summary: Facility Evaluation

raw_content:
Narrative:
On 10/08/ Community Care Licensing (CCL) and the County of Sacramento held the monthly Sacramento Welcome Home (SWH) TSCF (Temporary Shelter Care Facility) collaborative meeting over Microsoft Teams. In attendance were Cathi Johnson, Ali Neira, Alicia Wasklewics, and Tashna Ward from the County and, from CCL, Rosa Rodriguez, Jodean Hall, Hillary Hall, Connie Goldie, and Chad Cabigon. After introductions, the following was covered: CCL acknowledged and thanked the County for the submission of its Written Plan, received by CCL on 09/25/2024, in response to the items covered during the first collaborative meeting held on 09/10/2024. The County has since assigned two new program supervisors to the SWH locations and is looking to fill a third supervisor position pending the Sacramento County Board of Supervisors' approval which is expected to pass on 11/05/2024, bringing the total number of program supervisors to five (currently, there are four). Regarding the plan to re-designate an administrator, it was noted that Alicia Wasklewics is set to go through the administrator training/certification at the end of this month (October, 2024). CCL clarified that the required facility manager designation is specific to each shift per House/location when children are present. Being that there are only four supervisors covering all the Houses, there are times when no supervisor is available at a given location. The County stated that they have implemented an assigned Worker of the Day or "WOD" to cover those locations and/or times when a program supervisor is not available. CCL requested that on the schedules (on the LIC 500 or Personnel Report) it is specified who the WODs and supervisors are and that those designated are spelled out as 'facility managers', that all other CCL-required positions are spelled out (including, for example, Administrator) under the "Job Title," and that an updated form be submitted for each location by October 31, 2024. The County stated that some of the limitation(s) in properly reflecting these positions may be due to the need to have it cleared by the staff's union beforehand and that, relatedly, the same constraint(s) may be affecting the finalizing of job duty statements for care staff to acknowledge. (, 809-c) (PAGE 2) Also discussed were the missing full or seven-day reports which are the follow-up reports to the County's 24-hour notifications. Per the County, management is paying close attention to the October reports to ensure compliance: the 24-hour reports are being done in a timely manner but the intermediate step involving a supervisor de-brief is where the reports are getting held up. The County are actively working on a pilot program set to start at the end of November or the beginning of December, 2024, which is meant to help track reports through a more automated system. It is CCL's expectation that the outstanding full or seven-day reports for previously-submitted 24-hour notifications (for September, 2024) will also be submitted to CCL by October 31, 2024-the number of missing full or seven-day reports are as follows: Pasadena House - 11; Madison - 27, and Chicago - 10 (for a total of 48). It is also CCL's expectation that an immediate correction plan be put in place to be in compliance with Title Regulations. Regarding training requirements-specifically, Section 84065(i)(1)(D) which discusses the need for an assessment of the efficacy of training-CCL noted, based on interviews, that direct-care staff may not have a sufficient understanding of the training topics covered despite having received the training. CCL advised that post-testing or return demonstrations to assess for competency may be developed by the County, themselves, so long as those assessments are documented in each staffer's file. The County stated that management will check-in with the supervisors about this protocol and also added that the supervisors do meet with their staff every month, are probably doing at least some type of performance evaluations, and that they may just need to do better at documenting. CCL is requesting an implementation plan to be compliant with Title Regulations, and that this plan should be submitted by October 31, 2024. Additional training support: CCL advised that the Ombudsperson's Office only provides training on the Foster Youth Bill of Rights but not on anything more specific like medications, for example. CCL provided the Ombudsperson's Office portal and link to sign up for Bill of Rights training. The County asked if CCL, apart from the Ombudsperson's Office, provides more topic-specific training-CCL advised that it does and that this training will be scheduled for the County by the end of November or the beginning of December, 2024. On the SWH Program Statement being made accessible to staff: the County stated that they are still working on the employee handbook-along with this process the care staff have been given electronic access to the Title 22/Interim Licensing Standards (ILS) Regulations digitally and parts of the Program Statement on which staff get trained. (, 809-c) (PAGE 3) Regarding the POC for the Personal Rights citation on the Chicago House on inventory check/searches. The POC was submitted to CCL on 10/03/2024, this procedure is still under review by CCL. Regarding the POC for the Personal Rights citation on the Madison House, the County will check on the progress of training for staff which is expected to be completed by 10/11/2024. Regarding the POC for the overcapacity citation on the Pasadena House, this POC was submitted to CCL on 10/02/2024 and is still under review. A copy of this report is being emailed to the County for signature.


state: CA

facility_name: SACRAMENTO WELCOME HOME (SWH)-MADISON HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
On 12/10/2024, Community Care Licensing (CCL) and the County of Sacramento held the monthly Sacramento Welcome Home (SWH) TSCF (Temporary Shelter Care Facility) collaborative meeting over Microsoft Teams. In attendance from the County were: Cathi Johnson, Ali Neira, Alicia Wasklewicz,, and Veronica Carrillo. Attending from CCL: Margo Castaneda, Regional Manager (RM), Rosa Rodriguez, Licensing Program Manager (LPM), Jodean Hall, LPM, Hillary Hall, LPM, Connie Goldie, Licensing Program Analyst (LPA), Tina Thorn (LPA), and Chad Cabigon, LPA. Also present was Kelley Hartman and Alicia Bernstein from Systems of Care (SOC.) After introductions, the following was discussed: The County and CCL acknowledged what has been going well for them and for each facility. The County noted that operating two rather than three homes has been going well. CCL shared that all three locations were reported to have had great communication and LPAs have observed staff engaging with the youth. Alicia Wasklewics passed the Administrator Certification test and completed her background clearance. An expedited request will be sent by RM once paperwork is submitted. County plans to hire one more staff to meet the goal of having six supervisors. The LIC 500 will reflect a Worker of the Day (WOD), who meets Facility Manager qualifications. WOD will be present when a supervisor is not. There will be a WOD at each house during each shift. The County agreed to send a list of qualified facility managers for each facility as well as the staff schedules. The LIC 500 is to be sent to CCL by 12/11/24. CCL shared the staff training records submitted do not match the Program Statement and clarity is needed on the initial training versus annual training. The County said they would revise their program statement training requirements. CCL addressed a recent Incident Report (IR) involving a manual restraint. The County stated that while all staff are in the process of restrain training, restraints will always be a last resort. The County used the information provided by CCL regarding medication training and Personal Rights to create a self-paced training for the staff. The County has implemented information from the medication training and incorporated the new MARS form. The County is developing a staff training template and will send updated staff training records by 12/11/24. CCL requested information on the security guards at the facilities and the lack of security personnel mentioned in their Program Statement. CCL requested the security complete training on mandated reporting and Trauma Informed Care. CCL requested updates to the Program Statement on how the security is Trauma Informed and their level of engagement with staff and clients. Due date for Program Statement Update: January 11, CCL shared incident reporting by the County has improved in timeliness. The County is developing a system to track Incident Reports. Until development is complete, the County supervisor has created a schedule to review IRs. Monitoring Youth personal property and conducting searches was discussed. The County agreed to update the program statement to reflect and describe the Youth personal property log. The County will send CCL the Prudent Parent Activation form and Youth Care and Goal Plan. Inventories, not searches, are currently being conducted. The County explained that the inventory checks are a case-by-case. CCL recommended that the Youth Care and Goal Plan have an area in which client's history of substance use should be included to better predict the use of Prudent Parent Activation. The County provided updates on their Home-Based Shelter Program, which is near capacity. Next Meeting schedule for January 14, 2025.

report_type: Facility Evaluation

met_with: Cathi Johnson, Ali Neira, Alicia Wasklewicz, Veronica Carrillo, Kelley Hartman, and Alicia Bernstein


