Premium Care Services

Type of visit: Case Management - Licensee Initiated

Licensing Program Analyst (LPA) Natasha Persaud conducted a case management visit regarding Licensee initiated facility closure. LPA was greeted and allowed entry into the facility by Licensee, Sheikh Hafiz. On 07/06/2026, the licensee submitted a letter to the CCLD San Diego Regional Office stating that the facility would cease operations and close on 07/06/2026. Licensee stated all residents were successfully relocated as of 07/03/2026. During today's visit, LPA toured the interior and exterior of the facility and verified that there were no residents in care. All resident clothing and personal effects have been removed. All licensing postings have been taken down. The licensee provided their original license. No deficiencies were issued, and the facility is ready for closure. An exit interview was conducted with Licensee, Sheikh to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Jul 8, 2026

Allegation investigated: Staff did not ensure that resident was provided postural support according to their daily living needs Staff did not provide adequate food service for residents Staff did not provide residents comfortable living accomodations Staff did not maintain a comfortable temperature in the facility for residents Staff did not keep the facility free of cockroaches

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced visit to commence a complaint investigation. LPA identified herself and discussed the allegations mentioned above with Staff, Nelson Quebrel. LPA spoke with Administrator, Sheikh Hafiz via telephone, while at the facility. During the investigation, the facility was toured, records reviewed, and interviews conducted with staff and residents. It was alleged staff did not ensure Resident #1 (R1) was provided postural support according to their daily living needs and staff did not provide R1 comfortable living accommodations. It was reported R1 did not have bed rails on their bed and was a known fall risk and had an undersized mattress. R1 was not interviewed, as they passed away. The administrator explained that the hospice agency had the hospital bed delivered with a hospital mattress, there were no bed rails or orders. The administrator explained that R1’s physician and/or hospice agency did not order bed rails for R1 because it was not required. Administrator added they will advocate for the residents if the bed rails are needed for mobility use. Continued on LIC 9099C. Unsubstantiated Also, administrator stated if a resident is a fall risk, they do not request bed rails for that reason, as that’s not the intended purpose of the bed rail. The administrator went on to explain that hospice provided the hospital bed with a standard mattress, not undersized, and made out of foam, which is not spring loaded like a regular mattress. It was also alleged staff did not provide adequate food service for residents. It was reported that R1 was not receiving enough food. The administrator explained R1 was on hospice, declining and loss of appetite. R1 was always provided food, however, towards the end of life it was difficult for R1 to eat/swallow. The administrator said they were instructed by hospice to feed R1 but be careful due to choking hazard. Administrator added that R1’s family member was upset, as they wanted R1 to eat more food and eat the items brought by the family. However, the administrator followed hospice instructions for R1’s safety. Today, LPA observed a sufficient supply of food in the fridge, freezer, and pantry. Resident interviews confirmed they are receiving enough food and enjoy the food served. Staff stated they cook daily and provide meal options to the residents. It was also alleged staff did not maintain a comfortable temperature in the facility for residents. It was reported that on a day when the weather was 90 degrees F., staff only provided non-air-conditioning fans instead of adjusting the room temperature. The facility does not have centralized air conditioning, therefore, the room temperature cannot be adjusted. Today, LPA observed each resident’s room contained a fan, some had a portable window air conditioning units, and there were additional fans in the common areas. Today’s temperature reached 85 degrees F. Some residents were observed wearing sweaters and some using blankets. Resident interviews confirmed the facility was maintained at a comfortable temperature. Also, residents requested the fans not be turned on, as they pointed out they were wearing sweaters. When asked if they felt cold, they explained they were comfortable with their sweaters but did not require the heat to be turned on. The administrator explained they have a sufficient supply of fans. However, when they ask the residents if they would like the fans turned on it’s declined. Continued on LIC 9099C. Lastly, it was alleged staff did not keep the facility free of cockroaches. It was reported an outside source observed a cockroach inside a rice cooker containing uneaten rice. Staff explained they have not observed any cockroaches in food. Staff added the pest control was recently at the facility to spray. The administrator explained they have an annual contract with a professional pest control company. Pest control comes to the facility once a month to spray or more if requested. Resident interviews revealed they have not observed any cockroaches. Staff explained that the pest control company was at the facility two days ago to spray, and staff spray a safe chemical as well for precautionary measures. The facility has measures in place to address cockroaches by having the pest control company on contract. During the course of the investigation, interviews were conducted, and records were reviewed. Investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegations. The allegations are deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Administrator, Sheikh Hafiz whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Dec 10, 2025 · control 08-AS-20251204232010

