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Narrative:
confidential interview stated that were not aware if C1 was hit while in care. Based on confidential interviews and a review of pertinent documents, the allegation that licensee does not provide a safe environment for C1 may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted and a copy of this report was provided to licensee Lucia Wamutitu.

Investigation Findings:
13On December 4, 2025, Licensing Program Analyst (LPA) Maryjane Perez arrived at Lucia Small Family Home (SFH) and met with licensee Lucia Wamutitu to deliver the finding for the above stated allegation. On October 18, 2025, community care licensing received complaint allegation that licensee did not provide a safe environment for minor. On October 27,2025, LPA M. Perez conducted a health and safety inspection of the facility, and no hazards were observed. Lpa M. Perez also obtained pertinent documents and interviewed licensee (LS), client 1 (C1), client 2 (C2), and client 3 (C3). During confidential interviews it was reported that C2 has temper tantrums and will tend to throw things around but does not hit other clients in the home. Confidential interviews further explained when the clients' behaviors start to change they are separated into different areas of the home to then redirected. Another confidential interview stated that C2 used to hit peers in the past but doesn't do it anymore. Other confidential interviews indicated that there were sometimes tension between C1 and C2 but they don't get involved because they are older than C1 and C2. Another UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: MaryJane Perez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: LUCIA SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 12/04/2025


state: CA

facility_name: LUGOS' FAMILY CARE

summary: Complaint Investigation - Substantiated - 1 allegation

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Narrative:
Continued from A confidential interview disclosed that the Licensee traveled out of the country from October 21, 2024, to November 4, 2024. LPA reviewed the CCL facility file, and no report was found indicating that the LIC was going on vacation, or no documentation was found that the LIC informed foster children Social Workers or CCL. Based on confidential interviews and a review of pertinent documents, the allegation that the Licensee did not notify authorized representatives of her absence is substantiated. The preponderance of evidence standard has been met. The SFH is cited for a violation of Title 22, Division 6, Chapter 4, Article 06, California Code Regulations, Section 83061(a)(b) In addition to 80061, the following shall apply: The licensee shall notify the licensing agency and the child's authorized representative in advance when they intend to be absent from the home for 48 hours or longer... The facility did not follow reporting requirements when LIC went on vacation, which posed potential health, safety, and personal rights risk to the children in care. An exit interview was conducted. A copy of this report, LIC 811, and appeal rights were explained and given to La Queta Mormon.

Investigation Findings:
SubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:

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

report_type: Complaint Investigation

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Unsubstantiated - 1 allegation

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Narrative:
It was further reported that the church members performed an exorcism on FC1, where FC1 was levitating and the members had to hold FC1 down. It was further reported the exorcism took four hours and FC1 blacked out and couldn't remember what happened. It was reported that it was unknown if S1 or S2 was present during the exorcism. Confidential interviews reported church members performed an exorcism on FC1. Other confidential interviews reported that FC1, FC2, S1 and S2 regularly attend their usual church and that this church does not perform exorcisms on any church members. Other confidential interviews reported that the foster children in the small family home voluntarily attend their church and reported feeling safe there. Confidential interviews reported that the foster children in the small family home have not reported any exorcisms were performed on them and they didn't witness exorcisms performed on other members. Based on confidential interviews, the allegations that foster parent allowed church staff to restrain foster child to perform a church ritual without consent may have occurred or are valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted. A copy of this report (LIC 9099) and appeal rights were explained and given to Licensee Tanja Lugo.