summary: Facility Evaluation

raw_content:
Narrative:
On 01/14/2025 the CA Department of Social Services' (CDSS) Community Care Licensing Division (CCL) and the County of Sacramento held the monthly collaborative meeting over Microsoft Teams. The attendees were: from County, Cathi Johnson, Alondra Neira, Tashna Ward, Alicia Wasklewicz, and Veronica Carrillo, from CCL, Margo Castaneda, Jodean Hall, Rosa Rodriguez, Hillary Hall, Connie Goldie, Tina Thorn, Chad Cabigon, and from CDSS' System of Care Branch (SOC), Kelley Hartman, Levi Huser, and Alicia Bernstein. Topics discussed at the meeting were: What's working well: The County expressed having two TSCF's is much more manageable. They have also had a lower census on average as of late between the Welcome Home locations which has been helped by the recent capacity expansion through outside partners. Temporary move from Chicago House to Pasadena House: Due to an infestation of carpet beetles the facility is being fumigated. Designated Administrator: CCL noted that Alicia Wasklewicz passed the Administrator Exam; County was informed that Regional Manager (RM) Castaneda requested the expedited processing of Ms. Wasklewicz's administrator certification. CCL reiterated expectations for a facility administrator: to be on facility premises for the number of hours necessary to manage and administer the facility in compliance with applicable laws and regulations, and to be readily available for the responsibilities and oversight of the facilities. CCL also reiterated the need for staff to be designated to act on the administrator's behalf with the overall management of facilities in the administrator's absence. CCL emphasized that these designees also need to be able to provide Plans of Correction for citations issued during inspections-County confirmed that these facility manager designees have been given this authority. (, 809-c) (PAGE 2) Plan for Pasadena House license: The County will continue to keep the license until further notice. Training Requirements: Follow-Up: County will be sending the template for staff training. Security Guards - Fingerprint Clearance Needed: CCL advised that all security guards positioned in the home need to be fingerprinted and obtain criminal record clearances through Guardian due to the frequency, consistency, and recurring nature of their presence. The due date for the completion of fingerprinting is 01/31/2025. Reporting Requirement Update - Incident Reporting CCL discussed the continued issue of late and/or missing reports and acknowledged it is vastly improving. County stated that they are continuing to address this and with Ms. Wasklewicz as administrator, her presence in the Houses more frequently should help address the reporting. The County also expects to start testing the SMILE system this week with the goal of launching in the end of February. Inventory Check/Searches: CCL followed up on the submission of the County's Prudent Parenting activation form related to searches for CCL to review. The County will be submitting the form. CCL/SOC pointed out that Prudent Parenting is usually in reference to decisions that a substitute caregiver makes to afford youth something that resembles a more "normal" way of life such as allowing youth to participate in certain activities without prior approval from their authorized representative. SOC discussed that the Prudent Parent Standard is a general framework through which providers can respond as necessary to help support youth, but it might not always be appropriate, and its use should depend on the population and/or individual youth in question. Facility Overview: Both LPAs stated seeing an increase in engagement between youth and staff participating in various house activities. (, 809-c) (PAGE 3) Additional feedback: SOC reminded County of standing offer to provide consultation and guidance and encouraged County to reach out, as necessary. Training materials have been sent to County from SOC that may be helpful and could be integrated in the Shelter's program. County to submit Program Statement updates by 01/31/2025, to include clarification on the mandated initial vs. annual training, as well as policies and expectations related to contracted security personnel who work onsite at the SWH locations. Closing discussion on restraints: The County stated that all staff will start Phase 2 of the TCI training in February, 2025, and that they anticipate completion in March, 2025. CCL advised that a manual restraint should only be executed by a trained staff and should only be resorted to in a health and safety consideration for a child or staff, that it is more about good training that truly helps staff be proactive with early interventions, how to identify early on what the specific youth' triggers are, and how staff can equip themselves with enough techniques to de-escalate a situation. Additionally, it should also be helpful for the County to be familiar with the temperament and tendencies of their direct-care personnel so as to better inform management on staffing decisions and training considerations. A copy of this report is being provided to the County of Sacramento.

met_with: Catherine Johnson et al.


summary: Facility Evaluation

raw_content:
Narrative:
On 02/11/2025, at 10: AM, the CA Department of Social Services' (CDSS) Community Care Licensing Division (CCL) and the County of Sacramento held the monthly collaborative meeting over Microsoft Teams. The attendees were: from County, Cathi Johnson, Sac County Administrator, Alondra Neira,Program Planner, and Alicia Wasklewicz,Sac County Administrator, from CCL, Margo Castaneda, Regional Director, Jodean Hall, Rosa Rodriguez, Hillary Hall, Licensing Program Managers and Tina Thorn, Chad Cabigon, and Connie Goldie, Licensing Program Analysts and from CDSS' System of Care Branch (SOC), Levi Huser, Ashley Bray, and Alicia Bernstein. The following items were discussed- What's working well: Ms. Johnson stated that the County is continuing to focus on training of staff in various areas and two houses have placement. Duty statements will be reviewed with staff, signed, and placed in their files. CCL stated facility staff are pleasant, workers of the day are helpful during inspections and youth are observed to be engaged. CCL requested copy of duty statements by 02/21/2025. Administrator Update: Alicia Wasklewicz, administrator applicant provided Group Home Certificate to CCL on 02/11/2025. CCL clarified expectations that Administrator will provide oversight as needed. Program Statement Update: CCL received Program Statement updates as requested on 01/31/2025. CCL is in the process of reviewing received documentation. CCL's review of revisions will be completed by 02/21/2025. Continued on LIC809C. page Pasadena House License Status: The County stated the Pasadena House license will be maintained until further notice. County will communicate when this transition occurs. Trauma Informed Care (TIC): CCL requested a list of which staff are not currently trained in TIC. County stated they will provide a copy of the training log highlighting staff who still need to complete this training. CCL requests this be submitted by 02/14/2025. CCL asked if security guards will receive restraint training. The County stated security guards will not be restraint trained and will not put hands on youth. Reporting Requirement Update: CCL discussed the continued issue of late and/or missing reports for all TSCF facilities. The County stated that their records are not consistent with CCL reported numbers and requested that CCL attach which reports are missing going forward. Increase of Unauthorized Absences: CCL discussed observation of increased unauthorized absences and asked how staff attempt to prevent youth from leaving. County shared that staff follow youth to the property perimeter line when leaving due to safety concerns. It was also stated staff ratios can determine if a youth is followed. CCL advised the county to include reason for not going further than property line on incident reports. Levi Huser from Systems of Care Branch offered an opportunity for collaboration to discuss ideas on reducing law enforcement contacts. LIC Office Meeting Review: Licensing Program Analyst and Licensing Program Manager will have a Teams Meeting with the County to review the LIC809 report for the monthly collaboration meeting each month in order for any revisions to be made immediately as necessary. The reports will then be emailed to obtain a signature. Ashley Bray from Systems of Care offered to assist with creating individual safety plans with a harm reduction approach in order to be proactive. Ms. Bray suggested County staff and licensing staff participate in the meeting. The office meeting concluded at 10: AM.

met_with: Cathi Johnson, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Present: CCL: Margo Castaneda, Regional Manager Licensing Program Managers: Hillary Hall, Jodean Hall, and Rosa Rodriguez Licensing Program Analysts: Chad Cabigon, Tina Thorn, and Connie Goldie Sacramento Welcome Home County Partners: Cathi Johnson, Ali Neira, Tashna Ward, Alicia Wasklewicz Systems of Care: Alicia Bernstein, Ashley Bray and Levi Huster On 03.11.25, the following was discussed during the CCL collaboration meeting with Sacramento County regarding the Temporary Shelter Care Facility. Both the county and CCL reported on what's going well: Alicia Wasklewicz collaborated with Systems of Care representative and obtained resources and expressed gratitude for the connection. LPAs for each facility reiterated that the staff have been engaged with clients and responsive to LPAs. LPA Goldie reported on progress with Program Statement Review. LPA stated that she was able to access forms easily. LPA also stated that most of the revisions were a matter of gaining clarification, requesting transcripts, and having County provide more explanation regarding how the processes will be implemented. LPA Goldie gave a briefing on revision requests, namely the under 6 and discipline policies and of requesting transcripts for staff to ensure requirements are met. The County expressed that obtaining transcripts is proving to be a longer process depending on the time frame in which the staff took the required courses. The incident report submission process was discussed, with the county's new system, SMILE being implemented 03.17.25. C. Johnson explained that the county's new system should reduce the reporting time frame by providing email alerts to submit required reports and will provide more reminders to support staff. Continued 809C The county was informed that, going forward, they will be cited if incident reports are turned in late. CCL shared information about our Technical Support Program that will provide support and training for the facility. T. Ward reported 12 staff are fully trained in Therapeutic Crisis Intervention (TCI). There are still staff needing to be trained. It was reported that enough staff are trained to ensure there are 2 people per shift available to do restraints if necessary. The expectation is that all staff are trained by April 1, 2025. County reported that on March 22, 2025, Foster Hope is set to take over operations at the current Madison House. Youth will move to Pasadena and Chicago House to allow Foster Hope to get situated. The County expressed a desire to keep Pasadena House as a home to relocate youth if Chicago House needs to be evacuated for emergency reason or if something needs to be fixed at Chicago House. It was also expressed that Chicago House may be used to conduct staff training and/or for youth visitation when needed and if not occupied by youth. SOC asked if County wanted their harm reduction policies/forms reviewed. A. Bernstein provided email address to the County. Regional Manager M. Castaneda concluded the meeting after offering time for more questions or comments.


