summary: Facility Evaluation

raw_content:
Narrative:
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.


state: CA

facility_name: LENMOORE LOVE SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
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.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Melinda Moore-Licensee


summary: Facility Evaluation

raw_content:
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

raw_content:
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

visit_type: Annual

met_with: Melinda Moore


summary: Facility Evaluation

raw_content:
Narrative:
On September 17, 2024, at 2: PM Licensing Program Analyst (LPA) Cheri Wilkerson, Erika Butler, and Licensing Program Manager (LPM), JoAunne Griffin arrived at the above facility for the purpose of conducting an Annual Continuation 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 two. A health and safety assessment was conducted. 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. The garage was not inspected. Licensee advised that she does not have the key to access the garage and has to arrange for the garage to be unlocked. Currently there are 13 employees associated to the facility and eight in process. Licensee was advised that Licensee is responsible for participating with children in activities, anticipating with agencies and other responsible persons in planning for the needs of the child, ensuring that the child is clean and providing the child with training in personal cleanliness and hygiene, and making provisions for the child to attend available community treatment or training programs when the child has needs which can be met by such programs. Licensee shall be regularly present in the home when children are in the home full time. Licensee shall also ensure that caregivers meet initial and ongoing training requirements regarding the child's right. Licensee advised to review Title Regulations and Interim Licensing Standards. LPA conducted two staff interviews and two client interviews. LPA conducted three staff file reviews and two client file reviews. Continue on Page A technical Advisory has been issued as LPAs and LPM were not able to inspect garage due to Licensee not having access. Exit Interview was conducted, and a copy of this report will be emailed to Licensee, Melinda Moore at lenmoorelove@yahoo.com.


summary: Facility Evaluation

raw_content:
Narrative:
On September 23, 2024, at 1: PM Licensing Program Analyst (LPA) Erika Butler and Cheri Wilkerson arrived at the above facility for the purpose of conducting a Case Management - Other inspection for the purpose of inspecting the detached garage of the home. LPAs met with Licensee, who granted access into the garage and together a tour was conducted. A health and safety assessment was conducted. The back room and garage area was inspected. LPA observed a day bed frame, chairs, lamps in the back room, and the garage has mattresses, heater, and other belongings. The garage is used as storage space and is inaccessible to children in care. No hazardous materials or items were observed. Licensee was advised that garage is to be available for inspection to ensure health and safety of children in care. There were no deficiencies cited at this time. A copy of this report will be emailed to Licensee at lenmoorelove@yahoo.com.


summary: Facility Evaluation

raw_content:
Narrative:
On October 14, 2024, at 9: AM Licensing Program Analyst (LPA) Cheri Wilkerson arrived at the above facility for the purpose of conducting an Annual Inspection. LPA met with Licensee, Melinda Moore 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, and a 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 separate locked cabinet within the room. Bedroom #1: Is equipped with bunkbeds, television, and chair. There is adequate storage, closet space, and lighting. Continued on LIC 809 -C Bedroom #2: Is equipped with one twin size bed, mounted television, with chair 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 and were in proper 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 along with menus. Caregiver(s)/adults working/residing in the home have DOJ/FBI criminal record clearances and Child Abuse Index Checks. There are no clients or staff present at the time of inspection. LPA conducted 1 confidential interview, the Licensee. There were no deficiencies cited at this time. Licensee will email me a copy of client C1s JV 220. Exit Interview was conducted, and a copy of this report will be emailed to Licensee, Melinda Moore at lenmoorelove@yahoo.com.


facility_name: LIBEY'S HOME

summary: Facility Evaluation

raw_content:
Narrative:
On Wednesday June 30, 2021 at 2: PM Licensing Program Analyst (LPA) Linda Haynes conducted an unannounced required annual inspection. LPA met with Licensee Marie Hurtado-Ayup. There is one client in the home. There are six bedrooms, living room, dining room and family room, and six bathrooms. Bedroom one is arranged for one client. Bedroom 2 is arranged for one client. The rest of the bedrooms are for family members. LPA measured the hot water temperature at 120 degrees. The medications are in a locked closet in the hallway that is inaccessible to children. Disinfectants and cleaning solutions were stored and located in a locked closet in the hallway and inaccessible to children. The first aid kit was checked and found to be complete. LPA observed facility license, emergency disaster plan, facility sketch, menu and personal rights posted. There are no guns or weapons in the home per licensee Marie Hurtado-Ayup. A review of the Licensing Information System on June 14, 2021 indicates that all individuals are associated to the facility had DOJ, FBI and child abuse index check clearances. The front and backyard were inspected and found clear of hazards. There were no pools and/or bodies of water on at the facility. LPA reviewed one of one client files during the inspection and noted to have all documentation's required per regulations in file. Based on the facility inspection and file reviews this date, there are no deficiencies found at this time.

met_with: Marie Hurtado-Ayup


summary: Facility Evaluation

raw_content:
Narrative:
On March 24, 2023, at 9:36AM, Licensing Program Analyst (LPA) Carol Anderson conducted an unannounced required random/annual inspection. LPA met with Licensee Marie Hurtado-Ayup. The facility files were conducted prior to inspection. Currently there are two clients in care. LPA interviewed one staff. Clients were unavailable to be interviewed. At 9:45AM, LPA observed current disaster plan posted, first aid kit completed, Smoke alarms and carbon monoxide were checked and operable. The water temperature reading 107. Adequate food supply. Including a sufficient supply of fresh fruits, vegetables, can goods and meats, kitchen sharp items, knives, cleaning supplies and toxic which were stored in a locked cabinet in the laundry room near kitchen. Clients' room had adequate storage for clothing and there were 1 bed per client. Medications are locked in a cabinet in laundry room. LPA reviewed two client files and two staff files Personal Rights and License are posted Licensee Maria Ayrup stated there are no weapons or firearms at facility. There is no bodies of water on premises. Based on the facility inspection and file reviews this date, there are no deficiencies found at this time. An exit interview was conducted, and this report was reviewed with Licensee Marie Ayup. Facility is in compliance in accordance with Title 22, Division 6, of the code of Regulations. No deficiencies cited.

met_with: Marie Hurtado-Ayrup, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On August 25, 2025 at 10: AM, Licensing Program Analyst (LPA) Jacob Salem conducted an unannounced visit to the above facility and met with Samuel Hurtado, Designee for the purpose of conducting an annual inspection. LPA reviewed one client file (C1), which are kept locked in a staff bedroom. The client files reviewed contained the required information and records, including pre-placement screenings, personal rights acknowledgment, and needs and services plan. LPA reviewed three staff files (S1-S3). LPA inspected the facility's physical plant, including personal rights postings, health related services, buildings and grounds, food services, indoor and outdoor activity space, and furniture, fixtures, equipment and supplies. The home is clean, in good repair, and free from observable risks to clients' health, safety, and personal rights. The home is a two story building with two client bedrooms and two client bathroom which are set up as follows: Bedroom #1 downstairs has two twin beds and currently sleeps one client and bedroom #2 downstairs has two twin beds and currently sleeps no clients. There is a kitchen, living room, dining room and office space, laundry room and storage closets, and backyard/patio. LPA conducted two staff and one client interview. Based on observations made during the inspection, there were no deficiencies cited at this time. An exit interview was conducted with Samuel Hurtado, Designee and a signed copy of this report was provided.

