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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881569
Report Date: 09/04/2025
Date Signed: 09/04/2025 04:06:37 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
08/30/2025 and conducted by Evaluator Abdoulaye Zerbo
COMPLAINT CONTROL NUMBER: 18-AS-20250830130845
FACILITY NAME:GENTLE CARE ESTATES LLCFACILITY NUMBER:
331881569
ADMINISTRATOR:HAMED, EBRAHEEMFACILITY TYPE:
740
ADDRESS:18183 HAINES STTELEPHONE:
(786) 564-3771
CITY:PERRISSTATE: CAZIP CODE:
92570
CAPACITY:6CENSUS: 5DATE:
09/04/2025
UNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Sable SmithTIME COMPLETED:
04:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights violation
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
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.

During the visit, LPA learned Resident #1 (R1) never resided at this facility through records review and interviews.

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 to Caregiver Gloria Reyes.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Abdoulaye Zerbo
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
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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