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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361880681
Report Date: 08/11/2021
Date Signed: 08/11/2021 12:16:41 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
08/05/2021 and conducted by Evaluator Crystal Colvin
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20210805155349
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:
08/11/2021
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Ahmad "Adam" Abdallatef - Designated Facility RepresentativeTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Resident received a unlawful eviction
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Crystal Colvin arrived to investigate the above allegations of the complaint. LPA Colvin met with Designated Facility Representative Adam Ahmad "Adam" Abdallatef, as the Licensee/Administrator was unavailable at this time. LPA Colvin advised Adam of the purpose of the visit.

Regarding allegation "Resident received a unlawful eviction": LPA Colvin interviewed resident, staff, and Administrator/Licensee (via telephone), as well as reviewed resident file for the investigation of this complaint. During LPA Colvin's interviews, there were conflicting statements regarding whether or not R1 was in fact being evicted. Additionally, there was no physical eviction notice provided to R1 to memorialize this. Due to lack of physical evidence for the allegation of R1 being unlawfully evicted as well as conflicting statements regarding the situation, the allegation of "Resident received a unlawful eviction" 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.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2021
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-20210805155349
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: 08/11/2021
NARRATIVE
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LPA Colvin additionally spoke with Licensee/Administrator Najeh "Nick" Hamed on the telephone at length regarding Title 22 Regulations for evictions, so that if the Licensee/Administrator does choose to issue an eviction notice to R1, in attempts to ensure that R1's personal rights are not violated.

An exit interview was conducted where this report was discussed. A copy of this report was provided to Designated Facility Representative Adam Ahmad "Adam" Abdallatef during the exit interview, and LPA Colvin will be emailing a copy of the report to Administrator/Licensee Najeh "Nick" Hamed as well.
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2