361881241-5-30-2025-56-AS-NBRN-DQLRAY-20260123115151

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361881241
Report Date: 05/30/2025
Date Signed: 05/30/2025 12:46:42 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
04/07/2025 and conducted by Evaluator Lavette Farlow

COMPLAINT CONTROL NUMBER: 56-AS-20250407132505

FACILITY NAME:	FAIRVIEW LIVING LLC		FACILITY NUMBER:	361881241
ADMINISTRATOR:	ABDALLATEF, AHMAD		FACILITY TYPE:	740
ADDRESS:	1089 W HUFF STREET		TELEPHONE:	(909) 805-5025
CITY:	RIALTO	STATE: CA	ZIP CODE:	92376
CAPACITY:	10	CENSUS: 4	DATE:	05/30/2025
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Guadalupe Leon, Direct Support Professional and Yusef Nofal		TIME COMPLETED:	12:55 PM

ALLEGATION(S):

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Staffs at the facility are not treating resident with dignity and respect.
Staffs not providing healthful living accommodation to resident in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) LaVette Farlow conducted a unannounced visit to the facility to conclude the investigation and deliver the findings on the of above-mentioned allegations. LPA Farlow met with Direct Support Professional, Guadalupe Leon who was informed of the reason for today's visit. LPA Farlow spoke to Licensee Yusef Nofal via phone and informed him of the purpose of the visit. Later during the visit Licensee Yusef arrived to the facility. The investigation consisted of interviews with staff, residents and review of records.

Allegation 1: Staff at the facility are not treating resident with dignity and respect. LPA Farlow interviewed three (3) out of three (3) staff. All three (3) staff stated they are not aware of neither have they seen any staff not treat residents in care with dignity or respect. LPA interviewed six (6) residents in care. LPA’s interviews revealed that (5) out of (6) residents stated staff treat them with dignity and respect. Residents R2, R3, R4, R5, and R6 stated they have not seen any staff mistreat residents in care or not treat them with dignity and respect.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025

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-20250407132505

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: FAIRVIEW LIVING LLC	FACILITY NUMBER: 361881241
	VISIT DATE: 05/30/2025

NARRATIVE

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R1 stated staff are mean, but the night staff is nice. Based on LPA Farlow's interviews with staff and residents in care there was not enough evidences to substantiate the findings of staff not treating residents with dignity and respect.

Allegation 2: Staff not providing healthful living accommodation to resident in care. LPA interviews with S1, S2, and S3, revealed staff are taking resident concerns or health needs into consideration. S1, S2, and S3 revealed all residents smoke outside of the home. S1, S2, and S3 stated that staff assist with residents daily needs. Interview with staff revealed staff provide, 3 meals and snacks daily, assist with medical needs, and provide activities for residents. LPA interviewed R1, R2, R3, R4, R5 and R6. All six (6) residents stated the facility is providing healthy living accommodations. Six (6) out of six (6) residents stated staff, family, or themselves will schedule medical appointments and assist with transportation to visits. Residents stated smoking is done outside and not in the facility. Based on LPA’s interview and findings the allegation is UNSUBSTANTIATED.

Based on the information above, the allegations is unsubstantiated. A finding of UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted where this report LIC 9099 and LIC 9099C was discussed and a copy was provided to the Licensee, Yusef Nofal.

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Lavette Farlow
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025

LIC9099 (FAS) - (06/04)

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