summary: Facility Evaluation

raw_content:
Narrative:
On 11/12/2021 at 9:30AM Licensing Program Analyst (LPA) Olivia made an unannounced to Divinity Prophet Transitional Housing Placement plus Foster Care (THP + FC) Administrative Office for the purpose to conduct the Annual/Required licensing Inspection. LPA Rosas met with Staff#1(S1) who granted access to the Administrative Office and an inspection was conducted together. Individuals mention in this report are identify on the Confidential Names List (LIC811) dated 11/12/21. The annual fees are current. LPA Rosas inspected following during the inspection The facility is licensed to provide Transitional Housing Placement plus Foster Care (THP + FC) and Non-Minor Dependents (NMD) to sixty (60) participants ages eighteen (18) through twenty one (21). There are currently thirty-six (36) participants in placement at different remote sites in the Ventura County (sites are located in Oxnard, Moorpark and Ventura). Facility has two (2) Social Workers (1 per 12 participants) and one (1) Social Worker Supervisor (1 per Social Workers). The facility is currently operating within staff ratio. The administrative office is located at E. Thousand Oaks Blvd, #268, Thousand Oaks, CA 91362. The office is located on the second floor of a business office building and is set up as follows: Administration office is a three (3) room office with reception area and outdoor patio. The Administrator Office is equipped with a desk and locked file cabinets for staff files. The main office space consist of three (3) desk for case carrying social workers with locked file cabinets for client files. The Program Supervisor office is equipped with a desk and lock file cabinets. There is a door from the main office space and Program Supervisor office that leads to a roof patio. In the business office building there are two conference rooms that licensee states are available to conduct private interviews. Staff records are maintained in the Administrative Office inside locked cabinets and the client records are maintained in the Social Workers office space inside locked file cabinets. All posting requirements were met. Report continues on LIC 809-C Page 1 of LPA Rosas reviewed following during the inspection LPA Rosas requested the following forms for review, copy of applicable waiver and exceptions, Register of participants, Current Census, Personnel Report (LIC 500), Emergency Disaster Plan Protocols, Emergency Disaster Plan for Children's Residential Facilities (LIC 610C). The certification/decertification list of participants living units. Staff Records Review: LPA reviewed three (3) staff records stored in individual personnel file provided by S1. LPA ensured to thoroughly review the records of the primary active staff (i.e The Program Administrator, Supervising Case Manger, Social Worker). LPA reviewed the Personnel Report (LIC 500) and confirmed that facility has two (2) Social Workers (1 per 12 participants) and one (1) Social Worker Supervisor (1 per Social Workers) who carries social worker caseload. The facility is currently operating within staff ratio. LPA review of Facility's Personnel Report Summary on 11/08/2021 that indicates that all personnel have criminal record clearance has obtain the necessary clearances with DOJ, FBI, and Child Abuse Response. LPA reviewed staff qualifications and training hours. The facility has social worker personnel available on a 24-hour basis to respond to any emergency. Clients Records Review: LPA reviewed three (3) clients records which meet requirement. LPA reviewed the Admission Agreements, date of placement in unit, Emergency Contact information, and Needs and Services Plan. Staff Interviews: LPA Rosas conducted a confidential interview with one (1) on duty staff. LPA obtained contact information for Social Workers to conduct interviews at a later time. Client Interviews: LPA was not able to conduct participant interviews. LPA Rosas obtained register of participants with contact information to conduct interviews at a later time. LPA Rosas by email send the following PINS to S PIN 20-17-CRP: New Background Check Requirements, Assembly Bill 819 (Chapter 777, Statutes of 2019), PIN 21-20-CRP: Statewide Launch of New Inspection Tools for Children's Residential Licensees, PIN 21-05-CRP: The Family Urgent Response System (FURS). There were no deficiencies observed or cited at this time. Exit interview was conducted with Sq and a copy of this report was left at the facility.


state: CA

facility_name: DIVINITY PROPHET

summary: Facility Evaluation

raw_content:
Narrative:
On 11/12/2021 at 9:30AM Licensing Program Analyst (LPA) Olivia made an unannounced to Divinity Prophet Transitional Housing Placement plus Foster Care (THP + FC) Administrative Office for the purpose to conduct the Post Licensing Inspection. LPA Rosas met with Staff#1(S1) who granted access to the Administrative Office and an inspection was conducted together. Individuals mention in this report are identify on the Confidential Names List (LIC811) dated 11/12/21. The annual fees are current. LPA Rosas inspected following during the inspection The facility is licensed to provide Transitional Housing Placement plus Foster Care (THP + FC) and Non-Minor Dependents (NMD) to sixty (60) participants ages eighteen (18) through twenty one (21). There are currently thirty-six (36) participants in placement at different remote sites in the Ventura County (sites are located in Oxnard, Moorpark and Ventura). Facility has two (2) Social Workers (1 per 12 participants) and one (1) Social Worker Supervisor (1 per Social Workers). The facility is currently operating within staff ratio. The administrative office is located at E. Thousand Oaks Blvd, #268, Thousand Oaks, CA 91362. The office is located on the second floor of a business office building and is set up as follows: Administration office is a three (3) room office with reception area and outdoor patio. The Administrator Office is equipped with a desk and locked file cabinets for staff files. The main office space consist of three (3) desk for case carrying social workers with locked file cabinets for client files. The Program Supervisor office is equipped with a desk and lock file cabinets. There is a door from the main office space and Program Supervisor office that leads to a roof patio. In the business office building there are two conference rooms that licensee states are available to conduct private interviews. Staff records are maintained in the Administrative Office inside locked cabinets and the client records are maintained in the Social Workers office space inside locked file cabinets. All posting requirements were met. Report continues on LIC 809-C Page 1 of LPA Rosas reviewed following during the inspection LPA Rosas requested the following forms for review, copy of applicable waiver and exceptions, Register of participants, Current Census, Personnel Report (LIC 500), Emergency Disaster Plan Protocols, Emergency Disaster Plan for Children's Residential Facilities (LIC 610C). The certification/decertification list of participants living units. Staff Records Review: LPA reviewed three (3) staff records stored in individual personnel file provided by S1. LPA ensured to thoroughly review the records of the primary active staff (i.e The Program Administrator, Supervising Case Manger, Social Worker). LPA reviewed the Personnel Report (LIC 500) and confirmed that facility has two (2) Social Workers (1 per 12 participants) and one (1) Social Worker Supervisor (1 per Social Workers) who carries social worker caseload. The facility is currently operating within staff ratio. LPA review of Facility's Personnel Report Summary on 11/08/2021 that indicates that all personnel have criminal record clearance has obtain the necessary clearances with DOJ, FBI, and Child Abuse Response. LPA reviewed staff qualifications and training hours. The facility has social worker personnel available on a 24-hour basis to respond to any emergency. Clients Records Review: LPA reviewed three (3) clients records which meet requirement. LPA reviewed the Admission Agreements, date of placement in unit, Emergency Contact information, and Needs and Services Plan. LPA Rosas by email send the following PINS to S PIN 20-17-CRP: New Background Check Requirements, Assembly Bill 819 (Chapter 777, Statutes of 2019), PIN 21-20-CRP: Statewide Launch of New Inspection Tools for Children's Residential Licensees, PIN 21-05-CRP: The Family Urgent Response System (FURS). There were no deficiencies observed or cited at this time. Exit interview was conducted with Sq and a copy of this report was left at the facility.

report_type: Facility Evaluation

met_with: Staff#1 (S1)