summary: Facility Evaluation

raw_content:
Narrative:
On 09.26.24 at 04: PM Licensing Program Analyst (LPA) Tina Thorn conducted a Post-Licensing Inspectio,n. LPA Thorn met with Aquibi Davis,SWH Supervisor who assisted with this inspection. Upon arrival 4 staff 4 clients, and a secutity guard were present. LPA toured the facility on previous visits on 09.11.24 and 09.13.24 as well as on 09.26.24. See 809 from 09.13.24 for full description of premises.. LPA conducted two staff interviews on 09.13.24 and 2 client interviews on 09.26.24. LPA requested staff records on 09.11.24 and there was no manager or supervisor present to provide records for LPA to review. The records were sent via email on 09.12.24. LPA returned on 09.13.24 and a supervisor joined after being called by a staff member. LPA was unable to complete inspection on 09.13.24 so a subsequent visit was scheduled. On 09.26. LPA observed the facility to be clean and the outdoor area was freshly mowed and free of debris. Smoke detectors and carbon monoxide detectors were functional. A first-aid kit was available and contained required items. Children's records were observed to be incomplete. Placement agreements were unavailable in children's files. Only one of five clients had a file that included a signed personal rights form on this date and on the two previous visits a supervisor was not present to meet LPA until a staff member called for one. The facility did not have a list of persons allowed to visit clients nor were there consent forms in any of the clients' files with consent forms to authorize medical and dental treatment. LPA observed there to be 0 of five clients' files that included copies of removal and/or discharge policies and there were no copies posted in the facility. On 09.26. LPA cited facility for Title 22 deficiencies referenced in the following D pages and issued 1 technical violation. An exit interview was conducted with Aquibi Davis, SWH Supervisor. A hard copy of this report and appeal rights were provided to facility.

met_with: Aquibi Davis, Sacramento Welcome Home Supervisor


facility_name: SACRAMENTO WELCOME HOME (SWH)-MARIPOSA HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
On 07/15/ Licensing Program Analyst (LPA) Chad Cabigon conducted a Prelicensing Inspection of this property. Present were County of Sacramento DCFAS (Department of Child, Family, and Adult Services) Division Manager Cathi Johnson and Administrative Services Officer Diana Rethford. LPA was given a tour of the interior and exterior areas of the facility grounds; the findings of the inspection are as follows: The property has two common living areas adjacent to each other with ample couch seating. The house has three bedrooms for clients, each was furnished with two beds & mattresses, beddings & linens, and personal storage space in the form of stowable under-bed rolling bins all found to be in good condition. Each bedroom also had a working light fixture and a smoke detector that appeared to be in working order. There is one shared bathroom for clients' use-there is one toilet in good repair, a vanity and a bathtub shower whose fixtures provided hot water. There is a dining table in an area next to the kitchen; a working refrigerator maintained a temperature of 38 degrees F with a freezer that maintained a temperature of 0 degrees F. There is an extra freezer in the garage whose temperature was also kept at 0 degrees F. Per Ms. Johnson, an additional refrigerator will be obtained to ensure accommodation of the required perishables at capacity. There is a dedicated staff office that was securable, within which were lockable file cabinets for confidential files and storage for centrally-stored medications that can also be secured. The property has a working landline located within the staff office. The dwelling has centralized air and a thermostat located in the bedroom hallway that displayed a room temperature of 77 degrees F. The washer and dryer were located in the garage, and within which chemicals and other potentially dangerous liquids will be stored. The backyard outdoor space included a covered patio with seating and a bench or picnic table found to be in good condition. There was a pile of loose branches on the far end of the lawn that is to be cleared, otherwise, there were no potentially hazardous items or areas observed. (, 809-c) The following was communicated to Ms. Johnson and Ms. Rethford: all waste bins shall have covers; an inordinate amount of house flies observed during the inspection is to be addressed; required beddings and linens are to be in place; the weekly menu, foster youth rights (to be provided by Licensing), the Disaster or Mass Casualty Plan, and complaint procedures are to be posted conspicuously at the appropriate areas; the hot water out of the bathtub fixture was 130 degrees F-this needs to be adjusted and maintained between 105 - 120 degrees F. A subsequent onsite inspection is necessary to re-evaluate this property's readiness to serve clients. County of Sacramento is to inform LPA once the property is ready for the follow-up inspection. A copy of this report is being provided to Ms. Johnson.

visit_type: Prelicensing

met_with: Cathi Johnson, Diana Rethford


summary: Facility Evaluation

raw_content:
Narrative:
On 08/08/ Licensing Program Analyst (LPA) Chad Cabigon conducted a follow-up onsite walkthrough of this property to complete the Prelicensing Inspection. LPA met with County of Sacramento DCFAS (Department of Child, Family, and Adult Services) Division Manager Cathi Johnson, Program Manager Alicia Wasklewicz , and Administrative Services Officer Diana Rethford. The hot water temperature out of the bathtub shower fixture was 105 degrees F; no house flies were observed, all waste bins had covers in place; required beddings and linens for all the beds in clients' rooms were in place and each bedroom had the required storage space for personal belongings; the backyard did not have any potentially hazardous areas or items; the Disaster/Mass Casualty Plan and a weekly food menu were posted; the facility has perishable food sufficient for at least three days. The provisional Temporary Shelter Care License will be issued effective 08/11/2025. The County plans on housing clients at this location starting that date. A copy of this report is being provided to the County of Sacramento.

met_with: Cathi Johnson, Alicia Wasklewicz, Diana Rethford


summary: Facility Evaluation

raw_content:
Narrative:
On 9/25/2025 at approximately 12:30pm Licensing Program Analyst (LPA) Tatyana Shulz conducted an Informal Meeting with Sacramento county staff for the purposes of discussing the 0- Program Statement Review. Present during the meeting was LPA Tatyana Shulz, Licensing Program Managers (LPMs) Connie Goldie and Tamara Hill, Regional Manager (RM) Margo Castaneda, and county staff Catherine Johnson, Alondra Neira, and Alicia Wasklewicz. Below is a summary of the topics that were discussed and agreed upon: Facility Manager Training: LPA Shulz will review the approved training section of the Program Statement and determine whether the supplemental training section for the 0-6 population will cover the specific course work that state regulation requires. Physical Plant: LPA Shulz requested the county supply an Emergency Intervention Plan and Safety Plan for the 0-6 population stating how the facility will respond during a natural disaster and when there are escalated behaviors present in the home. Highlighting how they will ensure the safety of the younger population. The county agreed to provide an updated LIC999 referencing specific play areas designated for the under 6 population, a safety plan and an emergency intervention plan specific to ages 0-6 years.

visit_type: Case Management

met_with: Catherin Johnson- County Representative


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Based on the evidence gathered and confidential interviews conducted, the above allegation cannot be substantiated. While three individuals interviewed stated that staff supervision did not ensure safety, the remaining ten interviews were inconsistent and did not support that claim. It was confirmed that on 09/03/2025, at approximately 3:30 a.m., staff were conducting room checks and discovered an unknown individual hiding under a client's bed, and another individual was witnessed exiting through a client's window. Immediately following the discovery, facility staff took appropriate action by contacting law enforcement, notifying facility supervisors, and speaking to the youth present. Additionally, the facility completed and submitted an incident report to the appropriate parties in a timely manner. Due to ongoing safety concerns, law enforcement was contacted two additional times, and on both occasions, supervisory staff assisted law enforcement with a thorough search of the property and surrounding areas. During the second search, a supervisor located the safety concern. In addition, all personnel interviewed consistently reported that room checks are conducted every thirty minutes, and all staff present on the night of the incident confirmed that these checks were routinely conducted during that shift. Lastly, county social workers and staff reported that youth present during the incident never expressed concerns regarding safety due to lack of supervision by staff. Although the allegation may have happened or may be valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED. An exit interview was conducted. A copy of this report and the Appeal Rights were discussed with and provided to the Anne Yang, Worker of the Day.

Investigation Findings:
13On November 26, 2025, Licensing Program Analyst (LPA) Sarina Buchannan made an unannounced visit to deliver findings at the above location and met with Anne Yang, Worker of the Day. LPA conducted a walk-through of the facility; no deficiencies were observed. Prior to this meeting, LPA Buchannan conducted a 10-day inspection of the TSCF on 09/11/2025, followed by a subsequent inspection on 11/04/2025. During the inspections, LPA requested the following documents: staff roster, client census, client face sheets, staff schedule, staff contact information, related incident reports, room check form, and a summary of the incident email thread. LPA Buchannan attempted one confidential interview and conducted thirteen confidential interviews between 09/05/2025 and 11/24/2025. (report continued on LIC 9099C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Connie Goldie LICENSING EVALUATOR NAME: Sarina Buchannan 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: SACRAMENTO WELCOME HOME (SWH)-MARIPOSA HOUSEFACILITY NUMBER: VISIT DATE: 11/26/2025