Investigation Findings:
13On 04/17/2025, at 11: AM, Licensing Program Analysts (LPAs) Joon Choi and Claudia Aguilera conducted an unannounced visit to Lugos' Family Care Small Family Home (SFH) and met with Licensee Tanja Lugo to deliver the investigative finding for the allegation listed above. On 03/18/2025, Community Care Licensing received an allegation that foster parent allowed church staff to restrain foster child to perform a church ritual without consent. On 03/21/2025, LPA Joon Choi conducted a health and safety inspection at the SFH, and no immediate health and safety hazards were observed. During the investigation, LPA Choi obtained documents pertinent to the investigation and interviewed foster children 1 and 2 (FC1, FC2) and staff 1 and 2 (S1, S2). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Joon R Choi LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: LUGOS' FAMILY CAREFACILITY NUMBER: VISIT DATE: 04/17/2025

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

met_with: Tanja Lugo, Licensee

complaint_status: unsubstantiated


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Narrative:
Confidential interviews reported that LIC admitted to giving C1, three pills a day instead of the prescribed two pills a day. Other confidential interviews reported that LIC reported that C1's doctor verbally instructed LIC to give C1 3 pills a day. A review of records and C1's medication bottles showed that the written instructions for C1's prescription noted that two pills should be given each day. Based on confidential interviews and a review of pertinent documentation, the preponderance of evidence standard has been met, and the allegation that licensee is not administering medications to the foster child as prescribed is substantiated. The facility is being cited for violation of the Title Regulations, Division Chapter 4, Article 06, section 83075 of Health Related Services, (g) psychotropic medication shall only be used in accordance with the written directions of the physician prescribing the medication and in accordance with authorization requirements specified in Sections 369.5(a)(1) and 739.5(a)(1) of the Welfare and Institutions Code and Section 83070(b)(11). An exit interview was conducted. A copy of this report (LIC 9099), deficiencies page (LIC 9099D) and appeal rights were explained and given to Licensee's Caregiver Staff Laquita Momon.

Investigation Findings:
13On 07/17/2025, at 09: AM, Licensing Program Analyst (LPA) Joon Choi conducted an unannounced visit to Lugos' Family Care Small Family Home (SFH) and met with Licensee's Caregiver Staff Laquita Momon to deliver the investigative findings for the allegation listed above. On 04/09/2025, Community Care Licensing received an allegation that foster parent is not administering medications to the foster child as prescribed. On 04/17/2025, LPA Joon Choi conducted a health and safety inspection at the SFH, and no immediate health and safety hazards were observed. During the investigation, LPA Choi obtained documents pertinent to the investigation and interviewed FC1 (FC1) and the Licensee (LIC). In regard to the allegation that foster parent (LIC) is not administering medications to the foster child (FC1) as prescribed; it was reported that LIC called C1's pharmacy to get a refill for C1's psychotropic medication. It was further reported that there were concerns because C1's prescription was supposed to last 30 days. However, LIC ran out of the prescribed medication and called before the 30 days. CONTINUED ON THE NEXT PAGE SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Joon R Choi LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: LUGOS' FAMILY CAREFACILITY NUMBER: VISIT DATE: 07/17/2025

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

met_with: Laquita Momon, Caregiver/Staff


summary: Facility Evaluation

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Narrative:
On December 21, 2023, at 1: PM Licensing Program Analyst (LPA) Babatunde Aborchie began a Pre-Licensing inspection for a Small Family Home license. LPA met with applicant Tanja Lugo, led a tour of the home. The facility was toured both inside and out with the applicant. The applicant was applying to be licensed for 6 ambulatory clients. The home consisted of: Downstairs: Bedroom #1, It was furnished with a queen bed. It sleeps one foster daughter, aged 24 years. There was also a family room, a living room, dining area and one bathroom. Upstairs: Bedroom #2, The room consisted of two twin beds. It sleeps one adopted daughter, aged 20 years. Bedroom #3, The room was furnished with a queen bed. It was vacant. Bedroom #4, The room was furnished with two twin beds. It sleeps two foster children. Bedroom #5. The room was furnished with two twin beds. It sleeps two foster children. Bedroom #6, The room was furnished with a twin bed. It sleeps one foster child. Bedroom #7, Master bedroom. The room consisted of one king-sized bed. It sleeps the applicant and spouse. Bedrooms were arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate drawer and closet space for children's belongings. The smoke detectors were checked and were working properly. Inside the facility the fireplace was properly screened. Telephone service and appliances were in a working order. All hazardous items have been properly made inaccessible to areas where children will have access. The medication will be locked in the kitchen cabinet area. Cleansers/chemicals were locked and stored in the laundry room cabinet. Sharp knives were inaccessible and stored in a locked box in the kitchen cabinet. There were no guns or weapons as stated by the applicant at this time. The hot water temperature was tested and noted to be 112 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit was accessible with all required items and it was in the kitchen pantry. A Fire extinguisher was observed and properly charged. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request to be licensed for a small family home will be forwarded to Licensing Program Manager for final approval. A component III orientation was conducted with applicant Tanja Lugo. An exit interview was conducted. A copy of this report was provided to Applicant/Licensee