summary: Facility Evaluation

raw_content:
Narrative:
On 10/13/2022 at 9:00AM Licensing Program Analyst (LPA) Olivia made an unannounced to Divinity Prophet Transitional Housing Placement plus Foster Care (THP + FC) Administrative Office for the purpose to conduct the Annual/Required licensing Inspection. LPA Rosas met with Staff#1(S1) who granted access to the Administrative Office and an inspection was conducted together. Individuals mention in this report are identify on the Confidential Names List (LIC811) dated 10/13/22. The annual fees are current. LPA Rosas inspected following during the inspection The facility is licensed to provide Transitional Housing Placement plus Foster Care (THP + FC) and Non-Minor Dependents (NMD) to forty-eight (60) participants ages eighteen (18) through twenty-one (21). There are currently thirty-one (31) participants in placement at different remote sites in the Ventura County (sites are located in Oxnard, Moorpark and Ventura). Facility has three (3) Social Workers (1 per 12 participants) and one (1) Social Worker Supervisor (1 per Social Workers), and Program Administrator. The facility is currently operating within staff ratio. The office is located on the second floor of a business office building and is set up as follows: The administrative office is located at E. Thousand Oaks Blvd, #268, Thousand Oaks, CA 91362. Administration office is a three (3) room office with reception area and outdoor patio. The Administrator Office is equipped with a desk and locked file cabinets for staff files. The main office space consists of three (3) desks for case carrying social workers with locked file cabinets for client files. The Program Supervisor office is equipped with a desk and lock file cabinets. There is a door from the main office space and Program Supervisor office that leads to a roof patio. In the business office building, there are two conference rooms that licensee states are available to conduct private interviews. Staff records are maintained in the Administrative Office inside locked cabinets and the client records are maintained in the Social Workers office space inside locked file cabinets. All posting requirements were met. Report continues on LIC 809-C Page 1 of LPA Rosas reviewed following during the inspection: LPA Rosas requested the following forms for review, copy of Register of participants, Current Census, Personnel Report (LIC 500), Emergency Disaster Plan Protocols, Emergency Disaster Plan for Children's Residential Facilities (LIC 610C). The certification/decertification list of participants living units. Staff Records Review: LPA Rosas was not able to review staff records and will return to complete the file record review. LPA reviewed the Personnel Report (LIC 500) and confirmed that facility has two (2) Social Workers (1 per 12 participants) and one (1) Social Worker Supervisor (1 per Social Workers) who carries social worker caseload. The facility is currently operating within staff ratio. LPA review of Facility's Personnel Report Summary on 10/10/2022 that indicates that all personnel have criminal record clearance has obtain the necessary clearances with DOJ, FBI, and Child Abuse Response. The facility has social worker personnel available on a 24-hour basis to respond to any emergency. LPA Rosas was not able to conduct staff interviews and will return to complete the interviews. Clients Records Review: LPA Rosas was not able to review client records and will return to complete the file review. LPA Rosas together with S1 conducted a collateral visit to three (3) remote sites located in Oxnard, and Moorpark, CA. LPA Rosas during inspection of four apartments units did not have telephone service. S1 stated, the apartments units do not have telephone service. One deficiency was observed (refer to LIC 809D) and facility is cited for violation of California Code of Regulations, Title Division Six, Interim Licensing Standards AB Nonminor Dependents, THPP Article 06. Continuing Requirements: Telephones (a) (1) Telephone service in the THPP shall be readily accessible to a nonminor dependent which poses a potential Health, Safety or Personal Rights risk to residents in care. LPA Rosas by email send the following PINS to S1 by email: PIN 21-26-CRP Transitional Housing Placement Provider (THPP) Nonsubstantive Changes to Regulations Update, PIN 22-06-CCLD Guardian Background Check Best Practices, PIN 22-07-CCLD Guardian Webinar For Licensees and Providers, PIN 21-20-CRP Statewide Launch Of New Inspection Tools For Children's Residential Licensees, Foster Youth Bill Of Rights A Guide to Your Rights in Foster Care. Exit interview was conducted with S1 and a copy of this report was left at the facility.

visit_type: Annual


summary: Facility Evaluation

raw_content:
Narrative:
On 10/20/2022 at 11:30AM Licensing Program Analyst (LPA) Olivia made an unannounced to Divinity Prophet Transitional Housing Placement plus Foster Care (THP + FC) Administrative Office for the purpose of conducting the Annual inspection. LPA Rosas met with Staff#1(S1), Staff#2 (S2), and conducted record file review for client and staff records. Individuals mention in this report are identify on the Confidential Names List (LIC811) dated 10/20/22. LPA reviewed following during the inspection: Staff Records Review: LPA reviewed three (3) staff records stored in individual personnel file provided by S1. LPA ensured to thoroughly review the records of the primary active staff (i.e The Program Administrator, Supervising Case Manger, Social Worker). LPA reviewed the Personnel Report (LIC 500) and confirmed that facility has two (2) Social Workers (1 per 12 participants) and one (1) Social Worker Supervisor (1 per Social Workers) who carries social worker caseload. The facility is currently operating within staff ratio. LPA review of Facility's Personnel Report Summary on 11/08/2021 that indicates that all personnel have criminal record clearance has obtain the necessary clearances with DOJ, FBI, and Child Abuse Response. LPA reviewed staff qualifications and training hours. The facility has social worker personnel available on a 24-hour basis to respond to any emergency. LPA reviewed staff qualifications and training hours. The facility has social worker personnel available on a 24-hour basis to respond to any emergency. Clients Records Review: LPA reviewed five (5) clients records which meet requirement. LPA reviewed the Admission Agreements, that included date of placement, Emergency Contact information, medical, dental, vision and mental health services. LPA Rosas inspected records of accounts of cash resources, and personal property. Reviewed the Needs and Services Plan (NSP) and Transitional Independent Living Plan & Agreement (TILP) Report continues on LIC 809-C Page 1 of Staff Interviews: LPA conducted a confidential interview using the inspection tool interview form with three (3) staff. A review of Facility's Personnel Report Summary on 10/20/2022 indicates that all personnel have criminal record clearance has obtain the necessary clearances with DOJ, FBI, and Child Abuse Response. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was email to S1 for signature.

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On 8/16/2023, at 11: AM, Licensing Program Analyst (LPA) Regina Martin conducted a Case Management - Incident inspection at Divinity Prophet, Transitional Housing Placement Program (THPP) and met with Thomas Chavira II, Program Administrator in response to a Special Incident Report submitted to Community Care Licensing (CCL) on 8/14/2023. The incident, reports in part, on 8/12/2023, a participant was stabbed at the THPP's remote site by another participant resulting in the death of one participant. The participant who committed the stabbing was subsequently arrested as a result [See confidential names form LIC811; dated 8/16/2023]. During this inspection, LPA Martin informed the incident has been referred to CCL Investigations Branch, Investigator Dennis Seng. Upon completion of the investigation, the investigation findings will be discussed. LPA Martin requested and obtained the following documents from facility and Participant files: Participant/Client Roster, Personnel Report (Schedule) LIC500, facility staff job description, Participant needs and services plans and transitional independent living plans (TILP), as well as Admission Agreements for subject participants. The incident requires further investigation. Upon completion, the Department's findings will be issued and discussed. There are no deficiencies cited per California Code of Regulations, at this time. Exit Interview conducted, and a copy of this report was left with Program Administrator .

met_with: Thomas Chavira II, Program Administrator and Shari Wolvek, Director of Quality Assurance and Compliance


summary: Facility Evaluation

raw_content:
Narrative:
On 10/12/2023 at 9:30AM Licensing Program Analyst (LPA) Christine Wilson and Licensing Program Analyst (LPA) Jhane Haynes made an unannounced to Divinity Prophet Transitional Housing Placement plus Foster Care (THP + FC) Administrative Office for the purpose to conduct the Annual/Required licensing Inspection. LPA Wilson and LPA HAnes met with Facility Administrator (FA) who granted access to the Administrative Office and an inspection was conducted together. Individuals mention in this report are identify on the Confidential Names List (LIC811) dated 10/12/23. The annual fees are current. LPA Wilson and LPA Haynes inspected following during the inspection The facility is licensed to provide Transitional Housing Placement plus Foster Care (THP + FC) and Non-Minor Dependents (NMD) to sixty (60) participants ages eighteen (18) through twenty one (21). There are currently twenty-three (23) participants in placement at (16) different remote sites in the Ventura County (sites are located in Oxnard, Moorpark and Ventura). There is (1) participant on a placement waitlist. Facility has two (2) Case Management Social Workers (1 per 12 participants) and one (1) Facility Administrator (1 per Social Workers). The facility is currently operating within staff ratio. The administrative office is located at E. Thousand Oaks Blvd, #268, Thousand Oaks, CA 91362. The office is located on the second floor of a business office building and is set up as follows: Administration office is a three (3) room office with reception area and outdoor patio. The Administrator Office is equipped with a desk and locked file cabinets for staff files. The main office space consist of three (3) desk for case carrying social workers with locked file cabinets for client files. The Program Supervisor office is equipped with a desk and lock file cabinets. There is a door from the main office space and Program Supervisor office that leads to a roof patio. In the business office building there are two conference rooms that licensee states are available to conduct private interviews. Staff records are maintained in the Administrative Office inside locked cabinets and the client records are maintained in the Social Workers office space inside locked file cabinets. All posting requirements were met. Continues on 8009C Page 2 of Page LPA Wilson and LPA Haynes, requested the following forms for review, copy of applicable waiver and exceptions, Register of participants, Current Census, Personnel Report (LIC 500), Emergency Disaster Plan Protocols, Emergency Disaster Plan for Children's Residential Facilities (LIC 610C). The certification/decertification list of participants living units. There are (4) current Certificates of Compliance and (17) individual off-site units (14) are occupied, (1) is Non operational, 30-day notice issued . Off-Site Locations with a Current Certificate of Compliance approved by the Regional Office: S Moorpark Ave #21., Moorpark, CA 93033 with Thomas Chavira, Administrator S Moorpark Ave #23., Moorpark, CA 93033 with Thomas Chavira, Administrator. S. Moorpark Ave. # Moorpark CA. 93021 S. Rose Avenue #A., Oxnard, CA 93033 with Thomas Chavira, Administrator. (Non operational, 30-day notice issued) S. Rose Avenue #B., Oxnard, CA 93033 with Thomas Chavira, Administrator S. Rose Avenue #C Oxnard CA. 93033 E. Pleasant Valley Road. # Oxnard, CA 93033 with Thomas Chavira, Administrator. Del Norte #17, Ventura CA. 93004 Del Norte #9, Ventura CA. 93004 Amanda Drive # Ventura CA. 93003 Amanda Drive # Ventura CA. 93003 Corvette ST. Port Hueneme CA. 93045 Preble Ave. Ventura CA. 93003 Dallas Dr. #E Oxnard CA. 93033 E. Santa Clara Street #51, Ventura CA 93001 Preble Ave. Ventura CA. 93003 (Vacant) Future CoC: Preble Ave Ventura CA 93003 (Issued October 16, 2023) (Vacant) During an interview with PA, it was stated that the death certificate for an incident which occurred on 8/12/2023, as not been obtained. FA states he will follow up with the parole officer of the deceased to inquire, and will submit a copy of the death certificate to the Regional Office. (Continued on 809C Page 3 of 3) Page Staff Records Review: LPA Wilson and LPA Haynes reviewed three (3) staff records stored in individual personnel file provided by PA. LPAs ensured to thoroughly review the records of the primary active staff (i.e The Program Administrator, Case Manger, Social Worker). LPAs reviewed the Personnel Report (LIC 500) and confirmed that facility has two (2) Social Workers (1 per 12 participants) and one (1) Social Worker Supervisor (1 per Social Workers) who carries social worker caseload. The facility is currently operating within staff ratio. LPAs review of Facility's Personnel Report Summary on 10/12/2023 that indicates that all personnel have criminal record clearance has obtain the necessary clearances with DOJ, FBI, and Child Abuse Response. LPA reviewed staff qualifications and training hours. The facility has social worker personnel available on a 24-hour basis to respond to any emergency. Clients Records Review: LPA Wilson and LPA Haynes reviewed three (3) clients records which meet requirement. LPA reviewed the Admission Agreements, date of placement in unit, Emergency Contact information, and Needs and Services Plan. Staff Interviews: LPA Wilson and LPA Haynes conducted a confidential interview with one (1) on duty staff (PA). LPA obtained contact information for Social Workers to conduct interviews at a later time. Client Interviews: LPA Wilson and LPA Haynes was not able to conduct participant interviews. LPA Wilson and LPA Haynes obtained register of participants with contact information to conduct interviews at a later time. Location of clients for interviews is as follows: There are deficiencies at this time. (Please see 809D) Copy of report was read by PA and provided on site.

