The Arrow House

Deficiency cited at inspection

This is an amended report to amend the 809-D page regarding regulations Title Division Chapter Article 6 84070(b)(16)(G) Children's Records, and Title Division Chapter Article 6 84070(b)(16)(F) Children's Records (refer to LIC 809D). On July 17, 2024, at 2:20 pm, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Ehsan Ebrahim, Program Director, to discuss information that was reported to Community Care Licensing and records reviewed by LPA on June 27, 2024. LPA conducted confidential interviews with nine staff (S1-9), LPA also attempted to interview one staff (S10), and was unable to contact them despite multiple attempts. LPA also conducted a record review for three clients (C1-C3), which indicated that on June 4, 2024, S10 gave C C2's prescribed medication in error. The facility notified C1's Physician; however, the facility did not report the information and submit an Incident Report to Community Care Licensing until after LPA's visit on June 27, 2024. On June 27, 2024, while reviewing C1's Psychotropic Medication Administration Record or equivalent (PMAR), LPA observed C1's PMAR for May for medication #1 had an "R" (R = refers to a client refusal) recorded in the boxes for May 28, 29, and blank boxes for May 30, 31, and June 1-5. Records reviewed indicated that C1's Physician discontinued medication #1 on May 28. Additionally, LPA observed on C1's PMAR for June, C1's medication #2 did not have the times of the dosages ...

Deficiency cited at inspection

On July 2, 2024, at 10:30 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with John Lieberman, Chief Executive Officer, to assess a Civil Penalty. LPA Linley conducted confidential interviews and a record review which indicted that there were two Adults (A1, A2) who did not have a criminal record clearance prior to working at the facility. LPA reviewed Guardian to ensure that the individuals had a criminal record clearance; review indicated that A1 was not listed on the roster and was not listed in Guardian, and A2's clearance was pending. LPA Linley asked for any supporting documents the facility may have and they were unable to provide it or what they provided was incomplete. LPA Linley is administering two civil penalties during this visit. Based on record review and staff interviews, the facility is being cited for the violation of California Code of Regulations, Title 22, Division Six, regulation 80019(e) Criminal Record Clearance. Record review confirms A1 and A2 have worked in the facility without a criminal record clearance. An immediate civil penalty is being issued for $1,000.00. A civil penalty shall be assessed for a maximum of 5 days for the first violation. For subsequent violations within 12 months, a civil penalty shall be assessed for a maximum of 30 days. An exit interview was conducted with John Lieberman. Due to printer malfunction, a copy of this report and appeal rights were emailed to John Lieberman. A ...

Deficiency cited at inspection

On this date at 5:00 pm, Licensing Program Analyst (LPA) Charmaine Linley conducted an unannounced case management inspection to this facility. LPA Linley met with Ehsan Ebrahim, Program Director. LPA conducted a walk through of the facility and no deficiencies were observed. A case management has been opened regarding information reported to the Department. LPA interviewed one staff. Further information and interviews are required, therefore this case management is being extended. The outcome of the investigation will be provided to the Facility Administrator. The facility is reminded not to discuss the ongoing investigation with any interested parties. An exit interview was conducted and due to printer malfunction, a copy of this report will be emailed to the Facility Administrator.

Deficiency cited at inspection

On this date at 5:00 pm, Licensing Program Analyst (LPA) Charmaine Linley conducted an unannounced case management inspection to this facility. LPA Linley met with Ehsan Ebrahim, Program Director. LPA conducted a walk through of the facility and no deficiencies were observed. A case management has been opened regarding information reported to the Department. LPA interviewed one staff. Further information and interviews are required, therefore this case management is being extended. The outcome of the investigation will be provided to the Facility Administrator. The facility is reminded not to discuss the ongoing investigation with any interested parties. An exit interview was conducted and due to printer malfunction, a copy of this report will be emailed to the Facility Administrator.

Deficiency cited at inspection

On April 11, 2024, at 9:45 am Licensing Program Analyst (LPA) Charmaine Linley arrived at the facility to conduct a Comprehensive Annual Inspection visit. LPA and Ehsan Ebrahim, Facility Administrator, inspected the facility inside and outside. The facility was licensed as a group home on April 22, 2022. The facility is a single-story residence with a front house and a back house/main house, separated by the garage and driveway. There is at least one week's supply of nonperishable, and two days' supply of perishable foods. There is a variety of snacks available for the clients. There are cameras in the common areas and outside areas. The cameras are video only, with no audio. This home provides awake night staff. The facility has a capacity of 20. The group home serves clients between the ages of 12-17 years old, both female and male. There were five clients at the facility during LPA's visit. The front house consists of one living room, three offices, two storage rooms, one restroom, one kitchen, and one dining area. The garage is located next to the storage area and leads to the driveway and the back house/main house. The front house is mainly used for offices and the intake area for clients. The back house/main house has a school room, recreation room, kitchen, dining room, staff room, two offices, medication room/Nurse's station, group room, laundry room, pantry, supply closet, four bathrooms, and ten bedrooms. A physical plant inspection was completed and included the ...