report_type: Facility Evaluation

visit_type: Prelicensing

met_with: Tanja Lugo


summary: Facility Evaluation

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Narrative:
On August 28th, 2025 at 12:22PM Licensing Program Analyst (LPA) Cynthia Ramos met with Licensee Tanja Lugo who led a tour of the home. The purpose of the visit was to conduct an annual inspection of the home. The facility was toured inside and out with the Licensee. Currently there are no clients in placement. The home is a two-story home, with 7 bedrooms and 3 bathrooms. The home is set up as follows: On the first floor there was a large dining table, small living room and kitchen. In the kitchen, LPA observed knives, and medication was kept locked in a top cabinet. Additionally, there is a large family room with a television and games for clients. Bedroom #1 is located downstairs and is currently occupied by Licensee's adult daughter (25 years old) and always remains locked. Bathroom #1 was inspected and was in good repair. An additional closet was observed to have extra household items. A stairway led to the second floor of the home where Bedroom #2 (Master Bedroom) was located, this room is currently occupied by Licensee and Spouse and remains locked at all times. Master bedroom also contained Bathroom #2. Bedroom #3 was currently vacant for a future client and contained a twin bed, drawers and closet space. Bedroom #4 was currently vacant for future clients and contained two twin beds with adequate drawers and closet space. Bathroom #3 was inspected and in good repair. Bedroom #5 was occupied by Licensee's biological daughter (22-year-old) and remains locked at all times. Bedroom #6 was vacant with two twin beds and adequate drawers and closet space for future clients. Per Licensee, Bedroom #7 always remains locked as it is used for storage. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. The fireplace was properly screened. All hazardous items have been properly made inaccessible to clients. Cleansers/chemicals were locked and stored in the laundry room and are not accessible to clients. The first aid kit was located in the kitchen and was complete. Per Licensee, there are no guns or weapons in the home at this time. The hot water temperature was tested and noted to be 111.3 degrees F. Proper storage of all food was noted. Carbon monoxide/smoke detectors alarms were tested and were in good repair. During inspection, LPA observed trash cans for storage of solid waste without tight fitting lids, due to this a Technical Violation (TV) 80088 (f)(1) was given and explained to the Licensee. LPA observed the landline (phone) was broken during the visit. A Technical Violation 80073(a) was given and explained to the Licensee. The garage was inspected and contained additional storage, per Licensee clients do not have access to the garage and remains locked at all times. The backyard where clients will have access to play is completely fenced and free of hazards. There is no pool or other body of water. Staff records were reviewed and were in compliance. An exit interview was conducted, and a copy of this report was provided to Licensee.

