summary: Facility Evaluation

raw_content:
Narrative:
On 5/21/2025 at 9: AM, Licensing Program Analyst (LPA) Reagan Cohen and LPA Andrea Aceves arrived at the facility for the purpose of conducting an Requierd 2-Year Inspection. LPA's met Maria Sarkisian, Administrator for the facility who granted access and tour of the facility. The current census is 5. LPA's conducted a facility walk through. During the inspection LPA's observed the following: The facility is in a residential neighborhood. It is licensed to care and supervise up to six (6) male and female youth ages 12 to 17 ambulatory only. The facility is a two-story home with a garage being used as a gym, and a backyard with a pool. The facility does use cameras. The facility has synched dual smoke and carbon monoxide detectors in every room. The facility license and disaster plan are posted in the dinning room. Down Stairs Living Room: There is a couch and 4 beanbag chairs providing adequate seating. There is a TV, a fire place with a cover, a fully charged fire extinguisher, a thermostat, and adequate lighting. There is an locked activity closet with games, puzzles, and arts supplies. Living room leads to the therapists office, bathroom, the upstairs area, and group therapy room. Bathroom #1: This is a half bath with a toilet and a sink. There are working lights. No cleaning solutions stored. The water temp was measured at 105 degrees F. Therapy Room #1: This room is used by therapist as private area to talk with clients. There is a desk with a computer, a couch, and some chairs. There is a fully charged fire extinguisher. Bathroom #2: There is a bathroom in the therapy room that clients can but don't often use. The bathroom has a sink and toilet. There is adequate lighting. The water temp was 105 degrees F. Therapy Room #2: This room is used by therapist as private area to talk with clients. There is a desk with a computer, a couch, and some chairs. There is a fully charged fire extinguisher. Bathroom #3: There is a bathroom in the therapy room that clients can but don't often use. The bathroom has a sink and toilet. There is adequate lighting. The water temp was 105 degrees F. Group Therapy Room: Located next to the living room, this is an area for clients to meet together and receive group therapy. There is adequate seating and a white board. This room leads to the back yard or the kitchen. There is a hallway with an old wine cellar that has been converted into a library/book storage area. Kitchen/Dinning Room: This room has 2 dinning tables each with adequate seating. There is a water cooler for clients. The facility license, disaster plan, menu, and activity schedule are posted. There is a fooseball table. The kitchen has a working 6 burner stove/oven. There are an adequate amount of plates, cups, bowls, and utensils. There are no cleaning solutions stored in the kitchen. There is a fully charged fire extinguisher. There is a fridge and freezer. There are two sinks both with a water temp of 105 degrees F. Knives are kept on the chefs person and made inaccessible to clients. There is an adequate amount of perishable food. There is a snack mini fridge in the room. The kitchen leads to the back yard or the hallway to the education room. Pantry: There is a pantry in the hallway on in between the kitchen and education room. The pantry is locked and stores spices, snacks, cereal, canned goods, and other non-perishables. There is an adequate supply of non-perishable foods. There is also a monitor station for the facility cameras. It is locked and inaccessible to clients. It records live footage and stores it for a week. Education Room: This is a room fro clients do do their online schooling. There are 6 desks with 6 computers for all clients. There is a TV and a fully charged fire extinguisher. There is a staff restroom that is locked and inaccessible to clients. This room leads upstairs to the administrators office, to the backyard or to the laundry room. Laundry room: The laundry room has a washer and dryer unit. There are cabinets which store cleaning solutions. They are locked and made inaccessible to clients. This room leads to the garage. Garage: The garage is used as a exercise room equipped with 2 treadmills, a weights rack, 2 bike machines, and open space. There is another fridge and freezer for extra food and snack storage. This room leads to the outside front yard. There is also a driveway with a basketball hoop. Upstairs Administrators office: Located above the education room, the office is for the administrator only and is kept locked and made inaccessible to clients. There is a fully charged fire extinguisher and a first aid kit outside the office. In the office there are 2 desks with chairs, a printer, and a bathroom. Upstairs Landing: There is a landing/walkway upstairs with rails and plexiglass to prevent clients from falling. There are two closets which are locked and used as storage for supplies like brooms, vacuums, ladders, and emergency supplies etc. This area leads to bedroom #1 and the Hang Out Area. Bedroom #1: Located above the living room, this room sleeps 2 clients. There are two full beds complete with an adequate amount of pillows, blankets, and bedsheets. There are 2 dresser and built in dressers under the bed. There is a fire place with a plexiglass cover and a balcony that is kept locked and made inaccessible. Bathroom #3: This bathroom is located in bedroom #1. There is 2 sinks with water temps measured at 105 degrees F. There is a toilet and shower. There is a tub but clients don't use it. This bathroom does have a door to the nurses station but it is kept locked and inaccessible. Nurse Station: Located adjacent to bedroom #1 the nurse station stores clients meds, over the counter meds, extra hygiene equipment, the main first aid kit, and the medication logs. There is a med kit with tweezers, scissors, a thermometer, bandages, and wipes. LPA observed each clients meds labeled and kept separately. LPA's observed the medication distribution records. The nurses station is made locked and inaccessible. Hangout Area: Located across from Bedroom #1 this is an open area/hallway that leads to Bedrooms #2, 3, and 4. There are also 3 closets that are used as storage for extra towels, linens, and clients personal hygiene. Bedroom #2: Located above the kitchen, this room sleeps 1 client. There is 1 full beds complete with an adequate amount of pillows, blankets, and bedsheets. There is a closet and built in dressers under the bed. Bathroom #4: This bathroom is located in bedroom #2. There is 1 sink with water temp measured at 105 degrees F. There is a toilet and shower. Bedroom #3: Located above the kitchen, this room sleeps 1 client. There is 1 full beds complete with an adequate amount of pillows, blankets, and bedsheets. There is a closet and built in dressers under the bed. Bathroom #5: This bathroom is located in bedroom #2. There is 1 sink with water temp measured at 105 degrees F. There is a toilet and shower. Bedroom #4: Located above the kitchen, this room sleeps 2 clients. There are two full beds complete with an adequate amount of pillows, blankets, and bedsheets. There is a closet and built in dressers under the bed. There is balcony that is kept locked and made inaccessible. Bathroom #6: This bathroom is located in bedroom #4. There is 1 sink with water temps measured at 105 degrees F. There is a toilet and shower. Outside Backyard: There is a pool in the back yard. There is a gate that is at least 5ft tall and with bars that you can see through. There is a lot of open space to run around. There is a dinning table with adequate chairs. There is a grill are and counter top. There is a fully charged fire extinguisher. There is a garden in the very back. On the side of the house there are some building materials left from previous house projects. LPA advised Admin to remove or make the materials inaccessible to clients, Admin agreed to do so. LPA's requested and received a copy of the staff and client roster. LPA reviewed the facility disaster training logs. LPA will return to interview staff and clients, review staff and clients files, inspect the facility vehicle, and review the medication logs. There are no deficiencies cited at this time. Exit interview was conducted with Maria Sarkisian, Administrator. A copy of this report will be provided to the facility.

met_with: Administrator Maria Sarkisian


state: CA

facility_name: BOMAR GUEST HOME LLC

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Shoua Xiong and LPA Robert Sandles conducted an unannounced visit to the facility on 6/23/21 beginning at 11:30AM. LPAs met with the Administrator/Licensee, Dolfa Bomar, and explained the purpose of the visit was to conduct an Annual/Required inspection. On today's date, LPAs conducted a health and safety inspection of the facility. This facility is a four bedroom, two bathroom house. Three bedrooms are designated for clients in care. LPAs observed that there are no more than two clients to a room, each client is provided their own beds, beddings, dressers, and closet space. Each bedroom contained a night stand with lamps. A Smoke Detector/Carbon Monoxide Combo alarm was observed in each bedrooms, in the hallway, and by the front entrance. LPAs tested and observed that all alarms were in working order. The fourth bedroom is designated as a staff office. The office was observed to be locked. Upon inspection, the office contained client and staff files along with the Medication Administration Record binder. The Kitchen area contained a dining table that seated four. In the refrigerator and pantry, LPAs observed the required two days of perishable food items and seven days of non-perishable food items. Medications was observed to be stored and locked in a designated closet. This closet also contained a complete first aide kit. Sharps and cleaning chemicals/solutions was observed to be stored and locked in kitchen cabinets. LPAs observed a fire extinguisher that was charged and serviced within the last 12 months. The water temperature of sinks were tested and within the required range. The temperature inside the house was registered at 72 degrees and was comfortable. The front and back yard of the facility was observed to be clean and free of debris or safety hazards. LPAs inspected the facility vehicle and observe it had current, non-expired, registration and tags. The vehicle was observed to be in good shape with no safety concerns. On today's date, LPAs also reviewed four client files and nine staff files. All files was observed to be complete, containing the required documents. No deficiencies were cited on today. Exit interview conducted and a copy of this report was given to the Administrator/ Licensee, Dolfa Bomar.

