summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Paul Simien made an unannounced visit to the above listed facility. The purpose of this visit was to conduct a Case Management inspection. LPA discussed this with Shaniz Beza, Executive Director (ED) at 1: PM on 7/28/23. During LPA Simien's investigation of complaint 26-CR-20220930163206 (9/30/22) he was informed of a instance where a client was moved abruptly without much notice. LPA was not given the context of this instance and being concerned with potential personal rights violations opened up this case management. ED informed LPA that clients aren't moved unless it's an emergency or a client is struggling with compliance. If a client is struggling with compliance they will be placed on a 30 day behavioral contract. The client would then sign the agreement statement within the contract. The contract gives a 30 day notice to any potential changes, including moving rooms or a new location if compliance is not met. Exit interview was conducted and a copy of this report was provided to Shaniz Beza, ED whose signature on this form confirm receipt of these documents.

met_with: Shaniz Beza, Executive Director (ED)


state: CA

facility_name: PEACOCK ACRES THPP

summary: Facility Evaluation

raw_content:
Narrative:
On 3/18/24 at 11: AM, Licensing Program Analyst (LPA) Paul Simien and LPA Jasmine Cardeno conducted an unannounced visit to the above facility. The purpose of this visit was to conduct the required annual inspection. LPA met with Priscilla Negrete, Case Manager at the above facility to conduct the required annual inspection. LPAs reviewed five staff files and five client files. No deficiencies were cited at this time. The inspection is not complete at this time. LPA conducted an exit interview and a copy of this report was emailed to Shaniz Beza, Administraor.

report_type: Facility Evaluation

visit_type: Annual

met_with: Priscilla Negrete, Case Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 3/19/24 at 10: AM, Licensing Program Analyst (LPA) Paul Simien conducted an unannounced visit to the above facility. The purpose of this visit was to conduct the required annual inspection. LPA met with Shaniz Beza, Executive Director (ED) at the above facility to conduct the required annual inspection. LPA Simien completed Physical Plant, Operational Requirements, Disaster Preparedness, Staffing Records, Client Records sections of the CARE Tool. LPA Simien conducted one staff interview (only one staff member available for interview). One deficiency (ILS Title 22, Section 86270(a)(2)(B)(1)), three technical violations, and seven technical assistance were cited at this time. The facility will be cited (see 809-Ds for details). Appeal rights were discussed and provided. Exit interview was conducted and a copy of this report was provided to Shaniz Beza, ED whose signature on this form confirm receipt of these documents.

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Paul Simien and LPM Joel Segura conducted an unannounced visit to the above facility. The purpose of this visit was to conduct the required annual inspection. LPA met with Ana Hernandez, TAY Program Manager (TAY) at AM on 3/24/25. LPA/LPM reviewed five staff files and five client files. No deficiencies were cited at this time. The inspection is not complete at this time. LPA conducted an exit interview and a copy of this report was provided to TAY.

met_with: Ana Hernandez, TAY Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Paul Simien conducted an unannounced visit to the above facility. The purpose of this visit was to conduct the required annual inspection. LPA met with Ana Hernandez, TAY Program Manager (TAY) at AM on 3/25/25. LPA completed Operational Requirements, Disaster Preparedness, Emergency Intervention Plan, Staffing Records and Client Records sections of the CARE Tools. LPA Interviewed one staff member. The inspection is complete. One technical violation and one technical assistance were issued. LPA conducted an exit interview and a copy of this report was provided to TAY.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Paul Simien made an unannounced visit to the above listed facility. The purpose of this visit was to conduct a client interview on behalf of Chico RO. LPA discussed this with Christopher Brabant, Case Manager (CM) at 1: PM on 8/20/25. LPA Simien interviewed one client. Exit interview was conducted and a copy of this report was emailed to Shaniz Beza, Executive Director .

met_with: Christopher Brabant, Case Manager


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Paul Simien made an unannounced visit to the above listed facility. The purpose of this visit was to conduct a Case Management inspection. LPA discussed this with Ana Medoza, Case manger at 11: AM on 9/26/25. This case management was opened to discuss an incident report the department received on 9/22/25 regarding a client going to the hospital. Please see LIC 812 for details. As a result of this visit, there were no title 22 deficiencies observed. Exit interview was conducted and a copy of this report was provided to Ana Mendoza, Case Manager whose signature on this form confirm receipt of these documents.

met_with: Ana Mendiza, Case manager


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Paul Simien made an unannounced visit to the above listed facility. The purpose of this visit was to conduct a Case Management inspection. LPA discussed this with Ana Mendoza, Case manager (CM) at 11: AM on 12/19/25. This case management was opened to discuss an incident report the department received on 11/3/25 regarding a client being escalated and threatening to leave the facility with an adult who is suspected to be involved with CESC activities. CM stated that staff caught the client having inappropriate communications with this adult and filed a CPS report. CM stated that the facility suspect that this adult might be a staff member from a facility the client used to be placed at. Facility had a CFT shortly after the incident and the client's team decided to end the placement. Client left the facility on 11/5/ As a result of this visit, there were no title 22 deficiencies observed. Exit interview was conducted and a copy of this report was provided to CM, whose signature on this form confirm receipt of these documents.

met_with: Ana Mendoza, Case manager


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Paul Simien made an announced visit to the above listed facility to conduct a closure inspection. LPA met with Ana Mendoza, Case Manager (CM) at 10: AM on 2/4/26. LPA Simien toured the facility. Facility was cleared of client items. CM surrendered the facility licence to LPA Simien. As a result of this visit, there were no title 22 deficiencies observed. Exit interview was conducted and a copy of this report was emailed to CM.

met_with: Ana Mendoza, Case Manager


facility_name: PEACOCK ACRES, INC.

summary: Complaint Investigation - Substantiated - 1 deficiency

raw_content:
Narrative:
The interview with C1 confirmed that the client was restricted from outings as discipline and had their phone confiscated for similar reasons. An interview was conducted with C2 (see confidential names LIC811) on August 12, 2021. The interview confirmed that the client was also aware of cell phones being confiscated as discipline and understood that if they got in trouble restrictions on outings would extend on outings with CASA, county social workers or family visits. An interview conducted with facility Manager Shaniz Beza on April 13th, 2021 revealed that C1 had their phone confiscated due to discipline as a result of behavioral issues. Shaniz was unable to recall of any discipline that took place where C1 was restricted from outings due to discipline and indicated that the only recent restrictions that took place were due to COVID19 restrictions and shelter in place orders in 2020. A review of the facility Program Statement revealed that included during admission was a cell phone policy indicating a cell phone would be confiscated as discipline. Based on interviews and document evidence, it was determined that the THPP did confiscate personal belongings of C1 (cell phone) and limited visits of C1. Although regulations allow for confiscation of personal items as part of a discipline policy (86068.2), this must be documented in a Needs and Services Plan and justified as a risk to the Child's Health and Safety. At the time of the file review of C1 on 03/16/2021 there was no Assessment Needs and Services Plan (ANSP) for C1. The ANSP would have documented the Health and Safety Need for the client to have their phone confiscated as part of a discipline program. The regulations also allow limits on outings; however the limits must also be documented on the ANSP. C1 had no ANSP on file to review limits on visitation outside of the THPP. Based on the information obtained, there is a preponderance of the evidence to prove that the THPP violated the documentation regulations. Therefore, the above allegations are substantiated. Appeal Rights were provided and discussed with the facility manager and deficiencies were cited.

Investigation Findings:
13Licensing Program Analyst (LPA) Joel Segura conducted a follow-up complaint inspection to the Transitional Housing Placement Program (THPP) and met with the Facility Manager Shaniz Beza. The purpose of the inspection was to deliver the findings for the above complaint allegations. On March 10, 2021 the Department received a complaint alleging C1's (Child 1, see confidential names form (LIC 811) dated 08/25/2021) personal belongings were confiscated and the facility was restricting visits to the child as a form of discipline. Confidential interview was conducted with the reporting party (RP) on 04/20/2021. The interview with the RP revealed that the facility had restricted the client from outings as a form of discipline as well as confiscated C1's cell phone. A telephone interview was conducted with C1 on May, 25 2021. Continued on 9099C SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Joel Segura 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 26-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. First Street, Ste. San Jose, CA Facility Name: Peacock Acres, INC.FACILITY NUMBER: VISIT DATE: 08/25/2021

Deficiencies:
86068.21: (7) Visitation, including limitations on visits to the family residence and other visits inside and outside the transitional housing unit; (8) Limitations on written and telephonic communication, if ordered by a court.
1
2
3
4
5
6
7

report_type: Complaint Investigation

met_with: Shaniz Beza

complaint_status: SUBSTANTIATED

title:
2
3
4
5
6
7(a) ... The needs and services plan describes the following


raw_content:
Narrative:
An interview was conducted with S1 on 09/08/21 at approximately 1:45pm. Staff reported that they had found C1 had left the home without permission on multiple occasions; however, they indicated that C1 responded via text of their whereabouts. In an effort to build rapport with C1, S1 did not report that C1 had left the home without permission to their authorized representative or C1's case manager, S2. S1 admitted that they knew it was required for them to report C1 being absent without permission. S1 provided the facility screen shorts of their efforts to have client come back and keep track of their whereabouts. C1 was responsive to S1's texts and on some occasions sent selfies to show their whereabouts. A review of the screen shots submitted indicated that S1 was encouraging C1 to return the facility. A confidential interview was conducted with the reporting party (RP) on 07/15/2021 at 9am. The RP revealed that the facility failed to report the client leaving the facility without permission and failed to provide adequate supervision of C1. LPA Segura conducted a file review at the facility on 07/21/2021. LPA found that C1 did not have an Assessment Needs and Services Plan developed. Regulations for THPP programs require for a THPP to identify the level of care and supervision a client requires in their Assessment Needs and Services Plan. The facility had not complied with this requirement; therefore, LPA was unable to evaluate the level of supervision the client required. Based on the information obtained, there is a preponderance of the evidence to prove that facility staff failed to develop an Assessment Needs and Services Plan to assess the need for care and supervision the client required. Further facility staff failed to report the client had left the facility without permission. Therefore the allegations are substantiated. Appeal rights were provided and discussed with Shaniz Beza and deficiencies were cited. Exit interview conducted and a copy of the report was left with Shaniz Beza.

