360911449-7-23-2026-56-AS-NBRN-DWDNZ5-20260727105345

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 360911449
Report Date: 07/23/2026
Date Signed: 07/23/2026 01:50:05 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
02/02/2026 and conducted by Evaluator Beena Singh

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20260202114153

FACILITY NAME:	ST. JOSEPH'S HOME		FACILITY NUMBER:	360911449
ADMINISTRATOR:	RODRIGUEZ, JOSEPHINE F.		FACILITY TYPE:	740
ADDRESS:	2496 1/2 MACY STREET		TELEPHONE:	(909) 887-5884
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92407
CAPACITY:	8	CENSUS: 8	DATE:	07/23/2026
		UNANNOUNCED	TIME BEGAN:	11:07 AM
MET WITH:	Miguel I Sarabia-Staff/Caregiver		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff does not provide a comfortable environment for the residents.
Staff records are incomplete.

INVESTIGATION FINDINGS:

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On 07/23/2026, Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to the facility in order to deliver findings for the above allegations. Facility Administrator Ebraheem Hamed was informed of the visit and LPA Singh discussed the purpose of the visit with Administrator, Ebraheem Hamed. The investigation consisted of interviews and records review.

At the time of the visit there were two (2) staff and five(5) clients present, three (3) clients were attending Day Program.

First Allegation:-Staff does not provide a comfortable environment for the residents.
LPA Singh interviewed staff and residents at the facility and five(5) out of five(5) residents interviewed stated that facility do provide them comfortable environment and no staff is bringing any children in the facility. Furthermore, these residents affirmed that the facility is safe and noted that the staff consistently assists them whenever aid is required.

Overall, the facility is clean, in good repair, and operating in safe conditions for clients.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 56-AS-20260202114153

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: ST. JOSEPH'S HOME	FACILITY NUMBER: 360911449
	VISIT DATE: 07/23/2026

NARRATIVE

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Second Allegations:-Staff records are incomplete.
During the Staff file review, LPA Singh reviewed, three(3) staff and administrator records, to verify compliance with personnel requirements. Record review confirmed that all required First Aid and CPR certifications, criminal record clearances, annual training records, health screenings and employment contracts were fully up to date for staff and administrator files.

During the investigation, LPA Singh was not able to find sufficient evidence to corroborate the allegation. Statements, records, and interviews obtained did not provide sufficient information to corroborate the allegation.

Based on the evidence found during the investigation, the allegations listed above Staff does not provide a comfortable environment for the residents and Staff records are incomplete are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.

An exit interview was conducted where this report LIC 9099, 9099 C was discussed and provided to Miquel Sarabia, Staff/Caregiver, facility representative, at the conclusion of the visit.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026

LIC9099 (FAS) - (06/04)

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