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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603125
Report Date: 06/02/2026
Date Signed: 06/02/2026 12:04:57 PM

Document Has Been Signed on 06/02/2026 12:04 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:RANCHO SANTA FE VILLAFACILITY NUMBER:
374603125
ADMINISTRATOR/
DIRECTOR:		BAHA, RAY CYRUSFACILITY TYPE:
740
ADDRESS:8292 RUN OF THE KNOLLSTELEPHONE:
(858) 361-3322
CITY:SAN DIEGOSTATE: CAZIP CODE:
92127
CAPACITY: 6CENSUS: 4DATE:
06/02/2026
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:38 AM
MET WITH:Licensee/Administrator Ray BahaTIME VISIT/
INSPECTION COMPLETED:
12:05 PM
NARRATIVE
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Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced Case Management visit regarding a deficiency cited on 4/27/26 as well as a Plan of Correction (POC) visit to follow-up on two (2) deficiencies cited 5/13/26. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Licensee/Administrator Ray Baha.

On 4/27/26 during the facility's required annual inspection, LPA cited a deficiency for the facility locking exterior doors without having the fire clearance to do so. POC has since been met and the deficiency cleared (as of 5/22/26). However, as the violation was a Zero Tolerance Violation (ZTV), an immediate Civil Penalty of $500.00 has been assessed today as it was not assessed on the day of the deficiency on 4/27/26. Details are included on the attached LIC 421IM.

On 5/13/26 LPA cited a deficiency for the facility having not met reporting requirements. POC due date was set for 5/22/26 and was: "Licensee will submit an incident report of the event to Community Care Licensing by POC due date. Licensee will review 87211 and submit to LPA by the POC due date the facility's plan to ensure ongoing compliance with reporting timelines moving forward." While the Department received an incident report on 5/15/26 for the incident that took place 4/24/26, LPA had not received the secondary POC item by the due date, nor communication from the Licensee requesting for an extension. As the Licensee failed to correct the deficiency and notify LPA by the due date, LPA conducted a POC visit to verify correction and to assess a Civil Penalty Violation for Failure to Correct. A Civil Penalty of $100.00 a day has been assessed from 5/23/26 through today's date 6/2/26 for a total of $1,100.00. Details are included on the attached LIC 421FC. Licensee was able to provide LPA POC items during the visit and LPA cleared the deficiency. POC clearance letter was provided to Licensee Baha.

[Continued on LIC 809-C]
NAME OF LICENSING PROGRAM MANAGER: Sabel Martinez
NAME OF LICENSING PROGRAM ANALYST: Arian Golbakhsh
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/02/2026
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: RANCHO SANTA FE VILLA
FACILITY NUMBER: 374603125
VISIT DATE: 06/02/2026
NARRATIVE
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[Continued from LIC 809]

Additionally on 5/13/26 LPA cited a deficiency for the facility violating the right for residents to receive unopened correspondences. Please see complaint 08-AS-20260512093839 for additional information. POC due date was set for 5/15/26 and was: "Licensee will promptly provide any mail/correspondences for R1. Licensee will submit a written statement to LPA that they have provided R1 their packages and will continue to do so promptly for future packages. Licensee will submit proof to LPA by POC due date." LPA had not received POC items by the due date, nor communication from the Licensee requesting for an extension. As ten (10) working days have passed since the POC due date, LPA cannot issue a Civil Penalty for Failure to Correct. The deficiency is being re-cited today and details are included on the attached LIC 809-D page. Licensee was able to provide POC items during today's visit and LPA cleared the deficiency. LPA provided the POC clearance to Licensee/Administrator Baha.

One deficiency was cited during today's visit along with two (2) Civil Penalty assessments. An exit interview was conducted with Licensee/Administrator Baha to whom a copy of this report, the two (2) POC clearance letters, the LIC 421IM, LIC 421FC, and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.
NAME OF LICENSING PROGRAM MANAGER: Sabel Martinez
NAME OF LICENSING PROGRAM ANALYST: Arian Golbakhsh
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/02/2026 12:04 PM - It Cannot Be Edited


Created By: Arian Golbakhsh On 06/02/2026 at 09:37 AM
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: RANCHO SANTA FE VILLA
FACILITY NUMBER: 374603125

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/02/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/03/2026
Section Cited
CCR
87468.1(a)(15)

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87468.1(a): "Residents in all residential care facilities for the elderly shall have all of the following personal rights: (15) To send and receive unopened correspondence in a prompt manner."

This requirement is not met as evidenced by:
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Licensee will promptly provide any mail/correspondences for R1. Licensee will submit a written statement to LPA that they have provided R1 their packages and will continue to do so promptly for furture packages. Licensee will submit proof to LPA by POC due date.
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Based on LPA file review and interview, the licensee did not comply with the section cited above in ensuring a resident's right to receive unopened correspondences in a prompt manner was upheld, which poses a potential personal rights risk to 1 out of 4 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.
Sabel Martinez
NAME OF LICENSING PROGRAM MANAGER:
Arian Golbakhsh
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/02/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/02/2026


LIC809 (FAS) - (06/04)
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