summary: Facility Evaluation

raw_content:
Narrative:
On June 25, 2024, Licensing Program Analyst (LPA) Deborah Lee and Licensing Program Analyst Kenrick Ellis arrived at the above facility, for the purpose of conducting a Pre- licensing inspection for a Small Family Home License. LPA met with applicant, Eric Kinney who granted access into the home. The applicant and LPAs toured the facility both inside and out. Currently residing in the home is applicant. Applicant is requesting to be licensed for 4 clients ages 3-17 ambulatory only. The home was inspected and the following was observed: This is a one-story house on a duplex property with private home behind facility. The property does not contain a garage, a pool, or backyard. There is a chain link fence around the entire property. Living Room/Family Room: There is adequate furniture which is in good condition. The area is is equipped with a sofa, 4 straight back chairs, 32' television with gaming system on an entertainment center. Home entrance is protected by a black bar screen, followed by wooden door. Windows operational with vertical blind and screens are operational. There is hardwood flooring with an area rug located in the living room in front of sofa. Dinning area contains a four seated dining set with four straight back chairs. There is a wall heater next to the entertainment center with safety wall heater cover. Smoke alarms were tested during the inspection; there are a total of 4 smoke detectors (2 combo-Carbon/smoke detector located in living room and hallway, 2 smoke in bedrooms 1 and 2) and they all in working condition. Formal Dining Area has a 4 seated dining table. Page 1 of Kitchen: Is equipped with a functioning fire extinguisher mounted on the wall, an operable 4 burner stove, refrigerator/freezer, a chest deep freezer, small kitchen counter appliances, a proposed menu posted, locked cabinet for cleaning supplies and sharps to be inaccessible to clients in care. Bedroom #1: is located off of the hallway and is equipped with bunk bed, computer desk, operable computer, walk in closet with shelving and will be occupied by up to 2 clients. Bedroom #2: is located to right of hall way and is equipped with 2 twin beds, clean bedding, adequate closet, chest of drawers non operation ceiling fan ( has an operable standing portable fan. This room be occupied by up to 2 clients. Bedroom #3: is equipped with 1 king sized bed and it occupied by applicant. Room will be utilized a personal dwelling space and office. Room is equipped with desk computer, printer, office chair, refrigerator for potential medication storage. There is a locked container to be used for centrally stored medication. All rooms are clean, safe, and sanitary. Outdoor activity space (front yard) free of obstructions. The first aid kit checked and is complete with scissors, tweezers, thermometer, and gauzes, antiseptic. Fire Extinguisher available in the home. The home will utilize Dodge Charger to transport clients in care. Current automobile insurance is with Mercury Insurance Company and is current. Prior to being licensed the following is required: · Small repairs needed in driveway area. There was unlevelled concrete posing a potential safety. Applicant to repair area and send proof of repair to LPA. · Large rock to be removed from front yard which poses a potential safety hazard. Applicant to remove rock and show proof of removal to LPA Page 2 of LPA's recommendations: · Curtain rod in bedroom #1 needs to replaced · Written emergency/evaluation plan. Exit Interview was conducted and a copy of this report will be emailed to applicant Page 3 of 3

met_with: Eric Kinney, applicant


state: CA

facility_name: KINNEY SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On September 23, 2024, at 9: AM, Licensing Program Analyst (LPA), Cheri Wilkerson, and Licensing Program Manager (LPM), JoAunne Griffin arrived at the above facility for the purpose of conducting a Post-Licensing Inspection. LPA and LPM met with Licensee, Eric Kinney. A health and safety assessment was conducted. This is a one-story house on a duplex property with private home behind facility. Living Room/Family Room: Is equipped with a sofa, four chairs, television, and gaming system. Formal Dining Area: Is equipped with a table and four chairs. The wall heater has a safety cover. Kitchen: Is equipped with a fire extinguisher that is mounted to the wall, stove with burners, refrigerator/freezer, and deep freezer. Weekly menu is posted. The cleaning supplies and sharp objects are in a locked cabinet and inaccessible to clients in care. Bedroom #1: Is located off the hallway and is equipped with bunk beds, a computer desk, an operable computer, a walk-in closet with shelving, and adequate lighting. Bedroom #2: Is located to right of hallway and is equipped with two twin beds. There is adequate closet space and lighting. Continue Pg. Bedroom #3: Is equipped with one king sized bed and is occupied by the Licensee. The room will be utilized as a personal dwelling space and office. The room is equipped with a desk, computer, printer, and an office chair. There is a refrigerator and locked container to be used for centrally stored medication. Camera(s): There are two cameras located in the home. One camera is located in the living room corner. The other camera is located in the hallway. Mr.Kinney was advised to remove the sound to prevent voice recordings. The cameras are monitored through the Ring App. Facility was observed to be clean, safe, and sanitary. Water temperature is within a safe range. There are no firearms or dangerous weapons in the home. Outdoor activity space (front yard) is free of obstructions. The first aid kit is complete with required items. All smoke/carbon monoxide detectors were observed to be in working order. All posting requirements are met. Licensee advised that all assistant caregivers are required to be fingerprint cleared prior to working in the facility. The home will utilize Dodge Charger to transport clients in care. Current automobile insurance is with Mercury Insurance Company and is current. There were no deficiencies cited at this time. The exit interview was conducted, and a copy of this report will be emailed to Licensee.

report_type: Facility Evaluation

met_with: Eric Kinney, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On June 2, 2025, at 9: AM, Licensing Program Analyst (LPA), Erika Butler, and Licensing Program Manager (LPM), JoAunne Griffin conducted a Small Family Home (SFH) Component III office meeting with Licensee, Eric Kinney. LPA Butler and LPM Griffin met with Applicant to discuss forms required to be maintained, available, and posted at the facility for inspections. We discussed child and personnel records that are required to be documented, retained and available for inspection. We also discussed specific requirements, concerns and issues operating a SFH, such as, reporting requirements, personnel requirements, supervision, intake issues, compatibility, removal/discharge policies, complaint procedures, transportation, health services, food, hygiene, visitation, personal property, searches, and community sensitivity. A copy of this report will be emailed to the Licensee, Eric Kinney.


summary: Facility Evaluation

raw_content:
Narrative:
On July 28, 2025 at 2: PM Licensing Program Analyst (LPA) Cheri Wilkerson, License Program Anaylst (LPA) Erika Butler-Williams and Licensing Program Manager (LPM) Enrique Hernandez conducted an Informal Meeting with the Licensee Eric Kinney from Kinney Small Family Home. The meeting was conducted at El Segundo Local Unit Children Residential Regional Office located at Continental Blvd El Segundo, CA 90245. The purpose of the meeting was to discuss the facility concerns. El Segundo Children Residential has concerns on the following things: Complaint allegations 3 within 12 months License responsibilities and required presence Supervision and Training Mandated Reporting Responsibilities Document incident with Staff Protection of Child Personal Rights Facility Manager Concerns Staff Policy and Procedure Current food inventory practices and meal routines Capacity Change Request Discussion of intent and anticipated changes Open Discussion Summary of Next Steps (LIC Continued on 809C) Recommendations: The department recommends that the Licensee document instances when staff do not adhere to policies and procedures. It is important to update staff policies and procedures regularly. Continuing to ensure the safety and well-being of all minors in the facility is essential. The Small Family Home Licensee should be present at the Small Family Home during unannounced visits from the LPA. The Licensee must comply with Title 22 regulations and Community Care Licensing (CCL) requirements. During this meeting Eric Kinney was provided with the Technical Support Program (TSP) services handout. A copy of this report was provided to the Licensee.

met_with: Eric Kinney


facility_name: KIOWANEXUS

summary: Facility Evaluation

raw_content:
Narrative:
On October 16th, 2025 at 11: AM Licensing Program Analyst (LPA) Olena Maico , conducted an unannounced Post-Licensing Inspection for the Small Family Home and met with Jedidah Kiema, Licensee LPA Maico toured the facility inside and outside with the Licensee. This is a 2-story house which will serve ambulatory children. The first story of the house consists of: a dining area, kitchen, entrance to the backyard, living room, two bedrooms and 2 bathrooms (one full bath inside bedroom and 1/2 bathroom in the dining area). The first bedroom and full bath is currently occupied with an adult family member who has a Guardian clearance. The 2nd bedroom currently occupied by the youth in care and has two twin beds and storage area for the client. The rooms are safe and sanitary. LPA observed assistant form the Regional Center who is not employed by the SFH and does not being left alone with the children. LPA will contact Regional Center for clarification on the staff assignment and duties. LPA found the chemical stored under the kitchen sink and bathrooms and garage cabinets. LPA notified the licensee that the chemicals have to be made inaccessible to clients. Citation will be issued. LPA also observed mold under the kitchen sink and will issue a citation. LPA also observed knives unsecured inside the kitchen cabinets and informed licensee the knives have to be inaccessible. Citation will be issued. LPA observed cameras inside the facility and inside the room of the client. LPA inquired if the medical approval for camera use was received due to the client medical condition, and licensee was not able to provide it at this time. Licensee will contact the doctor to obtain a note. For now the licensee will arrange supervision other than camera until the approval is obtained. LPA observed the fire place to be accessible to client and have items near it, that could be a potential fire hazard. LPA informed the licensee the area has to be cleared and the fire place need to be made inaccessible. LPA also observed the garage, where there is storage and the washer/dryer hookup. The upstairs area has 3 bedrooms and 3 bathrooms. One of the rooms did not have beds inside. Licensee informed LPA they submitted documents to the Riverside Regional Office for the relocation and the fire clearance for that location was approved 09/29/25. LPA contacted Licensing Program Manager and Monterey Park has not received any information from Riverside about the relocation. LPA will contact the Riverside Regional Office for the status and update. LPA advised the licensee to update LIC 308 with current names of the staff, and the Affidavit for Cash Resources to reflect the correct amount based on the bond issued. Licensee will e-mail LPA the forms. LPA also advised the LIC 9020 to be completed for the client. LPA reviewed staff files and client files. Licensee is signed up for the online classes and will be taking the necessary hours by the end of the year. The medical assessment for the licensees was verified. LPA observed medical and dental assessments, Needs and Services Plans, admission agreements, educational documents for the clients. LPA issued 4 citation, Technical Violations and Two Technical Advisories. The copy of this report, LIC 811, Appeal Rights, LIC D and LIC 9120TV and 9120TA were provided to the licensee.