Investigation Findings:
13Licensing Program Analyst (LPA) Joel Segura conducted a follow-up complaint inspection to the Transitional Housing Placement Program (THPP). The purpose of the inspection was to deliver the findings for the above complaint allegations. LPA met with Interim Executive Director/Program Manager Shaniz Beza. On July 13, 2021 the department received a complaint reporting that the facility staff had failed to supervise clients and failed to report client leaving the facility without permission. On 07/21 at 12pm LPA Segura condcuted an interview with case manager of C1 (S2, Staff 2, Client 1, See confidential names list LIC 811 dated 09/30/21). Interview with case manager revealed that prior to leaving the home C1 was supposed to request permission from either the program manager or S2 prior to leaving the facility. Continued on 9099C SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Joel Segura 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 26-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. First Street, Ste. San Jose, CA Facility Name: Peacock Acres, INC.FACILITY NUMBER: VISIT DATE: 09/30/2021

Deficiencies:
00611: Based interviews with S1, S2 and the reporting party the licensee failed to report C1's1
2
3
4
5
6
7

title:
2
3
4
5
6
7(b)	(E) Any unusual incident or client absence which threatens the physical or emotional health or safety of any client. This requirement was not met as evidenced by


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Joel Segura conducted an unannounced inspection to the facility for the purpose of conducting a random inspection. LPA Segura met with Interim Executive Director Shaniz Beza. The Transitional Housing Placement Program (THPP) is licensed to serve 35 clients, ages 16-17 years old and non-minor dependents. Currently in placement are thirteen clients. LPA was assisted with the physical plant inspection by Belinda Valenzuela at approximately 1pm. LPA observed at the time of this visit, the facility to be clean, safe and sanitary. LPA observed the facility offices have private conference rooms for confidential visits. LPA observed client and staff files were in locked secure cabinets. During the inspection LPA observed that the THPP license was not posted; however, it was produced from a binder in the front office. See technical violation. During this inspection LPA Segura reviewed two staff files and verified criminal record clearances. See confidential names list LIC 811 for Staff 1 and Staff 2, dated 09/24/21. No client files were reviewed during todays inspection. However as part of the Operations inspection, LPA observed that the client register was missing clients ambulatory status and their attending physician. A technical violation was issued, as this information is present in client files. This inspection is incomplete at this time, the inspection will be completed at a later time. There were no deficiencies noted at today's evaluation; however, technical violations were issued. See attached Advisory notes. Exit interview conducted and a copy of the report was left with Shaniz Beza


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
An unannounced inspection was conducted by Licensing Program Analyst Joel Segura and student assistant Selena Hood on 09/28/21 at 11am. During the inspection LPA met with Interim Executive Director Shaniz Beza and continued the inspection started on 09/24/2021. LPA and student assistant reviewed 9 staff files at approximately 11:15 am and three client files at approximately 2pm. See confidential names list LIC 811 dated 09/28/21 for names of clients and staff. In the course of reviewing staff files. LPA found that 7 out of 9 staff files did not contain evidence that staff had participated in a one hour child abuse reporting training. LPA and student assistant did observe, that the facility covers child abuse reporting during initial staff orientation; however, the training covers many topics in a one hour span of time. In the course of reviewing three client files at approximately 2:00pm student assistant Hood observed that Client 2 did not contain a signature from their authorized representative and Client 3 did not contain a signature from the client in their respective Assessment Needs and Services Plans. Reviews of the three client Assessment needs and services plans revealed that none contained plans for providing services to meet the individual needs of clients in care. The review of client 1 file revealed that the file did not contain current court authorization for psychotropic medication. LPA and student assistant hood verified that all staff received a criminal record clearance by verifying a roster print out of the Guardian system. This inspection is incomplete at this time, the inspection will be completed at a later time. Continued on 809C Facility cited for violations of California Code of Regulations, Title Division Six, regulation 86065, 86069.2, 86168.3 and Health and Safety Code 1507.6. Per Title Regulations, deficiencies were cited during this inspection. Exit interview conducted, appeal rights discussed and a copy of the report was left at the facility with staff Ana Hernadez as Shaniz was unable to receive report.

Deficiencies:
86168.3(f): Deficient Practice Statement
1
2
3
4Based on record reviews, the licensee did not comply with the section cited above, clients 2 and 3 did not contain signatures in the Aseessment Needs and Services Plan, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/01/2021
Plan of Correction
1
2
3
4Plan of Correction is due on 10/01/21.

title:
Needs and Services Plan

(f) The Needs and Services Plan shall be signed by the nonminor dependent, the THPP administrator or social work personnel, and the person or agency responsible for placing the nonminor dependent, such as a social worker or probation officer, and maintained in the records for the nonminor dependent as specified in Section 86170, Nonminor Dependents' Records.

This requirement is not met as evidenced by


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced inspection was conducted by Licensing Program Analyst Joel Segura on 09/30/21 at 9:30am. During the inspection LPA met with Interim Executive Director Shaniz Beza and continued the inspection started on 09/24/2021. LPA Segura reviewed seven client files at approximately 9:50am. See confidential names list LIC 811 dated 09/30/21 for names of clients. In the course of reviewing client files LPA Segura observed that clients C8 and 9 did not contain a statement from a physician indicating if the clients were able to administer and determine their need for medication. See Technical Violation dated 09/30/21. LPA Segura also reviewed the disaster preparedness Plan during todays inspection, Staff 1 indicated that the facility has not conducted any disaster drills. It was further confirmed by facility manager Shaniz Beza that no disaster drills have been conducted. Facility cited for violation of Health and Safety code 1565(c) A facility shall conduct a drill at least quarterly for each shift. Exit interview conducted, appeal rights discussed and a copy of the report was left at the facility with Shaniz Beza.


facility_name: PENNY LANE CENTERS

summary: Facility Evaluation

raw_content:
Narrative:
On June 24, 2021 @ 1:45PM an unannounced site inspection was made for the purpose of conducting a Required Annual Evaluation. LPA Kathy Landry met with Program Manager and Director of Housing Services and toured facility. Tour began near 1:45PM. This program is a Transitional Housing Program operating with remote sites. There were 26 clients ranging in age from 18 to 21 residing in the facility's program. Facility has remote sites in Los Angeles County in close proximity of its headquarters. At 2:45PM a secondary tour by LPA Landry was conducted on one remote apartment site located at Gresham St. Unit #5, N. Hills, Ca 91343. There are no fire arms on any premises. There are no bodies of water on site premises. Children are supervised. Facility is clean, safe and in good repair. No passage ways, inclines, stairways, ramps or open porches are obstructed. Disinfectants/poisons are inaccessible. There is an adequate amount of emergency food supply. Clients are responsible for their medications and regular food supply. Personal Rights is posted. Childrens rights are upheld. Facility operates within its licensed conditions & limitations, including capacity. There are no excluded persons on premises. LPA Landry has requested an updated LIC 500 to review all staff Criminal Record Clearances. Facility has a current Plan of Operation. Staff have been instructed to report Personal Rights Violation. Licensee/Admin have been instructed to report changes in the plan of operation which affects clients. Facility Rep has been reminded to report client injuries requiring medical treatment and other special incidents. Four Clients records were reviewed. Staff records are secured at Human Resource Headquarters. Facility was within Title Regulations and no citations issued. Exit interview conducted.Copy of Report given.

