Ever Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation using the CARE Inspection Tool. LPA was greeted and granted entry by Caregiver Maricris Ampuan after introducing self and stating the reason for the visit. Administrator (Admin) Shahin Mokhtarzad shortly arrived on site to assist with the inspection. Admin Mokhtarzad has a valid certificate expiring November 11, 2027. The following was observed during the inspection accompanied by Admin: This is a single story property located in a residential neighborhood comprised of six private resident bedrooms and six private resident half bathrooms. There is a walk-in community shower shared by all residents. There is an additional private bedroom and full bathroom for the two live-in caregivers. Facility is operating within the conditions and limitations specified on the license. LPA observed six residents in care with one under hospice and another resident who is bedridden. LPA observed two staff present on duty. LPA toured the physical plant and observed the kitchen appliances and all bathrooms require a deep cleaning The kitchen exterior/interior refrigerator and freezer shelves and doors had food stains and particles. All other common areas were inspected including the attached two car garage. LPA inspected all resident bedrooms. The resident bedrooms' were appropriately furnished, beds and bedding supplies were in good condition, adequate lighting was provided, and sufficient storage space for each residents' personal belongings were observed. All bathrooms were found be operational but require a deep cleaning. The toilet bowls had fecal matter and urine causing odor, and the bathroom floor and shower had evidence of pink slime or film. Slip resistant mats were observed to be available. The hot water temperature in the resident bathrooms measured within range at 112.8, 112.6, 111.3, 111.3, 118,9, and 111.2 degrees Fahrenheit. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed ample two-day supply of perishables and seven-day supply of non-perishable food. LPA toured the exterior portion of the facility. The outdoor passageway is free of obstruction. The exit gates are operational, and there are sufficient seating and shading in the patio area. There are no bodies of water on premise, and the dual sided fire place was screened appropriately. The first aid kit contains all necessary elements. The two fire extinguishers were mounted, charged, and serviced on December 3, 2025. The auditory devices and smoke/carbon monoxide detectors were tested and operational in all areas. Facility maintains emergency food and water. A working telephone (949-837-3737) was tested and remains available. Complaint Poster, 'See Something, Say Something,' (PUB 475) was available and posted in the entry way in the correct size. LPA reviewed six residents and two personnel files. A discrepancy was noted with the staff records as two of two staff did not have their Health Screeninig Report (LIC503) and Tuberculosis (TB) tests on file as they were accidentally discarded per Admin. Present staff are background cleared and associated to the facility. Staff met their annual 20 hour training. The Emergency Disaster Plan (LIC610E) was reviewed. The disaster supplies noted on the plan are available. Disaster (fire) drills are conducted three times this year, January, March, and May 2026 per log. Medications were audited for three of six residents. No discrepancies were found with medication administration and documentation. LPA consulted on the following: to deep clean kitchen appliances and refrigerator as well as all bathrooms, to ensure staff obtains and completes the health screening report/TB tests, to organize/maintain resident records/files, and to conduct disaster drills accounting various emergency scenarios besides fire drills. Based on the observations made during today's visit, a deficiency is being cited and Technical Advisories are being issued An exit interview was conducted with Administrator Shahin Mokhtazad, and a copy of this report including the appeals rights were provided at exit.the state’s words, verbatim · CDSS document, May 22, 2026

The state marks this report as 8 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility administrator Shahin Mokhtazad after stating the purpose of the visit. There are currently six residents in care, two of which are receiving hospice care at this time. LPA observed residents relaxing in the facility's common living areas or in their respective bedrooms. Two residents are away in the community also. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with an attached garage. The facility has six private bedrooms along with two staff rooms. Bedrooms appear clean and sanitary. Some of the residents are using half rails or full rails for postural supports. Physician orders requested during the visit and faxed by the hospice provider. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are equipped with grab bars and slip mats. Hot water temperature measured at 117F in two separate bathrooms.. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items and the medication central storage are verified to be secured. Cleaning supplies and supplements are observed to be stored without being secured. Type B citation issued. The two wall-mounted fire extinguishers are charged, with up-to-date maintenance tags attached. LPA tested the smoke and carbon monoxide detectors which were found to be operational. The garage is inaccessible to residents and used for laundry as well as additional storage of food and supplies. CONTINUED ON FORM LIC809-C CONTINUED FROM LIC809 LPA and facility staff toured the outside of the facility. LPA observed an shaded outdoor seating area with furniture for resident use. There are self-latching gates on both sides of the property and the routes of egress are free of clutter and obstructions. There are no bodies of water on the premises. Facility does not utilize locked perimeters or delayed egress. LPA reviewed six resident records which included all necessary components. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. Medication is however being pre-poured by staff for multiple days at a time. Type B citation issued. Oxygen is currently in use with adequate signs posted. There is one resident currently assessed as being bedridden at the time of the visit while another non-ambulatory resident still shows as bedridden on their physician report even though they are witnessed having lunch in a wheelchair in the dining room. Consultation provided on the need to update the resident's assessment to reflect changes in condition. Resident interviews were conducted or attempted during the visit along with staff interviews. LPA reviewed staff records for two caregivers present during the visit. Present staff members have current CPR certificates on file. Annual training on file. Disaster drills are conducted three times a year with proof of attendance provided. Consultation provided. Both staff members present are background cleared and associated to the licensed location. Based on the observations made during today’s visit, two type B deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report along with appeal rights were provided to a facility representative.the state’s words, verbatim · CDSS document, May 20, 2025

The state marks this report as 8 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting the Required Annual Inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Administrator Shahin Mokhtazad was notified by telephone and arrived later to assist. During the inspection, LPA and facility staff conducted a tour of the physical plant and observed the following: The facility is a one-story home with six private resident bedrooms, one shared bathroom and one room dedicated to staff in addition to the common living areas. All resident bedrooms had the required furnishings. LPA observed all beds had linens and blankets and an adequate additional supply is present. There are orders on file for the postural supports in use. The backyard has a shaded area and the routes of egress are free of clutter and obstructions. There are currently six residents in care at the facility, two of which are receiving hospice care, including one bedridden resident which is authorized by the fire clearance on file. Residents are observed to be clean and appear well taken care of. Bathrooms faucets and toilets were operational. Water temperature was verified to be within acceptable range. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required. Combined smoke and carbon monoxide detectors tested operational. Fire extinguishers present are observed to be fully charged with up-to-date maintenance. Medication, sharp items and cleaning supplies were confirmed to be inaccessible throughout the physical plant. The medication central storage was also observed to be secure and reviewed for accuracy during the visit. LPA reviewed six resident files and three staff files. The two staff members on duty were interviewed along with the six residents. Based on the observations made during today’s inspection, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. Three Technical Violation Advisory Notes were also provided to the licensee. An exit interview was conducted, and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, May 8, 2024

The state marks this report as 4 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.