met_with: Jedidah Kiema, Licensee


facility_name: KIOWANEXUS CHILDREN HOME

summary: Facility Evaluation

raw_content:
Narrative:
On February 14, 2022, at 1:00PM, Humberto Flores, Licensing Program Analyst (LPA), conducted a Component II Face to Face meeting with Jedidah Wanjiku Kiema and Samuel Kioko Kiema. The purpose of the face-to-face interview, was to held to discuss the application packet and process, and to ensure that the attendees understand the services outlined in the facility program. LPA Flores reviewed Title 22 of the California Code of Regulations, and the provisions that are specific to the applicant facility type. The applicants were provided with assistance in understanding the process in its entirety. During the interview it was discussed and analyzed the licensing forms that need correction or are missing information: - LIC200 - Application. Capacity it is 6 (#10), but then in #11 you input 2 infants' clients, and 6 clients ages 3-17, that equals 8. Please correct it. - LIC308 - Designation of Facility Responsibility. The facility # 367800008 is missing. - LIC402 - The original form is needed and the amount of the bond must be for $3,000.00. - LIC500 - It needs to reflect a 24hrs schedule. cont.# LPA Flores highlighted the areas of the Program Statement (PS) that need to be developed and corrected. The applicants were explained that there are Sections in the PS that do not require to be addressed in different sections if they belong to the same topic. LPA Flores emphasized that every time that a section of regulation is referenced, that regulation needs to be named. Acronyms are highly recommended, but they need to be spelled at least one time. The applicants were reminded that the dateline for submitting the corrections indicated in the e-mail sent on 01/28/2022, is 02/28/2022. A copy of this report was provided to the Applicants. Exit interview conducted.

visit_type: Case Management

met_with: Jedidah W Kiema and Samuel Kiema


summary: Facility Evaluation

raw_content:
Narrative:
On February 25, 2022, at 10:30AM, Humberto Flores, Licensing Program Analyst (LPA), conducted an announced Pre-Licensing Inspection at the above address for the purpose of approval of its License and met with Jedidah and Samuel Kiema, the Applicants. LPA Flores toured the facility inside and outside with the Applicants. This is a 2-story house located in a community and will serve ambulatory children only. The first story of the house consists of: dinning room, kitchen, living room and a half bathroom. LPA Flores observed that sharp items and knifes are locked with child proof safety locks (CPSL) and inaccessible. The chemicals are located inside a closet with CPSL in the bathroom, the bathroom has no shower. Medications will be stored in a locked cabinet compartment located in the kitchen. The second story of the house has 4 bedrooms and 2 bathrooms: Room #1: has a queen bed with a mattress, sheets and pillow and a crib its mattress, it has drawers and a closet. The Applicants disclosed that this room will be use by an employee when overnight stay is needed. # Room #2: it has two beds with mattresses, sheets, pillows, drawers and a closet. There is a door that provides access to a small balcony. The Applicants will install alarm in the door as a safety feature and supervise when a child opens the door. Room #3: it has two beds with mattresses, sheets, pillows, drawers and a closet. There is a glass computer desk with a computer, keyboard and a chair. The Applicants were informed that bedrooms cannot be commonly used for other purposes, and the office equipment need to be removed. There is a door that provides access to a small balcony. The Applicants will install alarm in the door as a safety feature and supervise when a child opens the door. Room #4: Master Bedroom. It has a queen bed with mattres, sheets, pillows and a crib with its mattress and a bathroom. The bathroom has a shower and a tub. There is a third bathroom on the second story of the house with 2 sinks and a shower. This bathroom will be used by the placed children. The Applicants stated that there are no firearms in the house. The house temperature is maintained with a centralized air conditioning unit, during the inspection the temperature was at 68F. The water temperature was checked at 110F. The home phone was tested, and it is operational. The smoke detectors were checked and are operating properly. There are 2 fire extinguishers, 1 is located on the first story and the second one is located on the second story and are fully charged and not expired. cont.# According to the Applicants, the local Fire Department conducted a Fire Inspection on 02/24/2022. Pending with the result that will be mail to the Licensing agency. The Applicants requested another extension to submit the corrections to the Program Statement (PS) that are due by 02/28/2022. LPA Flores informed that the new dateline is 03/14/2022. The Applicants were informed that this inspection is pending the installation of the alarms on the doors in the children's bedroom #2 and #3, the Fire Clearance Inspection and the submission of the corrections needed of the PS. A video showing how the alarms works is needed and the Applicants agreed to send it to LPA Flores via text message. A copy of this report was provided to the Applicants. Exit interview conducted.

visit_type: Prelicensing

met_with: Jedidah Kiema, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On August 9, 2022, at 11:15AM, Licensing Program Analyst (LPA) Humberto Flores, conducted an unannounced Post-Licensing Inspection at Kiowanexus Small Family Home (SMH) and met with Samuel Jedidah. The purpose of the inspection was informed to the Licensee. During the inspection a copy of the Personnel Report was provided upon request. There is no client currently. The following topics were inspected: PHYSICAL PLANT: A tour of the facility was conducted, along with the Licensee. The License was placed in a prominent place. Children's foster rights were available upon request. LPA Flores observed that the facility is clean, safe, sanitary and in good repair. The passageways are unobstructed. The disinfectants and cleaning solutions were stored away from the kitchen areas, food preparation areas to the children. The food is safe and of the quality and the quantity necessary to meet the needs of the clients. cont.# Each meal meets at least 1/3 of the recommended in the USDA Basic Food Group Plan-Daily Food Guide. Supplies of staples non-perishable foods for one week and perishable foods for two days are maintained in the facility. The temperature in the rooms that clients will occupy is maintained between 68 and 85 degrees (F) and the hot water temperature was at 109 degrees (F). Emergency Intervention Plan: LPA Flores reviewed the Emergency Intervention Plan. CLIENT RECORDS: There is no client currently. Staff Records: A total of 2 employees' file was reviewed. The files contain the following documentation: Child Abuse Index Checks/Department of Justice (DOJ)/Federal Bureau of Investigation (FBI) criminal record clearances, criminal record statement, a health screening with tuberculosis test and First Aid Certificate and Cardiopulmonary Resuscitation for the licensees. No citation was issued. No further inspection is needed. A copy of this report was provided to the SMH representative. Exit interview conducted.

met_with: Samuel Jedidah, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced annual inspection was conducted by Licensing Program Analysts (LPA) Carrie Palmer on 2/16/2024. During this visit, LPA Palmer met with Jedidah Kiema and Samuel Kiema. Physical Plant LPA Palmer toured the facility. This is a 2-story house located in an enclosed community serving ambulatory children and non ambulatory children. The first story of the house consists of: a dinning room, kitchen, living room, 1st bedroom and a bathroom. The chemicals are located inside the cabinet under the kitchen sink and inaccessible. Medications are stored in a locked cabinet in the kitchen. The second story of the house has 3 bedrooms and 2 bathroom. Operational Requirements The operational requirements were reviewed. LPA Palmer conducted an emergency drill with the provider and walked the property to locate the utility shut off valve located in the garage. Temporary Relocation Sites were listed and emergency phone numbers were posted. Disaster drills must be conducted every 6 months by the provider. . No citation was issued. A copy of this report was provided to the Small Family Home representative. Exit interview conducted.

visit_type: Annual

met_with: Jedidah Kiema, Foster Parent


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced annual inspection was conducted by Licensing Program Analysts (LPA) Carrie Palmer on 3/06/2024. During this visit, LPA Palmer met with Jedidah Kiema and Samuel Kiema. Staff Interviews LPA Palmer conducted 2 staff interviews. LPA interviewed the Administrator and the Program Director who are also known as the foster mother and foster father in the small family home. Client Interviews The client is non-verbal. Staffing Records The administrator and program director were able to provide documents as it relates to training's such as CPR, Nutrition, Menu Planning, Caring for Medical Fragile Children, Independent Living Skills, Prudent Parenting Skills, How to Work with Child and Family Teams, How to Deal with Asthma and Respiratory Infections, and How to Help Children with Higher Education, etc.. LPA was able to review physical exams to include TB testing. LPA advised facility to organize their staff files and client files in separate folders. No citation was issued. A copy of this report was provided to the Small Family Home representative. An exit interview was conducted.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced annual inspection was conducted by Licensing Program Analysts (LPA) Carrie Palmer on 3/28/2024. During this visit, LPA Palmer met with Jedidah Kiema and informed her of the nature of the visit. The following domains were reviewed: Client Records and Children with Special Health Care Needs. Client Records During the review of the client records, LPA observed that the facility has a separate record for the client to include admission date and a signed placement agreement. The child's file also includes the name, address, and phone number of doctors, dentist and mental health providers. Assessments were provided for the child including ambulatory status. A copy of the Needs and Services Plan and the Individual Program Plan were present in the file. The Designated Facility Responsibility Form includes the emergency contacts in the event facility representatives are not available. There was no Form 9158 (Telecommunications Form) observed in the file. LPA Palmer, emailed the form to the facility and the facility printed the form and placed it in the file during the visit. There is evidence that the Needs and Services Plan has been updated at least quarterly. Page 1 of Medical Assessments were conducted within 30 days of acceptance and the medical assessments were in compliance (were not older than 1 year). The assessments were performed by licensed physicians. Diet restrictions were noted in the file. There was no evidence in the file regarding TB results and the facility administrator was unable to provide the document. Children with Special Health Care Needs During the review of client records it was observed that medical problems are listed in the Needs and Services Plan. It was also determined in an interview with the administrator and observation of storage in the facility that the small family home ensures the care for clients with incontinence and that products are stored to support the client such as diapers and wipes. The client is kept clean and dry and the facility remains free from odors. Technical Assistance Violation Telecommunications form LIC 9159 was not in the file. LPA sent the form to the Administrator during the review. Facility Administrator printed, signed form and placed in the file during Type B The facility staff was unable to provide evidence of TB results in the file for the child. One type B was issued and 1 technical assistance was issued during the visit. A copy of this report was provided to the Small Family Home representative. Exit interview was conducted. Page 2 of 2


facility_name: KJD SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On June 27, 2024 at 10:40AM, Licensing Program Analyst (LPA) Adaleyci Caballero met with Licensee Kameron Taylor via Microsoft Teams Meeting for a Component II of the application process. Lpa a. Caballero went over revisions needed for the application prior to license. Lpa a. Caballero gave a copy of the LIC 184, Notice of Incomplete Application, and additional correspondence to assist with the revisions needed to the application. A copy of this report was provided to applicant via email. Original signed copy of this report will be placed in the facility file.