report_type: Facility Evaluation

visit_type: Annual

met_with: Dolfa Bomar-Administrator/Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On August 15, 2022 at 12: P.M. Licensing Program Analyst Stephannie Verna arrived at the above facility and conducted an unannounced annual facility inspection. LPA met with, House Manager, Mariflor Dizon, and Dolfa Bomar, Facility Licensee and announced the reason for the inspection. Facility Licensee assisted with the inspection. LPA and the Licensee conducted a joint inspection of the interior and exterior areas of the facility's physical plant. The group is licensed for a capacity of 4 ambulatory clients, ages seven to 17 years old. There were two clients in care at the time of the inspection. One client was on an outing with the staff. The home is a one story home. The home consists of two single occupancy bedrooms and one double occupancy bedroom, and two bathrooms, a garage, and a backyard with no swimming pool or pond. The home had a kitchen, dining room, staff office, laundry room and living room. The facility license was posted in a prominent place, on the wall in the living room. The home had an Emergency Disaster plan, and Facility Sketch, Client Personal Rights and the Grievance policy, Client menu, Client Daily Schedule, and a calendar of activities were posted on a cork board in the dining room. The living room contained two couches, and 3 chairs, along with a television and entertainment center. There was an XBOX gaming system and games, games, DVDs in the entertainment center, The kitchen contained a working landline phone. The home did not have a fireplace. LPA observed that the dining area was off of the kitchen and the table was set up for placement of four and contained four chairs. LPA observed that the kitchen area was located off the dining and living room area of the facility and that the kitchen area had the stove, oven, toaster, dishwasher, microwave and refrigerator/freezer. The kitchen cabinets and drawers contained ample dishes, utensils, and cooking supplies, such as pots and pans, and PPE supplies. The sharps and cleaning chemicals were in locked cabinets. The pantry was located off of the kitchen in the entryway, with no lock on the door. continued on 809-c LPA observed expired food items, including boxes or rice and bags of beans, and salad dressings, expiring between dates ranging from May 2021 - June 2022. The staff removed the items immediately from the pantry and refrigerator. There was ample storage of fresh and frozen foods located in the refrigerator, freezer, and pantry to supply meals and snacks to the clients in care. Supplies of staple nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. Fresh fruits were observed on the kitchen island. The front and back yards were free of clutter; and the passageways and egress were unobstructed. No potentially hazardous items or areas were observed in the outdoor spaces. The backyard contains two seating areas with tables and multiple chairs, and umbrella shades to shade from the sun and a swinging bench. There were no locks on the side yard fence, and the side yard contains trash cans, and a bicycle. The garage contained a facility vehicle, lawn mower and weed eater, storage cabinets and a refrigerator and freezer. The cabinets contained paper supplies, games and toys, holiday decor, extra bags and backpacks, and kitchen supplies such as a crockpot. A table and chairs was also observed. The laundry room contained a washer and dryer, and locked cabinets which contained tools and chemicals, including paints. The locked cabinets also contained sponges, and flashlights. The locked cabinet near the ground contained cleaners, detergents, and a gas can will gas inside. The facility staff moved the gas can to a locked space in the garage when made aware. LPA observed that the bedrooms had a bed(s) and bedding including mattress cover, fitted sheet, top sheet and blanket, and pillows, dressers with drawers for personal items, night stand, lamp, and ample closet space. One single occupancy bedroom had the dresser/mirror combination placed in front of a window which did not allow window and emergency exit access in the case of an emergency, violating the fire clearance. Staff immediately moved the furniture from the window when made aware that it hindered from an emergency exit. Window screens were in good repair aside from the sliding door screen which was observed to have a two inch by three inch hole in it near the handle. The licensee is in the process of repairing it. There were two bathrooms observed in the facility. One bathroom was located in a bedroom, and the other bathroom was located in the hallway. continued on 809-c The bathrooms had a working toilet, shower/tub, and sink faucet. The water temperature was measured to be at 108 degrees Fahrenheit. The bathrooms contained soap and paper towels for hand washing, as well as hand washing guidelines were posted. Hygiene supplies were observed in the bathrooms for clients use. Ants were located near the toilet and trash can in the one bathroom. The staff sprayed bug spray and cleaned immediately to remove the ants. Both bathrooms contained a supply of gloves and hand sanitizers. The bathroom closet contained extra hygiene products, PPE, and bath mats. The hallways closet outside of the bathroom contained extra towels and wash cloths, and bedding. Trash cans with lids were observed in the bathrooms and kitchen. LPA observed a working Carbon Monoxide detector in the hallway and working smoke alarms in each bedroom, the entry area, staff office, and hallway. LPA observed that there was a fire extinguisher in the hallway and dining room. The fire extinguishers were charged and last inspected in March 2022. The fire clearance was conducted in April 2020 and a copy was provided to LPA. Upon arrival LPA observed a scent of cigarette smoke from the garage/backyard area. The licensee admitted that staff are allowed to smoke cigarettes in the backyard. LPA informed the licensee of regulation 84087(c). The licensee informed staff of the regulation and to smoke off of the facility premise during breaks. LPA observed that the medications and documents, and first aid kit were stored in a locked hallway closet. The confidential client and staff files, including the Register of Clients, and staff background clearances were stored in locked staff office. LPA reviewed a total of six staff files, two licensee files, and four client files. LPA observed that all files contained the required documentation, including Medication Administration Records, Including for Psychotropic Medications distributed, signed Needs and Services Plans, Appraisal of Needs and Services, JV-220 for one client, Immunization Records and proof of TB testing, and Placement Agreements. The sole exception was that the the licensee does not have a document in which bedroom sharing compatibility was discussed with the clients who share a bedroom, but maintains that the clients who share a bedroom are compatible and the licensee will discuss with the clients, and complete and place documentation in the clients files. continued on 809-c The facility was clean, safe, sanitary and in good repair, with the exception of being deficient related to the following, where: Technical Violations (TV) were issued, related to: California Code of Regulations, Title 22, division 6, chapter 1, section 80087(a) (1): The licensee shall take measures to keep the facility reasonably free of flies and other insects. California Code of Regulations, Title 22, division 6, chapter 1, section 80088(b): All window screens shall be in good repair and be free of insects, dirt and other debris. California Code of Regulations, Title 22, division 6, chapter 5, section 84087(c): The licensee shall prohibit smoking in the facility and on the ground of the facility; and Technical Advisories (TA) were issued, related to: California Code of Regulations, Title 22, division 6, chapter 1, section 80087(i): The items specified in Section 80087(g) above shall not be stored in food storage areas or in storage areas used by or for clients. California Code of Regulations, Title 22, division 6, chapter 1, section 80076(a)(18): All food shall be protected against contamination. Contaminated food shall be discarded immediately. California Code of Regulations, Title 22, division 6, chapter 5, section 84087(e): "In every situation where children share a bedroom, the licensee shall document that the bedroom sharing arrangement ensures the health and safety of each child and that the children are compatible...." See TVs and TAs for more information. Two staff and two clients were interviewed. The facility is being cited for violations of the California Code of Regulations, Title 22, division 6, chapter 1, section 80020(a) All facilities shall secure and maintain a fire clearance approved by the city or county fire department, the district providing fire protection services, or the State Fire Marshal. See 809-D for POC information. An exit interview was conducted with Dolfa Bomar, Facility Licensee and a copy of this report and appeal rights was provided to Dolfa Bomar, Facility Licensee.

met_with: Dolfa Bomar, Facility Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On August 30, 2023, at 11: A.M. Licensing Program Analyst (LPA) Donna Edwards arrived at the above facility and conducted an unannounced annual facility inspection. LPA met with, Dola Bomar, Facility Licensee and announced the reason for the inspection. Facility Licensee assisted with the inspection. LPA and the Licensee conducted a joint inspection of the interior and exterior areas of the facility's physical plant. The group home is licensed for a capacity of 4 ambulatory clients. There were two clients in care at the time of the inspection. The home is a one story home 4 bedrooms, 2 bathrooms, garage, and backyard with no swimming pool or pond. There are two single occupancy bedrooms and one double occupancy bedroom. The home had a kitchen, dining room, staff office, laundry room and living room. The facility license was posted in a prominent place, on the wall in the dining room area. The home had an Emergency Disaster plan, and Facility Sketch, Client Personal Rights and the Grievance policy, Client menu, Client Daily Schedule, and a calendar of activities were posted in the dining room. The living room contained two couches, and 3 chairs, along with a television and entertainment center. There was a gaming system, games, and DVDs in the entertainment center, The kitchen contained a working landline phone. The home did not have a fireplace. LPA observed that the dining area was off the kitchen and the table was set up for placement of four and contained four chairs. LPA observed that the kitchen area was located off the dining room area of the facility and that the kitchen had a stove, toaster, dishwasher, microwave, and refrigerator/freezer. The kitchen sink water temperature was measured to be at 105 degrees Fahrenheit the kitchen cabinets and drawers contained ample dishes, utensils, and cooking supplies, and pots and pans. The sharps and cleaning chemicals were in locked cabinets. The pantry was located from the kitchen in the entryway, with no lock on the door. There was ample storage of fresh and frozen foods located in the refrigerator, freezer, and pantry to supply meals and snacks to the clients in care. LPA observed fresh fruits on the kitchen island. Supplies of staple nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. The bathrooms had a working toilet, shower/tub, and sink faucet. The bathrooms contained soap and paper towels for hand washing, as well as hand washing guidelines were posted. Hygiene supplies were observed in the bathrooms for clients use. The bathroom closet contained extra hygiene products for clients. The hallway closet contained extra towels and wash cloths, and bedding. Trash cans with lids were observed in the bathrooms and kitchen. LPA observed a working Carbon Monoxide and Smoke alarms in the bedrooms, living room and hallway. There were two fire extinguishers in the home, in the dining area and the hallway. LPA observed the fire extinguishers were charged and last inspected in June 2023. The laundry room contained a washer and dryer, and locked cabinets which contained tools and chemicals, including paints. The locked cabinets also cleaning materials and towels. The locked cabinet below the sink, contained cleaners and laundry detergents. LPA observed the medications and first aid kit were stored in a locked hallway closet. The confidential client and staff files, including the Register of Clients, and staff background clearances were stored in locked staff office. LPA reviewed a total of six staff files. All files contained the required, including Criminal Records Statement, Personnel Records, TB Test, First Aid, and Employee Rights. The front and back yards were free of clutter; and the passageways were unobstructed. No potentially hazardous items or areas were observed in the outdoor spaces. The backyard contains two patio tables and eight chairs. There were no locks on the side yard fence, and the side yard contains trash cans. The garage contained a facility van, storage cabinets, refrigerator and freezer. Storage cabinet contained g products, extra toilet paper, games and holiday decor. A table and chairs , lawn mower were also observed. LPA reviewed six client files and conducted two staff interviews. Completed review of Operation and Disaster Preparedness. No Deficiencies were noted today. An exit interview was conducted with Dolfa Bomar, Facility Licensee and a copy of this report and appeal rights was provided to Dolfa Bomar, Facility Licensee. Appeal Rights given.