report_type: Complaint Investigation

met_with: Anne Yang, Worker of the Day

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On December 11, 2025, at 2: PM, Community Care Licensing (CCL) - Children's Residential Assistant Program Administrator Margo Castaneda, Regional Manager Danielle Walker-Flores, Licensing Program Manager (LPM) Connie Goldie, Licensing Program Analyst (LPA) Chad Cabigon, and Licensing Program Analyst (LPA) Orlando Areizaga conducted an Informal Meeting in the Sacramento Regional Office with Sacramento County Department of Child, Family and Adult Services' Deputy Director Melissa Lloyd, Division Manager Cathi Johnson, and Sacramento Welcome Home (SWH) Administrator Alicia Wasklewics. Also in attendance were Provider Policy Implementation Unit Manager Alicia Bernstein and Policy Analyst Levi Huser from CDSS' System of Care Branch. The purpose of the meeting was to discuss compliance concerns. The following areas of concern were addressed: staffing, staff training, accessibility of staff records, completeness of children's records, and overcapacity. The operations of the facility were discussed and additional action plan documentation was provided by Sacramento County. Action Plans include the following: Staffing: the facility is hiring additional staff for each location. Training expectations: overtime social worker staff are undergoing the required direct-care staff training; Alicia is to send training logs for staff who have training that are still outstanding by 12/24/25. (Continued on 809c) *the language on this page is an amendment of part of a report issued on 12/11/2025. Staff records: Alicia is to be the point person for access to personnel files. SWH staff who receive Community Care Licensing (CCL) personnel during onsite inspections are to contact Alicia for any staff records request. Children's records: The Worker of the Day (WOD) position was never discontinued, only decentralized; SWH is reinforcing the role by having the WOD per shift be responsible for client intake to the completion of a client's file within 24 hours. Alicia to send new checklist(s)/form(s) that are to be used by SWH staff as templates to ensure completion of client records. Overcapacity: SWH will provide CCL a collaborative plan for how overcapacity will be addressed through partnerships with other licensed facilities. A copy of this report is being provided to Sacramento County Division Manager Cathi Johnson.

met_with: Melissa Lloyd, Cathi Johnson, Alicia Wasklewics


summary: Facility Evaluation

raw_content:
Narrative:
On April 7, 2026 at approximately 10: AM, Licensing Program Analysts (LPA) Zaria Turner, made an unannounced visit to the above Temporary Shelter Care Facility (TSCF) facility, for the purpose of conducting a post licensing inspection. LPA met with Karla Garcia Maldonado, Social Worker, and walk through of the interior and exterior of the facility was conducted. LPA conducted a walk though of the interior and exterior of the facility. LPA observed the posting of License, Personal Rights, and Emergency Disaster Plan. The facility consists of 3 bedrooms, 2 bathrooms, living room, kitchen, dining room, lounge room, staff office, and garage. Each client room is equipped with 2 twin size beds, bedding, 2 bedside tables, and closet space for clothing and personal belongings. The youth and staff bathrooms at the facility are equipped with working toilets, shower/tub, and running water. Upon entry, there is a desk and monitor, 2 sofas, side table, a TV, and a coffee table. The dining room is equipped with a table, 3 chairs, a bench, a bookshelf, and lockers where personal youth belongings are kept. The lounge room is equipped with 1 sofas, 2 chairs, 1 monitor, and a TV. The staff office is equipped with 2 desks, 3 monitors, 4 chairs, a staff and client filing cabinet, and a staff fridge. The garage is converted into a storage room equipped with extra toiletries, cleaning supplies, dining utensils, racks used to store nonperishable foods, a fridge and freezer to store perishable foods. There is a washer and dryer located in the garage and cabinets above where extra linen, toiletries, and cleaning supplies are kept and locked away. Medication is centrally stored, locked, and inaccessible to clients in care. Disinfectants/cleaning solutions are inaccessible to clients in care and locked, in the office closet and above the laundry units. Continue summary of inspection on 809-C The refrigerator temperature is at or below 45 degrees F. There is nonperishable food for one week and fresh perishable food for three days minimum. There are containers to place leftover food. Carbon monoxide and smoke detectors are in working order. Temperature in facility is between 68 degrees F and a maximum of 85 degrees F. Hot Water between 105-120 degrees F. Fire Extinguishers are up to date and in working order. The toilets, bathtubs, and shower fixtures are in good repair. Soap and paper towels are available to clients in care. There is a working telephone accessible to clients. The facility is free of vermin. The backyard contains a covered patio area with 2 sofas, 3 chairs, and a picnic table. There is a grassy area with a picnic table. There is no pool on the premises. A Technical Violation (TV) was assessed during today's inspection. (See LIC TV) An exit interview was conducted with Social Worker, Karla Garcia Maldonado, and a copy of this report was discussed and provided during today's inspection.

met_with: Karla Garcia Maldonado, Social Worker


summary: Facility Evaluation

raw_content:
Narrative:
On April 7, 2026 at approximately 10: AM, Licensing Program Analyst (LPA) Zaria Turner, made an unannounced visit to the above Temporary Shelter Care Facility (TSCF) to follow up on an incident report received by the department on January 30, 2026, involving telephone policy. LPA met with Social Worker, Karla Garcia Maldonado. LPA conducted a walk though of the interior and exterior of the facility. LPA Turner conducted three staff interviews. This case management is closed, no further investigation is needed. An exit interview conducted and a copy of this report was left with Karla Garcia Maldonado, Social Worker.


facility_name: COUNTY OF SACRAMENTO DCFAS SUNSET HOUSE

summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
Based on observations and interviews, the preponderance of evidence standard has been met; therefore, the allegation that Unlicensed care is being provided is Substantiated. An exit interview was conducted, the Appeal Rights were discussed, and a copy of this report is being provided to Program Manager Carrillo.

Investigation Findings:
13On 05/03/2024 at 3: PM Licensing Program Analyst (LPA) Chad Cabigon met with Veronica Carrillo, Program Manager at the Branch Center Rd. County of Sacramento offices, the purpose of which was to deliver the findings of this complaint investigation. On 04/04/2024 the Community Care Licensing Division (CCLD) of the California Department of Social Services (CDSS) received a complaint alleging unlicensed care was being provided in a house located at the address indicated on the top portion of this report. On 04/08/ LPA Chad Cabigon conducted an onsite inspection at the aforementioned location and met with County of Sacramento Division Manager Cathi Johnson. LPA was given a tour of the interior and exterior areas of the physical plant; LPA observed that there was one youth on premises-an interview was conducted with said youth. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Chad Cabigon 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: COUNTY OF SACRAMENTO DCFAS SUNSET HOUSEFACILITY NUMBER: VISIT DATE: 05/03/2024

met_with: Veronica Carrillo

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
The Department investigated the allegation, "Staff are not properly trained." Two of five staff members interviewed stated they were behind on training. One staff stated they did not receive initial training upon hire. Record review of staff training log and program statement indicates that 10 of 11 staff have not received initial 90 day required training. Five of the staff have not completed Mandatory Reporting training. Six staff have not completed the De-escalation training. Therefore, the evidence supports that this allegation is substantiated. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 5 , Personnel Requirements (i)(3) are being cited on the attached LIC 9099D." An exit interview was conducted. A copy of all reports and appeal rights were discussed and provided to facility staff, Name, TITLE. The Department investigated the allegation. "Staff are denying minors mental health treatment." Two of two clients interviewed stated mental health services have been offered to them. Five of five staff corroborate that outside vendors come into the facility to offer support services to the clients in care and mental health services are offered to the youth during their initial Child and Family Team meetings. Therefore, it is not possible to determine whether the allegations occurred or not. Based on the investigation, the records reviewed, and the interviews conducted, the complaint finding is UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. In regard to the allegation, staff are not providing a safe environment for minors in care, both clients interviewed stated they feel safe in the facility. One client stated that staff help when kids are yelling by talking to them. Regarding the arrest alleged by the reporting party, upon review, this did not occur at this location. A supervisor of the facility stated there have been no arrests of clients for altercations between clients. And record review of incident reports supports this statement. Five of five staff corroborate the facility is safe. Statements by staff include "we engage with youth to keep them safe", "we set up the environment to be safe", "we keep others safe by directing them away from escalated youth", and "safety checks are conducted every thirty minutes." Therefore, it is not possible to determine whether the allegation occurred or not. Based on the investigation, the records reviewed and the interviews conducted, the complaint finding is UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted. A copy of all reports and appeal rights were discussed and provided to facility staff Danielle Chan Supervisor.