met_with: Licensee-Kameron Taylor


summary: Facility Evaluation

raw_content:
Narrative:
On July 10, 2024, at 1:30PM, Licensing Program Analysts (LPAs) Adaleyci Caballero and Rachel Vanegas completed a pre-licensing inspection of KJD Small Family Home (SFH). LPA met with Applicant Kameron Taylor who led a tour of the home. The facility was toured both inside and out with the applicant. There are no clients in placement. The home is a one-story building with three bedrooms and two full bathrooms which are set up as follows: · Bedroom #1 (Applicant) It consisted of a queen bed that sleeps applicant and adult. · Bedroom #2- It consisted of two single beds. The beds had linen, comforters, and pillows. It will sleep two clients. · Bedroom #3- It consisted of a single bed. The bed had linen, comforters, and pillows. It will sleep one client. · A living room, kitchen, dining area, den, laundry room, two car garage, and a backyard. The applicant's bedroom will be utilized as an office space inaccessible to clients in care. The garage will be utilized for storage. The clients' bedrooms were arranged so that no more than two clients will be in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the clients' belongings. There was a smoke detector in every bedroom. The six smoke detectors were checked and working properly. Smoke Detector and Carbon Monoxide detectors are combined. The home's central air conditioning module was in the backyard. The water heater was in the garage. The appliances were in working order. The client's files will be locked inside a filing cabinet in the applicant's bedroom. There was adequate food storage space and a supply of two days of perishable foods and a week of non-perishable foods. The home had a trash can for storage of solid waste with a tight-fitting lid. The sharp knives were locked in a lock box in a kitchen cabinet. Medications will be locked in a lock box inside the pantry. The hot water was at a temperature of 118.2 degrees Fahrenheit. The First Aid kit was accessible and was placed in a drawer in the kitchen. There was one fire extinguisher present in the home located in the laundry room. It was observed to be properly charged and inspected by the fire department. There are no firearms in the home. There is no pool or other bodies of water at the home. The backyard is fully fenced and free of debris. The home has six cameras on the outside premise and four cameras in the common areas of the home. No corrections to be made. Component III was conducted. An exit interview was conducted, and a copy of this report was provided to applicant Kameron Taylor. Application will be forwarded to Licensing Program Manager Jennifer Smith for licensure.


summary: Facility Evaluation

raw_content:
Narrative:
On September 24, 2024, at 10:45AM, Licensing Program Analyst (LPA) Adaleyci Caballero completed a post-licensing inspection of KJD Small Family Home (SFH). LPA met with Licensee Kameron Taylor who led a tour of the home. The facility was toured both inside and out with the licensee. There are two clients in placement. The home is a one story building with three bedrooms and two full bathrooms which are set up as follows: · Bedroom #1- (Licensee) It consisted of a queen bed that sleeps licensee and adult. · Bedroom #2- It consisted of two single beds. The beds had linen, comforters, and pillows. It sleeps client #1 and Client #2. · Bedroom #3- It consisted of a single bed. The bed had linen, comforters, and pillows. It will sleep a potential client. A living room, kitchen, dining area, den, laundry room, two car garage, and a backyard. The licensee's bedroom will be utilized as an office space inaccessible to clients in care. The garage will be utilized for storage. The clients' bedrooms were arranged so that no more than two clients will be in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the clients' belongings. There was a smoke detector in every bedroom. The six smoke detectors were checked and working properly. Smoke Detector and Carbon Monoxide detectors are combined. The home's central air conditioning module was in the backyard. The water heater was in the garage. The appliances were in working order. The client's files are locked inside a filing cabinet in the licensee's bedroom. There was adequate food storage space and a supply of three days of perishable foods and seven days of non-perishable foods. The home had a trash can for storage of solid waste with a tight-fitting lid. The sharp knives were locked in a lock box in a kitchen cabinet. Medications are locked in a lock box inside the licensee's bedroom. The hot water was at a temperature of 118.2 degrees Fahrenheit. The First Aid kit was accessible and was placed in a drawer in the kitchen. There was one fire extinguisher present in the home located in the laundry room. It was observed to be properly charged and inspected by the fire department. There are no firearms in the home. There is no pool or other bodies of water at the home. The backyard is fully fenced and free of debris. The home has six cameras on the outside premise and four cameras in the common areas of the home. LPA interviewed C1 and Licensee as part of the post-licensing inspection interview requirement. C2 refused an interview. Licensee did not have Tuberculosis tests records for Staff #3 and #4. Technical Violation was issued on the attached LIC 9102TV. An exit interview was conducted and a copy of this report, LIC9102TV, and LIC 811 was provided to Licensee Kameron Taylor.


summary: Facility Evaluation

raw_content:
Narrative:
On July 1, 2025 at 11:30AM, Licensing Program Analysts (LPAs) Rachel Vanegas and Carissa Aviles arrived at KJD Small Family Home (SFH) and met with Licensee, Kameron Taylor. The purpose of this visit was to follow-up regarding an incident involving Client 1 reported on June 12, 2025. An exit interview was conducted and a copy of this report, LIC 811, and appeal rights were reviewed and provided to the Licensee, Kameron Taylor.

met_with: Licensee - Kameron Taylor


summary: Facility Evaluation

raw_content:
Narrative:
On July 31, 2024, at 10: AM, Component II of the application process for K.E. Jones Living 625, located at W. Imperial Hwy, Los Angeles, CA 90047, took place at the California Department of Social Services, Community Care Licensing Division - Children's Residential Program - Regional Office in El Segundo. In attendance were Licensing Program Analyst (LPA) Dennis Jarmin, (LPA) Kim Dear and Applicant Keoishe Jones. The purpose of this Component II meeting was to review the submitted application and Program Statement, addressing and resolving any outstanding items or concerns. The following incomplete application forms were discussed: o A3. Designation of Administrative Responsibility (LIC 308) • Need a designation of responsibility for the one individual designated as the authorized person of the facility to act in the licensee's absence. o A12. Health Screening Report - Facility Personnel (LIC 503) • TB Test portion of the form must be filled out, including the result, or separate test verification is needed. o A15. Facility Sketch (LIC 999) • Sketch must give the dimensions of all rooms and designate their use. Door and window exits must be shown. Indicate exit routes by number as shown on the LIC 610/LIC 610A Emergency Disaster Plan. Rooms to be used by non-ambulatory clients/residents and staff should be identified. o Program Statement: o Update information in the area of medication destruction discussed, dietary options at school sample meal, and 30 days client post-admission assessment form required. Update on the fire clearance. The applicant was advised that the revisions and/or corrections needed to the application and/or Program Statement are due by August 14, 2024. A Pre-Licensing Inspection will be conducted on August 23, 2024, at 9: AM. A copy of this report will be provided to Mr. Jones, the applicant..

met_with: Keioshe Jones


summary: Facility Evaluation

raw_content:
Narrative:
On 08/14/2024, at 12: PM, Licensing Program Analyst (LPA) Dennis Jarmin and LPA Justine Armstrong conducted a pre-licensing visit with applicant Keoshe Jones at the above address. The home is a one story residence with 3 bedrooms and 1 full bathroom, currently with no children residing. The furniture throughout the home is in good condition. The living room features a sofa, wall mounted television, well maintained lighting, and an informational board with a computer desk near the hallway entry. The family room includes a sofa and a large mounted TV, with ample space for family activities, though there is an accessible open heater in the living room. The windows throughout the home are equipped with blinds and screens in good repair, providing natural light. The kitchen is well stocked with food representing all four food groups, and a fire extinguisher is wall mounted near the laundry area. LPAs confirmed that the smoke detectors located in the living room, bedrooms, and hallways are operable, along with an operable carbon monoxide sensor. A First Aid kit is available in a locked cabinet near the kitchen area. The home also features surplus cabinet space in the kitchen, secured with a locking mechanism, as well as a four burner stove, a microwave in good repair, and a dining table with appropriate seating located on the right side of the kitchen. A medication lock box is stored in the staff bedroom, and the hot water temperature was found to be between 105 and 120 degrees. The home is ventilated by natural air with fans throughout, supported by two large portable AC units in the family room and staff bedroom, and there are no bodies of water on the premises. All bleach and cleaning material are locked under the sink and knives were locked in the kitchen cabinet. LPAs observed no cameras at the time of the visit, and the applicant confirmed there are no firearms in the home. Bedroom #1, which is not occupied by the applicant, contains a twin-size bed and a night stand with drawers that need to be replaced with two separate night stands with drawers for each client, along with appropriate recessed lighting and a fan. The following items were identified and recommended: 1. The applicant was advised to replace the bathroom trash can with one that has a lid. 2. Bedrooms #1 and #2 each need separate night stands with 4 drawers for each client. 3. The screen frame in Bedroom #2 needs to be repaired or replaced. 4. The applicant was advised to send a copy of the CA ID for the designated employee and the Criminal Record Statement (LIC 508D). 5. The open-faced heater located in the living room and hallway must be locked and made inaccessible. The home was clean; however, repairs were being conducted during the visit, and a follow-up visit is recommended. An exit interview was conducted with the applicant.