met_with: Dolfa Bomar


summary: Facility Evaluation

raw_content:
Narrative:
On August 31, 2023, at 10: A.M. Licensing Program Analyst (LPA) Donna Edwards arrived at the above facility and conducted an unannounced annual facility inspection. LPA met with, Dola Bomar, Facility Licensee and announced the reason for the inspection. Facility Licensee assisted with the inspection. LPA reviewed three client files. The files contained required documents which included, Admission Agreement, Medical Assessment, TB Test, Consent Forms, Personal Rights and Consent Forms. Files were organized and case files were complete, however, all three case files were missing parent/guardian authorization for medications. LPA reviewed MAR logs for three clients. Medication and MARS was secured in a locked area. MAR logs were complete and all required information. LPA interviewed two clients. LPA observed, the facility has an Emergency and Disaster Plan, but the staff training documentation was missing. Administrated, stated she will train staff and keep a record in the Employee Files. Two deficiencies were cited today. Exit interview conducted and a copy of this report was given to the Administrator. Appeal Rights have been given.

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On June 20, 2024, at 10: A.M. Licensing Program Analyst (LPA) Kayla Green arrived at the above facility and conducted an unannounced annual facility inspection. LPA met with, Chrystal Arquines, Facility Manager. Facility Manager assisted with the inspection. LPA and the Manager conducted a joint inspection of the interior and exterior areas of the facility's physical plant. The group home is licensed for a capacity of 4 ambulatory clients. There were three clients in care during the inspection. The home is a one story home 4 bedrooms, 3 bathrooms, garage, and backyard with no swimming pool or pond. There are two single occupancy bedrooms and one double occupancy bedroom. The home had a kitchen, dining room, staff office, laundry room and living room. The facility license was posted in a prominent place, on the wall in the dining room area. The home had an Emergency Disaster plan, and Facility Sketch, Client Personal Rights and the Grievance policy, Client menu, Client Daily Schedule, and a calendar of activities were posted in the dining room. The living room contained two couches, and 3 chairs, along with a television and entertainment center. There was a gaming system, games, and DVDs in the entertainment center, The kitchen contained a working landline phone. The home did not have a fireplace. LPA observed that the dining area was off the kitchen and the table was set up for placement of four and contained four chairs. LPA observed that the kitchen area was located off the dining room area of the facility and that the kitchen had a stove, toaster, dishwasher, microwave, and refrigerator/freezer. The kitchen sink water temperature was measured to be at 107 degrees Fahrenheit the kitchen cabinets and drawers contained ample dishes, utensils, and cooking supplies, and pots and pans. The sharp knives and cleaning chemicals were in locked cabinets. The pantry was located from the kitchen in the entryway, with no lock on the door.

met_with: Chrystal Arquines Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Avelina Martinez made an unannounced annual inspection on May 01, 2025 at 9: AM. During the inspection LPA Martinez met with Dolfa Bomar (Administrator) who assisted with the inspection. LPA Martinez conducted a walk-through of the facility inside and out with Dolfa Bomar. Facility staff-client ratio at time of inspection (1 staff/ 0 clients present) Number of staff interviewed Number of clients interviewed LPA observed # 4 bedrooms, # 1 bathrooms LPA Martinez inspected and/or reviewed the following: Physical Plant Posting of license Posted; Personal Rights Posted; Disinfectants/Cleaning solutions inaccessible yes Refrigerator Temperature at or below 45 degrees F Yes Freezer Temperature at or below 0 degreesYes; Nonperishable Foods one week and fresh perishable foods two days minimum Yes; Menu present and posted Yes Working telephone Yes; Carbon monoxide detectors In good repair; Smoke Detector In good repair; First Aid Kit Fully stocked; Dining area Furnished and in good repair Continued... Medication centrally stored, locked/inaccessible Yes; Office (locked and privacy) Locked and Inaccessible; Hot Water between 105 degree F; Fire Extinguisher August 14, 2024; Toilets wash basin, bath and shower fixtures in good repair/no leaks/hot water temperature Yes; Soap and Paper towels Yes; Laundry Facilities In good repair; Bedrooms required linen and furnishings Yes; Motor Vehicle properly maintained , lights, tires, registration/insurance and working seat belts Maintained and in good repair; Facility free of vermin Yes; Locked Facilities (open locked storage area/building/sheds) Yes Bedroom (required bedding/furniture, furniture in good repair) Yes Disaster Preparedness Disaster and mass casualty plan updated and available Yes; Quarterly Drills conducted and documented Yes-04/01//25; Disaster preparedness supplies verified Complete and fully stocked; Client Records Number of Clients files reviewed 4; Needs and Services Plan complete/maintained; Centrally Stored Medication and log reviewed complete/maintained; Psychotropic Medication and log reviewed complete/maintained; Cash Resources complete/maintained; Compatible Assessment complete/maintained Staffing Number of Staff files reviewed Criminal record clearances verified Yes First Aid Certificate Current/maintained An exit interview was conducted, and a copy of this report was left with the Administrator/Licensee Dolfa Bomar.


facility_name: BORDON HOME III

summary: Facility Evaluation

raw_content:
Narrative:
On 7/29/22 at 10: AM, Licensing Program Analyst (LPA) Alyssa Ng made an unannounced annual/required inspection to listed facility and met with Shirley Bordon, Administrator. The facility is licensed for six residents, and currently in placement are 3 clients. During this inspection, 3 clients and 3 staff were present in the home. Safety precautions were taken, including screening call, hand hygiene, and mask-wearing. LPA Ng toured the facility inside and out. The home is single storied and has three double occupancy bedrooms and one staff bedroom. All client bedrooms were equipped with comfortable furnishings which included ample storage space for clients' belongings and twin sized beds. Each bedroom has a closet with sliding doors for extra storage space. Client bathroom was clean and furnished with hygiene supplies for each client. The water temperature measured 110 degrees F. The thermostat measured 71 degrees. The facility is clean, safe and sanitary. The kitchen was observed to be clean and free of hazards or chemicals. Sharps were located in a locked cabinet. Extra linens are located in a storage shed outside. The weekly menu was posted in the family room. LPA's observed at least 2 days of perishable foods and 7 days of nonperishable foods. The smoke detectors and fire extinguisher are in working order. No bodies of water on the premises. All walkways were free from debris or hazards. LPA Ng interviewed 2 staff and 0 clients. Clients are non-verbal. LPA toured the backyard and observed it to be free from hazards. The backyard is surrounded by a wooden fence with locked gates. The facility has a centralized AC unit in the side yard which is inaccessible to clients. All client records complete with all of the required documentation. Each client has their own separate binder of all required documents. Each psychotropic medication was did not have its own Psychotropic Medication Administration Record (PMAR). All medications were consistent with these records. Staff has a centralized binder that contained their training, qualifications, and other personal information. LPA looked through all binders and were complete with all the required documentation. Resident and staff records were observed to be complete and the facility in compliance, with only the following exceptions: LPA Ng reviewed medication logs for the three clients. LPA Ng noticed that the psychotropic medication did not have their own separate log. LPA advises per CCR regulation, 84070(b)(13), Children's Records. Please see 809D. The client in the home are all over 18. Clients ages are 26, 27, 21. Facility is in the process of submitting an Adult Residential License. LPA advises per CCR regulation, 80010(a), Limitations on Capacity and Ambulatory Status. Please see 809D. At this time, two deficiencies was cited. An exit interview was conducted, and a copy of this report was emailed to Licensee/Administrator Shirley Bordon.

met_with: Shirley Bordon


summary: Facility Evaluation

raw_content:
Narrative:
On 9/2/22 at 3: PM Licensing Program Analyst (LPA) Alyssa Ng made an unannounced inspection to finish the annual required inspection. The purpose of the continued annual inspection is to follow up on Emergency Intervention Procedures and observing the clients in care. There were three clients and three staff present at the time of the inspection. LPA Ng met with Administrator Shirley Bordon. LPA observed all three clients in care. All were non-verbal. LPA Ng observed the clients and staff interacting during their relaxation time. Staff were responsive to the clients needs and able to provide care and supervision to the clients in care. Clients were smiling and waving when the staff were putting on their favorite show. LPA Ng interviewed 2 staff regarding emergency intervention procedures. No deficiencies were cited and a copy of this report was emailed to Shirley Bordon, Administrator.


