Ash Enterprises

Type of visit: Required - 1 Year

On 12/16/2025 at 09:30 am Licensing Program Analyst (LPA) Lorena Casillas arrived at the facility for an unannounced one (1) year required visit. LPA was greeted and granted access by a staff member. LPA met with Licensee, Arlen Shahverdian. LPA informed Licensee of the purpose of the visit, entrance interview conducted. A fire clearance was approved on 8/20/2024, for four (4) non-ambulatory residents and two (2) ambulatory residents for a total capacity of six (6). The facility has four (4) bedrooms, three (3) of which are shared and for resident use. Currently the facility is occupied by six (6) residents. INFECTION CONTROL and EMERGENCY PREPAREDNESS PLAN: LPA reviewed facility Infection Control Plan and Emergency Preparedness Plan to make sure facility is following protocols. A tour of the physical plant was initiated at 10:30 am and the following was observed: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven and sink. There is an adequate supply of two (2) day perishable and seven (7) day nonperishable foods. LPA observed the kitchen to be clean and clear of clutter. All appliances were operative. Cleaning solutions are locked under the sink. Knives are kept locked in a kitchen cabinet inaccessible to residents. Continued on LIC809-C BEDROOMS: The facility has four (4) bedrooms, three (3) bedrooms are for resident use. Bedroom #1 and Bedroom #3 are designated for two (2) non ambulatory residents each. Bedroom #2 is designated for two (2) ambulatory residents. The applicant furnished the resident bedrooms with beds, nightstand, chairs, dresser, bedding and linens. All rooms had sufficient lighting. BATHROOMS: The facility has two (2) bathrooms. Bathrooms were observed to have the proper fixtures, trash cans with lids, paper towels, and non-skid mats. The hot water delivered in the bathrooms measured 116.9˚F. COMMON AREAS: These include the living room and dining room areas, which are equipped with living room furniture, a television, tables, and chairs. The dining room table is large enough to accommodate up to six (6) residents. There were no visible immediate hazards. The smoke alarms are functional, hard-wired and inter-connected. The carbon monoxide detector is functional. The facility has one fire extinguisher in the hallway that was purchased on 01/05/2025 and is fully charged. LAUNDRY ROOM: Laundry room is adjacent to the garage and has a functioning washer and dryer. Cleaning detergents and supplies are locked in the garage. MEDICATIONS: Medications and first aid kit are stored in a locked cabinet in the hallway closet. GARAGE: The garage is used for storage. There is a refrigerator used for extra food and water. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home were clear of obstruction. The backyard of the facility has a patio and backyard furniture. The facility backyard has sufficient yard space to accommodate outdoor activities. There are no bodies of water. STAFF AND RESIDENT FILES: LPA conducted a file review of staff records at 12:30 pm. No deficiencies cited. Exit Interview was conducted. Copy of report provided to Licensee.the state’s words, verbatim · CDSS document, Dec 16, 2025

Allegation investigated: Staff are financially abusing resident in care. Staff are not administering medication(s) to resident in care as prescribed. Staff do not ensure that resident's laundry needs are being met while in care. Staff do not ensure that resident is adequately fed while in care.

