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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435202884
Report Date: 02/19/2026
Date Signed: 02/19/2026 01:20:37 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/11/2026 and conducted by Evaluator Marcela Yanez
COMPLAINT CONTROL NUMBER: 26-AS-20260211123215

FACILITY NAME:M&K ADULT CARE LLCFACILITY NUMBER:
435202884
ADMINISTRATOR:ZAREGHBEITI, KHOSROWFACILITY TYPE:
735
ADDRESS:5527 CENTURY MANOR COURTTELEPHONE:
(408) 621-6871
CITY:SAN JOSESTATE: CAZIP CODE:
95111
CAPACITY:6CENSUS: DATE:
02/19/2026
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Khosrow (Bob) ZareghbeitiTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff was not fingerprint cleared to care and supervise residents.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) conducted an unannounced complaint investigation visit. LPA announced the purpose of the visit and met with Khosrow Zareghbeiti, Adminsitrator (ADM).

During visit LPA interviewed 3 residents and 3 staff including ADM and requested copies of pertinent documents.
On 01/24/26 Staff (S1) was hired and moved into facility and began to work as a Direct Support Staff. ADM stated S1 was given a brief training on how to give medication, cooking and cleaning. ADM stated staff was left alone with residents. S1 fingerprint was not cleared before S1 began working at the facility. S1 fingerprint clearance was cleared on 02/06/26.
The department completed its investigation and determined based on records review, interviews and observations there is preponderance of evidence to prove the alleged violation did occur; therefore, the allegation is substantiated. See 9099-D for deficiencies cited per the California Code of Regulations, Title 22.
Civil penalty in the amount of $500 was assessed during visit.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcela Yanez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 26-AS-20260211123215
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: M&K ADULT CARE LLC
FACILITY NUMBER: 435202884
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/19/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/20/2026
Section Cited
CCR
80019(e)(1)
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(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or … This requirement is not met as evidenced by:
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Staff S1 is no longer working at the facility as of 02/17/26 Licensee agreed to submit a plan in writing to ensure all new staff are fingerprint cleared and associated to the facility by POC date
Civil penalty in the amount of $500 was assessed during visit.
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Based on interview, observation and record review S1 was working and sleeping in the facility without obtaining a criminal record background clearance from date of hire 01/24/26 to fingerprint clearance obtained on 02/06/26 which poses an immediate health, safety and personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcela Yanez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3