Grandview Manor

Type of visit: Case Management - Other

This Case management inspection is being conducted by Licensing Program Analyst (LPA) Abdoulaye Zerbo on 08-26-26 for the purpose of amending the report for the deficiencies observed during the investigation into Complaint Control No. 18-AS-20260825145415, and conducting an health and safety check. LPA met with Administrator Jamal Shalabi and explained purpose of the visit. During the visit, LPA amended the deficiencies report and conducted a walk through of the facility to assess overall health and safety conditions. LPA observed that the air-conditioning system had been repaired, and the facility provided a copy of the service invoice. An exit interview was conducted and a copy of this report was discussed with and provided to facility representative, Jamal Shalabithe state’s words, verbatim · CDSS document, Aug 26, 2026

Allegation investigated: Due to lack of supervision, resident eloped from the facility. Staff did not follow elopement protocol.

On May 29, 2026, the California Department of Social Services/Community Care Licensing (CDSS/CCL) Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced follow-up complaint visit. The LPA met with the Administrator (A1), Shalabi Jamal, and explained the purpose of the visit. The investigation included collecting records and touring the facility. On May 20, 2026, the Department obtained various documents, including the Personnel Report LIC 500 (dated 02/26/26) and the Client Roster (dated 03/29/26). The Department reviewed and collected documents for residents 1 (R1), including the Admission Agreement, the physician's Report, the Medical Assessment, the Facility rules, and Riverside Community Hospital Discharge dated 06/20/24. The Department interviewed the Administrator (A1) and four staff members (S1- S4). The department interviewed eight Residents (R1-R8). Unsubstantiated Allegation #1: Due to lack of supervision, resident eloped from the facility. The complaint alleged that resident #1 (R1) left the facility on 06/14/24 at 10:00 pm. On 06/24/24, the department conducted a record review during an unannounced visit, examining the night-shift resident's two-hour check documentation list. On May 20, 2026, the department conducted a records review of resident R1. R1 was admitted to the facility on 05/03/2023. The department's review of the physicians' reports dated 01/15/2024 and 06/06/2025 indicates that R1 was able to leave the facility unassisted. On 06/16/2024, R1 was not present at the facility at 8 pm, 10 pm, 12 am, 2 am, and 4 am. On 06/17/2024, the facility contacted the Riverside Police Department and learned that R1 had been admitted to Riverside Community Hospital and was discharged on 06/20/2024. On May 20, 2026, the department interviewed the facility's administrator, who denied the allegations. The administrator explained that some residents are allowed to leave the facility on their own and can return at any time. The facility maintains a sign-in and sign-out sheet for residents. In R1's case,they also noted that R1 could leave the facility unassisted. S4 also stated that R1 does not typically leave the facility for more than a day. The facility has house rules that residents must follow, including notifying on-duty staff and signing in and out when leaving. The facility operates as an open facility, meaning it is not locked, and residents can come and go as they please. Report continued on LIC9099C On May 20, 2026, the department interviewed four staff members (S1-S4), all of whom denied the allegations. They stated that they check on residents every two hours to ensure they are in the facility. Some residents may be outside smoking rather than in their rooms. The staff is dedicated to regularly supervising residents and would notify all appropriate parties if a resident were to go missing. They also noted that R1 does leave the facility attended. The department also interviewed eight residents (R1-R8), all of whom denied that the facility lacks supervision. They acknowledged that, as it is an open facility, they have the right to come and go as they please, provided they sign in and out. However, some residents occasionally leave without signing out. Additionally, the department interviewed R1, who also denied being missing. R1 stated that they do not remember certain events, recalling only their hospitalization. On May 20, 2026, the department's review of the Unusual Incident Report dated 06/17/2024, which was reported to the Community Care Licensing. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation (s) did or did not occur, therefore, the allegation is Unsubstantiated. Report continued on LIC9099C Allegation #2: Staff did not follow elopement protocol. The complaint alleged that the facility staff did not follow protocol. On May 20, 2026, the department interviewed Administrator A1, who denied the allegation and stated that they followed protocol by immediately calling the police and by sending an unusual incident report to licensing. At the same time, the department interviewed four staff members (S1-S4), all of whom denied the allegation and stated they would notify the police within 24 hours if they didn’t find the residents. In the case of R1, S4 called the police and later learned that R1 had been admitted to the Riverside Community Hospital. Additionally, the department interviewed eight residents (R1-R8), all of whom denied ever being missing for a day; they also stated they only go to the small store a block away. R1 also stated that R1 had not been missing; R1 only goes to the store sometimes. On 06/16/2024, R1 was not present at the facility at 8 pm, 10 pm, 12 am, 2 am, and 4 am. The department records reviewed indicated that, on 06/17/2024, the facility contacted the Riverside Police Department and later learned that R1 had been admitted to Riverside Community Hospital on the same date. On 06/17/2024, the Community Care Licensing department received an unusual Incident Report from the facility regarding R1's disappearance. R1 was later found to be admitted to the Riverside Community Hospital. Report continued on LIC9099C Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation (s) did or did not occur, therefore, the allegation is Unsubstantiated. No deficiencies were cited. An exit interview was conducted. A copy of this report was provided to Administrator Shalabi Jamal.the state’s words, verbatim · CDSS document, May 29, 2026 · control 18-AS-20240618132724