met_with: Keoshe Jones


summary: Facility Evaluation

raw_content:
Narrative:
On 08/20/2024 at 01: PM, LPA Dennis Jarmin, arrived at K.E. Jones to conduct the follow-up Pre-licensing inspection. LPA conducted a walk through of the home to verify the below compliance concerns were completed. The following were observed and corrected: 1. Bathroom trash can was replaced with one that has a lid. 2. Bedrooms #1 and #2 each need separate night stands with 4 drawers for each client were corrected by applicant. 3. The screen frame in Bedroom #2 repaired. 4. Received a copy of the CA ID for the designated employee and the Criminal Record Statement (LIC 508D). 5. The open-faced heater located in the living room/hallway is locked and inaccessible. Exit Interview completed with applicant.


summary: Facility Evaluation

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Narrative:
On 01/27/2025 at 09:30AM, Licensing Program Analyst (LPA) Dennis Jarmin and LPA Justine Armstrong conducted a post licensing visit with licensee at the above address. The home is a one story residence with 3 bedrooms and 1 full bathroom, currently with no children residing. The furniture throughout the home is in good condition. The living room features a sofa, wall mounted television, well maintained lighting, and an informational board with a computer desk near the hallway entry. The family room includes a sofa and a large mounted TV, with ample space for family activities, though there is an inaccessible open heater in the living room. The windows throughout the home are equipped with blinds and screens in good repair, providing natural light. The kitchen is well stocked with food representing all four food groups, and a fire extinguisher is wall mounted near the laundry area. LPAs confirmed that the smoke detectors located in the living room, bedrooms, and hallways are operable, along with an operable carbon monoxide sensor. A First Aid kit is available in a locked cabinet near the kitchen area. The home also features surplus cabinet space in the kitchen, secured with a locking mechanism, as well as a four burner stove, a microwave in good repair, and a dining table with appropriate seating located on the right side of the kitchen. A medication lock box is stored in the staff bedroom, and the hot water temperature was found to be between 105 and 120 degrees. The home is ventilated by natural air with fans throughout, supported by two large portable AC units in the family room and staff bedroom, and there are no bodies of water on the premises. All bleach and cleaning material are locked under the sink and knives were locked in the kitchen cabinet. LPAs observed no cameras at the time of the visit, and the applicant confirmed there are no firearms in the home. Bedroom #1, which is not occupied by the applicant, contains a twin-size bed and a night stand with drawers that in good repair with two separate night stands with drawers for each client, along with appropriate recessed lighting and a fan. Currently, there is no child admitted at the home and therefore no Client Records reviewed and no Client Interview conducted. Staff 1, was interviewed and file reviewed. The home was clean, sanitized and all furniture are in good repair and no deficiency identified at this time. LPA's recommended for licensee to conduct fire drills every 6 months once clients are residing in the home. An exit interview was conducted with the applicant.


summary: Facility Evaluation

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Narrative:
On September 26,2025 at 12: PM, Licensing Program Analyst (LPA) LPA Justine Armstrong conducted a post licensing visit with licensee at the above address. The home is a one story residence with 3 bedrooms and 1 full bathroom, currently with 1 child residing. The furniture throughout the home is in good condition. The living room features 2 sofa, wall mounted television, well maintained lighting. There is an inaccessible open heater in the living room. There is an informational board with the emergency disaster plan, Facility License, Facility map, and suicide prevention poster. There is a computer desk with a computer, printer, and locked file cabinets that lock the client and staff files. Next to the computer desk there is a dining table with appropriate seating located on the right side of the kitchen. The windows throughout the home are equipped with blinds and screens in good repair, providing natural light. The kitchen is well stocked with food representing perishable and non-perishable foods. There was a fire extinguisher wall mounted near the laundry area as well as in the living. LPA confirmed that the smoke detectors located in the living room, bedrooms, and hallways are operable, along with an operable carbon monoxide alarm. (Continue on LIC809C) This was Amendment to correct information regarding the bedroom usage during the Annual Inspection. A First Aid kit is available in a locked cabinet near the kitchen and laundry area. The home also features a large cabinet space in the kitchen, secured with a locking mechanism, as well as a five-burner stove, and a microwave all in working order. The hot water temperature was found to be between 105 and 120 degrees. The home is ventilated by natural air with ac throughout. There are no bodies of water on the premises. All hazardous chemicals and knives are locked under the kitchen sink. LPA observed no cameras at the time of the visit, and the applicant confirmed there are no firearms in the home. Bedroom #1, which is the Licensee room has the locked medication cabinet with Queen bed. Bedroom #2 which is occupied by one client has two twin bed, a dresser, closest, a desk and a mounted TV. Bedroom #3 is not occupied but is ready for clients, it has clean linen on the two twin beds, a dresser, closest, a desk and a TV. All rooms are clean and in good repair. The restroom has a shower, working toilet faucet, trash can with lid, all in clean conditions. LPA reviewed Client file and Staff files. LPA interviewed 1 staff and 1 client. The home was clean, sanitized and all furniture are in good repair and no deficiency identified at this time. LPA's recommended for licensee to conduct emergency drills every 6 months and to document each drill. An exit interview was conducted with the applicant.

met_with: KEIOSHE JONES


summary: Facility Evaluation

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Narrative:
On November 6, 2025, at 1: PM, License Program Analyst (LPA) Justine Armstrong conducted an unannounced case management visit at the above location. Upon arrival the Licensee was not present. LPA called and text the licensee to inform about the visit, LPA will come back to the facility on a different day to resume the case management. On November 14, 2025 at 8: AM , License Program Analyst (LPA) Justine Armstrong returned to the Small Family Home to conducted an unannounced case management at the above location. This case management visit was focused on clarifying the number of beds in the facility and confirming whether the licensee intends to reduce the capacity to three instead of four. During the visit, the LPA observed the conditions in the client's rooms which are Bedroom 2 and Bedroom 3. Both rooms had two twin bed, a dresser, closest, a desk, and a mounted TV. Bedroom 1 is occupied by one client and Bedroom 2 is not occupied. The LPA informed the Licensee to increase or decrease the facility capacity this change would incur a fee of $25, which must be sent to the Regional Office in the form of a money order or check, and a new fire clearance request (STD 850) would need to be sent out to obtain a new fire inspection clearance for the capacity change. Additionally, the licensee would need to submit a LIC 200 form to officially change the capacity. The Licensee stated they do not want to change their capacity and will keep their capacity at four. A copy of this report was provided to the licensee.


facility_name: L & J HOME CARE

summary: Facility Evaluation

raw_content:
Narrative:
On June 19, 2023 at 10: AM Licensing Program Analyst (LPA) Babatunde Aborchie began a Pre-Licensing inspection for a Small Family Home license. LPA met with applicants Latrine Smith and Jerrel Glasper led a tour of the home. The facility was toured both inside and out with the applicants. Applicants are applying for a capacity of 2 ambulatory clients. The home consists of: Downstairs: Bedroom #1, It was furnished with a queen bed. It sleeps applicant's mother and father. There were also a living room, dining area and one bathroom. Upstairs: Bedroom #2, The room consisted of two full beds. It sleeps two biological sons, ages 12 and 14 years. Bedroom #3, The room was furnished with two full beds. It sleeps two biological daughters ages 14 and 18 years. Bedroom #4, The room was furnished with a bunk bed. It will sleep two clients. It is currently vacant. Bedroom #5, Master bedroom. The room consisted of one king sized bed. It has a walk-in closet, shower, a bath and a toilet. It sleeps the applicants. Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate drawer and closet space for children's belongings. The smoke detectors were checked and were working properly. Inside the facility there is no fireplace. Telephone service and appliances were in a working order. All hazardous items have been properly made inaccessible to areas where children will have access. The medication will be locked in a cabinet in the living room area. Cleansers/chemicals were locked and stored in the kitchen cabinet under the kitchen sink. Sharp knives were inaccessible and stored in the kitchen drawer. There were no guns or weapons as stated by applicants at this time. The hot water temperature was tested and noted to be 110 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit were accessible with all required items, and it was in the kitchen drawer and in the laundry room. Two Fire extinguishers were observed and properly charged. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request to be licensed for small family home will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to Applicants/Licensees

met_with: Latrina Smith and Jerrel Gasper


summary: Facility Evaluation

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Narrative:
On July 24, 2023 at 1: PM Licensing Program Analyst (LPA) Karen Beal began a Post-Licensing inspection and a capacity increase for L & J Home Care Small Family Home license. The licensees are requesting a increase from two ambulatory children to four ambulatory children. LPA met with applicants Latrina Smith and Jerrel Glasper led a tour of the home. The facility was toured both inside and out with the applicants. Applicants are applying for a capacity of 2 ambulatory clients. The home consists of: Downstairs: Bedroom #1, It was furnished with a queen bed -Vacant There were also a kitchen, living room, dining area, a locked storage closet, and one bathroom. Upstairs: Bedroom #2, The room consisted of two full and a toddler and sleeps 2 bio children Bedroom #3, The room consisted of two twin beds- vacant Bedroom #4, The room was furnished with a bunk bed. It will sleep two clients. Bedroom #5, Master bedroom. The room consisted of one king sized bed. It has a walk-in closet, shower, a bathroom, It sleeps the licensees. Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate drawer and closet space for children's belongings. The smoke detectors were checked and were working properly. ****Continued to LIC 809-C**** ****Continued from LIC 809-C**** Inside the facility there is no fireplace. Telephone service and appliances were in a working order. All hazardous items have been properly made inaccessible to areas where children will have access. The medication will be locked in a cabinet in the living room area. Cleansers/chemicals were locked and stored in the kitchen cabinet under the kitchen sink. Sharp knives were inaccessible and stored in the kitchen drawer. There were no guns or weapons as stated by applicants at this time. The hot water temperature was tested and noted to be 110 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit were accessible with all required items, and it was in the kitchen drawer and in the laundry room. Two Fire extinguishers were observed and properly charged. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request to be licensed for small family home will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to Applicants/Licensees