met_with: Program Manager, Lee Overson and Director of Housing Services Shiva Berjis


summary: Facility Evaluation

raw_content:
Narrative:
On November 2, 2023 at 8:41AM Licensing Program Analyst (LPA) Christine Wilson arrived to the above-listed THPP facility for the purpose of conducting a Required 2-yr Annual Evaluation. At 9:33am LPA LPA Wilson met with Program Manager and Social Worker Supervisor (PM/SWS) and conducted the evaluation This program is a Transitional Housing Program operating with remote sites. There were 27 clients ranging in age from 18 to 21 residing in the facility's program. Facility has remote sites in Los Angeles County in close proximity of its headquarters. LPA Wilson 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 fifty-two (52) participants ages eighteen (18) through twenty one (21). There are currently twenty-seven (27) participants in placement at (16) different remote sites in Los Angeles County. Facility has three (3) Case Management Social Workers (1 per 12 participants) and one (1) Facility Administrator and (1) Social Worker Supervisor (1 per Social Workers). The facility is currently operating within staff ratio. The administrative office is located at Rayen Street Los Angeles, CA 91343. The office is located at a Permanent Supportive Housing building and is set up as follows: Administration office is a one (1) room office. The Administrator Office space is designated for the social worker supervisor. The Social Worker Supervisor office is equipped with a desk and two (2) locked file cabinets for client and former client files. All posting requirements were met. The Program administrator was contacted by phone, and stated, staff files are located in another main office in North Hollywood. Office for three (3) Case Management Social Workers is located at Gresham Street Los Angeles, CA 91343. This is a one room office with (8 ) desks. All posting requirements were met. (Continued on 809C Page 2 of 3) Page LPA Wilson requested the following forms for review, 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 (20) current Certificates of Compliance and (20) individual off-site units (19) are occupied, (1) is Non operational, and utilized as a quarantine unit. Off-Site Locations with a Current Certificate of Compliance approved by the Regional Office: Gresham St. North Hills, CA. Unit 1, with Ryan Myvett, (PM/SWS) Program Manager Gresham St. North Hills, CA. Unit 2, with Ryan Myvett, (PM/SWS) Program Manager Gresham St. North Hills, CA. Unit 3, with Ryan Myvett, (PM/SWS) Program Manager Gresham St. North Hills, CA. Unit 4, with Ryan Myvett, (PM/SWS) Program Manager Gresham St. North Hills, CA. Unit 1, with Ryan Myvett, (PM/SWS) Program Manager Gresham St. North Hills, CA. Unit 2, with Ryan Myvett, (PM/SWS) Program Manager Gresham St. North Hills, CA. Unit 3, with Ryan Myvett, (PM/SWS) Program Manager Gresham St. North Hills, CA. Unit 4, with Ryan Myvett, (PM/SWS) Program Manager Gresham St. North Hills, CA. Unit 5, with Ryan Myvett, (PM/SWS) Program Manager Gresham St. North Hills, CA. Unit 6, with Ryan Myvett, (PM/SWS) Program Manager Acre St. North Hills, CA. Unit 1, with Ryan Myvett, (PM/SWS) Program Manager Acre St. North Hills, CA. Unit 2, with Ryan Myvett, (PM/SWS) Program Manager Acre St. North Hills, CA. Unit 3, with Ryan Myvett, (PM/SWS) Program Manager Acre St. North Hills, CA. Unit 4, with Ryan Myvett, (PM/SWS) Program Manager Acre St. North Hills, CA. Unit 5, with Ryan Myvett, (PM/SWS) Program Manager Acre St. North Hills, CA. Unit 6, with Ryan Myvett, (PM/SWS) Program Manager Acre St. North Hills, CA. Unit A, with Ryan Myvett, (PM/SWS) Program Manager Acre St. North Hills, CA. Unit B, with Ryan Myvett, (PM/SWS) Program Manager Acre St. North Hills, CA. Unit C, with Ryan Myvett, (PM/SWS) Program Manager Acre St. North Hills, CA. Unit D, with Ryan Myvett, (PM/SWS) Program Manager (Continued on 809C Page 3 of 3) Page Clients Records Review: LPA Wilson reviewed three (3) clients records (C1, C C3) which meet requirement. LPA reviewed the Admission Agreements, date of placement in unit, Emergency Contact information, and TILP. Staff Interview: LPA Wilson conducted a confidential interview with one (1) on duty staff (PM/SWS). LPA. Staff Records Review: At 1:45pm LPA Wilson reviewed three (3) staff records (PA, PM/SWS and CSW1) stored in individual personnel file provided by (PM/SWS). Staff files were located at the HR Office, Dubnoff Way North Hollywood, CA LPA ensured to thoroughly review the records of the primary active staff (i.e The Program Administrator, Program Manager, Social Worker). LPA reviewed the Personnel Report (LIC 500) and confirmed that facility has three (3) 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 11/02/2023 that indicates that all personnel have criminal record clearance has obtained 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. There is a Type B deficiency at this time. (Please see LIC809D) Copy of report was read by PM/SWS and provided on site.

met_with: Program Manager/Social Worker Supervisor


summary: Facility Evaluation

raw_content:
Narrative:
On June 16, 2021 at 10: AM, Licensing Program Analyst (LPA) Juliet Robles conducted an unannounced Annual/Required inspection to the Penny Lane Centers Transitional Housing Program Plus Foster Care (THP+FC) and met with Foster Family Agency Administrator, Charito Guerrero and Project Manager (PM) Lilie Amezquita. At 11: AM, LPA and Project Manager did a tour of the facility. Per PM, due to COVID, the Administrative offices used by THP+FC is currently being used by a different staff from another program. The Administrator of THP+FC, Lee Overson is currently in the North Hills office. Per THP+FC Administrator, currently there are no clients due to the expensive rents in the area. The THP+FC Administrative office shares the same building with other Foster Care Programs. The office is conveniently located for the public. The office has a reception area, conference rooms and individual offices that can be used for intakes by the THP+FC program. At 2: PM, LPA completed the review of staff file that was emailed and printed to the office from the Human Resource Department (HRD) and THP+FC Administrator. Currently there is one employee, the Administrator. Administrator meets the education and experience requirements, completed the required training, file contains the Statement acknowledging requirement to report child abuse, fingerprint and child abuse index check clearances and current with CPR and first aid. LPA obtained copies of current LIC 500 and Board of Director Meeting Minutes. No deficiency citation issued during this inspection. An exit interview was conducted, a signed copy of this report LIC 809 and LIC 859 was provided to the FFA Administrator.

met_with: Charito Guerrero


facility_name: PENNY LANE CENTERS THP+FC

summary: Facility Evaluation

raw_content:
Narrative:
On 05/26/2022 at 12:00PM Licensing Program Analyst (LPA) Olivia made an unannounced to Penny Lane Centers Transitional Housing Placement plus Foster Care (THP + FC) Administrative Office for the purpose to conduct the Annual/2 year 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 05/26/22. 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 four (24) participants ages eighteen (18) through twenty one (21). There are currently 12 participants in placement at six (6) apartment units with three different address on site. Facility has three (3) 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 Cedar Ave., Lancaster, CA 93534. The office is located on the property lot and is set up as follows: Administration office is a three (3) room office. The Administrator Office is equipped with a desk and locked file cabinets for staff files and client files. The staff office space consist of three (3) desk for case carrying social workers. The office has two offices that are available to conduct private interviews. Staff records are maintained in the Penny Lane Offices Head Quarters. All posting requirements were met. 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. Report continues on LIC 809-C Page 1 of Outdoor Area: There was no swimming pool or bodies of water on the premises.The activity space is free of hazard materials and debris. LPA observed a staff displayed the utility shut-off valves. The facility is surrounded by brick fence and is observed to be good condition. The laundry room is located behind the Administrative Office. The laundry is equipped with a washer and dryer unit that was observed to be in good condition. The attached two car garage is used as storage and is kept locked. There are two (2) vehicles available to transport youths; make and model are two Toyota Sienna. The vehicle has full coverage auto insurance with HUB International Insurance Services Inc. The have multiple fire extinguishers through the buildings. The facility has outdoor security cameras through the facility. Staff Records Review: LPA Rosas was not able to review staff records are they are maintained in Penny Lane Headquarter offices. LPA reviewed the Personnel Report (LIC 500) and confirmed that facility has three (3) 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. The facility has social worker personnel available on a 24-hour basis to respond to any emergency. Clients Records Review: LPA reviewed two (2) clients records which meet requirement. LPA reviewed the Admission Agreements, date of placement in unit, Emergency Contact information, and Needs and Services Plan. LPA Review the case plan and accounting records. Staff Interviews: LPA Rosas conducted a confidential interview with one (1) on duty staff. Client Interviews: LPA was not was not able conduct participant interviews. 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 S1 and a copy of this report was left at the facility.

