Aqua Bella Residential Care

We haven’t transcribed this report yet. The complete document is on the state’s site.

Type of visit: Required - 1 Year

On September 11, 2025, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced to conduct the Annual Inspection and met with the Licensee, Musarrat Khan. The facility file review was conducted at the Regional Office and additional records were requested and reviewed on site. The facility is licensed for six Elderly Adults and is currently operating at 100% capacity six Elderly Adults (740). LPA Mixson toured the facility along with the Licensee, Musarrat Khan and made observations pertaining to the annual inspection. LPA inspected the facility inside and outside there were no obstructions or debris to the indoor or outdoor passageways at the time of this visit. Additionally, there were no bodies of water on the premises. LPA discussed and reviewed sections included in the Care Tool, following is a summary. The facility consists of five resident bedrooms, two and one half bathrooms, one staff room, a kitchen and dinning areas, a living room area, a garage, and a yard and patio with sufficient seating and space for activities. According to Licensee, there no weapons are stored in the home. The facility is being maintained at a comfortable temperature. The outdoor and indoor passageways are kept free of obstruction and are free of debris and other trash at the time of this visit. There are grab bars for each toilet, bathtub and shower used by residents. Resident showers have non-skid mats or strips present. The carbon monoxide and smoke detectors were tested and were observed to be in operating condition. The home was kept clean, organized and free of any odors. Physical Plant: The facility phone number is (951)208-1825 and it is operable. LPA Mixson observed the residents’ bedrooms, and each was equipped with required furniture as per Title 22. LPA Mixson inspected facility bathrooms, and the hot water temperature tested within regulations. The bathrooms were clean, and appliances were operating appropriately currently at the time of this visit. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguishers. LPA Mixson observed required postings such as "If you See Something, Say Something,” the "Personal Rights, and the Ombudsman's information." The cleaning supplies and sharp items were locked and inaccessible to the residents in care presently. There was a designated storage space for the residents and staff files, and it was locked and inaccessible to residents in care currently at the time of this visit. Medications: Were locked and inaccessible to residents in care, and there was a sufficient supply of medication for each resident. The overall facility is clean, the furniture is in good condition. The facility cooling system and other appliances were operable currently at the time of this visit. The Administrator, Musarrat Khan informed LPA there are safety lights for night throughout the facility. Food Service: Non-perishable and perishable food supply is sufficient per regulations, and there are a variety of food types available for residents. Dishes and utensils were in sufficient supply and stored properly, and sharp items are locked. Food shopping is done twice a week and as needed. Care & Supervision/Administration: Adequate staff are present for the supervision of resident in care. Floor plans, telephone numbers and personal rights were found posted in the facility. The listed Administrator, Musarrat Khan has a current administrator’s certificate with an expiration date of 07/26/2027. Records Reviewed and Resident/Staff Files: LPA reviewed staff files and reviewed the facility's staff schedule. The staff files reviewed have criminal clearance and updated training along with First Aid Certification. Resident files reviewed had required paperwork. Disaster preparedness: LPA Mixson reviewed the facility's emergency and disaster plan as well as disaster training binder. LPA observed the last fire drill met the department standards, 06/03/2025, and was conducted at the facility. Infection Control: LPA Mixson observed the hand washing stations in the facility restrooms. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan and found all required infection control measures. Annual sections covered were within Regulations per Title 22, Division 6 of the California Code of Regulations at the time of visit. An exit interview was conducted. A copy of this report was discussed and given to Administrator, Musarrat Khan.the state’s words, verbatim · CDSS document, Sep 11, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA), Stephanie Martinez, conducted a required annual inspection to the facility. The LPA was allowed entrance into the facility and met with Administrator, Musarrate Khan. The LPA informed the Administrator of the purpose for the visit. The inspection included the following: Physical Plant: The facility consists of five (5) resident bedrooms, two and one half (2 1/2) bathrooms, one (1) staff room, a kitchen and dinning areas, a living room area, a garage, and a yard and patio with sufficient seating and space for activities. There are no bodies of water located on the property. According to Administrator Khan, no weapons are stored in the home. The facility is being maintained at a comfortable temperature. All outdoor and indoor passageways are kept free of obstruction and are free of debris and other trash. There are grab bars for each toilet, bathtub and shower used by residents. Resident showers have non-skid mats or strips present. The carbon monoxide and smoke detectors were tested and were observed to be in operating condition. The home was kept clean, organized and free of any odors. Food Service: There is a minimum of two (2) days supply of perishable foods and one (1) week's supply of non-perishable foods available. Sufficient dinning supplies were available for residents in care. A variety of food was observed to be available. Record Review: All staff were observed to have appropriate fingerprint clearances. LPA did not observe any excluded individuals on the premises at time of visit. Staff responsible for direct care and supervision have current first aid and CPR training. Dementia care and medication training was observed to be complete. Resident files had admission agreements and medical assessments available for review. One of six residents did not have an updated medical assessment on file. Resident Six (R6), whose health condition requires an annual medical assessment last had an evaluation on 10/04/2019. According to Administrator Khan, no previous medical assessments were requested for the resident until October 2024. A citation will be issued. In addition, one of six residents did not have an updated written record of care. The last written record of care for Resident Six (R6) was dated 06/08/2021. According to Administrator Khan, no updated record of care was completed for the resident. A citation will be issued. The facility was not operating beyond the conditions specified on the license. The facility currently has an approved Hospice Waiver for two residents and there is currently one residents in care receiving hospice services. The LPA observed current liability insurance on file. Medication Review: The LPA inspected resident medications. Medications were observed to be organized, appropriately labeled and inaccessible to unauthorized individuals. Technical Assistance and Technical Violations were issued to Administrator Khan for other, non-immediate, violations observed during the LPA's visit. Administrator Khan agreed to provide the LPA with a copy of the current liability insurance, proof of control of property, a staff schedule, and a resident roster to update the facility file. An exit interview was conducted with the Administrator, in which this report was reviewed and a copy was provided, along with the LIC 811, LIC 9098, and instructions on appeal rights.the state’s words, verbatim · CDSS document, Oct 30, 2024

The state marks this report as 13 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.