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Narrative:
Regarding the allegation that staff is not properly trained, it was specified that a staff was never trained from January to June 2022 and was often with clients and didn't know how to do anything for them. During investigation, confidential interview stated that staff received a minimal training. It was added that staff was only given a computer training, commercial sexual exploitation of children (CSEC) training, incident report training, and trauma informed care training. Another confidential interview indicated that staff stated they went through orientation with a group of new hires and received training on how to fill out documentation but was not provided 24-hour required training prior to working with the clients. Confidential interviews stated client thought that staff were good at interacting with clients but did not know how long staff had to train prior to supervising clients at the facility. LPAs were not available to receive documentation showing that the required training's were completed during inspection. Based on confidential interviews and record review the allegation that staff is not properly trained is substantiated. The preponderance of evidence standard has been met. Facility is cited for violation of Interim Licensing Standards (ILS) standard 87065. Supervision, Evaluation and Training Requirements (c)(2). The training plan shall address the initial 24-hour training for newly hired direct care staff. An exit interview was conducted, and a copy of this report along with the appeal right were provided to facility representative. Regarding the allegation that the facility drills are not being conducted, it was specifically alleged that the facility didn't conduct fire drills and had no logs. During investigation, confidential interview stated that fire drills were conducted and logged in a logbook in the staff office. Confidential interviews indicated that a fire drill was conducted when they were present at the facility. It was added that they did not know how often drills were conducted or if they were documented. Confidential interviews stated that the facility conducted a fire drill and all clients and staff went to the field during the drill. However, LPA received a conflicting information and LPAs observed the fire drills log was documented ahead and it was inconsistent. In regard to the allegation that residents are not being provided activities, it was specifically alleged that the clients don't get to do any activities. Confidential interviews disclosed that clients are provided with activities but could not provide a written plan for activities. Confidential interviews stated that clients were taken to movies and dinners, but she had not seen if they were documented. Confidential interviews stated that they did get taken out on outings like the movies and the carnival. It was added that they had water balloon fights and other activities around the facility. Based on confidential interviews, the allegations that facility drills were not being conducted and clients were not being provided activities, may have happened or valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, these allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with the appeal right were reviewed and provided to facility representative.

Investigation Findings:
13On February 08, 2023, Licensing Program Analyst (LPA) Rafael Enriquez arrived at Creekside Short Term Therapeutic Program (STRTP) and met with Program Supervisor- Elizabeth Pryer to discuss the finding for the allegation stated above involving the STRTP staff and clients (C1, C2) as listed on the Confidential Names List (LIC 811) dated February 08, 2023. On June 24, 2022, Community Care Licensing (CCL) received a complaint alleging that staff is not properly trained. On June 30, 2022, at 9: AM, LPA Almaraz initiated the investigation at the STRTP and obtained documents from the files and conducted a safety inspection. There were no immediate hazards observed. LPA conducted interviews for S1, S2, S3 & C1. On January 27, 2023, LPA Enriquez interviewed C2 at a collateral visit at the STRTP. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Rafael Enriquez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: CREEKSIDE STRTPFACILITY NUMBER: VISIT DATE: 02/09/2023

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: Program Supervisor- Elizabeth Pryer


state: CA

facility_name: CREEKSIDE STRTP

summary: Complaint Investigation - Unsubstantiated

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Narrative:
On October 04, 2023, at 02: PM, LPA Enriquez initiated the investigation at the STRTP and obtained documents from the files, conducted a safety inspection, and interviewed S1, S2, S3, C2 and C3. There were no immediate hazards observed. On December 28, 2023, LPA Enriquez attempted to conduct collateral interviews for C1, C5 and C6 but clients refused to speak to LPA. Regarding the allegation that staff do not ensure the facility has active smoke detectors, it was specifically alleged that the house has missing smoke detectors. During LPA's safety inspection smoke detectors were observed. Confidential interviews stated that the house did have smoke detectors. C1, C5 and C6 refused to be interviewed. LPA unable to gather additional information. In regard to the allegation that staff have not repaired the minor's beds while in care, it was specifically alleged that the children's beds look unsafe like they're breaking. During LPA's safety inspection client's beds looked safe and felt sturdy. Confidential interviews stated that the beds work properly and are comfortable. C1, C3, C5 and C6 refused to be interviewed. LPA unable to gather additional information. Concerning the allegation that staff are not meeting the mental health needs of the minors while in care, it was specified alleged that the mental health team is basically nonexistent. Confidential interviews stated that clients see an in-house therapist twice a week and an outside behavioral health therapist twice a week. C1, C3, C5 and C6 refused to be interviewed. LPA unable to gather additional information. Based on confidential interviews, the allegations that staff do not ensure the facility has active smoke detectors, staff have not repaired the minor's beds while in care and that staff are not meeting the mental health needs of the minors while in care may have occurred, however, there was not a preponderance of evidence to support or deny the allegations. Therefore, the above allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with the appeal right were reviewed and provided to facility representative.

Investigation Findings:
13On January 11, 2024, Licensing Program Analyst (LPA) Rafael Enriquez arrived at Creekside Short Term Residential Therapeutic Program (STRTP) and met with Program Supervisor Elizabeth Pryer to deliver the finding for the allegations stated above involving the STRTP staff and Client #1 (C1), Client #2 (C2), Client #3 (C3), Client #4 (C4), Client #5 (C5), Client #6 (C6), as listed on the Confidential Names List (LIC 811) dated January 11, 2024. On September 26, 2023, Community Care Licensing (CCL) received a complaint alleging that staff do not ensure the facility has active smoke detectors, staff have not repaired the minor's beds while in care and staff are not meeting the mental health needs of the minors while in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Rafael Enriquez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: CREEKSIDE STRTPFACILITY NUMBER: VISIT DATE: 01/11/2024

report_type: Complaint Investigation

met_with: Program Supervisor Elizabeth Pryer

complaint_status: unsubstantiated


raw_content:
Narrative:
On November 21, 2023, at 09: AM, LPA Enriquez initiated the investigation at the STRTP and obtained documents from the files, conducted a safety inspection, no interviews were conducted. There were no immediate hazards observed. On December 28, 2023, LPA Enriquez interviewed S1, S2 and attempted to conduct collateral interviews for C1, C2, C3, C4 and C5 but clients refused to speak to LPA. Regarding the allegation that staff did not ensure there was adequate amounts of food available at the facility for minors in care, it was specifically alleged that there were less than 10 times item in the fridge. Confidential interviews stated that there is enough food in the home. It was added that staff shop every Monday and will go to the store within the week if something runs out. C1, C2, C3, C4 and C5 refused to be interviewed. LPA unable to gather additional information. In regard to the allegation that staff did not ensure proper toiletries were available at the facility for minors in care, it was specifically alleged that the facility does not have hair care products for black children or feminine hygiene products. Confidential interviews stated that the clients are provided toiletries and feminine hygiene products. It was added that clients are taken to get their hair done professionally and get the products they need for their hair from the establishment. C1, C3, C5 and C6 refused to be interviewed. LPA unable to gather additional information. Based on confidential interviews, the allegations that staff did not ensure there was adequate amounts of food available at the facility for C1, C2, C3, C4, C5, and C6 in care and staff did not ensure proper toiletries were available at the facility for C1, C2, C3, C4, C5, and C6 in care may have occurred, however, there was not a preponderance of evidence to support or deny the allegations. Therefore, the above allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with the appeal right were reviewed and provided to facility representative.