Allegation investigated: Staff did not ensure that resident received proper nourishment. Staff did not ensure resident was hydrated. Staff did not ensure resident was provided a healthful environment.

On May 29, 2026, the California Department of Social Services/Community Care Licensing (CDSS/CCL) Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced follow-up complaint visit. The LPA met with the Administrator (A1), Shalabi Jamal, and explained the purpose of the visit. The investigation included collecting records and touring the facility. On May 20, 2026, the Department obtained various documents, including the Personnel Report LIC 500 (dated 02/26/26) and the Client Roster (dated 03/29/26). The Department reviewed and collected documents for resident #1 (R1), including the Admission Agreement, the physician's Report, the Medical Assessment, the unusual incident report dated 11/15/24, the death report dated 01/11/25, and the facility menu dated 05/01/2026. The Department interviewed the Administrator (A1) and four staff members (S1- S4). The department interviewed eight Residents (R2-R9). The department is unable to interview the resident R1 because R1 passed away on January 11, 2025. Unsubstantiated Allegation #1: Staff did not ensure that residents received proper nourishment. The complaint alleged that a resident was not alert, oriented, and was severely malnourished and looked to have not been provided with food and water. On May 20, 2026, the department conducted an interview with the Administrator (A1), who denied the allegation regarding inadequate nourishment. A1 stated that the residents (R1) receive three meals a day, with snacks between meals, and that R1 does not require assistance to eat and does not refuse meals. On the same day, the department interviewed four staff members (S1-S4), all of whom denied the allegations and affirmed that the facility provides three meals a day and snacks. S1 and S2 indicated that if a doctor orders a special diet for a resident, the kitchen ensures that the meals are prepared with the necessary ingredients. They also mentioned that the facility maintains a four-week rotating menu, allowing residents to know in advance what will be served each week and providing a variety of dishes. Additionally, the department interviewed eight residents (R2-R9), who reported being adequately nourished. Some stated that they find the food acceptable and that the facility's menus are satisfactory. A few residents mentioned that if they do not like the food provided, they can purchase their own meals. Report Continued on LIC9099C Unfortunately, the department was unable to interview R1, because R1 passed away on January 11, 2025, at Riverside Community Hospital. A review of the records including R1's physician report dated September 26, 2023, and 2024 indicated that R1 was not on any special diet. The department also reviewed the facility's weekly menu, which demonstrated that a variety of meals are regularly offered to the residents. On May 20, 2026, the department observed the facility serving lunch; the meals included a variety of dishes, along with juice and water. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation (s) did or did not occur, therefore, the allegation is Unsubstantiated. Allegation #2: Staff did not ensure that the residents were hydrated. The complaint alleged that the staff did not provide water for the residents. On May 20, 2026, the department interviewed the Administrator (A1), who denied the allegation. A1 stated that the facility has water dispensers located throughout the building, including in the dining room, living room, activities room, and hallway, allowing residents to drink as much water as they need. During lunch and dinner, both juice and water are offered. On the same day, the department interviewed four staff members (S1-S4), all of whom also denied the allegation. They confirmed that the facility has dispensable water that is constantly refilled and that meals are served with both juice and water. Report continued on LIC9099C On May 20, 2026, the department reviewed an unusual incident report dated November 15, 2024, that the facility submitted to the Community Care Licensing Department about R1's hospitalization, as well as R1's death report dated January 11, 2025. The department also observed several water dispensers with disposable cups at the facility; all filled with plenty of water. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation (s) did or did not occur, therefore, the allegation is Unsubstantiated. Allegation #3: The staff did not ensure resident was provided a healthy environment. The complaint alleged that the facility had neglected the resident for some time, given the resident's condition. On May 20, 2026, the department interviewed the Administrator (A1), who denied the allegation and stated that the facility supports residents' physical, social, and mental well-being by providing access to clean drinking water and activities, and by ensuring the absence of toxic chemicals, excessive noise, and dangerous living conditions. We also offer a healthy menu featuring fruits, vegetables, green salads, desserts, and various meats. On the same day, the department interviewed four staff members (S1-S4), all of whom denied the allegation and stated that the facility provides a healthy place for residents. We schedule activities twice a week and ensure residents' rooms are kept clean. Meals are served with juice and water. Report continued on LIC9099C At the same time, the department interviewed eight residents (R2-R9), who denied the allegation and stated that they do whatever they want—most of them like sitting outside or in the activity room watching TV. However, the department was unable to interview R1 because R1 passed away on January 11, 2025, at Riverside Community Hospital. The department also observed that the facility was not in disrepair and was clean. Some residents were sitting in the living room watching TV, some in the activity room, and some were sitting outside. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation (s) did or did not occur, therefore, the allegation is Unsubstantiated. No deficiencies were cited. An exit interview was conducted. A copy of this report was provided to the Administrator. Shalabi Jamal.the state’s words, verbatim · CDSS document, May 29, 2026 · control 18-AS-20241115151741