met_with: Samuel Hurtado, Designee


facility_name: LIDDO COWS FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On 07/2/2024 at 1: Pm, Licensing Program Analyst (LPA) Claudia Portillo conducted a pre-licensing inspection visit at the Liddo Cows Family Home. LPA Portillo met Facility Administrator and together toured the home. Physical Plant This facility is a two story house located in a quiet residential community. The facility consists of four (4) bedrooms, three bathrooms, kitchen, dining area, loft upstairs, laundry room in a 2-car garage, and small backyard. Overall, the facility is clean, sanitary and in excellent condition. Passageways are free from obstruction. Fixtures, Furniture, Equipment, and Supplies The home has toilets and wash basins for clients' use. Client bedrooms was observed to be clean, orderly, and contained twin beds. LPA observed clean pillows, bed sheets and blankets. The client's bedroom has adequate closet and drawer space to accommodate client's clothing and personal belongings. Heath Related Services and Record Keeping The first aid kit will be centrally stored in the kitchen. The kit contains all required supplies. The client, staff files and medication will be stored in a locked file cabinet in the licensee's bedroom. LPA also conducted Component III - Category Specific Orientation with the applicant. The following items were discussed and provided to the applicant: Title 22 regulations on Small Family Homes - Continuing Requirements (General Licensing Requirements) - Buildings and Grounds requirements - Personnel Records (forms) - Client Records (forms) -Reporting Requirements - Other administrative forms LPA requested applicant to submit an electronic Program Statement and Plan of Operation on or before 7/19/24. No deficiencies were observed on this date. LPA issued a technical violation. An exit interview was conducted, and a copy of this form was emailed to the Licensee.

visit_type: Prelicensing

met_with: LIddo Cows Family Home


summary: Facility Evaluation

raw_content:
Narrative:
On December 4, 2024 at 10: AM Licensing Program Analysts (LPA) Claudia Portillo conducted an unannounced inspection at the Small Family Home facility and met with the licensee. The purpose of the inspection was in regard to post licensing and a capacity increase, previously requested from two (2) to four (4) children. Currently the facility has two (2) children in care. The Department received the following documents from the licensee: LIC 200 (application), the appropriate licensing fee, updated program statement and an approved Chino fire clearance. There are currently two minors in care. This facility is a two-story house located in a quiet residential community. The facility consists of four (4) bedrooms, three bathrooms, office, kitchen, family room, dining area, laundry room in a 2-car garage, and a backyard. Overall, the facility is clean, sanitary and in excellent condition. Passageways are free from obstruction. LPA observed the Children's Personal Rights, license, and Emergency Plan LIC 610C posted in the facility. The medications, staff and client files are securely locked in the Administrator bedroom closet. LPA obtained and reviewed the following updated documentation: · LIC Personnel and client roster · Disaster Drills log · Plan of operation The following sleeping arrangements were noted: Bedroom #1 (Sister) it has, twin bed, closet. Bedroom #2 (Client 1 and Client 2) it has a crib/toddler bed, twin bed, closet, drawer space. Bedroom #3 free for possible Clients (2) - it has 2 twin beds, closet, and drawer space for 2 and a bathroom. Bedroom #4 - Licensee Licensee has space for the increase and LPA will submit file to LPM for approval of the capacity increase request. LPA reviewed two (2) client records and two (2) staff files. Licensee and staff have current first aid and CPR certificates. LPA checked required criminal record and child abuse index check clearance or exemption for all adults in the home. The client's files contained: Admission Agreement, Medical Assessment, Consent Forms, Emergency Information, Individual Family Service Plan, Immunization Record and Personal Rights. LPA provided licensee/administrator with PIN 24-09-CRP Video Cameras in Children's Residential Congregate Care Facilities. LPA advised administrator/licensee to start reviewing and update the Program Statement to reflect new guidelines for video surveillance due to cameras installed or if planning to install cameras in the facility. An exit interview was conducted, and a signed copy of this report was provided to the facility representative along with LIC 809, LIC 809D, LIC 811(Confidential Names) and Technical Violations. Appeal rights explained . A copy of this report was provided to the Administrator, Shavonna The Small Family Home (SFH) program was in compliance with 4 applicable areas of the Compliance and Regulatory Enforcement (CARE) Tools, for Children's Residential licensees: physical plant, operations, staff and client files. Community care licensing (CCL) focuses its efforts on three priority areas: prevention, compliance, and enforcement. The following sleeping arrangements were noted: Bedroom #1 (occupied by two foster children) Bedroom #2 (occupied by licensee) Bedroom #3 available for possible placement's: it has 2 twin beds, closet, and drawer space Bedroom #4 available for possible placement's: it has 2 twin beds, closet, and drawer space Licensee has space for the increase. However, approval of the capacity increase request is pending. LPA reviewed two (2) client records and one(1) staff file. Licensee and staff have current first aid and CPR certificates. LPA checked required criminal record and child abuse index check clearance or exemption for all adults in the home. The client's files contained: Admission Agreement, Medical Assessment, Consent Forms, Emergency Information, Individual Family Service Plan, Immunization Record and Personal Rights. An exit interview was conducted, and a signed copy of this report was provided to the facility representative along with LIC 809, LIC 809D, LIC 811(Confidential Names); Technical Violations and Technical Advisory's. Appeal rights explained . A copy of this report was provided to the Administrator, Shavonna Duffin..

met_with: Shavonna Duffin


summary: Facility Evaluation

raw_content:
Narrative:
On August 29,2025, Licensing Program Analyst (LPA), Claudia Portillo attempted to conduct an unannounced visit at the small family home (SFH) above for the purpose of conducting an annual inspection. However, the licensee was not home.


summary: Facility Evaluation

raw_content:
Narrative:
On September 2, 2025, Licensing Program Analyst (LPA), Claudia Portillo conducted an unannounced visit at the small family home (SFH) above for the purpose of conducting an annual inspection. LPA met with the licensee of the home, Shavonna Duffin. There are currently two clients in care. LPA conducted a physical plant inspection of the entire home (inside and out). LPA observed the Children's Personal Rights, license, and Emergency Plan LIC 610C posted in the facility. The medications are locked in the client's restroom, staff and clients' files are securely locked in a cabinet located in the living room. Only authorized representatives have access to the files and medications. The rooms approved for ambulatory clients are not used by non-ambulatory clients. LPA obtained and reviewed the following updated documentation: LIC Personnel and client roster The Small Family Home (SFH) program followed 4 applicable areas of the Compliance and Regulatory Enforcement (CARE) Tools, for Children's Residential licenses: physical plant, operations, staff, and client files. Community care licensing (CCL) focuses its efforts on three priority areas: prevention, compliance, and enforcement. LPA Portillo reviewed 1 staff and 2 client files. 1 staff interview was conducted. An exit interview was conducted, and a signed copy of this report was provided to the facility representative along with LIC 809, LIC 809D, LIC 811(Confidential Names) and Technical Advisory/violations, and appeal rights explained. A copy of this report was provided to the licensee.


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
During investigation, confidential interview denied that foster children in care engaged in inappropriate interactions due to lack of supervision. A confidential interview stated that all children were adequately supervised in the home while in care. Another confidential interview maintained that FC2 touched FC1 on one occasion, but the interview did not specify where on the body FC1 was touched. Additionally, confidential interview disclosed that the room door was opened when the incident occurred, and LS was in her room. Based on the confidential interviews, the allegation that foster children in care engaged in inappropriate interactions due to lack of supervision, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. A copy of this report and LIC 811 was provided to licensee.

Investigation Findings:
13On March 18, 2024, at 3: PM Licensing Program Analyst (LPA) Babatunde Aborchie met Liddo Cow Small Family Home Licensee Shavonna Duffin to deliver the investigative finding for the above stated allegation involving the Small Family Home and foster children. On May 10, 2023, Licensing Program Analyst (LPA) Babatunde Aborchie arrived at the small family home to initiate the investigation and conducted a safety inspection. LPA interviewed licensee (LS), two Foster Children (FC1 and FC2). LPA was unable to interview county social worker. On May 1, 2023, a complaint report was referred to Community Care Licensing (CCL) alleging foster children in care engaged in inappropriate interactions due to lack of supervision. It was specifically stated that FC2 went inside FC1's pants and touched FC1. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: LIDDO COWS FAMILY HOMEFACILITY NUMBER: VISIT DATE: 03/18/2024

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

report_type: Complaint Investigation

met_with: Shavonna Duffon

complaint_status: unsubstantiated


summary: Facility Evaluation

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Narrative:
On January 3, Licensing Program Analyst (LPA) Babatunde Aborchie, Licensing Program Manager (LPM) Abdoulaye Traore met with applicant Shavonna Duffin this date for a Component II. LPA and LPM went over revisions needed for the application prior to licensure. LPA and LPM gave a copy of the LIC 184, Notice of Incomplete Application, and additional correspondence to assist with the revisions needed to complete the application. Copy of this report was provided to applicant.