Investigation Findings:
13On January 11, 2024, Licensing Program Analyst (LPA) Rafael Enriquez arrived at Creekside Short Term Residential Therapeutic Program (STRTP) and met with Program Supervisor Elizabeth Pryer to deliver the findings for the allegations stated above involving the STRTP staff and Client #1 (C1), Client #2 (C2), Client #3 (C3), Client #4 (C4), Client #5 (C5), Client #6 (C6), as listed on the Confidential Names List (LIC 811) dated January 11, 2024. On November 13, 2023, Community Care Licensing (CCL) received a complaint alleging that staff did not ensure there was adequate amounts of food available at the facility for minors in care and staff did not ensure proper toiletries were available at the facility for minors in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Rafael Enriquez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: CREEKSIDE STRTPFACILITY NUMBER: VISIT DATE: 01/11/2024


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst's (LPAs) Rachel Vanegas and Carissa Aviles on June 05, 2025 at 09:55am. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPAs Vanegas and Aviles met with Shanikka Fields - Program Supervisor and Tiffany Williams - Residential Treatment Counselor, and inspected the facility inside and out. Program Supervisor Fields authorized Residential Treatment Counselor Williams to receive and sign this report. LPAs reviewed three of three child records and five of five staff personnel files on site at the facility. LPAs reviewed three of three child's psychotropic medications and medication records. LPAs interviewed zero of two staff on site to discuss the facilities policies and procedures of operation. LPAs interviewed two of three children currently prescribed psychotropic medication. LPAs provided a copy of this licensing report to Tiffany Williams - Residential Treatment Counselor. No deficiencies are being cited at this time. LPAs conducted and exit interview with Tiffany Williams - Residential Treatment Counselor.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Shanikka Fields - Program Supervisor Tiffany Williams - Residential Treatment Counselor


