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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604777
Report Date: 08/01/2024
Date Signed: 08/01/2024 05:40:51 PM


Document Has Been Signed on 08/01/2024 05:40 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:RAMONA SENIOR GARDENSFACILITY NUMBER:
374604777
ADMINISTRATOR:JAMIL, FAIZANFACILITY TYPE:
740
ADDRESS:1240 H STREETTELEPHONE:
(858) 663-9200
CITY:RAMONASTATE: CAZIP CODE:
92065
CAPACITY:68CENSUS: 0DATE:
08/01/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
04:50 PM
MET WITH:Administrator Faizan Jamil and Licensee Harris Jamil TIME COMPLETED:
06:00 PM
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Licensing Program Analyst (LPA) Juliana Barfield conducted an announced Pre-Licensing visit to observe the facility’s physical plant for compliance with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code. LPA was greeted by, identified themselves to, and explained the purpose of the visit to Administrator Faizan Jamil and Licensee Harris Jamil.

The facility fire clearance was approved and granted on 02/02/2024 for a secured perimeter. The facility was approved for sixty-eight (68) residents in total, of which 38 maybe non-ambulatory and 30 residents may be bedridden. The submitted facility sketch was consistent with the current layout of the facility.

During today’s visit, LPA, accompanied by Administrator Faizan Jamil and Licensee Harris Jamil, toured the interior and exterior of the facility and observed the secured perimeter of the facility.



The facility exits were observed to be compliant with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code. Pre-Licensing is complete and this facility has no deficiencies.

Administrator Faizan Jamil and Licensee Harris Jamil were advised that the facility’s application is pending management final review and approval.

An exit interview was conducted with Administrator Faizan Jamil and Licensee Harris Jamil to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.

SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Juliana BarfieldTELEPHONE: (619) 994-7269
LICENSING EVALUATOR SIGNATURE:
DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/01/2024
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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