summary: Facility Evaluation

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Narrative:
On January 27, 2023 at 9: AM, a pre-licensing inspection was conducted by Licensing Program Analyst (LPA) Babatunde Aborchie. LPA met with Licensee Shavonna Duffin. The purpose of the visit was to evaluate the facility for a possible license for a small family home of capacity of two ambulatory children as requested by applicant. The applicant is requesting to be licensed for a small family home with capacity to serve a total of two ambulatory children ages 0-17. During this inspection, LPA and applicant inspected the facility inside and out. The apartment consists of: Bedroom #1, It was furnished with a Cal King sized bed, it has a bathroom; it sleeps the applicant. Bedroom #2, It was furnished with two twin beds. It will sleep two clients. There were also a living room, dining area, a closet, a kitchen, a pantry and one bathroom for clients. Bedroom is 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 locked box in the refrigerator. Cleansers/chemicals were locked and stored in the kitchen cabinet under the sink. Sharp knives were inaccessible and stored in a locked cabinet in the kitchen. There were no guns or weapons as stated by applicant at this time. The hot water temperature was tested and noted to be 112 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit was accessible with all required items and it was in the kitchen cabinet. A Fire extinguisher was observed and properly charged. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. The patio where children will have access to play was free of hazards. There are no deficiencies to be cited at this time. The request to be licensed for a 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 Applicant/Licensee.

met_with: Applicant/Licensee


summary: Facility Evaluation

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Narrative:
On January 25, 2024 at 12: PM, Licensing Program Analyst (LPA) Karen Beal arrived at Liddo Cows Family Home(SFH) to conduct a required annual inspection.. LPA met with Licensee Shavonna Duffin. During this inspection, LPA and applicant inspected the facility inside and out. The apartment consists of: Bedroom #1, It was furnished with a Cal King sized bed, it has a bathroom; it sleeps the Licensee. Bedroom #2, It was furnished with two twin beds. It sleeps FC1 and FC2. There were also a living room, dining area, a closet, a kitchen, a pantry and one bathroom for clients and one for the Licensee. Bedroom is 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. Knives and chemicals are locked in the licensee's bedroom. There was 7 days of non-perishables and 3 days of fresh perishable foods observed in the pantry, refrigerator, and freezer. Telephone service and appliances were in working order. The hot water temperature was tested and noted to be at 117 degrees. Licensee First Aid Card expires on 8/1/2024. Trash cans for storage of solid waste have tight fitting lids. First Aid kit was accessible and contained all required items. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. As stated by Licensee, there were no weapons/firearms. Exit interview conducted and copies of this report are given.

met_with: Licensee, Shavonna Duffin


facility_name: LISA'S SMALL FAMILY HOME

summary: Facility Evaluation

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Narrative:
On March 21, 2025, at 12: PM Licensing Program Analyst (LPA), Timika Martin conducted a conducted a virtual Component ll session via Microsoft Teams with Director/Administrator, Lisa Njenga for the purpose of discussing the Small Family Home (SFH) application. During the meeting the following items were discussed: -All requested revisions in the application documents (LIC forms) and Program Statement/Plan of Operation. -The application documents/procedures. LPA Martin informed the Administrator that several revisions will need to be resubmitted to continue to move forward in approving the facility application for a license. LPA Martin provided the applicant with a copy of the revisions and discussed each one in detail. LPA Martin also provided additional resources that will assist the Administrator with completing the Program Statement & Plan of Operation. An exit interview was conducted and a copy of LIC 809 was provided to the licensee.

met_with: Lisa Njenga, Administrator


summary: Facility Evaluation

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Narrative:
On May 1, 2025 at 10: AM, Licensing Program Analyst (LPA) Timika Martin conducted a pre-licensing inspection visit at Lisa's Small Family Home (SFH). LPA Martin met with Facility Administrator, Lisa Njenga and toured the home. Physical Plant This facility is located in a quiet residential community. The facility consists of four (4) bedrooms, three (3) bathrooms, kitchen, dining area, laundry room in a 3-car garage, and a backyard. Overall, the facility is clean, sanitary and in excellent condition. Passageways are free from obstruction. Fixtures, Furniture, Equipment, and Supplies The home has toilets and wash basins for clients' use. Client bedrooms was observed to be clean, orderly, and contained twin beds. LPA observed clean pillows, bed sheets and blankets. The client's bedroom has adequate closet and drawer space to accommodate client's clothing and personal belongings. Heath Related Services and Record Keeping The first aid kit will be centrally stored in the kitchen. The kit contains all required supplies. The client, staff files will be in a locked file cabinet located in the garage. The medication will be stored in a locked cabinet in the kitchen. LPA also conducted Component III - Category Specific Orientation with the applicant. The following items were discussed and provided to the applicant: -Title Regulations on Small Family Homes - Continuing Requirements (General Licensing Requirements) - Buildings and Grounds requirements - Personnel Records (forms) - Client Records (forms) -Reporting Requirements - Other administrative forms The provider was also briefed about the importance of incident reporting and client education. Prior to being licensed the following are still pending: -Administrator needs to be associated to the home. -Pending revisions of the Program Statement/Plan of Operation. LPA Martin will conduct a final review once the requested documents are submitted, manager approval and all requirements being met and a new license will be mailed to SFH upon approval. An exit interview was conducted, and a copy of this form was emailed to the Administrator.

met_with: Administrator, Lisa Njenga


facility_name: LITTLE LAMBS TENDER CARE

summary: Facility Evaluation

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Narrative:
On Wednesday June 23, 2021 at 10: AM Licensing Program Analyst LPA Linda Haynes, met with licensee Sheela Georgiev, who led a tour of the home. The purpose of the visit was to conduct an annual inspection of the Little Lambs Tender Care Small Family Home. The facility was toured inside and out with Shella Georgiev. The home is a one-story residence with three bedrooms and two bathrooms. There were no clients in placement at time of inspection. 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. All hazardous items have been properly made inaccessible to areas where children will have access. The medications will be locked and stored in a kitchen cabinet. Cleansers/chemicals are locked and stored in the kitchen cabinet. Sharp knives are inaccessible and stored in kitchen drawer. The first aid kit is located in the closet of the children's bedroom. There are no guns or weapons as stated by Sheela Georgiev at this time. The hot water temperature was tested and noted to be 123 degrees. Proper storage of all food was noted. Trash cans for storage of solid waste have tight fitting lids. The Emergency Disaster Plan with exit map, Title Personal Rights, and visitation policies are posted at this time. The backyard where children will have access to play is completely fenced and free of hazards. There is no pool or other body of water. Toys are safe, clean, and age appropriate for the age group of children being cared for. CPR card expires 10/2021, and the First Aid card expires 10/2021. There are no records at this time as there are no children in placement. . A review of staff records on this date indicates that all facility staff have received criminal record and child abuse index check clearances. The Hot water measures at 123 degrees. LPA observed the hot water heater being turned down by the licensee. There are no Children in placement at this time so a deficiency will not be issued. Exit interview conducted and a copy of LIC 9099 was given to the Licensee.

met_with: Sheela Georgiev


facility_name: LITTLE LOVES SMALL FAMILY HOME

summary: Facility Evaluation

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Narrative:
On April 27,2021, at 11:00 am Licensing Program Analyst (LPA) Kourtney Williams conducted a component II meeting with applicant Kellie Davidson. LPA Williams discussed the corrections and or revisions needed for her application. · Applicant updated the Designation of Facility Responsibility. · Applicant will be obtaining a new LIC 503 . · Applicant will update LIC 500 to show Kellie Davidson as Licensee. ·Applicant submitted CPR/ First Aid Cards. ·Applicant will submit property deed to LPA. LPA Williams stated applicant will have up to 30 days to submit corrections/revisions, (DUE by 5/27/21). LPA Williams will then review the corrections and will contact Ms. Davidson to schedule the pre licensing inspection. Based on today's discussion applicant's home can meet the needs of three (3) children. Exit interview conducted and copy of this report given and explained to applicant.