facility_name: CREEKSIDE STRTP II

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst, Daniel Mena conducted a technical assistance meeting virtually via Teams with Creekside II Short Term Residential Therapeutic Program (STRTP) CEO, Darryl Monteilh and Erin Franco. Present at the meeting was System of Care Branch Manager, Marjana Jackson and Licensing Program Manager, Nicole Strickland . The Purpose of the meeting was to discuss and review the following pending Plan of Operation (POO) and Program Statement (PS) revisions: Plan of Operation Section A. Purpose and Goals 1. Purpose on page 2 and again on page 8? Combine 2. Virginia Satir's Theories Page 5. What is that? Summarize 3. Brene Brown's Same Resilience Theory? Page Summarize 4. Page 10 not necessary in this section. Section B. Administrative Organization 1. Pg. Facility administrator duties. On page 22 not necessary if covered later on in job description forms. 2. Did not see Administrator certificate 3. Designated administrator substitute when they are absent. Did not see addressed Section C. Facility Sketched 1. Which room would be designated as the NMD room if necessary? 2. Indicate 2 clients per bedroom Section D. Staff Plan 1. Explain how the staff training plan is appropriate to meet the needs of the staff, and the population served. Page 3 of 16 2. Explain how the staff training plan will provide staff with the knowledge, skills, and support to ensure the health and safety of youth in care. 3. Please include information about how to engage members of the child's family and community, including parents, siblings, caregivers, other relatives and nonrelated extended family members, and other supportive adults consistent with law and any applicable court orders. 4. Please explain HOW the training plan is designed to ensure: • cultural competency and sensitivity including but not limited to best practices for providing adequate care, services, and supports for children across diverse ethnic and racial background, as well as children identifying as lesbian, gay, bisexual, transgender, or nonbinary. • Methods to behaviorally support youth are appropriate for children impacted by trauma or child abuse and neglect. • Best practices for addressing the permanence, well-being and educational needs of youth including children with disabilities. 5. The comprehensive staff training plan is missing the following: • This section mentions 40 hours of job shadowing and nothing else. Job shadowing must follow section 87065.1(d)(1)(D) and 87065.1(c)(2)(A). • Missing 8-hour training assessment. • The 16-hour training assessment mentioned does not follow section 87065.1(d)(2)(B). • Missing required training topics for Direct Care Staff and Facility Manager. • Please identify the additional 16 hours of training that new staff will complete within 12 months of being hired. • It's mentioned that 20 hours of the 40 hours of annual training will consist of work from an entity not affiliated with the STRTP. However, it is not clear what that training is. Please indicate the training topics that will be from another entity. • Missing the designated employee training related to application of reasonable and prudent parent standard. • Need 2025 updated training schedule. Section F. Administrative Policies and Procedures 1. Conflict of interest, self-dealing, segregation of duties and less-than-arms-length transactions; Page 4 of 16 2. Internal controls, including, but not limited to, financial accounting, reconciliations, financial security measures, disbursements, petty cash and financial record keeping. • Did not see this addressed Section G. Admission Determination Procedures 1. Determination procedures do not demonstrate the willingness and capacity to assess and determine the appropriateness of placement within the program, consistent with the population to be served, on an individualized basis for each child referred by the placing agency. 2. Explain in detail how the determination procedures will consider the child's needs and strengths, the likelihood that the child will benefit from the program, and the extent to which the child's needs are in common with the existing client population. 3. Determination procedures do not include an explanation of how the program will evaluate the appropriateness of placement for referred children with any of the following behaviors or characteristics, including how the licensee defines these characteristics for the purposes of assessing appropriateness of fit: • Frequent runaways • Gang-related activity • Firestarting • Sexually assaultive behaviors • History of Commercial Sexual Exploitation • Substance abuse 5. Missing a statement that the list of behaviors or characteristics (above list) shall not be utilized as the sole basis to determine the appropriateness of placement and/or deny admission. 6. Determination procedures shall specify the following: (A) The timeframe for and manner of response to referrals for placement, as set forth in ILS Section 87068.05(c)(4): • The facility shall establish timeframes for response to the county placing agency regarding referrals for placement. • The established timeframes must include, but are not limited to, an initial response period in which the facility accepts, denies, or requires more information for the consideration of the referral for placement and; Page 5 of 16 • A final response period in which the facility accepts or denies the referral for placement. • The facility's initial response period shall not exceed 5 days following the receipt of referral for placement. (B) The minimum information that is necessary for a placing agency to provide to the STRTP in order for placement to be considered. 7. Missing elevated review procedures 8. If interviews are conducted during the admission process, need to include a statement that the interview cannot be used to determine placement appropriateness or deny admission for placement. 9. Missing referral documentation process. 10. Missing procedures for when the STRTP determines that the program is not capable of meeting the youth's needs with and without additional services and/or support. 11. There's no language affirming that admission decisions will not be based on race, ethnicity, gender identity, sexual orientation, or disability, which is a required element. 12. Which staff member will be responsible for reviewing the referral? Section H. Intake Policies and Procedures 1. This section mentions Admission Determination Procedures, which should be captured in section G. This section must include intake procedures for when the youth has been accepted for nonemergency placement in the STRTP. Please remove determination procedures and keep relevant information in this section to avoid confusion. Refer to PINs attached. 2. Missing the initial crisis management assessment as set forth in ILS Section 87068.1(d), which include, but are not limited to, how the component/s of the assessment that include input from the child shall be conducted in manner that is consistent with trauma-informed practices and the requirements in ILS Section 87078.2. • Assessment provisions and input from youth and family members. • Assessment must be used to inform the emergency interventions used on that specific youth. 6. Emergency placement procedures are not complete. 7. If orientation interviews are conducted as part of intake procedures, need to provide policies and procedures that demonstrate and provide descriptions and details that the purpose of the orientation interview is to support the youth's transition into placement. Section 87068.1(f)(1) through (2). Page 6 of 16 • In this section, I did not see a statement of the policies and procedures regarding intake of children and NMDs includes procedures for medical assessment, including TB results Section I. Admission Agreement 1. Typos page 98 2. Did not see procedures for modifying the agreements. 3. Did not see written statement regarding the type(s) of emergency interventions the licensee has been approved to use in the Admission Agreement Section J. Removal or Transfer Policies and Procedures 1. Missing procedures for removal and/or transfer of children and NMDs as described in Section 87068.1: • After program goals have been reached 2. Missing procedures that include a description of how the licensee will mitigate against potential impacts to a child as a result of removal or transfer, including but not limited to how the licensee will assist in preventing delays or gaps in delivery of services, types of trauma-informed support and transition services to be provided, and best practices for staff communication with the child during the transition 3. Procedures do not ensure that children and their authorized representatives are informed of removal/transfer policies in an age and developmentally appropriate manner. 4. Need a statement that the STRTP will not transfer the youth unless prior written approval of the transfer has been obtained. 5. Missing section 87068.4(c)(1)-(2). 6. Missing section 87068.4(e)(1)(A)-(F). 7. What are the "additional community-based supports and services" that the Director shall request? 8. Since STRTP will be operating under a provisional license, the Mental Health Head of Service cannot sign the statement providing the reason for the removal request. 9. Need a statement indicating that the request for placement change will not be initiated prior to the first update of the youth's NSP. 10. Missing procedures for notifying the youth that a notice to remove them has been issued. See section 87068.4(e)(2)(E). Page 7 of 16 11. Missing emergency removal procedures (there's a brief mention, but no procedures). 12. Removal procedures for NMDs are mentioned twice and are incomplete. 13. The notice that is given to the county for when the STRTP determines it cannot meet the needs of the youth is missing provisions listed in section 87068.4(e)(2)(A)(1)-(6). Section M. Consultants and Community Resources Utilized 1. Provide a list of consultants and community resources utilized by the facility as part of its program. 2. Provide a statement regarding how the facility will engage, coordinate, and contract with the consultants and community resources, which shall include but is not limited to, tribal partners,county placing agencies, and mental health providers. Section N. Trauma-Informed Intervention and De-Escalation Techniques 1. This section is vague. While it does mention trauma-informed and evidence-based interventions, there's no mention of de-escalation techniques that will be used to promote the safety of all individuals in the facility, including but not limited to children or NMDs who have a propensity for behaviors that result in harm to self or others. The trauma-informed and evidencebased interventions must be applied to the population this STRTP intends to serve. • Only saw definitions and not how it is implemented. Did not see any de-escalation techniques, including to those with a propensity to self-harm. Section Q. Continuous Quality Improvement (CQI) 1. This section repeats the requirements for this section but does not explain HOW the requirements will be met. 2. Who is part of the QI team? 3. Does not include frequent review, documentation and if necessary adjustment of the youth's NSP. 4. Explain in detail how CQI will incorporate active inclusion and participation of staff, children/NMDs, families, and community resources, including a description of a process for getting direct input from the children, as age appropriate, to inform program development and improvement Page 8 of 16 5. Explain in detail how the CQI will adopt outcomes, indicators, and practice standards, including outcomes associated with trauma-informed and culturally relevant services. 6. Missing collection of qualitative and quantitative data and information related to identified outcomes, indicators, and practice standards. 7. Explain how the facility will review, analyze, and interpret the data 8. Explain how the facility will take the data to inform and improve policies, practices, and programs 9. Missing procedures for evaluation of the STRTP's outcomes and results 10. Explain how CQI program will be culturally relevant, trauma-informed, and age and developmentally appropriate. 11. Explain how the facility shall work collaboratively with the Department on the CQI program by being timely and responsive to Department meeting requests, correspondence, and other similar requests by the Department related to CQI. 12. What role will the Board of Directors play in the CQI process? Program Statement 1. Population to be Served 1. Since the facility intends to serve NMDs, the program statement needs to include a description of programs or services to be provided consistent with assisting an NMD in preparing for the transition to independent living. 2. Please indicate if the facility intends to serve children or NMDs with special health care needs. If so, include a statement that it meets all requirements for a specialized STRTP, as defined in ILS Section 87001(s)(5), a description of its program or services to be provided to this population, and a description of how the programs and services meet the requirements as specified in the ILS including, but not limited to, ILS Sections 87010.2, 87064.1, 87065.6, 87066.1, 87068.12, 87069.2, 87070.2, 87072.3, and 87087.1. 3. The program statement does not include a description of how the facility programs have the ability to support: I. The individual needs of children, NMDs, and their families, with short-term, specialized,trauma-informed, and intensive treatment, including, but not limited to, treatment that implements child-specific short-and long-term needs and goals identified by the qualified individual's assessment of the child • A description of programs or services to be provided consistent with assisting an NMD in preparing for the transition to independent living. Not covered or addressed sufficiently. Page 9 of 16 3. Transportation Arrangements Who will be the primary person/position in charge of vehicle maintenance requirements.? 5. Trauma Informed Interventions and Treatment Practices 1. Demonstrate how the program is trauma-informed by including interventions, practices, services, and supports that recognize and adequately demonstrate how the program addresses each of the following: • Interventions, techniques, and practices that are trauma-informed, culturally relevant, age and developmentally appropriate, as provided by direct care staff to a child or consistent with a child's or NMD's needs and services plan and treatment plan. 2. Missing policies and procedures that include prevention services, interventions, and practices, services, and supports that demonstrate the following: • How observable behaviors will be identified and evaluated to assess the need for services. • How emergency interventions, including early interventions and de-escalation procedures, are trauma-informed; 3. Missing procedures for how the provider will access and make referrals for evidence-based and/or promising services and practices that are trauma-informed. 