Investigation Findings:
13Licensing Program Analysts (LPA) Connie Goldie arrived at the facility to conduct an unannounced complaint investigation inspection on 11/21/2024 at 1: PM. LPA Goldie spoke with Danielle Chan Supervisor to discuss the findings of the complaint investigation and allegations stated above. The initial 10-day complaint investigation inspection was conducted by LPAs Connie Goldie and Tina Thorn at the facility on 09/03/2024. LPAs conducted a Health and Safety inspection which was led by staff, Ka Xiong, Engagement Social Worker (ESW). LPAs conducted one staff interview with La Shon Tate, Supervisor. During the course of the investigation LPA conducted 4 additional staff interviews and two client interviews and reviewed the following records placement roster, staff training log, and serious incident reports. Two clients declined to be interviewed. Continued on LIC9099C SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Connie Goldie 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: SACRAMENTO WELCOME HOME (SWH) - CHICAGO HOUSEFACILITY NUMBER: VISIT DATE: 11/21/2024

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

met_with: Danielle Chan Supervisor Esteban Baul Engagement Social Worker-Facility Manager


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
The Department investigated the allegation, "Facility operating outside of the scope of their license." During the physical plant inspection, LPA observed a Fisher Price toy set up in the living room on an end table with bins of pre-school toys underneath. Staff stated the facility is now an all age, all gender home-0-18 years as it has become the intake house. The facility is licensed provisionally to provide temporary shelter care services up to 10 day to children 6-17 years old. Record review of census indicates on 11/22/2024, 12/02/2024 and 12/03/2024 children under six were placed in care at the shelter. (C2, age 4 months, C3 age 1 year, C4 age 3 years and C5 age 3 years) Therefore, the evidence supports that this allegation is substantiated. Based on LPA's observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 1, Article 2 , 80010(a) Limitations on Capacity and Ambulatory Status are being cited on the attached LIC 9099D." An exit interview was conducted. A copy of all reports and appeal rights were provided to the facility.

Investigation Findings:
13Licensing Program Analyst (LPA) Connie Goldie arrived at the agency to conduct an unannounced complaint investigation inspection on 12/18/2024 at 10: AM. LPA Goldie spoke with Ka Xiong, Facility Manager to discuss the findings of the complaint investigation and allegation stated above. The initial 10-day complaint investigation inspection was conducted by LPA Goldie at the facility on 12/03/2024. LPA conducted a Health and Safety inspection which was led by staff, Guillermo Torres, Engagement Social Worker (ESW). LPA conducted one staff and one client interview. LPA reviewed census documentation for 11/17/2024 through10: AM 12/03/2024 and facility provisional license. Continued on LIC9099C. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Connie Goldie 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: SACRAMENTO WELCOME HOME (SWH) - CHICAGO HOUSEFACILITY NUMBER: VISIT DATE: 12/18/2024

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

met_with: Ka Xiong, Facility Manager


raw_content:
Narrative:
The Department investigated the allegation, "Facility is in disrepair." During the physical plant inspection conducted on 10/24/2025, LPA observed a broken cabinet above washer and dryer which S1 stated had been broken since August 2024. LPA observed garage door exit to the backyard to have two pieces of plywood hammered on the outside making the door inaccessible. S1 stated the plywood was applied on 10/19/2024 by facility maintenance and it was estimated to be replaced in 2-3 weeks. Additionally, cloth storage space drawers for clients were visibly soiled in bedrooms #1 and #2. During a subsequent visit on 12/18/2024, LPA observed that garage exit door was still not repaired, and plywood pieces were still present. Therefore, this allegation is substantiated. Based on LPA's observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 1, Article 7, 80087(a) Buildings and Grounds are being cited on the attached LIC 9099D. Regarding the allegation, "Staff are not safeguarding residents' belongings", a youth, C3, stated their belongings were placed outside including a laptop, clothing, two backpacks and brushes, due to head lice and were unable to be accessed for a week or two. Three staff corroborated that these belongings were placed outside for this reason. A laptop requires being secured to be safeguarded. Record review of program statement indicates that belongings not in youth's possession are stored in the garage. Based on LPA's observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 1, Article 3 Safeguards for Cash Resources, Personal Property and Valuables of Residents are being cited on the attached LIC 9099D. An exit interview was conducted. A copy of all reports and appeal rights were provided to the facility. Regarding the allegation, "A youth displayed inappropriate sexual behavior in front of another youth", two clients declined to be interviewed. Six of six staff interviewed stated they were unaware of any youth masturbating in front of another youth in the home. Therefore, due to clients' refusal to be interviewed, it is not possible to determine whether the allegation occurred or not. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the allegation is unsubstantiated. An exit interview was conducted. A copy of all reports and appeal rights were provided to the facility.

Investigation Findings:
13Licensing Program Analyst (LPA) Chad Cabigon arrived at the agency to conduct an unannounced complaint investigation inspection on 02/06/2025 at 4: PM. LPA Cabigon spoke with Danielle Chan, Engagement Social Work Supervisor, to discuss the findings of the complaint investigation and allegations stated above. LPA Connie Goldie conducted this investigation. The initial 10-day complaint investigation inspection was conducted by LPA Connie Goldie at the facility on 10/24/2024. LPA conducted a Health and Safety inspection and conducted four staff interviews. LPA completed a record review of work requests submitted to facility managers, program statement and intake paperwork for C1, C2, C3 and C4. During the course of the investigation, six youth interviews and six staff interviews were completed. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Chad Cabigon 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: SACRAMENTO WELCOME HOME (SWH) - CHICAGO HOUSEFACILITY NUMBER: VISIT DATE: 02/06/2025

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

met_with: Danielle Chan


raw_content:
Narrative:
The Department investigated the allegation, "Youth in care are being restrained by untrained staff." Three of seven staff interviewed stated they have utilized "bear hugs" described as "open arms wrapped around a youth" and going underneath the arm of a youth and giving them a hug" when youth are unsafe. An additional staff disclosed that they have observed staff give youth "bear hugs" in the name of self-defense and another staff stated that "bear hugs" were taught in a self- defense class. Record review of training log did not indicate a self-defense course. A youth also disclosed witnessing a staff put hands on a youth forcefully to move them. Based on LPA's observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be substantiated. California Code of Regulations, Title 22, Division 6, Chapter 5, Article 8, Emergency Intervention Staff Training 84365(a) are being cited on the attached LIC 9099D." Administrator, Alicia Wasklewicz, provided the plan of correction via telephone for this citation. An exit interview was conducted. A copy of all reports and appeal rights were provided to the facility. The Department investigated the allegation, "Reporting requirements are not being met." It was alleged that reporting requirements are not being met in relation to restraints not being documented and submitted to the department. Staff interviewed stated that they understand the procedure and that it is a mandatory part of their job to report any restraints that occur during the staff member's shift. Six out of seven interviews reported that all incidents of restraints had been documented and submitted timely to the department. LPA reviewed records and not all staff have completed the incident reporting training. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated." An exit interview was conducted. A copy of all reports and appeal rights were provided to the facility.

Investigation Findings:
13Licensing Program Analyst (LPA) Connie Goldie arrived at the facility to conduct an unannounced complaint investigation inspection on 04/07/2025 at 02: PM. LPA Goldie spoke with Esteban Baul, Facility Manager to discuss the findings of the complaint investigation and allegation stated above. LPA Connie Goldie conducted this investigation. The initial 10-day complaint investigation inspection was conducted by LPAs Connie Goldie and Tina Thorn at the facility on 01/14/2025. LPA Thorn conducted a Health and Safety inspection and conducted four staff interviews. LPA Goldie completed a record review of staff schedules and youth rosters for November and December 2024. During the course of the investigation, eleven confidential interviews were completed. Continued on LIC9099C SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Connie Goldie 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: SACRAMENTO WELCOME HOME (SWH) - CHICAGO HOUSEFACILITY NUMBER: VISIT DATE: 04/07/2025

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

met_with: Esteban Baul, Facility Manager


raw_content:
Narrative:
page LIC The Department investigated the allegation, "Staff did not provide adequate supervision to ensure safety of youth." All interviewed youth admitted to being exposed to vaping and/or marijuana use in the facility. There was also substantial corroboration through obtained statements that youth were exposed to, or possibly even recruited for, CSEC (Commercially Sexually Exploited Children) activities. Staff interviewed stated they communicate with youth about safety and making healthy choices and provide harm reduction strategies when youth are determined to participate in unsafe activities. Upon observation of drug use, staff attempt to confiscate contraband. There was not enough evidence to clearly and directly attribute these instances to a lack of supervision on the part of facility staff. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated." An exit interview was conducted. A copy of all reports and appeal rights were discussed and provided to the facility.