met_with: Kellie Davidson


summary: Facility Evaluation

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Narrative:
On June 7, 2021 at 12: PM Licensing Program Analyst (LPA) Kourtney Williams began a pre-licensing inspection for a Small Family Home license. LPA met with applicant Kellie Davidson who led a tour of the home. The home was toured both inside and out with the applicant. The applicant is applying for a capacity of three ambulatory children. The two-story home consists of: Downstairs first floor: Bedroom #1- The room was furnished with a queen-sized bed. The room will be used a as guest room. Has an attached bathroom, living room and laundry room with a washer and dryer. Bedroom #2 - The room was furnished with a full- sized bed with attached bathroom. The room sleeps applicants 19- year- old son. Open playroom, mud room, kitchen, pantry room, living room, dining area, a common restroom. Backyard with a sliding door and a small play structure with a swing. Applicants plans on building a pool with a spa in the backyard. Upstairs second floor: Bedroom# 3 - The room was furnished with a full- sized bed with an attached bathroom. It sleeps applicants 17- year- old son. Bedroom #4- Master bedroom. It sleeps applicant. The room consists of a California king - sized bed with attached bathroom. Bedroom #5 - The room was furnished with a crib and a twin -sized bed. It will sleep two children. Bedroom #6 - The room was furnished with a crib and a twin- sized bed. It sleeps applicants 2- year -old daughter. It will sleep one more child. Another laundry room with washer and dryer located upstairs. Bedroom#7 - The room was furnished with twin - sized bed is vacant. 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 was adequate drawer and closet space for children's belongings. The smoke detectors were checked and working properly. The garage stores baby strollers and wheelchairs. There is no fireplace. The home has a house telephone. All hazardous items have been properly made inaccessible to areas where children will have access. The medications are upstairs in an small locked room near loft. The first aid kit is located in the pantry door. Cleansers/chemicals were locked and stored under the kitchen sink. Sharp knives were inaccessible locked and stored underneath the kitchen sink. There were no guns or weapons as stated by Applicant at this time. The hot water temperature was tested and noted to be 107.1 degrees Fahrenheit. Proper storage of all food was discussed. The kitchen trash- can has a tight-fitting lid. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. Based on this inspection, the home is appropriate for a capacity of three ambulatory clients, however, the licensee needs to add five bathroom trash -can with a lids. Applicant will obtain a lock box for refrigerated medications. After the corrections are completed, the applicant will notify LPA Williams. The applicant has been scheduled for a Component III on Wednesday June 9, 2021. The request of License will be forwarded to Licensing Program Manager for final approval once the component orientation is completed and the correction has been made. Exit interview conducted and a copy of this report was discussed and provided to applicant this date


summary: Facility Evaluation

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Narrative:
On July 26, 2023 at 10: AM, Licensing Program Analyst (LPA) Karen Beal met with Kellie Davidson to conduct an annual inspection. The licensee informed the LPA that a request was submitted to have the license terminated. Therefore, the annual inspection was not conducted. Currently the licensee do not have any placement at this time. A copy of this case management was provided to licensee.

met_with: Kellie Davidson, Licensee


facility_name: LITTLE NEST

summary: Facility Evaluation

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Narrative:
On November 4, 2025, at 9:30AM, Licensing Program Analyst (LPA) Rachel Vanegas met with Little Nest Small Family Home Applicant, Breeana Yon, at the Riverside Children's Residential Program Regional Office for the purpose of conducting a Component II meeting. LPA discussed corrections and revisions needed for the Program Statement and Small Family Home Application. The following is a summary of the corrections and revisions discussed and requested. These revisions are due by close of business on November 18, 2025. Section A Documents A10. Personnel Report (LIC 500) Please review and revise to account for care and supervision for 24hrs a day, 7 days a week. A13. Criminal Record Statement (LIC 508) Please complete LIC 508 for Chad O'Brien. A14. Emergency Disaster Plan (LIC 610C) Section I: Please review and revise "Caregiver" to "Licensee". Section IV: Please provide signed authorization letters for the use of relocation sites from the agency or business owners, including their name and job title. A15. Facility Sketch (LIC 999) All doors must be identified on the sketch of the facility. **Continued on the next page** A16. Fire Inspection Pending receipt of completed and granted fire clearance from the fire department. Section B Documents B7. Facility Program Description Please clearly identify placement source(s) for clients intended for your program Please provide more experience and qualification for Specialized Health Care Needs client population or remove reference to the client population throughout the entire program statement. Health Related Services Please review and revise how you will notify authorized representatives, etc. for health related emergencies (Pg. 7) Telephone Please review and revise the party responsible for long-distance calling charges (Pg. 7) Please review and revise reference to client's having access to use the phone with approval from their authorized representative. (Pg. 7) Medical Emergencies Describe where first aid supplies and a current edition of a first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency will be stored. Medication Procedures Please identify where medication will be securely locked and stored (Pg. 8) Please review and include how and where the medication administration will be documented (LIC 622A and/or LIC 622B) (Pg. 8 #3) Please review and include incident reporting requirement for medication refusal and medication errors (Pg. 9 #5) Please review and revise responsible party for cost of medications. (Pg. 9 #15) Please review and clarify #17 to include documentation to be used to track medication administration (LIC 622A and/or LIC 622B) (Pg. 10) **Continued on the next page** Describe how psychotropic medication shall only be used in accordance with the written directions of the physician prescribing the medication and in accordance with authorization requirements specified in Sections 369.5(a)(1) and 739.5(a)(1) of the Welfare and Institutions Code and Section 83070(b)(11). Please include a statement that there can be temporary administration of psychotropic medication authorized on the JV220(A) Physician's Statement while the JV223 is pending Describe how the facility will obtain a copy of the current court order, or written authorization of the child's parent or guardian, for each psychotropic medication, as defined in Section 84001(p)(4). Describe the use of Psychotropic Medication Administration Records (PMAR LIC 622B). A separate log for each psychotropic medication prescribed to the child documenting all the following in Title 22 83070(12). Provide a statement that medication errors will need to be reported and documented to CCL, per reporting requirements. Provide a statement that any medication refusal by a client is considered a "Special Incident" and a report will be sent to Community Care Licensing (CCL). Incident Procedures Identify how the Authorized Representative, Client, and CCL will be notified of a grievance/complaint, who responded, the timeframe, what the outcome was, how the outcome was documented, etc. Please identify where the procedures are documented and how they are reviewed. Please include CCL notification for changes to the organization, contact information, etc. within 10 days of the change occurring. (Pg. 12) Abuse Reporting Procedures Please review and revise reference to Adult & Elder Abuse to reflect Child Abuse (Pg. 13) **Continued on the next page** Please review and revise reporting notifications to align with Community Care Licensing (CCL) reporting requirements (Pg. 13) Please review and revise CCL Office information listed from Child Care to Children's Residential Program (Pg. 13) Rules of Discipline/Personal Rights Please state how you will provide a copy of the discipline policy and describe how the child will sign the form. (Pg. 14) Children's Complaint and Grievance Procedure Please remove references to Regional Center and revise Service Coordinator (Pg. 15) Please identify a timeline for "immediately" (Pg. 15) Please state how the Authorized Representative will be notified (Pg. 15) Please include the Child Abuse Complaint Hotline Phone Number (Pg. 15) Emergency Intervention Plan Please review and rename reference to Emergency Intervention Planning (EIP) (Pg.15) Runaway Plan Please match EIP renamed reference in this section (Pg. 16) Please match EIP renamed reference in this section (Pg. 17) Please include reporting requirements for AWOL/Law Enforcement Contact (Pg. 17) Admission Policies Please include transportation to outings for extracurricular activities, school, etc. (Pg. 18) Please review and revise "Lodging" currently there are four (4) beds offered, but that doesn't match the capacity application for two (2) beds. (Pg. 18) Food Service Please review and revise reference to "Rangel family members" to reflect alignment with Little Nest Small Family Home Application. (Pg. 20) **Continued on the next page** Optional Services Please review and revise reference to the child authorizing and/or signing agreement for added services (Pg. 20) Entrance Criteria Please revise age ranges listed (0-17) (Pg. 21) Please remove "Non-Ambulatory" and "Regional Center" (Pg. 21) Please remove reference Medically Fragile youth and Specialized Health Care Needs youth as discussed. (Pg. 21) Appraisal/Needs and Services Plan Please include a statement to reflect the Licensee's responsibility in creating a Needs and Services Plan for youth in care within 30 days of placement using a Licensing approved form (LIC 625). (Pg. 23) Discharge Criteria Please provide information regarding grounds for removal policy or procedure (P.g 25) Sample Menu Please review and revise mealtimes identified on this menu to align with the mealtimes identified on Page 3 (Pg. 28) Admission Agreement Please remove Chad O'Brien as a Licensee, please remove reference to eviction, please remove reference to Specialized Health Care Needs, please identify Needs and Services Plan requirements within 30 days of placement, please identify required signatures for the Needs and Services Plan, please remove reference to Adult clients, please remove references to Regional Center, please revise Personal Rights acknowledgment from LIC 613C to LIC 613B. LPA Vanegas conducted an exit interview and a copy of this report along with the signed LIC 281C, Care Tools Pre-licensing form, and Children's Residential Program Provider Information Notice 24-09 were reviewed and provided to the applicant, Breeana Yon.

