Eliaa LLC 2

Allegation investigated: Staff did not safeguard resident funds.

On June 11, 2026, Licensing Program Analyst (LPA), Jarred Torres, arrived unannounced at the facility to deliver the investigative finding pertaining to the alleged violation. LPA met with House Manager (HM), Roger Valenzuela, and explained the purpose of the visit. The investigation consisted of interviews with staff and clients and a record review. On April 28, 2026, Community Care Licensing received a complaint alleging that staff did not safeguard resident funds. It was alleged that Caregiver #1 (C1), Maribel Garcia, used Resident #1's (R1) debit card information to make an unauthorized personal purchase on a shopping application. LPA was unable to interview R1 due to them passing away. Continued on LIC 9099-C... Substantiated Information obtained from an interview with Manager (MGR), Ahmed Qasim, stated they spoke to C1 about the incident. C1 confessed to MGR that on March 30, 2026, they made an unauthorized purchase with R1's debit card using a personal phone in the amount of $228.53. During an interview with C1, they admitted to accidentally using R1's debit card information to make a purchase on Instacart. C1 explained they have a history of running shopping errands for clients in care whenever a client does not feel like leaving home. Clients would give C1 their cash or debit cards to purchase candy, snacks, or clothes because the clients wanted specific brands or more variety. C1 explained that change and receipts are always given to clients in care. Furthermore, C1 relayed that they were making a personal purchase on Instacart and did not pay attention to the card information that automatically populated on their personal phone before submitting the purchase. This resulted in R1's debit card being charged. Information obtained from interviews with residents stated that C1 does go on shopping errands for the clients. It was also reported that clients will give C1 cash or debit cards to go shopping for residents because residents don't want to leave the facility. This additional information obtained corroborates with C1's interview. LPA's record review consisted of R1's admission agreement. The admissions agreement does not state shopping errands as one of the services offered to clients in care. Nor does it afford staff the flexibility of using clients' debit cards to make purchases. Based on the facts revealed in the interviews and information obtained from R1's admission agreement, the allegation that staff did not safeguard C1's funds is substantiated. The preponderance of evidence standard has been met; therefore, California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099-D. An exit interview was conducted, and a copy of this report, deficiency, and appeal rights, were discussed and provided to House Manager, Roger Valenzuela, whose signature on this form confirms receipt.the state’s words, verbatim · CDSS document, Jun 11, 2026 · control 18-AS-20260428134041

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87217(c) · Plan of correction due date: Jun 30, 2026

87217(c) - Safeguards for Resident Cash, Personal Property, and Valuables: Every facility shall account for any cash resources entrusted to the care or control of the licensee or facility staff. This requirement is not met as evidenced by: Licensee failed to safeguard resident funds for one out of six residents in care when staff made an unauthorized transaction on March 30, 2026, in the amount of $228.53, by using a resident's debit card information.the state’s words, verbatim · CDSS document, Jun 11, 2026

Plan of correction: Administrator, Amirra Youna, and Licensee shall review the cited section to ensure future compliance. Also, the administrator and Licensee shall conduct staff training to ensure staff understand how to safeguard client cash resources. Administrator / Licensee shall submit proof to CCLD via e-mail by due date.

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Abdoulaye Zerbo and Aziz Faizi conducted an unannounced visit for a required annual inspection. The LPAs were greeted by Caregiver Maribel Garcia, notified them of the purpose for the visit and was allowed to enter the facility to conduct the inspection. The Administrator Ahmed Qasim joined the visit at a later time Facility Overview: The facility is a single-story home with three(3) bedrooms and (2) bathrooms for residents, three (3) bedroom and two (2) bathroom for staff, and attached garage. There is a gated pool meeting the department's requirements and there are no firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked in the kitchen area inaccessible to residents. The smoke detector and carbon monoxide detector were operational. LPA observed fire extinguishers to be in compliance with the department requirements and with an expiration date of 01-15-27. LPA observed the water temperature to meet requirements at 120.3°F. Continued on LIC809-C..... Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Care & Supervision/Administration: Adequate staff were present to supervise residents during the visit. The administrator holds a current administrator’s certificate with expiration date of March 24th, 2026 and a CPR certification with the expiration date of June 24, 2027 Record Review and Resident/Staff Files: LPA reviewed files for two(2) staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Three (3) residents' files were reviewed and contained all required documentation. LPAs observed first aid kit to be available and inaccessible to the residents in care. Health-Related Services/Incidental Medical Services: All residents' medications were securely locked and inaccessible tot the residents in care. LPA reviewed medications for three residents, confirming that all medications were listed and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan including documentation of the last emergency drill conducted on January 09,2026, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed, and a copy was provided to Caregiver Maribel Garcia.the state’s words, verbatim · CDSS document, Jan 16, 2026

