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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604383
Report Date: 02/02/2026
Date Signed: 02/02/2026 06:06:22 PM

Document Has Been Signed on 02/02/2026 06:06 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:AMARIAH HOME CAREFACILITY NUMBER:
374604383
ADMINISTRATOR/
DIRECTOR:		JR. ALVELA, JOSEPH P.FACILITY TYPE:
740
ADDRESS:1046 HELIX AVETELEPHONE:
(619) 731-1535
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY: 6CENSUS: 6DATE:
02/02/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Licensee/Administrator Joseph P. AlvelaTIME VISIT/
INSPECTION COMPLETED:
06:15 PM
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Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Licensee/Administrator Joseph P. Alvela.

According to the facility’s license: The facility has a maximum capacity of six (6) residents, of whom all may be ambulatory or non-ambulatory. Up to one (1) resident may be bedridden, if they in Bedroom #3. Up to six (6) residents may be under hospice care at a time. Per LPA observation, LIC602 Physician’s Reports, and staff interviews: During today’s inspection, there were a total of six (6) residents in care, of whom all were non-ambulatory. One (1) of the residents was also under hospice care.

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 working. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility’s ambient internal temperature was complaint at 72 F. Hot water temperature at taps normally accessible to residents were compliant in temperature. Refrigerators and freezers used to preserve perishable foods and medication were complaint in temperature. There were at least (2) days of perishable food and at least seven (7) days of non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present and in good condition.


[CONTINUED ON LIC 809-C, 1 of 2]
NAME OF LICENSING PROGRAM MANAGER: Simon Jacob
NAME OF LICENSING PROGRAM ANALYST: Dang Nguyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/02/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 7
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: AMARIAH HOME CARE
FACILITY NUMBER: 374604383
VISIT DATE: 02/02/2026
NARRATIVE
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[CONTINUED FROM LIC 809]

The facility did not have a swimming pool (or similar body of water). The fireplace was screened, as required. There were no open-faced heaters, toxic chemicals/poisons, or other hazardous objects accessible to clients. Smoke detectors, carbon monoxide detector, emergency lighting, night lights, and facility telephone were all working. The facility’s license did not include endorsements for delayed-egress doors or secured perimeter, and neither of these were present. There was a locked area for storage of medication. Confidential records were stored in secure areas. Required licensing postings were observed in visible areas of the facility. Per the Licensee, no firearms or ammunition were kept at the facility. Licensee presented proof of current business liability insurance.

During a review of resident records, LPA observed, and manager interview confirmed: Licensee did not within the last twelve (12) months hold a meeting/conference with the responsible person and other appropriate parties for four (4) of six (6) residents [Resident #1 (R1) through Resident #4 (R4)], for the purpose of reviewing and updating the resident’s written record of care / care plan, as was required. [See LIC811 Confidential Names List for a description of select person identifiers used in this report.] For two (2) of six (6) residents [R2 and Resident #5 (R5)], Licensee did not have documentation in the resident’s record of an annual routine visit with the resident’s licensed medical professional within the last twelve (12) months, as was required.

Two (2) of six (6) residents had Restricted Health Conditions (as defined in CCR 87614) for which they required some caregiver monitoring and/or assistance: R3 and R4 were both diabetic, using both glucometer-testing and Insulin flex-pen administration. While care staff displayed some skill/knowledge on how to care for diabetes, Licensee did not arrange for (and document) that a licensed medical professional (such as a nurse) provided the facility’s caregivers “hands-on instruction in both general procedures and resident-specific procedures,” as was required. Additionally, R1 was under hospice care, but Licensee did not arrange for (and document) that hospice agency personnel (such as the resident’s assigned hospice case manager nurse) provided “training specific to the current and ongoing needs of the individual resident receiving hospice care,” prior to the start of hospice care at the facility for R1, as was required.

