374604585-9-26-2024-08-AS-SJAB-DACP6Y-20241024110306

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604585
Report Date: 09/26/2024
Date Signed: 09/26/2024 03:48:27 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
11/30/2023 and conducted by Evaluator Tiffany Holmes

COMPLAINT CONTROL NUMBER: 08-AS-20231130100848

FACILITY NAME:	NOR LIVING 6, LLC		FACILITY NUMBER:	374604585
ADMINISTRATOR:	RZOK, NAJAH		FACILITY TYPE:	735
ADDRESS:	811 ELKELTON BLVD.		TELEPHONE:	(619) 335-0566
CITY:	SPRING VALLEY	STATE: CA	ZIP CODE:	91977
CAPACITY:	6	CENSUS: 4	DATE:	09/26/2024
		UNANNOUNCED	TIME BEGAN:	11:51 AM
MET WITH:	Edgar Casillas, Staff & Sonny Kareem- House Manager		TIME COMPLETED:	12:10 PM

ALLEGATION(S):

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Staff did not provide safe transportation for client
Staff was not competent to provide services to client due to being intoxicated

INVESTIGATION FINDINGS:

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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 Edgar Casillas, Staff to discuss the purpose of the visit. Sonny Kareem- House Manager/Ayad George, Licensee arrived during the visit. arrived during the visit.

LPA’s visit consisted of delivering findings on the above-mentioned allegations.
LPA conducted the initial investigation visit on 12/05/2023 and was able to interview clients, facility staff, and outside sources. LPA also reviewed records, and conducted a physical inspection of the facility. It was alleged that staff did not provide safe transportation for client. Interviews revealed that on the day in question Client 1 (C1) was at Nor 3 for dinner with Staff 1 (S1) and Staff 2 (S2). After dinner,

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

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 08-AS-20231130100848

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: NOR LIVING 6, LLC	FACILITY NUMBER: 374604585
	VISIT DATE: 09/26/2024

NARRATIVE

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the staff drove C1 home and stayed with them for the rest of the night. Interviews revealed the staff drove the client home safely. Interviews revealed there were no complaints from the client regarding how the staff drove them. Interviews revealed there was only one client living at the facility at the time. Interviews with client did not reveal any supporting witness statements regarding the staff not providing safe transportation for the client.

It was alleged that staff was not competent to provide services to client due to being intoxicated. Interviews with staff revealed that the staff was not intoxicated. Interviews with client did not reveal any supporting witness statements regarding the staff being intoxicated. Interviews with staff revealed the staff denied being intoxicated and driving the client around while intoxicated.

Based on the evidence obtained from interviews, the complaint allegations of the staff did not provide safe transportation for client and staff was not competent to provide services to client due to being intoxicated is 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 Sonny Kareem- House Manager 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: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2024

LIC9099 (FAS) - (06/04)

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