Golden Hearts Elderly Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Administrator Nargis Elahi and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents of which 1 may be bedridden. Facility has an approved hospice waiver for 4 residents and the home currently has 1 resident on hospice. LPA and Administrator toured the facility. Facility is a 2 story home, with 8 bedrooms, 5 bathrooms, living room, dining room, kitchen, staff room and a 2 car garage. The Administrator reported that none of the residents reside upstairs. LPA observed the See Something, Say Something poster (PUB 475) posted in the hallway. LPA toured the kitchen. LPA observed a 2 day perishable and a 7 day non-perishable food supply on hand in the kitchen. LPA observed the gas stove lights unassisted and has safety knobs on the stove. The knives are kept secured in a kitchen drawer. Cleaning supplies are kept locked under the kitchen sink. LPA observed all resident rooms are clean and organized. LPA observed all resident rooms had the required furnishings and bed linens. LPA observed all 3 bathrooms downstairs are clean and operational. Hot water measured 115.5 degrees Fahrenheit in all bathrooms. The garage is kept locked and used for storage. LPA observed supplies are kept in the garage. LPA toured the second floor. LPA observed there are 2 staircases upstairs one on the inside and on the outside that goes from the second story balcony to the backyard. LPA did not observe any emergency evacuation chairs at either staircase. LPA toured the backyard. No bodies of water observed. There is a covered patio with chairs to sit outside. No obstacles or hazards observed in the backyard. The exit gate is operational. Smoke detectors/carbon monoxide detectors tested operational. The last emergency drill was conducted on September 21, 2026. LPA reviewed 6 resident files and medications. LPA observed a 3 out of 5 residents did not have a current care plan/appraisal. 5 out of 5 residents did not have a signed acknowledgement of resident rights (LIC613-C) in their file. LPA reviewed 2 staff files. Both staff members are background cleared and associated to the facility. Both staff members are background cleared and associated to the facility. LPA observed Staff 1 does not have 20 hours of annual training. LPA observed Staff 2 does not have 40 hours of training. Both staff members have CPR/First Aid training. Deficiencies are being cited per Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of the report provided along with appeal rights.the state’s words, verbatim · CDSS document, Sep 28, 2026

The state marks this report as 7 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.

Type of visit: POC

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit for the purpose of a Plan of Correction (POC) visit based on deficiencies cited on 09/15/2025. LPA was greeted and granted entry into the facility and explained the reason for the visit. *Deficiency cited under Title 22 Regulation 87202 pertaining to Fire safety has been cleared. Licensee provided proof of correction. *Deficiency cited under H & S Code 1569.625(b)(2) has been cleared. Licensee provided proof of correction. Exit interview conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Oct 23, 2025

Type of visit: POC

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit for the purpose of a Plan of Correction (POC) visit based on deficiencies cited on 09/15/2025. LPA was greeted and granted entry into the facility and explained the reason for the visit. *Deficiency cited under Title 22 Regulation 87202 pertaining to Fire safety has NOT been cleared. Licensee did not ask for an extension however stated on 09/22/2025 that LPA would receive the document on 09/23/2025. During today's visit, Licensee stated it had been sent via email on 09/24/2025 but is not able to show LPA that the document was sent. Licensee provided the document during the visit. Licensee has NOT complied with the terms of the POC. CIVIL PENALTY ASSESSED. Exit interview conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Sep 25, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit to Golden Hearts Elderly Care. The purpose of today’s visit was to conduct the Annual Required inspection. LPA was allowed entry into the facility and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents of which 1 may be bedridden. Facility has an approved hospice waiver for 4 residents and the home currently has 1 resident on hospice. Administrator Nargis Elahi has an administrator certificate valid until 11/11/2026. LPA Lyman along with Administrator Elahi toured the facility at 10:29 AM. LPA toured the physical plant, checked food service, first aid kit and reviewed records. Facility appears to be clean and sanitary. The home consists of six resident bedrooms, 3 common restrooms, 1 resident restroom, one staff room, living room, dining room, and kitchen. Facility has a second story where the licensee resides. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. At 10:35 AM, LPA observed rooms for Residents #3 and #5 do not match the facility floor plan. The room has been split making two rooms where there is one on the floor plan. LPA observed two residents with full rails and one resident with half rails. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 94.2 degrees F and 101 degrees F in all facility restrooms. Resident bath towels and toiletries were adequately stocked at time of visit. Common areas were clean and clear of hazards. First aid kit had all the elements including thermometer, tweezers and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. At 10:50 AM, LPA observed unsecured knives and scissors in an unlocked cabinet. Smoke detectors tested operational during today's visit. Fire extinguishers are fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample shaded seating for residents. CONT ON LIC809-C DATED 09/15/2025 LPA reviewed the emergency disaster plan and infection control plan during the visit. Facility does not have proof of quarterly emergency drills. Facility provides activities in the form of exercise and puzzles. At 11:15 AM, LPA reviewed six resident files and one staff file. Resident files contained required documents including admission agreements, physician reports and resident appraisals. Three out of six residents do not have updated appraisals/ physician reports. Resident 1 has full rails and is not on hospice care. One out of one resident does not have a physician order for bed rails. Staff file reviewed contained required documentation as well as CPR training and criminal record clearance. LPA reviewed medication storage and administration. Medications are stored in a locked cabinet. Facility does not have orders for supplements/ PRN medications nor is documenting PRN usage. Facility does not use a medication administration record. Based on the observations made during today's visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with Administrator and a copy was provided as well as appeal rightsthe state’s words, verbatim · CDSS document, Sep 15, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Staff #1 at 1:00pm. During today’s visit, LPA met with Nargis Elahi, Administrator (AD). The facility is a two story building with six private rooms for residents downstairs and the administrator lives upstairs. The facility has an approved fire clearance of six non-ambulatory of which one may be bedridden and four may be on hospice. The facility currently has a census of five residents in care with one resident on hospice. During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperature in two of two resident bathrooms, and testing auditory devices on all exits. The hot water temperature measured between 118.2 and 119.9 degrees Fahrenheit and all smoke detectors were operational. The fire extinguisher is fully charged and was serviced on June 30, 2022. The facility’s last fire drill was conducted on July 26, 2024. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand and has extra emergency supplies in the garage. The First Aid kit had all the required elements. LPA observed medication storage and reviewed the centrally stored medications. Per review medications are being given as prescribed. A caregiver on the premises, who started on September 18, 2024, was not background cleared and was removed from the facility after AD drove caregiver to get fingerprinted. An immediate civil penalty of $100 per day was assessed on the LIC 421BG for a total of $100. (Continued on LIC 809-C) (Continued from LIC 809) LPA reviewed three of three staff training and fingerprint records and conducted a complete review of resident records. Two of five residents did not have updated medical assessments due to their diagnoses. A deficiency will be cited. LPA interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. LPA confirmed that administrator has a current administrator certificate which expires on November 11, 2024. The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Nargis Elahi, Administrator and a copy of this report was given to the facility along with a copy of the LIC 858, LIC 859; LIC 809-D, LIC 421BG and Appeal Rights.the state’s words, verbatim · CDSS document, Sep 19, 2024