Paradise Springs for the Elderly 1

Allegation investigated: Unlawful Eviction

Licensing Program Analyst (LPA) Paola Guerrero arrived at the facility to deliver investigative findings. LPA met with Facility Administrator Faryal Khan and explained the purpose of the visit regarding the allegation stated above. First allegation: Unlawful eviction. Regarding the allegation stated above, LPA conducted a file review pertaining to Resident #1 upon the review of records LPA observed that a 15-day eviction notice was issued to R#1 responsible party on 6/13/2026 for the reasoning that the facility could no longer meet the needs of R#1. LPA conducted an interview with Staff #1 regarding the alleged allegation and Staff #1 informed LPA that a reappraisal was not issued to R#1 to determine R#1 change of condition and to determine that the facility is not appropriate for R#1. Staff #1 informed LPA that R#1 left the facility on 6/14/2026. Staff #1 also indicated to LPA that the facility did not seek approval from Community Care Licensing Department prior to issuing the eviction notice. Substantiated Based on the evidence gathered during the investigation, the above allegation is Substantiated. A finding that the complaint is Substantiated means that the findings are valid because the preponderance of the evidence standard has been met. Title 22 Regulations, from division 6, chapter, article 6, is, cited on the attached LIC 9099 D. An exit interview was conducted where this report, appeal rights, and LIC9099-D was discussed, and a copy of the report was provided to Facility Administrator Faryal Khan the conclusion of the visit.the state’s words, verbatim · CDSS document, Aug 3, 2026 · control 56-AS-20260730100812

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(c)(d)(1) · Plan of correction due date: Aug 14, 2026

87224 Eviction Procedures…. (c) The licensee shall, in a) Then to either serving the required thirty (30) days notice , sixty (60) days notice or seeking approval from the Department and service three (3) days notice on the resident, notify or mail a copy of the notice to quit to the resident's responsible person….(d) The licensee shall set forth in the notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons…. (1) The notice to quit shall include the following information: This requirement is not met as evidence by: Based on interviews and record review, the Licensee did not adhere to eviction regulation by issuing an unlawful eviction notice to R#1 and not properly following eviction procedures based on Title 22 regulation, which poses an immediate health, safety, or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Aug 3, 2026

Plan of correction: The Licensee has agreed to read: Eviction Procedures, regulation and provide training for staff regarding the correct procedures when issuing eviction notices. The Licensee will provide LPA with proof of training by emailing LPA training sign sheets by POC date 8/14/2026. In addition, the Licensee will provide R#1 family a refund according to the dates/percentages of when R#1 was admitted and when R#1 was discharged. Licensee will provide LPA with proof of refund that is issued to R#1. LPA observed that a refund in the amount of $820.81 was issued to R#1 on 7/3/2026. Any additional amount owed R#1 will be issued upon review and proof will be provided to LPA on POC date provided.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Licensee Faryal Khan and was granted entry to the facility. At the time of the visit there were two (2) staff present, five (5) residents present and sixth (6) resident was out on a family outing. The facility is a five (5) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, with a detached garage. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (6) current census (6). LPA was accompanied by Facility Licensee, to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected residents’ bedrooms; they are equipped with required furniture such as mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms to be 115.6 degrees F The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside kitchen cabinet inaccessible to residents in care. Overall, the facility is clean, in good repair, and operates in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed six (6) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Medications were audited at random and appeared to be dispensed appropriately by staff members. During review of records LPA observed that last disaster/fire drill was conducted on 1/20/2026. During review of records LPA observed liability insurance to be current with a renewal to date for 8/8/2026. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Facility Licensee Faryal Khan .the state’s words, verbatim · CDSS document, Jan 22, 2026

Type of visit: Prelicensing

Licensing Program Analysts (LPA) Paola Guerrero conducted an announced pre-licensing visit to facility. LPA met with Facility Licensee Faryal Khan. The pending application is for a Residential Care Facility for Elderly (RCFE). There are currently four (4) residents in care. The Licensee accompanied LPA on a tour of the inside and outside of the facility. The home is a six (6) bedroom, three (3) bathroom home with a living room, dining room, activity room, kitchen, and detached garage. The physical plant, in general, was in good repair. The buildings and grounds are free from hazards. The indoor and outdoor passageways are free of obstruction. There are no pools, bodies of water, firearms, or ammunition. All bedrooms are furnished with a bed, nightstand, dresser, and chair. All bedrooms have adequate lighting for resident use. Bathroom's toilet, shower and tubs are in good repair and have non-skid mats. LPA measured and observed the water temperatures in the bathrooms to be at 110 degrees F. LPA observed food storage and preparation areas to be clean and sanitary. Refrigerator and freezer are maintained at appropriate temperatures. All appliances are clean and operating properly. Dishes, glasses, and utensils were in good condition. There is a sufficient supply of linens, towels, and personal hygiene items. The first aid kit was reviewed; all items are present. The backyard is completely enclosed with functioning gate to exit to front yard. The outdoor space is suitable for Resident use. LPA observed fully charged fire extinguisher present in the facility. Smoke alarms and carbon monoxide are present and functional. Medications were stored inside locked kitchen cabinet. Resident/Staff records were stored in staff office. Emergency disaster plans, personal rights, and complaint procedures were posted in a prominent area. There is adequate seating in the common areas. Facility had a supply of activities for the clients. Pre-licensing inspection is complete, and no corrections are needed to be made. The Comp III presentation was completed during today's visit. An exit interview was conducted, and a copy of this report was provided to Facility Licensee Faryal Khan.the state’s words, verbatim · CDSS document, Dec 24, 2024

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 6 COMP II Participants: Name - Faryal Khan CEO/ Renu Madahar Administrator Interview Method: Telephone interview On December 6, 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 the 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, Dec 6, 2024