Allegation investigated: Due to lack of supervision, resident was in a physical altercation with another resident Staff did not report incident to appropriate agencies

On 11/20/2025, Licensing Program Analyst (LPA) Valerie Flores and LPA Armando Perez conducted an unannounced visit to the facility for the purpose of delivering investigative findings into the allegations listed above. LPA Flores met with staff Roger Valenzuela and explained to Roger the purpose of the visit. The investigation consists of interviews, observation, and records review. Information received alleged that Resident #1 (R1) was in a physical altercation with Resident #2 (R2) due to lack of care and supervision. Interview conducted with R2 reported that an incident did occur between R1 and R2. R2 reports that they were sleeping on the ground when R1 allegedly ran over R2’s leg with a walker. R2 explained they preferred to sleep on the ground as it is more comfortable for them. From there, R2 reports a small physical altercation took place between R1 and R2. Interview with R1 confirmed that an altercation took place but did not want to go into detail of the incident as R1 and R2 made amends. (Continue to LIC9099C) Unfounded (Continuation from LIC9099) R1 reports feeling safe and is okay with sharing a room with R2. Interviews with R1 and R2 confirmed that the incident occurred in the middle of the night and do not believe anyone overheard the altercation. LPA interviewed Resident #3 (R3) who shares a common wall with R1 and R2. R3 reported that they did not overhear any altercation between R1 and R2. Records reviewed reported that Staff #1 (S1) was the only live-in staff onsite during the time of the incident. During a tour of the facility, LPA observed S1’s bedroom to be on the other side of the facility, away from any residents room. Interview with S1 reported that they did not overhear the altercation between R1 and R2. S1 further reported that staff are required to check on the residents (3) three times during the night. S1 reported doing their nightly rounds and did not observe anything out of the ordinary. The facility does not maintain a log of when nightly rounds are conducted. Records review conducted of R1 and R2’s needs and service plans do not address neither residents requiring 1:1 supervision. Records reviewed of the facility’s plan of operation do not report having wake staff during the nocturnal hours but do have live-in staff at the facility. Information received alleged staff did not report incident to Community Care Licensing. Interview with S1 and R1 corroborated that the physical altercation between Resident #1 (R1) and Resident #2 (R2) was reported to S1 the following morning. Interview with S1 reported that they called Staff #2 (S2) to inform S2 of what R1 divulged to S1. S2 instructed S1 to ask R1 if they would like to file a police report to which R1 declined. Interviews with S2 confirmed S1’s account of the telephone call taken place. Interviews conducted with S1 and R1 confirmed that R1 refused to file a police report. A records review conducted of the facility’s incident reports received at Community Care Licensing confirmed an incident report was received on 6/4/2025 detailing an altercation between R1 and R2. The incident took place on 5/31/2025. Per Title 22, Reporting Requirements, the facility has within 7 days to report an incident which threatens the welfare, safety or health of any resident, caused by staff or by other residents. Therefore, the allegation of due to lack of supervision, resident was in a physical altercation with another resident and staff did not report incident to appropriate agencies has been deemed unfounded. A finding that the allegation is unfounded meaning that the allegation was false, could not have happened, and/or is without a reasonable basis. An exit interview was conducted, and a copy of this report was provided to staff, Roger Valenzuela.the state’s words, verbatim · CDSS document, Nov 20, 2025 · control 18-AS-20250604084712

Allegation investigated: Facility refused to obtain medical attention for resident in care. Facility staff threatened resident in care. Illegal eviction.