visit_type: Annual

met_with: Licensee, Tanja Lugo


facility_name: LUMINOUS SOULS CARE

summary: Facility Evaluation

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Narrative:
On February 8, 2024 at 09: AM, Licensing Program Analyst (LPA) Linda Haynes began a pre-licensing inspection for Luminous Souls Care Small Family Home. LPA met with applicant Ashley Gauthier who led a tour of the home. The facility was toured both inside and out with the Applicant. Currently there are no children in placement The home is a one story building with three bedrooms and two bathrooms which are set up as follows: · Bedroom #1 (Master) has one bed, it sleeps the applicant. · Bedroom #2 (Client's) has two twin beds, it will sleep two clients. · Bedroom #3 (daughter) has one twin bed, it sleeps the daughter. · A great room/living room, kitchen, dining area, two bathrooms, an office, an attached two car garage, storage closet, and the backyard. The Client's bedrooms were arranged so that no more than two client's will be in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There was a smoke detector/Carbon Monoxide detector in every bedroom. The four smoke detectors/carbon monoxide detectors were checked, and they were working properly. There is a fire sprinkler system in the home. The home's central air conditioning module was located on the side of the home. The home's tankless hot water heater was located inside the garage and the temperature is set to 120 degrees Fahrenheit. The appliances were in working order. The client's files will be locked inside a cabinet in the office. There was adequate food storage space and a supply of two days of perishable foods and a week of non-perishable foods. A trash can for storage of solid waste had a tight-fitting lid and was present. The sharp knives are in a locked cabinet across from the applicants bedroom. The medications will be located in a locked box in the office. The hot water in the Master Bathroom measured to be 105.4 degrees Fahrenheit. The water temperature of bathroom 2 measured to be 107.7 degrees Fahrenheit. The First Aid kit was not present at time of inspection. one fire extinguisher was present in the home it is located in the kitchen. It was observed to be properly charged and inspected by the fire department. Applicant stated there were no weapons/firearms in the home. There is no pool or other body of water at the home. The backyard where clients will have access to play was completely fenced. The following corrections need to be made: 1. First aid kit to contain the following Supplies a. Current edition of the first aid manual b. Sterile first aid dressings c. Bandages d. Adhesive Tape e. Scissors f. Tweezers g. Thermometer h. Antiseptic Solution A component III was completed at this time. This application will be forwarded to the Licensing Program Manager for licensing. A copy of this report and Appeal Rights was given to Applicant.

met_with: Ashley Gauthier


summary: Facility Evaluation

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Narrative:
On April 3, 2025 at 09:55AM, Licensing Program Analyst (LPA) Rachel Vanegas arrived unannounced to the facility listed above for the purpose of conducting a post-licensing annual inspection. LPA met with Licensee - Ashley Gauthier, who led a tour of the home, both inside and outside. The home is a single story family home with four bedrooms and two restrooms. The home set up as follows: Bedroom #1 (Master) has one bed, it sleeps the Licensee Bedroom #2 (Client) has two twin beds, it sleeps one client and has one vacant bed. There is a dresser and a closet with adequate space for storage of personal belongings Bedroom #3 (daughter) has one twin bed, it sleeps the Licensee's daughter Bedroom #4 (Office/Storage) is used as a storage room and office space A great room/living room, kitchen, dining area, two bathrooms, a laundry room that stores cleaning chemicals and remains locked, an attached two car garage, a storage closet, and the backyard. The client's bedrooms was arranged so that no more than two client's will be in the room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. The sharp knives are in a locked storage closet across from the Licensee's bedroom. The medications are stored in a box in the Licensee's bedroom, where they are securely stored and inaccessible to clients in care. There are combination smoke detector/carbon monoxide detectors in every bedroom and hallway. The smoke detector/carbon monoxide detectors were tested and are in properly functioning order. There is one fire extinguisher in the home that was observed to be properly charged, located in the kitchen.The home has a tankless water heater located inside the garage and the temperature is set to 120 degrees Fahrenheit. The hot water temperature was checked in the kitchen and registered at 117.5 degrees Fahrenheit. Telephone services and appliances were in working order at the time of this inspection. **Continued on LIC 809-C** The home has two cameras located inside, one camera is in the great room/living room and one is in the hallway. There are two additional cameras located outside of the home, one in the front yard and one in the backyard. LPA observed an adequate supply of perishable and non-perishable foods and posted meal menus in the kitchen. There was a trash can for storage of solid waste with a tight-fitting lid located in the kitchen. The first aid kit is located in a storage closet near the Licensee's bedroom and contained all of the required materials. LPA also observed other required postings upon entry to the home including the facility license, foster youth personal rights, visitation policy, etc. The backyard was observed to be clean and free of hazards. The backyard has a life size Connect 4 game and jump ropes available for outdoor activities for the children in care along with additional recreation games. There is no pool or other body of water at the facility at this time. LPA conducted one client file review for Client 1 (C1) and observed the needed documents in the files including, needs and services plans, consent to medical treatment authorization forms, placement agreements, signed personal rights form, etc. One out of one files did not contain documented results of tuberculosis (TB) screening for C1. LPA conducted one staff file review for Staff 1 (S1) and observed that one out of one staff files contained needed documents including CPR/First Aid certificates, Drivers License, Job Duties, Health Screening, etc. LPA discussed with the Licensee that the Designation of Facility Responsibility, LIC 308, needs to be updated. LPA further discussed with the Licensee that Program Statement updates are required to include the Camera Policy revisions in accordance with Provider Information Notice, 24-09-CRP. Based on observation and record review, the facility is being cited one Type B violation in accordance with California Code of Regulations (CCR) (Title 22) 80069(c)(1) for not having documentation of a medical/TB examination on file for C1 within 30 days of admission. An exit interview was conducted and a copy of this report, LIC 811, and appeal rights were reviewed and provided to the licensee - Ashley Gauthier.