Allegation investigated: Staff did not treat resident with dignity

Licensing Program Analyst (LPA), Natasha Persaud conducted an unannounced visit to conclude the complaint investigation regarding the above mentioned allegations. LPA was greeted and allowed entry into the facility by Staff, Roser Loja. The Administrator, Sheik Hafiz arrived during the visit. During the investigation, the facility was toured, records reviewed, and interviews conducted with staff, residents, and outside sources. It was alleged staff did not treat resident with dignity. It was reported Staff #1 (S1) called Resident #1 (R1) bad names and goosed R1’s butt. It was explained S1 poked R1 between the buttocks. Outside source interviews revealed R1 used to goose people in their past and thought it was funny. S1 explained R1 would goose S1, so S1 admitted they did it back to R1, as a friendly gesture and they would both laugh. S1 denied calling R1 names. In addition, S1 was using rubber bands to tie the doorknobs together to hold the door shut. S1 was sleeping in the hallway outside of R1’s room and the light was disturbing S1 at night. Continued on an LIC 9099C. Substantiated S1 explained the rubber bands were used to hold the doors closed due to the light shining from R1’s room into the hallway. R1 was not treated with dignity when S1 goosed R1, by poking R1 in between their buttocks and using rubber bands to hold R1’s doorknobs closed. The licensee’s interview revealed they removed S1 from providing care to R1 and R1 is no longer sleeping in the hallway in front of R1’s room. S1 is currently residing in the garage. The administrator was made aware staff are not allowed to sleep in the garage unless approved by the Fire Department. The licensee stated they will submit documentation for the fire department review. Based on LPA’s observations and interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation was found to be substantiated. California code of Regulations, Title 22, Division 6 & Chapter 8 is being cited on the attached LIC 9099D. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Administrator, Sheik Hafiz whose signature below confirms receipt of these rights. S1 stated there was no scratch or injury that occurred. S1 stated, R1 scratched their hand on their walker. S1 offered to clean the skin tear, but R1 refused, it’s unknown how exactly R1 sustained the scratch. Outside source interview revealed the day the resident stated the incident occurred, there were no visible scratches or wounds. R1 also stated the same incident occurred at their prior facility. LPA observed the wall in the bedroom that R1 stated they were pushed against and noticed it was not possible as there was a bed located in the area reported. Resident interviews revealed they have never been pushed or injured by staff. Residents also reported not being aware of the incident. Staff interviews revealed they have not witnessed or heard S1 push R1 against the wall. Staff interviews stated R1 had a scratch on their hand, but they didn’t know how R1 sustained it. It was also alleged that S1 locked R1 in their room by tying rubber bands around the doorknobs to lock R1 in their room. S1’s interview revealed they were sleeping on a cot in the hallway located outside of R1’s room. S1 stated they used large rubber bands around the two (2) doorknobs to hold the door closed due to the lighting coming through the door opening. The double doors to R1’s room do not close completely, allowing lighting through the opening of the double doors. S1 explained the door was not locked with the rubber bands, as the doors could easily be opened. R1’s interview confirmed their doors were never locked and they were able to enter and exit their room at any time. R1 was not aware of any rubber bands on their doorknobs. It was also alleged that staff did not ensure R1 had access to incontinent equipment. It was reported that staff were hiding R1’s urinal at night. R1 is able to ambulate and use the restroom independently. R1 has a urinal for nighttime use to ensure safety from getting up to go to the bathroom at night. On 02/03/25, LPA observed two (2) urinals located in R1’s bedroom. R1 denied not having access to their urinal. Staff interviews confirmed R1 has two (2) urinals for nighttime use, as R1 uses the bathroom independently during the day. Staff explained that the urinals are only taken by staff to discard the urine and clean the urinals, then it’s returned to R1. R1 denied not having access to their incontinent equipment. Lastly, it was alleged that staff did not refill R1’s medications. R1’s responsible party’s interview confirmed that they manage R1’s finances and the out of pocket cost for the medication was costly. Therefore, they didn’t always purchase it for R1. Also, due to R1’s medical insurance, some medications were held. R1’s responsible party explained the facility was not responsible for any errors with R1’s medications and R1’s primary care physician (PCP) was involved. R1’s responsible party also indicated R1’s physician’s assistant was calling in the refills to the pharmacy not the facility. In addition, R1 was no longer taking the medication in question, therefore, it was not refilled. During the course of the investigation, interviews were conducted, and records were reviewed. Investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegations. The allegations are deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Administrator, Sheik Hafiz whose signature below confirms receipt of these rights. [See LIC 811 Confidential Names List to identify Resident #1 and Staff #1]the state’s words, verbatim · CDSS document, Aug 19, 2025 · control 08-AS-20250127114918