met_with: Latrina Smith & Jerrl Gasper Licensees


summary: Facility Evaluation

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Narrative:
On July 7th, 2025, at 09: AM Licensing Program Analyst (LPA) Claudia Aguilera arrived at L &J Small Family Home (SFH) to conduct and unannounced annual inspection. Currently, there is one ambulatory client, the home is licensed for a capacity of five clients. The Facility was toured both inside and out with Licensee Latrina Smith. The home is a two-story building with five bedrooms and three bathrooms. Upon entry, the downstairs floor consisted of the living room with television and couch. The dining area consisted of a large dining room table with eight chairs. The kitchen contained an island with two additional stools for seating, an operable fire extinguisher and a trashcan with a closed lid were observed. Bedroom #1 was also located downstairs and consisted of a bunk bed, large chair, closet and dressers and is currently vacant for two future clients. Bathroom #1 was fully inspected and functioning. The hallway closet remains locked, and it stores medications, sharps, first aid kit with all required items, and client files. An additional hallway storage space was observed to contain linens and hygiene products. The garage was inspected and used for storage. The water temperature was tested and measured at 112.6 degrees F. LPA observed a minimum of seven-day non-perishable and a three-day perishable supply of food. There was a variety of snacks available for the client as well. The upstairs consisted of the master bedroom that sleeps licensees and remains locked and also included bathroom #2. Bedroom #3 consists of one twin bed, a portable closet, television, a dresser and is currently vacant for one client. The laundry room was also located upstairs; cleansers/chemicals/detergents were locked and stored in the laundry room cabinet. Bedroom #4 consisted of two twin beds, television, dresser, and closet. One twin bed is currently occupied by 17-year-old client, the other twin bed is currently vacant for a future client. Bathroom #3 was also located in the upstairs hallway, it was inspected and fully functioning. Bedroom #5 sleeps licensee's biological son. No room was commonly used for other purposes other than a bedroom, and no bedroom serves as a passageway to another room.There was adequate drawer and closet space for each child's belongings. An additional upstairs closet was observed to store additional linens and games. The smoke and carbon monoxide detectors were checked and working. Two operable fire extinguishers were observed: one upstairs and one downstairs . All hazardous items have been properly made inaccessible to areas where clients have access. All windows and screens were in good repair. There were no guns or weapons in the home as stated by licensees. The Licensees were interviewed and one client and no issues were found. The facility outside grounds were also inspected and observed to be clean and well maintained. Emergency exits were free from obstruction. Clients' files and staff files were reviewed and found to be in compliance. During the visit, there were no deficiencies observed. An exit interview was conducted, and a copy of this report was discussed and provided to Licensees.

met_with: Licensees Latrina Smith and Jerrel Glasper


facility_name: LA SIERRA SMALL FAMILY HOME

summary: Facility Evaluation

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Narrative:
On February 9, 2022 at 9: AM Licensing Program Analyst (LPA) Babatunde Aborchie, met with licensee Ivonne Ugalde, who led a tour of the home. The purpose of the visit was to conduct an annual inspection of the La Sierra Small Family Home. The facility was toured inside and out with the licensee. Currently, there are four clients in the home. Three are young adult (YA1, YA2) and two are under legal guardianship (YA3 and C1). The home is set up as follows: · Bedroom #1- YA1's bedroom with full sized bed. Located downstairs. · Bedroom #2- Master suite with Cal-King. Licensee's bedroom. Located upstairs. · Bedroom #3- YA3's bedroom has full sized bed. Located upstairs. · Bedroom #4- YA2's bedroom has a full bed. Located upstairs. · Bedroom #5- C1's bedroom has a full bed. Located upstairs. Bedrooms were arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawer and closet space for children's belongings. The fireplace was properly screened. All hazardous items have been properly made inaccessible to areas where children will have access. Cleansers/chemicals were locked and stored in the locked laundry room. Sharp knives are inaccessible and stored in locked kitchen cabinet. The first aid kit is located in the locked closet between the kitchen and the living room. There were no guns or weapons as stated by licensee at this time. The hot water temperature was tested and noted to be within regulatory requirements. Proper storage of all food was noted. Trash cans for storage of solid waste had tight fitting lids. The smoke detectors located in the hallways were tested and were in good working order. The carbon monoxide detector located downstairs was also operable. The Emergency Disaster Plan with exit map, Title Personal Rights, and visitation policies were posted at this time. The backyard where children will have access to play is completely fenced and free of hazards. There were no bodies of water on the premises. A review of staff records on this date indicates that all facility staff have received criminal record and child abuse index check clearances. In accordance with Title 22, Division 6, Chapters 1 & 4 there were no deficiencies being cited at this time. Exit interview conducted and a copy of this report along with a Confidential Names List (LIC 811) was provided to facility licensee.

met_with: Licensee


summary: Facility Evaluation

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Narrative:
On March 13, 2023 at 1: PM Licensing Program Analyst (LPA) Karen Beal met with licensee Ivonne Ugalde, who led a tour of the home. The purpose of the visit was to conduct a required annual inspection of the La Sierra Small Family Home. The facility was toured inside and out with the licensee. The home is a two-story residence with 5 bedrooms, and 4 bathrooms. There were four three young adults and one child under legal guardianship. According the licensee, the home was also licensed as Adult Residential Facility effective 04/22/2022 and is waiting for Inland Regional Approval. · Bedroom #1-Adult bedroom with full sized bed. Located downstairs. · Bedroom #2- Master suite with Cal-King. Licensee's bedroom. Located upstairs. · Bedroom #3- Adult bedroom has full sized bed. Located upstairs. · Bedroom #4- Adult bedroom has a full bed. Located upstairs. · Bedroom #5- C1's bedroom has a full bed. Located upstairs. Bonus room is being used as an exercise room. Bedrooms were arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawer and closet space for children's belongings. The fireplace was properly screened. All hazardous items have been properly made inaccessible to areas where children will have access. Cleansers/chemicals were locked and stored in the locked laundry room. Sharp knives are inaccessible and stored in locked kitchen cabinet. The first aid kit is located in the locked closet between the kitchen and the living room. The first aid kit is complete and unexpired. The fire extinguisher was replaced on January 11, 2023; it is good for one year. There were no guns or weapons as stated by licensee at this time. The upstairs loft is being used as an office. The house temperature is listed as 68 degrees and the water temperature measured at 112 degrees. The smoke detectors and carbon monoxide detectors were tested and were operational. There were food to cover more than three days.

met_with: Ivonne Ugalde, Licensee


facility_name: LEAP OF FAITH SMALL FAMILY HOMES

summary: Facility Evaluation

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Narrative:
On June 12, 2025, at 1:00 pm, Licensing Program Analyst (LPA) Charmaine Linley, met with applicant Maria Serrano Sanchez for Component II Orientation via Microsoft Teams Meetings. The following areas were covered: two emergency relocations identified and authorization letters provided, health screening report completed, and a copy of the control property documents that show the home is not in escrow. The following questions were discussed and answered: Fire Inspection has not been scheduled yet, a new health screening report can be submitted if needed, and applicant will complete six topics of training identified from Title Regulations 83017(b) Applicant Qualifications. Revisions are due to LPA by end of day on June 27, 2025. LPA will contact the Fire Department to find out the status of the inspection. LPA sent a copy of the LIC 184, LIC 281, Care Tools Pre-licensing form, and CRP PIN 24-09, to assist with the revisions needed to the application via email. A copy of this report was provided to the applicant via email along with the signed Orientation form indicating Component II has been completed. A copy of this report will be placed in the facility file.

met_with: Maria Serrano Sanchez


summary: Facility Evaluation

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Narrative:
On the date listed above, Licensing Program Analyst (LPA) Charmaine Linley conducted Component III Small Family Homes via Microsoft TEAMS with Applicant, Maria Serrano Sanchez. A copy of the handout was emailed prior to Component III and the Pre-Licensing Inspection is scheduled for November 5, 2025, at 10:30 am. A copy of this report was emailed to Maria Serrano Sanchez for a signature and a copy of the signed report will be placed in the facility file.


summary: Facility Evaluation

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Narrative:
On November 5, 2025, Licensing Program Analyst (LPA) Charmaine Linley arrived at the facility to conduct a pre-licensing inspection of the facility. LPA met with Applicant, Maria Serrano-Sanchez, who led a tour of the facility. The facility was toured inside and outside with the Applicant. Currently, there are no clients in placement. The facility is a one-story building with four bedrooms and three bathrooms which are set up as follows: Bedroom #1 (Primary) has one Queen-Sized bed and sleeps the Licensee and their spouse and their infant child. Bedroom #2 (Client) has two single beds and will sleep two clients. Bedroom #3 (Guest) has one Queen-Sized bed and there are no clients that will reside in the bedroom. In the future, this bedroom will be the personal bedroom for the Licensee's infant child. Bedroom #4 (Office) does not have any beds and is used as Office Space. There are no clients that will reside in this bedroom. The facility also consists of a family room, kitchen, dining room, three bathrooms, a laundry room located in the hallway next to bedroom #1, a three- car garage, and the backyard. There is no pool at the home at the time of this inspection. The Client's bedroom was arranged so that no more than two client's will be in a room. No room commonly used for other purposes is used as a bedroom and no bedroom serves as a passageway to another room. *** There was adequate closet space for the client's belongings. There were five smoke/carbon monoxide detectors in every bedroom and hallway. The combo detectors were checked and in properly functioning order. The home's central air conditioning module was located on the East side of the outside of the home. The home's tankless water heater was located in the garage. The home appliances were in working order at the time of this inspection. The Client and Staff files will be locked in a file cabinet located in the locked staff office (bedroom #4). There was adequate food storage space. LPA observed a three day supply of non-perishable food. A trash can for storage of solid waste had a tight-fitting lid and was present in the kitchen. The sharp knives are in a locked cabinet, inaccessible to clients. The medications will be located in a locked box in the locked cabinet in the kitchen. The hot water in the kitchen was measured and registered at 118 degrees at 11:00 am. The bathroom water temperature was checked and registered at 118 degrees, which is within the regulatory requirements. The home's First Aid kit was accessible and is located under the kitchen sink and contained all required supplies. There were two fire extinguishers present in the home located in the kitchen near the dining room and one in the garage. They were observed to be properly charged and inspected by the fire department. There is one firearm, Smith and Wesson 9 firearm, which is stored in a locked safe behind the locked door of the office (Bedroom #4). The ammunition is stored separately and locked in a locked box behind the locked door of the office. The firing pin is stored separately and locked in a locked box behind the locked door of the office. The backyard where clients will have access to play is fenced. The home has five video cameras located on the outside corners of the home and one video camera is located in the kitchen corner above the sink. The following corrections need to be made to the home: Additional storage space will be obtained for the clients bedroom and a photo of the additional drawer space will be emailed to LPA within one week. Applicant was asked to notify their assigned LPA when the first client is placed at the facility. An exit interview was conducted, and a copy of the report was provided to the Applicant. A copy of this report will be placed in the facility file. Licensing Program Manager will review the application and this report and once approved, the Facility License will be printed out and emailed to the applicant.


