Routine inspection·April 29, 2026

On 04/29/2026, Licensing Program Analyst (LPA) Janette Romero conducted an announced visit to the facility to conduct a required annual inspection. LPA met with Licensee Mahboubeh Arabshahi who was informed of the purpose of the visit. Licensee reported the facility has not accepted resident placement for approximately the past eight (8) years. However, licensee wishes to maintain the facility's license active in the event she decides to accept resident placement in the future. Licensee was advised to notify Community Care Licensing if and when she receives resident placement. The facility has a fire clearance for six (6) non-ambulatory elderly residents to reside in the facility's first floor. LPA toured the facility with licensee and observed the facility is made up of a two-story home with four (4) resident bedrooms, two (2) bathrooms, a kitchen, dining room, living room, and attached garage. The facility has operating utilities including electricity, water, and gas. Two of four resident bedrooms are adequately furnished. The required bedding and furniture for the remaining two rooms is stored in the garage and available for future resident placement. Resident bathrooms are equipped with grab bars. The facility has a working refrigerator and kitchen cabinet space to store a two-day supply of perishable foods and seven-day supply of non-perishable food items. Indoor and outdoor pathways are free of obstruction. No bodies of water were observed on the premises. Licensee tested the smoke alarms/carbon monoxide detectors and LPA heard them to be operational. LPA observed a charged fire extinguisher in the kitchen with a tag noting it was last serviced on 03/22/2024. Due to not having resident placement in years, LPA was unable to review resident records. Licensee's administrator's certificate expires on 06/09/2027. Licensee reported there have not been any changes to the individual licensee entity since the facility became licensed. The facility's licensing fees are current and do not have an ongoing balance. The facility has separate areas to secure centrally stored medications, disinfectants, sharp objects, confidential resident/staff files, and other potentially hazardous items for future residents. During today's visit, LPA did not observe evidence to suggest the home is currently occupied by residents. Long-Term Care Ombudsman's contact information, resident's personal rights, and updated emergency disaster plan are visibly posted on the hallway wall leading to the dining room. No deficiencies were cited during today's visit. An exit interview was conducted and a copy of this report was reviewed and provided to Licensee Arabshahi.