4. Missing policies and procedures for collaboration with Child Welfare, Probation, County Mental Health, CFTs, and outside partners to ensure effective and consistent provision of care and services that are trauma-informed. 5. Missing procedures for maintaining consistency with TILPS (when applicable). 6. Licensed Nursing Staff 1. If the STRTP is unable to hire a nurse, what's the plan to ensure there is access to nursing services? 7. Development, Implementation, and Modification of Needs and Services Plan 1. Recommend revising this entire section as it does not adhere to sections 87022.1, 87068. Page 10 of 16 2. Describe the procedures for the development, implementation, and periodic updating of needs and services plan for children and NMDs, that are trauma-informed, culturally relevant, and age and developmentally appropriate, and procedures for collaborating with the CFT that include a description of the following: • This section does not mention the short-and long-term needs and goals of the child or NMD as assessed by the qualified individual under WIC sections 4096 and 11462.01 • Explain how the STRTP will ensure the processes to treatment is consistent with the shortand long-term needs and goals for the child, including as specified in the child's permanency plan • Describe the procedures for the development, implementation, and periodic updating of needs and services plan for children and NMDs, that are trauma-informed, culturally relevant, and age and developmentally appropriate, and procedures for collaborating with the CFT that include a description of the following: • Provide the services to be provided or arranged to meet the short-and long-term needs and goals of the child or NMD as assessed by the qualified individual under WIC sections 4096 and 11462.01 • Explain how the STRTP will ensure the process of treatment is consistent with the short-and long-term needs and goals for the child, as specified in the child's permanency plan • Include the anticipated duration of treatment • Include the process to ensure that consistent progress is made toward the timeframe and plan for transitioning the child or NMD to a less restrictive family environment • Missing procedures to ensure the child or NMD's needs and services plan is consistent with the case plans including the needs as identified by the qualified individual, as developed by the county placing agency and recommendations by the CFT • Missing procedures to support the reasonable and prudent parent standard, as specified in Section 87067 3. The NSP is missing section 87068.2(c)(1)-(3). 4. Missing section 87068.2(d)-(h)(1). 5. Missing section 87068.2(b)(1)-(9). 6. Please provide details for the modifications and refer to section 87068.3(b)-(c). 7. Please note NSP for NMDs differ and should follow provisions listed in section 87068.22(a)- (g). 8. Missing procedures to support the reasonable and prudent parent standard, as specified in Section 87067. Page 11 of 16 8. Planned Activities 1. This section includes activities, but there is no clear plan for the following: • Activities that require group interaction. • Planned recreational activities to encourage socialization. • Educational services and remediation. • Activities which meet the training, money management, and personal care, grooming needs, and any other independent living skills identified in the children's/NMD's needs and services plans • Pre-vocational or vocational counseling. • The development of community support systems for children/NMDs to maximize utilization of non-mental health community services and other resources. • Use of the residential environment to assist children/NMDs in the acquisition, testing, and refinement of community living and interpersonal skills. • Access to computer technology and the internet, consistent with the child's age, maturity, developmental level, court order, and CFT decision. 2. The written plan for activities does not demonstrate that it allows children/NMDs to participate in age or developmentally appropriate extracurricular, enrichment, cultural, and social activities and ensures that the reasonable and prudent parenting standard as specified in Section 87067 will be applied. 3. Please specify if there will be any on-site vocational trainings provided in the facility, including skills taught, goals of the training, hands-on experience received, materials provided, number of hours per day/days per week, and funding. 4. For outdoor activities. Where are some of these places located? Give names of hiking trails & specific parks in the area. 5. Access to computer technology and the internet, consistent with the child's age, maturity, developmental level, court order, and CFT decision. Not addressed. 9. Services During Placement and After Discharge 1. Need to specify the name, location, and services provided by an agency or agencies that STRTP has partnered with, either formally or informally, to provide additional supports and services to families and children, including NMDs during care and post-permanency. Page 12 of 16 2. Since mental health approval has not yet been obtained, provide a detail description of how the STRTP will provide children in its care access to mental health services. 10. Plan for Participation in Child and Family Team ("CFT") 1. Describe the facility's plan for participation in CFTs, including when the provider will request a CFT meeting if needed. 2. Describe how the facility plans to participate in CFT meetings in a manner that is traumainformed, culturally relevant, and age and developmentally appropriate. 3. Explain how the STRTP plans to honor the youth's request for a CFT. 11. Identification of Home-Based Settings and Family-Based Aftercare Support Plan and Aftercare Services 1. Provide a detailed description of how the facility, in accordance with the child's case plan and the CFT recommendations, will provide for, arrange for the provision of, or assist in, all of the following: • Development of an individualized family-based aftercare support plan that identifies necessary supports, services, and treatment to be provided for at least six months postdischarge as a child moves from the STRTP to a home-based family care setting or to a permanent living situation through reunification, adoption, or guardianship, or to a transitional housing program. This plan shall be developed, pursuant to WIC section 4096.6, in collaboration with the county placing agency, the CFT, and other necessary agencies or individuals for at least six months post-discharge. • Aftercare services may be provided by the following, including, but not limited to: a STRTP, county placing agency, child welfare agency, probation department, mental health plan, or other agencies or individuals pursuant to WIC section 4096.6. • Documentation of the process by which the STRTP will implement treatment and services to support the short- and long-term, child-specific mental health goals identified by a qualified individual pursuant to WIC section 4096(g). 12. Family and Sibling Participation Page 13 of 16 1. On and after October 1, 2021, a description of how the STRTP will, to the extent clinically appropriate, consistent with any applicable court orders, and in accordance with the child's best interest, do all of the following: I. Document how family members will be integrated into the treatment process for the child, including post-discharge, and how sibling connections are maintained. • Did not see how the outreach is made, including contact information or how the child shall be engaged to determine the preferred family members to interact with. 15. Family Visitation • Should have a process by which staff speak to child to "debrief" and ensure that all went well and clients are not victimized during unsupervised visits or visitations. 16. Personal Rights 1. Describe policies and procedures that demonstrate compliance with personal rights. 2. The procedures do not include the requirement to explain and advise the child and their authorized representative of personal rights at the request of the child, and each time a new right has been added. 3. Missing the language that the personal rights will be explained in a trauma-informed, age and developmentally appropriate manner. 4. Additional trainings after hire? Mention that staff also sign personal rights form. 17. House Rules for Child(ren)/NMDs 1. Provide a description of how the house rules are culturally relevant. 2. Please include that any restrictions on electronics will be in the NSP. 3. Indicate/mention how House Rules shall not violate the personal rights of children and NMDs 18. Positive Discipline Policies and Procedures Page 14 of 16 1. Types of discipline permitted must also include the ones listed in section 87072.1(d)(1)-(5). 2. Need to include a statement that youth will not be subject to a consequence for refusing to take their psychotropic medication. 3. Missing procedures for when a youth is subject to positive discipline. 4. Need to include a statement that calls or threats to call law enforcement are not a form of discipline. 5. Explain how the positive discipline policies will not violate personal rights. 6. This section includes NMDs. Please remove NMDs from this section, as this section does not apply to NMDs. 7. Explain how the positive discipline policies and procedures will be age and developmentally appropriate. 19. Expectations and Consequences for NMDs 1. Need to include a statement that NMD will not be subject to a consequence for refusing to take their psychotropic medication. 2. Need to include a statement that calls or threats to call law enforcement are not a form of discipline. 3. Explain how the positive discipline policies will not violate personal rights. 4. Types of discipline permitted must also include the ones listed in section 87072.11(e)(1)(A)- (B). 5. Missing section 87072.11(b)(1)-(5). 6. Missing procedures for when an NMD is subject to positive discipline. 7. Types of discipline not permitted. Not addressed 8. Provisions for informing staff, NMDs, and the NMD's authorized representative(s) of expectations and consequences policies and procedures; Not addressed 21. Safeguards For Cash Resources, Personal Property, and Valuables • Indicate what procedures are implemented to ensure property, cash and valuables are safeguarded when clients are on AWOL or after clients are removed or relocated to another facility. Page 15 of 16 24. Mental Health Program Approval 1. Explain how the STRTP providing care and supervision to children diagnosed by a physician, psychologist, or licensed clinical social worker as mentally disordered shall make provision for at least monthly consultation from a psychiatrist, or clinical psychologist, or licensed clinical social worker regarding the program of services, or more often as appropriate to the needs of the child or NMD. 25. Food and Nutritional Plan/Sample Menus/Schedule • Procedures on how all staff will be made aware of any special dietary needs due to allergies, medical conditions, religion etc. • Clothing and hygiene needs not necessary for this section 26. Emergency Intervention Plan (Runaway Plan) 1. Explain how the Emergency Intervention Plan is: • Appropriate for the population of the youth served • Appropriate for the staff qualification and staff emergency intervention training • Trauma-informed, culturally relevant, appropriate for the age, size, emotional, behavioral and developmental level of the children and account for the particular traumas of specialized populations, including but not limited to, commercially sexually exploited children. 2. Missing procedures that include and support recognized trauma-informed principles, approaches, and trauma specific interventions, de-escalation and harm reduction techniques. 3. Missing procedures that include descriptions and details in the written procedures to demonstrate how the licensee will ensure the prevention of personal rights violations. 4. Each emergency intervention is missing the following: • A description of each emergency intervention technique, including manual restraints, to be used and in what types of situations they will be used. • Maximum time limits for each emergency intervention technique, not to exceed maximum time limits as specified in Section 87095.22(f). • In what situations each emergency intervention technique is not to be used. • Expected outcome, benefits to the child. Page 16 of 16 5. Specify the behaviors that may require the use of emergency intervention. 6. Missing sections 87095.22(d)(5)-(11). 7. The Manual Restrain Plan is missing sections 87095.22(f)(1)-(7) and procedures for the following: • documenting and maintaining a monthly log of each use of manual restraints, as specified in ILS Section 87095.61(g) • debriefing following a review of the use of manual restraint, as set forth in 87095.68. • accessing community emergency services, including, but not limited to, law enforcement if the use of emergency interventions is not effective or appropriate. • concerning when and how to involve law enforcement in response to an incident at the facility consistent with ILS Section 87072(c)(32). 8. Missing the Emergency Intervention Staff Training Plan. See section 87095.22(g)(1)-(6). 9. There's a brief mention of biannual review but there are no procedures. See section 87095.22(h). 10. There's no mention of the admission agreement. 11. The Runaway Plan does not describe how staff will respond to the following: • Child(ren) outside of the facility property without permission, but who are within view of the staff. 12. Explain how the Runaway Plan is trauma-informed, culturally relevant, appropriate for the age, size, emotional, behavioral, and developmental level of the child(ren), and account for the particular traumas of specialized populations, including, but not limited to, commercially sexually exploited children. 13. The Runaway Plan is missing section 87095.24(c)(4) and sections 87095.24(c)(7)-(9). 14. The Runaway Plan is missing section 87095.24(e)(1)(A)-(C). 15. Intervention plan procedure if multiple children AWOLing? A copy of this report was provided. Mr. Darryl Monteilh stated that corrections would be submitted for review to Licensing Office by November 17, 2025. Corrections made will be highlighted.