On 10/29/25 at 10:00 am, Licensing Program Analyst (LPA) Lorena Casillas conducted an unannounced 10-day complaint visit to the facility to investigate the above allegations. LPA was greeted and granted access to the facility by staff. LPA spoke with Administrator Artisha Hickman and explained the reason for the visit. Entrance interview conducted. At approximately 10:30 am, LPA requested copies of resident and staff rosters. LPA also requested copies of admission agreements, medication records, food menu and any documents relevant to the investigation. At 11:30 am, LPA conducted a physical plant tour to ensure the health and safety of the residents are protected. At approximately 12:00 pm LPA conducted a file review of documents provided. Between 10:30 am and 03:30 pm, LPA conducted interviews with Administrator, one (1) staff, and five (5) out of five (5) residents. Continued on LIC9099-C Unsubstantiated Allegation#1: Staff are financially abusing resident in care. It is alleged that staff are financially abusing resident in care. Regarding this allegation it is reported that Resident #1 (R1) had given their food stamp card to a staff member so that Halloween candy could be purchased on R1’s behalf, but instead of purchasing the candy, the staff member took R1’s cash benefits out of the account. Interview with R1 revealed that R1 gave their food stamp card to a staff member with the name “Lopez” and that “Lopez” took out their cash benefits. R1 then stated that R1’s funds were stolen but when LPA asked how much was stolen, R1 stated that it was food stamps. LPA asked if R1 receives cash benefits and R1 stated that they do not. LPA inquired about a PIN for a food stamp card and R1 stated that only they knew the PIN confirming that this was not shared with anyone. LPA interviewed Administrator who denied this allegation and stated that staff are not allowed to and do not take any cards from the residents to make purchases as they do not handle residents’ finances. Administrator states that residents are responsible for their own finances as described in the Admission Agreement/House Rules section. Furthermore, Administrator stated that a PIN is required to use a food stamp card and that no one but the residents would have access to that PIN, also none of the residents receive actual money in their cards because they receive Social Security Insurance (SSI) making them ineligible for cash benefits. Interview with Staff #1 (S1) revealed that at no point do staff take any money or cards from residents, instead the residents are taken to the store of their choice and staff assist residents with the purchase of what they need, but do not directly make purchases for the residents to avoid this exact situation. LPA interviewed four (4) additional residents and all of them stated that the staff is not directly involved in making purchases for them, instead staff take them to the store and residents make their own purchases. LPA reviewed personnel records and there is no staff or has ever been a staff member with the name or last name of “Lopez”. LPA reviewed Admission Agreement/House Rules section where it is stated that facility is not responsible for resident finances as they handle their own. Therefore, based on interviews, record reviews and observations, this allegation is deemed unsubstantiated. Continued on LIC9099-C Allegation#2: Staff are not administering medication(s) to resident in care as prescribed. It is alleged that staff are not administering medication(s) to resident in care as prescribed. Regarding this allegation it is reported that Resident #1 (R1) is not getting their medication as prescribed. Interview with R1 revealed that they do not remember making this statement nor does R1 recall going without medication or not having medication administered as prescribed. Interview with Administrator revealed that R1 was having issues with their insurance and there had been a delay in establishing a primary care provider. However, when R1’s medication ran out the Administrator resorted to taking R1 to the hospital to get R1’s medication refilled. Adding that at no point did R1 go without medication as the facility had sought alternate means of getting medication through the hospital. Furthermore, Administrator stated that this is no longer an issue and that R1 has had a primary care doctor for approximately two (2) months and has had continuous medical attention to include medication and administration of said medication. Interview with Staff #1 (S1) confirmed what Administrator stated, adding that R1 has not gone without medication and that S1 and other staff administer the medication as instructed by the care provider. Interview with other residents present revealed that none of them have gone without medication nor do they have any concerns with not having or not getting medication administered as prescribed. LPA reviewed medication logs and could not find a lapse in medication being administered to any of the residents. Therefore, this allegation is deemed unsubstantiated. Allegation #3: Staff do not ensure that resident’s laundry needs are being met while in care. It is alleged that staff do not ensure that resident’s laundry needs are being met while in care. Regarding this allegation it is reported that Resident #1 (R1)’s laundry is not being done. LPA interviewed R1 and they admitted that laundry services are being met and that there are no concerns regarding laundry, that this was a mistake on R1’s part and that there are no issues with laundry services. Administrator denied the allegation, stating that staff are constantly doing residents’ laundry sometimes twice a day depending on their needs. If a resident were to refuse, Administrator states that they respect their wishes, however that has not been the case. Interview with S1 corroborates Administrators’ statement adding that they offer doing laundry for all residents, some take the offer and some don’t but those that refuse are usually asked again, and they tend to agree. Interview with four (4) residents revealed that they do not have any concerns with laundry and that staff are attentive to their needs, offering to do the laundry or assist with doing the laundry with them. During facility tour LPA was able to observe the laundry room equipped with washer, dryer and locked detergents. LPA also observed staff currently assisting a resident with a load of laundry. Therefore, based on interviews and observations this allegation is deemed unsubstantiated. Allegation #4: Staff do not ensure that resident is adequately fed while in care. It is alleged that staff do not ensure that resident is adequately fed while in care. Regarding this allegation it is reported that Resident #1 (R1) is not being well fed. Interview with R1 revealed that they are being adequately fed and that they did not mean to say that they were not being well fed. R1 stated that the food is good and that R1 is given enough, sometimes R1 just has behaviors and throws the food provided. LPA interviewed Administrator who denied the allegation, stating that there is always plenty of nutritious food in the facility for all the residents. Administrator stated that resident requests are taken into consideration when putting the menu together in efforts to make sure that residents are happy with the meals provided. Interview with Staff #1 (S1) revealed that the staff personally assist with putting together the menu with the residents so that they all are included. Furthermore, it was revealed by S1 and Administrator that R1 either throws their food away or throws their food on the floor, refusing to eat what has been served, but that an alternative is always offered and R1 eats that instead. Interview with four (4) residents revealed that they are asked what they would like to eat and confirmed that it is included in the menu, they also stated that the food is well made. Additionally, three (3) residents revealed that they have witnessed R1 throwing the food served away, but staff replace it with something different and R1 eats it. During LPA tour it was observed that kitchen was well stocked with the required two-day of perishable and seven-day non-perishable foods. It was also observed that staff was preparing a fresh meal for lunch. LPA reviewed weekly menu and food listed on the menu was present in the facility. Therefore, based on record review, interviews and observations, this allegation is deemed unsubstantiated. No citations issued. Exit interview conducted. Appeals rights discussed and provided along with copy of the report.the state’s words, verbatim · CDSS document, Oct 29, 2025 · control 31-AS-20251023113527