On 10/09/2025, Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced complaint visit. LPA Richard met with House Manager/Caregiver Roger Valenzuela and later with Amirr Younes, the Administrator. LPA Richard explained the purpose of this visit. The investigation included the following steps: On October 9, 2025, the Licensing Program Analyst (LPA) interviewed the Administrator (A1), one staff member (S1), and three residents (R2-R4). The LPA also to interview a representative from Innovaged Placement Agency. During the investigation, the LPA obtained and reviewed several documents, including: Resident roster dated June 11, 2025. Staff roster dated June 11, 2025. R1's Innovaged Supporting Housing Authorization and Resident Payment documents, marked for move-in on May 23, 2022. Hospital visit summaries dated June 12, 2022; July 5, 2022; and July 14, 2022. Innovaged Voluntary Disenrollment Letter dated August 31, 2022. Verbal consent from R1, along with the signature of the Innovaged Representative, dated September 1, 2022. Illegal eviction notices dated July 16, 2022, and August 7, 2022. Unsubstantiated Allegation #1: Facility refused to obtain medical attention for the residents in care. The complaint alleged that the staff refused to take the resident to the hospital despite the resident being in pain. A review of the LPA records for Resident 1 (R1) showed multiple hospital visits from June 12, 2022, to July 14, 2022. During the investigation, LPA interviewed the Administrator (A1), who denied the allegations and stated that R1 had been admitted to the facility only a month before R1 began complaining about pain. A1 asserted that the staff always call 911 when R1 requests to go to the hospital. LPA Richard also interviewed one staff member (S1), who denied having provided medical attention to R1. S1 mentioned that R1 complained of pain even after taking pain medications, but also noted that R1 refused to take the pain medication at times. Additionally, LPA interviewed three other residents (R2-R4), all of whom confirmed that the staff would call 911 when they needed to go to the hospital. On October 9, 2025, at approximately 9:30 am, LPA interviewed the Innovage Representative regarding R1. The representative stated that R1 is no longer with Innovage after leaving the facility. LPA Richard was unable to interview R1, as R1 is no longer residing at the facility. Based on the evidence gathered, interviews conducted, the preponderance of evidence standard has not been met. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the above-mentioned allegation is found to be UNSUBSTANTIATED. Report continued on LIC9099-C Allegation #2: Facility staff threatened residents in care. The complaint alleged that the facility threatened to evict residents requesting medical attention. On October 9, 2025, the Licensing Program Analyst (LPA) interviewed the Administrator (A1), who denied the allegation, stating that staff members would never threaten residents for seeking help, as they are responsible for the residents' well-being. The LPA also interviewed with a staff member (S1), who similarly denied the allegation. S1 mentioned that R1 occasionally called 911 independently, and that emergency services would respond and transport R1 to the hospital. Additionally, the LPA interviewed three residents (R2, R3, and R4), all of whom stated that facility staff had never threatened them regarding calling 911 for assistance. The LPA also conducted a records review of R1's hospital visits, which dated from June 12, 2022, through July 14, /2022, and indicated that R1 has been transported to the hospital numerous times. The LPA was not able to interview R1 because R1 is no longer residing at the facility. Based on the evidence gathered, interviews conducted, the preponderance of evidence standard has not been met. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the above-mentioned allegation is found to be UNSUBSTANTIATED. Report Continued on LIC9099-C Allegation #3: Illegal Eviction. The complaint alleged that the facility provided the resident with a verbal notice to leave by September 7, 2022. On October 9, 2025, the Licensing Program Analyst (LPA) interviewed the Administrator (A1), who denied having given a verbal notice to the resident. A1 stated that, instead, a legal eviction notice was issued on July 16, 2022, due to the fact that the residents (R1) required a higher level of care. R1 expressed a desire to transition to the Inland Empire House Plan (IEHP) rather than remain at the facility. LPA interviewed three residents #2-4 (R2-R4), all of whom denied ever receiving a writing or verbal eviction notice from the facility. On the same date, the LPA reviewed the Innovage Voluntary Dis-enrollment Letter from Resident R1, dated August 31, 2022, as well as notes from a verbal consent discussion held via phone with the Innovage Representative on September 1, 2022. During this conversation, R1 indicated a wish to discontinue services with Innovage and to remain with IEHP, fully understanding that this decision would result in the loss of housing with the facility ELIAA LLC 2. At approximately 9:30 a.m. on October 9, 2025, the LPA interviewed the Innovage Representative regarding R1. The representative confirmed that R1 is no longer affiliated with Innovage after leaving the facility. The LPA, Richard, was unable to interview R1, as R1 is no longer residing at the facility. Report Continued on LIC9099-C Based on the evidence gathered, interviews conducted, the preponderance of evidence standard has not been met. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the above-mentioned allegation is found to be UNSUBSTANTIATED. No deficiencies cited. An exit interview was conducted. A copy of this report was provided the staff member Roger Valenzuela.the state’s words, verbatim · CDSS document, Oct 9, 2025 · control 18-AS-20220902165305

