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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361880833
Report Date: 02/25/2025
Date Signed: 02/25/2025 01:12:07 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO 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
02/20/2025 and conducted by Evaluator Lavette Farlow
COMPLAINT CONTROL NUMBER: 56-AS-20250220093618
FACILITY NAME:NICK'S MAPLE HOME IIFACILITY NUMBER:
361880833
ADMINISTRATOR:HAMED, NAJEHFACILITY TYPE:
740
ADDRESS:1065 W HUFF STREETTELEPHONE:
(909) 440-5252
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY:8CENSUS: 8DATE:
02/25/2025
UNANNOUNCEDTIME BEGAN:
09:17 AM
MET WITH:Najeh Hamed, Administrator, and Yusef Nofal, LicenseeTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Staff providing marijuana to resident(s) resulting in resident to relapse.
INVESTIGATION FINDINGS:
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Licensed Program Analysts (LPA) Lavette Farlow, conducted an unannounced visit to the facility to commence a complaint investigation and deliver the findings. LPA was greeted and granted entrance at the door by Staff, Marebell Barnes. LPA identified self and discussed the purpose of the visit. LPA also presented self to Administrator, Nejah Hamed and Licensee, Yusef Nofal and discussed the purpose of the visit. LPA conducted interviews with staff and residents, reviewed documents and did a walk-through of the facility.

It is alleged that staff is providing marijuana to resident(s) resulting in resident to relapse. LPA interviewed (5) five staff members and seven (7) residents. LPA interviewed revealed that five (5) out of seven (7) residents stated they have never witness staff one (S1) sell marijuana to residents in care. LPA interviews with staff one (S1) and staff two (S2) revealed that staff transport residents to the smoke shop, store, appointment and the dispenary, but does not sell marijuana to residents in care.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025
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 2
Control Number 56-AS-20250220093618
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: NICK'S MAPLE HOME II
FACILITY NUMBER: 361880833
VISIT DATE: 02/25/2025
NARRATIVE
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Based on the information above, 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. An exit interview was conducted where this report LIC 9099 was discussed, and a copy was provided to Administrator Najeh Hamed.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2