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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604585
Report Date: 10/01/2024
Date Signed: 10/01/2024 03:03:46 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
04/15/2024 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20240415105323
FACILITY NAME:NOR LIVING 6, LLCFACILITY NUMBER:
374604585
ADMINISTRATOR:RZOK, NAJAHFACILITY TYPE:
735
ADDRESS:811 ELKELTON BLVD.TELEPHONE:
(619) 335-0566
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:6CENSUS: 4DATE:
10/01/2024
UNANNOUNCEDTIME BEGAN:
09:26 AM
MET WITH:Edgar Casillas, StaffTIME COMPLETED:
09:42 AM
ALLEGATION(S):
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Staff did not prevent clients from engaging in a physical altercation
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.

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

LPA conducted the initial investigation visit on April 24, 2024 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 the staff did not prevent clients from engaging in a physical altercation. Interviews revealed there are usually 2-3 staff at the facility that assist the clients.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024
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-20240415105323
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: 10/01/2024
NARRATIVE
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Interviews revealed that the staff redirect the clients in situations that put the clients or themselves in harm. Interviews with clients revealed that the clients feel safe in the facility and that the staff are helpful and keep them safe. Interviews revealed when there are incidents that occur the staff step in quickly are right there to prevent the clients from engaging in a physical altercations. Interviews with an outside revealed the staff always try to prevent the clients from engaging in physical altercations and this time the staff were right there when it occurred and they immediately and removed the clients and had them in their own areas.

Based on the evidence obtained from interviews, and record review, the complaint allegation of the staff did not prevent clients from engaging in a physical altercation 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 Edgar Casillas, Staff 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: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2