Allegation investigated: Staff member physically assaulted resident. Staff member yelled at resident.

On May 21, 2026, the California Department of Social Services/Community Care Licensing (CDSS/CCL) Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced follow-up complaint visit. The LPA met with the Administrator (A1), Shalabi Jamal, and explained the purpose of the visit. The investigation included collecting records and touring the facility. On May 20, 2026, the Department obtained various documents, including the Personnel Report LIC 500 (dated 02/26/26) and the Client Roster (dated 03/29/26). The Department reviewed and collected documents for one resident #1 (R1), including the Admission Agreement, the physician's Report, the Medical Assessment, the unusual incident report dated 12/16/25, and the death report dated 12/17/25. The Department interviewed the Administrator (A1) and four staff members (S1- S4). The department interviewed eight Residents (R2-R9) but was unable to interview Resident (R1) because R1 had passed away on December 16, 2025. Unsubstantiated Allegation #1: Staff member physically assaulted resident. The complaint alleged that a staff member working on utilities hit the resident while entering the resident's (R1) room. On May 20, 2026, the department interviewed the Administrator (A1), who denied the allegation and stated that construction workers were working on the utility outside in the hallway. Then, resident R1 accused them of hitting R1, which had never happened. On the same day, the department interviewed four staff members (S1-S4), all of whom denied the allegation and stated that they would never physically hit a resident. S2 and S4 stated that residents physically push staff when they are mad. At the same time, the department interviewed eight residents (R2-R9), who denied that staff ever hit them. Some stated they noticed residents being physically aggressive toward staff members. The department was unable to interview R1 because R1 passed away on December 16, 25, at Riverside Community Hospital. The department records reviewed of the facility rosters and the Licensing Information System (LIS) showed no staff member by the name of the suspected abuser that was provided. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation (s) did or did not occur, therefore, the allegation is Unsubstantiated. The Report Continued on LIC9099C Allegation #2: Staff member yelled at resident. The complaint alleged that while staff entered R1’s room with a broom, they began yelling at R1. On May 20, 2026, the department interviewed the Administrator (A1), who denied the allegation and stated that construction workers were fixing the utilities outside R1’s room. R1 accused them of yelling because R1 didn’t like the worker working outside R1's room. They never touched or yelled at R1. On the same day, the department interviewed four staff members (S1-S4), all of whom denied the allegation and stated that they would never yell at a resident. S4 stated that some residents are stubborn and refuse to follow orders, so they had to repeat instructions more than once, but never in a yelling manner. At the same time, the department interviewed eight residents (R2-R9), who denied that staff ever yelled at them. Some stated they noticed residents being aggressive and cursing staff members. The department was unable to interview R1 because R1 passed away at Riverside Community Hospital on December 16, 2025. On May 20, 2026, the department’s review of the facility rosters, and the Licensing Information System (LIS) showed no staff member by the name of the suspected abuser that was provided. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation (s) did or did not occur, therefore, the allegation is Unsubstantiated. No deficiencies were cited. An exit interview was conducted. A copy of this report was provided to the Administrator. Shalabi Jamal.the state’s words, verbatim · CDSS document, May 21, 2026 · control 18-AS-20240426101158