facility_name: LEAR SMALL FAMILY HOME

summary: Facility Evaluation

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Narrative:
On March 08, Licensing Program Analyst (LPA) Stephannie Verna arrived at the above facility for the purpose of conducing a required/annual inspection of the facility. LPA met with Jeffery Lear, Licensee and introduced self and explained the purpose of the visit. LPA began the required/annual inspection of the facility. The facility is a Small Family Home, consisting of six bedrooms and three bathrooms. There are a total of three clients in care, all are ambulatory. Three clients share a bedroom and they are compatible to share a room. There are a total of two live-in staff, the two licensees. LPA Verna completed a physical inspection of the facility and observed that: The facility was observed to be clean, organized, sanitary, safe and free of debris and clutter. The home contained a living room, a kitchen, dining room, and family room. The dining room and family room had a table for the clients to sit and eat, and complete activities and homework. The client bedrooms were observed to contain an individual bed or crib, clean linens, ample room for medical equipment and storage space for client property. There was a hall closet with extra blankets and linens. LPA observed client games and learning materials stationed in the kitchen dining area and family room. The facility license, facility sketch, emergency plan, emergency telephone numbers, were observed to be posted in a prominent place. The facility smoke and carbon monoxide detectors are present and were tested and are in working condition. The fire extinguisher was observed to be in a prominent location and was charged, up-to-date and was last serviced in the last year. The facility had documentation of drills being completed monthly, however the drills lacked details and what topics were covered during the drill. LPA recommended to licensee to create a disaster drill template, and to include more details about what topic/drill was covered, and any safety tests that were done, including testing of CO2 and smoke alarms in the SFH. The refrigerator and freezer and pantry held enough perishable and nonperishable food in the home in a quantity to meet the needs of the next three meals and the between meal snacks. There was also a refrigerator and freezer located in the garage which held extra frozen foods and the refrigerated medication of the clients. The garage also stored storage items, tools, bikes and activities. The front and backyards were observed to be well maintained and free of debris and hazards. The backyard contained trees, fruit trees, and patio tables and chairs for sitting. During the course of the inspection, LPA reviewed three client files and seven staff files, and observed that: One out of seven staff files reviewed did not contain documentation of a health screening, One out of seven staff files reviewed did not contain documentation of a health screening, One out of seven staff files reviewed did not contain a signed criminal record statement, and One out of seven staff files reviewed did not contain documentation of a current valid CPR and first aid certificate. - See TVs, and There was no documentation of cultural competency training being completed for seven out of seven staff files reviewed. - See TA Only one out of three client files contained a Needs and Services Plan. Three out of three client files did not contain NSPs that were completed/documented annually based on the client's date of placement; One out of three NSP filed in the client files were not signed by the Authorized Representative; and there was no documentation of the licensee's attempts to obtain the NSP signature from the Authorized Representative. - See TVs Interviews were conducted with two staff. Interviews were unable to be conducted with the clients due to their age, being non-verbal and lack of willingness to answer LPA Verna's questions. No citations were issued during today's inspection. An exit interview was conducted with Valerie Lear, Licensee. A copy of this report, were reviewed and provided to Valerie Lear, Licensee.

met_with: Jeffery Lear, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On March 10, Licensing Program Analyst (LPA) Stephannie Verna arrived at the above facility for the purpose of conducing a required/annual inspection of the facility. LPA met with Valerie Lear, Licensee. LPA continued the required/annual inspection of the facility. LPA Verna completed a physical inspection of the facility and during the course of the inspection, LPA reviewed three client medication (MAR) logs, and medications, and observed that: Client medication was observed to be locked, kept separate per each client, and medication administration documentation (MAR) was in compliance with CCL regulations. The medication in the refrigerator in the garage did not have a lock on it. The inside door of the home to access the garage, however did have a lock. The licensee stated they will install a lock on the garage refrigerator as well. - See TV A complete first aid kit was observed and inventoried. The water temperature of the facility was tested at multiple sources, including two client bathroom sinks, and the kitchen sink, and was observed to measure at 105-120 degrees. One interview was conducted with the licensee. Based on staff interviews, it was determined that the staff and licensee require additional training on Mandated Reporting requirements. - See staff Job Duty TV. LPA Verna completed the annual inspection on today's date. No citations were issued during today's inspection. An exit interview was conducted with Valerie Lear, Licensee. A copy of this report were reviewed and provided to Valerie Lear, Licensee.

met_with: Licensee, Valerie Lear


summary: Facility Evaluation

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Narrative:
On 5/11/23 at 8: AM Licensing Program Analyst (LPA) Kim Pawlowicz arrived unannounced at the above-named facility for the purpose of conducting a required annual inspection. Current census is six. One client was present along with 2 staff. LPA met with Matt Lear, Co-Administrator of the facility. LPA toured the two story- 6 bedroom, 3 bath home inside and out with the assistance of Matt Lear, Co-Administrator. The outside of the facility was clean, free of debris, and no safety hazards were observed. There is adequate space and furnishings for clients and their personal belongings. The facility is stocked with food and surplus supplies needed to care for clients. Smoke/Carbon detectors and fire extinguishers are in working order however there is no functioning smoke detector/carbon monoxide detector on the second floor. LPA reviewed five client files and five staff files. LPA interviewed the two staff that were on shift and one non-verbal client with the assistance of staff. One Title 22 deficiency is being cited at today's inspection for CCR 83078(e) Buildings and Grounds: Every small family home shall have one or more functioning carbon monoxide detectors on every occupiable level of the home, including basements, and near all sleeping areas as required by the California Fire Code, that meets the standards established in Health and Safety Code Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The detector shall be audible in each bedroom. An exit interview was conducted and appeal rights were discussed with Matt Lear, C0-Administrator. A copy of this report was emailed due to LPA's printer not working.

met_with: Matt Lear, Co-Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Kayla Green made an unannounced Annual inspection on 05/15/24 at 10:05 am. During the inspection LPA met with Valerie Lear Licensee who assisted with the inspection. LPA conducted a walk-through of the facility inside and out. LPA inspected and/or reviewed the following: Currently there is one client home and three staff. LPA observed the facility is a two story home with 6 bedrooms and 3 bathrooms. LPA Green inspected the Physical Plant has: Posting of license_X__ Personal Rights_X Disinfectants/Cleaning solutions inaccessible_X_ Refrigerator Temperature at or below 45 degrees F _ Freezer Temperature at or below 0 degrees__-4_ Nonperishable Foods one week and fresh perishable foods two days minimum_X_ Menu present and posted__X_ Working telephone _X_ Carbon monoxide detectors __X__Smoke Detector _X_ Common Room available_X Dining area (enough seating, furniture good condition, not broke or damaged) _X_ Medication centrally stored, locked/inaccessible _X Office (locked and privacy) _X_ Hot Water between 105-120 degree F (Properly labeled if over 125 degree F_X_ Fire Extinguisher (note inspection date) _03/01/24__ Toilets wash basin, bath and shower fixtures in good repair/no leaks/hot water temperature _X__ Soap and Paper towels _X__ Laundry Facilities(available, work assign dates) __X__ Bedrooms-required linen and furnishings __X_ Motor Vehicle properly maintained , lights, tires, registration/insurance and working seat belts_X__ Facility free of vermin _X__ Locked Facilities (open locked storage area/building/sheds) N/A. Bedroom (required bedding/furniture, furniture in good repair) _X____ LPA observed the backyard and front yard and saw nothing of concerning. LPA reviewed three client files and six staff files. There was three staff in the home and one client during the inspection.

met_with: Valerie Lear Administrator


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) Maie Soliman made an unannounced Annual inspection on 05/14/2025 at 08:50 am. During the inspection LPA met with Valerie Lear Licensee who assisted with the inspection. LPA conducted a walk-through of the facility inside and out. LPA inspected and/or reviewed the following: Currently there is one client home and three staff. LPA observed the facility is a two story home with 6 bedrooms and 3 bathrooms. LPA Soliman inspected the Physical Plant has: Posting of license_X__ Personal Rights_X Disinfectants/Cleaning solutions inaccessible_X_ Refrigerator Temperature at or below 45 degrees F _ Freezer Temperature at or below 0 degrees__-4_ Nonperishable Foods one week and fresh perishable foods two days minimum_X_ Menu present and posted No Working telephone _X_ Carbon monoxide detectors __X__Smoke Detector _X_ Common Room available_X Dining area (enough seating, furniture good condition, not broke or damaged) _X_ Medication centrally stored, locked/inaccessible _X Office Hot Water between 105-120 degree F (Properly labeled if over 125 degree F_X_ Fire Extinguisher (note inspection date) _02/01/25__ Soap and Paper towels _X__ Laundry Facilities(available, Bedrooms-required linen and furnishings __X_ Locked Facilities (open locked storage area/building/sheds) N/A. Bedroom (required bedding/furniture, furniture in good repair) _X____ LPA observed the backyard and front yard and saw nothing of concerning. LPA reviewed three client files. LPA is issuing three TV for CCR 80023(a), 80026(e) and 80076(a)(5). An exit interview was conducted with Licensee Valerie Lear and a copy of this report was left with Licensee.

