San Diego Senior Care Living

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Janet Ngallo 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 herself, and explained the purpose of the visit to Licensee Houssam Yousif Mariam. The facility fire clearance was granted on 05/11/2026 and reflected that the facility was approved for six(6) residents in total, of which all may be non-ambulatory, one(1) may be bedridden. The facility's fire clearance did not include delayed egress doors or secured perimeter endorsements, and neither were present during today's visit. The submitted facility sketch was consistent with the current layout of the facility. During today’s visit, LPA, accompanied by the licensee, toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were well lit and free of obstruction and slip hazards. Resident bedrooms allowed for easy passage and contained the required furnishings. Toilets, sinks, and showers were in working order. Hot water temperature at taps accessible to residents were compliant. The facility has enough linens, hygiene supplies, cooking and dining supplies for future resident use. All kitchen appliances were in working order. (Cont. on LIC 809-C) (Cont. from LIC 809) The facility has sufficient space and equipment to facilitate laundry, visitation, meetings, and resident activities. The facility has locked areas for storage of sharp objects, medication, and confidential resident and staff records. No pools or bodies of water were observed on the premises. There were no toxic chemicals/poisons, open-faced heaters, or other hazards accessible to residents. Per the licensee, no firearms or ammunition are or will be stored at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all operational. The facility's fire extinguisher was serviced within the last 12 months. A complete first aid kit was present. Required licensing postings were observed in visible areas of the facility. The items reviewed were complaint with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code. The applicant passed the pre-licensing inspection. LPA also provided the Component III Training during today’s visit. Licensee was advised that the facility’s application is pending department final review and approval. An exit interview was conducted with Licensee Houssam Yousif Mariam, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Jul 6, 2026

Type of visit: Office

Facility Type: RCFE Application Type: INITIAL Capacity: 6 Census (if any clients in care): Method: Telephone call with CAB COMP II Participants: Mariam,Houssam Adeeb On 5/22/2026, the applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, May 22, 2026