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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604628
Report Date: 12/01/2025
Date Signed: 12/01/2025 04:55:07 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
08/05/2025 and conducted by Evaluator David Roman
COMPLAINT CONTROL NUMBER: 08-AS-20250805105440
FACILITY NAME:YAI GARJAN LANE ENHANCED BEHAVIORAL SUPPORTS HOMEFACILITY NUMBER:
374604628
ADMINISTRATOR:AZEEZ LAMINAFACILITY TYPE:
737
ADDRESS:17106 GARJAN LANETELEPHONE:
(341) 201-9993
CITY:RAMONASTATE: CAZIP CODE:
92065
CAPACITY:4CENSUS: DATE:
12/01/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Assistant Director, Zach McCormick TIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Facility is not free of ordors.
Staff did not dispose of solid waste resutling in pests.
Facility is not clean/sanitary.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) David Roman conducted an unannounced telework call to deliver findings in the above complaint allegation. LPA identified himself and discussed the purpose of the telework call with Facility Assistant Manager, Zach McCormick.

On August 05, 2025, Community Care Licensing Division (CCLD) received a complaint alleging facility is not free of odors, staff did not dispose of soild waste resulting in pest, and facility is not clean/sanitary. During the investigation, LPA D. Roman collected pertinent facility records, conducted interviews with staff, and outside sources. Interviews revealed contradicting information regarding the above mentioned allegations. LPA observations revealed that the facility is conducting its due diligence in maintaining the residents safety and care to the best of their abilities while complying with Title 22 regulations. Records review revealed the residents needs for higher level of care services such as those provided by EBSH's.

(Cont. on 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: David Roman
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 08-AS-20250805105440
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: YAI GARJAN LANE ENHANCED BEHAVIORAL SUPPORTS HOME
FACILITY NUMBER: 374604628
VISIT DATE: 12/01/2025
NARRATIVE
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Based on evidence obtained, the preponderance of evidence standard was not met, therefore, the allegations are unsubstantiated.

An exit interview was conducted with Facility Assistant Manager, Zach McCormick, to whom a copy of this report and Licensee/Appeals Rights (LIC 9058) were provided.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: David Roman
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2