met_with: Staff#1 (S1)


summary: Facility Evaluation

raw_content:
Narrative:
On 05/14/2024 at 9:58am Licensing Program Analyst (LPA) Christine Wilson made an unannounced visit to Penny Lane Centers Transitional Housing Placement plus Foster Care (THP + FC) Administrative Office for the purpose to conduct the Annual/2 year Required licensing Inspection. LPA Wilson met with Staff#1(S1) who granted access to the Administrative Office and an inspection was conducted together. Individuals mentioned in this report are identify on the Confidential Names List (LIC811) dated 05/14/2024. There are currently 11 participants in placement at six (6) apartment units with three different address on site. Facility has four (4) Social Workers (1 per 3 participants) and one (2) Social Worker Supervisor/Program Managers (1 per Social Workers). The facility is currently operating within staff ratio. The administrative office and sub-administrative unit dwellings are located at Cedar Ave., Lancaster, CA 93534. The office is located on the property lot and is set up as follows: Administration office is a three (3) room office. The Administrator Office is equipped with desks and locked file cabinets for client files. The staff office space consist of three (3) desk for case carrying social workers. The office has two offices that are available to conduct private interviews. There is a kitchenette for staff with refrigerator, microwave and air fryer . There are (3) fire extinguishers with current inspection and one half bathroom. Staff Files records are maintained in the Penny Lane Offices Head Quarters in North Hollywood. All posting requirements were met. LPA Wilson observed LIC610C, LIC500, LIC9010, Facility Sketch, Unit Verification Forms/Certificates of Compliance, Allowance receipts, Savings Agreements, Medical and Dental Referrals, Unit Supplies Inventory Sheet, Support Animal Agreements, THP-NMD Visitor Policy, Orientation checklist, and Entry Assessment Vehicles: There is one (1) vehicle available to transport youths; vehicle is a Blue Toyota Camry. The vehicle has full coverage auto insurance with HUB International Insurance Services Inc., current registration and first aid kit. Continued on 809C Page Page Outdoor Area: There was no swimming pool or bodies of water on the premises. The activity space is free of hazard materials and debris. LPA observed a staff displayed the utility shut-off valves. The facility is surrounded by a fence with a key locked entry gate and is observed to be good condition. The laundry room is located behind the Administrative Office. Laundry: The laundry is equipped with a coin washer and dryer unit that was observed to be in good condition. The facility has outdoor security cameras through the facility. Clients Records Review: LPA reviewed two (2) clients records with (S1) assistance. LPA and (S1) reviewed the Admission Agreements, date of placement in unit, Emergency Contact information, Medical information and TILP on digital file. Staff Interviews: LPA Wilson conducted a confidential interview with one (1) on duty staff (S1). Client Interviews: LPA conducted (1) participant interview with (C1). LPA Wilson was not able to review staff records because they are maintained in Penny Lane Headquarter offices. LPA Wilson will conclude the review of staff records on another day. There were no deficiencies observed or cited at this time. Exit interview was conducted with (S1) and a copy of this report was emailed to facility.

met_with: THP NMD Case Manager (S1)


summary: Facility Evaluation

raw_content:
Narrative:
On 05/16/2024 at 9:28am Licensing Program Analyst (LPA) Christine Wilson made an unannounced visit to Penny Lane Centers Transitional Housing Placement plus Foster Care (THP + FC) Administrative Office located at Dubnoff Way, Los Angeles, for the purpose to conclude the Annual/2 year Required licensing Inspection. LPA Wilson met with Program Manager (PM1) 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 05/16/2024. LPA Wilson inspected following during the inspection: Disaster Preparedness Plan: LPA Wilson observed written procedures to address storage and preservation of medications, training on emergency procedures, monthly emergency drills, a disaster and mass casualty plan, a roster and contact information for clients and vehicles for evacuation. Emergency Intervention: Restraints are not used in the facility. Staffing Records: A review of records for staff (S1, S2), shows that all staff have FBI, DOJ and Child Abuse Index Check clearances, educational diplomas, job description, identification, adult and pediatric first aid/cpr certification. Not all staff files showed completion/certification of CPI training. Staff Interviews: LPA Wilson conducted a confidential interview with one (1) on duty staff (PM1). LPA Wilson by email will send the following PIN to licensee: USE OF THE EVERBRIDGE EMERGENCY NOTIFICATION SYSTEM TO NOTIFY LICENSEES AND PROVIDERS OF DISASTERS AND EMERGENCIES There was (1) deficiency and (1) technical advisory observed or cited at this time (See LIC809D and LIC9102). Exit interview was conducted with (PM1) and a copy of this report was left at the facility.

met_with: Program Manager (PM1)


summary: Facility Evaluation

raw_content:
Narrative:
On 08/06/24 at 9:10am, Licensing Program Analyst (LPA) Christine Wilson made an unannounced visit to the Penny Lane THPP administrative offices, located at Dubnoff Way in North Hollywood for the purpose of conducting a case management inspection, regarding SIR dated 07/27/2024. Facility Manger (FM) was not at the location. At 9: LPA WIlson called the THPP office in Lancaster, CA. to speak with Case Manager (CM). At 9:37am, LPA Wilson called (FM). At 9:44am LPA Wilson called (FM) and discussed the case management via telephone. No deficiencies were cited on this day. Copy of report will be sent to (FM) for signature. Licensee will be provided with a signed copy of this report.


facility_name: PHOENIX TRANSITIONAL HOUSING PLUS

summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On September 17, 2024, Licensing Program Analyst (LPA) Vanessa Galvan traveled to Phoenix THPP located in Exeter, CA and met with Administrator Brian Gambini. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the above allegations. During the course of the investigation, LPA conducted confidential interviews, reviewed files, and obtained pertinent documentation. Based on confidential interviews and record review, it was determined that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur, therefore the allegations are deemed unsubstantiated. An exit interview was conducted, copy of this report and appeal rights were provide to Brian Gambini at the conclusion of the inspection. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Vanessa Galvan 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: Brian Gambini

complaint_status: unsubstantiated


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13On October 31, 2024, Licensing Program Analyst (LPA), Vanessa Galvan traveled to Phoenix THPP located in Exeter, CA to conduct an unannounced complaint inspection and met with Program Representative Sandra Hyatt. The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the above complaint allegation. During the course of the investigation, LPA conducted confidential interviews, file review and obatined documentation. Based on information obtained and confidential interviews, it was determined that the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. The agency is being cited for Interim Licensing Standards, AB Nonminor Dependents, THPP, Article 06. Continuing Requirements, Health-Related Service 86275(a)(1). See Attached LIC 9099D for further information. An exit interview was conducted discussing this report and the appeal rights. A copy of this report and appeal rights were provided to Sandra Hyatt at the conclusion of the inspection. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Vanessa Galvan 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 24-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FRESNO RO, E SHAW AVE FACILITY NAME: PHOENIX TRANSITIONAL HOUSING PLUSFACILITY NUMBER: 547207203

met_with: Sandra Hyatt


raw_content:
Investigation Findings:
13On October 11, 2024, Licensing Program Analysts (LPAs) Vanessa Galvan and Melissa Renovato traveled to Phoenix THPP located in Exeter, CA and met with Administrator Brian Gambini. The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the above allegation. During the course of the investigation, LPA conducted confidential interviews, reviewed files, and obtained pertinent documentation. Based on confidential interviews and record review, it was determined that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur, therefore the allegations are deemed unsubstantiated. An exit interview was conducted, copy of this report and appeal rights were provide to Brian Gambini at the conclusion of the inspection. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Vanessa Galvan 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 2


summary: Facility Evaluation

raw_content:
Narrative:
On September 29, 2021, Licensing Program Analysts (LPAs) Tamara Melikian and Les Inouye conducted an unannounced annual inspection at the THP+NMD program of CTC. Met at the CTC office by Administrator Brian Gambini and Program Director Mary Beth Irons. The THP+NMD is licensed to serve ages 18-23 years old. An inspection of the office was conducted at 9:30AM and confidential meeting space, locked area for files and the license was observed. Client and staff files were inspected at 10:00AM. There are a total of NMDs in placement and 10 files were reviewed. Three staff files were reviewed on this date. Interviews and discussions were conducted with Mr. Gambini and Ms. Irons at 11:30AM. An exit interview was conducted at 12:00PM. There are no deficiencies to be cited on this date. A copy of this report was provided to the Administrator at the conclusion of the inspection.

met_with: Brian Gambini, Mary Beth Irons


summary: Facility Evaluation

raw_content:
Narrative:
On 07/28/2022, Licensing Program Analyst (LPA) Vanessa Galvan conducted an unannounced case management inspection. The purpose of the visit was to discuss termination/eviction of a client. LPA met with Administrator (ADM) Brian Gambini. LPA discussed the termination/eviction policy for Phoenix Transitional Housing Plus. ADM discussed concerns of a client refusing to leave the premises after an eviction was issued. LPA reviewed documentation. There are no deficiencies to be cited on this date. A copy of this report was left with Administrator Brian Gambini at the conclusion of the visit.