met_with: Applicant - Breeana Yon


summary: Facility Evaluation

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Narrative:
On January 21, 2026 at 10:25am, Licensing Program Analyst (LPA) Rachel Vanegas completed a pre-licensing inspection of Little Nest Small Family Home (SFH). LPA met with the Applicant - Breeana Yon who led a tour of the home. The SFH was toured both inside and out with the applicant. Currently there are no clients in placement. The home was a one story building with three bedrooms and two bathrooms which were set up as follows: Bedroom #1 (Applicant's Children) had bunk beds and sleeps the applicant's two children. Bedroom #2 (Clients') had two single beds and will sleep two clients'. Bedroom #3 (Applicant) had one bed and sleeps the applicant and spouse. There is also a great room/living room, kitchen, dining area, two bathrooms, a locked garage and laundry room in the garage, and the backyard. There is a properly secure fire place in the living room. The clients' bedroom was arranged so that no more than two clients' will be in a room. No room commonly used for other purposes was 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 combo carbon/smoke detector in every bedroom and hallway. The combo carbon/smoke detectors were checked and they were working properly. The home's central air conditioning module was located in the backyard. The home's water heater was located in the garage. *Continued on the next page* The hot water in the kitchen was measured and registered at 110.6 degrees Fahrenheit. The home appliances were in working order at the time of this inspection. All sharp knives, medications, and cleaning chemicals were securely stored in the locked storage cabinet by the kitchen which was locked and inaccessible to clients. There were two first aid kits located in the home. Both first aid kits were inspected and contained all required supplies. One first aid kit was located in a locked storage cabinet and the second first aid kit was accessible in an unlocked hallway storage closet. There was one fire extinguisher in the home located near the front entrance of the home. The fire extinguisher was observed to be properly charged and inspected by the fire department. The client and staff files will be located in a locked filing cabinet in the hallway closet in the living room. There was adequate food storage space. LPA observed a two day supply of perishable and a seven day supply of non-perishable food. A trash can for storage of solid waste was present in the kitchen. There was no pool or accessible body of water at the home at the time of this inspection. The applicant stated and confirmed that there are no firearms or weapons on the facility grounds at the time of this inspection. The backyard where clients will have access to play is fenced. There was one large storage shed located on the property that was securely locked and inaccessible to clients in care. There was a playground and swing set available for client use in the backyard. The home had an enclosed dog run in the backyard which was secured and inaccessible to clients, where two family dogs are securely housed. The home does not have any cameras at the time of the inspection. Based on this inspection, there are no corrections needed to be made to the home. An exit interview was conducted a copy of this report and appeal rights were reviewed and provided to the applicant, Breeana Yon. Application will be forwarded to the Licensing Program Manager for Licensing.


facility_name: LITTLE STORMS, THE

summary: Facility Evaluation

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Narrative:
On January 16, 2025, at 2:30 p.m., Licensee completed a Face to Face (Component II) interview on 1/16/2025 with Licensing Program Analyst (LPA) Christopher J. Williams and Licensing Program Manager (LPM) Jean Herring. During the interview, LPA went over sections in the facility's program statement and on the Licensee's application that needed to be corrected and/or revised. Exit interview conducted. LPA instructed Licensee to make corrections and/or revisions to the appropriate sections and then resubmit to LPA by or before 1/31/2025. No further information to report.

met_with: Gerome Robinson, Administrator


summary: Facility Evaluation

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Narrative:
On September 12, 2025, at 9:18 a.m., Licensing Program Analysts (LPAs) Christopher J. Williams and Gilbert Gutierrez conducted an unannounced post-licensing inspection at the above address and met with the Administrator, Gerome Robinson. The home is a two-story home located in a residential neighborhood. The home's current census is one (1). At around 9:20 a.m., Administrator Robinson gave a tour of the home. The home has three bedrooms and three bathrooms. LPAs observed the following: the posted license, facility sketch, and Children's Personal Rights. The sharp objects were stored and locked in a closet in what is referred to as the living room area. There were perishable and nonperishable foods in the home. The cleaning solutions were stored and locked in a closet inside of the house. Inside the 2 bedroom(s) reserved for clients, there are queen size beds, a closet, and drawers for clients' clothing. The extra linens and towels were stored in the hallway closet on the second floor. All confidential records will be stored and locked in the Administrator's bedroom office cabinet. All medications will be stored in separate containers and locked in a closet located in the living room area. A complete first aid kit is readily available in a central location in the facility. The facility has a working landline telephone. The facility has working centralized heating and air conditioning. All the lights and appliances were working. No cameras observed were installed inside the home. The walkways and hallways were unobstructed. The facility has no bodies of water. The facility is clean, sanitary and in good repair. One Type (B) violation was discussed and given to the Licensee (See Care Tool Summary). One Technical Advisory (TA) was discussed and given to the Licensee. An exit interview was conducted and a copy of the LIC 809 was discussed and provided to the Administrator.


facility_name: LIVING HOPE SMALL FAMILY HOME

summary: Facility Evaluation

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Narrative:
On December 20, Licensing Program Analyst (LPA) Babatunde Aborchie and Licensing Program Manager (LPM) Abdoulaye Traore met with applicant Jackie White this date for a Component II. LPA and LPM went over revisions needed for the application prior to licensure. LPA and LPM gave a copy of the LIC 184, Notice of Incomplete Application, and additional correspondence to assist with the revisions needed to the application. Copy of this report was provided to applicant.

met_with: Jackie White


summary: Facility Evaluation

raw_content:
Narrative:
On January 13, 2023 at 10: AM, a pre-licensing inspection was conducted by Licensing Program Analyst (LPA) Babatunde Aborchie. LPA met with applicant Jackie White. The purpose of the visit was to evaluate the facility for a possible license for a small family home of capacity of two ambulatory children as requested by applicant. The applicant is requesting to be licensed for a small family home with capacity to serve a total of two ambulatory children ages 0-17. During this inspection, LPA and applicant inspected the facility inside and out. The home consists of: Downstairs: Bedroom #1, It was furnished with a bunk bed. It will sleep two clients; it is currently vacant. There were also a family room, a fireplace, formal dining area, a closet, a pantry, a kitchen, a laundry room and a bathroom. Upstairs: Bedroom #2, Master bedroom. The room consisted of one king-sized bed, a bathroom and two walk-in closets. It sleeps the applicant. Bedroom #3, The room was furnished with a twin sized bed. It sleeps adopted daughter age 14 years. Bedroom #4, The room was furnished with a twin sized bed. It sleeps a foster child, age 7 years. Bedroom #5, The room is currently used as a storage. Bedroom #6, The room was furnished with two twin sized beds. It sleeps two foster children, ages 4 and 8 years. There were also a loft, a full bathroom and an office space. 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, fireplace is properly screened. 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 the pantry in a locked box. Cleansers/chemicals were locked and stored in the laundry room cabinet above the washer. Sharp knives were inaccessible and stored in a locked box in the pantry. There were no guns or weapons as stated by applicant at this time. The hot water temperature was tested and noted to be 109 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit was accessible with all required items and it was in the pantry. A Fire extinguisher was 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 a 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 Applicant/Licensee.