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: Sep 16, 2025

Personal Rights of Residents in All Facilities. To be accorded dignity in their personal relationships with staff, residents, and other persons. Based on observations and interviews the licensee did not ensure 1 out of 5 [R1] residents were treated with dignity, which poses a potential personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Aug 19, 2025

Plan of correction: The administrator stated staff are no longer sleeping in the hallway. The administrator agreed to have staff trained on personal rights and submit proof of training by POC due date.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA), Natasha Persaud conducted an unannounced Case Management Deficiencies visit. LPA was greeted and allowed entry into the facility by Staff, Roser Loja. The Administrator, Sheik Hafiz arrived during the visit. During a complaint investigation, it was discovered staff were sleeping in the living room and the garage. The licensee admitted staff sleep in the living room, as residents are not present. It was explained to the licensee that the living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents and staff. Therefore, staff are not allowed to use the living room as sleeping quarters. The administrator explained staff are no longer sleeping in the living room, they are sleeping in the garage. The administrator was not aware approval was needed. The administrator and staff confirmed the staff have comfortable accommodations. LPA explained the Fire Department will make the decision if staff are allowed to sleep in the garage. The administrator stated they will submit documentation for approval/denial for staff sleeping in the garage. Based on interviews which were conducted a deficiency was observed and being cited on the attached LIC 809D. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Administrator, Sheik Hafiz whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Aug 19, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87307(a) · Plan of correction due date: Sep 16, 2025

Personal Accommodations and Services. Living accommodations and grounds shall be related to the facility's function. The facility shall...provide comfortable living accommodations...residents, staff, and others who may reside in the facility. The following provisions shall apply: This requirement is not met as evidenced by: Based on interviews, the licensee did not ensure there was sufficient sleeping quarters for 3 out of 5 [S1-S3] and allowed staff to sleep in the living room, which poses a potential safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Aug 19, 2025

Plan of correction: The administrator stated they will submit an application along with a facility sketch for fire department approval/denial for staff to sleep in the garage.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was greeted and allowed entry into the facility and conducted the visit with Staff, Roser Loja. The administrator, Sheik Hafiz arrived during the visit. LPA, accompanied by staff, 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. Resident bedrooms contained the required furnishings. Doors, windows and screens, 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 resident activities. Hot water temperature at taps accessible to residents were all compliant and measured at 117 F.. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, and/or fireplaces accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water were observed on the premises. Per the licensee's staff, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed multiple staff and resident records/files. The reviewed files contained required documents. Confidential records were stored in locked areas. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Administrator, Sheik Hafiz to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Aug 19, 2025

Allegation investigated: Staff are sleeping in residents' room/living room

Licensing Program Analyst (LPA), Natasha Persaud conducted an unannounced visit regarding the above mentioned allegation. LPA was greeted and allowed entry into the facility by staff, Khymberlie Talledo. LPA discussed the allegation with Licensee, Sheikh Hafiz via telephone, while at the facility. During the investigation, the facility was toured, records reviewed, and interviews conducted with staff, residents, and outside sources. It was alleged staff are sleeping in residents’ room/living room. It was reported staff use roll away bed and sleep in the living room, as well as on the floor in resident rooms. Resident interviews confirmed staff are sleeping in the living room but not the resident rooms. Staff confirmed they sleep in the living room, as there are no staff rooms available. Licensee confirmed staff are sleeping in the common area/living room, but not resident rooms. The LIC 999 Facility Sketch was reviewed and identified the living room as the intended purpose, not sleeping quarters. By allowing staff to sleep in the living room it precludes the use of the room for the intended purpose. Licensee stated staff will no longer sleep in the common area/living room. Continued on an LIC 9099C. Substantiated The facility requires awake staff, l0:00 p.m. to 6:00 a.m. due to a bedridden resident. However, there are three (3) staff available to assist. Therefore, some staff can sleep during those hours. Based on interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation was found to be substantiated. California code of Regulations, Title 22, Division 6 & Chapter 8 is being cited on the attached LIC 9099D. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Staff, Roser Loja whose signature below confirms receipt of these rights. The licensee stated he supplies the facility with a sufficient supply of food so that they make fresh meals for the residents. LPA observed a sufficient supply of perishable items for cooking. During the course of the investigation, interviews were conducted, and observations were made. Investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegation. The allegation was deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Staff, Roser Loja whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Apr 15, 2025 · control 08-AS-20250410160604

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87307(a) · Plan of correction due date: May 13, 2025

Personal Accommodations and Services. Living accommodations and grounds shall be related to the facility's function. The facility...accommodations and privacy for the residents, staff, and others who may reside in the facility.This requirement is not met as evidenced by: Based on interviews, the licensee did not ensure living accommodations were related to the facility's function for 5 out 6 [R1-R5] residents, which posed a potential safety and/or personal rights violation.the state’s words, verbatim · CDSS document, Apr 15, 2025

Plan of correction: Licensee stated staff will no longer sleep in the common areas/living room. In addition, Licensee agreed to attend training regarding Personal Accommodations and Services and provide proof of training by POC due date.

