<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603688
Report Date: 12/21/2022
Date Signed: 04/13/2023 10:53:30 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
12/19/2022 and conducted by Evaluator Stephanie Torres
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20221219140229
FACILITY NAME:SAPPHIRE CHARDONNAYFACILITY NUMBER:
374603688
ADMINISTRATOR:NAGHIBI, ALIFACILITY TYPE:
740
ADDRESS:484 CHARDONNAY COURTTELEPHONE:
(760) 539-7791
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY:6CENSUS: 6DATE:
12/21/2022
UNANNOUNCEDTIME BEGAN:
09:24 AM
MET WITH:Ali Naghibi, AdministratorTIME COMPLETED:
01:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not serve food of the quality and quantity necessary to meet resident needs
Staff do not maintain facility at a comfortable temperature for resident
Staff do not answer telephone calls
Facility does not encourage socialization
Resident is not treated fairly
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
 Licensing Program Analyst (LPA), Stephanie Torres, conducted an unannounced visit the facility to initiate the investigation into the above allegations. The LPA met with Administrator, Ali Naghibi, and informed him of the purpose of the visit.

The LPA conducted staff/resident interviews, toured the interior/exterior areas of the facility, reviewed records and received copies of pertinent documentation.
Regarding the allegation, "Staff do not serve food of the quality and in the quantity necessary to meet resident needs," it was alleged Resident One (R1) is not served nutritious meals, is served small portions, and is served food that is reheated in the microwave. Interviews revealed the resident is served nutritious meals and is served sufficient portions. Interview revealed R1 was served a reheated soup on one occasion, however, it was not an issue for R1. R1 was interviewed and denied the allegation. Resident interviews revealed staff do provide food items requeted and sufficient amount of food is provided. Therefore, based on interviews, this allegation is deemed UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Stephanie TorresTELEPHONE: (951) 204-5924
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
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 4
Control Number 18-AS-20221219140229
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: SAPPHIRE CHARDONNAY
FACILITY NUMBER: 374603688
VISIT DATE: 12/21/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Pertaining to the allegation, “Staff do not maintain facility at a comfortable temperature for resident," it was alleged the bedroom of Resident One (R1) is cold and the resident is uncomfortable. Interviews revealed R1 has been known to open their bedroom exit door, causing cool air to come into the room. A tour of the facility revealed the home does have central heating, which is in working condition. Interview revealed the bedroom of R1 is occasionally cold, however, staff will accommodate the resident by turning on the heater. Additional interviews with residents revealed the temperature in the home is cold, however, requests by the residents to increase the thermostat have not been made. Therefore, based on interviews, this allegation is deemed UNSUBSTANTIATED. Regarding the allegation, "Staff do not answer telephone calls," it was alleged the facility is not answering telephone calls made to or regarding R1. Staff interviews revealed calls are not denied to R1 that are made to the facility land line. It was reported R1 also has a cell phone and receives calls on the device as well. R1 was interviewed and reported the staff have handed over the facility telephone when they have received a call. R1 also confirmed their cell phone is working and they have received calls in the last few days. Additional resident interviews could not corroborate or refute the validity of the allegation. Therefore, based on interviews, this allegation is deemed UNSUBSTANTIATED. Regarding the allegation, "Facility does not encourage socialization," it was alleged R1 remains in their bedroom and is not encouraged to socialize. Interviews revealed R1 enjoys remaining in their bedroom and does not come out frequently. According to Administrator, Naghibi, R1 was approved to attend a senior center, however, the resident declined to attend. R1 was interviewed and denied the allegation. Additional resident interviews revealed socialization does occur when meal periods take place and/or during group outings. Therefore, based on interviews, this allegation is deemed UNSUBSTANTIATED. Pertaining to the allegation, "Resident is not treated fairly," it was alleged facility staff permit other residents to utilize a portable heater, while R1 is not. A tour of the facility revealed there to be one portable heater in one (1) of five (5) resident bedrooms. Additionally, the LPA observed central heating to be available and in working order. R1 was interviewed and stated they had requested a heater; however, they did not get a response from staff. R1 also reported staff do turn on the central heater when requested. Additional resident interviews could not corroborate or refute the validity of the allegation. Therefore, based on interviews and observation, this allegation is deemed UNSUBSTANTIATED.

A finding that the complaint is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

This report was reviewed with Naghibi and a copy was provided.
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Stephanie TorresTELEPHONE: (951) 204-5924
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
12/19/2022 and conducted by Evaluator Stephanie Torres
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20221219140229

FACILITY NAME:SAPPHIRE CHARDONNAYFACILITY NUMBER:
374603688
ADMINISTRATOR:NAGHIBI, ALIFACILITY TYPE:
740
ADDRESS:484 CHARDONNAY COURTTELEPHONE:
(760) 539-7791
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY:6CENSUS: 6DATE:
12/21/2022
UNANNOUNCEDTIME BEGAN:
09:24 AM
MET WITH:Ali Naghibi, LicenseeTIME COMPLETED:
01:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff speaks to resident inappropriately
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA), Stephanie Torres, conducted an unannounced visit the facility to initiate the investigation into the above allegation. The LPA met with Administrator, Ali Naghibi, and informed him of the purpose of the visit.

The LPA conducted staff/resident interviews, toured the interior/exterior areas of the facility, reviewed records and received copies of pertinent documentation. Regarding the allegation, "Staff speaks to resident inappropriately," it was alleged Staff One (S1), when asked for assistance from R1, will respond by saying, "I can't" and I am busy." In addition, it was alleged S1 is rude to R1. Interviews revealed staff have responded to R1 by making the statement that they were busy. S1 was interviewed and confirmed they have responded to R1 by saying they were busy, however, returned to assist the resident at a later time. R1 was interviewed and confirmed the allegation has happened on occasion. R1 also reported staff do return, though it is only after being asked a second time. R1 denied S1 is rude to them. Therefore, based on interviews, this allegation is deemed UNSUBSTANTIATED at this time. A finding the complaint is unsubstantiated means that although the
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Stephanie TorresTELEPHONE: (951) 204-5924
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 18-AS-20221219140229
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: SAPPHIRE CHARDONNAY
FACILITY NUMBER: 374603688
VISIT DATE: 12/21/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
allegation may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violation occurred.

This report was reviewed with Naghibi and a copy provided.
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Stephanie TorresTELEPHONE: (951) 204-5924
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4