met_with: Program Administrator (PA)


summary: Facility Evaluation

raw_content:
Narrative:
On October 18, 2023 at 1: PM Licensing Program Analyst (LPA) Christine Wilson met with Program Administrator to continue the annual inspection at the following off-site locations (sub-administrative offices): Rose Ave #B Oxnard, CA. 93033 Rose Ave #C Oxnard CA 93033 4725S. Moorpark Ave # Moorpark, CA Client Interviews: LPA Wilson obtained register of participants with contact information to conduct interviews at a later time. Location of clients for interviews is as follows: Rose Ave #B Oxnard, CA. 93033 (C1) Rose Ave #C Oxnard CA 93033 (C2) 4725S. Moorpark Ave # Moorpark, CA 93021(C3) There are no deficiencies at this time. Report was reviewed with PA and provided, and a copy was provided..


summary: Facility Evaluation

raw_content:
Narrative:
On 4/9/2023, at 3: PM, Licensing Program Analyst (LPA) Regina Martin conducted a Case Management - Incident inspection at Divinity Prophet, Transitional Housing Placement Program (THPP). LPA Martin later spoke with Thomas Chavira II, Program Administrator via telephone to deliver findings concerning Special Incident Report submitted to CCL on 8/14/2023. The incident reported in part, on 8/12/2023, a participant was stabbed at the THPP's remote site by another participant resulting in the death of one participant. The participant who committed the stabbing was subsequently arrested as a result. CCL Investigator, Douglas Real conducted the investigation consisting of confidential interviews with facility residents, staff members and contacts with the Ventura Police Department. The investigation revealed residents live independently in their own residences and Facility Case Managers conduct weekly visits to the Participants homes to monitor and assess Participant progress as well as provide guidance and assistance with independent living. Participants #1 (P1) and #2 (P2) resided in the same apartment and their case manager visited both participants two days prior to the incident leading to P1's death. Records reviewed revealed P1 resided in the residence for ten days prior to the incident and no issues, problems, or safety concerns were reported to the case manager by either participant. Confidential statements revealed no apparent problems or issues with the care provided by the facility or its employees. Statements obtained further deny claims of neglect or lack of supervision resulted in the stabbing death of P1 by P2. Based on the statements gathered, and records reviewed the Department has determined there is not a preponderance of the evidence to prove that the alleged violation occurred or that neglect, or lack of supervision resulted in the stabbing death of P1 by P2. The Department's finding is therefore determined Unsubstantiated. There are no deficiencies per California Code of Regulations cited at this time. Exit interview completed. A copy of this report was provided to Program Administrator by email for signature.

met_with: Facility Representative


summary: Facility Evaluation

raw_content:
Narrative:
On November 17, 2023 at 12:33 pm, Licensing Program Analyst (LPA) Christine Wilson made an unannounced visit to the above listed facility, in order to conduct a case management deficiency. LPA Wilson met with (PA) Program Administrator. During the annual required inspection on October 18, 2023 to Divinity Prophet Transitional remote site for (C3), with (PA) Program Administrator; it was discovered that Law Enforcement was called during an incident that involved the resident. LPA Wilson spoke to staff (PA), and requested that the Incident Report be sent to Community Care Licensing ( CCL). An incident report for the youth (C3), Special Incident Report (SIR) dated 08/03/2023, was not received by CCL until 10/05/2023 , which poses a potential health and safety risk to persons in care The following Type B deficiency has been cited. (See LIC 809D) An exit interview was conducted and Plans of Correction was developed and reviewed with the licensee. A copy of this report and appeals rights were discussed and left with Program Administrator. (PA) whose signature on this form confirm receipt of these documents.

met_with: Program Administrator


facility_name: DIVINITY PROPHET- RIVERSIDE

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
On January 17, 2023, Community Care Licensing (CCL) received a complaint alleging that facility staff are engaging in human trafficking, facility staff are supplying client(s) with drugs, and facility staff do not ensure that clients are provided with a safe environment. CCL specifically received a report identifying S1 as the alleged perpetrator of these allegations. Regarding the allegations that S1 was engaging in human trafficking, the department received inconsistent information regarding whether S1 was engaging in human trafficking while C1 was in placement. There was no supportive evidence to prove that the alleged violation occurred or other known witness to the allegation. LPA did receive information through a confidential interview that S1 was observed taking clients out of the facility overnight to unknown locations. Confidential interview could not provide further details about the incident or whether these overnights with clients were linked to human trafficking. There were no other known witnesses to the allegation. Other confidential interviews denied that S1 was engaging in human trafficking. Regarding the allegations that staff are supplying client(s) with drugs and that facility staff do no ensure that clients are provided with a safe environment. SI, Jackson received inconsistent information whether S1 was supplying clients with drugs (marijuana) and whether S1 was providing a safe environment for clients in care. while other confidential interviews stated that the allegation was true. The department received inconsistent information regarding the allegations. Based on confidential interviews, the allegation that facility staff are engaging in human trafficking, facility staff are supplying client(s) with drugs, and facility staff do not ensure that clients are provided with a safe environment, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report along with the appeal rights will be emailed to Program Administrator, Tonnette Ellis.

Investigation Findings:
13On October 31, 2023, at 12: PM, Licensing Program Analyst (LPA), Cynthia Urena met with Divinity Prophet Transitional Housing Program (THP) Program Administrator, Tonnette Ellis to deliver the investigative finding for the above stated allegations. On January 24, 2023, at 1: PM LPA Daniel Mena initiated the investigation at the facility and collected pertinent documents to assist with the investigation process. LPA Mena informed the facility that Special Investigator (SI) Charlotte Jackson would be leading the investigation. SI, Jackson conducted interviews with three clients (C1, C2, C3), three staff members (S1, S2, S3) and a witness. LPA Urena conducted interviews with a County Social Worker (CSW), and continued interviews with three staff members (S1, S2, S3) and a client (C2). LPA made several attempts to re-interview C1 but was unsuccessful. LPA also attempted to interview client #4 (C4) however, due C4 to living out of state and last known contact information not valid an interview with C4 could not be conducted. Therefore, no additional information was obtained. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Cynthia Urena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 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 Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: DIVINITY PROPHET- RIVERSIDEFACILITY NUMBER: VISIT DATE: 10/31/2023

Allegations:
- UnsubstantiatedEstimated Days of Completion: Unsubstantiated Estimated Days of Completion: Unsubstantiated Estimated Days of Completion:

report_type: Complaint Investigation

met_with: Program Administrator, Tonnette Ellis

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On 6/24/2021, Licensing Program Analysts (LPA) Kendal Zirbes met with Administrator Kim Hayward Glover who granted access to the facility. The purpose of this inspection was to conduct an announced pre-licensing inspection for a Transitional Housing Placement Program (THPP) for Non-Minor Dependents (NMD) Sub Office. The administrative office was toured both inside and out with the Administrator at 12:05pm. Presently, the THPP NMD has requested a capacity of NMD's who will be placed in remote site apartments. Administrator was advised the apartments must be located within two hours of the administrative office. The THPP Administrative office is located in Riverside County. The office is located in a retail business establishment. The office consists of a reception area, two meeting/conference rooms, three case managers offices, three Administrative offices, locked storage area, two interview rooms, two bathrooms, and a kitchen area. In addition, there are five computer stations for the NMD's located in the reception area. The administration office was equipped with working office equipment, furniture, and supplies. According to Administrator, all participant files will be stored in locked cabinets within the case managers offices. The staff files will be located in a locked cabinet within the Administrators office. Currently the THPP is only staffed with the Administrator, all additional positions will be hired after obtaining the CCL license. During this inspection Component III for THPP NMD was conducted by LPA Zirbes. During this component, LPA discussed Post Licensing inspection that Community Care Licensing (CCL) may provide, solutions to problematic areas, overview of Title 22, THPP regulations; NMD regulations, personal fingerprint requirements, associations, abuse reporting requirements and licensing fees. LPA informed the Administrator, about the reporting requirements specifically, AB388 and LIC LE. Furthermore, Provider Information Notices (PIN), Resource Guides and the process for designating a new facility Administrator was reviewed. Licensee was advised that this pre-licensing report and application will be reviewed by the Department. The facility will be notified once they are licensed as a THPP NMD. An exit interview was conducted with Administrator Kim Hayward Glover and a copy of this report was emailed to the facility.

