Nir Community III

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced Required Annual Inspection. LPA was greeted and allowed entry into the facility and conducted the visit with Staff, Milagros Galvan. Administrator, Administrator, Faria Huq arrived during the visit. LPA, accompanied by staff, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. Hot water temperature at taps accessible to residents were all compliant and measured at 115 F.. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, and/or fireplaces accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water were observed on the premises. Per the staff, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detector, emergency lighting, and facility telephone were all working. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed multiple staff and resident records/files. The reviewed files contained required documents. Confidential records were stored in locked areas. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Administrator, Faria Huq to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Dec 24, 2025

Allegation investigated: Staff did not provide adequate supervision resulting in residents wandering away from facility

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced visit to commence a complaint investigation. LPA identified herself and was allowed entry into the facility by Staff, Conchita Gallardo. LPA discussed the allegation mentioned above wtih staff present. Administrator, Faria Huq and Licensee, Rana Huq arrived during the visit. During today's visit, LPA briefly toured the facility, reviewed records, interviewed staff, and residents. It was alleged staff did not provide adequate supervision resulting in a resident wandering away from facility. It was reported Resident #1 (R1) wandered away from the facility on 10/29/25. R1's Physician's Report dated 05/08/2023 indicated R1 was ambulatory, and had a diagnosis of a Major Neurocognitive disorder. It also indicated R1 was unable to leave the facility unassisted. On 10/29/25, R1 wandered out the front door and entered the neighbor's house requesting police assistance. Staff interviewed stated one caregiver was assisting a resident in their room, while the other caregiver was assisting another resident. Staff were not aware R1 left the facility usassisted. Staff stated once they realized R1 was missing they went to search for R1. Continued on LIC 9099C. Substantiated R1 was found outside the facility being escorted by the police. R1 did not sustain any injuries. Staff admitted R1 wanders, therefore, a padlock was placed on the front door to prevent R1 from exiting during the day and at night. Also, a lock was placed on R1's sliding door exit of their room. According to Licensee the lock was placed on the sliding door to prevent people from breaking in at night. However, the additional sliding door exits do not have locks. LPA observed an auditory device on the front door. However, it was not activated. The administrator removed the padlock and the lock on the sliding door, and turned on the auditory devices during the visit. In addition, the facility did not have an absentee plan on file for residents. Based on interviews and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California code of Regulations, Title 22, Division 6 & Chapter 8 is being cited on the attached LIC 9099D. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Staff, Milagros Galvan whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Nov 6, 2025 · control 08-AS-20251029134201

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.312(d) · Plan of correction due date: Nov 7, 2025

Basic services requirements. Being aware of the resident's general whereabouts, although the resident may travel independently in the community. This requirement is not met as evidenced by: Based on interviews, the licensee did not know the whereabouts of 1 out of 4 [R1] residents, which posed an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 6, 2025

Plan of correction: Administrator, Faria Huq had the locks immediately removed. In addition, they will ensure the auditory devices are operable, and conduct training on ensuring staff are aware of residents whereabouts by POC due date.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced Case Management - Deficiencies visit. LPA identified herself and was allowed entry into the facility by Staff, Conchita Gallardo. LPA discussed the purpose of the visit with staff present. Administrator, Faria Huq and Licensee, Rana Huq arrived during the visit. During a complaint investigation, it was discovered the licensee did not submit an incident report involving Resident #1 (R1). On 10/29/25, R1 wandered away from the facility and staff were not aware. R1's Physician's Report dated 05/08/2023 indicated R1 was ambulatory, and had a diagnosis of a Major Neurocognitive disorder. It also indicated R1 was unable to leave the facility unassisted. The licensee failed to report the incident. Today, LPA observed the following deficiencies: A padlock on the front door and a locking device on R1's sliding door exit located in their room. Staff explained R1 wanders, therefore, the locks were put in place to prevent R1 from wandering from the facility; Cough syrup was on the kitchen counter, accessible to residents; A new laundry room was built but the lock was inoperable and could not be locked, which made cleaning supplies and items that pose a danger accessible; Sharp tools were observed in the backyard; The resident's files did not contain Absentee Notifications; and medical assessments were not within a year for R1 and Resident #2, as the reports were issued in 2023. In addition, the licensee made alterations to the facility. Licensee stated licensing was not notified of the alterations to the facility because a permit was not required by the City to add a wall, which was added for the new laundry room. Continued on LIC 809C. While at the facility, the licensee emailed LPA proof of permit for the Additional Dwelling Unit (ADU), along with an updated LIC 999 Facility Sketch to identify the new additions. The administrator explained the ADU has renters that have no access to the facility or residents. During the visit, R1 attempted to exit the facility unassisted through their sliding door located in their room. Staff was able to immediately redirect R1. Licensee and administrator were made aware of the exit seeking behavior. They were also notified awake staff was required for wandering residents. They ensured R1's needs will be met. Deficiencies were observed and cited along with a civil penalty for a fire clearance violation. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Staff, Milagros Galvan whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Nov 6, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a) · Plan of correction due date: Nov 7, 2025

