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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361881309
Report Date: 01/24/2025
Date Signed: 01/24/2025 11:24:47 AM

Unfounded


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
01/23/2025 and conducted by Evaluator Raquel Hernandez
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20250123163833
FACILITY NAME:GOLDEN HORIZON SENIOR CAREFACILITY NUMBER:
361881309
ADMINISTRATOR:HAMED, EBRAHEEMFACILITY TYPE:
740
ADDRESS:1524 S EUCLID AVETELEPHONE:
(786) 564-3771
CITY:ONTARIOSTATE: CAZIP CODE:
91762
CAPACITY:22CENSUS: 21DATE:
01/24/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Administrator Ebraheem HamedTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff are witholding food and water from residents
Facility is not kept clean
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Raquel Hernandez conducted an unannounced visit to deliver findings on the allegation listed above. LPA met with Administrator Ebraheem Hamed and explained the purpose of the visit. The investigation consisted of staff and resident interviews and facility tour.

LPA Hernandez interviewed (4) residents and (1) staff. 4 out of the 4 residents stated staff do no withold food and water from residents in care. Staff interviewed stated facility staff do not withold food and water from residents. Additionally, 4 out of the 4 residents stated facility is kept clean. Staff stated facility is cleaned daily and all residents are assisted with cleaning needs.

Administrator Ebraheem Hamed confirmed visitor does not live at the facility and visits residents at the facility from time to time. Administrator Ebraheem Hamed stated there is no unlicensed care being provided to the home next door to the facility. Administrator owns and rents out the property located next door.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025
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-20250123163833
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: GOLDEN HORIZON SENIOR CARE
FACILITY NUMBER: 361881309
VISIT DATE: 01/24/2025
NARRATIVE
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Based on the evidence gathered, the allegation is deemed UNFOUNDED. A finding that the complaint allegation is UNFOUNDED means that the allegation was without a reasonable basis. Therefore, the allegation dismissed. An exit interview was conducted where this report LIC9099 was discussed and provided to Administrator Ebraheem Hamed.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2