visit_type: Prelicensing

met_with: Administrator Kim Hayward Glover


summary: Facility Evaluation

raw_content:
Narrative:
On August 8, 2022 at 9:10 am, Licensing Program Analysts (LPA) Darlene Almaraz-Oseguera met with Administrator Kim Glover who granted access to the facility. The purpose of this inspection was to conduct an announced post-licensing inspection for a Transitional Housing Placement Program (THPP) for Non-Minor Dependents (NMD) Sub Office. The administrative office was toured both inside and out with the Administrator. Currently the THPP has twenty-one NMD's placement's and fifteen remote site apartments. The remote apartments were all within two hours of the administrative office. The THPP Administrative office is located in Riverside County. The office is located in a retail business establishment. The office consists of a reception area, two meeting/conference rooms, three case managers offices, three Administrative offices, locked storage area, two interview rooms, two bathrooms, and a kitchen area. In addition there is a computer lab and there are motivational signs, along with an educational and employment resource area. The office is equipped with working office equipment, furniture, and supplies. LPA reviewed seven NMD files. The files were stored in locked cabinets within the case managers offices. LPA also reviewed all staff files which was a total of four. The staff files were in a locked cabinet in the Administrators office. Based on the annual inspection on this date, the THPP is in compliance. An exit interview was conducted with Administrator Kim Glover and a copy of this report was emailed to the facility.

met_with: Kim Glover


summary: Facility Evaluation

raw_content:
Narrative:
On June 14th 2023, Licensing Program Analysts (LPA's), Darlene Almaraz-Oseguera and Emina Preciado arrived at Divinity Prophet, Riverside, Transitional Housing Placement Program (THPP). LPA's met with Program Administrator, Shari Wolvek, who granted access to the facility. The purpose of the visit was to conduct an unannounced required two year inspection for the THPP for Non-Minor Dependents (NMD's). The administrative office was toured both inside and out with the Administrator. Currently the THPP has twenty five NMD placement's and nineteen remote site apartments. The remote apartments were all within two hours of the administrative office. The THPP Administrative office is located in Riverside County. The office is located in a retail business establishment. The office consists of a reception area, one meeting/conference room, three case managers offices, three Administrative offices, locked storage area, two interview rooms, two bathrooms, and a kitchen area. In addition there is a computer lab and there are motivational signs, along with an educational and employment resource area. The office is equipped with working office equipment, furniture, and supplies. LPA's reviewed six non-minor dependent files. All files reviewed were complete and had the required documents. Facility provided a copy of the drill log of the emergency disaster and mass casualty plan. LPA's reviewed all staff files which was a total of three. All staff met the minimum qualifications and training requirements. A review of records shows that all staff have FBI, DOJ, and Child Abuse Index Check clearances. The staff files were in a locked cabinet in the Administrators office. Staff was informed that each Social Worker should maintain a 1 to 12 ratio, which should never be exceeded. Staff is aware of submitting unusual incident reports as needed to the Department and to include all Law Enforcement contacts. Based on observation and record review, the annual inspection on this date, the THPP is in compliance. An exit interview was conducted and a copy of this report was provided to Administrator, Shari Wolvek.

met_with: Shari Wolvek, Program Administrator


facility_name: DIVINITY PROPHET-GARDENA

raw_content:
Investigation Findings:
13On June 25, 2021 at 2: PM, Licensing Program Analyst (LPA), Charmetha White made an unannounced visit to Divinity Prophet-Gardena THPP for the purpose of delivering findings on the on attached complaint investigation. LPA spoke to Office Manager, Dosalyn Smith and discussed the findings. During the course of this investigation LPA interviewed pertinent parties, reviewed relevant information, and conducted a walk through of the unit. Staff denied the allegations. Staff said the unit is safe, that Child #1 was provided a new bed when she moved into the unit, and that Child #1 has not voiced any concerns about her roommate nor the area to staff. Staff stated there is also a Sheriff's and Probation Department located a few blocks from the unit. Child #1 stated she is fine living in unit, that she does not have any issues with her roommate, but said she could use a bigger bed because she is tall. Child #2 said she does not have multiple people come in and out of the unit, but said she does have a friend over every now and then. Based on information obtained this investigation is being closed Unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the allegations occurred. No deficiencies cited. Exit interview completed. A copy of this report was left with facility Staff. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 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 2

Allegations:
- UnsubstantiatedEstimated Days of Completion: Unsubstantiated Estimated Days of Completion: Unsubstantiated Estimated Days of Completion:

met_with: Office Manager - Dosalyn Smith


summary: Complaint Investigation - Substantiated

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Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward completed the investgation of the above allegation. LPA spoke to the CEO of Divinity Prophet, the Probation Officer of Participant #1 and the orginal complainant. LPA also searched for SIR's regarding the departure of Participant #1 from the program. There were no SIRs found dor this matter. Per emailed statement provided by CEO Hope Ricks, an SIR was not submitted because Participantt #1 left the program on his own after notifying staff of his intent to do so. However, per Title Section 86261(d) the licensee shall notify the Department when a non-minor dependent is discharged in accordance with Title 22, Section 86268.4(c)(1)(B). Based on the information obtained during this investigation, the allegation that the licensee did not follow proper discharge procedure is resolved as substantiated. A finding that an allegations is substantiated means that the "preponderance of the evidence" standard has been met. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 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 Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: DIVINITY PROPHET-GARDENAFACILITY NUMBER: 198209608

met_with: Meka Brown, Director of Programs, Licensed Care

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Substantiated

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Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward met with Meka Brown, Shari Wolvek & Deborah Smith to discuss the allegation that the facility did not provide a full crib for the newborn infant of Participant #1. LPA Jones-Steward previously spoke to Particiapant #1 and verified that the crib in her apartment has no mattress. Per Ms. Smith there was a full crib offered but Participant #1 did not want that crib so a mini-crib was purchased. However the mini-crib does not have a mattress and Ms. Smith has been unable to find one that fits. Ms. Smith, Ms. Wolvek and Ms. Brown stated that there will be a full crib or bassinet in place within a matter of hours. Based on the information gathered during this investigation the above allegation is substantiated. Subtantiated means that the "preponderance of the evidence" standard has been met. Facility was cited under Title 22 86088(b)(1) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 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 Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: DIVINITY PROPHET-GARDENAFACILITY NUMBER: 198209608

met_with: Meka Brown, Director of Programs. Licensed Care


summary: Complaint Investigation - Unsubstantiated

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Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward investigated the above allegations. LPA spoke with Meka Brown, Shari Wolvek, Diana Flaggs and Maurissa Mitchem. However no specific client was named as having had the above inappropriate fines levied against them. Without such information the allegations cannot be substantiated nor negated. Therfore they are resolved as unsubstantiated. Unsubstantiated means that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 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

met_with: Meka Brown, Shari Wolvek


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Narrative:
The two toured units posed some physical plant concerns of a broken sliding door, cracked mirror, and front door panel damage. These concerns were cited and addressed during the initial visit. LPA was unable to justify rodents and expired food due to specific units not identified in the photos. Confidential interviews indicated that participants could leave their unit to go to work, school, and conduct personal business. Per staff interviews, the following was stated: Participants are required to notify case manager if they will be gone beyond a 24-hour period. Participants are required to work or be enrolled as a requirement of the program. The program was providing transportation prior to COVID but now encourages participants to take public transportation. Participants are responsible for purchasing their own hygiene products. The allegations stated minors are not provided allowance however, per client and staff interviews, an allowance is given every two weeks. There is no supporting evidence and it is unclear which clients did not receive an allowance. Per staff interviews, support was provided for budgeting and saving however, due to COVID it stopped and there isn't a set date for it to return. While touring one of the units, LPA/LPM observed a participant asking for parenting and anger management classes and staff stated they would accommodate. The initial photos provided, were not dated nor did they identify which unit they were taken in. The concerns do not reflect in the allegations and the alleged allegations occurred two years ago. Based on review and analyzing all of the evidence, the LPA has found this complaint to be Unsubstantiated, meaning the allegation may have happened or is valid, but there is not a preponderance of evidence to prove that the alleged violation occurred. There were no deficiencies cited at this time. A copy of this report and appeal rights will be emailed to the Case Mgr Supervisor and The Program Administrator Due to technical difficulties with the LPA's printer.