facility_name: BOYS HOPE

summary: Facility Evaluation

raw_content:
Narrative:
On July 14, 2022 at 9:25 am, Licensing Program Analyst (LPA) Charmaine Linley conducted an unannounced inspection at the facility above. LPA met with Briana Ramirez, Program Director. The purpose of the inspection is to conduct a required annual inspection. LPA inspected the facility inside and out with Briana Ramirez, Program Director. Three ambulatory clients were present at time of inspection. Another client arrived at the facility after school. The home is a two-story residence with a total of seven bedrooms (four staff bedrooms and three client bedrooms) and six bathrooms (two client and four staff). LPA inspected the physical plant, operational requirements, disaster preparedness, emergency intervention plan and reviewed four out of four client files (C1-C4) (see confidential name list, LIC811, dated 07/14/2022). LPA conducted four out of four interviews (C1-C4). The client are maintained in the staff office and readily available. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. The bathrooms were clean and in good repair. The hot water in client bathroom #1 of 2 was measured to be 118.2 degrees Fahrenheit. The hot water in the client bathroom #2 of 2 was measured to be 108 degrees Fahrenheit. The hot water in the kitchen was measured to be 108.6 degrees Fahrenheit. In the staff office there is a locking cabinet for medications. At this time, there are not any clients on medications. Cleansers/chemicals, cooking knives are accessible to clients based on the prudent parent guidelines and program statement approval. The facility's smoke detectors in all bedrooms were checked and were operable. The carbon monoxide detectors located in the hallways were operable. There are no guns or weapons in the facility as stated by Briana Ramirez, Program Director. *** CONTINUED FROM PAGE LPA observed a minimum 7-day non-perishable and a 2-day perishable supply of food. There was a variety of snacks available for clients as well. The facility outside grounds was also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. LPA left the facility from 1:20-2:20 pm for lunch. The following required posted items were observed and accessible to clients: Grievance Procedures, Personal Rights, Visitation policies, and current menu. LPA received a copy of the property tax bill while at the facility. Due to time constraints and the need to complete staff interviews and staff file reviews, this inspection will need to be continued at a later date. Based on interviews and observations made during the inspection, no deficiencies were observed during today's visit. An exit interview was conducted, and this report was reviewed with Briana Ramirez, Program Director. A copy of this report will be emailed to Briana Ramirez, Program Director, due to printer malfunction. The following forms are to be updated and emailed to the licensing office within 30 days; LIC 308 (Designation of Facility Responsibility), LIC 500 (Personnel Report), LIC 610 (Emergency Disaster Plan for Children's Residential).

met_with: Briana Ramirez, Program Director


summary: Facility Evaluation

raw_content:
Narrative:
On July 15, 2022 at 11:50 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the corporate office to conduct an Annual Continuation of the Required Two-Year Annual inspection that began on 07/14/2022. LPA met with Tim Rogers, Executive Director. During the inspection, LPA attempted to review staff files. All the staff files are stored and secured at the corporate office. LPA partially reviewed three out of four staff files (see confidential name list, LIC811, dated 07/15/2022). LPA was unable to review complete staff files, as part of the files are with the Administrator who was unable to meet the LPA at the office. Due to time constraints and the need to complete staff interviews and staff file reviews, this inspection will need to be continued at a later date. An exit interview was conducted, and a copy of this report was explained and provided to Tim Rogers, Executive Director. Due to printer malfunctioning, a copy of this report will be emailed to Briana Ramirez, Program Director.

met_with: Tim Rogers, Executive Director


summary: Facility Evaluation

raw_content:
Narrative:
On July 18, 2022 at 11:30 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the corporate office to conduct an Annual Continuation of the Required Two-Year Annual inspection that began on 07/14/2022. LPA met with Briana Ramirez, Program Director. During the inspection, LPA reviewed staff files. All the staff files are stored and secured at the corporate office. LPA completed reviewing four out of four staff files (see confidential name list, LIC811, dated 07/18/2022). LPA reviewed staff training records. During the inspection, LPA interviewed one out of one staff. Based on the facility inspection, and files reviewed there are no deficiencies found at this time. An exit interview was conducted, and a copy of this report was explained to Briana Ramirez, Program Director. Due to printer malfunction, a copy of this report and LIC 811 will be emailed to Briana Ramirez, Program Director. A copy of this report will be placed in the facility file.


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On March 6, 2025, at 12:45pm, Licensing Program Analyst (LPA) Gilbert Marquez conducted an unannounced inspection at the facility above. LPA met with Joshua Abzun, Office Assistant II. The purpose of the inspection is to conduct a required annual inspection. LPA inspected the facility inside and out with Joshua and Francisco Perez, Americorp Volunteer. Joshua called Christina Abarca, Administrator, to come to the facility to meet with LPA. The facility is licensed for the capacity of six clients, with a current census of five. Two clients were present at time of inspection. The home is a two-story residence with a total of seven bedrooms (four staff bedrooms and three client bedrooms) and six bathrooms (two client and four staff). LPA inspected the physical plant, operational requirements, disaster preparedness, and reviewed five out of five client files(C1 through C5). LPA conducted two out of five client interviews (C1 and C2). The client files are maintained in the staff office and readily available. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. Bedroom #1 had its door unattached and was in need of replacement. The bathrooms were clean and in good repair. The hot water in client bathroom #2 was measured to be 118.6 degrees Fahrenheit. In the staff office there is a locking cabinet for medications. At this time, there are no clients on medications. Cleansers/chemicals, cooking knives are accessible to clients based on the prudent parent guidelines and program statement approval. Facility's smoke detectors were checked and was operable. Carbon monoxide detectors located in the hallways were operable. Three regular fire extinguishers were maintained since May 2024. There are no guns or weapons in the facility as stated by Christina Abarca, Administrator. ***Continued on Lic809-c***. **Continued from LIC809** LPA observed a minimum of 7-day non-perishable food and a 2-day perishable supply of food. There was a variety of snacks available for clients as well. The facility outside grounds were also inspected and were observed to be clean and well maintained. Emergency exits were free from obstruction. The following required posted items were observed and accessible to clients: facility license, grievance procedures, personal rights, visitation policies, current menu, chores list. There is an AED unit available for use on the first floor. Due to time constraints and the need to complete staff file reviews, this inspection will need to be continued at a later date. Two staff interviews were done (S1 and S2) Facility cited for violation of California Code of Regulations, Title Division Six, regulation 80019(e)(1): Criminal Record Clearance. Section 80066(a)(12)(B) Personnel Records (refer to LIC 809D) Civil Penalties of $500 ($100 x 5 days) assessed. Record review and Administrator's statement confirmed the violation occurred. Facility cited for violation of Interim Licensing Standard (ILS) 84487(f) Building and Grounds, refer to LIC D. LPA observation of the client bedrooms during Physical Plant review confirmed the violation occurred. Facility given a Technical Violation for California Code of Regulations, Title Division Six, regulation 80087(c) Building and Grounds. See LIC9102 for full text of TV. LPA observation of backyard confirmed the technical violation occured. Facility given a Technical Violation for Health and Safety Code regulation 1565(c) Emergency Disaster Plan. See LIC9102 for full text of TV. LPA review of Drill binder confirmed technical violation occured. An exit interview was conducted, the report and appeals rights were discussed and provided to Christina Abarca, Administrator.

Deficiencies:
80019(e): Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility

met_with: Christina Abarca


summary: Facility Evaluation

raw_content:
Narrative:
On March 10, 2025, at 9: AM, Licensing Program Analyst (LPA) Gilbert Marquez arrived announced at the corporate office of Boys Hope ( Cowan, Ste 150, Irvine, CA 92614) to conduct an Annual Continuation of the Required Two-Year Annual inspection that began on 03/06/2025 at the Boys Home Group Home facility. LPA met with Quinn Tran, Executive Director. During the inspection, LPA reviewed five of six Staff files (S1 - S5, see Confidential Names List, LIC811). All staff files are stored and secured at the corporate office. A review of administrative records indicate that the facility has paid their current licensing fees. Based on the files reviewed during this inspection, there are no deficiencies found at this time. An exit interview was conducted, and a copy of this report was given and explained to Quinn Tran, Executive Director.

met_with: Quinn Tran, Executive Director


facility_name: BOYS HOPE/GIRLS HOPE

summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
to have sex with C1. Record review provided confirmation that S1 took C1 to a motel on at least one occasion. Record review provided consistent statements were made by multiple confidential interviews confirming S1 had sex with C1. Record review provided documentation that S1 was arrested on June 8, 2021 and charged with five felony counts including unlawful intercourse with minor perp 21+/victim -16. Based on record review and confidential interviews the allegation Staff member (Staff #1 [S1]) sexually abused group home child (Child #1 [C1]) is substantiated. The preponderance of evidence standard has been met. Facility is cited for violation of California Code of Regulations: 84072(d)(11) The licensee shall ensure that each child, regardless of whether the child is in foster care, is accorded the personal rights specified in Welfare and Institutions Code section 16001.9, as applicable (11) To be free from physical, sexual, emotional, or other abuse, and corporal punishment. An Enhanced Civil Penalty (ECP) determination is pending. If an ECP is assessed a Community Care Licensing (CCL) representative will return to the facility to deliver the penalty assessment. LPA Nicole Strickland received verbal and written documentation for House Manager Chelsea Breckenridge to sign on behalf of the facility. A copy of the report was discussed and provided along with appeal rights to Boys Hope/Girls Hope House Manager Chelsea Breckenridge.