met_with: Darryl Monteilh


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst, Daniel Mena conducted a second technical assistance meeting virtually via Teams with Creekside II Short Term Residential Therapeutic Program (STRTP) CEO, Darryl Monteilh and Erin Franco. Present at the meeting was System of Care Branch Manager, Marjana Jackson and Licensing Program Manager, Nicole Strickland . The Purpose of the meeting was to discuss and review the following pending Plan of Operation (POO) and Program Statement (PS) revisions: Creekside II STRTP Application 2ndReview Plan of Operations Section B. Administrative Organization 1. Did not see Administrator certificate Section C. Facility Sketched 1. Which room would be designated as the NMD room if necessary? 2. Indicate 2 clients per bedroom (Facility sketch/s not included) Section D - Staff Plan 5. The comprehensive staff training plan is missing the following: · Missing 8-hour training assessment. 87065.1(d)(1)(E). · The 16-hour training assessment mentioned does not follow section 87065.1(d)(2)(B). · It's mentioned that 20 hours of the 40 hours of annual training will consist of work from an entity not affiliated with the STRTP. However, it is not clear what that training is. Please indicate the training topics that will be from another entity. · Missing the designated employee training related to application of reasonable and prudent parent standard. Training listed under best practices course title, is this training going to only be focused on NMD's? · Please include information about how to engage members of the child's family and community, including parents, siblings, caregivers, other relatives and nonrelated extended family members, and other supportive adults consistent with law and any applicable court orders. G. Admission Determination Procedures 1. If interviews are conducted during the admission process, need to include a statement that the interview cannot be used to determine placement appropriateness or deny admission for placement. Not addressed. 2. Missing procedures for when the STRTP determines that the program is not capable of meeting the youth's needs with and without additional services and/or support. Not addressed. Procedures do not include language about admission determination if additional services or supports are provided. Section H. Intake Policies and Procedures 1. This section mentions Admission Determination Procedures, which should be captured in section G. This section must include intake procedures for when the youth has been accepted for nonemergency placement in the STRTP. Please remove determination procedures and keep relevant information in this section to avoid confusion. Refer to PINs attached. 2. Missing the initial crisis management assessment as set forth in ILS Section 87068.1(d), which include, but are not limited to, how the component/s of the assessment that include input from the child shall be conducted in manner that is consistent with trauma-informed practices and the requirements in ILS Section 87078.2. • Assessment provisions and input from youth and family members. • Assessment must be used to inform the emergency interventions used on that specific youth. 6. Emergency placement procedures are not complete. 7. If orientation interviews are conducted as part of intake procedures, need to provide policies and procedures that demonstrate and provide descriptions and details that the purpose of the orientation interview is to support the youth's transition into placement. Section 87068.1(f)(1) through (2). • In this section, I did not see a statement of the policies and procedures regarding intake of children and NMDs includes procedures for medical assessment, including TB results Section I. Admission Agreement 1. Did not see written statement regarding the type(s) of emergency interventions the licensee has been approved to use in the Admission Agreement J. Removal or Transfer Policies and Procedures 1. Missing procedures for removal and/or transfer of children and NMDs as described in Section 87068.1: · After program goals have been reached- Not addressed. 2. Missing section 87068.4(c)(1)-(2). Need to clearly explain this requirement. What services and supports will be provided? How will facility work with the placing county or state agency? 3. Missing procedures for notifying the youth that a notice to remove them has been issued. See section 87068.4(e)(2)(E). Notifying youth is listed under emergency removal, should also been mentioned under removal/transfer procedure. 4. The notice that is given to the county for when the STRTP determines it cannot meet the needs of the youth is missing provisions listed in section 87068.4(e)(2)(A)(1)-(6). Required information should be included in written notice. 5. Since STRTP will be operating under a provisional license, the Mental Health Head of Service cannot sign the statement providing the reason for the removal request. 6. Need a statement indicating that the request for placement change will not be initiated prior to the first update of the youth's NSP. 7. Typo- Page 237 "Movie" instead of move. Q. Continuous Quality Improvement (CQI) 1. This section repeats the requirements for this section but does not explain HOW the requirements will be met. 2. Who is part of the QI team? Not clearly indicated. 3. Does not include frequent review, documentation and if necessary adjustment of the youth's NSP. Not addressed. 4. Explain in detail how the CQI will adopt outcomes, indicators, and practice standards, including outcomes associated with trauma-informed and culturally relevant services. Not addressed. 5. Explain how the facility shall work collaboratively with the Department on the CQI program by being timely and responsive to Department meeting requests, correspondence, and other similar requests by the Department related to CQI. Not addressed. 6. What role will the Board of Directors play in the CQI process? Not addressed. Section says information will be presented to the Board of Directors, no indication of their role. 7. Explain how CQI program will be culturally relevant, trauma-informed, and age and developmentally appropriate. Program Statement 5. Trauma Informed Interventions and Treatment Practices 1. Missing procedures for how the provider will access and make referrals for evidence-based and/or promising services and practices that are trauma-informed. Still not addressed, how with the facility do this? 2. Missing policies and procedures for collaboration with Child Welfare, Probation, County Mental Health, CFTs, and outside partners to ensure effective and consistent provision of care and services that are trauma-informed. Still not addressed, how with the facility do this? 3. Missing procedures for maintaining consistency with TILPS (when applicable). 7. Development, Implementation, and Modification of Needs and Services Plan 1. Missing procedures to support the reasonable and prudent parent standard, as specified in Section 87067. 2. • Explain how the STRTP will ensure the process of treatment is consistent with the short-and long-term needs and goals for the child, as specified in the child's permanency plan 3. • Include the anticipated duration of treatment 4. • Missing procedures to ensure the child or NMD's needs and services plan is consistent with the case plans including the needs as identified by the qualified individual, as developed by the county placing agency and recommendations by the CFT 8. Planned Activities 1. This section includes activities, but there is no clear plan for the following: · Pre-vocational or vocational counseling. Not addressed, need to add language for this requirement to this section. · Use of the residential environment to assist children/NMDs in the acquisition, testing, and refinement of community living and interpersonal skills. Not addressed, need to add language for this requirement to this section. 2. The written plan for activities does not demonstrate that it allows children/NMDs to participate in age or developmentally appropriate extracurricular, enrichment, cultural, and social activities and ensures that the reasonable and prudent parenting standard as specified in Section 87067 will be applied. Not addressed, need to add language about extracurricular activities to meet this requirement to this section. 3. Please specify if there will be any on-site vocational trainings provided in the facility, including skills taught, goals of the training, hands-on experience received, materials provided, number of hours per day/days per week, and funding. Not addressed, need to add language for this requirement to this section. 4. The development of community support systems for children/NMDs to maximize utilization of non-mental health community services and other resources. 5. Access to computer technology and the internet, consistent with the child's age, maturity,developmental level, court order, and CFT decision. Not addressed. 11. Identification of Home-Based Settings and Family-Based Aftercare Support Plan and Aftercare Services • Documentation of the process by which the STRTP will implement treatment and services to support the short- and long-term, child-specific mental health goals identified by a qualified individual pursuant to WIC section 4096(g). 16. Personal Rights 1. The procedures do not include the requirement to explain and advise the child and their authorized representative of personal rights at the request of the child, and each time a new right has been added. 2. Additional trainings after hire? Mention that staff also sign personal rights form. 18. Positive Discipline Policies and Procedures 1. Missing procedures for when a youth is subject to positive discipline. Not addressed, need details on when positive discipline will be used. 2. Explain how the positive discipline policies will not violate personal rights. Not addressed, how will this be done? 3. Explain how the positive discipline policies and procedures will be age and developmentally appropriate. Not addressed, how will this be done? 19. Expectations and Consequences for NMDs 1. Need to include a statement that NMD will not be subject to a consequence for refusing to take their psychotropic medication. Not addressed, language needed for this section. 2. Need to include a statement that calls or threats to call law enforcement are not a form of discipline. Not addressed, language needed for this section. 3. Explain how the positive discipline policies will not violate personal rights. Not addressed, how will this be done? 4. Missing section 87072.11(b)(1)-(5). Not addressed 5. Missing procedures for when an NMD is subject to positive discipline. Not addressed, need details on when positive discipline will be used. 6. Types of discipline not permitted. Not addressed 7. Provisions for informing staff, NMDs, and the NMD's authorized representative(s) of expectations and consequences policies and procedures; Not addressed 25. Food and Nutritional Plan/Sample Menus/Schedule 1. Procedures on how all staff will be made aware of any special dietary needs due to allergies, medical conditions, religion etc. 26. Emergency Intervention Plan (Runaway Plan) 1. Missing procedures that include descriptions and details in the written procedures to demonstrate how the licensee will ensure the prevention of personal rights violations. 2. Specify the behaviors that may require the use of emergency intervention. 3. The Manual Restrain Plan is missing sections 87095.22(f)(1)-(7) and procedures for the following: Still not addressed · documenting and maintaining a monthly log of each use of manual restraints, as specified in ILS Section 87095.61(g) 4. There's a brief mention of biannual review but there are no procedures. See section 87095.22(h). 5. There's no mention of the admission agreement. 6. Explain how the Runaway Plan is trauma-informed, culturally relevant, appropriate for the age, size, emotional, behavioral, and developmental level of the child(ren), and account for the particular traumas of specialized populations, including, but not limited to, commercially sexually exploited children. A copy of this report was provided. Mr. Darryl Monteilh stated that corrections would be submitted for review to Licensing Office by February 13, 2026. Corrections made will be highlighted.


summary: Facility Evaluation

raw_content:
Narrative:
On April 16, 2026, at 9: AM Licensing Program Analyst (LPA) Daniel Mena conducted a pre licensing inspection of the facility. At time of inspection LPA met with applicant Darryl Monteilh. The facility was toured inside and out with Mr. Monteilh. The home is a one story four bedroom home with three bathrooms, and two staff offices. Home is divided into two units (building 1 & building 2). Facility has a detached laundry room and mental health office. Bedroom # 1 is furnished with two twin beds and sleeps two clients. Bedroom # 2 is furnished with two twin beds and sleeps two clients. Bedroom # 3 is furnished with one twin bed and sleeps one client. Bedroom # 4 is furnished with one twin bed and sleeps one client. Bedrooms are arranged so that no more than two clients are in a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. The bathrooms were clean and in good repair. All hazardous items have been properly made inaccessible. The medications will be stored in a locked cabinet in the staff office. Cleansers/chemicals and sharp knives will be stored and locked. Continues on next page The is a First Aid Kit on the premises. The facility's smoke detectors and carbon monoxide detectors were operable. There are no guns/weapons in the facility. The following required posted items will be made accessible to clients: Grievance Procedures, Personal Rights, and Visitation policies. The facility outside grounds was also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. There are no pools or other body of water on grounds. There is a creek behind the facility that has been made inaccessible with fencing. The request of License will be forwarded to Licensing Program Manager for final approval once Fire Clearance is provided. Exit interview conducted and a copy of this report was discussed and provided to Applicant, Darryl Monteilh on this date.

visit_type: Prelicensing


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
On July 01, Community Care Licensing received an allegation that C1 was inappropriately touched by C2. Confidential interviews and documents reviewed revealed that C2 touched C1's genital area. Confidential interviews and documents reviewed revealed that C2 did not touch C1 inappropriately nor did C2 engage in inappropriate acts with C1. Confidential interviews revealed staff members conduct checks of client rooms every 15 minutes and clients are not allowed to sit on each other's beds. Confidential interviews revealed staff members never saw C1 or C2 engaging in inappropriate acts and never allowed sexual activities to go on among residents. Based on confidential interviews and record review, the allegation that that C1 was inappropriately touched by another child (C2) in care may have occurred; however, it is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with appeal rights was provided to Erika Vasquez.