Deficiency cited at inspection

On April 11, 2024, at 9:45 am Licensing Program Analyst (LPA) Charmaine Linley arrived at the facility to conduct a Comprehensive Annual Inspection visit. LPA and Ehsan Ebrahim, Facility Administrator, inspected the facility inside and outside. The facility was licensed as a group home on April 22, 2022. The facility is a single-story residence with a front house and a back house/main house, separated by the garage and driveway. There is at least one week's supply of nonperishable, and two days' supply of perishable foods. There is a variety of snacks available for the clients. There are cameras in the common areas and outside areas. The cameras are video only, with no audio. This home provides awake night staff. The facility has a capacity of 20. The group home serves clients between the ages of 12-17 years old, both female and male. There were five clients at the facility during LPA's visit. The front house consists of one living room, three offices, two storage rooms, one restroom, one kitchen, and one dining area. The garage is located next to the storage area and leads to the driveway and the back house/main house. The front house is mainly used for offices and the intake area for clients. The back house/main house has a school room, recreation room, kitchen, dining room, staff room, two offices, medication room/Nurse's station, group room, laundry room, pantry, supply closet, four bathrooms, and ten bedrooms. A physical plant inspection was completed and included the ...

Deficiency cited at inspection

On July 21, 2022, at 11: AM, Licensing Program Analyst (LPA) Charmaine Linley arrived at the facility to continue a Comprehensive Annual Post-Licensing Inspection visit that began on 07/20/2022. LPA met with John Lieberman, Facility Administrator. During the inspection, LPA reviewed staff files and client files. All the staff files are stored and secured electronically at the corporate office. LPA reviewed ten out of twenty staff files (see confidential name list, LIC811, dated 07/21/2022) via Zoom with Human Resources Director, Jennifer Richardson from 9:00 am-10:15 am. All staff that works at the facility have Department of Justice, FBI, and Child Abuse Index Clearances. LPA reviewed staff training records. During the inspection, LPA interviewed three out of five staff. LPA reviewed four out of five client files (C1-C4) (see confidential names list, LIC 811, dated 07/20/2022). LPA was unable to conduct interviews, due to clients attending group sessions. The client files are maintained in a locked cabinet in the medication room. LPA completed the component III Orientation and discussed Incident reporting, including incidents related to Assembly Bill 388 law enforcement contacts as well as incidents involving emergency interventions. The facility was informed that the address to this facility is available to the public. All special incident reports (SIRs) will be sent via e-mail to: cclpaccr@dss.ca.gov. The reporting requirements were reviewed with the Facility ...

Deficiency cited at inspection

On July 21, 2022, at 11: AM, Licensing Program Analyst (LPA) Charmaine Linley arrived at the facility to continue a Comprehensive Annual Post-Licensing Inspection visit that began on 07/20/2022. LPA met with John Lieberman, Facility Administrator. During the inspection, LPA reviewed staff files and client files. All the staff files are stored and secured electronically at the corporate office. LPA reviewed ten out of twenty staff files (see confidential name list, LIC811, dated 07/21/2022) via Zoom with Human Resources Director, Jennifer Richardson from 9:00 am-10:15 am. All staff that works at the facility have Department of Justice, FBI, and Child Abuse Index Clearances. LPA reviewed staff training records. During the inspection, LPA interviewed three out of five staff. LPA reviewed four out of five client files (C1-C4) (see confidential names list, LIC 811, dated 07/20/2022). LPA was unable to conduct interviews, due to clients attending group sessions. The client files are maintained in a locked cabinet in the medication room. LPA completed the component III Orientation and discussed Incident reporting, including incidents related to Assembly Bill 388 law enforcement contacts as well as incidents involving emergency interventions. The facility was informed that the address to this facility is available to the public. All special incident reports (SIRs) will be sent via e-mail to: cclpaccr@dss.ca.gov. The reporting requirements were reviewed with the Facility ...