Investigation Findings:
13On August 23, 2021 at 1:00 pm Licensing Program Analyst (LPA), Nicole Strickland, met with Boys Hope/Girls Hope Program House Manager Chelsea Breckenridge to deliver the finding for the above stated allegation. The investigation was conducted by Community Care Licensing (CCL) Investigation Branch Special Investigator (SI) Annette Renquist. The investigation included interviews with Program Director, Staff #1 (S1), Child #1 (C1), Child #2 (C2), Child #3 (C3), Child #4 (C4), Child #5 (C5), and Fullerton Police Department officers. In addition, county records and facility records were reviewed. On June 4, Community Care Licensing (CCL) received an allegation alleging Staff member (Staff #1 [S1]) sexually abused group home child (Child #1 [C1]). Specifically, it was reported between August 2020 and February 2021, S1 would touch C1 inappropriately while in the facility and while being transported. Additionally, it was reported on at least two occasions S1 took C1 from the facility in the middle of the night SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland 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 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: BOYS HOPE/GIRLS HOPEFACILITY NUMBER: VISIT DATE: 08/23/2021

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

report_type: Complaint Investigation

met_with: Chelsea Breckenridge

complaint_status: SUBSTANTIATED


summary: Facility Evaluation

raw_content:
Narrative:
On September 2, 2021 at 1: PM, Associate Governmental Program Analyst (AGPA) Kim Robinson met with the group home (GH) administrator, Briana Ramirez, to assess an Enhanced Civil Penalty (ECP). On August 23, 2021, the Department concluded a complaint investigation under this GH. The complaint alleged that Child Care Coordinator #1 (S1) engaged in sexual acts with fifteen-year-old client #1 (C1) (See the Confidential Names List, LIC 811, dated September 2, 2021) The confidential interviews and S1 acknowledging performing multiple lewd and lascivious sexual acts, on separate occasions, with C1 were consistent. The allegations were substantiated and the GH was cited under the Title Regulations, Section 84072(d)(11). Based on the analysis of the Fullerton Police report and Licensing Special Investigative Bureau report, the Department has determined that an enhanced civil penalty is warranted for the physical abuse of C1. The Penal Code section 288a defines sexual conduct with a minor as physical abuse. This section describes a number of more or less direct and (always) willful acts that constitute sexual assault, as defined in the Health and Safety (H&S) code section 1548 (f)(1)(E). The Department will be issuing an immediate civil penalty of $2,500.00. An exit interview was completed, and appeal rights discussed. A copy of this report, the Confidential Names List, Appeal Rights and a Civil Penalty Assessment - Serious Bodily Injury/Physical Abuse (Form 421-D) were provided to the administrator.

met_with: Briana Ramirez


summary: Facility Evaluation

raw_content:
Narrative:
On September 21, 2022 at 10:30 am Licensing Program Analyst (LPA) Charmaine Linley conducted an annual inspection of the facility. The facility was toured inside and out with Program Director Briana Ramirez. The home is a one story residence with a total of seven bedrooms (four staff bedrooms and three client bedrooms) and four bathrooms (two client and two staff). One client was present at time of inspection. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. The bathrooms were clean and in good repair. At 10:45 am, the hot water in client bathroom 1 of 2 was measured to be 121.6 degrees Fahrenheit. At 10:50 am, the hot water in the client bathroom #2 of 2 was measured to be 116.7 degrees Fahrenheit. At 11:00 am, the hot water in the kitchen was measured to be 120.7 degrees Fahrenheit . All hazardous items have been properly made inaccessible to areas where clients will not have access. In the staff office there is a locking cabinet for medications. At this time, there are two clients prescribed medication. Cleansers/chemicals, cooking knives are accessible to clients based on the prudent parent guidelines and program statement approval. The facility's smoke detectors in all bedrooms were checked and were operable. The carbon monoxide detectors located in the hallways were operable. There are no guns or weapons in the facility as stated by Program Director Briana Ramirez. The following required posted items were observed accessible to clients: Grievance Procedures, Personal Rights, Visitation policies, and current menu. LPA observed a minimum seven day non-perishable and a two day perishable supply of food. There was a variety of snacks available for clients as well. The facility outside grounds was also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. *** LPA reviewed four of four client files and all files contained necessary documents required for inspection. LPA reviewed four of four staff files. All staff that work at the facility have Department of Justice, Federal Bureau of Investigation and Child Abuse Index Check clearances. A review of administrative records indicate that the facility has paid their current licensing fees. LPA left the facility at 1:30 pm to take a 30 minute lunch break and drive to the corporate office, located in Irvine, to review staff files. Based on records review, Client #1 and Client #2 did not have a Centrally Stored Medication and Destruction Record. The facility is being cited for violation of CCR Section 80075(k)(7), Health-Related Services. Based on records review, Client #1 and Client #2 did not have a record of current medications, including the name of the prescribing physician, and instructions, if any, regarding control and custody of medications. The facility is being cited for CCR Section 80070(b)(10), Client records. Exit interview was conducted and appeal rights were discussed. Due to printer malfunction, a copy of this report will be emailed to Program Director Briana Ramirez. A copy of this report will be placed in the facility file.

met_with: Briana Hernandez, Program Director


summary: Facility Evaluation

raw_content:
Narrative:
On March 10, 2025, at 2: PM, Licensing Program Analyst (LPA) Gilbert Marquez arrived unannounced at the corporate office of Boys/Girls Hope ( Cowan, Ste 150, Irvine, CA 92614) to begin a Required Two-Year Annual inspection. LPA met with Quinn Tran, Executive Director. During the inspection, LPA reviewed four staff files (S1 - S4, see Confidential Names List, LIC811). An updated LIC Personnel Report was given to LPA. An updated LIC Emergency Disaster Plan was also given to LPA during the Mass Casualty and Disaster Plan review. All staff files are stored and secured at the corporate office. A review of administrative records indicate that the facility has paid their current licensing fees. Due to staff files being held at a different location, LPA will conduct a continuation of the annual at another date. Based on the files reviewed during this inspection, there are no deficiencies found at this time. An exit interview was conducted, and a copy of this report was given and explained to Quinn Tran, Executive Director.

met_with: Quinn Tran, Execuitve Director


summary: Facility Evaluation

raw_content:
Narrative:
On March 12, 2025, at 9: AM Licensing Program Analyst (LPA) Gilbert Marquez conducted a continuation of the annual inspection of the facility that began on March 10, 2025, at the corporate office in Irvine, CA. LPA met with House Manager, Kellin Hostler-Burrows who accompanied LPA on a tour of the facility inside and out. The home is a one story residence with a total of six bedrooms (three staff bedrooms and three client bedrooms) and four bathrooms (two client and two staff). There is one room used for meditation and privacy, and one room that is used for working out and holds gym supplies. Clients were not present at the beginning of the inspection, however arrived later in the day after school. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. The bathrooms were clean and in good repair. The hot water in client bathroom one of two was measured to be 113.6 degrees Fahrenheit, the regulation states that hot water shall measure between 105 degrees to 120 degrees Fahrenheit. In the staff office there is a locking cabinet for medications. At this time, there are no clients who are taking prescribed medication. Cleansers, chemicals, cooking knives are accessible to clients based on the prudent parent guidelines and program statement approval. The facility's smoke detectors in all bedrooms were checked and were operable. The carbon monoxide detectors located in the hallways were operable. There are no guns or weapons in the facility as stated by Administrator Christina Abarca. The following required posted items were observed accessible to clients: grievance procedures, personal rights, visitation policies, and current menu. LPA observed a supply of non-perishable and perishable food that was within regulations. There was a variety of snacks available for clients as well. The facility outside grounds were inspected and it was observed to be clean and in good repair. Emergency exits were free from obstruction. **Continued on Lic809-c** **Continued from LIC809** LPA reviewed five of five client files, and all files contained necessary documents required for inspection. LPA conducted two out of three staff interviews(S1 and S2) and two out of five client interviews(C1 and C4); see LIC811 03/12/2025. LPA left the facility at 11: AM and returned at 3: PM to do client interviews and conduct an exit interview with Administrator Abarca. Based on records review, interviews, and physical plant inspection, no deficiencies were observed.

met_with: Christina Abarca, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Carolyn Flynn made an attempt to complete the annual inspection at the above listed facility on 9/10/2021 at 10: AM. The home was dark and there was a for sale sign by Intero Reality in the front yard. LPA waked around the facility and all doors were locked and no one answered the knocking or the facility listed phone number. LPA will called Administrator Cheree Ashley and left a message asking for a return call and an update on the status of the facility.


facility_name: BRIGHT FUTURES 2

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
The police report states the client did not have any skin tissue or blood under fingernails or on the client's hands. Staff involved in the altercation with the client state none of them scratched the client or saw another staff scratch the client's face. Because of the inconsistencies and lack of corroboration, the allegation is determined to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted, and a copy of the report and appeal process was emailed to the administrator at pam@brightfuturesres.com.

Investigation Findings:
UnsubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:

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

met_with: Administrator

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPAs) Ignacia Villapudua-Soto and Dawn Eunice conducted an unannounced Annual/Required Inspection at the facility on 7/20/21 beginning at 12: PM. LPAs met with Pam McGrew, Administrator, and explained the purpose of the inspection. This facility is licensed for 5 clients and currently serves 5 clients. On today's date, a Health and Safety Annual / Inspection was conducted. The facility serves developmentally delayed children ages 6 to 17. The home has four bedrooms, two bathrooms, both of which are used for clients and staff. One bedroom has two male clients-twin beds, closet space and dressers for each client. There is a living room, a recreation room and an office located adjacent to the rec room. Each bedroom was observed with an operational smoke detector. Personal Rights poster was posted in a public area. In the kitchen area, menus were displayed on the refrigerator. The refrigerator and pantry was stocked with the required amount of both perishable and non-perishable food items. Smoke Detectors and Carbon Monoxide detectors were present in each building. Client files were observed to be locked in an office. This office also contained client medications which were locked in a glass cabinet and the Medication Administration Record binder. Throughout the facility grounds, there are areas where clients are able to participate in recreational activities LPAs also reviewed three client files. All required documents were present. No deficiencies were noted in client files. LPAs were unable to finish the Annual Inspection and will return on another date and time. No citations were issued on today's date. Exit interview conducted and a copy of this report was left at the facility with Pam McGrew Administrator.