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ferrer Sabarias conducted an unannounced annual required visit. Upon entry, LPA was greeted by Caregiver Roger Valenzuela and informed him of the purpose of the visit. At the time of the visit, there were two (2) staff members and three (3) residents present. Facility Overview: The facility is a one-story home with three(3) bedrooms and (2) bathrooms for residents, three (3) bedroom and two (2) for staff including an attached garage. There are no body of water on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well-maintained. Fixtures and furniture were in good repair. The outdoor area was free of hazards. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked and inaccessible to residents. According to the Administrator there are no firearms and ammunition kept in the home. Both the smoke detector and carbon monoxide detector were operational, and the hot water temperature was 119.4°F. Fire extinguishers are in working order, last service date 1/16/24. Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Continue to LIC809C... Continued from LIC809... Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate valid until 12/27/25. Record Review and Resident/Staff Files: LPA reviewed files for two staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Two resident files were reviewed and contained all required documentation. Health-Related Services/Incidental Medical Services: All resident medications were securely locked. LPA reviewed medications for two residents, confirming that all medications were listed on the Medication Administration Record (MAR) and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last fire drill conducted on 11/7/24, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed and provided to Administrator Ahmed Qasim.the state’s words, verbatim · CDSS document, Jan 6, 2025

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA), Janette Romero conducted a case management visit to issue a deficiency observed during LPA's visit at the facility on 7/29/2024. On 7/29/2024, LPA toured the facility with Caregiver, Roger Valenzuela and observed two (2) refrigerators in the kitchen. The refrigerator next to the pantry was locked with a four (4) digit lock placed on the refrigerator doors. Resident interviews revealed the four (4) digit pin is not provided to the residents, making food in that refrigerator inaccessible to residents in care. LPA observed more than a 2-day supply of perishable foods in that refrigerator. Caregiver Valenzuela reported the refrigerator is locked because one (1) resident requires insulin pens that have to be refrigerated and inaccessible to all residents. LPA advised Caregiver Valenzuela that it is a personal rights violation for residents to not have access to their food. Caregiver Valenzuela reported the second refrigerator had food accessible to the residents. LPA observed the second refrigerator (located next to the kitchen counter) did not have a 2-day supply of perishable foods for six (6) residents and instead had mostly condiments including four (4) tubs of butter. LPA also observed Caregiver Valenzuela use a key to unlock the pantry storing the 7-day supply of non-perishable foods for the residents. LPA inquired as to why the pantry was locked and Caregiver Valenzuela did not provide an explanation. LPA called Administrator, Amirra Younes and informed them of the deficiency observed. Administrator Younes reported they would have facility staff purchase a mini refrigerator for the insulin pens and remove the lock from the refrigerator and pantry during LPA's visit. During the visit, LPA observed House Manager, Ahmed Manassra arrive with a new mini refrigerator, which was installed in Administrator Younes' office. LPA observed Administrator Younes remove the insulin pens from the kitchen refrigerator and place them into the mini refrigerator stored in their office. LPA also observed Caregiver Valenzuela remove the lock on refrigerator and unlock the pantry. Based on the aforementioned, the facility will be cited pursuant to California Code of Regulations (Title 22, Division 6, Chapter 8). An exit interview was conducted and a copy of this report was reviewed and provided to Administrator Younes along with LIC809-D and Appeal Rights.the state’s words, verbatim · CDSS document, Jul 29, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(3) · Plan of correction due date: Jul 29, 2024

