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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604706
Report Date: 08/30/2024
Date Signed: 08/30/2024 12:29:05 PM

Document Has Been Signed on 08/30/2024 12:29 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:FABIAN ADULT CARE FACILITYFACILITY NUMBER:
374604706
ADMINISTRATOR/
DIRECTOR:		HANNA, AMMARFACILITY TYPE:
735
ADDRESS:1213 TANGERINE STTELEPHONE:
(619) 357-1005
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY: 6CENSUS: 0DATE:
08/30/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced visit to complete a Required Annual Inspection. LPA knocked on the facility door, there was no answer. LPA walked around the facility and observed that there were no people in the facility and the facility appeared to be unoccupied.

LPA called the facility phone number, the call went direct to voicemail. LPA called the mobile phone number on file and left a voicemail requesting a call back. Licensee Fabian Hanna called LPA and stated that there are no clients currently living at the facility. New clients will be arriving on September 3, 2024. Fabian also stated that he was currently out of the county (about 1.5 hours away) and was not able to arrive to the facility in a short period of time.

LPA was not able to complete the Annual Inspection and will return in September 2024 to complete the inspection.

No deficiencies were observed or cited during today's visit.

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE: DATE: 08/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/30/2024
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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