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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881239
Report Date: 10/09/2025
Date Signed: 10/09/2025 01:37:02 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 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
09/02/2022 and conducted by Evaluator Antonine Richard
COMPLAINT CONTROL NUMBER: 18-AS-20220902165305
FACILITY NAME:ELIAA LLC 2FACILITY NUMBER:
331881239
ADMINISTRATOR:YOUNES, AMIRRAFACILITY TYPE:
740
ADDRESS:17520 BROWN STREETTELEPHONE:
(650) 656-7941
CITY:PERRISSTATE: CAZIP CODE:
92570
CAPACITY:6CENSUS: 3DATE:
10/09/2025
UNANNOUNCEDTIME BEGAN:
08:24 AM
MET WITH:AMIRR YOUNESTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility refused to obtain medical attention for resident in care.
Facility staff threatened resident in care.
Illegal eviction.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/09/2025, Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced complaint visit. LPA Richard met with House Manager/Caregiver Roger Valenzuela and later with Amirr Younes, the Administrator. LPA Richard explained the purpose of this visit.

The investigation included the following steps: On October 9, 2025, the Licensing Program Analyst (LPA) interviewed the Administrator (A1), one staff member (S1), and three residents (R2-R4). The LPA also to interview a representative from Innovaged Placement Agency. During the investigation, the LPA obtained and reviewed several documents, including: Resident roster dated June 11, 2025. Staff roster dated June 11, 2025. R1's Innovaged Supporting Housing Authorization and Resident Payment documents, marked for move-in on May 23, 2022. Hospital visit summaries dated June 12, 2022; July 5, 2022; and July 14, 2022. Innovaged Voluntary Disenrollment Letter dated August 31, 2022. Verbal consent from R1, along with the signature of the Innovaged Representative, dated September 1, 2022. Illegal eviction notices dated July 16, 2022, and August 7, 2022.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2025
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 5
Control Number 18-AS-20220902165305
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: ELIAA LLC 2
FACILITY NUMBER: 331881239
VISIT DATE: 10/09/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Allegation #1: Facility refused to obtain medical attention for the residents in care.

The complaint alleged that the staff refused to take the resident to the hospital despite the resident being in pain. A review of the LPA records for Resident 1 (R1) showed multiple hospital visits from June 12, 2022, to July 14, 2022. During the investigation, LPA interviewed the Administrator (A1), who denied the allegations and stated that R1 had been admitted to the facility only a month before R1 began complaining about pain. A1 asserted that the staff always call 911 when R1 requests to go to the hospital. LPA Richard also interviewed one staff member (S1), who denied having provided medical attention to R1. S1 mentioned that R1 complained of pain even after taking pain medications, but also noted that R1 refused to take the pain medication at times. Additionally, LPA interviewed three other residents (R2-R4), all of whom confirmed that the staff would call 911 when they needed to go to the hospital.

On October 9, 2025, at approximately 9:30 am, LPA interviewed the Innovage Representative regarding R1. The representative stated that R1 is no longer with Innovage after leaving the facility. LPA Richard was unable to interview R1, as R1 is no longer residing at the facility.

Based on the evidence gathered, interviews conducted, the preponderance of evidence standard has not been met. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the above-mentioned allegation is found to be UNSUBSTANTIATED.

Report continued on LIC9099-C

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 18-AS-20220902165305
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: ELIAA LLC 2
FACILITY NUMBER: 331881239
VISIT DATE: 10/09/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Allegation #2: Facility staff threatened residents in care.

The complaint alleged that the facility threatened to evict residents requesting medical attention. On October 9, 2025, the Licensing Program Analyst (LPA) interviewed the Administrator (A1), who denied the allegation, stating that staff members would never threaten residents for seeking help, as they are responsible for the residents' well-being. The LPA also interviewed with a staff member (S1), who similarly denied the allegation. S1 mentioned that R1 occasionally called 911 independently, and that emergency services would respond and transport R1 to the hospital.

Additionally, the LPA interviewed three residents (R2, R3, and R4), all of whom stated that facility staff had never threatened them regarding calling 911 for assistance. The LPA also conducted a records review of R1's hospital visits, which dated from June 12, 2022, through July 14, /2022, and indicated that R1 has been transported to the hospital numerous times. The LPA was not able to interview R1 because R1 is no longer residing at the facility.

Based on the evidence gathered, interviews conducted, the preponderance of evidence standard has not been met. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the above-mentioned allegation is found to be UNSUBSTANTIATED.

Report Continued on LIC9099-C

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 18-AS-20220902165305
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: ELIAA LLC 2
FACILITY NUMBER: 331881239
VISIT DATE: 10/09/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Allegation #3: Illegal Eviction.

The complaint alleged that the facility provided the resident with a verbal notice to leave by September 7, 2022. On October 9, 2025, the Licensing Program Analyst (LPA) interviewed the Administrator (A1), who denied having given a verbal notice to the resident. A1 stated that, instead, a legal eviction notice was issued on July 16, 2022, due to the fact that the residents (R1) required a higher level of care. R1 expressed a desire to transition to the Inland Empire House Plan (IEHP) rather than remain at the facility. LPA interviewed three residents #2-4 (R2-R4), all of whom denied ever receiving a writing or verbal eviction notice from the facility.

On the same date, the LPA reviewed the Innovage Voluntary Dis-enrollment Letter from Resident R1, dated August 31, 2022, as well as notes from a verbal consent discussion held via phone with the Innovage Representative on September 1, 2022. During this conversation, R1 indicated a wish to discontinue services with Innovage and to remain with IEHP, fully understanding that this decision would result in the loss of housing with the facility ELIAA LLC 2.

At approximately 9:30 a.m. on October 9, 2025, the LPA interviewed the Innovage Representative regarding R1. The representative confirmed that R1 is no longer affiliated with Innovage after leaving the facility. The LPA, Richard, was unable to interview R1, as R1 is no longer residing at the facility.

Report Continued on LIC9099-C

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 18-AS-20220902165305
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: ELIAA LLC 2
FACILITY NUMBER: 331881239
VISIT DATE: 10/09/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on the evidence gathered, interviews conducted, the preponderance of evidence standard has not been met. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the above-mentioned allegation is found to be UNSUBSTANTIATED.

No deficiencies cited.

An exit interview was conducted. A copy of this report was provided the staff member Roger Valenzuela.

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5