Investigation Findings:
13Licensing Program Analyst (LPA) Connie Goldie arrived at shelter to conduct an unannounced complaint investigation inspection on 04/25/2025 at 03: PM. LPA Goldie spoke with Danielle Chan, Engagement Supervisor and Michael Gilbert, Facility Manager to discuss the findings of the complaint investigation and allegation stated above. The initial 10-day complaint investigation inspection was conducted by LPA Chad Cabigon on 02/06/2025. At the shelter, LPA Cabigon obtained the following documentation: PMIs (Placement Matching Information), Youth Intake Screening Tools, Health & Education Passports, Daily Progress Logs, and a youth's Care & Goal Plan as well as a Safety Plan. During the investigation, eighteen confidential interviews were conducted between 02/06/2025 and 04/17/2025. Continued on LIC9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Connie Goldie 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: SACRAMENTO WELCOME HOME (SWH) - CHICAGO HOUSEFACILITY NUMBER: VISIT DATE: 04/25/2025

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

met_with: Danielle Chan, Engagement Supervisor Michael Gilbert, Facility Manager


raw_content:
Narrative:
Regarding the allegation, "Staff did not ensure that the facility was free of pest in a timely manner," seven of nine confidential interviews stated that pest concerns were not initially handled efficiently. Record review of documentation indicates C1 and C2 were treated for bug bites on 01/01/2025 and 1/10/2025. After learning a potential bed bug exposure occurred on 01/02/2025, staff did look for evidence of bugs present but did not observe presence of pests. According to documentation, staff did not take preventative steps until 01/10/2025 after another child received bites. On 01/12/2025, Orkin Pest Control was contacted and observed the presence of bed bugs and beetles on 01/13/2025 and the youth were evacuated the same day to another location. The shelter was fumigated. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 & Chapter 1, 800879(a)(1) Buildings and Grounds are being cited on the attached LIC 9099D." An exit interview was conducted. A copy of all reports and appeal rights were provided to the facility. The Department investigated the allegation, "Staff are providing unnecessary searches of minors." Five of nine confidential interviews stated inventory checks are requested but, youth can refuse to comply. Two of nine interviewed stated youth are not allowed inside until an inventory check is completed. Due to inconsistent statements made corroboration was unable to be reached. Regarding allegation "Staff did not safeguard belongings" it was alleged that a youth's belongings were placed outside in trash bags that were not fully closed, leaving them exposed to the elements and damp conditions. Confidential interviews did not corroborate that this occurred. One of six youth interviewed stated their stuff was put outside but, then taken by a staff to have professionally cleaned. Another stated that they didn't know what was done with their stuff and a third stated staff placed their belongings in a bag in the garage. One of five staff stated clothing was laundered professionally the day youth vacated the home so it could be treated. The Department investigated the allegation, "Facility's washer is in disrepair." Two of nine confidential interviews stated washing machine was broken In January. One interviewee stated it was broken for 2-3 weeks in January 2025. One stated they were unsure if washer was broken. It was stated that a laundering service picked up laundry while the washer was out of service once a week. It is unknown if a request was made for repair of the washing machine prior to 01/10/2025. Based on record review, the washing machine was reported to be broken on 01/10/2025 and a new one was ordered the same day and delivered to the facility on 01/14/2025. Although these allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated." An exit interview was conducted. A copy of all reports and appeal rights were provided to the facility.

Investigation Findings:
13Licensing Program Analyst (LPA) Connie Goldie arrived at the facility to conduct an unannounced complaint investigation inspection on 04/25/2025 at 04: PM. LPA Goldie spoke with Danielle Chan, Engagement Supervisor and Michael Gilbert, Facility Manager to discuss the findings of the complaint investigation and allegation stated above. LPA Connie Goldie conducted this investigation. The initial 10-day complaint investigation inspection was conducted by LPAs Connie Goldie and Tina Thorn at the facility on 01/14/2025. LPA Thorn conducted a Health and Safety inspection and conducted four staff interviews. LPA Goldie completed a record review of staff schedules and youth rosters for November and December 2024, and medical report for C1. During the course of the investigation, ten confidential interviews were completed. Continued on LIC9099C SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Connie Goldie 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: SACRAMENTO WELCOME HOME (SWH) - CHICAGO HOUSEFACILITY NUMBER: VISIT DATE: 04/25/2025

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


raw_content:
Narrative:
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. An exit interview and appeal rights were discussed with Danielle Chan, Engagement Supervisor. A copy of this report along with the appeal rights were given to the facility.

Investigation Findings:
13On May 21, 2025, at 09: AM, Licensing Program Analyst (LPA) Michelle Silvas arrived at Sacramento Welcome Home - Chicago House, to deliver the findings of the allegations listed above. LPA met with Danielle Chan, Engagement Supervisor, who assisted with today's inspection. LPA conducted a walkthrough of the facility inside and out. 3 staff and 2 youth are present. LPA conducted the initial 10-day complaint investigation at the facility on February 12, 2025. LPA conducted nine confidential interviews between 2/12/25 - 5/5/25. It was alleged that a staff member has given a youth a "wedgie", made fun of a youth's confidential information and shared it with other youth in the home and has tried to initiate a fight with a youth. Eight out of nine confidential interviews stated that they have never seen a staff member give a wedgie to a youth in care. Nine out of nine confidential interviews stated that they have never observed a staff member try to initiate a fight with a youth in care. Eight out of nine confidential interview stated that they have not observed a staff member share a youth's confidential information with other youth in the home. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Michelle Silvas 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: SACRAMENTO WELCOME HOME (SWH) - CHICAGO HOUSEFACILITY NUMBER: VISIT DATE: 05/21/2025

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

met_with: Danielle Chan, Engagement Supervisor


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Tamara Hill conducted an initial complaint inspection on 7/8/25 at 9: AM and met with Alicia Wasklewicz, Program Manager. LPA Hill discussed the complaint allegation with Ms. Wasklewicz, and it was discussed that C1 (see LIC811 dated 7/8/25) arrived at the facility on 6/11/25 and due to overcapacity, there were no bedrooms available so C1 was placed in the living room to sleep from 6/11/25 through 6/16/25. Ms. Wasklewicz did acknowledge that C1 was not provided a bedroom during these days. As a result of the complaint allegation and interview conducted with Ms. Wasklewicz, the allegation that client was not provided appropriate bedroom accommodations is SUBSTANTIATED meaning the "preponderance of the evidence" standard has been met. The facility was cited for violation of Group Home Regulation, Section 84087(b)(4) Buildings and Grounds as no room commonly used for other purposes shall be used as a bedroom and it was observed that C1 slept in the living room for the days indicated. Exit interview was conducted and documentation was provided to the facility, along with appeal rights. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Tamara Jensen-Hill 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: SACRAMENTO WELCOME HOME (SWH) - CHICAGO HOUSEFACILITY NUMBER: 347006592

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

met_with: Alicia Wasklewicz, Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 06/14/ Licensing Program Analyst (LPA) Chad Cabigon was given a tour of the prospective Temporary Shelter Care Facility grounds; the following were observed: -# of bedrooms: 3 for clients, 1 room to be utilized as staff office -# of bathrooms: 3.5 -bodies of water: none -furnishings: full -notable health & safety concerns: none

met_with: Cathi Johnson, County of Sacramento Division Manager; Alondra Neira, Program Planner


summary: Facility Evaluation

raw_content:
Narrative:
On 04/08/ Licensing Program Analyst (LPA) Chad Cabigon conducted a Prelicensing Inspection at this location as part of the licensure process for a Temporary Shelter Care Facility (TSCF). LPA met with County of Sacramento Division Manager Cathi Johnson. LPA was given a tour of the interior and exterior areas of the facility's physical plant. The facility has three client bedrooms with each room having two beds; the bedrooms contained the required bedding and furniture which were observed to be in good repair; sufficient storage/drawer space for clients' personal belongings was also observed. There is one common or shared full bathroom in the hallway that leads to the bedrooms. There was a carbon monoxide detector observed in the hallways. There is an additional ensuite full bathroom in one of the client bedrooms. All the bathrooms were generally in good repair, with toilets that flushed and fixtures that provided hot water. The temperature in spaces/rooms that clients occupy was within the required range. There are multiple refrigerators and/or freezer units all observed to be in good working condition and provided temperatures within the required range for perishable items. There is also sufficient storage space for dried goods or non-perishable items. The facility currently has a sufficient amount of perishable and non-perishable food items for at least three days and one week, respectively. Also observed within a secured staff office off the hallways were lockable cabinets for confidential files and medications. Most of the potentially hazardous cleaning agents and chemicals were stored appropriately in a secured cabinet. The backyard was found to not have any potentially hazardous areas or items; the pathways are unobstructed. The following items will need to be addressed for the issuance of the provisional license: two of the three bedrooms did not have smoke detectors; there was an exposed light socket in the ensuite bathroom of one of the bedrooms; cleaning agents/chemicals were found readily accessible under the kitchen sink; there was no posted weekly food menu; the hallway bathroom sink's water temperature was 134 degrees F; there needs to be a separate log for each psychotropic medication being administered; the facility also needs to post the Foster Youth Bill of Rights in a conspicuous location.. A copy of this report is being provided to Ms. Johnson.