Investigation Findings:
13On June 29, 2022, at 10:45am Licensing Program Analyst (LPA), Enrique Hernandez, arrived at the facility for the purpose of concluding complaint findings of the investigation conducted by LPA Kuliema Callaway and LPM Lakescia Smith. LPA met with Deborah Smith Case Mgr Supervisor and Paisley Moore The Program Administrator at Divinity Prophet- Gardena. During the investigation, LPA Kuliema Calloway and LPM, Lakescia Smith reviewed documentary evidence, photos, toured two living units, and conducted confidential interviews. LPA and LPM attempted to tour three additional unit sites but were unsuccessful. One of the attempted sites in Carson had a lock box on the door. LPA contacted staff to inquire and they did not respond. Confidential interviews provided inconsistent statements and no witnesses to corroborate allegations. During the tour, there were no observations of drugs or dangerous objects however, LPA/LPM did observe empty liquor bottles in one of the units. Living units were observed to be clean, sanitary, and without odor. Continue on LIC9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Enrique M Hernandez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 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 Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: DIVINITY PROPHET-GARDENAFACILITY NUMBER: VISIT DATE: 06/29/2022

Allegations:
- UnsubstantiatedEstimated Days of Completion: Unsubstantiated Estimated Days of Completion: Unsubstantiated Estimated Days of Completion:

met_with: Deborah Smith Case Mgr Supervisor


raw_content:
Narrative:
Although the allegations may have happened are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has determined that the allegations Personal Rights are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There are no deficiencies noted or cited. An exit interview was conducted, and a copy of this report was left at the Program Administrator.

Investigation Findings:
13On October 27, 2022 at 10: AM Licensing Program Analyst (LPA), Rosslyn Gray made an unannounced visit to DIVINITY PROPHET-GARDENA to conclude the investigation on the above allegations. LPA met with the Program Administrator to conclude the investigation and to deliver the findings. During the investigation LPA-Gray interviewed and accounted for all available relevant parties; and gathered pertinent information regarding the allegations. Based on the interviews and statements obtained during the investigation process, the allegation cannot be corroborated because supporting evidence includes the following: The Licensee denied the allegations.LPA accessed and found discrepancy in the alleged victims' statements. There is no evidence or witnesses to support that the facility "Staff did not afford a NMD privacy while in care and that staff mishandled a NMD while in care. Documented evidence and confidential interviews were congruent and confirmed that the youth obtain the proper allowances; that the staff followed provided proper protocol and directives when entering the participants unit and there were no witnesses present to confirm that the staff mishandled a NMD while in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 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 Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: DIVINITY PROPHET-GARDENAFACILITY NUMBER: VISIT DATE: 10/27/2022

Allegations:
- UnsubstantiatedEstimated Days of Completion: Unsubstantiated Estimated Days of Completion: Unsubstantiated Estimated Days of Completion:


raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward completed the complaint investigation that was began by LPA Charmetha White. LPA Jones-Steward spoke to three of the five current and former particiapants that were also enrolled in the Divinity Prophet program in 2020. The other two participants were unreachable. The participants all denied any major problems with receving their allowances. The majority stated that they felt safe in their apartments. They also stated that repairs were generally made in a timely manner, although one stated that they had to pay for repair of damages out of their allownance. LPA also reviewed allowance logs for the time period in question and allowances were always signed for according to procedure set forth by Divinity Prophet. Based on the vaguries of these allegations, the age of the complaint when received by this LPA and the small pool of clients available for interview, the above allegations are resolved as unsubstantiated. Unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that it did happened. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 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 1

met_with: Shari Wolvek, Director of Quality Assurance & Compliance


raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward met with Ms. Meka Brown and Ms. Sheri Wolvek to resolve the above allegations. During the investigation, LPA interviewed staff, C1 and the original reporter. LPA reviewed PEX card statements and discussed them with Ms. Wolvek and C1. The situation of C1's alleged lack of a consistent case worker was discussed with staff, C1 and with the original reporter. Based on confilicting information gathered via interviews and record reviews LPA was not able to conclude that the allegations are true or false. Therefore they are resolved as unsubstantiated. Unsubstantiated means that an allegation lacks a preponderance of the evidence to prove that the violation occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 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

met_with: Meka Brown, Director of Programs


raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward investigated the above allegation. LPA interviewed Participant #2 and the Case Manager for Participant #1. LPA could not make contact with Participant #1. During the course of the investigation, it was revealed that Divinity Prophet was made aware that a visitor to the living unit of Participant #1 and Participant #2 did fire off his handgun during an argument with Participant #1. However Divinity Prophert staff did not report the incident to Community Care Licensing because they thought that DCFS staff would make the call. Based on interviews with the staff and participants, this allegation is substantiated. Substantiated means that an allegation is considered valid because the preponderance evidence standard has been met. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION , N. Continental Blvd. #290B This is an official report of an unannounced visit/investigation of a complaint received in our office on 05/05/2022 and conducted by Evaluator Connie Jones-Steward COMPLAINT CONTROL NUMBER: 34-CR- FACILITY NAME:DIVINITY PROPHET-GARDENAFACILITY NUMBER: ADMINISTRATOR:TAMARA PERKINSFACILITY TYPE: ADDRESS: LA TIJERA BLVD. STE.106TELEPHONE: (310) 327- CITY:LOS ANGELESSTATE: CAZIP CODE: CAPACITY:140CENSUS: DATE: 05/10/ UNANNOUNCEDTIME BEGAN: 01: PM MET WITH:Margaret Davis, Executive DirectorTIME COMPLETED:01: PM 9Buildings and Grounds 1) The unit that participant #1 lived in had a vermin infestation INVESTIGATION FINDINGS: 13Licensing Program Analyst Connie Jones-Steward investigated the above allegation. LPA interviewed Participant #2 and the Case Manager for Participant #1. LPA could not make contact with Participant #1. During the course of the investigation, staff and clients provided contradictory accounts. Therefore, LPA was not able to conclusively determine if the unit previously shared by Participant #1 and Participant #2 was infested with vermin. Based on lack of congruent accounts and lack of physical evidence the allegation is resolved as unsubstantiated. Unsubstantiated means that an although an allegation may have happened or is valid, there is not a preponderence of evidence that it is valid. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 2 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: DIVINITY PROPHET-GARDENAFACILITY NUMBER: 198209608

met_with: Margaret Davis, Executive Director


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward investigated the above allegation. Per staff and client interviews, the facility does provide cell phones for the participants but not landlines. Per staff interviews cell phones were provided in lieu of landlines at the request of social workers and probation department. Per today's discussion, landline service will be provided by the end of May 2022 per agreement reached with Maurissa Mitchem and Michael Scroggins of the Department of Children and Family Services. Based on on interviews with staff and clients, landlines were not provided in the living units of the participant. Therefore this allegation is substantanitated, A substantiated complaint means that the preponderance of evidence standard has been met. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 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 Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: DIVINITY PROPHET-GARDENAFACILITY NUMBER: 198209608

met_with: Shari Wolvek


raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward spoke with executive director Margaret Davis about the allegations, Per Ms. Davis, C1 was moved to a new location in December 2021 because the management at the buliding where he was living would not do anything about the pest control issues. Ms. Davis provided invoices for new furnishings which were delivered to his new apartment as proof that client was relocated. Per Ms. Davis, C1 no longer resides with Divinity Prophet. He left in March 2022. Therefore LPA was not able to speak to C1. Likewise the administator and the case manager during the period of the allegation no longer work for Divinity Prophet. Based on the available information, the allegation is resolved as unsubstantiated. Unsubstantiated means that though an allegation may be true, there is not a preponderance of evidence to prove that it did or did not happen. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 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 1

met_with: Margaret Davis, executive director


raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward investigated the above allegation. LPA interviewed Participants #2 and #3, Divinity Prophet Staff and DCFS social workers. LPA also reviewed work orders and purchase orders and receipts. LPA was not able to gain entry into the units of the Participants. Based on information gathered during the interviews of involved parties, it was determined that Divinity Prophet living units of Participant #2 and Participant #3 were often in a state of disrepair. The units were at times plagued with issues such as vermin infestation, plumbing issues and carpets in need of cleaning. Therefore the allegation is resolved as "substantiated". A substantiated finding means that the "preponderance of the evidence" standard has been met. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B This is an official report of an unannounced visit/investigation of a complaint received in our office on 12/12/2022 and conducted by Evaluator Connie Jones-Steward COMPLAINT CONTROL NUMBER: 34-CR- FACILITY NAME:DIVINITY PROPHET-GARDENAFACILITY NUMBER: ADMINISTRATOR:TAMARA PERKINSFACILITY TYPE: ADDRESS: LA TIJERA BLVD. STE.106TELEPHONE: (310) 327- CITY:LOS ANGELESSTATE: CAZIP CODE: CAPACITY:0CENSUS: DATE: 05/10/ UNANNOUNCEDTIME BEGAN: 02: PM MET WITH:Margaret Davis, Executive DirectorTIME COMPLETED:02: PM Particiapant living units have foul odors INVESTIGATION FINDINGS: 13Licensing Program Analyst Connie Jones-Steward investigated the above allegation. LPA spoke to Divinity Prophet staff, DCFS Social Workers and two Participants. The participant who lived in the unit reported to have a foul odor was not available for interview. The other two participants denied having any strong or foul odors coming from their apartments. Based on conflicting accounts by the parties interviewed, this allegation is resolved as unsubstantiated. An unsubstantiated finding means that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 3 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: DIVINITY PROPHET-GARDENAFACILITY NUMBER: 198209608