Type of visit: Case Management - Other

On 4/07/2026, Licensing Program Analyst (LPA) Valerie Flores conducted an unannounced case management visit to the facility for the purpose of amending the needs further LIC9099 report for complaint control number 18-AS-20260325103119. LPA Flores met with caregiver Elena Filarca and explained the purpose of the visit. During the visit, LPA explained that an additional allegation will be added to the complaint report. LPA requested and collected pertinent documentation pertaining to the allegation. During the time of visit, LPA did not observe any health and safety concerns. An exit interview was conducted and a copy of this report was provided to the caregiver, Elena Filarca.the state’s words, verbatim · CDSS document, Apr 7, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry by Elena Filarca. LPA began inspection with introduction, visit purpose and provided the facility caregiver with LPA identification and business card. Resident record review began- Eight (8) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility is meeting documentation requirements. Employee records review began- Eight (8) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and current administrator certification. CPR and requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Administrator certification is present and current 08/30/2026. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The facility is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 111.0 degrees F. Laundry facilities is present for storing laundry soap and other chemicals in the laundry room. All outdoor and indoor passageways are free of obstruction. A locked area is provided for medications in the office and sharp objects in the kitchen. LPA verified there is a telephone working at this location. (Continued Page 2) (Continued from LIC809, Page 1) Food Service- Food supply meets the of one week supply of nonperishable and 2-day supply of perishables food on hand. A menu is posted, foods are dated to assure safety. Food prep areas are clean and organized. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation, and the structure remains unchanged according to the approved floor plan. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers are tested or replaced annually and were last done so on 10/03//2024. Facility Iis conducting emergency disaster drills quarterly; last done on 08/14/2025. Corporation is active and in good standing. Based on the information received during this visit today, there are zero (0) deficiency is being cited per Title 22, Division 6 of The California Code of Regulations. This report was reviewed with Jamal Shalabi and a copy provided at the time of the exit interview. *LPA was away from the facility from 12:00 PM-1:00 PMthe state’s words, verbatim · CDSS document, Sep 25, 2025

Type of visit: Case Management - Health Checks

On 8/5/2025, Licensing Program Analyst (LPA) Valerie Flores made an unannounced case management visit in response to the recent passing of Resident #1 (R1). LPA was greeted and granted entry by Administrator, Jamal Shalabi, who was informed of the purpose of the visit. During the visit, LPA toured the facility, reviewed and obtained copies of pertinent documentation, and interviewed Administrator, Jamal Shalabi, to obtain additional information regarding R1 who reportedly passed away on 8/1/2025. Per Jamal, the official death certificate has not been issued at this time. LPA advised Jamal to send a copy of the death certificate via email to the Department as soon as the certificate becomes available. During today's visit, LPA did not observe any imminent health or safety concerns, and no deficiencies were cited. An exit interview was conducted, and a copy of this report was reviewed and provided to Administrator, Jamal Shalabi, along with a copy of the Confidential Names list (LIC811).the state’s words, verbatim · CDSS document, Aug 5, 2025

Type of visit: Required - 1 Year

On September 6, 2024, Licensing Program Analyst (LPA), Venus Mixson, made an unannounced visit to the facility for the purpose of conducting the Required Annual inspection, and met with Lead Caregiver, Alice Santos, introduced herself and stated the purpose for the visit. The File review was conducted in the Regional Office and additional forms were requested and reviewed on site. LPA Mixson toured the facility along with the Lead Caregiver and made observations pertaining to the annual visit. LPA inspected the facility inside and outside there were no obstructions or debris to the indoor or outdoor passageways at the time of this visit. PHYSICAL PLANT: The facility is a 41-room facility located at 4411 Chicago Ave Riverside CA. 92507. Phone number is (909) 781-8400 and is operable. Facility is licensed for 82 Elderly Adults and is operating at 80 which is within the conditions and limitations of the license. LPA Mixson observed the residents’ bedrooms, and each was equipped with required furniture as per Title 22. LPA Mixson inspected facility bathrooms, and the hot water temperature tested within regulations. The bathrooms were clean, and appliances were operating appropriately currently at the time of this visit. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguishers. LPA Mixson observed required postings such as "If you See Something, Say Something" and the "Personal Rights." The cleaning supplies and sharp items were kept locked and inaccessible to the residents in care. There was a designated storage space for the residents and staff files, and it was locked and inaccessible to residents in care currently at the time of this visit. FOOD SERVICE: There was a variety of food which appeared to be selected and stored in a safe and healthful manner. Food supply of nonperishable and perishable foods was sufficient. The kitchen was observed to be clean. LPA Mixson observed the required two-day supply of perishable and seven-day supply of non-perishable foods. Care & Supervision/Administration: Adequate staffs are present for the supervision of residents in care. Floor plans, telephone numbers and personal rights were found posted in the facility. The listed administrator possesses an administrator certificate that they have paid for a renewal as the expiration date was 08/30/2024 but has submitted the updated renewal. Record Review and Resident/Staff Files: LPA Mixson reviewed four staff files and reviewed the facility's staff schedule. Of the staff files reviewed LPA observed criminal clearance and updated training along with CPR/First Aid Certification. Eight resident files were reviewed and possessed required paperwork and include resident safeguards for valuables. MEDICATION: Medications were reviewed and seen to have labels and maintained in compliance with label instructions and State and Federal law. Medications were observed to be safe, locked, and inaccessible to residents in care. Medications and medication documentation was observed to be well organized and monitored. Disaster preparedness: LPA Mixson reviewed the facility's emergency and disaster plan as well as disaster training binder. LPA observed the last fire drill met the department standards and was conducted on 04/30/2024. Infection Control: LPA Mixson observed the hand washing stations in the facility restrooms. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan and found all required infection control measures. Temperature and sign in stations. No deficiencies were cited per Title 22, Division 6 of the California Code of Regulations at this time. An exit interview was conducted where a copy of this report was discussed and given to Lead Caregiver, Alice Santos.the state’s words, verbatim · CDSS document, Sep 6, 2024