summary: Facility Evaluation

raw_content:
Narrative:
On February 23, 2023, at 11: AM, a post-licensing inspection was conducted by Licensing Program Analyst (LPA) Karen Beal. LPA met with licensee Jackie White. During this inspection, LPA and applicant inspected the facility inside and out. The home consists of: Downstairs: Bedroom #1, It was furnished with two twin beds. It sleeps one client. There were also a family room, a fireplace, formal dining area, a closet, a pantry, a kitchen, a laundry room and a bathroom. Upstairs: Bedroom #2, Master bedroom. The room consisted of one king-sized bed, a bathroom and two walk-in closets. It sleeps the applicant. Bedroom #3, The room was furnished with a twin sized bed. It sleeps adopted daughter. Bedroom #4, The room was furnished with a twin sized bed. It is currently vacant Bedroom #5, The room is currently used as a storage. Bedroom #6, The room was furnished with two twin sized beds. it is currently vacant.. There were also a loft, a full bathroom and an office space. SFH is operating within capacity/limitation, is clean, safe, sanitary and in good repair, the outdoor area is free of safety hazards, no pool or other bodies of water on premise. The SFH has adequate supply of perishable and nonperishable foods, chemicals are locked in the laundry room, knives are store in a locked box in the pantry. The water temperature was measures at 116 degrees. Medications are stored in master bedroom in a lock box, the disaster plan, personal rights, and other documentation is properly posted, smoke detectors are operable/tested. There are no firearms or dangerous weapons per licensee. First aid kit is maintained and complete First Aid certifications are current and in expire 04/2025. All adults subject to background checks are cleared. There are no deficiencies to be cited at this time. An exit interview was conducted. A copy of this report was provided to Licensee.

met_with: Jackie White, Licensee


summary: Facility Evaluation

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Narrative:
On May 2, 2025, at 11: AM, Licensing Program Analysts (LPAs) Maya Chavez and Claudia Aguilera arrived at Living Home Small Family Home (SFH) to conduct an annual inspection. LPAs met with licensee Jackie White who granted LPAs access to the home. At 11:25AM, LPAs began a tour of both the inside and outside of the SFH with licensee. Currently the SFH has three children in placement, one was at the SFH at time of visit. During this inspection, LPAs inspected the facility inside and out. The home consists of: Downstairs: Bedroom #1, It was furnished with one twin bed. It is currently vacant. There was also a family room, a fireplace, formal dining area, a closet, a pantry, a kitchen, a laundry room and a bathroom. Upstairs: Bedroom #2, The room was furnished with a twin sized bed. It sleeps adopted daughter. Bedroom #3, The room was furnished with a twin sized bed. It is currently vacant Bedroom #4, The room is a furnished with a twin sized bed. It currently sleeps one client Bedroom #5, The room was furnished with two twin sized beds. It currently sleeps two clients. There was also a loft, a full bathroom and an office space. Bedroom #6, Master bedroom. The room consisted of one king-sized bed, a bathroom and two walk-in closets. It sleeps the licensee and licensee's husband. (See Lic809-c) (Cont. FROM LIC809) The SFH is operating within capacity/limitation, is clean, safe, sanitary and in good repair, the outdoor area is free of safety hazards, no pool or other bodies of water on premise. The SFH has adequate supply of perishable and nonperishable foods, chemicals are locked in the laundry room, knives are store in a locked box in the pantry. The water temperature for the kitchen sink measured at 111.6 degrees and the temperature for the downstairs bathroom shower measured at 108.5 degrees. Medications are stored in master bedroom in a lock box and client's insulin is stored in a lockbox in the kitchen refrigerator. The disaster plan, personal rights, and other documentation are properly posted, smoke/carbon monoxide detectors were tested and are operable. There are no firearms, dangerous weapons, nor poisons in the home per licensee. First aid kit is maintained and complete First Aid certifications are current. All adults subject to background checks are cleared. There are no deficiencies to be cited at this time, however, LPAs issued three technical advisory's (TA) that were explained and given to the licensee. An exit interview was conducted, and a copy of this report along with the TAs were reviewed and provided to Licensee.

met_with: Licensee- Jackie White


facility_name: LIVINGSTON SMALL FAMILY HOME

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Narrative:
Allegation: Caregiver over medicates Ref. #2 - The LPA observed a letter from Ref. #2's doctor that indicated that the Caregiver took Ref. #2 to the Emergency Room on May 19, 2023 and Ref. #2 was medically cleared. The letter indicated that Ref. #2 had been on the prescribed medication for years. An interview with the CSW Supervisor indicated that one particular medication was the cause of Ref. #2's issues observed at school and that Ref. #2 was taken off it after a Child and Family Team Meeting with all the parties. There was no evidence provided that the Caregiver over medicated Ref. #2. The LPA observed no issues with the Psychotropic Medication Administrator Record (MAR). Allegation - Caregiver does not ensure that client is properly fed - A review of the Psychological Evaluation conducted February 17, 2022 indicated Ref. #2 suffered with an eating disorder. The interview with the CSW Supervisor indicated that the medication that Ref. #2 takes made Ref. #2 sleepy and Ref. #2 was not eating. The Supervisor stated that this was the medication that was stopped. The LPA toured the SFH and observed a sufficient supply of perishable and non-perishable food. The LPA observed nutritious meals on the menu. Ref. #2 indicated that they get enough food to eat and is able to get any food from the kitchen that they want. Allegation - Caregiver does not ensure client's hygiene is being met. The Caregiver indicated that there was a complaint, because Ref. #2 wears hair long and dresses in a gothic style. There were statements that Ref. #2's clothes were dirty, hair long, obstructive and unwashed. The LPA observed the client to be clean, dressed in a t-shirt and shorts. Ref. #2 indicated that they shower and wash their hair daily. The LPA observed the SFH to be cluttered with furniture, but observed it to be sanitary without hazards. Allegation - Caregiver does not ensure client is meeting academic needs. The LPA observed a Graduation Status Notification indicating that Ref. #2 had not completed all of the credits to graduate, but Ref. #2 has an IEP which outlines Ref. #2's learning disability. The CSW Supervisor indicated that since Ref. #2 no longer takes that one medication that was causing problems, Ref. #2 has improved at school. The LPA is unable to corroborate the allegations. There was no preponderance of the evidence to substantiate the allegations. So, although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegations are unsubstantiated. There are no deficiencies to be cited regarding these allegations. A copy of this complaint was provided to the facility representative.