summary: Facility Evaluation

raw_content:
Narrative:
On September 19, 2022, Licensing Program Analyst (LPA) Vanessa Galvan traveled to Phoenix Transitional Housing Plus in Exeter, CA to conducted an unannounced annual inspection LPA met Administrator Brian Gambini and Program Director Mary Beth Irons. The THP+NMD is licensed to serve ages 18-23 years old. An physical plant inspection of the office was conducted. The office included a confidential meeting space, locked area for files, and the agency's license was observed. LPA reviewed client and staff files on this date. There are a total of NMDs in placement and (10) files were reviewed. There are a total of 8 staff members and (5) files were reviewed. Interviews and discussions were conducted with Mr. Gambini and Ms. Irons. An exit interview was conducted. There are no deficiencies to be cited on this date. A copy of this report was provided to the Administrator at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On August 10, 2023, Licensing Program Analyst (LPA) Wayne Aoki traveled to Phoenix Transitional Housing Plus in Exeter, CA to conducted an unannounced Required Annual Inspection. LPA was met by Administrator Brian Gambini. The agency currently serves THP NMD, two full time Social Workers, four Case Managers, one Clerical/Education and Vocational Specialist and an Administrator. A general overview of their program and a tour of the facility was provided. This facility has a reception area, waiting area, conference room, and office space for staff. Observed fixtures and furniture, equipment and supplies necessary for this operation. Also observed locked cabinets for client and staff files in order to ensure confidentiality. 10 minors files and 6 staff files were reviewed. Interview and discussion was conducted with Mr. Gambini. LPA requested that the following items are updated and sent to CCL by August 31, 2023: LIC 308, LIC 309, LIC 500, LIC 610C and an updated copy of the lease/rental agreement for the agency. An exit interview was conducted. There are no deficiencies to be cited on this date. A copy of this report was provided to the Administrator at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On November 20, 2023, Licensing Program Analyst (LPA) Vanessa Galvan traveled to Phoenix THPP located in Exeter, CA, to conduct an unannounced Case Management inspection and met with the Brian Gambini, Administrator. The purpose of the inspection is to follow up on a Special Incident Report (SIR) submitted to the department on 11/07/2023. On the evening of 11/4/23 at Client's 1 residence, it was reported to case manager (CM) that there had been a drive by shooting at C1's apartment. It was reported to CM that C1 had some friends over to hang out with and words were exchange between C1's guests and by passers. Evidentially a short time later shots were exchanged between the two parties. No one was reported injured. Visalia Police department (VPD) arrived onsite within minutes and C1 and guest were detained. C1 was released the next morning 11/5/23. CM notified C1 on 11/5/23 that C1 was terminated from the program and was not to return to the apartment. CM meet with C1's family member on 11/6/23 at the apartment to collect C1's belongings. C1 did not have a roommate. No Phoenix staff were present during the event. All information stated in the incident report was gathered from conversations with C1's family members. VPD would not give any information out when CM arrived at the apartment. After receiving the phone call informing CM of the situation, CM immediately went to the apartment. When he arrived, VPD was on-sight conducting their investigation. They did not allow access to the apartment or divulge information concerning the investigation. CM was later informed that a friend of C1 admitted to law enforcement having the gun and firing the shots. C1's probation in agreement with Phoenix of C1's termination of the program. Based on the information obtained through the interview and records review, there are no violations. No deficiencies are being cited at this time. An exit interview was conducted, and at the conclusion of the inspection a copy of this report and the LIC 811 were provided to Brian Gambini.


summary: Facility Evaluation

raw_content:
Narrative:
On November 7, 2024, Licensing Program Analyst (LPA) Vanessa Galvan traveled to the Phoenix Transitional Housing Plus office located in Visalia CA. LPA was met by Administrator (ADM) Brian Gambini for the purpose of a scheduled pre-licensing inspection for a THP + NMD. A general overview of their program and a tour of the facility was provided. This facility has a reception area, waiting area, office space for staff and space for confidential meetings. LPA observed fixtures and furniture, equipment and supplies necessary for this operation. Also observed locked cabinets for client and staff files to ensure confidentiality. The office was equipped with a first aid kit and a fire extinguisher. All required LIC forms and personal rights are posted in a common area. The ADM is in the process of setting up a Guardian account to transfer and associate staff. Agency to provide to LPA Galvan association requests and copies of current identification for any staff to be associated prior to Guardian account approval. A copy of this report was provided to Brian Gambini at the conclusion of the inspection.

visit_type: Prelicensing


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst Lisa Slusher arrived at Phoenix Transitional Housing Plus for the purpose of conducting an unannounced Post Licensing inspection. LPA met with Administrator Brian Gambini and inspected the facility, inside and out. The facility has a written emergency disaster plan. A fire extinguisher is properly charged. Certificates of compliance were observed for all remote/scattered sites where participants are placed. The facility employs Administrator, 1 full time Social Worker Supervisor/Social Worker , 2 part time Social Workers, Case Managers, Clerical employees. Six records of personnel/staff members were reviewed to ensure staff meet regulatory requirements. Personnel Files are maintained on-site. All staff are appropriately fingerprint cleared and associated. Six Records of clients were reviewed. Staff interviews were conducted. No deficiencies noted in areas observed. One Technical violation is noted in the area of documenting Education and Experience. A copy of this report and appeal rights were provided at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On October 21, 2025, Licensing Program Analysts (LPAs) Vanessa Galvan and Olivia Medrano traveled to the Phoenix Transitional Housing Plus office located in Visalia CA. LPA was met by Administrator (ADM) Brian Gambini and Jennifer Steinhauer Social Worker Supervisor for the purpose of conducting an unannounced Annual Required Inspection. LPAs conducted a physical plant inspection and included the following observation and checks: client and staff files are kept locked. The agency has adequate confidential meeting space, space for Social Worker and Case Manager to complete job duties. The facility has a current copy of the license, Facility Sketch, Client Personal Rights, LIC 610C, posted in a common area. The agency has a client register roster, with all required information. The agency's office is located within two hours of travel time of the THPP participants living units. The agency employs (1) Administrator, (1), Program Director, (1) Social Worker Supervisor/Social Worker, (2) Social Workers, (11) Case Managers, (2) Clerical employees. LPAs reviewed five staff files and conducted two staff interviews. A review of the staff files on this date indicates that Staff files meet regulatory standards. LPA Galvan reviewed the LIC 500 and confirmed all staff have been cleared through Guardian on today's inspection. The agency currently has (84) THPP NMD participants. LPAs reviewed (5) THPP NMD Participant files on this date. The facility is being cited for Title 22, Division 6, Chapter 7, Article 06. Continuing Requirements, section 86069(a) and 86069(b)(1), Participant Medical Assessments. (See Attached LIC 809D) An exit interview was conducted. A copy of this report and appeal rights were provided discussed to Brian Gambini at the conclusion of the inspection.

met_with: Brian Gambini and Jennifer Steinhauer


summary: Facility Evaluation

raw_content:
Narrative:
On November 19, 2025, Licensing Program Analyst (LPA) Vanessa Galvan traveled to Phoenix Transitional Housing Plus, located in Visalia, CA, to conduct an unannounced inspection and met with Administrator Brian Gambini. The purpose of the inspection is to conduct a case management regarding an incident reported to the department. During the inspection, the LPA conducted a confidential interview, reviewed a file, and obtained pertinent documentation. LPA gathered additional information about the incident that occurred on 11/15/2025, involving the death of Nonminor Dependent 1(NMD1). (see LIC 811 for confidential names). The incident is being investigated by law enforcement, and information is still evolving at this time. No deficiencies were observed or cited at this time. An exit interview was conducted to discuss the report, and a copy of this report was provided to Brian Gambini via email due to a printer error at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On January 23, 2026, Licensing Program Analysts (LPAs) Vanessa Galvan and Olivia Medrano traveled to Phoenix Transitional Housing Plus, located in Visalia, CA, to conduct an unannounced inspection and met with Administrative Assistant, Sandra Hyatt. The purpose of the inspection is to conduct a case management regarding an incident reported to the department. During the inspection, the LPA conducted a confidential interview, reviewed a file, and obtained pertinent documentation. LPA gathered additional information about the incident that occurred on 01/05/2025, involving law enforcement and Client 1 (C1). (See LIC 812 for additional information). No deficiencies were observed or cited at this time. An exit interview was conducted to discuss the report, and a copy of this report was provided to Sandra Hyatt via email due to printer issue.


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13On February 25, 2026, Licensing Program Analyst (LPA), Vanessa Galvan traveled to Phoenix Transitional Housing Plus located in Visalia, CA, to conduct an unannounced inspection and met with Administrator Brian Gambini. The purpose of the inspection was to deliver the findings regarding the above complaint allegations. The Department has investigated the above complaint allegation. LPA conducted confidential interviews, reviewed files, and obtained pertinent documentation. Based on a file review and confidential interviews, it was determined that the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. The agency is being cited for Title 22, Division 6, Chapter 1, Article 07. Physical Environment Section Buildings and Grounds 80087 (a). See Attached LIC 9099D for further information. An exit interview was conducted discussing this report and the appeal rights. A copy of this report and appeal rights were provided to Brian Gambini at the conclusion of the inspection. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Vanessa Galvan 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 24-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FRESNO RO, E SHAW AVE FACILITY NAME: PHOENIX TRANSITIONAL HOUSING PLUSFACILITY NUMBER: 547207265


summary: Facility Evaluation

raw_content:
Narrative:
On 5/1/25, at 10:45am, Licensing Program Analyst (LPA) Nancy O'Connell conducted an announced Pre-Licensing inspection at Phoenix Transitional Housing Plus THPP, located at N. Halcyon Rd. #A, Arroyo Grande CA 93420. LPA met with applicant, Brian Gambini, Denise Rabena (proposed program director), Sandra Hyatt (proposed administrative assistant). At the time of the visit, there are no children in placement. The facility is seeking a license to provide care for thirty (30) ambulatory, Non-Minor Dependents, ages 18-21. The only interview conducted was with the applicant. Facility Overview: The facility is located within an office building. The office is comprised of two office rooms, a bathroom, a kitchen, and a lobby/reception area. The main office has a desk area for staff, locked filing cabinets, a computer, a functional telephone for youth to make telephone calls, and a printer. LPA observed required postings and additional relevant documents. LPA completed the related Care Tool for Transitional Housing Placement Programs (THPP) and verified all required information. LPA reviewed all related regulations and provided an opportunity for applicant and staff to ask questions. LPA confirmed qualifications of the Administrator and Social Worker roles. LPA confirmed that the applicant is seeking approval to operate a remote site model and confirms that the remote sites will be located within a two-hour driving distance. Applicant identified area in office that may be used for confidential meetings and phone calls for youth. An exit interview was conducted with applicant, Brian Gambini, and an electronic copy of this report was sent via email.