met_with: Pam McGrew, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPA) Ignacia Villapudua-Soto conducted an unannounced Annual/Required Continuation Inspection at the facility on 7/28/21 beginning at 11: AM. LPAs met with Pam McGrew, Administrator, and explained the purpose of the inspection. This facility is licensed for 5 clients and currently serves 5 clients. On today's date, a Health and Safety Annual Inspection Annual/required was conducted. The facility serves developmentally delayed children ages 6 to 17. This office also contained client medications which were locked in a glass cabinet and the Medication Administration Record binder. Throughout the facility grounds, there are areas where clients are able to participate in recreational activities LPA also interviewed two client and Administrator and one staff. All required documents were present. LPA received updated documents. No deficiencies were noted in client files or staff files. The facility is in compliance with Title 22. Exit interview conducted and a copy of this report was left at the facility with Pam McGrew Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 8/17/22, Licensing Program Analyst (LPA) Jessica Caplinger, conducted an unannounced inspection for the purpose of a Case Management to verify the closure of Bright Futures 2. A walk through was conducted and no concerns were observed. An exit interview was conducted with Pam Mcgrew; Administrator and this case management was left during inspection.

met_with: Pam Mcgrew; Administrator


summary: Facility Evaluation

raw_content:
Narrative:
During the course of conducting interviews for a complaint allegation, Licensing Program Analyst, (LPA) Tana Kinder was made aware that a client AWOL'd from the facility. The client was upset throughout the day and according to staff interviews, the client's interview, and the incident report related to the complaint, the client had communicated and attempted multiple times to leave the house and run away. Prior to awoling from the home, the client was involved in an incident that escalated, resulting in a restraint and then released from the restraint. Eventually the client exited the home while the staff observed the client from inside the home, at a window. There is discrepancy as to why the client was able to exit the home this particular time, when multiple attempts had been made and verbalized by the client about leaving the home and prevented. The client left the property and staff were not able to communicate which direction the client went, and at what time, nor did staff "shadow" the client. Staff did not have client in line of sight at all times, resulting in client leaving the grounds of the home, running into a grocery store and having law enforcement return the client to the home. Staff and incident reports indicate this client has a history of attempting and succeeding at Awoling from the home.


facility_name: BRIGHTER DAY

raw_content:
Narrative:
At this time, the LPA observed no issues that would require the Administrator to spend additional time at the facility. The LPA toured the kitchen and observed the food supply, observing sufficient perishable and non-perishable food at the facility as outlined in the Interim Licensing Standards (ILS), Food Service. The LPA observed a Weekly Menu and it met the requirements outlined in the General Regulations regarding Food Service. The Administrator indicated that upon placement clients are questioned about their food choices. The Administrator specified that the facility shops for groceries weekly and there is never a shortage of food. The Administrator indicated that the staff may not agree with what a client chooses to eat, but clients are allowed to eat what they want and the Prudent Parent Standard is used. The clients indicated that the staff cook and they receive sufficient food to eat. One client indicated that the type of snacks eaten is monitored. Interviews with the clients did not reveal evidence that the food service was inadequate. The investigation revealed no evidence that the food service was inadequate. The LPA observed a One Month Schedule of Activities, interviewed the Administrator and two clients, which showed that the facility met the requirements outlined in the ILS as it relates to Planned Activities. The Administrator and Facility Manager indicated that the clients have active gym memberships and enrolled in boxing and cheerleading. The clients indicated that they go to the arcades, play games at the facility, go to the movies, and go to have their hair and nails done. The investigation did not reveal evidence that the clients were not provided activities. The investigation revealed that a County Social Worker (CSW) had one concern, but it did not pertain to the allegations. The CSW's concern was that the facility did not have robust support services for Client Ref. #2. The investigation did not reveal witnesses to the allegations and the LPA was 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 this allegation. A copy of this complaint was provided to the facility representative.

Investigation Findings:
On August 8, 2025 at 2:30 p.m., Licensing Program Analyst (LPA), Karen McGee, delivered the findings of the complaint investigation. The LPA met with Facility Manager, Travis Bates. On May 1, 2025, 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 Administrator via telephone; two clients (see Confidential Names, LIC Ref. #1 and #2 dated August 8) one at the facility on June 26, 2025 and one a their new placement on July 24, 2025; one Facility Manager at the facility on July 24, 2025, and two County Social Workers via telephone on July 29, 2025 and August 8, 2025. The LPA observed a sample menu and activity schedule. The investigation revealed a statement that the Administrator is only present two days a month in order to log in prescriptions for client's medication. The Administrator indicated that they work at two facilities and divide their time between both, 25 hours per week each. The Administrator stated that they interact with both clients and staff, taking clients to appointments and attending staff and Child & Family Team Meetings. The LPA observed that the Personnel Report (LIC500) is reflective of the approximate time the Administrator works at the facility. (cont'd) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tira Logan 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 MONTEREY PARK CRP RO, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BRIGHTER DAYFACILITY NUMBER: VISIT DATE: 08/08/2025

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

met_with: Travis Bates


summary: Facility Evaluation

raw_content:
Narrative:
On 12/23/2024 at 10: AM Licensing Program Analyst (LPA) Olena Maico and Licensing Program Manager (LPM) Tira Logan-Shanks conducted a Component II - Face to Face Meeting at the Monterey Park Regional Office via Teams. The following were present: Ayan Hill, Applicant/Licensee. LPA and LPM discussed their application and program statement and advised of the following corrections. The following information must be completed and submitted to Licensing: Section A · LIC Monthly Operating Statement Operating section line 4 and 6 need to be completed and recalculated and other revenue added to line 4, fill out line 6. · LIC Surety Bond with original embossed seal. LPA will pick it up from the Licensee at the time of pre-licensing. · LIC Addition needs to be corrected on the form. · LIC Financial Information Release and Verification - pending response from the financial institution. · LIC 500 has no Facility Manager Position for each shift that would require Facility Manager. No on-call person identified. Please provide the Administrator Qualification Verification according to the Title Regulations {84064 (e)}. · LIC 610C Emergency Disaster Plan for Children's Residential will require at least 3 people to be assigned to the tasks. Licensee can put TBD next to the position. Once positions and personnel are established, each designee's phone number and e-mail will need to be provided on the form. We would need letters from the relocation sites for the permission to relocate children in a case of emergency. Licensee will change the park location to a different relocation site and will provide a letter. Continue on the Page Page 2 · LIC 508D for the Administrator is not included. Licensee will send form to the LPA. · LIC All rooms need to be labeled for the ambulatory vs non-ambulatory, staff, or clients' bedroom, how many clients in each bedroom, all windows and exits noted, locations of utility shut-off. Facility yard sketch needed to be attached with all the requested information. · Completed fire clearance form LIC 850 was e-mailed to the LPA by the applicant/licensee during the Component II Section B · Part I - Program Identification · Part II - Program Population, Services & Capabilities · Part III · Part III Section 6. Medical/Dental · Describe the procedures of administering medications, what forms will be used for regular medications and psychotropic medications and refusal procedures (Use of Medication Administration Records (MAR LIC 622A) and Psychotropic Medication Administration Records (PMAR LIC 622B)). Identify staff positions responsible for dispensing and destroying the medications. Consent forms, completed by the child's authorized representative(s), to permit the facility to authorize medical care. Section 7. Transportation. · Facility will utilize the facility vehicle, as a last resort will utilize staff vehicles. Safety of the vehicle will be checked. Driver licenses will be checked during the application process. Continue on the Page Page Section 8. Admission/Intake · Will you be taking emergency placement. Then describe the procedures. · If the placement is not compatible, how will the client and representative will be notified. · Admission agreement needs to be provided or if the agency will be using the placement agency admission form. Section10. Discharge/Removal Policies · How will the Policies and Procedures be provided to Children and Authorized Representatives. Written Removal/Discharge Policies Developed and Maintained by Social Work Staff. Discharge cannot occur without notifying the authorized representative. Timeline for emergency discharge. Section 11. Visitation rules and policies. · Add Visitation is allowed unless it is documented in the NSP or court order if visits from the person is not allowed. · Specify when visits are not permitted. Visits will occur based on the Needs and Services Plan. Section 12. House rules · Specify curfew hours and quiet hours. Policy of allowing children to be unsupervised away from the facility including issuing passes to children. How will the clients and their representatives will be notified and made aware of the house rules. Using Reasonable and Prudent Parent standard when crating and enforcing house rules. Bedroom sharing. Section 14. Emergency Intervention Plan · If manual restraints not used, what is the alternate procedures if the de-escalation techniques do not work? Continue on the Page Page Section Runaway Plan: · No manual restraints should be used to prevent runaway. Section 16. Children complaints and grievance procedures. · How are the clients informed of their rights to file a complaint or grievance. Where is Complaint/Grievance form kept for easy access. How will clients and their authorized representatives and staff receive copies of the written complaint/grievance procedures. Section 17. Handling of Children's Funds, Allowances and Salaries. · Provide the amount of allowance and the date it will be dispersed. It must be a set amount and age appropriate, and it may not be withheld for the children not doing their chores. The children can earn extra doing the extra chores. Accurate record keeping by maintaining the receipts and not comingle with licensee funds. Policies on handling the cash resources upon discharge. 18. Chores · How are clients and the representatives notified about the chores and earning extra money doing the chores. Applying Reasonable and Prudent Parent Standards to the process of teaching the children various chores. Section Staff Schedule. · Add Facility Manager to the schedule. Section 22. Staff Qualifications. · Add Facility Manager position and Qualifications. · Add education for the Administrator based on the Title Regulations. Continue on the Page Page Section 23. Facility Manager Job Description. · Therapist listed on the job description, change to social worker. Section Administration · Provide a current organizational chart which shows lines of administrative authority. · Facility will not utilize cameras at this time, will add it if need arises. The Pre-Licensing inspection and Component III is scheduled for 01/17/2025. A signed copy of this report was provided to the applicant. Exit interview.