Fire Clearance. All facilities shall maintain a fire clearance approved by the city...or the State Fire Marshal. Prior to accepting or retaining...obtain an appropriate fire clearance...or the State Fire Marshal. This requirement is not met as evidenced by: Based on observations and interviews, the licensee did not comply with their fire clearance, by using a padlock to lock the front door, enabling residents to exit for 4 out of 4 [R1-R4] residents, which posed an immediate health, safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Nov 6, 2025

Plan of correction: Administrator removed all locks during the visit. Administrator stated they will provide training regarding supervision and danger in locking residents inside the facility and provide proof of training by POC due date. An immediate $500 civil penalty was assessed for fire clearance violation.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87465(h)(2) · Plan of correction due date: Nov 7, 2025

Incidental Medical and Dental Care. The following requirements shall apply to medications which are centrally stored: Centrally stored medicines shall be kept in a safe and locked place that is not accessible... supervision of the centrally stored medication. This requirement is not met as evidenced by: Based on observations, the licensee did not centrally store medications making them accessible to 1 out of 4 [R1] residents, which posed an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 6, 2025

Plan of correction: Administrator stated they will schedule training on centrally storing medication and provide scheduled training dates by POC due date. In addition, the training will be submitted within 2 weeks.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: Nov 7, 2025

Storage Space and Access. Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions...tools, sharp objects...are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Based on observations, the licensee did not ensure cleaning supplies and tools were inaccessible to 4 out of 4 [R1-R4] residents, which poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 6, 2025

Plan of correction: Administrator locked the tools and replaced the lock on the laundry room, making them inaccessible to residents. Proof of scheduled training for ensuring items are properly stored by POC due date. In addition, proof of training will be submitted within 2 weeks.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87211(a)(1) · Plan of correction due date: Dec 4, 2025

Reporting Requirements. A written report shall be submitted to the licensing agency...of any of the events specified in (A) through (D) below. This report shall include...date and nature of event...findings, and treatment, if any; and disposition of the case. This requirement is not met as evidenced by: Based on interviews and record review, the licensee did not report an incident for 1 out of 4 [R1] residents, which posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 6, 2025

Plan of correction: Administrator stated she will attend training on reporting requirements and submit an incident report for R1 by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87463(h) · Plan of correction due date: Dec 4, 2025

Reappraisals. The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment. This requirement is not met as evidenced by: Based on interviews and record review, the licensee did not obtain an annual routine medical visit for 2 out of 4 [R1-R2] residents in care, which posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 6, 2025

Plan of correction: Administrator stated R1 and R2 will be evaluated by a medical professional and documentation will be submitted by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: HSC1569.317 · Plan of correction due date: Dec 4, 2025

Absentee notification plan for missing residents. Every residential care facility...resident is missing from the facility...plan shall include... administrator...inform authorized representative...notify local law enforcement...is missing from the facility. This requirement is not met as evidenced by: Based on interviews and record review, the licensee did not ensure 4 out of 4 [R1-R4] residents had an absentee notification in their written record of care, which posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 6, 2025

Plan of correction: Administrator stated they will submit an Absentee Notification Plan for residents for POC due date.

