Raksha 13 Care Home

Type of visit: Required - 1 Year

On 05/22/2026 at 11:15AM, Licensing Program Analyst (LPA) Andrew Christy arrived unannounced to conduct the 1-Year Annual Required inspection. LPA met with Administrator, Nalini Bhutani, and explained the purpose of the visit. The facility currently houses 12 residents with a max capacity of 13 residents. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area, and backyard. All outdoor and indoor passageways are kept free of obstruction. No bodies of water were observed. A comfortable indoor temperature is maintained at 69.0 degrees Fahrenheit. The hot water temperature in the residents’ shared bathroom was measured at 105.1 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 05/06/2026 and have an appointment for servicing the extinguishers in June. At 12:30PM, LPA reviewed five (5) resident files and five (5) staff files, all found to be complete. The emergency disaster plan was last reviewed 05/06/2026. Quarterly emergency drills were last conducted 05/06/2026. A review of resident medications and the Medication Administration Record (MAR) found no outstanding errors. No deficiencies cited during visit. Exit interview conducted and a copy of this report was provided to the administrator.the state’s words, verbatim · CDSS document, May 22, 2026

Allegation investigated: Staff overcharged a resident for services not received

On 11/24/2025 at 5:30pm, Licensing Program Analyst (LPA), L. Hall arrived unannounced to deliver a complaint finding for the allegation above. LPA met with Elsabet Tufa, Caregiver, and explained the reason for the visit. LPA L. Hall spoke with Co-Administrator, Nalini Bhutani, via telephone and was given approval for signature. During the course of the investigation the Department conducted interviews with staff, witnesses, and residents, obtained and reviewed records. Allegation: Staff overcharged a resident for services not received Continued on LIC9099C. Substantiated Continued from LIC9099. During the investigation the complainant stated R1 was charged additionally for basic services and therapy. LPA reviewed the admission agreement and observed the additional services in section F (Level of Care) which were also included in section B (Basic Services), except for therapy. S3 stated R1 did receive therapy from home health as well as the staff. Based on LPA’s interviews which were conducted and record reviews, 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), are being cited on the attached LIC 9099D. Exit interview conducted. A copy of the appeal rights and this report provided. Continued from LIC9099. During the investigation the complainant stated R1 requested information regarding medication and R1’s financial contract to be made available to his family members and staff were not allowing an authorized representative to access R1’s records. During interview with W1, it was stated that the facility gave all information requested. LPA reviewed the durable power of attorney notarized January 26, 2023, and the advanced health care directive notarized on November 21, 2024. Both named R1’s responsible person that was able to make decisions. Allegation: Staff are unable to communicate effectively During the review of complaint submitted the complainant stated R1 reported that the staff often spoke limited English or was hard to understand which made staff unable to communicate effectively mostly at night. W1 stated during investigation there was not any problem communicating with the staff. LPA spoke with staff at the facility and did not have any problem communicating. Allegation: Staff demonstrated inappropriate form of discipline towards a resident During the review of complaint submitted the complainant stated R1 reported being punished/neglected for asking for help at night, which demonstrated staff conducting inappropriate form of discipline towards a resident. The complaint stated R1 received mental abuse. W1 stated during interview that R1 was never disciplined or Continued on LIC9099C. Continued from LIC9099C. neglected. W1 stated the facility took care of R1 to the best of their disability. S3 stated there was no report of any type of punishment or discipline towards any of the residents. Allegation: Staff did not answer timely to the facility telephone During the review of complaint submitted the complainant stated the facility staff never answered the facility telephone and the voicemail box was always full. LPA reviewed text messages dated December 20, 2024, between the reporting party and S3 regarding R1’s phone and the facility phone. S3 stated that the staff answers the phone but there were times when the staff is busy and not able to answer or assist R1 with his phone. S3 also stated R1’s family members called and visited the facility and there weren’t any problems. Allegation: Staff mishandled a resident's medication During review of the complaint submitted the complainant stated staff continued to administer medication and the medication was increased over the five (5) month period that R1 resided at the facility. Complainant also stated there were no visits to the doctor to justify the increase. LPA reviewed the facility assessment notes, the physician’s orders, and the medication administration (MAR) records from October 2024 until March 2025. LPA observed on the MAR’s and physician reports there were notes where the medicine was changed and discontinued. LPA observed from the assessment notes indicating there were visits and a meeting from the EASE Care nurse Continued on LIC9099C. Continued from LIC9099. for R1. S3 stated there were never any changes without the responsible party being aware. Allegation: Staff interfered with a resident's medical decisions During review of the complaint submitted the complainant stated R1 verbally expressed he did not want additional medication, but staff continued to administer the medication. LPA reviewed R1’s Advance Health Care Directive notarized November 21, 2024, which named the person responsible for R1’s medical decisions. S3 stated there were not any changes done unless the nurse makes the request and it had to be ordered by the physician. The facility staff cannot increase, decrease, or add any type of medication whether a prescription is needed or if it’s over the counter to any of the residents. Allegation: Staff did not abide to the admission agreement During review of the complaint submitted the complainant stated the facility did not abide by the admission agreement. During interviews with S1, S2, S3, and W1 it was stated that the facility did abide to the admission agreement. After reviewing the admission agreement, it was identified that the facility did abide by the admission agreement. Based upon the information obtained during investigation. The above allegations are unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted and a copy of report was given.the state’s words, verbatim · CDSS document, Nov 24, 2025 · control 15-AS-20250818120528