(3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions... This requirement was not met as evidenced by: During LPA's visit on 7/29/2024, LPA observed a four (4) digit lock placed on one of the refrigerator doors, which made the 2-day supply of perishable foods inaccessible to residents in care. LPA also observed the pantry to be locked. This poses a potential personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Jul 29, 2024

Plan of correction: During LPA's visit on 7/29/2024, LPA observed Caregiver Valenzuela remove the lock from the refrigerator and unlock the pantry. This will suffice as proof of correction.

Type of visit: Required - 1 Year

On 1/12/2024, Licensing Program Analyst (LPA) Chinwe Nwogene arrived unannounced at the facility to conduct an annual inspection. LPA Nwogene was greeted and granted entry by Caregiver, Roger Valenzuela who was informed of the purpose of the visit. Roger called the House Manager, Amirr Younes and Licensee, Ahmed Qasim who arrived at the facility shortly after and were both informed of the purpose of visit. At the time of visit there were two #2 staff and three #3 resident present. LPA was informed the other two residents were out in the community. LPA toured the facility inside and out with Roger Valenzuela. Tour included: Kitchen: LPA toured the kitchen and observed kitchen to be clean. Food is stored in a safe and healthful manner. Utensils and dishware are sufficient for the capacity. The refrigerator and stove are in working order. Sharps are stored in a locked kitchen cabinet, available only to authorized individuals. Trash cans has tight-fitting lid. Fridge, Freezer, and all need appliances were present and shown to be in working condition and clean. Dining and Livingroom; LPA toured the dinning and Livingroom area. LPA observed area to be clean and furnitures in good condition. Temperature was 68 degrees Fahrenheit. Hallway: LPA toured the hallway and observed hallway to be clean with no pathway obstruction. LPA inspected the fire extinguisher and found it to be in compliance. Carbon monoxide & smoke detector were tested and functioning properly. LPA observed additional linens and hygiene items. Medication: Medications were labeled and stored in separate bins inside of a locked medication closet and are distributed according to physician orders. The first aid kit was complete. Bathroom: LPA toured hall bathroom and observed bathroom to be clean and equipped with grab bar and non-skid mat. There is also a good number of personal toiletries available for the residents in care. The hot water measured at 105 degrees Fahrenheit. Bedroom: LPA toured four #4 out of #4 resident bedrooms and observed bedrooms to be clean and furnished according to regulation, which includes proper furniture, dressers, chairs, and lighting. Resident #1 bedroom has a private bathroom. LPA observed bathroom to be clean and hot water was measured at 105 degrees Fahrenheit. Garage: LPA tour the garage and observed garage to be clean. Laundry: Washing machine and dryer are all in good repair and sufficient for census. Cleaning supplies are stored away in the laundry room, inaccessible to clients. Backyard: LPA toured the backyard and observed backyard to be clean and furnitures in good condition. The backyard was free from obstruction and the side gate remain unlocked. No bodies of water were observed. Food Services: There are seven days non-perishable and two days of perishable food supply present, and all food was properly stored and available to residents. Fridge and Freezer are large enough to accommodate required perishable foods. Records: All staff present have a criminal record clearance in file and are confirmed as being associated with the facility. Three #3 staff and #3 resident records were reviewed. All required postings, including COVID’s postings, were posted near the entryway and throughout the facility. The administrator certificate expires on 12/27/2025. Interview: Two staff and three residents were interviewed. No deficiencies noted at the time of visit. An exit interview was conducted, and a copy of this report was reviewed and provided to Ahmed Qasim.the state’s words, verbatim · CDSS document, Jan 12, 2024