met_with: Ayan Hill, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On 01/17/2025 at 10: AM, Licensing Program Analyst (LPAs) Olena Maico conducted an announced pre-licensing inspection at the above address. LPAs met with Ayan Hill, Licensee. LPA Maico conducted a physical plant inspection inside and outside the home alongside with the applicant. The following were observed at the time of inspection: This facility is a single level home located in a residential neighborhood. The facility consists of 4 bedrooms, 2 full bathrooms, a living room, kitchen, dining room, 2-car garage, laundry room, and a backyard. Overall, the facility is clean, sanitary and in good condition. The facility has no bodies of water. LPA observed the facility sketch posted on the wall as well as the Administrator Certificate, visitation policies, grievance procedures and children's personal rights. The facility has a centralized heat and air-conditioning unit. Temperatures in all rooms are maintained at 70 degrees (F). The hot water temperature was measured at 117 degrees (F). Carbon monoxide and smoke alarms were tested and observed to be operational. The fire extinguisher located in the laundry room. Knives and sharps are kept in a locked container above the refrigerator in the kitchen. Disinfectants and cleaning solutions are kept in the cabinet located under the sink and are locked. The facility has a working telephone. The Emergency disaster plan is posted next to the telephone. The applicant reports no firearms on the premises. The grounds are free from obstructions and hazards. Facility will be licensed for 5 clients and clients will be utilizing all 4 bedrooms. Bedroom #1, #2 and # 3 each has 1 full bed and a side drawer, storage drawer and adequate closet space to accommodate client's clothing and personal belonging. The closets have hampers and laundry bags, as well as the hangers for the clients. Bedroom # 4 has 2 full beds and adequate storage to accommodate 2 clients' needs as well as it has a side drawer and drawers for clients' belongings. Bedrooms have appropriate window blinds for client's privacy and the lights in the rooms work properly. Bedrooms can be used by ambulatory and non-ambulatory clients. Applicant was informed for the bedroom # 4 which has 2 full beds cannot have both ambulatory and non-ambulatory clients at the same time. LPA observed two bathrooms to be in good repair and working order. Bathroom #1 has 2 sinks, shower with the shower curtain and non-slip mat, and a toilet, and will be used by both staff and clients. Bathroom # 2 located inside bedroom # 4 and has 2 sinks, shower with a non-slip mat and a working toilet and will be used by clients. The shower and the sinks and toilets are in working condition. Individual beds are observed to be in good repair, equipped with good springs, clean mattresses and pillows, as well as appropriate clean linens in good repair. LPA also observed extra linens stored in the hallway closet. Medications will be centrally stored in the lockboxes in the kitchen cabinets. Complete first aid kit is readily available in the kitchen and contains all the necessary items. Clients' files will be stored electronically on the tablet in the kitchen area. Kitchen has a refrigerator, dishwasher,stove and adequate utensils and tableware to accommodate the number of clients. LPA observed the kitchen area to be clean and the refrigerator is clean. LPA observed emergency food supply storage in the kitchen. Licensee has no kids in placement, food will be stocked once children are in placement. LPA also observed a complete food menu posted on the kitchen table. Dining room has a table with 5 chairs to accommodate clients and the living room has a working TV and couches with enough room for 5 clients. Backyard is free of hazards and has enough space for the clients to use. There are no cameras inside the home. There is a ring door bell and licensee has no access to it. Licensee is aware if cameras will be installed, they will notify the licensing agency. LPA also received original surety bond from the licensee today at the pre licensing. The fire department clearance was granted. Before today's visit, the applicant submitted the final Program Statement/Plan of Operation to LPA Maico. LPA Maico will submit it for final review, and a new license will be mailed to the licensee upon approval. During the pre-licensing a Component III was conducted on what to expect after licensing. An exit interview was conducted a signed copy of this report was provided to the applicant.

visit_type: Prelicensing


summary: Facility Evaluation

raw_content:
Narrative:
On 03/24/2025 at 12: PM, Licensing Program Analyst (LPAs) Olena Maico conducted an announced post-licensing inspection at the above address. LPAs met with Travis Bates, Facility Manager. LPA Maico conducted a physical plant inspection inside and outside the home alongside with the Facility Manager. The following were observed at the time of inspection: This facility is a single level home located in a residential neighborhood. The facility consists of 4 bedrooms, 2 full bathrooms, a living room, kitchen, dining room, 2-car garage, laundry room, and a backyard. Overall, the facility is clean, sanitary and in good condition. The facility has no bodies of water. LPA observed the facility sketch posted on the wall as well as the Administrator Certificate, visitation policies, grievance procedures and children's personal rights, Emergency Disaster Plan, menu, schedule of activities. The facility has a centralized heat and air-conditioning unit. Temperatures in all rooms are maintained at 70 degrees (F). The hot water temperature was measured at 116 degrees (F). Carbon monoxide and smoke alarms were tested and observed to be operational. The fire extinguisher located in the laundry room. Knives and sharps are kept under the sink in the lockbox. Disinfectants and cleaning solutions are kept in the cabinet located under the sink and are locked. The facility has a working telephone. The Emergency disaster plan is posted next to the telephone. The applicant reports no firearms on the premises. The grounds are free from obstructions and hazards. Facility has 2 clients and one client per bedroom. LPA reviewed insurance and registration for the vehicle and it is up to date. First aid kit is in the vehicle and meet the standards and licensing requirements. Bedroom #1, #2 and # 3 each has 1 full bed and a side drawer, storage drawer and adequate closet space to accommodate client's clothing and personal belonging. The closets have hampers and laundry bags, as well as the hangers for the clients. Bedroom # 4 has 2 full beds and adequate storage to accommodate 2 clients' needs as well as it has a side drawer and drawers for clients' belongings. Bedrooms have appropriate window blinds for client's privacy and the lights in the rooms work properly. Clients occupy bedroom # 1 and # 2. LPA requsted an updated LIC 500 and LIC 9020 as well as 610C and LIC 308 to be e-mailed to the LPA by the end of business 03/25/25. Due to time limitations LPA needs to return to complete an inspection and conduct interviews. One technical violations were issued to the facility. The copy of this report were explained and given to the Facility Manager.

met_with: Travis Bates, Facility Manager


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On 03/26/2025 at 08; AM Licensing Program Analyst (LPA) Olena Maico made an unannounced visit to the facility for the purpose of continuation of post licensing inspection. LPA met with the Administrator Ayan Hill and Facility Manager Travis Bates. Physical Plant domain was reviewed during the initial post licensing. During the previous visit LPA Maico requested documents and the administrator e-mailed the requested information to the LPA. LPA received a copy of the LIC 500 and the Client Roster LIC 9020, as well as LIC 308 and LIC 610C. A review of Licensing Information System on 03/25/2025 indicates that all facility staff associated to the Group Home have DOJ, FBI, and Child Abuse Index clearances. LPA also reviewed 4 electronic staff files, 2 electronic children file, interviewed 2 staff. Residents were afforded the opportunity to be interviewed and all residents declined. Disaster Preparedness Plan: Facility maintains a current, written disaster and mass casualty plan of action. LPA reviewed emergency drill binder, no drills recorded in the binder yet, as they are conducted quarterly, and the facility has not done one yet. LPA advised the Facility Manager to add phone number and e-mails to the person designated on the emergency disaster plan. Facility maintains an emergency and disaster plan, register of clients, Needs and Services Plan for each client electronically, medication records, and contact information for each client's responsible party. Client Records LPA reviewed two (2) client records. All client records are available to the licensing to review electronically. Client records contain required information including, but not limited to, consent forms, personal rights acknowledgement, immunization records, personal property and valuables, cash resources records, authorization to medical treatment. Facility also has medication administration record with the medication information, as well as the information for the prescriber and medication administration instructions. Clients do not take psychotropic medications currently. Clients are scheduled to have their doctor's appointment (one on 03/27/25 and one pending scheduling) before 30 days from placement date. Staff Records Staff records are stored electronically in the cloud. LPA reviewed 4 staff files. Staff files are electronic and contain staff job duties, resumes, CPR training, medical screening and TB test, personnel records, driver license, criminal record and child abuse clearances. Staff records were missing proof of initial 8 hour training for the staff, as well as emergency intervention training. Two deficiencies will be issued to the facility regarding staff training and emergency intervention training. LPA was not able to verify the health screening or TB test for the S3. Two deficiencies will be issued for this section. An exit interview was conducted, and a signed copy of this report, LIC809Ds, LIC811 and appeal rights were provided and explained to the facility manager.

