331881569-9-2-2025-18-AS-APEZ-DLSKHZ-20250923075558

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331881569
Report Date: 09/02/2025
Date Signed: 09/02/2025 03:11:12 PM

Unfounded

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
08/25/2025 and conducted by Evaluator Abdoulaye Zerbo

COMPLAINT CONTROL NUMBER: 18-AS-20250825143222

FACILITY NAME:	GENTLE CARE ESTATES LLC		FACILITY NUMBER:	331881569
ADMINISTRATOR:	HAMED, EBRAHEEM		FACILITY TYPE:	740
ADDRESS:	18183 HAINES ST		TELEPHONE:	(786) 564-3771
CITY:	PERRIS	STATE: CA	ZIP CODE:	92570
CAPACITY:	6	CENSUS: 5	DATE:	09/02/2025
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Sable Smith		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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9

Food services are inadequate.
Staff are not allowing resident to make phone calls as necessary.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Abdoulaye Zerbo conducted an unannounced visit to the facility to investigate the allegations listed above. LPA met with Caregiver Sable Smith, who was informed of the purpose of the visit. Administrator Bashar Mayyas joined the visit at a later time.

LPA toured the facility and obtained copies of pertinent records. During the visit, LPA learned Resident #1 (R1) never resided at this facility through records review and interviews. The Administrator also confirmed that R1 never resided at this facility.

Based on record reviews and interviews, the allegations listed above are Unfounded. A finding of Unfounded means the allegation could not have happened, is false, and/or is without a reasonable basis.

LPA conducted an exit interview and a copy of this report was provided Administrator Bashar Mayyas.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Abdoulaye Zerbo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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