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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604585
Report Date: 07/11/2025
Date Signed: 07/11/2025 09:40:45 AM

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
04/18/2025 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20250418085219
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: 6DATE:
07/11/2025
UNANNOUNCEDTIME BEGAN:
09:29 AM
MET WITH:Evan Sitto, House ManagerTIME COMPLETED:
09:45 AM
ALLEGATION(S):
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Staff mishandled the clients medications while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA)Tiffany Holmes contacted the facility to deliver findings for a complaint investigation via tele-virtual. LPA identified herself to, and explained the purpose of the visit and the basic elements of the complaint with Evan Sitto, House Manager.

LPA previously conducted interviews with residents, staff, and outside sources, made observations, and obtained and reviewed pertinent records. LPA conducted the initial visit on April 23, 2025 and conducted a tour of the facility.

It was alleged that staff mishandled the clients medications while in care.
The Department also reviewed the LIC602 Physician’s Reports, lists of prescribed medications, and Medication Administration Records (MARs) for all clients.

[CONTINUED ON LIC 9099]
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2025
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-20250418085219
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: 07/11/2025
NARRATIVE
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[CONTINUED FROM LIC 9099]

Per LPA observation: The facility’s locked medication cabinet was organized. The clients’ MARs contained timely and consistent staff initials and documentation.

Interviews of clients, staff, and outside sources revealed there were no known recent medication errors at the facility, nor a pattern of medication errors when looking further back in time. Interviews revealed that the direct care staff that LPA interviewed attested that they previously underwent formal and hands-on training on medication assistance.

The Department has investigated the above-mentioned allegation and based on interviews, LPA observations, and records review, it was determined that the complaint allegation is Unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Evan Sitto via face time and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) was provided via email. An electronic email read receipt confirms the documents were received.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2025
LIC9099 (FAS) - (06/04)
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