Apple Senior Care of Corona

Type of visit: Required - 1 Year

On 9/10/2026 at 8:20 AM, Licensing Program Analyst (LPA) Matthew Aguilar made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA met with Administrator Yaseen Bari and was granted entry to the facility. At the time of the visit there were three (3) staff present, and one (1) resident present. The facility is a four (4) bedrooms, two (2) bathroom home with a kitchen/dining area, living room/activity room. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of two (2) non-ambulatory, four (4) ambulatory, and six (6) hospice care waivers and 1 maybe bedridden and the current census is one (1) resident. LPA was accompanied by a staff 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 Division (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 76 degrees Fahrenheit. LPA inspected resident bedrooms; they are equipped with the 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. LPAs measured and observed the water temperatures in the bathroom to be at 110 degrees Fahrenheit. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Fire extinguisher was also observed at the facility. Posters such as personal rights, the CCLD complaint poster, and the disaster plan were posted in a common area. ***Continuation in LIC809C *** 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. There is a Medicine closet with the resident’s medications locked. LPAs observed first aid kit and first aid book at the facility. Yards/Outside: One shaded patio, one (1) side gate with self-latching handle on the right side of the house that leads into the backyard, attached two (2) car garage observed. All outdoor pathways were free of obstructions. Food Service: Seven (7) days’ supply of Non-perishable foods and two (2) days’ supply of perishable food supply were observed and sufficient for the number of residents in care. LPA observed that the facility has sufficient 72 hour emergency food and water. Care & Supervision: The facility has an Administrator present in the facility with enough hours to appropriately manage the facility. The facility has sufficient number of staff to provide care and supervision to the residents in care. The facility is licensed for 1 bedbound room. Record Review: LPA reviewed one (1) resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPA observed resident files reviewed were incomplete. The facility is missing resident admission agreement, medical assessment, preplacement appraisal, and a needs and services plan. LPAs reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. LPA found that staff#3 (S3) is not associated with the facility at the time of the inspection. Based on record review and administrator interview, the facility did not complete quarterly fire and earthquake drills. Deficiencies for staff, resident, and disaster drill files will be issued. Based on the observations made during today’s visit, three (3) deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report LIC809, LIC809D forms, and Appeal Rights were discussed and provided to Administrator Yaseen Bari.the state’s words, verbatim · CDSS document, Sep 10, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(c) · Plan of correction due date: Sep 10, 2026

87355(c) A licensee... must request a transfer of a criminal record clearance from one state licensed facility to another, ... to a state licensed facility by providing the following documents to the Department Based off of observation and record review at the time of inspection, the facility did not comply with assosciating staff to the facility which poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Sep 10, 2026

Plan of correction: Licensee has agreed to associate staff member at the time of the investigation. POC will be cleared.

From the deficiency page — Deficiency type: Type B · Section cited: HSC1569.695(a)(c) · Plan of correction due date: Sep 10, 2026

(a) ...a residential care facility for the elderly shall have an emergency and disaster plan ... (c) facility shall conduct a drill at least quarterly for each shift... Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff... Based off observation and record review, the facility did not conduct quarterly fire and earthquake drills, which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Sep 10, 2026

Plan of correction: Licensee agreed to conduct and start their quartlery fire and earthquake drill. POC due date is on 09/24/2026.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(a) · Plan of correction due date: Sep 10, 2026

(a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. Based off of interview and records review, the facility did not maintain resident records readily avaialble on site, which poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Sep 10, 2026

Plan of correction: Licensee has agreed to email signed admission agreement, medical assessment, preplacement appraisial, and needs and services plan by POC due date. POC due date is 9/24/2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Raquel Hernandez made an announced visit to the facility in order to conduct a pre-licensing inspection for an initial application. LPA Hernandez identified herself to Licensee/Administrator, Yaseen Bari, who was also advised of the purpose of the visit. The pending application is for a Residential Care for The Elderly. The facility has been granted a fire clearance for a total capacity of five non-ambulatory resident and1 bedridden resident by the Riverside County Fire Department on 08/01/2025. The facility has a total of three resident bedrooms, two bathrooms, a kitchen/dining area, a living room, a family room, and backyard. LPA toured the interior and exterior areas of the facility. The following was inspected: LPA inspected resident bedrooms; the bedrooms have the required bedding and furniture, such as, clean mattresses/linen, night stands, dressers, chairs, and lighting. LPA inspected resident bathrooms; the bathroom appliances were operating in safe and sanitary conditions and contained appropriate hygiene items for clients. LPA inspected the kitchen, which contained utensils and dishware in good condition for the residents. LPA also observed that kitchen appliances and countertop were free of debris and in good repair. There was also a meal menu available for review. LPA inspected the common areas; in which LPA observed that there was a locked area for knives, cleaning supplies. LPA observed a charged fire extinguisher, operating smoke detectors, and carbon monoxide alarms at the time of visit. LPA observed required postings including the complaint reporting poster and personal rights. The facility was equipped with a complete first aid kit and manual. There was a locked and centralized storage area for medications and area for resident files and staff files. The facility had a working telephone for resident use. There was adequate seating and activity space in the common areas. LPA observed that all passageways were free from obstruction. Overall, LPA Hernandez observed no apparent health and safety risks at the time of visit. LPA has determined that the facility has met operational requirements for residents. The pre-licensing inspection is complete and this facility has no deficiencies. Applicant has satisfied all requirements in accordance with Title 22, California Code of Regulations. LPA also completed COMP III with the applicant at the conclusion of the inspection. An exit interview was conducted where this report was discussed and a copy was provided to Yaseen Bari at the conclusion of the inspection.the state’s words, verbatim · CDSS document, Sep 30, 2025