374602444-10-27-2025-08-AS-DNGN-DMUV33-20251027160405

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374602444
Report Date: 10/27/2025
Date Signed: 10/27/2025 04:04:54 PM

Document Has Been Signed on 10/27/2025 04:04 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME:	LA MESA WORK CENTER		FACILITY NUMBER:	374602444
ADMINISTRATOR/ DIRECTOR:	RON FABIAN		FACILITY TYPE:	775
ADDRESS:	6134 UNIVERSITY AVE		TELEPHONE:	(619) 286-2144
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92115
CAPACITY: 112		CENSUS: 59	DATE:	10/27/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Administrative Assistant Angelica Menes		TIME VISIT/ INSPECTION COMPLETED:	04:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Dang Nguyen made an unannounced visit to conduct a Required Annual Inspection. The day program’s facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Administrative Assistant Angelica Menes. LPA then met with Licensee/Administrator Dr. Ronald Fabian and Documentation Specialist Marlene Fabian, who arrived shortly after. According to the facility license, the day program site has a maximum capacity for 112 clients, of whom 25 may be non-ambulatory, but none may be bedridden. Per LPA observation, LIC602 Physician’s Reports, and staff interviews: During today’s inspection, there were a total of 59 clients enrolled, of whom 15 were non-ambulatory, and none were bedridden. The day program did not have endorsements for delayed-egress doors or secured perimeter doors, and neither of these were present. LPA reviewed multiple client care records and multiple personnel files and training records. LPA interviewed multiple staff and interacted with multiple clients. LPA toured the interior and exterior of the facility, inspecting all classrooms and common areas. The day program’s facility was clean, sanitary, and in good repair. Doors, windows, toilets, shower, and lighting fixtures were all working. Pathways were free of obstruction and slip hazards. There was sufficient space and equipment to facilitate client learning/activities, meetings, meals, and visitation. The facility’s ambient internal temperature was complaint at 73 F. Where tested, hot water temperature at taps accessible to clients were compliant in temperature: Activity Room Sink was 113 F, Bathroom #1 Sink was 111.2 F, and Bathroom #2 Sink was 110.5 F. [CONTINUED ON LIC 809-C]

NAME OF LICENSING PROGRAM MANAGER: Simon Jacob
NAME OF LICENSING PROGRAM ANALYST: Dang Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/27/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: LA MESA WORK CENTER	FACILITY NUMBER: 374602444
	VISIT DATE: 10/27/2025

NARRATIVE

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[CONTINUED FROM LIC 809] The refrigerator and freezer used to preserve perishable food were also complaint in temperature. There were snacks available for those clients who forget to bring their own lunch from home. Disposable plates and cutlery were present.

There was a locked area for storage of medication. Confidential records were stored in locked areas. Required licensing postings were observed in visible areas of the facility. There were no toxic chemicals/poisons, open-faced heaters, or other hazardous objects accessible to clients. Smoke detectors, carbon monoxide detector, emergency lighting, and facility telephone were all working. A complete First Aid kit was present. The facility's fire extinguishers were serviced within the last twelve (12) months. The program does not have a fireplace or swimming pool (or similar body of water). Per the Licensee, no firearms or ammunition were kept at the facility. Licensee presented proof of current business liability insurance.

During the facility tour, LPA observed, and staff interview confirmed: The day program did not have a drinking water dispenser or container directly accessible to the clients, as required. [Licensee maintained a small cache of water bottles inside a locked staff office. This, however, required clients to ask staff for water (if they even knew to ask for the bottles).]

During records review, LPA observed, and staff interview confirmed: For 5 of 5 client records [Client #1 (C1) through Client #5 (C5)] which LPA randomly selected, Licensee did not have the name, address, and telephone number for the clients’ dentist (and where applicable, other mental health provider), as required. [See LIC811 Confidential Names List for a description of select person identifiers used in this report.]

Two (2) deficiencies were cited per California Code of Regulations, Title 22 (refer to the LIC809-D page). Plans of Correction were jointly developed with the Licensee. LPA also provided Technical Assistance (TA) regarding installing auditory staff alert devices on select exterior exit doors (refer to the LIC 9102-TA page).

An exit interview was conducted with Licensee/Administrator Dr. Ronald Fabian, Documentation Specialist Marlene Fabian, and Administrative Assistant Angelica Menes, to whom a copy of this report, the LIC 809-D page, the LIC9102-TA page, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today’s visit.

NAME OF LICENSING PROGRAM MANAGER: Simon Jacob
NAME OF LICENSING PROGRAM ANALYST: Dang Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/27/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/27/2025 04:04 PM - It Cannot Be Edited

Created By: Dang Nguyen On 10/27/2025 at 03:29 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: LA MESA WORK CENTER	FACILITY NUMBER: 374602444
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/27/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

82075(h)(1)

Health-Related Services

(h) There shall be at least one person in the day program at all times, who is capable of and responsible for communicating with emergency personnel. The following information shall be readily available to that person: (1) The name, address, and telephone number of each client's physician and dentist, and other medical and mental health providers, if any. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on records review and manager interview, for 5 of 5 sampled clients (C1 through C5), Licensee did not have readily available the name, address, and telephone number of each client's dentist and (where applicable) mental health provider(s). This posed a potential health risk to persons in care.
	POC Due Date: 11/27/2025
	Plan of Correction
1 2 3 4	Licensee agreed to communicate with responsible persons to update the Facesheets for C1 through C5 to include the name, address, and telephone number for each clients' dentist and (where applicable) mental health provider(s). If a client does not have a preferred dentist, Licensee may list a generic/default one who can be called for emergencies. Licensee agreed to E-mail the updated Facesheets for C1 through C5 to LPA, by the POC due date. Licensee agreed to independently audit all other clients' Facesheets for completeness.

Type B

Section Cited

CCR

82088.2(a)

Drinking Water

(a) Drinking water from a noncontaminating fixture or container shall be readily available both indoors and outdoors. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA observation and manager interview, Licensee did not ensure that drinking water from a noncontaminating fixture or container was readily available. This posed a potential health and personal rights risk to 59 of 59 clients [C1 through Client #59 (C59)] in care.
	POC Due Date: 11/27/2025
	Plan of Correction
1 2 3 4	Licensee agreed to install and maintain at least one (1) drinking water dispenser, with disposable cups and a trash can, in a space where the facility's clients can have direct access to it. Licensee agreed sent to LPA a video of the dispenser in place and working, by the POC due date. Until said water dispenser is up and running, Licensee agreed to place bottled water on a table in the common area, in plain view and directly accessible to the clients.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Simon Jacob
NAME OF LICENSING PROGRAM MANAGER:

	Dang Nguyen
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/27/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025

LIC809 (FAS) - (06/04)

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