Allegation investigated: Absence of supervision at night Staff are leaving residents in soiled diapers for extended periods of time Licensee did not provide the required quantity or quality of food to meet the needs of the residents Licensee is charging for fees not outlined in admission agreement

LPM II Donna Teutschel conducted a telephone conference with Licensee/Administrator, Rana Huq. A review was conducted of the allegations listed and investigative details available.to date. Facility has night time sleep staff but residents have a call button system that will alert staff if they need assistance. If staff are alerted by a resident to have diaper changed staff respond. No evidence was provided regarding leaving residents in soiled diapers for extended period of time or that food quality was not acceptable. The service fee invoiced for cable was a one-time fee and that was performed by the licensee in procurring a cable box and hooking the cable up to the residents room, cable box and television which was verbally agreed to. The Department is unable to prove or disprove the allegations and the findings are determined to be Unsubstantiated. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jun 30, 2025 · control 08-AS-20210506084436

Allegation investigated: -Staff refused to assist resident with transfer -Staff required resident to wear diaper -Staff did not ensure resident was hydrated -Staff did not seek medical attention for resident timely

LPM II Donna Teutschel conducted a telephone conference with Licensee/Administrator, Rana Huq. A review was conducted of the allegations listed and investigative details available.to date. The Department is unable to prove or disprove the allegations and the findings are determined to be Unsubstantiated. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jun 30, 2025 · control 08-AS-20230228093653

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was greeted and allowed entry into the facility and conducted the visit with Staff, Milagros Galvan and Administrator, Rana Huq. LPA, accompanied by staff, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. Hot water temperature at taps accessible to residents were all compliant and measured at 108 F.. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, and/or fireplaces accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water were observed on the premises. Per the administrator, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detector, emergency lighting, and facility telephone were all working. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed multiple staff and resident records/files. The reviewed files contained required documents. Confidential records were stored in locked areas. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Administrator, Rana Huq to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Dec 18, 2024

Type of visit: Case Management - Other

Licensing Program Analyst (LPA), Natasha Persaud conducted a Case Management - Other visit. LPA was greeted and allowed entry into the facility by Staff, Mila Galvan. Licensee, Faria Huq and Administrator, Rana Huq arrived during the visit. A visit was conducted to investigate an incident involving a resident. During staff interviews, it was discovered the resident does not reside at this facility. The incident will be addressed at the correct facility. No deficiencies were observed today. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Staff, Mila Galvan whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Nov 7, 2024

Allegation investigated: Licensee did not treat pest

Licensing Program Analyst (LPA), Natasha Persaud conducted an unannounced visit to conclude the complaint investigation regarding the above-mentioned allegation. LPA met with Staff, Conchita Gallardo. During the investigation, the facility was toured, records reviewed, and interviews conducted with staff, residents, and outside sources. It was alleged the licensee did not treat pest. It was reported a cockroach was observed in Resident #1’s (R1) cup and around the room approximately two (2) to three (3) months ago. It was also reported the roach was observed two (2) weeks ago. Conflicting statements were made. Staff interviews revealed they have not observed any pest or roaches. However, they are taking precautionary measure by spraying inside and outside of the facility once a week. Outside sources revealed the roach was observed but it was only one (1) time a few months ago and there have not been any other observations of pest or roaches. Resident interviews confirmed there were no pest or roaches observed in the facility. Continued on an LIC 9099C. Unsubstantiated On 05/15/24, LPA toured the facility and observed private and common areas, no pest or roaches were observed. The licensee stated they have not observed any pest or roaches but will be having a professional extermination company coming to the facility as a precautionary measure due to the weather changing, which can bring out pest. During the course of the investigation, interviews were conducted, and records were reviewed. Investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegation. The allegation was deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Staff, Conchita Gallardo whose signature below confirms receipt of these rights. [See LIC 811 Confidential Names List to identify Resident #1]the state’s words, verbatim · CDSS document, May 17, 2024 · control 08-AS-20240506103142

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was greeted and allowed entry into the facility by Staff, Milagros Galvan. Licensee, Rana Huq and Administrator, Faria Huq arrived during the visit. LPA, accompanied by staff, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. Hot water temperature at taps accessible to residents were all compliant and measured at 105 F.. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were knives and cleaning supplies accessible to residents in the kitchen cabinet and kitchen drawer. Locks were present but not in use. Medications were not stored in locked areas. The medications were pre-poured in containers sitting on the microwave and Afrin spray sitting on a cabinet. No pools or bodies of water were observed on the premises. Per the licensee, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. Disaster drills are not being conducted. LPA interviewed multiple staff and residents. LPA reviewed multiple staff and resident records/files. The interviews did not raise any significant licensing concerns. The reviewed files contained required documents. Confidential records were stored in locked areas. Deficiencies were observed during today's annual inspection and cited on the attached LIC 809D. Also, a Technical Advisory was issued. An exit interview was conducted with Licensee, Rana Huq to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Dec 14, 2023

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.