Facility Evaluation Report

On 1/10/25 an unannounced annual visit was conducted by Licensing Program Analyst (LPA) Perchui Milena Khurshudyan. Upon arrival, LPA met with the Caregiver Janet Araba, who granted access to the facility. LPA introduced herself and explained the reason for the visit. Shortly after the Administrator, Mubeen Naimuddin arrived and helped with physical plant tour and staff/residents files.

During today's visit, LPA conducted a physical plant walk through, at approximately 11:00am, to ensure that the facility is in compliance with rules and regulations under California Code of Regulations, Title 22.

The facility is a single-story home and is licensed for capacity of six (6) residents, of which six (6) may be Non-Ambulatory and of which fire clearance for six (6) Bedridden. Facility also has a hospice waiver for six (6) residents. There are six (6) bedrooms in the facility of which five (5) are designated for residents’ use. All bedrooms observed to be appropriately furnished. All bedrooms have appropriate lighting. There are three (3) bathrooms in the facility of which two (2) are designated for residents’ use and one (1) for staff use. LPA observed bathrooms have soap, paper towels and hand washing signs. The hot water temperature measured at 11:30 to be 109°F. Extra towels and linens were readily available. There are grab bars for each toilet and shower, bathrooms have non-skid mats. All trash cans in bathrooms had fitted lids to protect from cross contamination.

LPA observed facility alarms were present on all exit doors and all of the signals were functional.

SMOKE DETECTORS/CARBON MONOXIDE. The smoke detectors and carbon monoxide are hard wired, inter-connected and were located throughout the facility. At 12:00pm they were tested and observed to be operational. The facility has one (1) fire extinguisher that was last purchased on August 12, 2024.