<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880633
Report Date: 11/09/2022
Date Signed: 11/09/2022 11:43:55 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/04/2022 and conducted by Evaluator Janira Arreola
COMPLAINT CONTROL NUMBER: 18-AS-20221104143419
FACILITY NAME:CALIFORNIA MANOR GUEST HOME #1FACILITY NUMBER:
331880633
ADMINISTRATOR:HAMED, NAJEHFACILITY TYPE:
740
ADDRESS:8536 & 8548 CALIFORNIA AVETELEPHONE:
(786) 219-6008
CITY:RIVERSIDESTATE: CAZIP CODE:
92504
CAPACITY:12CENSUS: 11DATE:
11/09/2022
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Administrator, Najeh HamedTIME COMPLETED:
11:50 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff is not fingerprinted
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Janira Arreola, made an unannounced visit to the facility on 11/9/2022 at 10:00 a.m. in order to initate a complaint investigation into the above allegations. LPA met with Administrator, Najeh Hamed who was informed of the purpose of the visit.

LPA conducted interviews and collected resident and facility documentation. Regarding the allegation "Facility staff is not fingerprinted" based on documentation reviewed and interviews conducted with administrator, LPA determined that this finding was unsubstantiated. LPA found that staff #1 (S1) had been fingerprinted and was on the guardian roster. LPA also found through interviews that this information was corroborated, S1 is fingerprinted.

A finding of unsubstantiated means that although the allegation may be valid, the proponderance of the evidence standard has not been met.

An exit interview was conducted where this report was reviewed and provided to Administrator, Najeh Hamed.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2