Investigation Findings:
13On October 25, 2021, at 1: PM, Licensing Program Analyst (LPA) Jesus Cervantes made an unannounced visit at the facility. LPA met with Program Director, Erika Vasquez, to issue the investigative findings of the allegation listed above. On 07/12/2021, Licensing Program Analyst (LPA) Jesus Cervantes conducted a 10-day/file review visit to Crittenton Services for Children and Families and reviewed clients and staff files. LPA Cervantes obtained the following documents: Complaint Investigation Reports, Facility Profile, Facility Personnel Report Summary and Personnel List. Investigator Lucius Charlemagne with the Community Care Licensing Investigation Branch investigated this complaint. Investigator Charlemagne obtained and reviewed the following documents: Fullerton Police Department report, medical records from Children's Hospital Orange County (CHOC). Investigator Charlemagne interviewed Staff #1 (S1), Staff #2 (S2), Staff #3 (S3), Child #1 (C1), Child #2 (C2), Riverside County Probation Officer, Los Angeles County Senior Social Worker, Fullerton Police Department Investigative Branch personnel, and Doctors from CHOC. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Jesus Cervantes LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, THE CITY DR., SUITE FACILITY NAME: CRITTENTON SVCS FOR CHILDREN AND FAMILIESFACILITY NUMBER: VISIT DATE: 10/25/2021

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

visit_type: Complaint Investigation

met_with: Erika Vasquez


facility_name: DANGERFIELD HOME #1

raw_content:
Investigation Findings:
13On 08/13/2021 at 2: PM, Licensing Program Analyst (LPA) Charmetha White arrived at the above location for the purpose of concluding the investigation and deliver findings on the above allegation. LPA spoke with Administrator, Chinyere Paris Ukattah and discussed the findings. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Staff said some clients have been attending school virtually and staff denied preventing clients from attending school. Staff said clients are provided 3 meals a day and are issued weekly allowance. Staff denied threatening clients and said staff have not denied any client their approved visit pass. Staff stated clients are treated with dignity and respect, and staff address each client based on the needs of their treatment plan. Client #1 said staff do not treat everyone the same and said staff told him if he did not go to school he could not go to work. Client interviews revealed clients are feed regularly and that they have community passes. Clients said they use the facility WiFi to attend Zoom classes and they receive their allowance. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. No deficiencies cited. Exit interview completed. A copy of the report was left with Administrator, Chinyere Paris Ukattah. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White 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 2

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

met_with: Administrator - Chinyere Paris Ukattah


raw_content:
Narrative:
Although the allegations may have happened are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has determined that the allegations Personal Rights are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. Per California Code of Regulations, Title Regulations, Division 6, Chapters 1 & 5 (GROUP HOMES), There are no deficiencies noted or cited. An exit interview was conducted, and a copy of this report was left at the facility.

Investigation Findings:
13On 02/03//2022 4: PM (LPA) Licensing Program Analysts Rosslyn Gray arrived at the DANGERFIELD HOME #1 to conclude the investigation on the above allegation/s and to deliver the findings. LPA met with the Direct Care Staff. Based on the interviews and statements obtained during the investigation process, the allegation cannot be corroborated because supporting evidence includes the following: Supporting evidence obtained from the internal Investigation conducted revealed that there is not enough evidence to support the allegations that "Inappropriate form of discipline used with minor in care. Minor was pushed while in care; Minor was threatened while in care" occured. Evidence to support that appropriate consequences were implemented, was provided with support to meet the childs needs; Trauma informed were implemented identifying triggers and understanding the needs of the child that included Crisis interventions implemented by several staff to intervene and deescalate the situaton. In addition the child denied that the allegations occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: DANGERFIELD HOME #1FACILITY NUMBER: VISIT DATE: 02/03/2022

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

met_with: Direct Case Staff


raw_content:
Narrative:
Due to lack of evidence obtained during the investigation, LPA determines that the allegation of Neglect/Lack of Supervision, and Personal Rights are Unsubstantiated at this time meaning, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. There are no deficiencies cited at this time. An exit interview was conducted, and a copy of this report was left at the Facility Administrator.

Investigation Findings:
13On September 23,2022, at 12:30PM Licensing Program Analyst (LPA), Rosslyn Gray made an unannounced visit to DANGERFIELD HOME #1 to conclude the investigation on the above allegation/s and to deliver the findings. LPA met with the Facilty Administrator to conclude the investigation and to deliver the findings. Prior to entering the facility LPA-Gray conducted a Health and safety risk assessment and asked were there any positive COVID-19 cases and or Monkey Pox. During the investigation LPA-Gray interviewed and accounted for all available relevant parties;and gathered pertinent information in reference to the allegations. The Licensee denied the allegations. Based on confidential interviews and review of documentary evidence, there is no evidence or witnesses to support that the facility staff did not supervise minors and that the staff did not seek medical attention for minor. Documentary interviews were congruent that staff provided the proper supervision and crisis intervention to deescalate and separated the alleged victims. There was no evidence of injuries or bruises. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: DANGERFIELD HOME #1FACILITY NUMBER: VISIT DATE: 09/23/2022

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

met_with: Facility Administrator


raw_content:
Narrative:
Due to lack of evidence obtained during the investigation, LPA determined that the allegations of Personal Rights is Unsubstantiated at this time meaning, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. There are no deficiencies cited at this time. An exit interview was conducted, and a copy of this report was left at the Facility Administrator.

Investigation Findings:
13On September 29,2022, at 9: AM Licensing Program Analyst (LPA), Rosslyn Gray made an unannounced visit to DANGERFIELD HOME #1 to conclude the investigation on the above allegation/s and to deliver the findings. LPA met with the Facility Administrator to conclude the investigation and to deliver the findings. During the investigation LPA-Gray interviewed and accounted for all available relevant parties; and gathered pertinent information regarding the allegations. The Licensee denied the allegations. Based on confidential interviews and review of documentary evidence, there is no evidence or witnesses to support that the facility terminated placement without notice and that the staff withheld minor's allowance. Document evidence confirm that the facility implemented a transition determination plan prior to termination. Documented evidence and confidential interviews were congruent and confirmed that minor's obtain allowances based on their age range and that the staff provided proper supervision and crisis intervention in effort to prevent the child from going AWOL. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: DANGERFIELD HOME #1FACILITY NUMBER: VISIT DATE: 09/29/2022

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


raw_content:
Investigation Findings:
13On 06/19/25, at 1: PM, Licensing Program Analyst (LPA) Andrea Aceves and Licensing Program Manager (LPM) Lakescia Smith made an unannounced visit to the above facility to conclude the investigation and to deliver the findings on the above allegation. LPA Andrea and LPM Lakescia met with Facility Manager Patrick Henry. During the investigation, LPA Andrea interviewed all available parties and reviewed LIC500-Personnel Report, Staff daily notes and Needs and Services Plan. It was reported that (1) "Facility staff threatened youth in care". Based on interview statements from staff, there was insufficient evidence to support said allegation. LPA Andrea was able to confirm that an incident occurred in the kitchen involving S1 and C1 but there were conflicting statements regarding S1 threatening C1. In addition, there were no witnesses that the allegation occurred. LPA attempted to obtain information regarding the incident from C1 but client refused to speak to LPA. As a result, this investigation is being closed. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur, therefore, the allegation is unsubstantiated. Exit interview was completed and copy of the report and appeal rights were discussed and provided to Facility Manager, Patrick Henry. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Andrea Aceves LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Facility Manager-Patrick Henry


