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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603755
Report Date: 07/23/2025
Date Signed: 07/23/2025 09:48:19 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
06/09/2021 and conducted by Evaluator Natasha Persaud
COMPLAINT CONTROL NUMBER: 08-AS-20210609155427
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: 5DATE:
07/23/2025
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Staff, Petra GalindezTIME COMPLETED:
09:55 AM
ALLEGATION(S):
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Unlawful eviction
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Natasha Persaud conducted an unannounced visit to conclude the complaint investigation regarding the above mentioned allegation. LPA met with Staff, Petra Galindez. LPA discussed allegation with the administrator, Raushon Ahmed via telephone while at the facility.

During the investigation, the facility was briefly toured, and interviews conducted with staff, residents and outside sources. It was alleged that R1 was unlawfully evicted. Outside source #1’s (OS1) interview revelaed R1 went to the hospital on 06/07/21 for a mental condition. R1 was discharged from the hospital on 06/09/21. However, the administrator denied R1’s return to the facility. The administrator confirmed they denied the return of R1 due to being worried R1 may attempt to hurt themselves. The administrator also stated the facility was not equipped to handle that type of mental condition. A 30 day eviction notice in writing was not provided to R1. Continued on an LIC 9099C.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
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 5
Control Number 08-AS-20210609155427
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: FAHIMA CARE HOME 1
FACILITY NUMBER: 374603755
VISIT DATE: 07/23/2025
NARRATIVE
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Based on interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California code of Regulations, Title 22, Division 6 & Chapter 8 is being cited on the attached LIC 9099D. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Staff, Petra Galindez whose signature below confirms receipt of these rights. [See LIC 811 Confidential Names List to identify Resident #1]
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 08-AS-20210609155427
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: FAHIMA CARE HOME 1
FACILITY NUMBER: 374603755
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/30/2025
Section Cited
CCR
87224(a)
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Eviction Procedures. The licensee may, upon thirty (30) days written notice to the resident, evict the resident...of the facility, development of a need not previously identified, and/or a change of use of the facility. This requirement is not met as evidenced by:
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The Administrator explained R1 no longer resides at the facility. The administrator agreed to attend training on evictions and submit proof of training by POC due date.
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Based on interviews, the licensee did not accept 1 out of 5 [R1] residents to return to the facility after discharge from the hospital, which posed a potential health, safety, and personal rights violation to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
06/09/2021 and conducted by Evaluator Natasha Persaud
COMPLAINT CONTROL NUMBER: 08-AS-20210609155427

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: 5DATE:
07/23/2025
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Staff, Petra GalindezTIME COMPLETED:
09:55 AM
ALLEGATION(S):
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Licensee did not provide nutritious quality meals to meet the residents needs
Licensee did not provide planned activities for the residents
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Natasha Persaud conducted an unannounced visit to conclude the complaint investigation regarding the above-mentioned allegations. LPA met with Staff, Petra Galindez. LPA discussed allegation with the administrator, Raushon Ahmed via telephone while at the facility.

During the investigation, the facility was briefly toured, and interviews conducted with staff, residents and outside sources. It was alleged that the licensee did not provide nutritious quality meals to meet the residents’ needs. It was reported that the food was not good, and they ate half-frozen hot dogs for a week. Residents were interviewed and denied being served half frozen hot dogs. Staff interviewed confirmed they do not serve frozen hot dogs. Staff stated they fry the hot dog to ensure it’s fully cooked. Resident interviews confirmed the facility serves fruits, vegetables, chicken, spaghetti, potatoes, pancakes, waffles, eggs and soups. Residents also commented that the food was good. Staff confirmed serving a variety of cooked foods to the residents. On 06/15/21, LPA observed the fridge, and the freezer had a sufficient supply of nutritional foods. The administrator also had an additional fridge and freezer in the garage with an extra supply of food. Continued on an LIC 9099C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 08-AS-20210609155427
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: FAHIMA CARE HOME 1
FACILITY NUMBER: 374603755
VISIT DATE: 07/23/2025
NARRATIVE
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The administrator explained they are at the facility daily and observe staff cooking the food, but also stated they have frozen foods as well. The administrator denied residents being served half frozen hot dogs and added they serve meals of nutritional value.

It was also alleged that the licensee did not provide planned activities for the residents. On 06/15/21, LPA observed residents laying in their beds. The administrator’s interview indicated the residents have some sort of mental condition. Therefore, it can be a challenge to get the residents to participate in activities. However, the facility has activities and offers them to the residents. The administrator explained the residents have different preferences for activities, such as using the computer and word puzzles. Some residents prefer walking and residents that receive hospice services prefer to be in bed. The administrator also stated they spend a lot of time conversing with a resident like a companion, as an activity, which assists with brain stimulation. Resident interviews confirmed they have activities they prefer such as using their computer or watching television. Staff interviewed said they have plenty of activities, but the residents never want to participate. Staff offer activities and the residents refuse so they don't force them.

During the course of the investigation, interviews were conducted. Investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegations. The allegations are deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Staff, Petra Galindez whose signature below confirms receipt of these rights.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5