[CONTINUED FROM LIC 809-C, 2 of 2]
NAME OF LICENSING PROGRAM MANAGER: Simon Jacob
NAME OF LICENSING PROGRAM ANALYST: Dang Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2026
LIC809 (FAS) - (06/04)
Page: 3 of 7
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: AMARIAH HOME CARE
FACILITY NUMBER: 374604383
VISIT DATE: 02/02/2026
NARRATIVE
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[CONTINUED FROM LIC 809-C, 1 of 2]

During a review of personnel records, LPA observed, and manager interview confirmed: Three (3) of three (3) direct care staff [Staff #1 (S1), Staff #2 (S2), and Staff #3 (S3)] did not complete the minimum twenty (20) hours of continuing training within the last twelve (12) months, as required. [Regulation requires twenty (20) hours per direct care staff, of which at least eight (8) hours must be on Dementia care, and at least four (4) hours must be related to postural supports, restricted health conditions, and hospice care.] Additionally, two (2) of three (3) direct care staff who pass medications (S1 and S3) did not complete eight hours of in-service training on medication-related issues in the last twelve (12) months, as required.

Four (4) deficiencies were cited per California Code of Regulations, Title 22, and two (2) deficiencies were cited per California Health and Safety Code (see the attached LIC809-D pages). Plans of Correction were jointly formed with the Licensee.

An exit interview was conducted with Licensee/Administrator Joseph P. Alvela, to whom a copy of this report, the LIC809-D pages, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during today’s visit.
NAME OF LICENSING PROGRAM MANAGER: Simon Jacob
NAME OF LICENSING PROGRAM ANALYST: Dang Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2026
LIC809 (FAS) - (06/04)
Page: 4 of 7
Document Has Been Signed on 02/02/2026 06:06 PM - It Cannot Be Edited


Created By: Dang Nguyen On 02/02/2026 at 03:15 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: AMARIAH HOME CARE
FACILITY NUMBER: 374604383

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/02/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1569.625(b)(2)
Other Provisions
(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review and manager interview, Licensee did not ensure that 3 of 3 staff (S1, S2, and S3) had completed 20 hours of training within the last twelve (12) months, of which 8 hours were required to be on dementia care and of which 4 hours were required to be on postural supports, restricted health conditions, and hospice care. This posed a potential health and personal rights risk to 6 of 6 residents [R1 through Resident #6 (6)] in care.
POC Due Date: 03/04/2026
Plan of Correction
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Licensee agreed to have S1, S2, and S3 each finish 20 hours of annual training (ensuring at least 8 hours are on dementia care and at least 4 hours are on "postural supports, restricted health conditions, and hospice care"). Licensee agreed to clearly document the training, and to send proof of completion to LPA, by the POC due date.
Type B
Section Cited
HSC
1569.69(b)
Other Provisions
(b) Each employee who received training and passed the examination required in paragraph (5) of subdivision (a), and who continues to assist with the self-administration of medicines, shall also complete eight hours of in-service training on medication-related issues in each succeeding 12-month period.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and manager interview, Licensee did not ensure that 2 of 3 medication-passing staff (S1 and S3) had completed 8 hours of in-service training on medication-related issues within the the last twelve (12) months. This posed a potential health risk to 6 of 6 residents [R1 through Resident #6 (6)] in care.
POC Due Date: 03/04/2026
Plan of Correction
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Licensee agreed to have S1 and S3 each finish 8 hours of annual training on medicaiton-related topics. Licensee agreed to clearly document the training, and to send proof of completion to LPA, by the POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Simon Jacob
NAME OF LICENSING PROGRAM MANAGER:
Dang Nguyen
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 02/02/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2026


LIC809 (FAS) - (06/04)
Page: 5 of 7
Document Has Been Signed on 02/02/2026 06:06 PM - It Cannot Be Edited


Created By: Dang Nguyen On 02/02/2026 at 03:15 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: AMARIAH HOME CARE
FACILITY NUMBER: 374604383

