Victoria Care Home 2

Type of visit: Required - 1 Year

On 08/24/2026, Licensing Program Analyst (LPA) V Gorban arrived unannounced to conduct Required Annual Inspection. LPA met with staff Helen Jovenir. Administrator (AD) was notified and arrived shortly, certification number 7000632740 and expiration date 10/17/2027. LPA conducted facility tour inside and out of facility with staff. Five residents observed at the facility in rooms during breakfast time. The facility was observed to be at a comfortable temperature of 75 degrees, clean, in good repair, and no passageway obstructions or fire hazards observed. Fire extinguisher was observed with a service date of 01/08/2026 Last fire/ disaster drill conducted and recorded in June 2026. Dining area and Kitchen were toured. An adequate supply of perishable and non-perishable food was observed to be properly stored in freezer, refrigerator, and pantry. Food is delivered once a week. The facility is comprised of single level, residents’ rooms observed. The census during the visit is 5 assisted living residents, one out of five are under hospice care. LPA toured resident bedrooms. Residents' rooms were toured and observed adequately furnished with bed, dresser, and adequate lighting. Hot water temperature tested at 105 degrees F. LPA observed securely fastened grab bar and non-skid mat in shower area. Medications were stored in a locked medication cart in the hallway. Medications records were reviewed. The first Aid Kit was observed with all required items. LPA toured the laundry room and observed chemicals were stored and locked in for staff use only. LPA reviewed facility records with no concerns observed. The facility courtyard was toured and observed to be free from debris. LPA requested facility files for review. Exit interview conducted, report signed and copy of this report provided for facility recordsthe state’s words, verbatim · CDSS document, Aug 24, 2026

Type of visit: Post Licensing

On 2/03//2026, Licensing Program Analyst (LPA) M, Medina conducted an unannounced Post Licensing Inspection. LPA arrived, introduced self, and allowed entrance. LPA me with Administrator, Nahrin Davoodi, Harmeen Jhutti and Charise Canlas. The facility is a 5 bedroom and 2 bathroom home, there are currently six (6) residents in home. All residents were home at time of visit. Facility tour began in residents bedrooms. All bedrooms observed to have required furnishings and adequate lighting. Resident bathroom toured, bathroom fixtures observed operational, shower has a non-skid mat, grab bars and shower chair available. Water temperature measured at 116 degrees F. Facility living room and dining room observed to have adequate seating available for residents in care. Kitchen toured, facility observed to have a 2-day supply of perishable and a 7-day supply of non-perishable food available. All knives observed to be locked and secured, all knobs were removed from stove. Fire extinguisher present with a service date of 1/08/2026, smoke detectors and carbon monoxide detectors present and observed operational during post licensing inspections. Staff and resident files reviewed during inspection. Outside of facility toured. Facility has a shaded area with seating available. Fire exit clear of hazards. No deficiencies observed. A copy of report provided to Administrator for facility records.the state’s words, verbatim · CDSS document, Feb 3, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Katie Brown arrived at the facility to conduct a Pre-Licensing Inspection. LPA met with Administrator (AD) Nahrin Davoodi and Joseph Gitti. LPA began the tour by entering through the front door of the 6-bedroom, 2-bathroom home. This facility has fire clearance for 5 non-ambulatory, 1 bedridden residents. 1 room is designated for care staff. Required postings were observed hung in the entry way. Common areas throughout the home were well lit with functioning ceiling fans, clear walkways and flooring intact. LPA observed required supply of cleaning, disinfecting and paper products properly stored. LPA observed resident bedroom to find required furniture, bed linens, lighting, towels and personal hygiene/grooming products. The bathrooms are clean, with grab bars and skid resistant mats in good repair with faucets delivering hot water at 110 degrees F. Smoke and Carbon Monoxide detectors were tested and found to be in working order. The Fire Extinguishers were purchased 2/10/2025. The kitchen was observed to have a supply of dishes, plates, utensils, and cooking items. Cleaning supplies, chemicals, sharps and knives are locked and stored as required. Appliances were found to be in working order. LPA observed food supply, including separate emergency food, water and supplies. Resident medications will be stored in a locking kitchen cabinet. The First aid kit contained the required items. Doors and passageways are unobstructed throughout the inside of the home. See LIC809C for continuation of this report Page 2 Outside of the facility was toured. There is a covered seating area, and a self-releasing gate found to be working properly. Walkways in front and backyards are clear. The facility phone number is (559) 293-4749 Emergency Disaster and Infection Control Plans were reviewed, and COMP III was conducted during this visit with AD. An exit interview was conducted, and a copy of this report was signed and emailed to 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.the state’s words, verbatim · CDSS document, Jul 9, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): N/A COMP II Participants: Licensee/administrator Nahrin Davoodi Interview Method: Telephone interview On 6/19/2025, 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. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Jun 19, 2025