Type of visit: Post Licensing

On 04/30/2025 at 09:30 am, Licensing Program Analyst (LPA) Lorena Casillas conducted an announced Post-Licensing Inspection with Licensee Arlen Shahverdian and Administrator Artisha Hickman. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on 05/09/2024. A fire clearance was approved on 8/20/2024, for four (4) non-ambulatory residents and two (2) ambulatory residents for a total capacity of six (6). The purpose of today’s visit is to inspect the facility to ensure that it maintains compliance under California Code of Regulations, Title 22, Division 6. A tour of the physical plant was initiated at 10:30 am and the following was observed: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven and sink. There was an adequate supply of two (2) day perishable and seven (7) day nonperishable foods. LPA observed the kitchen to be clean and clear of clutter. All appliances were operative. Cleaning solutions are locked under the sink. Knives are kept locked in a kitchen cabinet inaccessible to residents. BEDROOMS: The facility has three (3) bedrooms for resident use. Bedroom #1 and Bedroom #3 are designated for two (2) non ambulatory residents each. Bedroom #2 is designated for two (2) ambulatory residents. The bedrooms are furnished with beds, nightstands, chairs, dresser, bedding and linens. All rooms had sufficient lighting. Continued on LIC809-C BATHROOMS: The facility has two (2) bathrooms. All bathrooms were observed to have the proper fixtures, and non-skid mats. The hot water delivered in the bathrooms measured 116.9 degrees F. COMMON AREAS: These included the living room and dining room areas, which are equipped with living room furniture, a television, tables, and chairs. The dining room table is large enough to accommodate up to six (6) residents. There were no visible immediate hazards. The smoke alarms are hard wired and inter-connected. The carbon monoxide detector is functional. The facility has one fire extinguisher that was purchased on 10/18/2024 and is fully charged that is located in the kitchen. LAUNDRY ROOM: Laundry room has washer and dryer. Cleaning detergents and supplies are locked in the garage. MEDICATIONS: Medications and first aid kit are stored in a locked cabinet in the hallway closet. GARAGE: The garage is used for storage. There is a refrigerator used for extra food and water. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. The backyard of the facility has a patio and backyard furniture. The facility backyard has sufficient yard space to accommodate outdoor activities. There is no swimming pool or bodies of water. STAFF FILES: LPA conducted a file review of staff records at 12:00 pm. RESIDENT FILES: LPA conducted a file review of resident records at 1:00 pm. Exit Interview was conducted, and a copy of this report was given to applicant.the state’s words, verbatim · CDSS document, Apr 30, 2025

Type of visit: Prelicensing

On 11/19/2024 at 09:30 am, Licensing Program Analyst (LPA) Lorena Casillas conducted an announced Pre-Licensing Inspection with Licensee Arlen Shahverdian and Administrator Artisha Hickman. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on 05/09/2024. A fire clearance was approved on 8/20/2024, for four (4) non-ambulatory residents and two (2) ambulatory residents for a total capacity of six (6). The purpose of today’s visit is to inspect the facility to ensure that it maintains compliance under California Code of Regulations, Title 22, Division 6. The Component III presentation was conducted from 10:15 am until 12:05 pm with Licensee and Administrator. A tour of the physical plant was initiated at approximately 01:00 pm and the following was observed: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, microwave oven and sink. There was an adequate supply of nonperishable food and dining ware to accommodate a maximum capacity of six (6). Perishable food will be purchased once residents are established. Knives will be locked in a kitchen drawer. BEDROOMS: The facility has three (3) bedrooms for resident use. Bedroom #1 and Bedroom #3 are designated for two (2) non ambulatory residents each. Bedroom #2 is designated for two (2) ambulatory residents. The applicant furnished the resident bedrooms with beds, nightstand, chairs, dresser, bedding and linens. All rooms had sufficient lighting. BATHROOMS: The facility has two (2) bathrooms. All bathrooms were observed to have the proper fixtures, and non-skid mats. The hot water delivered in the bathrooms measured 119.6 degrees F. COMMON AREAS: These included the living room and dining room areas, which were equipped with living room furniture, a television, tables, and chairs. The dining room table is large enough to accommodate up to six (6) residents. There were no visible immediate hazards. The smoke alarms are hard wired and inter-connected. The carbon monoxide detector is functional. The facility has one fire extinguisher that was purchased on 10/18/2024 and is fully charged that is located in the kitchen. LAUNDRY ROOM: Laundry room has washer and dryer. Cleaning detergents and supplies are locked in the garage. MEDICATIONS: Medications and first aid kit will be stored in a locked cabinet in the kitchen area. GARAGE: The garage is used for storage. There is a refrigerator used for extra food and water. STAFF/RESIDENT RECORDS: Staff and resident records will be stored in a locked cabinet, located in the living room. The applicant was advised to ensure that resident and staff records will be accessible to the licensing agency upon request or during inspection. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. The backyard of the facility has a patio and backyard furniture. The facility backyard has sufficient yard space to accommodate outdoor activities. There is no swimming pool or bodies of water. Exit Interview was conducted, and a copy of this report was given to applicant.the state’s words, verbatim · CDSS document, Nov 19, 2024

Type of visit: Office

Facility Type:RCFE Application Type:Initial Capacity:6 Census 0 COMP II Participants: Name, Title Interview Method: Telephone interview On [08/29/2024], 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. 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, Aug 29, 2024