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87464(f)(1) · Plan of correction due date: Dec 5, 2025

(f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement was not met as evidence by: Based on interviews and record reviews the Licensee did not comply with the section cited above in charging R1 for services that are included in basic services, which poses a potential personal rights risk to person in care.the state’s words, verbatim · CDSS document, Nov 24, 2025

Plan of correction: Co-Administrator agreed to break down additional charges that is not included in basic services and refund monies and submit proof to CCLD by POC date.

Type of visit: Office

On 8/19/2025 at 10:30 AM, the Oakland CCLD Adult & Senior Care Regional Office conducted a virtual meeting with representatives for Raksha 13 to review the plan of corrections for violations dated 08/08/2025. CCLD Licensing Program Manager, Yvonne Flores-Larios, discussed the fire clearance violations, plans to get back into compliance, questions, and clarifications were addressed. Meeting Participants: • Isaac Taggart– Licensing Regional Manager, CCLD, Oakland ASC • Yvonne Flores-Larios – Licensing Program Manager, CCLD, Oakland ASC • Lisha Holmes – Licensing Program Analyst, CCLD, Oakland ASC • Shalini Bhutani – Administrator, Raksha 13 • Sheeva Bhutani – Administrator, Raksha 4 • David Ridley – City of Albany Fire Inspector This report was emailed to Shalini Bhutani for signatures and to be returned to CCLD Oakland Regional Office.the state’s words, verbatim · CDSS document, Aug 19, 2025

Type of visit: Case Management - Deficiencies

On 08/08/25 at 12:00 PM, LPA L. Holmes conducted a case management visit to discuss the implementation of a fire watch and a plan going forward to bring the facility into compliance. Lpa met with Nalini Bhutani, Co-Administrator. LPA and ADM discussed the details of the fire watch, required requested documents by CCLD, and the results from the fire drill conducted on 08/01/25 at Raksha 4. On 08/01/25, LPA requested the following documentation as soon as possible in addition to the Albany Fire Department requesting a strategy by close of business on 08/01/25 for Raksha 4 and Raksha 6; documentation was not received. Interviews with S1 and W1, revealed that R1 was admitted to the facility on 07/25/25, is bedridden, and the facility has not received approval from CCLD. Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of correction (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted, Appeal Rights, and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 8, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a) · Plan of correction due date: Aug 11, 2025

87202 Fire Clearance (a) All facilities shall maintain a fire clearance approved by the city...Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved... by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal. -This requirement is not met as evidenced by: Licensee/Administrator did not obtain approval for bedridden residents.the state’s words, verbatim · CDSS document, Aug 8, 2025

Plan of correction: 1.Licensee/ED to review regulation 2. Advise and consult the RP's regarding discharge and/or eviction by POC.