summary: Facility Evaluation

raw_content:
Narrative:
On May 27, 2022, at 10: AM, Licensing Program Analyst (LPA) Rosslyn Gray made an unannounced to DANGERFIELD HOME #1 for the purpose to conduct the Required Year Inspection. There is a visitor sign in an a COVID-19 questionnaire at the entrance. LPA met with the Program Administrator, who granted access into the home, and who provided a tour of the entire physical plant inside and out. This facility is Licensed to provide care and supervision for six (6) children ages 14-17 years old, Ambulatory only. The facility also provides services to non-minor dependents. The census this day is five (5). The facility acquired The National Accreditation through Commission on Accreditation of Rehabilitation Facilities (CARF) valid extended through June 30, 2024. The facility current License, Mental Health Certification dated November 25, 2021, and expires November 24, 2022. There are no bodies on water on the premises. Staff confirmed that there are no firearms or dangerous weapons in the facility. STRTP Overview: The facility is a single-story home located in a residential neighborhood and it is constructed as follows: 4 bedrooms, two (2) full-size bathrooms, living room, kitchen, laundry area, and backyard. Living room: is equipped with 2 sofas, chair, wooden and glass coffee table, mounted TV, and has a non-operable fireplace. There is also a two (2) small desk chairs, printers, small file cabinet and office supplies. Kitchen: is equipped with a wooden table and 6 chairs, a stove/oven that has 5 gas burners, a refrigerator/top freezer, a microwave, and a deep freezer. LPA's observed adequate perishable/nonperishable food supplies clients are provided nutritious snacks between meals. The Sharp knives, disinfectants/cleaning solutions made inaccessible to the children locked in cabinets. Water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. The food menu and children personal right are posted on the side of the refrigerator in the kitchen. All medications are kept in a locked kitchen cabinet inaccessible to clients. There is a locked cabinet labeled as First Aid with three (3) First Aid kits complete with scissors, tweezers, thermometer, gauzes, antiseptic and a 1st Aid Manual. Dining Area: One large table with six chairs. Laundry area is located outside on the side of the house near the kitchen door. The laundry area is equipped with a washer and dryer unit that was observed to be in good condition. The laundry detergent is made inaccessible to the children and is disputed according to the load of the laundry. Disinfectants and chemicals are locked in cabinets made inaccessible. Office/Therapy room: This is a 4th bedroom; it is located adjacent to the living room and it is utilized as an office/therapy room. The room is equipped with a sofa, desk, chairs, printer, bookshelf, facility binders and office supplies.Staff office: Is equipped office furniture (i.e desk, computers, printers. There is one (1) facility vehicle parked outside inspected to be in good operating condition. Outdoor Area: LPA observed the facility to have adequate indoor and outdoor activity space and materials. The front and backyards were inspected and found to be clean and free of debris and observable hazards. LPA observed the hot water heater. LPA observed a staff displayed the utility shut-off valves. Bedroom # 1: Currently occupied by one (1) client, the bedroom is equipped two (2) twin sized beds, comfortable mattresses, linen, blankets, and pillows; adequate drawer and one (1) walk in closet. There is adequate lighting, and the windows have horizontal slide locked with curtains observed to be in good condition. Bedroom # 2: Currently occupied by two (2) clients, has two (2) twin sized beds and comfortable mattresses, linen, blankets, and pillows; adequate drawer and one (1) walk in closet. There is adequate lighting, and the windows have horizontal slide locked with curtains observed to be in good condition. Bedroom # 3: Currently occupied by two (2) clients. The bedroom has two (2) twin sized beds and comfortable mattresses, linen, blankets, and pillows; adequate drawer and one (1) walk in closet. There is a locked double door from the inside and outside; bathroom #2 with a walk-in closet and a locked storage room with overflow of supplies. Bathrooms: There are two (2) full-size bathrooms. Bathroom #1 is located along the hallway. Bathroom #2 is located inside of bedroom #3. Both bathrooms were observed to be in good repair and working order. Water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. The Facility was inspected, and the following was observed: The home is clean, safe, sanitary, and in good repair. Carbon monoxide and smoke detectors are working properly. There are two (2) fire extinguishers and was fully charged. Continued LIC Page 2 of Children will be accorded personal rights. Ombudsperson Grievances and Personal Rights are posted on the wall and a suggestion box mounted on the wall. Clients lounge in the living, therapy office and the back yard. The facility phone is located is the living room, clients make private phones calls in the therapy office. LPA observed the child's Needs and Services plans kept in client's personal file; (filed in an individual binder). Children are accompanied to outside extracurricular activities and social events (concerts, NBA, NFL, NHL game, movie theater, bowling, hiking, swimming etc.) Alternate activities have been implemented. Clients are also accompanied parks and recreational facilities and amusement parks. Staff Records Review: LPA reviewed three (3) staff records stored in individual personnel file/binders provided by S1. LPA ensured to thoroughly review the records of the primary active staff (i.e Program Administrator, Facility Manager; and a Direct Care Staff. LPA reviewed the Personnel Report (LIC 500) and confirmed that Direct Care Staff Ratio present for six (6) clients. LPA confirmed that All staff have required criminal record clearance. DOJ, FBI and Child Abuse Response; which meet qualification. QA Administrator provided evidence of staff training transcripts stored RELIAS Training Program Hours of training for various topics. Clients Records Review: LPA reviewed three (3) clients records. . Staff Interviews: LPA conducted a confidential interview with three (3) on duty staff. Client Interviews: LPA conducted confidential interviews with three (3) of the five (5) clients according to the census willing to be interviewed. There were no deficiencies cited at this time. LPA's concluded the Required Year Inspection. An exit interview was conducted, and a copy of this report was left at the facility with the Facility Administrator on 05/27/ PER California Code Regulations, TITLE 22, DIVISION 6, CHAPTERS 9.5, there were no deficiencies observed or cited at the time of the visit. Exit Interview was conducted, and a copy of this report was left at the facility. Continued LIC Page 3 of 3

met_with: ADMINISTRATOR


summary: Facility Evaluation

raw_content:
Narrative:
On June 6, 2024, at 10: AM Licensing Program Analyst (LPA) Rosslyn Gray made an unannounced to DANGERFIELD HOME #1 for the purpose to conduct the Annual Random Inspection. LPA conducted a Health and safety risk assessment upon arriving at the facility. LPA met with the Program Administrator, who granted access into the home, and who provided a tour of the entire physical plant inside and out. This facility is Licensed to provide care and supervision for six (6) children ages 7-17 years old, Ambulatory only. The facility also provides services to non-minor dependents. The census this day is six (6). The facility acquired The National Accreditation through Commission on Accreditation of Rehabilitation Facilities (CARF) valid extended through June 30, 2027. The facility current License, Mental Health Certification dated November 24, 2024, and expires November 24, 2025. There are no bodies on water on the premises. Staff confirmed that there are no firearms or dangerous weapons in the facility. STRTP Overview: The facility is a single-story home located in a residential neighborhood and it is constructed as follows: 4 bedrooms, two (2) full-size bathrooms, living room, kitchen, laundry area, and backyard. Living room: is equipped with 2 sofas, chair, wooden and glass coffee table, mounted TV, and has a non-operable fireplace. There is also a two (2) small desk chairs, printers, small file cabinet and office supplies. Kitchen: is equipped with a wooden table and 6 chairs, a stove/oven that has 5 gas burners, a refrigerator/top freezer, a microwave, and a deep freezer is located outside. LPA's observed adequate perishable/nonperishable food supplies clients are provided nutritious snacks between meals.The Sharp knives, disinfectants/cleaning solutions made inaccessible to the children locked in cabinets. Water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. The food menu and children personal right are posted on the side of the refrigerator in the kitchen. All medications are kept in a locked mental health room inaccessible to clients. There is a locked cabinet labeled as First Aid with three(3) First Aid kits complete with scissors, tweezers, thermometer, gauzes, antiseptic and a 1st Aid Manual; 1 is located in the facility vehicle. Dining Area: One large table with six chairs. Laundry area is located inside in the kitchen area. The laundry area is equipped with a washer and dryer unit that was observed to be in good condition. The laundry detergent is made inaccessible to the children and is distributed according to the load of the laundry. Disinfectants and chemicals are locked in cabinets made inaccessible. Office/Therapy room: located adjacent to the living room and it is utilized as an office/therapy room. The room is equipped with a two seater sofa, desk, chairs, printer, bookshelf, facility binders and office supplies. Staff office: Is equipped office furniture (i.e desk, computers, printers. There is one (1) facility vehicle parked outside inspected to be in good operating condition. Outdoor Area: LPA observed the facility to have adequate indoor and outdoor activity space amenities. punching bag, weight lifting unit, barbecue grill, lemon tree, and other outdoor plants. The front and backyards were inspected and found to be clean and free of debris and observable hazards. LPA observed the hot water heater on the house exit to the kitchen door. LPA observed a staff displayed the utility shut-off valves. Bedroom # 1: Currently occupied by two (2) children, the bedroom is equipped two (2) twin sized beds, comfortable mattresses, linen, blankets, and pillows; adequate drawer and one (1) walk in closet. There is adequate lighting, and the windows have horizontal slide locked with curtains observed to be in good condition. Bedroom # 2: Currently occupied by two (2) clients, has two (2) twin sized beds and comfortable mattresses, linen, blankets, and pillows; adequate drawer and one (1) walk in closet. There is adequate lighting, and the windows have horizontal slide locked with curtains observed to be in good condition. Bedroom # 3: Currently occupied by two (2) clients. The bedroom has two (2) twin sized beds and comfortable mattresses, linen, blankets, and pillows; adequate drawer and one (1) walk in closet. There is a locked double door from the inside and outside; bathroom #2 with a walk-in closet and a locked storage room with overflow of supplies. Bathrooms: There are two (2) full-size bathrooms. Bathroom #1 is located along the hallway. Bathroom #2 is located inside of bedroom #3. Both bathrooms were observed to be in good repair and working order. Water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Continued LIC Page 2 of The Facility was inspected, and the following was observed: The home is clean, safe, sanitary, and in good repair. Carbon monoxide and smoke detectors are working properly. There are two (2) fire extinguishers and was fully charged mounted on the kitchen wall. Children will be accorded personal rights. Ombudsperson Grievances and Personal Rights are posted on the wall and a suggestion box mounted on the wall. Clients lounge in the living, therapy office and the back yard. The facility phone is located is the living room, clients make private phones calls in the therapy office. LPA observed the child's Needs and Services plans kept in client's personal file; (filed in an individual binder). Children are accompanied to outside extracurricular activities and social events (concerts, NBA, NFL, NHL game, movie theater, bowling, hiking, swimming etc.) Alternate activities have been implemented. Clients are also accompanied parks and recreational facilities and amusement parks. Staff Records Review: LPA reviewed three (3) staff records stored in individual personnel file/binders provided by S1. LPA ensured to thoroughly review the records of the primary active staff (i.e Program Administrator, Facility Manager; and the Rehabilitation Specialist LPA reviewed the Personnel Report (LIC 500) and confirmed that Direct Care Staff Ratio present for six (6) clients. LPA confirmed that All staff have required criminal record clearance. DOJ, FBI and Child Abuse Response; which meet qualification. QA Administrator provided evidence of staff training transcripts stored RELIAS Training Program Hours of training for various topics. Clients Records Review: LPA reviewed three (3) clients records. . Staff Interviews: LPA conducted a confidential interview with three (3) on duty staff. Client Interviews: LPA did not interview clients due to the two (2) of the six refused and four (4)children being at school at the time of the inspection. There were no deficiencies cited at this time. PER California Code Regulations, TITLE 22, DIVISION 6, CHAPTERS 9.5, there were no deficiencies observed or cited at the time of the visit. LPA concluded the Annual/Random Inspection. An exit interview was conducted, and a copy of this report was left at the facility with the Administrator/Chinyere Ukattah Continued LIC Page 3 of 3

