374604706-9-19-2024-08-AS-LSIA-D99VKZ-20240919163109

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374604706
Report Date: 09/17/2024
Date Signed: 09/19/2024 04:31:45 PM

Document Has Been Signed on 09/19/2024 04:31 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 FACILITY		FACILITY NUMBER:	374604706
ADMINISTRATOR/ DIRECTOR:	HANNA, AMMAR		FACILITY TYPE:	735
ADDRESS:	1213 TANGERINE ST		TELEPHONE:	(619) 357-1005
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92021
CAPACITY: 6		CENSUS: 4	DATE:	09/17/2024
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:30 PM
MET WITH:	Licensee Fabian Hanna and Administrator Ammar Hanna		TIME VISIT/ INSPECTION COMPLETED:	05:00 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) Liliana Silveira conducted an unannounced required Annual Inspection. The facility file was reviewed prior to the visit. LPA identified herself, discussed the purpose of the visit and was granted entry by Licensee Fabian Hanna and Administrator Ammar Hanna. According to the facility’s license, there may be a maximum of six (6) clients all of whom must be ambulatory, age range 18 through 59. There are currently (4) clients living at the facility. During today’s inspection, 2 clients were present. LPA, accompanied by Fabian and Ammar, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and activities. The facility’s ambient internal temperature was comfortable and compliant, at 75 F. Hot water temperature at taps accessible to clients were also compliant: sink in restroom #1 was 105.1 F, sink in restroom #2 was 105 F. There was at least 2 days of perishable food, and at least 7 days non-perishable food present. Cooking/dining equipment and utensils were present, and all safely stored. There were no toxic chemicals/poisons accessible to clients. Medications were properly labeled, as required, and stored in a locked cabinet. The medication logs were also reviewed. [CONTINUED ON LIC 809-C]

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

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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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: FABIAN ADULT CARE FACILITY	FACILITY NUMBER: 374604706
	VISIT DATE: 09/17/2024

NARRATIVE

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[CONTINUED FROM LIC 809]
No pools or bodies of water were observed on the premises. Per Licensee Fabian Hanna, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present (1) and serviced within the last 12 months. First aid kit(s) were complete and readily accessible.

LPA interviewed staff and clients, and reviewed staff and client records. LPA interviews and review of facility files did not raise any licensing concerns. Confidential records were stored in a locked area. Required licensing postings were observed in a visible area of the facility.

There were no deficiencies observed or cited during today's annual inspection.

An exit interview was conducted with Licensee Fabian Hanna, to whom a copy of this report, along with the Licensee/Appeal Rights (LIC9058 03/22) were provided. The signature below confirms the documents were received.

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

LIC809 (FAS) - (06/04)

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