met_with: Margaret Davos, Executive Director


raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward investigated the above allegation. LPA interviewed Divinity Prophet staff and reviewed C1's financial records. C1 could not be reached for comment. Neither her social worker or the ombudsman office have a current telephone number for her.Per review of C1's available financial records, she did not have a savings account because she opted out of the choice to establish one. Her discharge records show that she was formally discharged on 06/02/22 but did not leave the unit until 06/06/22. Since she was no longer an actual participant in the program, she did not receive an allowance for that five day period. Based on the available information it appears that Client #1 had no funds due her upon her discharge from Divinity Prophet. However due to an inability to obtain a statement from C1, this cannot be fully verified. Therefore the allegation is resolved as unsubstantiated. an ubsubstantiated findings means that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 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 1


raw_content:
Investigation Findings:
13The above allegations were investigated by LPAs Connie Jones-Steward and LPA Daphne Edison. LPA Edison spoke with Divinity Prophet staff. LPA Jones-Steward spoke with the social worker for Clients #2 and #3. Neither LPA Jones-Steward nor Edison were able to make contact with any of the Clients. LPA Edison attempted to gain entry into the apartments of Clients #1 and #2 but was unsuccessful as clients did not respond to her requests. Based on the inability to interview the clients or gain entry into their apartments, the above allegations are resolved as unsubstantiated. An unsubstantiated finding means that an allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 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 1

met_with: Margaret Davis, Executive Directo


summary: Facility Evaluation

raw_content:
Narrative:
On September 14, 2021 at 9: AM, Licensing Program Analyst (LPA) Charmetha White made an unannounced visit to the above location for the purpose of conducting a Case Management Incident visit in response to a Client Death. LPA met with Administrator, Tamara McKinstry. Community Care Licensing (CCL) received a Law Enforcement Contact/Special Incident Report stating Client #1's infant died the morning of 09/10/2021. The incident was reported to Administrator and staff went to the remote location to provide support to the client and gain additional information. During this visit, LPA reviewed Client #1's file and obtained a statement from staff regarding the death of client's infant and the actions taken by the staff following the notification of the incident. LPA was informed that Los Angeles County Sheriff's Department went to the location and took a report. LPA obtained police report number and copies of documents from Client #1's file. Additionally, staff was advised to obtain and forward a copy of the death certificate to CCL once received. There was no evidence to support that staff violated any policies and procedures. No deficiencies cited. Exit interview completed. A copy of this report was left with staff.

met_with: Administrator - Tamara McKinstry-Perkins


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with Ms. Brown and Ms Wolvek to discuss previously resolved complaint #34-CR-20220204130028. LPA explained that one of the findings within the complaint would be changed from unfounded to substantiated upon review by management. LPA also discussed the appeal process with Ms. Brown and Ms. Wolvek.

met_with: Meka Brown & Shari Wolvek


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with Ms. Wolvek and other personnel to observe the living units with which DCFS expressed concerns. LPA and Ms. Wolvek visited three units. LPA observed that in Unit #1 there were no current deficiencies. However in Unit 2, the shower door was off track and one of the the two ovens did not work, In Unit #3, the wall heater did not work and the carpet in the hallway was loose and torn. LPA observed that there were no land line telephone service in the units. However all clients had personal cell phones, Ms. Wolvek stated that the organization is in the process of providing land line service to all units. LPA discussed the deficiencies with Ms, Wolvek and issued a plan of correction,

met_with: Shari Wolveck, Director of Quality Assurance


summary: Facility Evaluation

raw_content:
Narrative:
On April 27, 2022 at 9: AM Licensing Program Analyst, Kuliema Calloway and Licensing Program Manager, Lakescia Smith, made an unannounced visit for the purpose of a follow up Case Management- Deficiencies visit. LPA and LPM met with Tamara Perkins, Program Administrator for Divinity Prophet and informed Tamara that during a physical plant inspection on 4/8/2022, multiple compliance concerns were observed in Participants 1, 2 and 3's unit. However, the initial report did not address all compliance concerns. The following concerns were observed: Liquor bottles on top of the refrigerator and in a box on the floor in the kitchen. There were beer bottles and beer cans on the balcony in a box. The sliding glass door for P1's bedroom did not have a latch/lock or a screen. The participant was provided with a small, window lock to secure the door. In the bedroom for P2, the closet glass door has multiple cracks. LPA and LPM took several pictures of the deficiencies in the units. LPA requested and obtained copies of the maintenance request on 4/11/2022. The facility is being cited for violation of Interim Licensing Standards, Section 86022 (e) Plan of Operation. Exit interview conducted, appeal rights provided.

met_with: Tamara Perkins, Program Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with Ms. Shari Wolvek to conduct the Required 2 year inspection. At this time, the facility is in the process of relocating, therefore most equipment is packed in anticipation of the move. There are currently no clients in placement. There is one social worker and one social worker supervisor on staff. There are no participant units associated to this license currently. LPA Jones-Steward discussed with Ms. Wolvek, the documents required for the relocation: LIC 200, LIC 610, LIC 999, LIC 500, a check to cover the relocation fee and a board resolution to approve the move. LPA Jones-Steward reviewed the staff files for the social worker and the social work supervisor. The social worker was found to not have the required Masters Degree. The facility was cited under Title Section 86065.3 (e) and advised to submit an exception request to allow Staff #2 to work as a social worker.


summary: Facility Evaluation

raw_content:
Narrative:
While investigating complaint # 34-CR- Licensing Program Analyst Connie Jones-Steward was made aware of organizational changes that were not reported to Community Care Licensing as required by Title 22. Specifically there was an unreported change to the executive director and there is currently no administrator. The licensee was cited under Title Sections 80061(e) and 86064(a)


facility_name: DIVINITY PROPHET-PALMDALE

summary: Facility Evaluation

raw_content:
Narrative:
This Report Has Been Amended from the Previous Date 12/08/ Due to Confidential Information Listed. On December 8, 2021 at 10: AM Licensing Program Analyst, (LPA) Rosslyn Gray made an unannounced inspection at for the purpose of conducting Pre-Licensing Inspection for DIVINITY PROPHET- PALMDALE (THPP) Transitional Housing Placement Program LPA met with the Administrator, Elizabeth Richard who granted access into the Administrative Office and provided a tour. The Administrative Office is located at: 38345 30th St. East Suite B-1A Palmdale, CA 93550. The office is located on the 1st floor of the building. LPA observed the entire Administrative office. The restroom is located outside the administrative office to the left. The facility is licensed to provide Transitional Housing Placement for Non-Minor Dependents (NMD) for 27 participants ages eighteen (18) through twenty-one (21). There are currently seventeen (17) participants in placement residing in the program -Remote Sites. The Administrator stated that there are ten (10) Remote Sites are all located in the Palmdale and Lancaster. The administrator confirmed that no staff is residing in the Remote Sites. There are no bodies of water on the premises. LPA viewed the location of the Remote Sites and Residential Lease confirmed for Palmdale and Lancaster. LIC Page 1 of This Report Has Been Amended from the Previous Date 12/08/ Due to Confidential Information Listed. LPA's observed the entire Administrative office. The office is set up as follows: At the entrance. There is a front lobby there is a sliding glass Receptionist Window to greet clients and authorized representatives to sign in. There is locked door adjacent to the receptionist window that leads to the main administrative conference area. The Administrators office; is equipped with an office desk, desk top computer, office supplies, locked file cabinet, a book shelf utilized to store files. The shut valves are located inside the door. There is large conference table with ten (10) chairs; two (2) Case Management offices (desk, table top computers and chairs) an interview office utilized for residents, social workers and any other authorized representative. There are 2 seated desks with office supplies, a book shelf with additional office supplies; office equipment (printer fax machine) (1) computer, portable folding table and covered trash cans. There a small size kitchen equipped with cabinets, a sink, microwave, coffee maker, and supplies for the clients, food pantry, additional supplies for the units. LPA observed the THP+FC residence files and staff files were stored in the locked file cabinets. Currently the facility is staffed with two (2) Social Workers. The administrator is aware that the social worker meets the regulation requirements ratio 1 to 24 for supervision. The administrator is aware of submitting unusual incident reports as needed. The administrator ensures that the THPP residents are provided care and supervision by conducting visit at minimum of 1x weekly for one (1) hour session. The administrator stated that client independently cook their own food. The THPP provides a distributes allowances of $100 including gifts cards for incentives. The administrator conducts events to encourage the residents to build rapport; establish appropriate relations, discuss boundaries and limitations. Continued LIC Page 2 of LPA reviewed three (3) staff files and five (5) client files contain; (Admission agreement/ COVID-19/Intake/ Policy and Procedures, /Allowance Logs/Savings Log/Case Notes/Goals/ Incident Reports/Disciplinary notes/Vital documents/Mental Health/Disaster plan/Physical Health/Employment Education/Life Skills/County Benefits/Files and Transitional Resources LPA reviewed the LIC- Personnel Report; and the Register of Facility Client/Residents staff roster. LPA confirmed criminal record clearances with DOJ, FBI, and Child Abuse Index Check clearances for three (3) staff. LPA interview one (1) Staff/Administrator Per California Code of Regulations, Title Regulations, Division 6, Chapter 7, there are no deficiencies to be cited at this time. Exit interview was conducted with the Administrator and a copy of this report was left with the Administrator LIC Page 3 of 3

