California Manor Guest Home #1

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Facility staff did not provide resident roster to Ombudsman.

Licensing Program Analyst (LPA), Armando Perez, conducted an unannounced visit to deliver findings for a complaint investigation regarding the above allegations. LPA Perez met with House Manager Fermin Cornista, where the LPA explained the purpose of the visit and the elements of the allegations. The investigation consisted of interviews with staff and witnesses, observations, and file reviews. On July 29, 2025, Community Care Licensing received a complaint alleging facility staff did not provide a Resident Roster (LIC 9120) to the Long-Term Care Ombudsman (LTCO). Throughout the investigation, LPA interviewed staff and residents and obtained supportive documentation to aid in determining the findings of the noted allegations. Interview with Witness 2 (W2) reported that on June 26, 2025, a copy of the LIC9120 was requested from Administrator Najeh Hamed. W2 reported Hamed indicated they would email the form. Continued on LIC 9099-C. Unsubstantiatedthe state’s words, verbatim · CDSS document, Sep 12, 2025 · control 18-AS-20250729094957

Allegation investigated: Staff is locking the refrigirator at night time. Staff does not allow residents to keep their pets.

Licensing Program Analyst (LPA), Armando Perez, conducted an unannounced visit to deliver findings for a complaint investigation regarding the above allegations. LPA Perez met with Caregiver, Fermin Cornista, where the LPA explained the purpose of the visit and the elements of the allegations. The investigation consisted of interviews with staff and witnesses, observations, and file reviews. On July 17, 2025, Community Care Licensing received a complaint alleging facility staff is locking the refrigerator at night and staff do not allow residents to keep their pets. Throughout the investigation, LPA interviewed staff and residents and obtained supportive documentation to aid in determining the findings of the noted allegations. Multiple interview attempts were made with Additional Witness 1 (AW1) to gather further information, however, AW1 did not respond to the interview request. Continued on LIC 9099-C. Unfoundedthe state’s words, verbatim · CDSS document, Aug 29, 2025 · control 18-AS-20250717143749

Allegation investigated: Staff did not prevent an altercation between residents resulting in resident's injury

Licensing Program Analyst (LPA), Armando Perez, conducted an unannounced visit to deliver findings for a complaint investigation regarding the above allegation. LPA Perez met with Administrator, Ahmad Abdallatef, where the LPA explained the purpose of the visit and the elements of the allegation. The investigation consisted of interviews with staff and witnesses and file reviews. On May 29, 2025, Community Care Licensing received a complaint alleging facility staff did not prevent an altercation between residents resulting in resident's injury. Throughout the investigation, LPA interviewed staff and residents and obtained supportive documentation to aid in determining the findings of the noted allegations.Through interview with Administrator Najeh Hamed, it was confirmed that the incident did occur, but staff was present and available to separate the residents and diminish any further acts. Additional interviews with multiple staff members corroborated that the incident on May 26, 2025the state’s words, verbatim · CDSS document, Jul 11, 2025 · control 18-AS-20250529222455

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Staff are not assisting resident to refill their medication

Licensing Program Analyst (LPA) Ruth Martinez visited the facility to further investigate into the above identified complaint allegation. LPA arrived at facility and was greeted at the door by Fermin Cornista, caregiver and granted entry. Ahmad (Adam) Abdallatef, Administrator arrived shortly after and met with LPA and LPA explained the purpose of the visit. Findings are based upon this investigation which included records review, interviews with the following: 5 out of 5 residents, and 2 of 2 staff. It is alleged that staff are not assisting resident to refill their medication. Interview with 2 of 2 staff revealed that resident’s medication is ordered and dispensed through Innovage and they send refills 3-4 days prior to end of month for all residents. Medication comes in a box and is individually packaged for each resident for each dose and time. It makes it easier for staff to dispense medication to each resident. Records Continued on LIC9099-C Unsubstantiatedthe state’s words, verbatim · CDSS document, Nov 20, 2024 · control 18-AS-20220721164247

Allegation investigated: Facility staff is not providing food to the residents

Licensing Program Analyst (LPA) Ruth Martinez visited the facility to further investigate into the above identified complaint allegation. LPA arrived at facility and was greeted at the door by Fermin Cornista, caregiver and granted entry. Ahmad (Adam) Abdallatef, Administrator arrived shortly after and met with LPA and LPA explained the purpose of the visit. Findings are based upon this investigation which included records review, interviews with the following: 4 out of 4 residents, and 2 of 2 staff. It is alleged that facility staff is not providing food to the residents. Tour of the physical plant conducted on September 01, 2023, by LPA Arreola and tour conducted on today’s visit by LPA Martinez observations reveled that facility has two refrigerators and 1 freezer as well as 2 pantries and additional food storage in the garage. Interview with 4 of 4 residents revealed that they have never had an issue with the food Continued on LIC9099-C Unsubstantiatedthe state’s words, verbatim · CDSS document, Nov 20, 2024 · control 18-AS-20230823135335

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Facility staff assaulted residents

Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced visit to the facility in order to initate an investigation into the allegations above. LPA met with Staff, Ahamed Abdallatef who was informed of the purpose of the visit. LPA collected documentation, conducted interviews and documented observations. It was alleged that R1 was assaulted by a staff at the facility. Upon review of the staff roster and staff and resident interviews, it was found that the alleged staff mentioned in the complaint was a resident and not a staff member. Therefore the allegation is found to be unfounded, meaning the allegation is false, could not have happened or is without a reasonable basis. An exit interview was conducted where this report was reviewed and provided to, Staff, Ahamed Abdallatef. Unfoundedthe state’s words, verbatim · CDSS document, Sep 1, 2023 · control 18-AS-20230823135335

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.