A.R.K. Residential Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mia Lankford arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff Elizabeth Mahmoud and granted entry. LPA began introduction and the reason for the visit. Administrator Rabah Mahmoud joined us. Upon arrival LPA learned that four (4) clients that reside at this facility and there are currently one (1) caregiver present and Administrator. There is an Infection Control Plan on file. LPA began review of client records. Four (4) records were reviewed. LPA reviewed for identification and emergency information, admission agreement, medical assessment, and TB test results, needs and service plans, placement, functional assessment, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. LPA began review of employee records- Two (2) records were reviewed. LPA reviewed employee records for first aid certification which House Manager Elizabeth Mahmoud does not have, she has criminal record clearance or an exemption, health screening and TB test results, employee rights, training verification, and current administrator certification; expiration date 12/20/2026. Food prep areas are clean and organized. Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables. Emergency food CONT...809C and water supply is present. There is a locked location for chemicals and sharps in the garage. LPA toured the facility inside and outside. LPA observed the facility to be clean and in good repair. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 116.2 degrees F. Laundry facilities are cleaned and a locked cabinet is present for storing laundry soap and other chemicals are stored in the garage. All outdoor and indoor passageways are free of obstruction. Emergency lighting is available. There is a telephone working at this location, the number is (951) 213-6255. The LIC 610, emergency disaster plan is maintained and kept on the wall in hallway. There are no firearms stored at this home and no bodies of water observed. Medications- are centrally stored. There is a locked door allocated for medication storage. Centrally stored medication and destruction logs are maintained. Medications reviewed appear to have been dispensed accurately. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguisher was recharged last year 2/25/26. The facility is conducting emergency disaster/fire drills quarterly. This LIC 809 report was reviewed with the facility representative and a copy was provided and appeal rights attached.the state’s words, verbatim · CDSS document, Mar 12, 2026

Type of visit: Prelicensing

On 03/13/25, Licensing Program Analyst (LPA) Debbie Palacios conducted an announced visit to complete the Pre-licensing inspection and met Licensee Rabah Mahmoud. Facility was approved to serve residents ages 60 and over; six (6) residents in which 3 (three) may be Non-ambulatory. The facility is a five (5) bedroom, one (1) office room, one (1) staff bedroom and three resident (3) bedrooms, three (3) bathrooms, kitchen/dining area, one (1) living room area, laundry room and a backyard. LPA toured the interior and exterior areas of the facility. The following were inspected: LPA observed resident bedrooms had the required bedding and furniture, such as, clean mattresses/linen, night stands, dressers, lighting, and emergency lighting. Resident bathrooms had clean appliances that were operating in safe and sanitary condition and the showers contained non-slip mats and grab bars. LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. LPA observed the facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods. The knives and sharp objects were in a locked box in the kitchen cabinet. The facility's hot water temperature was recorded at 118F. The washer and dryer are located in the laundry room and has a cabinet for the towels and bedding sheets. the detergents and cleaning supplies are in a locked cabinet in the garage. Client files, staff files, will be located in the staff office in a lock cabinet; medications will be locked in the hallway closet. The facility maintains an adequate supply of clean linen and personal hygiene supply. The facility does not have any bodies of water on the property. All passageways were free from obstruction. LPA observed two (2) charged fire extinguishers in the facility. The smoke detectors and carbon monoxide alarms were operational. LPA observed required postings including the emergency/disaster plans, complaint procedures, and personal rights. The facility has an adequate area in the living room for activities; LPA observed board games and activity books. LPA observed a first aid kit with the required items and manual mounted on the living room wall. The facility has a central heating and air conditioning system installed with a central panel located in the hallway to control entire house. The facility has working telephone for resident use. LPA observed that the physical plant is clean, in good repair, and to be hazard-free during today’s visit. LPA have determined that the facility meets the operational requirements for licensure. The Pre-licensing inspection is complete, and this facility has no deficiencies. The facility has satisfied all requirements in accordance with Title 22, California Code of Regulations. Applicant Rabah Mahmoud completed the COMP III training on 03/11/25. An exit interview was conducted, and this report was discussed and provided.the state’s words, verbatim · CDSS document, Mar 13, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Method: Telephone call with CAB COMP II Participants: Mahmoud, Rabah On 2/10/25, the applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. 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, Feb 10, 2025