visit_type: Annual

met_with: Administrator/Chinyere Ukattah


summary: Facility Evaluation

raw_content:
Narrative:
On June 14, 2024, at 12: PM Licensing Program Analyst (LPA) Rosslyn Gray made an unannounced to DANGERFIELD HOME #1 for the purpose to conduct the Case Management - Annual Continuation. LPA conducted a Health and safety risk assessment upon arriving at the facility. LPA met with the Program Administrator inquired about the current census, requested the Register of Clients in placement and requested to interview all available clients. Client Interviews: LPA interviewed two (2) of the six (6) clients. S1 stated one (1) client is on a unauthorized absence, two (2) clients were unavailable due to being offsite on community pass and one (1) client refused to be interviewed. LPA took the initiative to encourage client to interview. Client was adamant in his decision not to be interviewed.. There were no deficiencies cited at this time. PER California Code Regulations, TITLE 22, DIVISION 6, CHAPTERS 9.5, there were no deficiencies observed or cited at the time of the visit. LPA concluded the Case Management - Annual Continuation. An exit interview was conducted, and a copy of this report was left at the facility with the Administrator/Chinyere Ukattah


facility_name: DANGERFIELD HOME #2

raw_content:
Investigation Findings:
13On 08/13/2021 at 12: PM, Licensing Program Analyst (LPA) Charmetha White made an unannounced visit to Dangerfield Home #3, located at W. 42nd Street Los Angeles, Ca. 90062, for the purpose of concluding an investigation and to deliver findings on the above allegation. LPA spoke with the Administrator, Earlene Johnson and discussed the findings. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Interviews and records did not produce corroborating evidence to support the allegation. Staff denied the allegation) and stated they did step in to prevent the client from harming herself and said they also contacted Law Enforcement's SMART team to assist them with the situation. Client #1 admitted to cutting herself with a razor and said the staff tried to take the razor from her once they saw it. Based on information obtained, the allegation is found to be unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. No deficiencies cited. Exit interview completed and a copy of this report was left with or emailed to Administrator, Earlene Johnson. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White 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 2

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

met_with: Administrator - Earlene Johnson


raw_content:
Investigation Findings:
13On October 15, 2021 at 1: PM, Licensing Program Analyst (LPA) Charmetha White arrived at the above location for the purpose of delivering findings on the above allegation. LPA met with Facility Administrator, Earlene Johnson and discussed the findings. During the course of this investigation, LPA interviewed pertinent parties, reviewed records and Special Incident Reports. Interviews and records did not produce corroborating evidence to support the allegations. Staff denied the allegation and stated any time a client attempts to AWOL, staff follow AWOL procedures. Staff stated prior to Client #1's AWOL, Staff attempted to verbally redirect and discourage Client, once Client AWOLED Staff contacted Law Enforcement, and Client #1's placement agency to notify them of the AWOL. Additionally, LPA was informed Client #1's bed was closed effective 06/29/2021. LPA was unable to obtain a statement from Client #1 as client was AWOL. Based on information obtained, the allegation is found to be unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. No deficiencies cited. Exit interview completed and a copy of this report was left with Facility Administrator, Earlene Johnson. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White 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 2

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

met_with: Facility Administrator - Earlene Johnson


raw_content:
Narrative:
LPA determined that the allegation of Neglect/Lack of Supervision is Unsubstantiated at this time meaning, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. There are no deficiencies cited at this time. An exit interview was conducted, and a copy of this report was left at the Facility Administrator.

Investigation Findings:
13On October 21, 2022 at 2: PM Licensing Program Analyst (LPA), Rosslyn Gray made an unannounced visit to DANGERFIELD HOME #2 to conclude the investigation on the above allegation. LPA met with the Facility Administrator to conclude the investigation and to deliver the findings. During the investigation LPA-Gray interviewed and accounted for all available relevant parties; and gathered pertinent information regarding the allegations. The Licensee denied the allegation. Based on confidential interviews and review of documentary evidence. there is no evidence or witnesses to support that the facility Lack of supervision to prevent minors from AWOLing. Documented evidence and confidential interviews were congruent that the staff provided proper supervision and crisis intervention in effort to prevent the children from going AWOL. Due to lack of evidence obtained during the investigation. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: DANGERFIELD HOME #2FACILITY NUMBER: VISIT DATE: 10/21/2022

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

met_with: Facility


raw_content:
Narrative:
Confidential interviews were congruent that the staff provided proper supervision and crisis communication to redirect, distract and intervene in on conversations that may escalate to a physical altercation. There is no evidence of medical records to confirm that the youth in care required special dietary needs. Confidential interviews were congruent that the youth in care are provided with three (3) meals a day including snack and options to obtain alternative food items to the weekly menu. LPA's observation and confidential interviews confirmed that the youth in care are offered individual foot lockers with a combination lock to safeguard their personal belongings and that the facility provides personalized hair products on a monthly bases and hygiene products on a weekly basis. Due to lack of evidence obtained during the investigation, LPA determined that the allegations are Unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that a violation occurred. There are no deficiencies cited at this time. An exit interview was conducted, and a copy of this report was left with the Facility Administrator

Investigation Findings:
13On June 8,2023, at 3: PM (LPA),Licensing Program Analyst Rosslyn Gray made an unannounced visit to conclude the investigation and to delivery the findings on the above allegations. Prior to entering the facility LPA Gray conducted a health and safety risk assessment. During the investigation, LPA Gray interviewed all available relevant parties and gathered pertinent information in reference to the allegations. The Licensee denied the allegations. Based on confidential interviews and review of documentary evidence, there is no evidence or witnesses to support, or to determine Neglect/Lack of Supervision,and Personal Rights occurred. There is no evidence or witnesses to determine that the staff did not proved a safe and healthful environment for youth in care. Records confirm that the staff were in ratio to monitor the youth, implemented the facilities Emergency Intervention plan, and a Safety Plan was put in place immediately to secure a safe environment for the youth in care. LPA reviewed Special Incident Reports (SIR), written in a timely manner, specific to each individualized situation and was cross reported to the authorized representatives regarding, threats, peer to peer assaultive behavior that involved law enforcement. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: DANGERFIELD HOME #2FACILITY NUMBER: VISIT DATE: 06/08/2023

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