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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361880681
Report Date: 08/05/2021
Date Signed: 08/05/2021 01:00:18 PM

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
07/27/2021 and conducted by Evaluator Melody Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20210727140234
FACILITY NAME:SUNSHINE BOARD & CAREFACILITY NUMBER:
361880681
ADMINISTRATOR:HAMED, NAJEHFACILITY TYPE:
740
ADDRESS:720 N LINDEN AVETELEPHONE:
(786) 219-6008
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY:12CENSUS: 12DATE:
08/05/2021
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Estrella HellerTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Resident’s personal belongings are stolen.
INVESTIGATION FINDINGS:
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Licensing Program Analysts Melody Brown and Natalie Gayoso conducted an unannounced complaint visit to investigate the above allegation. LPA's were greeted and allowed entrance by caregiver Estrella Heller. Administrator Najeh "Nick" Hamed was contacted and unable to come to the facility.

The investigation consisted of interviews with pertinent parties. The allegation indicates residents personal belongings are stolen. Interview with Staff 2 (S2) stated Resident 1 (R1) tends to always misplaced his belongings. R1 tends to misplace their glasses throughout the facility. S2 stated R1 never informed them that two (2) of R1's watches were missing. Interview with R1 stated that his glasses and watches were found. They were informed by another resident, Resident 2 (R2), that R1 had left their glasses and watches on the front table were residents, staff, and visitors sign in.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021
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
Control Number 18-AS-20210727140234
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: SUNSHINE BOARD & CARE
FACILITY NUMBER: 361880681
VISIT DATE: 08/05/2021
NARRATIVE
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Based on interviews, which were conducted, the allegation is UNSUBSTANTIATED. A finding of Unsubstantiated means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, there fore the allegation is Unsubstantiated.

An exit interview was conducted and a copy of the report was provided to caregiver Estrella Heller.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2