Allegation investigated: Staff did not ensure resident's room was free of pests.

Licensing Program Analyst (LPA), Javina George made an unannounced visit to commence a complaint investigation for the allegation noted above. LPA met with Yusef Nofal and explained the purpose of the visit and the elements of the allegation. The investigation consisted of observations, interviews, and records review. On 11/06/2023, Community Care Licensing received an allegation that staff did not ensure resident's room was free of pests. On 11/13/23 LPA conducted a complaint visit, during the visit LPA conducted nine (9) resident interviews and seven (7) of the (9) residents confirmed that they had seen cockroaches at the facility specifically in the bathrooms, under their beds and corner of the walls, as recent as this morning going back to a couple of weeks ago. The residents reported that the cockroaches come in through the bathrooms and the vents inside the ceiling, in the resident bedrooms. The residents denied seeing and exterminator spray inside only outside, per Caregiver Yusef the exterminator either comes out every two weeks or once a month it depends on *** Continued on 9099C Substantiated the season. LPA observed the exterminator invoices and the facility was last serviced on 10/16/23., and monthly going back to June 2023. Additionally while LPA was in a resident bedroom, LPA observed a cockroach that had been stepped on/smashed on the ground. Based on observations and interviews the allegation of staff did not ensure resident's room was free of pests is SUBSTANTIATED. A finding that the complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. An exit interview was conducted where a copy of this report, and appeal rights were reviewed and provided to Yusef Nofal. Per resident interviews there is no smoking allowed inside of the facility, only in the designated areas. Per Caregiver Yusef there are a lot of residents that do in fact smoke, but do so in the designated areas. Based on observations and interviews the allegation is UNSUBSTANTIATED. Allegation: Staff did not provide adequate meals to resident in care. It was alleged that the facility staff did not provide adequate meals to resident in care. On 11/13/23 LPA conducted a complaint visit during the visit, LPA conducted nine (9) resident interviews and four (4) of the nine (9) residents stated that the food that is served is cold, the portions are small, but allowed to have seconds and that there usually are a lot of flies flying around. LPA conducted a tour of the interior and exterior of the facility. LPA observed for the back doors to be propped open by the residents who were going in and out of the building to smoke. The front door is also propped open. The door would be closed and then opened back up again. LPA was present while lunch was served and the food was observed to be hot, as there was steam visibly observed coming from the food. LPA did observe for there to a fly, flying around in the dining room. Per Caregiver Yusef the Cook is not allowed to prepare meals hours in advance, The meals are prepared within a 1-2 hour window, and it depends on what is being served. LPA conducted a tour and observed at 9:45am for the meatloaf to be in the oven baking. Lunch is served 11:00am-12:00pm. Based on observation and interviews the allegation is UNSUBSTANTIATED. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation(s) occurred. An exit interview was conducted where a copy of this report, was reviewed and provided to Yusef Nofal.the state’s words, verbatim · CDSS document, Nov 13, 2023 · control 18-AS-20231106141024

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.269)a)(5) · Plan of correction due date: Nov 14, 2023

ENUMERATED RIGHTS: SEVERABILITY Residents of residential care facilities for the elderly shall have all of the following rights: To be accorded safe, healthful, and comfortable accommodations, furnishings, and equipment. This regulation was not met as evidenced by: 7 of 9 residents confirmed that there are in fact roaches at the facility. This is an immediate Health and Safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 13, 2023

Plan of correction: The Licensee agrees to have the exterminator come and treat the deisignated areas such as the bathrooms inside resident room. The licensee is to submit receipts or invoice to CCL by 5pm on the due date indicated.