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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603755
Report Date: 01/13/2022
Date Signed: 01/14/2022 08:26:45 AM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/11/2022 and conducted by Evaluator Natasha Persaud
COMPLAINT CONTROL NUMBER: 08-AS-20220111140516
FACILITY NAME:FAHIMA CARE HOME 1FACILITY NUMBER:
374603755
ADMINISTRATOR:RAUSHON AHMEDFACILITY TYPE:
740
ADDRESS:8554 CAPRICORN WAYTELEPHONE:
(858) 800-7455
CITY:SAN DIEGOSTATE: CAZIP CODE:
92126
CAPACITY:6CENSUS: 3DATE:
01/13/2022
UNANNOUNCEDTIME BEGAN:
03:50 PM
MET WITH:Administrator, Raushon AhmedTIME COMPLETED:
05:10 PM
ALLEGATION(S):
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Facility does not have running hot water
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced visit to commence a complaint investigation. LPA identified herself and discussed the allegation mentioned above with Administrator, Raushon Ahmed.

During today's visit, LPA briefly toured the facility, interviewed staff and outside sources. It was alleged the facility does not have hot running water. LPA checked all sink faucets and showers, there was running hot water. LPA observed the hot water temperature today measured at 115 degrees F. Per the Licensee and administrator there have been no issues with the hot water. Staff confirmed the hot water is operating within regulation temperature of 105-120 degrees F. LPA interviewed an outside agency that comes to the facility weekly to provide bed baths for certain residents. The outside agency confirmed the facility has hot water and they have been able to provide bed baths with hot water. Based on observations and interviews, this agency has investigated the complaint alleging facility does not have running hot water. Continued on an LIC 9099C,
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022
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 08-AS-20220111140516
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: FAHIMA CARE HOME 1
FACILITY NUMBER: 374603755
VISIT DATE: 01/13/2022
NARRATIVE
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We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. An exit interview was conducted with Administrator and a copy of this report, along with Licensee/Appeal Rights (LIC 9058 01/16), were provided to the Administrator via electronic mail. An electronic read receipt confirmation was requested to be sent by the Administrator upon receipt of the documents.
SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2