met_with: Valerie Lear, Licensee


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) Maie Soliman made an unannounced Annual inspection on 05/22/2025 at 12:00 pm to continue annual inspection. During the inspection LPA met with JEFFERY LEAR Licensee and Matt Lear, Direct Support Professional, Dianna Markel care giver who assisted with the inspection. LPA conducted a walk-through of the facility inside and out. LPA inspected and/or reviewed the following: Currently there are three clients home and three staff. LPA reviewed the following: Client Records Number of Clients files reviewed three Individual Program Plan two Centrally Stored Medication and MAR log reviewed three Staffing Number of Staff files reviewed four Criminal record clearances verified four First Aid Certificate four Certified Administrators certificate valid and current one Job title/qualification verified four Hours required training verified Not updated. The following items were reviewed for compliance in the regional office prior to the facility inspection: Annual fees -Annual Emergency Intervention Log - Personnel Roster, Facility Sketch, LIC 500, LIC 610C and LIC 308 - Waivers and Exceptions. Based on records reviewed the Licensee did not comply with the following: Ensure the individualized health care plan for each child with special health care needs is updated. This is a violation of CCR 83069.1(b). Ensure the maintenance, for each client, of a record of centrally stored prescription medications... 80075(k)(7) An exit interview was conducted with Matt Lear and a copy of this report along with citations and appeal rights will be emailed to Matt Lear, Direct Support Professional and and Valerie Lear, Licensee.

met_with: Matt Lear, Direct Support Professional


facility_name: LEGACY

summary: Facility Evaluation

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On April 25, 2023 at 9: AM, Licensing Program Analyst (LPA) Linda Haynes began a pre-licensing inspection for Legacy Small Family Home license. LPA met with applicant Monique Leonard who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there is no client in the home. The applicant is applying to serve 2 clients ages 3 to 17. The home is a two story building with three bedrooms and one and one half bathrooms which are set up as follows: · Bedroom #1 (Master) has one bed sleeps the licensee · Bedroom #2 (Client's) was vacant has two twin beds, it will sleep two clients. · Bedroom #3 (sons) has one full bed, it sleeps the son. · A great room/living room, kitchen, dining area, one and one half bathrooms, an attached one car garage, storage closet, and the backyard. The Client's bedroom was arranged so that no more than two clients will be in the room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There was a smoke detector/Carbon Monoxide detector in every bedroom. The four smoke detectors/carbon monoxide detectors were checked, and they were working properly. There is a dedicated phone line however there is no home phone. The home's central air conditioning module was located on the back porch. The home's tankless hot water heater was located inside the garage and the temperature is set to 120 degrees Fahrenheit. The appliances were in working order. . The client's files will be locked inside a cabinet in the master bedroom. There was adequate food storage space and a supply of two days of perishable foods and a week of non-perishable foods. A proper storage of all food was discussed. A trash can for storage of solid waste had a tight-fitting lid and was present. The sharp knives are in a locked kitchen drawer. The medications are located in a locked cabinet in the master bedroom. The hot water in the bathroom 1 measured to be 110.1 degrees Fahrenheit. The water temperature of bathroom 2 measured to be 112.1 degrees Fahrenheit. The home's First Aid kit was accessible and is located in a cabinet by the refrigerator and had all required supplies. One fire extinguishers was present in the home and is located in the pantry. They were observed to be properly charged and inspected by the fire department. There is one firearm in the home it is stored in a locked box above the stove and the ammunition is in a locked box in a locked cabinet by the pantry. There is no pool or other body of water at the home. The backyard where clients will have access to play is not fenced as fencing is not allowed however there is an alarm on the back door. The following items need to be completed: A home phone The request for a license will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to Monique Leonard.

met_with: Monique Leonard


summary: Facility Evaluation

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Narrative:
On October 29, 2025, Licensing Program Analyst (LPA) Babatunde Aborchie arrived at Legacy Small Family Home (SFH) annual required inspection. Currently, there is one client in placement. The home was licensed for a capacity of two clients (all ambulatory). The Facility was toured both inside and out with the licensee. The home is a two-story building with three bedrooms and 1.5 bathrooms. During the inspection, LPA observed that downstairs consisted of the kitchen, a living room, a dining area, a pantry, a half bath, a laundry and a garage. Sharp knives were inaccessible and stored in a locked cabinet in the kitchen. The First Aid Kit was in a cabinet in the kitchen by the living room and contained all required items. The garage was inspected and used for cars and laundry. The water temperature was tested and measured at 115 degrees F. LPA observed a minimum of seven-day non-perishable and a three-day perishable supply of food. There was a variety of snacks available for clients. In addition to the downstairs space, there was also a half bathroom fully functioning. A trash can was observed to have tight fitting cover. The following required posted items were observed accessible to clients: personal rights, visitation policy, and current menu. One fire extinguisher was observed and operable. Upstairs was bedroom #1, it was fully furnished with one bunked bed; it sleeps one biological son, age 9. Bedroom #2, it was fully furnished with two twin beds; it sleeps the one client. Medications were stored in a locked cabinet by the pantry. Bedroom #3 was fully furnished with one full-sized bed, a closet and plenty of storage space. It sleeps licensee. The licensee's bedroom is not accessible to the clients. All bedrooms were arranged for one child per bed. No room was commonly used for other purposes other than a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for each child's belongings. The smoke and carbon monoxide detectors were checked and working. Cleansers/chemicals were locked and stored in the kitchen cabinet under the kitchen sink. The upstairs space includes a bathroom used by clients and licensee. All hazardous items have been properly made inaccessible to areas where clients have access. All windows and screens were in good repair. Licensee states that there were no guns/weapons in the home at this time. There was a total of three cameras, located indoors which met the title 22 camera policy. The facility outside grounds were also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. Clients' files and staff files were reviewed and found to comply. Based on today's inspection and observations, there are no deficiencies being cited at this time. LPA will provide a copy of this report to the LPM for final approval. An exit interview was conducted, and a copy of this report was discussed and provided to Licensee.


facility_name: LENMOORE LOVE SMALL FAMILY HOME

summary: Facility Evaluation

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Narrative:
On May 22, 2023, at 10:00am, Licensing Program Analyst (LPA) Daphne Edison conducted a Component II, Face-to-Face meeting with Lenmoore Love Small Family Home Licensee, Melinda Moore. The purpose of the meeting was to discuss the pending Small Family Home application and Program Statement review. LPA discussed and advised licensee to submit the incomplete documentation by June 23, 2023. The following concerns were discussed: Missing Items: • Recent TB Test Needed (last one administered on 6/9/2021). • Current LIC 9182, Criminal Background Clearance Transfer Request with a legible copy of driver license (Melinda Moore and Gentria Lenoir) · Current First Aid/CPR (Expires 6/1/2023) Corrections: • Program Statement: Pg. 15 - Facility Name Program Statement: • Treatment • Education • Transportation • Discipline Continued on LIC 809-C Emergency Intervention Plan · AWOL/Run Away Plan · Telephone Policy · Mail • Recreation • Protection • Religious Services • Personal Hygiene Items • Personal Allowance/Paid Jobs • Medical/Dental • Record and Reporting FOLLOW - UP: A Pre-Licensing Inspection will be conducted on 5/25/2023 at 9:00am. A Component III meeting will be conducted on 6/19/2023 at 10:00am. An exit interview was conducted, and a copy of this report was given to the Licensee.

met_with: Melinda Moore-Licensee


summary: Facility Evaluation

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On May 25, 2023, at 8:59am, Licensing Program Analyst (LPA) Daphne Edison arrived at Lenmoore Love Small Family Home for the purpose of conducting a Pre-Licensing Inspection Visit. LPA met with Melinda Moore, Licensee who granted access into the home and together a tour was conducted. The home will provide care and supervision to four (4) developmentally disabled children, male and female, ages 0-17 years, ambulatory only. The census on this day is zero (0). The home is single-story located in a residential neighborhood and is set up as follows: Three (3) bedrooms, one (1) bathroom, a living room, a dining room, kitchen, laundry room, detached two (2) car garage, and a backyard. Living Room: Equipped with a sofa, table, playpen, and television. All furniture is in good repair. Kitchen: Equipped with a four (4) -burner gas stove and a refrigerator/freezer. Laundry Room: Located off the kitchen. Equipped with an operable washing machine and dryer, first aid kit and fire extinguisher. Dining/Staff Office Area: Equipped with a table and six (6) chairs, desk, computer, locked cabinet for staff/client files, toys and games. There is also a baby changing table and highchair located in the dining area. All furniture is in good repair. Hallway: Equipped with a locked cabinet and four (4) drawers for extra linens, towels, and extra personal hygiene products for clients. There is a second closet and cabinet for licensee personal clothing items. Bedroom #1: Occupied by Licensee. Equipped with a king-sized bed, television, and a bassinet. Bedroom #2: Vacant. Equipped with two (2) twin sized beds, television, and a desk. There is adequate storage and closet space. Bedroom #3: Vacant. Equipped with two (2) twin sized beds and a desk. There is adequate storage and closet space. Bathroom #1: Equipped with a bathtub, separate shower, a toilet, and a sink. Clean and in operable condition. Backyard: Has no debris or hazardous materials. Detached two-car garage used for storage. The living room and dining room furniture are in good repair. The home was observed to have a two-week supply of perishable and non-perishable food items. All bedrooms were observed to have adequate lighting, mattresses in good repair and clean linens and bedding. All sharp knives and medication are kept locked in Bedroom #1 and made inaccessible to children in care. All disinfectants/cleaning solutions will be kept in a locked cabinet in the kitchen and made inaccessible to the children. The hot water was tested, and the temperature was found to be within a safe range. All prescribed medications will be stored in a locked cabinet in the licensee bedroom and made inaccessible to children. The first aid kit was checked and found to be missing a thermometer. Smoke detectors and carbon monoxide detectors tested audible and were in appropriate working order. The home has one (1) regulation fire extinguishers fully charged. LPA observed the home to have adequate indoor and outdoor activity space. The front and backyards were inspected and found to be clean and free of debris and observable hazards. Foster youth bill of rights and grievance procedures were posted. Caregiver(s)/adults working/residing in the home must have DOJ/FBI criminal record clearances and Child Abuse Index Checks. Emergency Mass Disaster Plan was posted. LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. The home will operate within the capacity and limitations of the license. The following must be corrected: · Trash can with lid · Missing thermometer (First Aid Kit) · Missing Crib Lock for kitchen cabinet for disinfectants/cleaning solutions. · Activity Schedule · Weekly Menu · Garage must be made accessible for licensing inspection · Removal of candles from dining room table Licensee provided LPA with LIC 9182 and a photocopy of driver license for licensee and staff for processing by the Regional Office. LPA advised Licensee that binders must be set up for staff/client files. LPA will conduct a follow-up visit to the home to be scheduled with licensee. Exit Interview was conducted, and a copy of this report will be emailed to the Licensee.


