Routine inspection·April 27, 2026

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced, required Annual Inspection. The facility file and personnel report was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Caregivers Weny Labuguin and Angelita Hernandez. Administrator Ray Baha arrived shortly after LPA. The facility's license shows a maximum capacity of six (6) non-ambulatory residents. Bedrooms #1, #4, #5, and #6 are approved for bedridden. Additionally, the facility is approved for a hospice waiver for six (6). During today’s inspection there were four (4) residents in care, with none currently on hospice. Note, LPA did step out from 12:50-1:50 for lunch. LPA and Administrator Baha toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Hot water temperature at taps accessible to clients were all compliant: common bathroom sink adjacent to bedroom #7 was 107.2F. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least two (2) days of perishable food, and at least seven (7) days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. Knives were locked and inaccessible to residents. While looking at the unlocked cabinet under the sink, LPA observed a number of cleaning chemicals. One type A deficiency was issued for the accessible chemicals to residents. Staff immediately moved the items to a locked storage room. [Continued on LIC 809-C] [Continued from LIC 809] Additionally, while touring the enclosed courtyard at the center of the home, LPA was shown the doorway to the garage area. LPA observed that the door was only lockable from the inside and was currently unlocked. Inside the garage were a number of chemicals, in addition to an accessible door into the medication/chemicals storage room. Per Administrator Baha, the facility was in the process of changing several locks (garage door included) in the home so that they are all accessible by the same key for efficiency. Administrator Baha locked the doorway from the inside and exited through the lifting garage door so that the garage was no longer accessible to residents. LPA observed that the doors to the enclosed courtyard space were unlocked, allowing for resident access. However, the exterior doors of the home leading outside were all locked aside from the front door and required a key to open. The facility does not have approval for locked exterior doors and/or a locked perimeter. Administrator Baha explained that the exterior yard is not safe for resident use and the enclosed courtyard is the designated outdoor space for resident use. One type A deficiency was cited for the unapproved locked exterior doors. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Administrator Baha, no firearms or ammunition are kept at the facility. Smoke and carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguishers were serviced within the last 12 months, dated for February 2026. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA observed a private care aid (identified as S1) who was present at the facility for their assigned resident (identified as R1). LPA requested S1's background clearance from the facility for review and was informed that they did not have it on file. Per interview with S1, it was revealed S1 was not employed by a private care agency. Upon review of the Guardian background check database, it was revealed that S1 had not undergone the LiveScan process (fingerprint submittal and background check). One Type A deficiency was issued for S1 providing care and supervision services on the premises without a required background check. LPA ensured S1 was escorted off the premises. [Continued on LIC 809-C] [Continued from LIC 809-C] While at the facility, LPA observed five (5) camera monitor systems displaying common facility areas and the inside of four (4) resident rooms, along with audio from each space. Per Administrator Baha, the responsible parties of the residents were aware of the use of cameras in private spaces and gave permission. While the use of surveillance cameras are not expressly prohibited in Title 22 regulations, efforts to protect resident privacy must be maintained by the facility and a waiver request must be submitted to the Department for camera use in private resident rooms. An audio component for video surveillance in facilities is strictly prohibited. One Type B citation was issued for the use of video and audio surveillance in private areas of the facility without Department approval. Administrator Baha turned off all five monitors. LPA interviewed two (2) staff and one (1) clients, and interviews did not reveal any additional licensing or regulatory concerns. LPA reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. LPA noted consent forms signed by resident responsible parties included in the files of only three (3) of the four (4) resident rooms that contained cameras. Four (4) deficiencies were cited during the inspection. An exit interview was conducted with Administrator Baha to whom a copy of this report, the LIC 421BG form, and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.