met_with: Program Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On May 23, 2022, at 12: PM., Licensing Program Analyst, Kuliema Calloway and Licensing Program Manager, Lakescia Smith conducted an unannounced Post-Licensing visit to 38345 30th Street Ste. B-1A, Palmdale, CA 93550. LPA and LPM met with Annlelise Galaviz, Case Manager Supervisor and conducted a tour of the administrative office. LPA was informed that Elizabeth Richard is no longer the Program Administrator and administrator qualifications were submitted one month ago for Annelise Galaviz to become the new Program Administrator. The Administrators office; is equipped with with four offices, a lobby, and a kitchen. A locked file cabinet is used to store client files and staff files are stored in one of the offices. The license is posted on the wall adjacent the conference table and LPA observed the Certificate of Compliance for the residential units. LPA will follow up with Annelise regarding on-call staff, Jaime Kirk who is not associated with the facility. LPA was informed it is currently one case manager and one case manager supervisor. One case manager is part-time and should reflect on the personnel report. Eight NMD's are assigned to Annelise and four NMD's are assigned to Carlos MIna. LPA advised staff to update personnel report to reflect staff current work schedule and submit to CCL. The following deficiency was cited (See 809D) Exit interview completed. A copy of this report was provided to the staff, Annelise Galaviz. Note: LPA will return at a later date to complete the inspection.

met_with: Annelise Galaviz, Case Manager Supervisor


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On May 27, 2022, at 11: AM., Licensing Program Analyst, Kuliema Calloway and Licensing Program Manager, Lakescia Smith made an unannounced Case Management Annual Continuation Visit at the Administrative Office. LPA and LPM met with staff, Annelise Galaviz and requested to review staff and client files. A file review was completed but LPA will return to complete the client record's review. LPA requested for Meka Brown, Director of Programs' file to be brought to the office for review since she is the acting Administrator for the this facility and filling in for Elizabeth Richard that is currently on a leave of absence. The following deficiencies were cited (See 809D). Exit interview completed, a copy of this report was given to Annelise Galaviz.

Deficiencies:
86066(a): Personnel Records

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information


summary: Facility Evaluation

raw_content:
Narrative:
On September 23,2022 at 10:45 a.m., Licensing Program Analyst (LPA) Kuliema Calloway made an unannounced Case Management Continuation Inspection visit to conduct an Annual inspection. LPA met with Annelise Galaviz, Program Administrator, who granted access and a tour of the administrative office located at 38345 30th Street East Ste. # B-1A, Palmdale, CA., 93550. The facility is a Transitional Housing Placement Program licensed to care for Non- Minor Dependent clients. (See confidential name list LIC 811 dated 09/237/2022). LPA conducted staff interviews with Staff (S1) and (PD). LPA continued the annual inspection by reviewing the Client Record's for Clients (C1), (C2), (C3), and (C4) and Staff Records for Staff (S1) and (PD). [See LIC 811 dated 9/23/22]. There was one deficiency cited at this time. See D. Exit interview was conducted. A copy of this report was left at the facility with Annelise Galaviz, Program Administrator.

met_with: Annelise Galaviz, Program Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 02/09/2023 at 9:30AM Licensing Program Analyst (LPA) Olivia made an unannounced to Divinity Prophet Transitional Housing Placement plus Foster Care (THP + FC) Administrative Office for the purpose to conduct the Annual/Required licensing Inspection. LPA Rosas met with Staff#1(S1) and Staff#2 (S2) who granted access to the Administrative Office and an inspection was conducted together. Individuals mention in this report are identify on the Confidential Names List (LIC811) dated 02/09/23. The annual fees are current. LPA Rosas inspected following during the inspection: The facility is licensed to provide Transitional Housing Placement plus Foster Care (THP + FC) and Non-Minor Dependents (NMD) to twenty-seven (27) participants ages eighteen (18) through twenty-one (21). There are currently six (6) participants in placement at different remote sites in the Antelope Valley (sites are located in Palmdale and Lancaster). The facility currently has Administrator serving as the Social Worker (1 per 12 participants) and the Director of Programs as the Social Worker Supervisor (1 per Social Workers). The facility is currently operating within staff ratio. If the capacity increased, then additional personnel would need to be added. The administrative office is set up as follows: The administrative office is located at E TH, EAST Suite B-1A., Palmdale, CA 93550. Administration office is equipped with (4) four offices with reception area, and a kitchen. Staff records and client records are maintained in inside locked cabinet. All posting requirements were met. Report continues on LIC 809-C Page 1 of LPA Rosas reviewed following during the inspection: LPA Rosas requested the following forms for review, copy of Register of participants, Current Census, Personnel Report (LIC 500), Emergency Disaster Plan Protocols, Emergency Disaster Plan for Children's Residential Facilities (LIC 610C). The certification/decertification list of participants living units. Staff Records Review: LPA Rosas reviewed (2) two staff files. LPA reviewed the Personnel Report (LIC 500) and confirmed that facility has currently has Administrator serving as the Social Worker (1 per 12 participants) and the Director of Programs as the Social Worker Supervisor (1 per Social Workers). The facility is currently operating within staff ratio. If the capacity increased, then additional personnel would need to be added. LPA review of Facility's Personnel Report Summary on 02/06/2023 that indicates that all personnel have criminal record clearance has obtain the necessary clearances with DOJ, FBI, and Child Abuse Response. The facility personnel available on a 24-hour basis to respond to any emergency. Clients Records Review: LPA reviewed three (3) clients records which meet requirement. LPA reviewed the Admission Agreements, date of placement in unit, Emergency Contact information, and Needs and Services Plan. Staff Interviews: LPA conducted a confidential interview using the inspection tool interview form with one (1) staff. LPA Rosas together with S1 conducted a collateral visit to three (3) remote sites located in Palmdale, CA. LPA Rosas during inspection the housing units did have telephone service but had no dial tone. S2 was able to provide LPA Rosas with a copy of Verizon monthly telephone. The monthly bill showed remote sites phone numbers listed as active line. S1 and S2 stated, the living units do have telephone service and checking with Verizon on why they are not working. LPA Rosas by email send the following PINS to S1 by email: PIN 21-26-CRP Transitional Housing Placement Provider (THPP) Nonsubstantive Changes to Regulations Update, PIN 22-06-CCLD Guardian Background Check Best Practices, PIN 22-07-CCLD Guardian Webinar For Licensees and Providers, PIN 21-20-CRP Statewide Launch Of New Inspection Tools For Children's Residential Licensees. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was left with S1.

met_with: Staff#1 (S1)


facility_name: DOWNS & MARTIN THP+FC

summary: Facility Evaluation

raw_content:
Narrative:
A TEAMS Conference Meeting was conducted on Wednesday, March 30, 2022 at 10:00 am. The purpose of this meeting was a Program Statement Review to discuss the Application/ Program Statement submitted to the Community Care Licensing office. Meeting Attendees: Latricia Rogers- Licensing Program Analyst Christina Barns- Licensing Program Manager Cheraki Davis- Licensing Program Manager Emmett Downs- Program Director Anita Downs- Human Resource Director Rosa Hernandez- Housing Manager Jesse Vega- Program Manager The topics listed below were discussed during the meeting: Licensing Program Analyst (LPA) Rogers asked E. Downs for clarification regarding locations for physical sites/ housing for future participants as Application (LIC 200) only referenced an address for an office space. E. Downs informed LPA Rogers that they do not currently have placement sites and that they are in partnership with several apartment complexes for future placements. FORMS REVIEW · Supplemental Financial Information Form (LIC 401a) Needs Signature · Balance Sheet (LIC 403) Needs Signature · Surety Bond (LIC 402) Needs Signature · Personnel Report (LIC 500) Missing Support Staff · Transitional Housing Program Plus Foster Care (SOC 179) Change Section 12 to reflect Remote site ORGANIZATIONAL CHART Update Organizational Chart to match Job Descriptions submitted: · Organizational Chart Staff: o Director/ Administrator o Consultant/ Trainer o Program Manager o Housing Specialist o Case Worker Supervisor o Case Worker o Support Staff · Job Description: o Executive Director o Social Worker o Housing Specialist o Case Worker o Administrator LOCATION Address on lease agreement (Latham St. #140, Riverside) is a lease for office building. Where would the actual Staffed Site and Remote Site be located? STAFF · LIC500 does not show qualified Social Work personnel available on 24-hour basis for any emergency. (Title Section 86065 (5). · Social Worker qualification does not match Title Section 86065.3 regulations. · Executive Director/ Administrator qualification does not match Title Section 86064 regulations · Social Work Supervisor Job Description/ Duties/Qualifications missing. · Program Supervisor Job Description/ Duties/Qualifications missing. TRAINING · Qualifications for trainer Dr. D. Finklestein, PhD. · Training of New Employees · Ongoing Training · Initial Training Requirements (not listed) · Annual Training Requirements (not listed) EMERGENCY PROCEDURES Program Supervisor will rotate weekly responsibilities for managing 24 hour on-call phones. This is a duty for a Social Worker. PROGRAM STATEMENT · Does not address removal and/ or discharge procedures · Does not address telephone service for staffed site/ remote site (Administrative office is at different location) · Transportation for staffed sites? · Obtain valid Driver's License and Insurance for staff · Page #45- # Will NMD will learn how to locate a home or apartment in their price range. · All staff should be located in one section not throughout program statement. · Explain what is section 84470 as listed on page #48 · What are the disciplinary/ discharge policies for Remote Site · Where is the Program Policies & Shared Living agreement for Remote Site · Shared Living Agreement should be a part of the Program Statement and not only a sample of signed agreement for client and staff. · Medical Emergencies/ Personal Safety Plans · Unauthorized Purchases/ Grounds for Termination · Disciplinary measures (for each site) ITEMS NOT INCLUDED/ DETAILED · Procedures for Complaints · Emergency Plan/ 24-hour emergencies (how will handle) · Procedures for paying rent/ utilities/ consequences for not doing so · Furnishings (upon discharge from program? What can client keep/ take?) After TEAMS Meeting LPA Rogers contacted Emmett. Downs via telephone and discussed due to there being the need for additional clarification/ information of all three sites (staffed, remote, host) to incorporate into the submitted program statement; It was suggested to E. Downs to focus on updating and submitting application for remote site program and adding staffed site and host site at a later date. E. Downs agreed to only submit application for remote sites at this time. LPA Rogers informed E. Downs to submit an updated LIC 200 and Transitional Housing Program Plus Foster Care Form (SOC 179) (indicating for remote site only) along with updated Program Statement specifically addressing remote sites. E. Downs agreed to submit suggested updates/ changes to Community Care Licensing by Friday, April 22, 2022. LPA Rogers will email a copy of this Program Statement Review report to E. Downs for review and signature. E. Downs agreed to email signed copy back to LPA Rogers after review.