Investigation Findings:
13On September 28, 2023 at 1:45 p.m., Licensing Program Analyst (LPA), Karen McGee, arrived at the Small Family Home (SFH)(see Confidential Names, LIC Ref. #1 dated September 28, 2023) for the purpose of deliving the Complaint Investigation Report findings. The LPA met with Caregiver Darlene Livingston. On March 22, 2023, the Monterey Park Children's Residential Program (MPCRP), received a complaint with the above mentioned allegations. Confidential interviews were conducted that included, but were not limited to: the Caregiver and Client, Ref. #2, at the SFH on May 31, 2023; and the County Social Worker (CSW) Supervisor via telephone on September 27, 2023. The LPA reviewed the following documents: Psychological Evaluation, Letter from medical doctor, Psychotropic Medication Administration Record (MAR), medical examination forms, food menu, Individualized Education Program (IEP) and Graduation Status Notification. The Caregiver and Ref. #2 denied the allegations. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Karen McGee LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION LA & TRI-COASTAL CR, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: LIVINGSTON SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 09/29/2023

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

visit_type: Complaint Investigation

met_with: Darlene Livingston


summary: Facility Evaluation

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Narrative:
On February 11, 2022, Licensing Program Analyst (LPA), Janeth Chavez, conducted an unannounced inspection at the small family home (SFH) above for the purpose of conducting an annual inspection. LPA met with the licensee of the home, Ms. Darlene Livingston. During the inspection there were no other staff or foster children present at the home. There is only 1 foster placement in the home. The licensee does not have any other staff employed. A physical plant inspection was completed and included the following checks: small family home grounds are free of observable hazards. There is adequate indoor and outdoor activity space, including an outdoor yard. The smoke and carbon monoxide detectors are in working order. Knives and sharps are locked in a kitchen drawer. LPA observed the Children's Personal Rights, Emergency Contacts, Emergency Plan (evacuation) and foster Ombudsman poster posted on the wall in the facility. The medications and client's files are locked inside a file cabinet located in the living room area. Emergency Intervention Plan: LPA Chavez reviewed the Emergency Intervention Plan. Upon a physical inspection of the facility, the hot water in the kitchen was measured to be 110 degrees. Chemicals and cleaning products are locked in the garage area. Ms. Livingston confirmed there are no weapons and/or ammunition in the home. There are three bedrooms: Room 1 is used by the client and has two twin beds, Room 2 has two twin beds and is vacant, Room 3 is licensee's bedroom with own bathroom. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good condition. Each bedroom has enough drawer and closet space for each person. Bedrooms are arranged so that no more than two persons share a room and there is one person per bed. There are two full bathrooms in the home, and each appeared to be in working order. Client Records: LPA Chavez reviewed one (1) client file. The files contain: Admission Agreement, Medical Assessment, Consent Forms, Emergency Information, Appraisal & Needs Service Plan, Immunization Record and Personal Rights. The Safeguards For Cash Resources was not available during inspection. Staff Records: There is no staff other than the licensee. LPA reviewed licensee's file and it contained the following documentation: Child Abuse Index Checks/Department of Justice (DOJ)/Federal Bureau of Investigation (FBI) criminal record clearances, criminal record statement. LPA Chavez observed a health screening and tuberculosis. The Licensee's First Aid Certificate and Cardiopulmonary Resuscitation is valid until 10/2023. An exit interview was conducted and a copy of this report, along with appeal rights, was provided to licensee, Ms. Darlene Livingston.


summary: Facility Evaluation

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Narrative:
On April 19, 2024, at 9:15 a.m., Licensing Program Analyst (LPA) John Bonilla and Licensing Program Manager (LPM) Jean Herring arrived at the Livingston Small Family Home (SFH) for the purpose of conducting an unannounced Annual/Required inspection. LPA and LPM met with Darlene Livingston, Licensee. The SFH currently does not have any clients in placement. LPA and LPM toured the home. The SFH has all appropriate licensing forms posted. The SFH is a three bedroom home, with two bedrooms available for 3 clients. The SFH has a kitchen, living room area, and a backyard for client activities. LPA and LPM observed working smoke detectors, carbon monoxide alarms, and a current fire extinguisher. LPA and LPM conducted the Physical Plant and Operations domains of the Department's Compliance And Regulation Enforcement (CARE) tool. The SFH was issued a technical assistance. See LIC9102-AN. Exit interview conducted. A signed copy of this form and LIC9102-AN were provided to Darlene Livingston. Appeal rights provided. No further action is required.

met_with: Darlene Livingston, Licensee


summary: Facility Evaluation

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Narrative:
On July 11, 2024, at 10: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez made a case management inspection to the facility and met Administrator, Darlene Livingston. The case management was a follow-up regarding the Special Incident Report (SIR) received on 07/01/24. The SIR indicated that on 06/29/24 at around 4: PM, 911 was called and police came to the home. Client (C1) broke into administrator's locked bedroom and took the medication that was in the administrator's purse. Per Administrator Livingston, C1 has a history of suicidal ideations. She keeps C1's medication locked inside a security safe box in her bedroom which she showed this LPA. When the incident happened last 06/29/24,they just came home from the recreational park swimming pool. C1 suddenly broke into her bedroom that was locked at the time while she was unpacking their things. C1 took the medication container that was still in her purse on top of her bed and ran straight into the bathroom and jumped into the tub. She followed C1 and tried to get the medication container back but C1 started hitting her arm. She called 911, and the police came to the home and able to retrieve the medication and took C1 to the hospital. As a safety plan, administrator bought another security safe box where she will keep C1's medication when they travel and will put the medication back into the security safety box that was kept in her bedroom. She also put a new lock in her bedroom door. LPA asked the administrator to make an SIR addendum to add more information to the initial SIR dated 06/29/24. An exit interview was conducted and copy of the LIC 809 and LIC 811 was provided to the administrator. No deficiency citation issued at the time of the inspection.


summary: Facility Evaluation

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Narrative:
On July 26, 2024, at 11:45 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management inspection at Livingston Small Family Home (SFH) for the purpose of following up on a Special Incident Report (SIR) received by the Department on July 18, 2024. LPA met with licensee Darlene Livingston. The SIR indicated that on 07/17/24 at 5:53 p.m., 911 was called and police came to the home after client (C1) (See LIC Confidential names list dated 07/26/24) had broken into a locked cabinet and smashed a ceramic plate on the floor and started cutting on both arms during a wrap around session. During this inspection, LPA reviewed C1's Needs and Services Plan (NSP), which was still being completed by licensee as C1 was recently placed at the home. Licensee stated she plans to complete the NSP over the weekend, but that is dependent on C1's behaviors. As a result of incident, C1 was taken on a psychiatric hold. Upon discharge, a safety plan was created by the psych team recommending outpatient services. Licensee stated that wraparound services have increased to daily. LPA has spoken with County Social Worker (CSW) and CSW is aware of the situation at the SFH. No deficiencies were cited during this inspection. An exit interview was conducted and copy of the LIC 809 and LIC 811 was provided to the licensee. No further action required.


summary: Facility Evaluation

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Narrative:
On March 19, 2025, at 10:30 a.m., Licensing Program Analyst (LPA) Brent Lockhart and Licensing Program Manager (LPM) Jean Herring arrived at the Livingston Small Family Home (SFH) for the purpose of conducting an unannounced Annual/Required inspection. LPA and LPM met with Darlene Livingston, Licensee. The SFH currently does not have any clients in placement. LPA and LPM toured the home. The SFH has all appropriate licensing forms posted. The SFH is a three bedroom home, with two bedrooms available for 3 clients. The SFH has a kitchen, living room area, and a backyard for client activities. LPA and LPM observed working smoke detectors, carbon monoxide alarms, and a current fire extinguisher. LPA and LPM conducted the Physical Plant,Operations and Staffing domains of the Department's Compliance And Regulation Enforcement (CARE) tool. During the inspection LPA Lockhart notice the hot/cold water flow in the clients bathroom was very low. The SFH was issued a technical violation. See LIC9102-TV. Exit interview conducted. A signed copy of this form and LIC9102-AN were provided to Darlene Livingston. No further action is required.

met_with: Darlene Livingston - Facility Administrator


facility_name: LONNA'S GENTLE CARE HOME

summary: Facility Evaluation

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Narrative:
On September 25, 2025, Licensing Program Analysts (LPAs) Briana Placencia and Danny Macias traveled to Lonna's Gentle Care Home located in Patterson CA. LPA was met by Licensee Philana Grayson, for the purpose of a scheduled pre-licensing inspection for the Small Family Home. A general overview of their program and a tour of the facility was provided. The facility is a single story residence with three bedrooms, the bedrooms have all required furnishings, the facility has three restrooms and the master bedroom serves as the office. Facility is to ensure water temperature is maintained between 105 and 120 degrees or post warning signs as today the hot water read 146.4. LPAs observed fixtures and furniture, equipment and supplies necessary for this operation. LPAs observed locked cabinets for client and staff files in order to ensure confidentiality. The facility does have a pool on site that meets regulatory standards. The agency employs one administrator, and one direct care staff. The facility is equipped with a first aid kit and a fire extinguisher. All required LIC forms and personal rights are posted in a common area. Items discussed were the hot water temperature and window screens. The Small Family Home will need set up a guardian account and will need to associate all staff and submit the required documents to LPA Placencia before being licensed. The above licensee meets the needs to be a licensed as a Small Family Home in Stanislaus County, with the ability to place participants within a two hour radius. A copy of this report was provided to the Licensee.

met_with: Philana Grayson


facility_name: LUCIA SMALL FAMILY HOME

summary: Complaint Investigation - Unsubstantiated

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Narrative:
Based on confidential interviews and a review of pertinent documents, the allegation that licensee does not ensure a minor is meeting their hygiene needs may have happened or is valid but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted. A copy of this report, LIC 811 and appeal rights were explained and given to Lucia Wamutitu.