summary: Facility Evaluation

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Narrative:
On June 22, 2023 at 10:58am, Licensing Program Analyst (LPA) Daphne Edison arrived at Lenmoore Love Small Family Home for the purpose of conducting a follow-up visit for a Pre-Licensing Inspection which took place on May 25, 2023. LPA met with Melinda Moore, Licensee who granted access into the home and together a tour was conducted. The home will provide care and supervision to three (3) developmentally disabled children, male and female, ages 0-17 years, ambulatory only. The census on this day is zero (0). The home is single-story located in a residential neighborhood and is set up as follows: Two (2) bedrooms, one (1) bathroom, a living room, a dining room, kitchen, laundry room, detached two (2) car garage, and a backyard. Bedroom #1: Vacant. Equipped with two (2) twin sized beds, television, and a desk. There is adequate storage and closet space. Bedroom #2: Occupied by Licensee. Equipped with a king-sized bed, television, crib, and a bassinet. Storage Room (located in hallway next to Bathroom #1): Will be used to store extra non-perishable food items such as bottled water. Equipped with a locked cabinet which stores sharp knives and medication and made inaccessible to children in care. Detached Garage: Located in the back of the home and was observed to be used for storage. Backyard: LPA observed concrete slab pushed up from ground by a tree root growing underneath the concrete slab which runs along the fence that separates from the neighboring backyard. Licensee informed LPA that per city requirements, Licensee is not authorized to remove tree/root. Licensee informed LPA that outside trash cans are used to place in front of concrete slab to make inaccessible to children. LPA observed outside trash cans placed at the end of front driveway for trash pickup. LPA informed Licensee will follow up regarding uprooted tree and concrete slab. LPA completed a walk through to address concerns from previous inspection which took place on May 25, 2023. The following corrections have been made: · Kitchen Trash can is equipped with a tight-fitting lid. · First Aid kit contains thermometer. · Crib is placed in Bedroom #2 occupied by Licensee. · Kitchen cabinet containing disinfectants/cleaning solutions is equipped with a lock. · Activity Schedule is posted. · Weekly food menu is posted. · Garage made accessible for inspection by licensing authority. · Candles have been removed from dining room table. Licensee converted previous Bedroom #1 to storage room to be used for storage of extra non-perishable food items and locked cabinet for medication and sharp knives, which is inaccessible to children in care. LPA informed applicant, per California Code of Regulations, Title 22, Division 6, regulation 83087(3) Buildings and Grounds, "No room commonly used for other purposes shall be used as a bedroom". Licensee provided LPA with signed LIC 200 to change capacity, current First Aid/CPR certificate, current TB test for Licensee, and CPMB criminal background clearance letter for licensee and staff to be placed in facility file. Licensee stated will provide LPA with current TB test, health screening, and current First Aid/CPR certificate for staff. An exit interview was conducted, and a copy of this report will be emailed to the Licensee.


summary: Facility Evaluation

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Narrative:
On January 4 2024, at 9:30am Licensing Program Analyst (LPA) Deborah Lee arrived at Lenmoore Love Small Family Home for the purpose of conducting a Post-Licensing Inspection Visit. LPA met with Melinda Moore, Licensee, who granted access into the home and together a tour was conducted. The home will provide care and supervision to three (3) developmentally disabled children, male and female, ages 0-17 years, ambulatory only. The census on this day is one (1). The home is single-story located in a residential neighborhood and is set up as follows: Three (3) bedrooms, one (1) bathroom, a living room, a dining room, kitchen, laundry room, detached two (2) car garage, and a backyard. Living Room: Equipped with a sofa, mounted TV, table (with various board games in storage of table, and television. All furniture is in good repair. Kitchen: Equipped with a four (4) -burner gas stove refrigerator/freezer and small countertop appliances (toasters, crockpot, blender). Laundry Room: Located off the kitchen. Equipped with an operable washing machine and dryer, first aid kit and fire extinguisher. Dining/Staff Office Area: Equipped with a table and six (6) chairs, desk, computer, locked cabinet for staff/client files. All furniture is in good repair. Hallway: There are cabinets in the hallway area used for towels, linens and extra personal hygiene products for clients. There is a locked room where cleaning supplies, knives and medicine are stored. The medications are stored in a separated locked cabinet within the room. Bedroom #1: Located in the hallway; it is used as storage area for cleaning supplies, knives and medication (see above). This room is always locked and inaccessible to clients in care. Continued on 809C Bedroom #2: . Equipped with two (2) twin sized beds with clean linens, mounted television, two (2) desks with chairs and dresser with 6 drawers There is adequate storage and closet space. Bedroom #3: Occupied by Licensee. Equipped with a king-sized bed, television drawer and closet. Bathroom #1: Equipped with a bathtub, separate shower, a toilet, and a sink. The bathroom was clean and in operable condition. Backyard: Has no debris or hazardous materials. Detached two-car garage used for storage. The living room and dining room furniture are in good repair. LPA observed the home to have a 7-day supply of non-perishable foods and 2-day supply of perishable food items. All bedrooms were observed to have adequate lighting, mattresses in good repair and clean linens and bedding. All sharp knives, medication and disinfectants/cleaning solutions are kept in a locked room that is inaccessible to children in care. The hot water was tested, and the temperature was found to be within appropriate range between 105 and 120 degrees Fahrenheit. The first aid kit was observed to be complete with all required items. Smoke detectors and carbon monoxide detectors tested audible and were in proper working order. The home has one (1) regulation fire extinguisher fully charged. LPA observed the home to have adequate indoor and outdoor activity space. The front and backyards were inspected and found to be clean and free of debris and observable hazards. Foster youth bill of rights and grievance procedures were posted in addition to the Emergency Mass Disaster plan. Caregiver(s)/adults working/residing in the home have DOJ/FBI criminal record clearances and Child Abuse Index Checks. LPA conducted 1 confidential interview. Client unavailable for interview. There were no deficiencies cited at this time. Exit Interview was conducted, and a copy of this report will be emailed to Licensee, Melinda Moore

met_with: Melinda Moore, Licensee


summary: Facility Evaluation

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Narrative:
This Report is Amended from 9/11/2024 to Correct Census. On September 11, 2024, at 9: AM Licensing Program Analyst (LPA) Cheri Wilkerson, Erika Butler, and Licensing Program Manager, JoAunne Griffin arrived at the above facility for the purpose of conducting an Annual Inspection. LPA and LPM met with Licensee who granted access into the home and together a tour was conducted. Currently there are two children in placement. The census on this day is zero. The home is single-story located in a residential neighborhood and is set up as follows: Three bedrooms, one bathroom, a living room, a dining room, kitchen, laundry room, detached two car garage, and a backyard. Living Room: equipped with a sofa, mounted TV, and table. Kitchen: equipped with a four-burner gas stove, refrigerator/freezer, and microwave. Laundry Room: located off the kitchen. Laundry room is equipped with a washing machine and dryer, first aid kit and fire extinguisher. Dining/Staff Office Area: Is equipped with a table and six chairs, desk, computer, locked cabinet for staff/client files. Hallway: There are cabinets in the hallway area used for towels, linens and extra personal hygiene products for clients. There is a locked room where cleaning supplies, knives and medicine are stored. The medications are stored in a separated locked cabinet within the room. Bedroom #1: Is equipped with bunkbeds, television, and chair. There is adequate storage, closet space, and lighting. Continue LIC 809-C Bedroom #2: Is equipped with two twin size beds, mounted television, two desks with chairs and dresser with six drawers. There is adequate storage, closet space, and lighting. Bedroom #3: Is occupied by Licensee. Equipped with a queen-sized bed, television, and drawer. Disinfectants/cleaning solutions supplies, knives, and medications are stored in room and inaccessible to children in care. Bathroom #1: Is equipped with a bathtub, separate shower, toilet, and a sink. Backyard: Is free of debris or hazardous materials. Detached two-car garage used for storage. Home is clean and sanitary. Furniture is in good repair. LPA observed to have perishable and non-perishable foods. The hot water was tested, and the temperature was found to be within appropriate temperature range. The first aid kit was observed to be complete with all required items. Smoke detectors and carbon monoxide detectors tested audible and were in proper working order. The home has one fully charged fire extinguisher. LPA observed the home to have adequate indoor and outdoor activity space. The front and backyards were inspected and found to be clean and free of debris and observable hazards. License, Emergency Mass Disaster plan, grievance procedure, and activity schedule were observed to be posted. Caregiver(s)/adults working/residing in the home have DOJ/FBI criminal record clearances and Child Abuse Index Checks. LPA conducted 1 confidential interview. There were no deficiencies cited at this time. Exit Interview was conducted, and a copy of this report will be emailed to Licensee, Melinda Moore at lenmoorelove@yahoo.com

met_with: Melinda Moore