met_with: Emmettt Downs- Program Director


summary: Facility Evaluation

raw_content:
Narrative:
On Monday, April 4, 2022 @ 11:30 am, Licensing Program Analyst (LPA) L. Rogers spoke with E. Downs- Program Director. LPA Rogers informed E. Downs that the LIC 809 dated 03/30/22 needed signatures on all pages. LPA Rogers asked E. Downs to sign all pages of the LIC809 dated 03/30/22 and email signed pages to LPA Rogers. LPA Rogers also reminded E. Downs that because of the agreed decision to only submit application for remote sites at this time, could the application corrections be submitted earlier on Friday, April 15, 2022. E. Downs agreed to submit an updated LIC 200 and Transitional Housing Program Plus Foster Care Form (SOC 179) (indicating for remote site only) along with updated Program Statement specifically addressing remote sites. E. Downs agreed to submit suggested updates/ changes to Community Care Licensing by Friday, April 15, 2022.


summary: Facility Evaluation

raw_content:
Narrative:
On Wednesday, April 27, 2022, Licensing Program Analyst (LPA) Rogers spoke with Emmett Downs regarding the submitted revisions to the THPP application and Program Statement. LPA Rogers informed Emmett Downs more information is needed in the following areas: 1. UTILITIES Give details as to who is responsible for acquiring and paying utilities for apartments (lights, gas, water, trash, cable). 2. FURNITURE Give details as to what furniture/ bedding/ towels/ kitchen utensils will be provided to clients upon entering THPP program. Give details as to what furniture/ bedding/ towels/ kitchen utensils clients can keep upon leaving the THPP program. 3. LOCATION Please verify if office location is open for business. 4. APPLICATION Please update LIC200 with a contact phone number where someone is available to answer the phone and able to leave a message. LPA Rogers informed E. Downs to submit the revisions to program statement to the Community Care Licensing office. E. Downs agreed to submit suggested revisions to Community Care Licensing by Friday, April 29, 2022. LPA Rogers will email a copy of this Program Statement Review report to E. Downs for review and signature. E. Downs agreed to email signed copy back to LPA Rogers after review.


summary: Facility Evaluation

raw_content:
Narrative:
On May 13, 2022, at 8:40am, Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an announced pre-licensing inspection at the facility agency's administrative office located at Latham St. suite #140, Riverside, Ca. 92502. LPA met with Administrator, Emmett Downs, housing specialist, Rosa Hernandez and program manager, Jesse Vega and was given a tour of the facility. Upon entrance into the facility, there is a spacious open area with a large table that will be used training's and equipped with a work station with a large printer/scanner. There are three separate offices with locked doors. Office # Identified as the Administrator's office. Offices #2 and #3 adjacent are the Supervising Social Worker Offices. All offices are fully equipped with work desk units, telephones computers and computer stations. Records: Client files will be locked in office #1. There is a staff break room equipped with refrigerator and microwave. The restroom are located inside the building. The conference room is equipped with a table, chairs, white board and file cabinets and television. The facility has Wi-Fi accessibility. The facility meets the Regulatory requirements and is ready for licensure at the conclusion of the visit. Exit interview conducted. A copy of this report was given to the Applicant

met_with: Emmett Downs


summary: Facility Evaluation

raw_content:
Narrative:
On April 11, 2023, at 8:30am, Licensing Program Analyst's (LPA's), Darlene Almaraz-Oseguera and Emina Preciado, conducted an unannounced post-licensing inspection at the facility agency's administrative office located at Latham St. Suite #140, Riverside, CA 92502. LPA's met with housing specialist, Rosa Hernandez, and Intake Coordinator, Rita Hill, and were given a tour of the facility. There are currently four participants residing in the program, which include two remote sites in the city of Riverside. Upon entrance into the facility, there is a spacious open area with a large table that is used for training's and is equipped with a workstation with a large printer/scanner. There are three separate offices with locked doors. The conference room is equipped with a table, chairs, white board, file cabinets, and television. The facility has Wi-Fi accessibility. The restroom are located inside the building. Office # Identified as the Administrator's office. Offices #2 and #3 adjacent are the Supervising Social Worker Offices. All offices are fully equipped with work desk units, telephones computers, and computer stations. LPA's observed that Participant files were stored in a locked cabinet in Office #1. Currently, the facility is staffed with two full-time Life Coaches (Social Workers), one Housing Specialist, one Supervising Social Worker, and one Program Director. Staff was informed that each Social Worker should maintain a 1 to 12 ratio, which should never be exceeded. Staff is aware of submitting unusual incident reports as needed to the Department and to include all Law Enforcement contacts. LPA's reviewed four staff records. All staff met the minimum qualifications and training requirements. A review of records shows that all staff have FBI, DOJ, and Child Abuse Index Check clearances. LPA's reviewed four non-minor dependent files. All files reviewed were complete and had the required documents. Facility provided a copy of the drill log of the emergency disaster and mass casualty plan. Based on observation and record review, the facility is in compliance, no deficiencies were noted at this time. Exit interview conducted with Housing Specialist, Rosa Hernandez, and a copy of this report was provided to the facility representative.

met_with: Rosa Hernandez


summary: Facility Evaluation

raw_content:
Narrative:
On April 11, 2024, at 11:10am, Licensing Program Analyst's (LPAs), Darlene Almaraz-Oseguera and Cynthia Robinson, conducted an unannounced annual/required inspection at the facility agency's administrative office located at Latham St. Suite #140, Riverside, CA 92502. LPAs met with Program Director Emmett Downs, housing specialist, Rosa Hernandez, and Intake Coordinator, Rita Hill, and were given a tour of the facility. There are currently 16 participants- Non Minor Dependents (NMD) residing in the program, which include 8 remote sites throughout Riverside County and 1 remote site in San Bernardino County. Upon entrance into the facility, there is a spacious open area with a large table that is used for training's and is equipped with a workstation with a large printer/scanner. There are three separate offices with locked doors. The conference room is equipped with a table, chairs, white board, file cabinets, and television. The facility has Wi-Fi accessibility. The restroom are located inside the building. Office # Identified as the Administrator's office. Offices #2 and #3 adjacent are the Supervising Social Worker Offices. All offices are fully equipped with work desk units, telephones computers, and computer stations. LPAs observed that Participant files were stored in a locked cabinet in Office #1. Currently, the facility is staffed with two full-time Life Coaches (Social Workers), one Housing Specialist, one Supervising Social Worker, and one Program Director. Staff was informed that each Social Worker should maintain a 1 to 12 ratio, which should never be exceeded. Staff is aware of submitting unusual incident reports as needed to the Department and to include all Law Enforcement contacts. LPAs reviewed four staff records. All staff met the minimum qualifications and training requirements. A review of records shows that all staff have FBI, DOJ, and Child Abuse Index Check clearances. LPAs reviewed four NMD dependent files. All files reviewed were complete and had the required documents with the exception of NMD (C1) missing the TB test. Facility provided a copy of the drill log of the emergency disaster and mass casualty plan. Continued Next Page Based on observation and record review, the facility is in compliance, no deficiencies were noted at this time. Exit interview conducted with Program Director Emmett Downs, and a copy of this report was provided to the facility representative.