Arlington Heights Assisted Living and Memory Care

Type of visit: Required - 1 Year

On 7/23/2026, Licensing Program Analyst (LPA) Mia Lankford arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction, visit purpose and provided the facility caregiver with LPA identification, one staff presenting with language barrier and Administrator Zainab Shafiq arrived within a few minutes afterwards. There is an Infection Control plan on file. Resident record review began- Four (4) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility is meeting documentation requirements. Employee records review began- Two (2) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and administrator certification was renewed and pending. CPR and requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 118.0 degrees F. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals in the garage. Cont... Cont... All outdoor and indoor passageways are free of obstruction. A locked area is provided for medications and sharp objects. LPA verified there is a telephone working at this location. Food Service- Food supply meets the requirement of one week supply of nonperishable and 2-day supply of perishables food on hand. A menu is posted, foods are dated to assure safety. Food prep areas are clean and organized. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation, and the structure remains unchanged according to the approved floor plan. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers are tested or replaced annually and were last done so on 8/14/2025. The facility is conducting emergency disaster drills quarterly. The last disaster drill was conducted on 05/10/2026. There are no bodies of water observed and no firearms stored at this home. An exit interview was conducted and a copy of this report was left with the Administrator Zainab Shariq.the state’s words, verbatim · CDSS document, Jul 23, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction, visit purpose and provided the facility caregiver with LPA identification, two staff presenting with language barrier. Arsalan Syed arrived within a few minutes and Administrator Saher Choudry arrived afterwards. There is an Infection Control plan on file. Resident record review began- Four (4) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility is meeting documentation requirements. Employee records review began- Two (2) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and administrator certification was renewed and pending. CPR and requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 118.0 degrees F. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals in the garage. (Continued on LIC809, Page 2) (Continued from LIC809, Page 1) All outdoor and indoor passageways are free of obstruction. A locked area is provided for medications and sharp objects. LPA verified there is a telephone working at this location. Food Service- Food supply meets the requirement of one week supply of nonperishable and 2-day supply of perishables food on hand. A menu is posted, foods are dated to assure safety. Food prep areas are clean and organized. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation, and the structure remains unchanged according to the approved floor plan. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers are tested or replaced annually and were last done so on 05/16/2025. The facility is conducting emergency disaster drills quarterly. The last disaster drill was conducted on 05/16/2025. There are no bodies of water observed and no firearms stored at this home Based on the information received during this visit today, there are one (1) deficiency with Civil penalties for $1000 is being cited/assessed per Title 22, Division 6 of The California Code of Regulations. At the time of the exit interview, this report, LIC809-D, LIC421IM and Appeal Rights was reviewed with Saher Choudry and copies will be sent by email due to LPA printer issues. LPA will request a confirmation of receipt.the state’s words, verbatim · CDSS document, Jun 19, 2025

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Yolanda Delgado conducted a case management visit for residents in care, during the visit, there were working utilities, food supply was sufficient, staff available to provide care & supervision; it was discovered one (1) of two (2) staff did not have criminal background clearance. No residents were observed to be without basic needs and services. Facility will be cited for 87355(b) with civil penalties of $500 and plan of correction is due 12/10/2024. An exit interview was conducted with Saher Choudry and a copy of this report, 809-D, LIC421BG and appeal rights were provided.the state’s words, verbatim · CDSS document, Dec 9, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(b) · Plan of correction due date: Dec 10, 2024

Criminal Record Clearance: (e) All individuals...shall prior to working, residing or volunteering in a licensed facility: (b) Prior to the Department issuing a license, the applicant, administrator and any adults other than a client, residing in the facility shall have a criminal record clearance or exemption. This requirement was not met as evidenced by: Based on observation and interviews, the Licensee did not comply with the above regulation with at one staff (S1). LPA Delgado learned that S1 does not have fingerprint clearance and are not associated to this facility. This is an immediate safety risk to all residents in care.the state’s words, verbatim · CDSS document, Dec 9, 2024

Plan of correction: Licensee agrees to have S1 complete fingerprints by POC due date and obtain clearance/association in order continue to have S1 work at the facility. Licensee to provide LPA Delgado with proof of submitted request by 5pm on the due date indicated.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Yolanda Delgado conducted an announced visit to the facility for purpose of a Pre-Licensing evaluation. At approximately 9:00 AM, LPA met with Licensee/Administrator Saher Choudry. An initial application to operate a Residential Care for the Elderly facility (RCFE) was submitted to the Central Applications Bureau (CAB) on 1/11/2024 for a total capacity of six, five (5) non-ambulatory and one (1) bedridden residents. Fire clearance was granted on 02/16/2024. LPA Delgado observed the following: Structure: Facility was a one-story house with four (4) resident bedrooms, two (2) resident bathrooms, living room, dining area and kitchen. There is an attached two car garage in the front of the house. Heating/Cooling System: Central heating and air conditioning system installed with a central panel located in the dining area to control entire house. Bedrooms: Each resident bedroom #1 shared room, #2 shared room, #3 private room, #4 shared room for bedridden resident. Four (4) resident bedrooms were not adequately furnished with bed, chair, however closet, appropriate linens, adequate lighting, and an operable smoke alarm was sufficient. (Continued on page 2) (Continued from page 1) Bathrooms: The two (2) resident bathrooms has a working toilet, wash basin, and shower with an adequate supply of paper towels, toilet paper, and soap. At 10:05 AM, LPA tested the water temperatures in the resident bathrooms. LPA verified water temperature was measured at 108.9 degrees Fahrenheit. Kitchen/Laundry: An adequate supply of dishes, glasses, utensils, pots and pans were observed. Knives/sharp instruments were secured in a locked cabinet located in the kitchen. There was adequate room for food storage. LPA observed the stove to be operational. Refrigerator/freezer were in working condition and had sufficient storage for perishable food. There was adequate seating for meals for all clients. Laundry room with washer and dryer was located inside the garage. Laundry detergents and cleaning supplies were observed in garage away from residents. Living/Family room: There was a living/family room with seating for all clients and TV. Linens and Hygiene Supplies: An adequate supply of linens was stored in a cabinet in the main hallway of the residence. Yards/Outside: Patio tables and chairs were observed in the backyard. There was a gate on the East and West sides of the property have a self-latching door. All outdoor pathways were free of obstructions. Emergency Phone Numbers, and Exit Plan: Facility sketch, Obudsman poster and Let-Us-No posters observed posted, however no exit plans were posted. (Continued on page 3) (Continued from page 2) General items: One (1) fire extinguishers were charged and located in the kitchen. Seven (7) dual smoke alarm/carbon monoxide detectors were tested and were observed to be working, Client records will be stored in a locked closet. First Aid kit with required components, and locked area for medication storage was observed. LPA observed a facility phone and it was verified to be operational as evidenced by LPA dialing the number to trigger a ring. Emergency water supply was observed however the required 72-hour emergency food supply was not discernible from the regular food supply. Component III was completed on 04/25/2024 at the RO in Riverside. Pre-Licensing is incomplete and the following corrections to be resolved by 5/6/2024: obtain a separate 72-hour emergency food supply obtain additional emergency water post exit plans at exit areas obtain PPE supplies re-arrange room #2 setup obtain additional chair, lamp, bedside table and chest drawers for rooms #1, room #2 obtain emergency lightning for each resident obtain paper towels stands obtain night light for hallway replace 3 exterior window screens An exit interview was conducted, and a copy of this report was given.the state’s words, verbatim · CDSS document, May 3, 2024