met_with: Cathi Johnson, Division Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 04/17/ CDSS (California Department of Social Services) and the County of Sacramento DCFAS (Department of Child, Family and Adult Services) held a virtual meeting on the Microsoft Teams platform. The attendees were, from the County, Melissa Lloyd and Cathi Johnson, and from DSS, Margo Castaneda, Ashley Bray, Alicia Bernstein, Rosa Rodriguez, Kayla Haith, Chadwyck Moore, and Chad Cabigon. The following items were discussed: -County to continue sending daily reports to CFSD (Children and Family Services Division) listing children staying at this location and their demographic information. -special incident reporting: County to submit reports for previously unreported unusual incidents at this, and any other, location since the start of residential operations; C. Johnson has commenced sending incident reports to C. Cabigon as of 04/05/2024. -LIC 200 (Application for a Community Care Facility): County to clarify/revise as needed item # 11 on form to reflect Program Statement narrative language addressing the age range of children to be accepted by the facility. -C. Johnson discussed possibility that County may need to update Plan of Operation/Program Statement to include provisions for the care of children under six years of age should outside TSCF providers not meet programmatic regulatory requirements allowing the admission of this age group. -continuing collaboration between County and CDSS via quality improvement evaluations, technical assistance calls, and ETCFT (Expedited Transition Child and Family Team) meetings discussed by A. Bray; feedback provided by C. Johnson on these processes. -updates on capacity building efforts are being given by County during recurring calls between CDSS and County of Sacramento.

met_with: Melissa Lloyd; Cathi Johnson


summary: Facility Evaluation

raw_content:
Narrative:
On 04/26/ Licensing Program Analyst (LPA) Chad Cabigon conducted an unannounced inspection of this pending TSCF (Temporary Shelter Care Facility) in response to reported operational concerns. LPA met with Engagement Social Worker Michael Gilbert who facilitated a tour of the physical plant; Mr. Gilbert also facilitated LPA interviews with two clients--Mr. Gilbert, himself, was interviewed by LPA regarding designated rooms/spaces being, or may be, utilized by youth for meetings (CFTs, etc.) or other other purposes that could require privacy. LPA inspected the House's stock of food items. Further inspection may be required; a copy of this report is being provided to the County of Sacramento.

met_with: Michael Gilbert


summary: Facility Evaluation

raw_content:
Narrative:
On 05/24/ Licensing Program Analyst (LPA) Chad Cabigon conducted a second prelicensing inspection of this facility and was met by Division Manager Cathi Johnson and Admin. Services Officer Hazel Magett. A tour of the facility was conducted with focus on items/areas that needed to be addressed during the last prelicensing inspection, namely: 1) the clients, for their bedrooms, have been offered roll-out bins for clothing and personal belongings that can be stowed under the beds, 2) warning signs have been prominently displayed by fixtures that delivered water above the temperature limit set by Regulations (one in the hallway bathroom by the client bedrooms and one in the restroom by the entrance to the garage), 3) the curtain rods in all of the client bedrooms were observed to be secured, 4) one smoke detector in a client bedroom was missing--a youth who occupied that bedroom stated that they (the client) had taken it out the night before, and 5) the light fixture in the master bedroom en-suite bathroom has been fixed. No other deficiencies were observed during this inspection. A copy of this report is being provided to the County of Sacramento.

met_with: Cathi Johnson, Hazel Magett


summary: Facility Evaluation

raw_content:
Narrative:
On 08/07/2024, at 09: AM, Regional Manager, (RM) Margo Cataneda, Licensing Program Manager , Jodean Hall and Licensing Program Analyst (LPA) Connie Goldie met with Engagement Social Worker-acting supervisor Esteban Baul to continue an unannounced Post Licensing Inspection. Mr. Baul stated that four staff and three clients are currently in the facility. A security guard was also present. A walk through of the facility and grounds was completed. Four outside cameras were observed pointing away from home. LPA requested Esteban Baul to obtain staff files in order to conduct file review of staff files for S1, S2, S3, S4 and S5 as they are not located on site. LPM spoke with Veronica Curillo, Program Manager to request staff files and they were unable to provide. Background clearances of staff present were verified. LPA Goldie conducted a medication review. Medication Administration Records (MAR's) were observed, policies and procedures were discussed, and medication counts were conducted. LPM Hall conducted three staff interviews, S4, S5, S6, and 1 client interview C3. RM conducted a record review of three children's files. Reporting Requirement documents observed included the Daily Log and Missing Person Reports. A follow up visit is needed to complete this Post licensing Inspection. RM, LPM and LPA conducted exit interview with Esteban Baul at 1: PM. A copy of this report was left at the facility.

met_with: Esteban Baul


summary: Facility Evaluation

raw_content:
Narrative:
On 09/10/2024, at 11: AM, Regional Manager, Margo Castaneda, Licensing Program Managers, (LPMs) Jodean Hall, Hillary Hall, and Rosa Rodriguez and Licensing Program Analysts, (LPAs) Connie Goldie, Tina Thorn and Chad Cabigon conducted an in-person Office Meeting. Present from Sacramento County's Chicago House, Pasadena and Hilltop/Madison Temporary Shelter Care Facility Homes is Cathy Johnson, Division Manger, Alondra Neira, Program Planner, CPS, Veronica Carrillo, Program Manager, CPSU, Tashna Ward, Program Manager Alicia Wasklewicz, CPS Planner. Present from Systems of Care is Ashley Bray, Staff Services Manager II and Kayla Haith, Health Program Specialist II. The purpose of the meeting is to discuss CCL's concern regarding issues around the non-compliance in the facilities and to collaborate and problem solve together for the success of the programs. The primary areas of concern discussed, and outcomes provided include the following: ·Administrator/ Designation of Authority o It was discussed that a qualified administrator shall be on the premises for the number of hours necessary to manage and administer the facility in compliance with applicable laws and regulations. There needs to be someone readily available for the responsibilities and over site of all three facilities. There also needs to be staff designated to act on the administrator's behalf in the overall management of the facility when the administrator is not at the facility. These designees also need to be able to provide plan of corrections on site during an inspection. o CCL requested a written plan by 9/25/2024. Continued on LIC809C · Reporting Requirements o CCL is receiving 24-hour notifications as required but, the full reports continue to be received past the regulatory requirement of seven days following the incident. o County staff communicated that they have streamlined the approval process to become compliant with full report. o CCL requested a written plan by 9/25/2024. · Training opportunities o CCL identified training concerns in the following areas: emergency intervention procedures, personal rights, medication, and job descriptions. o CCL offered training support by CCL staff and the Ombudsperson office. · Services Provided o Child specific services, Intake Assessment, CFT's and community resources are some of the services being provided. o Further collaboration will be ongoing. · Additional items discussed: o CCL suggested that a copy of Title 22 regulations, the Program Statement and a copy of the policies and procedures be located at the facility and available to staff. o The County shared that they are in the process of creating an employee handbook. o Administrator shared that two additional supervisors are being added which will provide supervision in the homes for all shifts. Written plans shall be submitted by email to all CCL attendees. A copy of this report was emailed to Cathy Johnson, Division Manager for signature.