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/02/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87463(h)(1)
Reappraisals
(h) The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment. (1) Documentation of the annual routine visit, such as a visit summary, shall be added to the resident's record.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and manager interview, Licensee did not ensure that 2 of 6 residents (R2 and R5) had documentation of an annual routine visit with a licensed medical professional. This posed a potential health risk to persons in care.
POC Due Date: 03/04/2026
Plan of Correction
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Licensee agreed to coordinate with responsible persons (RP) to ensure that R2 and R5 complete their respective annual routine physical/medical visit. (In cases where the RP refuses the annual visit, Licensee will document such refusal in writing.) Licensee agreed to send proof of completion to LPA, by the POC due date.
Type B
Section Cited
CCR
87467(a)(3)
(a) Prior to, or within two weeks of the resident's admission, the licensee shall arrange a meeting with the resident, the resident's representative, if any, appropriate facility staff, and a representative of the resident's home health agency, if any, and any other appropriate parties, to prepare a written record of the care the resident will receive in the facility, and the resident's preferences regarding the services provided at the facility. (3) The licensee shall arrange a meeting with the resident and appropriate individuals identified in Section 87467(a)(1) to review and revise the written record as specified, when there is a significant change in the resident's condition, or once every 12 months, whichever occurs first. Significant changes shall include, but not be limited to occurrences specified in Section 87463, Reappraisals. This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on records review and manager interview, for 4 of 6 residents (R1 through R4), Licensee did not within the last 12 months arrange a meeting with the resident and required individuals to review and revise the resident's written record of care. This posed a potential health risk to persons in care.
POC Due Date: 03/04/2026
Plan of Correction
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For R1 through R4 each, Licensee agreed to conduct a care conference with their responsible person (and visiting care agency personnel, as applicable) to review the resident's facility Plan of Care, updating it as needed. All parties to the meeting will sign. Licensee agreed to E-mail proof of care conference completion to LPA, by the POC due date. Going forward, Licensee agreed to facilitate such care conferences at least once every 12 months for each resident.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Simon Jacob
NAME OF LICENSING PROGRAM MANAGER:
Dang Nguyen
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 02/02/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2026


LIC809 (FAS) - (06/04)
Page: 6 of 7
Document Has Been Signed on 02/02/2026 06:06 PM - It Cannot Be Edited


Created By: Dang Nguyen On 02/02/2026 at 03:15 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: AMARIAH HOME CARE
FACILITY NUMBER: 374604383

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/02/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87633(b)(6)(B)
Hospice Care for Terminally Ill Residents
(b) A current and complete hospice care plan shall be maintained in the facility for each hospice resident and include the following: (6) Identification of the training needed, which staff members need this training, and who will provide the training relating to the licensee's responsibilities for implementation of the hospice care plan. (B) The hospice agency will provide training specific to the current and ongoing needs of the individual resident receiving hospice care and that training must be completed before hospice care to the resident begins.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on records review and manager interview, Licensee did not ensure that the hospice agency trained 3 of 3 facility staff (S1, S2, and S3) on 1 of 6 resident' (R1's, who was under hospice care) current and ongoing individual care needs. This posed a potential health risk to persons in care.
POC Due Date: 03/04/2026
Plan of Correction
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Licensee agreed to coordinate with the hospice agency for R1, to have their nurse lead an in-service training for current facility staff, covering both R1's hospice care plan and the current and their ongoing care needs. Licensee agreed to E-mail the training sign-in sheet to LPA, by the POC due date.
Type B
Section Cited
CCR
87613(a)(2)(A)
87613 General Requirements for Restricted Health Conditions: (a) Prior to admission of a resident with a restricted health condition, the licensee shall: (2) Ensure that facility staff who will participate in meeting the resident’s specialized care needs complete training provided by a licensed professional sufficient to meet those needs. (A) Training shall include hands-on instruction in both general procedures and resident-specific procedures.” This requirement was not met, as evidenced by:
Deficient Practice Statement
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2
3
4
Based LPA observation, records review, and manager interview, 2 of 6 residents (R3 and R4) had at least one restricted health condition, but Licensee did not have proof that 3 of 3 facility staff (S1, S2, and S3), who will participate in meeting the resident’s specialize care needs, completed training provided by a licensed professional, which included hands-on instruction in both general procedures and resident-specific procedures. This posed a potential health risk to persons in care.
POC Due Date: 03/04/2026
Plan of Correction
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2
3
4
Licensee agreed to coordinate with a licensed professional (such as nurse) to lead a hands-on in-service training for all current caregivers on at least the following Restricted Health Conditions which are present at the facility: Diabetes (including blood sugar basics, controlled carbohydrate diets, use of glucometer, use of insulin flex pens and other diabetic medications, signs and symptoms of hypoglycemia/hyperglycemia, and diabetic emergencies requiring medical intervention.) Licensee agreed to E-mail the staff training sign-in sheet to LPA, by the POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Simon Jacob
NAME OF LICENSING PROGRAM MANAGER:
Dang Nguyen
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 02/02/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2026


LIC809 (FAS) - (06/04)
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