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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604317
Report Date: 08/23/2022
Date Signed: 08/23/2022 01:55:46 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
03/11/2022 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20220311184933
FACILITY NAME:NOR LIVING 2 LLCFACILITY NUMBER:
374604317
ADMINISTRATOR:GEORGE, AYADFACILITY TYPE:
735
ADDRESS:1950 AVON LANETELEPHONE:
(619) 335-0566
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:6CENSUS: 6DATE:
08/23/2022
UNANNOUNCEDTIME BEGAN:
11:24 AM
MET WITH:Jasmine Magee- FrakerTIME COMPLETED:
12:01 PM
ALLEGATION(S):
1
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9
Licensee is not allowing visits
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA)Tiffany Holmes conducted an unannounced complaint visit to the facility to deliver findings on the above-mentioned allegation. LPA gained access to the facility, identified herself, and met with Jasmine Magee- Fraker House manager to discuss the purpose of the visit.

LPA’s visit consisted of delivering findings on the above-mentioned allegation.

LPA conducted the initial investigation visit on March 16, 2022, and was able to interview clients, facility staff, and outside sources. LPA also reviewed records, and conducted a physical inspection of the facility. Interviews revealed that Client 1 (C1) has had visitations. Interviews revealed staff denies denying visits to C1 or any other clients. Interviews with outside sources revealed C1 does get visits and that the facility has not denied any visits.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
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 2
Control Number 08-AS-20220311184933
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: NOR LIVING 2 LLC
FACILITY NUMBER: 374604317
VISIT DATE: 08/23/2022
NARRATIVE
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Client interviews did not produce any evidence to verify that staff are not allowing visits.

Based on the evidence obtained from interviews, and record review, the complaint allegation is found to be unsubstantiated; as there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted with Jasmine Magee- Fraker and a copy of this report along with Licensee/Appeal Rights (LIC 9058 01/16) was provided at the conclusion of the visit
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2