Robabeh

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Daiquiri Boyd arrived at the facility to conduct an unannounced Annual Inspection. LPA was greeted by staff, who called Licensee/Administrator (AD) Gita Khattaie, who came to the home a short time later. LPA began the tour by entering through the front door of the 5 bedroom - 5 bathroom home. Common living spaces have new, clean furniture and lighting. Flooring is intact throughout the home. Smoke and Carbon Monoxide detectors were tested and found to be in working order. The Fire Extinguisher was purchased in 12/2025. LPA observed a supply of extra bed linens, towels, and personal hygiene and grooming products. Resident rooms are found to be in good repair and contained required furnishings, and lighting. The resident bathrooms are clean, in good repair with faucets delivering hot water at 113 F degrees. The kitchen was observed to have a supply of dishes, plates, utensils and cooking items. Food storage areas are clear and appropriate for food preparation. Cleaning supplies, chemicals, and sharps/knives are locked as required. Appliances were found to be in working order. Resident medications are stored in a designated locking dining room closet. The First Aid kit is new and contains all required items. Doors and passageways are unobstructed throughout the inside and outside of the home. Outside of the facility was toured. There is a swimming pool which is enclosed by a locked, wrought iron gate. There is a covered seating area on the back patio. There is a rental house in the backyard. Required postings are placed. Disaster Plan, Plan of Operation, and Infection Control Plan were reviewed. Resident binders were reviewed, LPA found that there were missing and incomplete documents. Staff binders were not present at the facility, AD stated she would email them to me at a later time. LPA, together with AD, pulled up the CCLD website and reviewed where to find documents, forms, and information. LPA explained to AD that she can call the Regional Office and ask for the Officer of the Day at any time, to seek additional help. Deficiencies were issued on this day. A copy of this report was given to AD whose signature on this form confirms receipt of these reports. LPA requested Licensee to submit the following documents to Licensing by 03/11/2026: LIC500, Proof of Liability Insurance.the state’s words, verbatim · CDSS document, Mar 3, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Daiquiri Boyd arrived at the facility to conduct a Pre-Licensing Inspection. LPA met with Licensee/Administrator (AD) Gita Khattaie. LPA began the tour by entering through the front door of the 5 bedroom - 5 bathroom home. Common living spaces have new, clean furniture and lighting. Flooring is intact throughout the home. Smoke and Carbon Monoxide detectors were tested and found to be in working order. The Fire Extinguisher was purchased in 12/2024. LPA observed a supply of extra bed linens, towels, and personal hygiene and grooming products. Resident rooms are found to be in good repair and contained required furnishings, and lighting. The resident bathrooms are clean, in good repair with faucets delivering hot water at 120 F degrees. The kitchen was observed to have a supply of dishes, plates, utensils and cooking items. Food storage areas are clear and appropriate for food preparation. Cleaning supplies, chemicals, and sharps/knives are locked as required. Appliances were found to be in working order. Resident medications will be stored in a designated locking dining room closet. The First Aid kit is new and contains all required items. Doors and passageways are unobstructed throughout the inside and outside of the home. Outside of the facility was toured. There is construction in the backyard that is kept separate by a chain link fence. There is a swimming pool which is enclosed by a locked, wrought iron gate. There is a covered seating area on the back patio. LPA confirmed the facility phone number is activated by calling (559) 470-9206. Required postings are placed. See continuation of inspection on LIC809C. LPA, together with AD, pulled up the CCLD website and reviewed where to find documents, forms, and information. Emergency Disaster and Infection Control Plans were reviewed and COMP III was conducted during this visit with AD. The applicant has met all pre-licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued. An exit interview was conducted and a copy of this report was left with AD, whose signature confirms receiptthe state’s words, verbatim · CDSS document, Jan 31, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): COMP II Participants: Gita Khattaie, licensee/admin Interview Method: Telephone interview On December 13, 2024, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Activities/Medication 3. Staffing requirements & Training 4.General provisions/Pre-Licensing Readinessthe state’s words, verbatim · CDSS document, Dec 13, 2024