Investigation Findings:
13On March 28th, 2025, Licensing Program Analysts (LPAs) Maryjane Perez and Claudia Aguilara made an unannounced visit to Lucia Small Family Home (SFH) to deliver the finding for the above stated allegation. On November 1st, Community Care Licensing received complaint allegation that licensee does not ensure a minor is meeting their hygiene needs. On November 6, LPA conducted a health and safety inspection of the facility, and no hazards were observed. Lpa M. Perez also obtained pertinent documents and interviewed licensee (LS), client 1 (C1), client 2 (C2), and client 3 (C3). During the investigation, confidential interviews stated that licensee will provide clients with the proper materials to use for hygiene purposes. Other confidential interviews stated that the clients in the home are not bathing when they are supposed to. Another confidential interview stated they don't know if they take showers or not. LPA was unable to gather additional information due to clients refusing to continue with interview. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: MaryJane Perez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: LUCIA SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 03/28/2025

met_with: Licensee- Lucia Wamutitu


summary: Facility Evaluation

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Narrative:
On April 02, 2024, Licensing Program Analysts (LPAs) Rafael Enriquez and Karen Beal and Licensing Program Manager (LPM) Abdoulaye Traore met with applicant Lucia Wamutitu for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the notification of incomplete application (LIC 184), letter of Incomplete Application, and additional correspondence to assist with the revisions needed to the application. Copy of this report was emailed to applicant and a signed copy will be placed in the facility file.

met_with: Applicant Lucia Wamutitu


summary: Facility Evaluation

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Narrative:
On May 06, 2024, at 9: AM, Licensing Program Analyst (LPA) Rafael Enriquez began a pre-licensing inspection and component III for Lucia Small Family Home for an initial license. LPA met with applicants Lucia Wamutitu & Samuel Muhungi who led a tour of the home. The facility was toured both inside and out with the applicants. Currently there are no children placed in the home. The applicant was approved to serve four children ages 0 to 17. The home is a single-story building with three bedrooms and two bathrooms which is set up as follows: · Bedroom #1 will sleep two foster children, has two beds. It was vacant. · Bedroom #2 will sleep two foster children, has two beds. It was vacant. · Bedroom #3 sleeps the applicants, has a king bed, has a bathroom and a walk-in closet. · A living room area, kitchen with dining area, storage, two bathrooms, two car garage, backyard, and a laundry room. Bedrooms were arranged so that no more than two children share a room, and there was 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 was adequate drawer and closet space for children's belongings. The smoke detectors and carbon monoxide detectors were checked, and they were working properly. Telephone service and appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients/children will have access. Sharp knives and sharp objects were locked in a cabinet in the kitchen. Cleansers/chemicals were inaccessible and stored in laundry room which has a lock on the door. There was adequate food storage space and a supply of two days of perishable foods and a week of non-perishable food. A proper storage of all food was discussed. Trash cans for storage of solid waste had tight fitting lids. The water temperature was observed to be at 107.4 degrees. First Aid kit were accessible with all required items, and it was on the kitchen counter. A Fire extinguisher was observed and properly charged. All the appropriate forms were posted in view of facility clients. As stated by applicant, there were no weapons/firearms and there were no pools or other bodies of water. 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 for licensure will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to applicants Lucia Wamutitu & Samuel Muhungi.

met_with: Licensees Lucia Wamutitu & Samuel Muhungi


summary: Facility Evaluation

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Narrative:
On June 13, 2024, at 01: PM, a post-licensing inspection was conducted by Licensing Program Analyst (LPA) Rafael Enriquez. LPA met with licensee Lucia Wamutitu. During this inspection, LPA and licensee inspected the facility inside and out. The home is a single-story building with three bedrooms and two bathrooms which consists of: Bedroom #1, It was furnished with two twin sized beds. It will sleep two foster children. It was vacant. Bedroom #2, It was furnished with two twin sized beds. It will sleep two foster children. It sleeps two foster children aged 8 and 7 years. Bedroom #3, The master bedroom, furnished a king-sized bed, had a bathroom and a walk-in closet. It sleeps the licensees. There was also a living room area, kitchen with dining area, storage, two bathrooms, two car garage, backyard, and a laundry room. The Small Family Home (SFH) is operating within capacity/limitation, is clean, safe, sanitary and in good repair, the outdoor area is free of safety hazards, no pool, or other bodies of water on premise. The SFH has adequate supply of perishable and nonperishable foods, chemicals are locked in the laundry room and under the kitchen sink, knives are locked in a kitchen cabinet. The water temperature was measures at 107.4 degrees. Medications are stored in a locked kitchen cabinet, the disaster plan, personal rights, and other documentation are properly posted, smoke detectors are operable/tested. There are no firearms or dangerous weapons per licensee. First aid kit is maintained, and complete First Aid certifications are current and in expire 10/2025. All adults subject to background checks are cleared. There are no deficiencies to be cited at this time. An exit interview was conducted. A copy of this report was provided to Licensee Lucia Wamutitu.


summary: Facility Evaluation

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Narrative:
On March 3, Licensing Program Analyst (LPA) Maryjane Perez conducted a pre-licensing visit for a change of location at Lucia Small Family Home. LPA met with Licensee Lucia Wamutitu who led a tour of the entire home. The licensee is applying for a capacity of 4 children ages 0 to 17. The home is a one story building with 4 bedrooms and 2 bathrooms. The entry way consisted of emergency escape plan. There was bedroom #1 that had two twin size beds with appropriate bedding dresser and closet space that will be utilized for clients. Bathroom #1 was fully functioning with water temperature reaching 110.8 degrees Fahrenheit. Bedroom #2 had two twin size beds fully furnished with dresser and closet space and will be utilized for clients. There was a storage closet storing toilet paper, towels and linen. Bedroom #3 also had two twin size beds with closet and dresser space. There was a laundry room that will be locked at all times as it stored laundry detergents and essentials. The hallway holds fire extinguisher #1 that is up to date and another storage closet with household items. There was a kitchen that was clean and sanitary, the refrigerator and pantry was fully stocked. There were locked cabinets for medications and knives. The kitchen also had fire extinguisher #2 that was up to date. There was a dining table, a living room fully furnished with couch and TV. The master bedroom for licensee held a crib for an infant with all required bedding essentials and bathroom #2 that was fully functioning. The hallway leading to master bedroom had a bulletin board with all required postings such as: personal rights, menu, and emergency evacuation plan. Bedrooms were arranged so that no more than two children share a room, and there was 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 drawers and closets for children's belongings. The smoke detectors and carbon monoxide detectors were checked, and they were working properly. Appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients/children will have access. There was a stationed land line service to be used by both licensee and clients There was adequate food storage space and a supply of three days of perishable foods and a week of non-perishable food. Trash cans for storage of solid waste had tight fitting lids. First Aid kit was accessible with all required items located in a kitchen cabinet. All the appropriate forms were posted in view of facility clients. As stated by licensee, there were no weapons/firearms and there were no pools or other bodies of water. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies observed at this time. The request for licensure will be forwarded to Licensing Program Manager for final review and approval. An exit interview was conducted. A copy of this report was provided to licensee Lucia Wamutitu.