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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881239
Report Date: 06/11/2026
Date Signed: 06/11/2026 11:54:52 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/28/2026 and conducted by Evaluator Jarred Torres
COMPLAINT CONTROL NUMBER: 18-AS-20260428134041
FACILITY NAME:ELIAA LLC 2FACILITY NUMBER:
331881239
ADMINISTRATOR:YOUNES, AMIRRAFACILITY TYPE:
740
ADDRESS:17520 BROWN STREETTELEPHONE:
(650) 656-7941
CITY:PERRISSTATE: CAZIP CODE:
92570
CAPACITY:6CENSUS: 5DATE:
06/11/2026
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:House Manager, Roger ValenzuelaTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff did not safeguard resident funds.
INVESTIGATION FINDINGS:
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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
Estimated Days of Completion:
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Jarred Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026
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 3
Control Number 18-AS-20260428134041
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: ELIAA LLC 2
FACILITY NUMBER: 331881239
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/30/2026
Section Cited
CCR
87217(c)
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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:
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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.
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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.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Jarred Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20260428134041
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: ELIAA LLC 2
FACILITY NUMBER: 331881239
VISIT DATE: 06/11/2026
NARRATIVE
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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.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Jarred Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3