374603481-12-10-2025-08-AS-RCLK-DPUSRV-20251230130659

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603481
Report Date: 12/10/2025
Date Signed: 12/10/2025 07:23:00 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

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

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/13/2024 and conducted by Evaluator Debbie Correia

COMPLAINT CONTROL NUMBER: 08-AS-20240513161313

FACILITY NAME:	MARYAM ARF		FACILITY NUMBER:	374603481
ADMINISTRATOR:	LEEDA DOST		FACILITY TYPE:	735
ADDRESS:	9319 NORTHVIEW TERRACE		TELEPHONE:	(858) 348-7247
CITY:	SANTEE	STATE: CA	ZIP CODE:	92071
CAPACITY:	6	CENSUS: 6	DATE:	12/10/2025
		UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Caregiver Fawzia Shalabi		TIME COMPLETED:	05:30 PM

ALLEGATION(S):

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Facility staff transported client in an unsafe manner.
Facility staff did not maintain client's records.
Facility staff's conduct posed a threat to the health and safety of the client.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Debbie Correia conducted a visit to conclude a complaint investigation regarding the above mentioned-allegations. LPA was greeted by Caregiver Shalabi, identified herself, and explained the purpose of the visit.

The Departments investigation included client, staff and outside source interviews and a facility and staff records reviews.

It was alleged that facility staff transported a resident in an unsafe manner, failed to maintain the resident’s medical records, and exhibited conduct that posed a threat to the health and safety of the resident. The investigation included interviews with Outside Source 1 (OS1), Staff 1 (S1), Staff 2 (S2), Client 1 (C1), and Client 2 (C2), as well as a review of facility and client records.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2025

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

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20240513161313

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: MARYAM ARF	FACILITY NUMBER: 374603481
	VISIT DATE: 12/10/2025

NARRATIVE

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[Continuation from LIC 9099]

OS1 reported that S1 became combative while signing in C1 for a doctor’s appointment, did not have C1’s medical records, and left the office abruptly with C1 in an unsafe manner. OS1 also alleged that S1 prevented C1 from speaking and acted in a verbally aggressive manner.

Interviews with S1, C1, S2, and C2 consistently described S1 as calm, respectful, and professional. C1 stated that S1 had never made them feel uncomfortable and denied that the transportation was unsafe. S1 explained that they had taken C1 to the appointment under the belief it was with a specialist. Upon learning it was with a Primary Care Physician (PCP), S1 canceled the appointment, stating that C1 already had an established PCP.

S1 reported that OS1 attempted to persuade C1 to switch PCPs, which triggered behavioral concerns in C1. S1 stated they attempted to deescalate the situation by disengaging OS1 from questioning C1 and ultimately left the office. C1 confirmed this account and requested their paperwork back during the incident. Both S1 and C1 denied that the transportation was unsafe. A review of C1’s records revealed a history of aggressive and assaultive behaviors triggered by similar situations. Additionally, the facility was found to be in possession of C1’s medical records, contradicting the claim that records were not maintained. [See LIC811 for confidential names]

Based on the information obtained through interviews and record reviews, the allegations are Unsubstantiated as there is not a preponderance of evidence to support the claims

An exit interview was conducted with Caregiver Shalabi, and a copy of the report and appeal rights were provided. Signature below confirms receipt of the reports.

SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2025

LIC9099 (FAS) - (06/04)

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