Deficiencies:
84065(i): Personnel Requirements

(i) Notwithstanding Sections 80065(f)(1) through (6), new child care staff hired on or after July 1, 1999, shall complete a minimum of 24 hours of initial training comprised of the 8 and 16-hour training as specified in (1) and (2) below

met_with: Travis Bates, Facility Manager Ayan Hill, Administrator


facility_name: BRIGHTER DAY 2

summary: Facility Evaluation

raw_content:
Narrative:
On 02/13/2025 at 10: AM Licensing Program Analyst (LPA) Olena Maico and Licensing Program Manager (LPM) Tira Logan-Shanks conducted a Component II - Face to Face Meeting at the Monterey Park Regional Office via Teams. The following were present: Ayan Hill, Applicant/Licensee. LPA and LPM discussed their application and program statement and advised of the following corrections. Licensee submitted a complete packet with the documents from Sections A and B, as well as the Program Statement. The Program Statement for the Brighter Day Group Home License 157807022 has been already approved by the Department and Brighter Day 2 will utilize the same program statement. LIC 403 states rent, the property has deed of trust, licensee will change it to mortgage. Licensee needs to add the facility manager from 308 to the LIC 500 roster. LPA will receive the bond LIC 402 at the time of the pre-licensing inspection. Phone number and e-mail need to be added next to the Administrator's name on the LIC 610C. Also add first aid kit location on the 610C. Facility Sketch LIC 999 mark the exits on the garage door and the garage side door. Fire Clearance has been e-mailed and mailed to the Kern County Fire Prevention last week. Licensee contacted the fire department on 02/12/2025 and the request has not been received yet. LPA e-mailed another request to the fire department on 02/12/2025 to the e-mail provided by the licensee with the comment the prior request has already been send to the Kern County Fire Prevention. LPA inquired about the rate difference between the Brighter Day and Brighter Day 2 and the licensee stated that the operational cost is the same for both facilities and the rates are given based on the operational cost and the number of children at the facility. LPM TIra Logan-Shanks also requested for the section 4 to be added CSEC services anad wrap-around services provided to clients, as well as the recreational community activities (loclal libraries, YMCSs etc). It was also requested to add special education support (IEP plans). Section 14 of the program statement will be amended with the information who writes the Emergency intervention Plan and the education for the person who writes it. Section 22 will be added a CSEC training as a part of trauma informed care. Sect 24 will have an addition who will be conducting the training for the staff (administrator, licensee, outside training etc). LPM also mention about the night time supervision ration and ensure that the licensee will ensure they have the on-call staff during the night time to be able to provide the care and supervision for the remaining clients in care. Licensee will update the schedules for the staff as needed to ensure of the proper supervision is being provided. LIC 9106 will be updated with both facilities under the licensee since one program statement is utilized. Hours for the Administrator will stay as "varies" due to the same Administrator being assigned to both facilities. LPA checked the Guardian, no associations to the facility as of 02/13/2025.Licensee will be working on associating employees to the facility once receives approval from Guardian. The Pre-licensing inspection tentatively scheduled for March 14 2025. The copy of this report LIC 809 will be e-mailed to the licensee for review and signature.


summary: Facility Evaluation

raw_content:
Narrative:
On 03/14/25 at 9: AM, Licensing Program Analyst (LPAs) Olena Maico conducted an announced pre-licensing inspection at the above address. LPA met with Ayan Hill, Licensee. LPA Maico conducted a physical plant inspection inside and outside the home alongside with the applicant. The following were observed at the time of inspection: This facility is a single level home located in a residential neighborhood. The facility consists of 6 bedrooms, 3 full bathrooms, office, a living room, kitchen, dining room, 2-car garage, laundry room, and a backyard. Overall, the facility is clean, sanitary and in good condition. The facility has no bodies of water. LPA observed the facility sketch posted on the wall as well as the Administrator Certificate, visitation policies, discipline policies, grievance procedures and children's personal rights. The facility has a centralized heat and air-conditioning unit. Temperatures in all rooms are maintained at 68 degrees (F). The hot water temperature was measured at 116 degrees (F). Carbon monoxide and smoke alarms were tested and observed to be operational. The fire extinguisher located between bathroom #2 and bedroom #2. Licensee installed manual fire hand pulled alarm per Bakersfield City Fire Department request. Knives and sharps are kept in a locked container in the kitchen cabinet. Disinfectants and cleaning solutions are kept in the locked box in the garage. The kitchen sink also has a lock and that is where the cleaning solutions and chemical will be kept once the facility is operational. The facility has a working telephone. The Emergency disaster plan is posted next to the telephone. The applicant reports no firearms on the premises. The grounds are free from obstructions and hazards. Facility will be licensed for 6 clients and clients will be utilizing all 6 bedrooms. All bedrooms have 1 full bed and a side drawer, storage drawer and adequate closet space to accommodate client's clothing and personal belonging. The closets have hampers and laundry bags, as well as the hangers for the clients to use. Bedrooms have appropriate window blinds for client's privacy and the lights in the rooms work properly. Bedrooms can be used by ambulatory and non-ambulatory clients. LPA observed three bathrooms to be in good repair and working order. Bathroom #1 has a sink, shower with the shower curtain and non-slip mat, and a toilet.. Bathroom # 2 located inside bedroom # 3 and with 2 sinks, shower with a non-slip mat and a working toilet. Bathroom #3 has a sink, bathtub with the shower with non-slip mat, and a toilet. Individual beds are observed to be in good repair, equipped with mattress in a good condition and pillows, as well as appropriate clean linens in good repair. LPA also observed extra linens stored in the hallway closet of the facility. Medications will be centrally stored in the lockboxes in the kitchen cabinets. Complete first aid kit is readily available in the kitchen and contains all the necessary items. Clients' files will be stored electronically on the tablet in the kitchen area. Kitchen has a refrigerator, dishwasher, stove and adequate utensils and tableware to accommodate the number of clients. Licensee has no kids in placement, food will be stocked once children are in placement. LPA also observed a complete food menu posted on the kitchen table and the schedule of activities. Dining room has a table with 6 chairs to accommodate clients, as well as 4 stools by the kitchen island area. and the living room has a working TV and couches with enough room for 6 clients. Games are located on the kitchen counter. Office has room for the employees to sit and the federal and stater labor law posters. Backyard is free of hazards and has enough space for the clients to use. No equipment stored on the back yard. There are no cameras inside the home. Each room has motion alarm attached to the wall and it is connected to the security system, alarm is not currently active. LPA also received original surety bond from the licensee today at the pre licensing. The fire department clearance pending. LPA sent another fire clearance request. LPA reviewed Guardian website clearance and the Administrator is cleared and associated to the facility. The facility will be utilizing the same Program Statement as the Brighter Day Group Home that was already approved by licensing. The copy of this report was provided and explained to the licensee.


summary: Facility Evaluation

raw_content:
Narrative:
On 06/12/25 at 10: AM, Licensing Program Analyst (LPAs) Olena Maico conducted unannounced post-licensing inspection at the above address. LPA met with Ayan Hill, Licensee and Administrator of the Facility and Travis Bates, Facility Manager. LPA requested and received via e-mail LIC 500, LIC 9020, LIC 308 and LIC610C before the inspection. LPA also reviewed Guardian associations to the facility and found all the staff to have clearance or exemptions and being associated to the facility. LPA Maico conducted a physical plant inspection inside and outside the home alongside with the Administrator. The following were observed at the time of inspection: Physical Plant This facility is a single level home located in a residential neighborhood. The facility consists of 6 bedrooms, 3 full bathrooms, office, a living room, kitchen, dining room, 2-car garage, laundry room, and a backyard. Overall, the facility is clean, sanitary and in good condition. The facility has no bodies of water. LPA observed the facility sketch posted on the wall as well as the Administrator Certificate, visitation policies, discipline policies, grievance procedures and children's personal rights. The facility has a centralized heat and air-conditioning unit. Temperatures in all rooms are maintained at 68 degrees (F). The hot water temperature was measured at 109 degrees (F). Facility has carbon monoxide and smoke alarms throughout the facility. The fire extinguisher located between bathroom #2 and bedroom #2 and fully charged. Continue PG Pg Knives and sharps are kept locked in the kitchen cabinet and also some of them are in the garage in the locked box. Disinfectants and cleaning solutions are kept in the locked box in the garage as well. Some of the chemicals also kept in the kitchen drawers and are locked. The facility has a working telephone. The Emergency disaster plan is posted next to the telephone. LPA advised the Administrator to add phone number and e-mail for one staff in charge of the emergency plan. The applicant reports no firearms on the premises. The grounds are free from obstructions and hazards All bedrooms have 1 full bed and a side drawer, storage drawer and adequate closet space to accommodate client's clothing and personal belonging. The closets have hampers and laundry bags, as well as the hangers for the clients to use. Bedrooms have appropriate window blinds for client's privacy and the lights in the rooms work properly. Kitchen has a refrigerator, dishwasher, stove and adequate utensils and tableware to accommodate the number of clients. Dining room has a table with 6 chairs to accommodate clients, as well as 4 stools by the kitchen island area. The living room has a working TV and couches with enough room for 6 clients. First aid kit located in the kitchen and has all the necessary and required items. Medications will be centrally stored in the lockbox in the office. Currently no clients are taking medications. Office has room for the employees to sit and the federal and stater labor law posters. Backyard is free of hazards and has enough space for the clients to use. No equipment stored on the back yard. The facility has been approved to use cameras, but licensee has not installed any cameras yet. Disaster Preparedness Plan: Facility maintains a current, written disaster and mass casualty plan of action. LPA reviewed emergency drill records on the Administrator's laptop. LPA advised the Administrator to add phone number and e-mails to the person designated on the emergency disaster plan. Facility maintains an emergency and disaster plan, register of clients, Needs and Services Plan for each client electronically, medication records, and contact information for each client's responsible party. Continue PG Pg Emergency Intervention: Staff has training in Emergency Intervention and it is recorded in staff files. Staff being currently trained in CPI and facility has been just approved for usage of Manual Restraints. No restraint will be conducted until all the staff is trained in CPI. Staff files Staff records are stored electronically in the cloud. LPA reviewed 5 (five) staff files. Staff files are electronic and contain staff job duties, resumes, CPR training, medical screening and TB test, personnel records, driver license, criminal record and child abuse clearances, initial 8 and 16 hour training along with the Administrator's job performance review. Client Records LPA reviewed two (2) client files. All client records are available to the licensing to review electronically. Client records contain required information including, but not limited to, consent forms, personal rights acknowledgement, immunization records, TB tests, personal property and valuables, cash resources records, authorization to medical treatment, record of cash allowance received. LPA interviewed 2 (two) staff. LPA attempted interview 1 (one) client and client refused. Another client was asleep at the time of the visit and LPA was not able to conduct the interview. No deficiencies are issued at the time of visit. An exit interview was conducted, and a signed copy of this report and LIC811 were provided and explained to the Facility Manager.

met_with: Ayan Hill, Administrator Travis Bates, Facility Manager