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA), Natasha Persaud conducted a Case Management - Incident visit. LPA was greeted and allowed entry into the facility by staff, Khymberlie Talledo. LPA discussed the purpose of the visit with Staff, Roser Loja and Licensee, Sheikh Hafiz via telephone, while at the facility. During today's visit, LPA toured the facility, requested records, and interviewed staff and residents. The facility self reported an incident involving Resident #1 (R1). The report indicated on 02/17/25, a caregiver was assisting R1 with a brief change when R1 reported pain in their left leg. R1 was unable to turn over due to the pain. The facility contacted R1's responsible party to notify them of R1's condition. R1's responsible party arrived at the facility and transported R1 to the hospital. R1 was diagnosed at the hospital with a fracture in their upper femur, near the hip. Per the licensee, R1 received surgery and later returned to the facility. After returning to the facility, R1 was no longer eating and was placed on hospice. R1 passed away on 03/29/25, to an unrelated reason to the fracture. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Staff, Roser Loja whose signature below confirms receipt of these rights. [See LIC 811 Confidential Names List to identify Resident #1]the state’s words, verbatim · CDSS document, Apr 15, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was greeted and allowed entry into the facility by Staff, Flora Maravillas. Administrator, Sheikh Hafiz arrived during the visit. LPA, accompanied by staff, 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. Resident bedrooms contained the required furnishings. Doors, windows and screens, 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 resident activities. Hot water temperature at taps accessible to residents were all compliant and measured at 108 F.. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, and/or fireplaces accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water were observed on the premises. Per the administrator, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed multiple staff and residents. LPA reviewed multiple staff and resident records/files. The reviewed files did not contain required documents. Staff did not have First Aid or CPR training on file. In addition, Resident reappraisals were not current. A deficiency was observed or cited during today's annual inspection. Also, Advisory Notes were issued. An exit interview was conducted with Administrator, Sheikh Hafiz to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Aug 23, 2024

Allegation investigated: Licensee did not ensure a comfortable temperature was maintained for residents at all times

Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced visit to commence a complaint investigation. LPA identified herself and discussed the allegation mentioned above with Staff, Roser Loja. During today's visit, LPA briefly toured the facility, interviewed staff and residents. It was alleged the licensee did not ensure a comfortable temperature was maintained for residents at all times. It was reported the facility's temperature was 88 degrees F. on 06/25/24. An online review of AccuWeather indicated the weather on 06/25/24 was 83 degrees F. in the Mira Mesa area. Outside source interviews revealed a resident was hot and sweating in their bed due to the hot temperature of 88 degrees F. on 06/25/24. Staff and resident interviews confirmed the resident that was in bed sweating has a shared room and the resident's roommate turned off the fan, due to feeling cold. Even though the facility’s temperature reached 88 degrees F. not all residents were hot, due to different body temperatures. Continued on an LIC 9099C Unsubstantiated The facility has multiple residents with different body temperatures. Today's temperature outside was 79 degrees F. The facility's thermostat today reflected 81 degrees F. LPA observed a resident wearing a shirt, sweater and under two blankets. Resident interviews confirmed it was not too hot. Some residents were cold with the use of the fans today but made aware it was necessary to keep the facility's temperature within regulation. Staff interviews revealed the facility was not too hot and there are multiple fans in use, along with the doors and windows left open. LPA observed one (1) portable air conditioning unit, one (1) tower fan, and a working ceiling fan located in the room in which the resident was hot and sweating, all in use. The roommate complained today it was too cold. The staff has positioned the portable air conditioning unit towards the resident that was hot, so that it would not affect the roommate. Staff also indicated they provide blankets and jackets to the residents that may cold, to ensure the facility's temperature is regulated. The facility has one (1) portable air conditioning unit; twelve (12) fans; and five (5) ceiling fans throughout the facility. They also have four (4) extra fans and two (2) extra portable air conditioning units located in the garage for resident use. LPA observed one (1) resident had three (3) fans in their room but only one (1) in use, by choice. Another resident requested the fan be turned off. Due to multiple residents with different body temperatures, the facility is ensuring to meet each resident’s needs regarding the facility temperature. During the course of the investigation, interviews were conducted, and records were reviewed. Investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegation. The allegation is deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Staff, Roser Loja whose signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Jul 3, 2024 · control 08-AS-20240627094003