met_with: Brian Gambini, applicant


summary: Facility Evaluation

raw_content:
Narrative:
On 5/1/25, at 12:00pm, Licensing Program Analyst (LPA) Nancy O'Connell conducted Component II of the application process for Phoenix Transitional Housing Plus THPP, at the facility office location. Individuals present were Brian Gambini (applicant). The purpose of the Component II meeting was to review the submitted application, address outstanding items, and to resolve any concerns related to application documents submitted thus far. Documents/Topics discussed and updates required: LIC610- provide specific information regarding relocation sites LIC999- include outdoor space of facility on separate sketch in addition to garage B1. Partnership Agreement/Articles of Organization- missing B2. Verification of Administrator Qualifications and Certification- missing B3. Verification of Social Worker Qualifications- missing B5. Personnel Policies- contained in unrelated section. B6. In-service training for staff- contained in unrelated section B7. Program description- missing B8. Rules of Discipline/Personal Rights- missing B9. Admission Policies- missing B12. Bacterial Analysis of Private Water Supply- missing Applicant will organize "B documents" into separate sections All supportive documents will be organized with page numbers, and cover pages All submitted documentation will be updated as needed to reflect new facility location Policies will be updated to include specific and verifiable and measurable information updated control of property In addition to items listed above, the applicant was advised that all revisions and corrections to the application are due by 6/1/2025. LPA O'Connell provided a verification signature on applicant Component II certificate. A Pre-Licensing Inspection is scheduled for 5/1/2025. A copy of this report will be provided to the applicant, Brian Gambini via email.


summary: Facility Evaluation

raw_content:
Narrative:
On 7/7/25, at 1: PM, Licensing Program Analyst (LPA) Nancy O'Connell conducted Component III of the application process for Phoenix Transitional Housing Plus. The meeting was held virtually by the Children's Residential Program local unit office in Woodland Hills. Individuals present were Brian Gambini, applicant, Denise Rabena, Program Director, and Sandra Hyatt Administrative Assistant. The purpose of the Component III meeting was to familiarize the applicant and team members with the category specific regulations for the facility, discuss potential problem areas, and provide clarification on related licensing forms and general requirements. Topics discussed: General and category specific regulations, Licensing forms (LIC, 500, LIC 9020, LIC624LE, LIC624, LIC200), Reporting Requirements, Criminal Record Clearance requirements, administrator change process, contact information for CCLD SIR inbox, and officer of the day, Personal Rights, Buildings and Grounds, Inspection Authority, compliance process/civil penalties/plans of corrections Complaint process, CCLD website, and provider resources. The applicant and team members were provided with opportunities to ask questions, and demonstrated agreement and understanding of all material presented. LPA provided a signature on the applicant's orientation certificate and returned the original document to the applicant. LPA will submit the application for final approval and request that the facility be granted a provisional license. A copy of this report was provided to the applicant via email and an electronic signature is retained on file.

met_with: Brian Gambini, Applicant


summary: Facility Evaluation

raw_content:
Narrative:
On January 06, 2026, at 10:00 am, Licensing Program Analyst (LPA) Nestor Gomez conducted an unannounced visit for the purpose of a post-licensing inspection of the above-mentioned facility. Licensing staff met with Director and Lead Case Manager (S1), Denise Rabena, who granted access, and who provided a tour of the office for the inspection. The current census is 6. During the time of inspection, LPA Nestor conducted an inspection of the following areas: The facility is located within an office building. The office is comprised of two office rooms, a bathroom, a kitchen, and a lobby/reception area. The main office has a desk area for staff, locked filing cabinets, a computer, a functional telephone for youth to make telephone calls, and a printer. LPA observed required postings and additional relevant documents. There is one (1) fire extinguisher located in the kitchen. LPA observed the carbon monoxide/smoke detectors to be in working order when tested by the licensee. LPA observed all required posting. Vehicles: LPA Nestor inspected one (1) facility vehicles in total. Ford Transit Wagon (White) with current registration that expires on 12/31/2026. Insured by Guide One Specialty Insurance that expires on 7/23/2026. Continue on 809-C (Page 1) Vehicles are in good condition with no issues. Staff Interview: LPA Nestor conducted one (1) staff interview with S1. Client Interview: LPA Nestor conducted two (2) client interviews with C5 and C6. Staff Records Review: LPA reviewed two (2) staff records for S1 and S2. Clients Records Review: LPA reviewed two (2) client records for C5 and C6 which meet qualification. LPA Nestor has completed the inspection. There were no deficiencies observed or cited at this time. A copy of this report was reviewed and provided to Facility Administrator (FA) Brain Gambini and S1.

met_with: Denise Rabena - Director and Lead Case Manager


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Investigation Findings:
13On 1/6/2026, at 10:00 am, Licensing Program Analyst (LPA) Nestor Gomez made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation(s) and deliver the findings. LPA spoke with Director and Lead Case Manager (S1), Denise Rabena and together, discussed the investigative findings. During the investigative process by Licensing program Analyst (LPA), Nestor Gomez, all relevant parties have been accounted for. The validity of the allegations could not be determined. The parties interviewed either confirmed or denied the allegations. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nestor Gomez 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

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


facility_name: PLEASANTLY SUPPORT SERVICES

summary: Facility Evaluation

raw_content:
Narrative:
On Wednesday August 27, 2025, at 12:00PM, Administrator for Pleasantly Support Services Transitional Housing Placement Program (THPP) Farrah Richmond and Administrator Assistant Devoree Ealy, Licensing Program Manager (LPM) Jean Herring and Licensing Program Analyst (LPA) Humberto Flores, conducted a face-to-face Component II of the application process for the THPP. During the meeting LPA Flores reviewed the application, including all supporting documentation. It was noted that the THPP representatives need to submit for their correction the following licensing forms: - A Verification Document from the foster care facility where Farrah Richmond used to work, Group Home Heritage. - Orientation Certificate. The Administrator and a Board member needs to attend an orientation and obtain this certification. - A signed Job Description for Farrah Richmond detailing her job duties at the THPP. - Administrator Farrah Richmond needs to provide her High School Diploma. cont.#2 - All Board members need to review and signed LIC9165 "Board of Directors Statement". Department policy "Facts You Need To Know" was provided. A link was sent to the THPP representatives via e-mail. - The Board Resolution authorizing Farrah Richmond to submit the Program Statement (PS) and Plan of Operation (POO) needs to specify that it is also to submit the Application. - Specify the roll and title that Devoree Ealy will be conducting at the THPP. Additional to this topic, an updated LIC Personnel Report needs to be submitted. - Complete the required documentation to transfer fingerprint clearances to the THPP license . The THPP representatives agreed to submit the required documentation by Friday September 12, 2025. A copy of this report was provided to the THPP representatives. Exit interview conducted.

met_with: Farrah Richmond and Devoree Ealy


summary: Facility Evaluation

raw_content:
Narrative:
On Wednesday October 8, 2025, at 10:30AM, Licensing Program Analyst (LPA) Humberto Flores met with Administrator Assistant (AA) Devoree Ealy, to conduct a face-to-face follow-up of the application process for the Transitional Housing Placement Program (THPP) Pleasantly Support Services. During the meeting LPA Flores reviewed with AA Ealy the corrections of the Program Statement (PS) and Plan of Operation (POO) that were previously submitted in multiple e-mails with its attachments. AA Ealy was advised to present the corrections following the order and with the structure that is in the THPP tool. It was noted that the THPP representative needs to submit the correction by August 24, 2025. This report was amended to change the type of visit to Office. A copy of this report was provided to the Applicant. Exit interview conducted.

met_with: Administrator Assistant Devoree Ealy


summary: Facility Evaluation

raw_content:
Narrative:
On February 13, 2025, at 9:10AM, Licensing Program Analyst (LPA) Humberto Flores conducted a Pre-licensing Inspection at Pleasantly Support Services Transitional Housing Placement Program (THPP). LPA Flores met with Applicants Farrah Richmond and Devoree Ealy, the Applicants. The THPP occupies a single suite in a multi suites commercial building. When needed, the THPP will have access to a conference room that is next to the suite. The conference room is commonly used by the others tenant of the building. Currently, the THPP office is staffed by one (1) Administrator, Farrah Richmond and one (1) Director of Business and Finance, Devoree Ealy. LPA Flores conducted a tour of the THPP's administrative office. The office is conveniently located for the public in a commercial building with multiple parking spaces next to the building. LPA Flores observed the individual office for the Administrator and the Director of Business and Finance. The office will be used during the intakes process for participants and employees. The THPP participants' and employees' records will be stored in a locked filing cabinet inside the Administrator's office. Currently, the THPP has a filling cabinet for the employees. LPA Flores informed the Applicants that a filling cabinet is needed to store and file the participants' records. The Applicants disclosed that the filling cabinet for the participants' records will be ready by Tuesday February 17, 2026. A picture will be sent to LPA Flores. cont.# The THPP will use the type of participant living units: Remote Sites. Currently, the Applicants are in the process to sign an agreement with County of Riverside Department of Public Social Services. The Applicants are actively looking for apartments in Riverside County. The THPP will complete and sign a Certificate of Compliance for each THPP participant living unit, as defined in California Code of Regulations (CCR), Title 22, Division 6, Chapter 7, Section 86001(6), that verifies that the participant living unit meets the requirements of the Health and Safety Code Section 1501(b)(5) (Ref. CCR, Title 22, Division 6, Chapter 7, Section 86030.5.) The THPP has not identified any living unit at this time. The applicant will notify the Department once the living units are identified. A copy of the LIC809-Pre Licensing Inspection was provided to the Applicants.