met_with: Cathy Johnson Division Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 10/08/ Community Care Licensing (CCL) and the County of Sacramento held the monthly Sacramento Welcome Home (SWH) TSCF (Temporary Shelter Care Facility) collaborative meeting over Microsoft Teams. In attendance were Cathi Johnson, Ali Neira, Alicia Wasklewics, and Tashna Ward from the County and, from CCL, Rosa Rodriguez, Jodean Hall, Hillary Hall, Connie Goldie, and Chad Cabigon. After introductions, the following was covered: CCL acknowledged and thanked the County for the submission of its Written Plan, received by CCL on 09/25/2024, in response to the items covered during the first collaborative meeting held on 09/10/2024. The County has since assigned two new program supervisors to the SWH locations and is looking to fill a third supervisor position pending the Sacramento County Board of Supervisors' approval which is expected to pass on 11/05/2024, bringing the total number of program supervisors to five (currently, there are four). Regarding the plan to re-designate an administrator, it was noted that Alicia Wasklewics is set to go through the administrator training/certification at the end of this month (October, 2024). CCL clarified that the required facility manager designation is specific to each shift per House/location when children are present. Being that there are only four supervisors covering all the Houses, there are times when no supervisor is available at a given location. The County stated that they have implemented an assigned Worker of the Day or "WOD" to cover those locations and/or times when a program supervisor is not available. CCL requested that on the schedules (on the LIC 500 or Personnel Report) it is specified who the WODs and supervisors are and that those designated are spelled out as 'facility managers', that all other CCL-required positions are spelled out (including, for example, Administrator) under the "Job Title," and that an updated form be submitted for each location by October 31, 2024. The County stated that some of the limitation(s) in properly reflecting these positions may be due to the need to have it cleared by the staff's union beforehand and that, relatedly, the same constraint(s) may be affecting the finalizing of job duty statements for care staff to acknowledge. (, 809-c) (PAGE 2) Also discussed were the missing full or seven-day reports which are the follow-up reports to the County's 24-hour notifications. Per the County, management is paying close attention to the October reports to ensure compliance: the 24-hour reports are being done in a timely manner but the intermediate step involving a supervisor de-brief is where the reports are getting held up. The County are actively working on a pilot program set to start at the end of November or the beginning of December, 2024, which is meant to help track reports through a more automated system. It is CCL's expectation that the outstanding full or seven-day reports for previously-submitted 24-hour notifications (for September, 2024) will also be submitted to CCL by October 31, 2024-the number of missing full or seven-day reports are as follows: Pasadena House - 11; Madison - 27, and Chicago - 10 (for a total of 48). It is also CCL's expectation that an immediate correction plan be put in place to be in compliance with Title Regulations. Regarding training requirements-specifically, Section 84065(i)(1)(D) which discusses the need for an assessment of the efficacy of training-CCL noted, based on interviews, that direct-care staff may not have a sufficient understanding of the training topics covered despite having received the training. CCL advised that post-testing or return demonstrations to assess for competency may be developed by the County, themselves, so long as those assessments are documented in each staffer's file. The County stated that management will check-in with the supervisors about this protocol and also added that the supervisors do meet with their staff every month, are probably doing at least some type of performance evaluations, and that they may just need to do better at documenting. CCL is requesting an implementation plan to be compliant with Title Regulations, and that this plan should be submitted by October 31, 2024. Additional training support: CCL advised that the Ombudsperson's Office only provides training on the Foster Youth Bill of Rights but not on anything more specific like medications, for example. CCL provided the Ombudsperson's Office portal and link to sign up for Bill of Rights training. The County asked if CCL, apart from the Ombudsperson's Office, provides more topic-specific training-CCL advised that it does and that this training will be scheduled for the County by the end of November or the beginning of December, 2024. On the SWH Program Statement being made accessible to staff: the County stated that they are still working on the employee handbook-along with this process the care staff have been given electronic access to the Title 22/Interim Licensing Standards (ILS) Regulations digitally and parts of the Program Statement on which staff get trained. (, 809-c) (PAGE 3) Regarding the POC for the Personal Rights citation on the Chicago House on inventory check/searches. The POC was submitted to CCL on 10/03/2024, this procedure is still under review by CCL. Regarding the POC for the Personal Rights citation on the Madison House, the County will check on the progress of training for staff which is expected to be completed by 10/11/2024. Regarding the POC for the overcapacity citation on the Pasadena House, this POC was submitted to CCL on 10/02/2024 and is still under review. A copy of this report is being emailed to the County for signature.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/24/2024 at 10: AM, Licensing Program Analyst (LPA) Connie Goldie, conducted a case management inspection at the facility. The purpose of the inspection was to inquire about incident that was reported to the Department on 10/15/2024 and occurred on 09/21/2024. LPA met with LaShon Tate, Supervisor who helped facilitate the inspection. 2 residents, and 4 staff are present in the facility. LPA completed a walk through of the facility inside and outside. LPA conducted one staff interview. Further follow-up is required to resolve case management. LPA Goldie provided a copy of report to facility staff. Document signed by Engagement Social Worker Karla Garcia-Maldonado..

met_with: La Shon Tate Supervisor


summary: Facility Evaluation

raw_content:
Narrative:
On 12/18/2024, at 11: AM, Licensing Program Analyst (LPA) Connie Goldie conducted an unannounced case management inspection at the facility. The purpose of the inspection was to inquire about a concern that was reported to the Department on 12/03/2024. LPA met with Ka Xiong, Facility Manager who helped facilitate the inspection. Five staff and four clients are present in the facility. LPA conducted a walk through of the facility inside and outside. LPA conducted one staff interview. LPA requested staff schedule for November 2024 and staff contact phone numbers. Further follow-up is required to resolve this case management. LPA Goldie provided a copy of report to Ka Xiong, Facility Manager.


summary: Facility Evaluation

raw_content:
Narrative:
On 01/08/2025, at 1: PM, Licensing Program Analyst (LPA) Connie Goldie conducted an unannounced case management inspection at the facility. The purpose of the inspection was to inquire about an incident that was reported to the Department on 12/24/2024. LPA met with Ka Xiong, Facility Manager who helped facilitate the inspection. Five staff and one client are present in the facility. Gloria Hancox, Child Development Specialist, assisted LPA with a walk through of the facility inside and outside. LPA conducted two staff interviews. LPA obtained medical documentation for incident that occurred on 12/16/2024.. Further follow-up is required to resolve this case management. LPA Goldie provided a copy of report to Guillermo Torres, Facility Manager.

met_with: Ka Xiong, Facility Manager Guillermo Torres, Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 01/08/2025, at 4: PM, Licensing Program Analyst (LPA) Connie Goldie conducted an unannounced case management inspection at the facility. The purpose of the inspection was to inquire about an incident that was reported to the Department on 12/26/2024 and occurred on 12/24/2024. LPA met with Guillermo Torres, Facility Manager who helped facilitate the inspection. Four staff and two clients are present in the facility. Gloria Hancox, Child Development Specialist, assisted LPA with a walk through of the facility inside and outside. LPA conducted three staff interviews. LPA received staff schedule for 12/24/ PM shift. Further follow-up is required to resolve this case management. LPA Goldie provided a copy of report to Guillermo Torres, Facility Manager.

met_with: Guillermo Torres, Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 01/14/2025 the CA Department of Social Services' (CDSS) Community Care Licensing Division (CCL) and the County of Sacramento held the monthly collaborative meeting over Microsoft Teams. The attendees were: from County, Cathi Johnson, Alondra Neira, Tashna Ward, Alicia Wasklewicz, and Veronica Carrillo, from CCL, Margo Castaneda, Jodean Hall, Rosa Rodriguez, Hillary Hall, Connie Goldie, Tina Thorn, Chad Cabigon, and from CDSS' System of Care Branch (SOC), Kelley Hartman, Levi Huser, and Alicia Bernstein. Topics discussed at the meeting were: What's working well: The County expressed having two TSCF's is much more manageable. They have also had a lower census on average as of late between the Welcome Home locations which has been helped by the recent capacity expansion through outside partners. Temporary move from Chicago House to Pasadena House: Due to an infestation of carpet beetles the facility is being fumigated. Designated Administrator: CCL noted that Alicia Wasklewicz passed the Administrator Exam; County was informed that Regional Manager (RM) Castaneda requested the expedited processing of Ms. Wasklewicz's administrator certification. CCL reiterated expectations for a facility administrator: to be on facility premises for the number of hours necessary to manage and administer the facility in compliance with applicable laws and regulations, and to be readily available for the responsibilities and oversight of the facilities. CCL also reiterated the need for staff to be designated to act on the administrator's behalf with the overall management of facilities in the administrator's absence. CCL emphasized that these designees also need to be able to provide Plans of Correction for citations issued during inspections-County confirmed that these facility manager designees have been given this authority. (, 809-c) (PAGE 2) Plan for Pasadena House license: The County will continue to keep the license until further notice. Training Requirements: Follow-Up: County will be sending the template for staff training. Security Guards - Fingerprint Clearance Needed: CCL advised that all security guards positioned in the home need to be fingerprinted and obtain criminal record clearances through Guardian due to the frequency, consistency, and recurring nature of their presence. The due date for the completion of fingerprinting is 01/31/2025. Reporting Requirement Update - Incident Reporting CCL discussed the continued issue of late and/or missing reports and acknowledged it is vastly improving. County stated that they are continuing to address this and with Ms. Wasklewicz as administrator, her presence in the Houses more frequently should help address the reporting. The County also expects to start testing the SMILE system this week with the goal of launching in the end of February. Inventory Check/Searches: CCL followed up on the submission of the County's Prudent Parenting activation form related to searches for CCL to review. The County will be submitting the form. CCL/SOC pointed out that Prudent Parenting is usually in reference to decisions that a substitute caregiver makes to afford youth something that resembles a more "normal" way of life such as allowing youth to participate in certain activities without prior approval from their authorized representative. SOC discussed that the Prudent Parent Standard is a general framework through which providers can respond as necessary to help support youth, but it might not always be appropriate, and its use should depend on the population and/or individual youth in question. Facility Overview: Both LPAs stated seeing an increase in engagement between youth and staff participating in various house activities. (, 809-c) (PAGE 3) Additional feedback: SOC reminded County of standing offer to provide consultation and guidance and encouraged County to reach out, as necessary. Training materials have been sent to County from SOC that may be helpful and could be integrated in the Shelter's program. County to submit Program Statement updates by 01/31/2025, to include clarification on the mandated initial vs. annual training, as well as policies and expectations related to contracted security personnel who work onsite at the SWH locations. Closing discussion on restraints: The County stated that all staff will start Phase 2 of the TCI training in February, 2025, and that they anticipate completion in March, 2025. CCL advised that a manual restraint should only be executed by a trained staff and should only be resorted to in a health and safety consideration for a child or staff, that it is more about good training that truly helps staff be proactive with early interventions, how to identify early on what the specific youth' triggers are, and how staff can equip themselves with enough techniques to de-escalate a situation. Additionally, it should also be helpful for the County to be familiar with the temperament and tendencies of their direct-care personnel so as to better inform management on staffing decisions and training considerations. A copy of this report is being provided to the County of Sacramento.

met_with: Catherine Johnson et al.