Type of visit: Required - 1 Year

On 05/06/25 around 10:15 AM, Licensing Program Analyst (LPA) L. Holmes arrived unannounced to conduct a required Annual Inspection. LPA was greeted by one Care Staff upon entry and explained the purpose of the visit; Nalini Bhutani, Co-Administrator (ADM) arrived about 10 minutes later. The facility’s fire clearance was approved for thirteen (13) non-ambulatory residents; hospice waivers for four (4). LPA requested the resident roster, staff roster, three (3) staff files, five (5) resident files. LPA observed a visitor sign-in log at the entry. Emergency Disaster Plan is posted. LPA and ADM toured the facility, including but not limited to bedrooms, two (2) bathrooms (BA), kitchen, common area, front yard and backyard. All indoor passageways were free of obstruction. There were not any bodies of water present. Residents were lounging and watching television, one (1) went on a walk, the others were either sleeping, or engaged in something else. A comfortable temperature for residents was maintained at 72 degrees Fahrenheit (F), and the water temperature measured at 129.6 (F) in BA #1 and 118.2 in BA #2. LPA observed lighting in all rooms to be adequate for the comfort and safety of all the residents. The bathrooms were safe, sanitary and in operating condition. Hand washing posters, paper towels, and soap observed at all hand washing stations. Linen and hygiene supplies were available for all residents. PPE and paper goods remain sufficient. There is a minimum supply of 2-day perishables and 7-days of non-perishable foods. continued on LIC809C... ...continued from LIC809 Smoke detectors/carbon monoxide were in operating condition during visit. Fire extinguisher last serviced on 11/22/24, first aid kit is stored in a locked medication room, and the last emergency disaster drill was conducted on 02/2024 with the fire department; next quarterly drill to include all staff and residents. The following forms are to be updated: -LIC308 Designation of Administrative Responsibility -LIC610D Emergency Disaster Plan to be updated. Exit interview conducted and a copy of this report provided to Nalini Bhutani, Co-Administrator.the state’s words, verbatim · CDSS document, May 6, 2025

Type of visit: Required - 1 Year

On 05/03/24 around 09:00 AM, Licensing Program Analyst (LPA) L. Holmes arrived unannounced to conduct a required Annual Inspection. LPA was greeted by one Care Staff upon entry and explained the purpose of the visit; Nalini Bhutani, Co-Administrator (ADM) arrived about 20 minutes later. The facility’s fire clearance was approved for thirteen (13) non-ambulatory residents; hospice waivers for four (4). LPA reviewed the resident roster, staff roster, five (5) staff files, five (5) resident files and the Emergency Disaster Plan. LPA observed a visitor sign-in log at the entry. LPA and ADM toured the facility, including but not limited to bedrooms, two (2) bathrooms (BA), kitchen, common area, front yard and backyard. The facility consists of seven (7) total bedrooms. All indoor passageways were free of obstruction. There were not any bodies of water. Five (5) residents were lounging in the front yard, one (1) reading a newspaper, the others were either sleeping, watching television or engaged in electronics in the facility. A comfortable temperature for residents was maintained at 72 degrees Fahrenheit (F), and the water temperature measured at 111 (F) in BA #1. LPA observed lighting in all rooms to be adequate for the comfort and safety of all the residents. The bathrooms were safe, sanitary and in operating condition. Hand washing posters, paper towels, and soap observed at all hand washing stations. Linen and hygiene supplies were available for all residents. PPE and paper goods remain sufficient. There is a minimum supply of 2-day perishables and 7-days of non-perishable foods. continued on LIC809C... ...continued from LIC809 Smoke detectors/carbon monoxide were in operating condition during visit. Fire extinguisher last serviced on 01/22/24, first aid kit is stored in a locked medication room, and the last emergency disaster drill was conducted on 04/01/24 with all staff; next quarterly drill to include staff and residents. The following forms are to be updated: -LIC500 Personnel Report -LIC308 Designation of Administrative Responsibility -LIC610D Emergency Disaster Plan to be updated. -An updated copy of Administrator Certificate(s) -Update personnel files Exit interview conducted and a copy of this report provided to Nalini Bhutani, Administrator.the state’s words, verbatim · CDSS document, May 3, 2024

The state marks this report as 6 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.