met_with: Administrator, Farrah Richmond, Director of Business and Finance, Devoree Ealy


summary: Facility Evaluation

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Narrative:
On February 13, 2025, at 12:00PM, Licensing Program Analyst (LPA) Humberto Flores conducted a Component III Inspection at Pleasantly Support Services Transitional Housing Placement Program (THPP). LPA Flores met with Farrah Richmond and Devoree Ealy, the Applicants. During the meeting continuing requirements for THPPs were discussed. The purpose of Component III is to familiarize the Applicants with general Rules and Regulations, prepare the Applicants on how to maintain and operate their facility, provide information to avoid potential problem areas, provide clear description of Licensing Program Analyst's (LPA) role in operation of facility, and provide clear description of Civil Penalties. During this category-specific training LPA Flores explained in detail the following forms: - LIC503, Health Screening Report - Facility Personnel. - LIC602, Physician's Report for Community Care Facilities. - LIC 613B, Personal Rights Children's Residential Facilities. - LIC 621, Client/Resident Personal Property and Valuables. - LIC624, Unusual Incident/Injury Report. - LIC624A, Death Report. - LIC624LE, Law Enforcement Contact Report. cont.#2 - LIC627B, Consent for Emergency Medical Treatment Children's Residential Facilities. - LIC9020, Register of Facility Clients/Residents. Copies of all the forms were provided to the Applicants. During the inspection it was discussed the latest set of corrections that need to be submitted to the Licensing Agency and the Newly Adopted Regulations for Transitional Housing Placement Programs (Ord No. 0323-02) / Pin 25- Crp. A copy of this report was provided to the Applicants. Exit interview conducted.


facility_name: PRIME IMPACT SERVICE CORP

summary: Facility Evaluation

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Narrative:
On the above date, Licensing Program Analyst (LPA) Reyna Martinez traveled to the Prime Impact Service Corp office in Fresno CA. LPA was met by Licensee Shayla Taylor and Administrative Assistant Virginia Hernandez, for the purpose of a scheduled initial pre-licensing inspection for a THPP+NMD. A general overview of their program and a tour of the facility was provided. This facility has a reception area and office space for staff. Observed fixtures and furniture, equipment and supplies necessary for this operation. Also observed locked cabinets for client and staff files in order to ensure confidentiality. Discussed daily ongoing functions including incident reports. There is ample confidential space for meeting with clients on an as needed basis. The agency employs one administrator, one social worker supervisor, and one administrative assistant. The office was equipped with a first aid kit and a fire extinguisher. All required LIC forms and personal rights are posted in a common area. The THPP is in the process of setting up a Guardian account to associate staff. Agency to provide to LPA Martinez association requests and copies of current identification for any staff to be associated prior to Guardian account approval. The above licensee meets the requirements to be licensed as a THPP+NMD in Fresno County, with the ability to place participants within a two hour radius. On a quarterly basis, facility is to submit a roster of THPP+NMD clients that includes client names, dates of birth, county worker and current address of placement. A copy of this report was provided to the Licensee.

met_with: Shayla Taylor


summary: Facility Evaluation

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Narrative:
On the above date, Licensing Program Analyst (LPA) Reyna Martinez arrived at Prime Impact Service Corp. for the purpose of conducting an unannounced Post Licensing inspection. LPA met with Shayla Taylor, Executive Director and inspected the facility, inside and out. LPA Martinez conducted a physical plant inspection and included the following observation and checks: Client and staff files are kept in locked filing cabinets. The agency has adequate confidential meeting space and space for Social Workers to complete job duties. The facility has a current copy of the license posted in a common area. The agency's office is located within two hours of travel time of the THPP participants living units. The agency has a client roster, with the unit addresses, and contact numbers. The agency employs Administrator/Case Manager, Executive Director, Social Worker Supervisor, Administrator Assistant. A review of their staff files on this date indicates that all facility staff has received child abuse index clearances and fingerprint clearances. Agency staff meets the requirements of respective job descriptions. Staff files meet regulatory standards. The agency currently has THPP NMD participants. LPA Martinez reviewed two THPP NMD Participant files on this date. Participants' files meet regulatory standards. LPA Martinez obtained an updated LIC 500, roster of clients, and certified THPP units certificated. LPA discussed the participant's medical assessments and the assessment to be used to help develop the client's needs and services plans. No deficiencies were noted on this date. An exit interview was conducted, and a copy of this report was provided to Shayla Taylor, Executive Director at the conclusion of the inspection.


facility_name: PRO YOUTH CENTERS THP+FC

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Narrative:
On May 25, 2023, Investigator Miles arrived unannounced at the Transitional Housing Placement Program Participant Living Unit (Reseda location). Investigator Miles was not able to meet with facility staff or Administrator during this visit as there were no staff available during the hours of operation. Confidential statements obtained revealed the live-in staff often left residents unsupervised, unattended and was unreliable. Confidential statements further revealed that drugs and alcohol were often being used by the residents and other individuals while in the facility. According to the programs House Rules, "no drugs or alcohol" are allowed in the home. Based on statements and record reviews, the preponderance of evidence standard has been met, therefore the allegations are deemed substantiated. A deficiency is cited, California Code of Regulations, Title 22, Division 6, Chapter 7, Plan of Operation. Exit interview was conducted with the Administrator. A copy of this report and appeal rights are discussed and provided. Information obtained revealed a lack of evidence to support or corroborate reported claims. Confidential interviews found not enough evidence to prove the alleged as statements indicate denial and or no knowledge of said allegations. Administrator informed LPA that the THPP once located in Reseda has since been closed and is no longer in operation. Based on gathered information, the allegations are determined Unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. There are no deficiencies cited at this time. Exit interview completed. A copy of this report and LIC811 was provided to Facility Representative. Exit interview was conducted. A copy of this report was left with the Administrator.

Investigation Findings:
13On March 5, 2024, at 1: PM, Licensing Program Analyst (LPA), Regina Martin conducted a subsequent complaint inspection to deliver findings concerning the above-mentioned allegations. LPA Martin met with Miki Mcree, Facility Administrator, to discuss the investigative outcome. The investigation was referred to and conducted by Community Care Licensing (CCL) Investigations Branch, Investigator Philippe Ryan Miles. On May 17, 2023, CCL received allegations concerning neglect/lack of supervision as it was reported in part that staff did not prevent youth from using illegal drugs while in care. It was further reported that Residents were not provided with the proper level of care and supervision of the facility. The investigation included review of facility file history, confidential interviews of two Transitional Housing Placement Program Participants, staff members, Administrator, and other related parties. (Continued on page LIC9099-C) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Regina Martin 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 EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: PRO YOUTH CENTERS THP+FCFACILITY NUMBER: VISIT DATE: 03/05/2024

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

met_with: Miki Mcree, Administrator


summary: Complaint Investigation - Unsubstantiated - 3 allegations

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Investigation Findings:
13On 1/30/2025 at 9:30am Licensing Program Analyst (LPA) Justine Armstrong conducted an unannounced visit to Pro Youth Centers THP-FC to conclude the investigation of the above allegations and deliver the findings. LPA met with Miki Mcree, who granted access to the facility, and together, they discussed the investigation details. During the investigation process, all relevant parties have been accounted for. It was reported that Staff allows the minors to engage in sexual intercourse on the facility grounds and Staff allows inappropriate activities on the facility grounds. After conducting confidential interviews and reviewing documents, there was insufficient evidence or testimony to substantiate the allegations.Although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has decided that the allegation of Neglect/Lack of Supervision is Unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies cited. An exit interview was completed, and a copy of this report was provided to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Enrique M Hernandez LICENSING EVALUATOR NAME: Justine Armstrong 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

