Follow-up on corrections·August 11, 2021

Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility unannounced in order to investigate two complaints (#18-AS-20200803114859 & #18-AS-20210805155349). During LPA Colvin's investigation of the complaints, LPA Colvin observed some additional deficiencies. LPA Colvin met with Facility Representative Adam Ahmad "Adam" Abdallatef at the facility and Administrator/Licensee Najeh "Nick" Hamed was contacted via telephone. LPA Colvin advised Adam and Nick of the purpose of the visit. During LPA Colvin's investigation of a complaint (#18-AS-20200803114859), LPA Colvin was provided with an Eviction Notice from staff member (S1) for a prior resident (R1). In review of this Eviction Notice, LPA Colvin observed the following issues: 1. Notice was not provided to Licensing when given to the recipient, 2. Notice did not contain the required resources for the resident. The Notice was alleged to have been provided to R1 on 4/29/20, as indicated on the date for the typed notice, as well as the date signed by designated staff. Community Care Licensing (CCL) was not provided with a copy of this Notice until 6/24/21 when LPA Colvin was discussing the issues at hand in the complaint investigation with S1. Title 22 Regulations require facilities to provide CCL with copy of all Eviction Notices within 7 days after they are supplied to the resident. Deficiency cited . Additionally, LPA Colvin observed that while the Notice did provide a reason allowable under Title 22 for eviction, the Notice did not supply R1 with any resources required to aid R1 with finding alternative housing. Since the eviction notice was not upheld and the Licensee assisted with finding a new facility for R1 to move to, LPA Colvin will not be issuing a deficiency and instead will be issuing a Technical Violation Advisory Note (TV) . Additionally, the Notice should have also detailed the specifics for why R1 was being provided with an eviction notice, whereas the notice provided to LPA Colvin only states "recent misbehavior and complaints". Deficiency cited. Lastly, the base incident of the complaint (#18-AS-20200803114859) was regarding a physical altercation between three residents on 5/19/20, one of which was taken into custody by law enforcement. A Special Incident Report (SIR) was not submitted to CCL until 8/11/20, when it was requested by LPA Colvin for the purpose of investigating the situation. Facilities are required to report incidents which pose a risk for safety of any resident within seven (7) days. SIR was not submitted for nearly three (3) months. L PA Colvin will be issuing a Technical Violation Advisory Note (TV) instead of a deficiency since the facility had copies of the incident reports in the file with notations that they were faxed to Licensing. LPA Colvin consulted with Licensee/Administrator over possibly mailing the SIRs or emailing them to Licensing's office email address at CCLDASCPRiversideRO@dss.ca.gov and to keep additional records/documentation to show proof of submission to Licensing. Due to observations made by LPA Colvin, the facility was cited, and deficiencies noted on the LIC809D. A copy of this report was provided along with LIC809D, LIC9102 Technical Violation, and appeal rights during the exit interview with Facility Representative Adam Ahmad "Adam" Abdallatef. LPA Colvin will be emailing a copy of the report to Administrator/Licensee Najeh "Nick" Hamed as well.