Temple Heights

Type of visit: POC

Licensing Program Analyst (LPA) Ivashia Wright conducted an unannounced visit to the facility for a case management POC visit to follow up on complaint control 18-AS-20260808122859. The LPA was allowed entrance into the facility and met with MaryGrace Dalit, Caregiver. The LPA informed the Caregiver of the purpose of the visit. LPA toured the facility and made observations. The facility had the required two day supply of perishable foods and seven day supply of non perishable food on hand. Uncleared staff has been removed from the facility. POCs have been cleared. LPA reviewed and observed a medication bottle for R1 still missing a medications label. A deficiency will be cited and civil penalty will be assessed. A copy of this report, LIC 809D, and LIC 421FC, and appeal rights are being provided to Caregiver MaryGrace Dalit.the state’s words, verbatim · CDSS document, Sep 24, 2026

From the deficiency page — Deficiency type: Type A · Section cited: HSC 87915(a)(2) · Plan of correction due date: Oct 2, 2026

87915 Storage of Medications (a) The following requirements shall apply to medications which are centrally stored: (2) All medications shall be labeled and maintained in compliance with label instructions and state and federal laws. This requirement is not as evidenced by: Based on observation, there was no label on (1) of resident 1 (R1) medication. This poses a potential health and safety risk to the residents in care.the state’s words, verbatim · CDSS document, Sep 24, 2026

Plan of correction: Administrator will provide proof of new medication bottle with label to CCLD. Proof of correction must be submitted to LPA Wright by 5pm on 9/30/2026.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ivashia Wright conducted an unannounced visit for a required annual inspection. The LPA was greeted by Caregiver Niki Bonovich, notified them of the purpose for the visit and was allowed to enter the facility to conduct the inspection. Ceo, Dr Rahman arrived shortly after. Facility Overview: The facility is a single story building composed of five (5) residents bedrooms, three (3) bathrooms, a living room, a kitchen area, and a garage. There is no gated pool or no firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department's requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked in kitchen cabinet and inaccessible to residents. The smoke detector and carbon monoxide detector were in good working condition. LPA observed fire extinguisher to be in compliance and last serviced 6/12/2025. The water temperature was tested and not within regulations measuring at 122 F. Continued 809-C...... Care & Supervision/Administration: Adequate staff were present to supervise residents during the visit. The administrator holds a current administrator’s certificate with expiration date of 11/11/2027 and CPR of 2/5/2027. Record Review and Resident/Staff Files: LPA reviewed files for three (3) staff members, confirming criminal clearance, and CPR/First Aid certification. LPA observed annual training last conducted in 2024. Two (2) resident files were reviewed and contained all required documentation. LPA observed first aid kit to be locked and inaccessible to the clients in care. The resident and staff files were inaccessible to unauthorized individuals. Health-Related Services/Incidental Medical Services: All residents medications were securely locked in a kitchen cabinet. LPA reviewed medications for two(2) residents, confirming that all medications were listed and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan. LPA was not able to view last emergency drill due to the facility not having file present. All facility exits were clear of obstructions. Deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed, and a copy was provided.the state’s words, verbatim · CDSS document, Jun 10, 2026

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an announced pre-licensing inspection at the facility and met with Licensee Mohammad Rahman. Application: The inspection is a Change of ownership (CHOW) for a Residential Care Facility for Elderly (RCFE). The Murrieta Fire Department approved a fire clearance on 01-14-2025 for five (5) non-ambulatory and one(1) bedridden. Buildings and Grounds: The facility is composed of five (5) residents bedrooms, three (3) bathrooms, a living room, a kitchen area, an office and a garage. Water temperature was measured at 108.5 F. The interior and exterior walkways of the facility were observed to be clutter free with no obstructions present. Smoke and Carbon Monoxide detectors were in working order. There is a no pool and there are no weapons stored in the facility. Residents' bedrooms are fully furnished, and privacy is available. Outdoor areas have sufficient room for activities and leisure. A washing machine and dryer were available and in working order. The facility has a working phone witnessed by calling the phone number. Storage and Supplies: Medications, residents and staff files will be stored in a locked cabinet in the kitchen area, inaccessible to any unauthorized individuals. A complete first aid kit was observed to be available. Cleaning supplies will be stored in the laundry room. Linens and equipment appeared to be in good repair and sufficient for the approved census. Fire extinguishers were available and fully charged with an expiration date of June 12th, 2026. Continued 809-C... Food Service: Utensils and dishware are sufficient for the requested capacity. The refrigerator and freezer are in working order. Sharps knives will be stored in a locked cabinets in the kitchen area, available only to authorized individuals. Forms: The following signs were observed to be posted at the facility: Personal Rights, Complaint information, Emergency disaster plan, the facility sketch. LPA verified the Administrator's Certification, with an expiration date of January-11-27, and CPR certification with the expiration date of February-05-27. LPA observed that the physical plant is clean, in good repair, and to be hazard-free during today’s visit. The applicant completed Comp III on June 10, 2025. LPA determined the facility meets the operational requirements for licensure. The Pre-licensing inspection is complete and has satisfied all requirements in accordance with Title 22, California Code of Regulations. An exit interview was conducted, and this report was discussed and a copy was provided Licensee Mohammad Rahman.the state’s words, verbatim · CDSS document, Jun 13, 2025

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for the Elderly (RCFE) Application Type: Change in Ownership (CHOW) Capacity: 6 Census (if any clients in care): 4 COMP II Participants: Ruzedana Rahman, Administrator Mohammad Rahman, Applicant Interview Method: COMPONENT II Waived On December 24, 2024, applicant(s)/administrator participated in COMP II for the below pending facilities: Temple Heights—33188557 requesting to waive Temple Park Living—331881556 requesting to waive Temple Court—331881561 COMP II on 12/24/2024 and licensed on 5/23/2025. Temple Gardens –331881558 COMP II on 12/24/2024 and licensed 5/23/2025 Identification of the applicant(s) and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant(s) and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant and 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, Jun 4, 2025