was greeted and granted entry by Caregiver Ronelex Dalut and stated the reason for the visit. Administrator (Admin) Arya Maghbouleh arrived on premise and remained at the facility to assist with the inspection. Admin Arya has a valid administrator's certificate expiring on August 17, 2027, August 17, 2027 for Arash Maghbouleh, and August 15, 2027 for Arlene Mahinay The following was observed during the inspection: This is a single story property located in a residential neighborhood comprised of five resident bedrooms and two resident bathrooms. Facility operates within the conditions and limitations specified on the license. LPA observed four residents in care of which two are receiving hospice services. LPA observed three caregivers on duty and verified fingerprint clearance and association statuses including the administrators. LPA toured the interior portion of the facility. All common areas were inspected which includes the laundry room and attached two car garage. The fireplace was screened. LPA inspected the five resident bedrooms. The resident bedrooms' were appropriately furnished, beds and bedding supplies were in good condition, adequate lighting was provided, and sufficient storage space for each residents' personal belongings were observed. All bathrooms were found be in compliance, clean, and operational. The hot water temperature in both bathrooms measured at 112.8 and 111.3 degrees Fahrenheit. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed ample two-day supply of perishables and seven-day supply of non-perishable food. LPA toured the exterior portion of the facility. The outdoor passageway is free of obstruction. The two exit gates on each side of the property were operational, and there were sufficient seating and shading in the patio area. The two fire extinguishers were serviced on June 13, 2025 per review of the invoice. The auditory devices and smoke/carbon monoxide detectors were tested and operational. LPA observed the emergency food/water and supplies in the closet and kitchen. The first aid kit had all necessary elements. Fire drills were conducted monthly. The required Complaint Poster (PUB475) poster was posted in the entry way in the correct size requirement. LPA reviewed four out of four resident files and three personnel files in which no discrepancies were found. Facility maintained all bed rail orders for the three residents. Medications were audited for two out of four residents and no discrepancies were found. The following was addressed during the visit: to ensure the emergency drills conducted account different emergency scenarios. Admins were advised to inform the Department prior to making any alterations and will provide a plan as discussed during the consult. Based on the observations made during today's visit, no deficiencies are being cited. An Advisory Note is being issued. An exit interview was conducted with Administrators Kathy Maghbouleh, Arya Maghbouleh, and Arash Maghbouleh, and a copy of this report was provided at exit.