Routine inspection·June 17, 2024

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Amelia Matoneng, Caregiver. During today’s visit, LPA met with Moneli Sharifan, Administrator Designee (AD). The facility is a single story building with an approved fire clearance of six non-ambulatory residents of which one may be bedridden with a hospice waiver for six. The facility currently has a census of six residents in care with three on hospice. During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperature in two of two resident bathrooms, and testing auditory devices on all exits . The hot water temperature measured between 116.2 and 120.5 degrees Fahrenheit and all smoke detectors were operational . The fire extinguisher is charged and was serviced on February 28, 2023. The facility’s last fire drill was conducted on May 8, 2024. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand . LPA observed med ic ation storage and reviewed the centrally stored medications. Per review medications appea r to be being given as prescribed. LPA reviewed three of three staff training and fingerprint records. LPA conducted a complete review of resident records. LP A interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. LPA confirmed that administrator designee has a current administrator certificate which expires on May 13, 2025. The administrator on record, Shahin Mokhtarzad also has a current certificate and was at another location. Based on the observations made during today’s visit, the facility appears to be in compliance with Title 22 Division 6 of the California Code of Regulations, no deficiencies cited on this date. An exit interview was conducted with Moneli Sharifan, AD and a copy of the report and files reviewed (LIC 858 & LIC 859) were given at the time of the visit.