Allegations:
- UnsubstantiatedEstimated Days of Completion:
- Unsubstantiated Estimated Days of Completion:
- Unsubstantiated Estimated Days of Completion: 60

met_with: Miki Mcree


summary: Facility Evaluation

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Narrative:
On November 18, 2021; This report was Amended due to LPA- Licensing Program Analyst Rosslyn Gray made corrections to identify the correct name where the Residents reside: Single-Site Model Homes. On November 16, 2021 at 10: AM Licensing Program Analyst, (LPA) Rosslyn Gray and LPA Bernice Karnsrithong made an unannounced inspection at for the purpose of conducting an Annual Required Inspection. LPA met with the Administrator, Miki McRee, who granted access into the Administrative Office and provided a tour. The Administrative Office is located at: Canwood St. Ste. Agoura Hills, CA 91301. The office is located on the 2nd floor of the building, and in an executive suite that is shared amongst other businesses. LPA's observed the entire Administrative office. The facility is licensed to provide Transitional Housing Placement plus Foster Care (THP+FC) and Non-Minor Dependents (NMD) for 18 participants ages eighteen (18) through twenty one (21). There are currently fifteen (15) participants in placement residing in the program single site located in Oxnard. The Administrator stated that there are three (3) Single-Site Model Homes located in the Ventura County Oxnard and Residential Lease confirmed. There is one (1) staff is residing in an additional dwelling unit attached to each of the three (3) remote homes. The three (3) Single-Site Model Homes all located in Oxnard California. There are no bodies of water on the premises. The Single-Site Model Homes area located in the following areas: Jason Pl. Oxnard, CA 93033 (4) clients currently in placement; Residential Lease confirmed, copies obtained. Saratoga Street Oxnard, CA 93035 (6) clients currently in placement; Residential Lease confirmed, copies obtained. Deodar Ave. Oxnard, CA 93030 (5) clients currently in placement; Residential Lease confirmed, copies obtained. This report was Amended due to LPA- Gray made corrections to the name where the residents reside: Single-Site Model Homes. LPA reviewed photo images of all three (3) Single-Site Model Homes. The Administrator emailed images of all three (3) as well. LPA's observed the entire Administrative office. The office is set up as follows: There is a conference room with ten (10) chairs, that is utilized for private meetings. This administrative office is equipped with a six (6) chairs conference table, a desk with one (1) computer, a fireplace, and a built in cabinet. This office is used for the Administrator , residents, social workers and any other authorized representative. LPA observed the THP+FC residence files and staff files were stored in the locked file cabinets. Currently the facility is staffed with one (1) Social Worker. The administrator provided evidence of Annual fees are current as date October 26, 2021 and confirmed the total amount of fees. 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 THP+FC residents are provided care and supervision by conducting visit at minimum of 1x weekly. The administrator takes initiative to cook hot meals for all three (3) Single-Site Model Homes. The last week of every month and distributes allowances and grocery gifts cards. The Administrator and staff observe holidays and assist the residence with decorating the homes. LPA's reviewed four (4) staff files and three (3) client files. LPA obtained copies of the Residential Leases for all three (3) Single-Site Model Homes; copy of the LIC- Personnel Report; and the Register of Facility Client/Residents staff roster. LPA cross referenced the criminal record clearances with DOJ, FBI, and Child Abuse Index Check clearances. 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 Amended report will be e-mailed to the Administrator of the THP+FC on 11/18/2021 for signature.

met_with: ADMINISTRATOR


summary: Facility Evaluation

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Narrative:
Licensing Program Manager Angela King and Licensing Program Analyst Sethany Yem conducted a case management inspection on 9/20/23 at 10:43am based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. During this inspection, 3 out of Direct Care Staff and 6 out of 11 youth files were reviewed. 3 out of Direct Care Staff and 3 out of 11 youths were interviewed. (See the Confidential Names List, LIC 811, 9/20/23). The Plan of Operation including policies and procedures were reviewed. Minutes from the Board Meeting Minutes related to the facility's incidents involving contact with law enforcement were reviewed. Based on the analysis of the confidential interviews and youth file review including the Safety Plan, Crisis Prevention Plan and Needs and Services Plan, the licensee uses trauma-informed and evidence-based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. LPM Angela King observed documentation of completed training on policies and procedures on when and how to involve law enforcement in response to an incident. Training records show staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance to their Emergency Intervention Plan when there is an immediate risk of serious harm to a child or others. There are no deficiencies cited at this time. A copy of this report was discussed and provided to Administrator Miki McRee.

met_with: Administrator Miki McRee


summary: Facility Evaluation

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Narrative:
November 09, 2023 at 9:58AM LPA- Licensing Program Analyst Rosslyn Gray made an unannounced visit PRO YOUTH CENTERS THP+FC Administrative Office is located at: Canwood St. Ste. Agoura Hills, CA 91301, in attempt to conduct an Annual Random Inspection. Upon arrival LPA made several calls via phone and text message to contact the Administrator, Miki McRee. Prior to departing S1 returned the call and informed LPA that she will not be available due to traveling out of town. LPA and S1 agreed upon a date the following week to conduct the inspection. On November 15, 2023 at 10: AM LPA- Licensing Program Analyst Rosslyn Gray returned to conduct an Annual Random Inspection. LPA met with the Administrator, Miki McRee, who granted access to the Administrative Office. The Administrative Office Suite 203 is located on the 2nd floor amongst other businesses. The facility is licensed to provide Transitional Housing Placement plus Foster Care (THP+FC) and Non-Minor Dependents (NMD) for 18 participants ages eighteen (18) through twenty-one (21). LPA observed the entire Administrative office. There are currently eleven (11) participants in placement residing in the program Single-Site Model Homes located in Oxnard and Ventura County. There is one (1) staff residing in an additional dwelling unit attached to each of the two (2) homes. There are no bodies of water on the premises. LPA reviewed the Personnel Report (LIC 500) and confirmed that staff present for eleven (11) participants in placement. LPA confirmed that all staff have required criminal record clearance. DOJ, FBI and Child Abuse Response; which meet qualification. LPA observed staff training certificates from Community Training Connection and RELIAS training for various topics including Trauma Informed. LPA observed that the clients receive mental health services including psychiatric services from Ventura County Behavioral Health and the Transitional Aged Youth Program. LIC Page: 1 of LPA obtained and confirmed the Residential Lease agreement for the two (2) (Single-Site Model Homes . The 1st Single-Site Model Home located in Oxnard six(6) clients currently in placement. The 2nd One (1) Single-Site Model Home located in Ventura five (5) clients currently in placement. LPA ensured to thoroughly review active staff files (i.e Program Administrator, two (2) Live in Staff/Case Workers, Support and Assess staff and the Social Worker. Staff Records Review: LPA reviewed four (4) staff records stored in individual personnel file/binders. Clients Records Review: LPA reviewed six(6) clients records which met qualification. Staff Interviews: LPA conducted a confidential interview with one (1) staff. Client Interviews are not required. There were no deficiencies cited at this time. LPA's concluded the Annual/Random Inspection. An exit interview was conducted, and a copy of this report was left at the facility with the Facility Manager on 11/15/2023. LIC Page: 2 of 2


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Narrative:
continued...Plan, provide resources for after care by means of providing referrals to alternate residential programs where the youth can continue to obtain case management, individual and group therapy, as well as medication management, if needed, and ensured the client is financially stable. Staff also reported the incident within proper time frame. Due to lack of evidence obtained during the investigation. LPA determined that the allegations of lack of supervision is Unsubstantiated at this time meaning, although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. There are no deficiencies cited at this time. An exit interview was conducted, and a copy of this report was provided to the Program Administrator Miki McRee. PAGE 2 of 2

Investigation Findings:
13On March 10, 2026, at 04.30PM Licensing Program Analyst (LPA), Rosslyn Gray contacted the administrator to conclude the complaint investigation and to deliver the findings. Prior to entering the facility LPA Gray conducted a health and safety risk assessment. During the investigation, LPA Gray interviewed all relevant parties available and gathered pertinent information in reference to the allegations. Based on confidential interviews and review of documentary evidence, there is no evidence or witnesses to support, or to determine Staff are not preventing client from engaging in inappropriate behaviors. Records confirm that the staff were in ratio to monitor the youth. Confidential interviews were congruent that the staff provided proper supervision observed, provided verbal intervention, encouraged the client to make better choice, and identified a threat, contacted law enforcement to ensure the safety of clients and staff. Staff notified the clients authorized representatives, ensured to meet the needs of client during placement by means of an Appraisal/Needs And Service.. 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 EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: PRO YOUTH CENTERS THP+FCFACILITY NUMBER: VISIT DATE: 03/10/2026

met_with: Miki Mcree Program Administrator


facility_name: PRO YOUTH CENTERS, INC

summary: Facility Evaluation

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Narrative:
On July 17, 2025, License Program Analyst Justine Armstrong(LPA) and License Program Manager Enrique Hernandez (LPM) made an announced visit to the Pro Youth Transitional Housing Placement Program Administrator's Office for the purpose of conducting a pre-licensing visit. LPA met with Administrator Miki McRee at 10: AM and toured the administrator's office. Applicants will be utilizing an office space located at Palma Dr., Ventura, CA. The office is a private suite equipped with one desk, three chairs, and a computer. The Licensing Program Analyst (LPA) also observed a locked file cabinet designated for client files, a printer, a shredder, and extra office supplies on the desk. The office has one door for entry and exit. The office space displays the Facility License, a client roster, an Emergency Disaster Plan, and a facility map. The LPA and LPM toured the office and observed three conference rooms: two located upstairs and one downstairs. The first upstairs conference room contains three chairs and one table, the second upstairs conference room has eight chairs and one table, and the downstairs conference room features one desk with seven chairs. These conference rooms are available for conducting private and confidential meetings with clients and social workers. Continued on LIC809C All required documents have been received by the LPA. No additional documentation was obtained during today's pre-licensing inspection. LPA advised the Administrator to buy a noise generator to utilize in the conference room to increase the privacy and confidentiality of client and social worker meeting. LPA also advised the Administrator to update the forms in the Program Statement with the new administrator address and to send a copy to LPA J. Armstrong once updated. LPA provided a copy of this report to the Administrator.

met_with: Miki McRee