met_with: Licensee - Ashley Gauthier


facility_name: M & B SMALL FAMILIES

summary: Facility Evaluation

raw_content:
Narrative:
On January 16, 2024, Licensing Program Analyst (LPA) Karen Beal and Licensing Program Manager (LPM) Abdoulaye Traore met with applicants Banesa Torres & Marquice Washington for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the notification of incomplete application (LIC 184), letter of Incomplete Application, and additional correspondence to assist with the revisions needed to the application. Copy of this report was provided to applicant.

met_with: Banesa Torres & Marquice Washington


summary: Facility Evaluation

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Narrative:
On February 21, 2024, at 10: AM Licensing Program Analysts (LPAs) Karen Beal, LPA Maya Chavez and Licensing Program Manager (LPM) Abdoulaye Traore began an inspection for a Small Family Home license. LPAs and LPM met with applicants Marquice Washington & Banesa Torres who led a tour of the home. The facility was toured both inside and out with the applicants. Applicants are applying for a capacity of 3 ambulatory children and the house is a 3-bedroom two-story house: Downstairs: It consists of a kitchen; a closet, a half bathroom; a pantry; a large dining table; a living room; a game area with a pool table and the garage. Upstairs: Bedroom #1- The room was furnished with a bunk bed (to be used for one foster child) Bedroom #2- The room consist with a bunk bed (to be used two foster children) Bedroom #3, - Applicant bedroom Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate drawer and closet space for children's belongings. Outside the bedrooms, there was a laundry room, a loft area which contained sofas, a bookshelf, and a table. The smoke detectors and carbon monoxide detectors were checked and are working properly. All hazardous items have been properly made inaccessible to areas where children will have access. Cleansers/chemicals and medication lockbox were locked and stored in downstair closet. Sharp knives were inaccessible and stored downstairs in a locked closet. First Aid kit was accessible with all required items. A Fire extinguisher was observed and properly charged. There were no guns or weapons as stated by Mr. Washington. The hot water temperature was tested and noted to be 111 degrees. Applicants understand that the water temperature must be maintained within the regulation range of 105-120 degrees. Proper storage of all food was noted. Trash cans for storage of solid waste have tight fitting lids. The Emergency Disaster Plan with exit map, Title Personal Rights, and visitation policies were posted at this time. The home have a telephone service at this time. The backyard where children will have access to play is completely fenced and free of hazards. There is no pool or other body of water. Component III orientation was conducted by LPM A. Traore during the visit. Based on this inspection, the home is appropriate for a capacity of 3 ambulatory children. The request of License will be forwarded to Licensing Program Manager for final approval. Exit interview conducted and a copy of this report was discussed and provided to Marquice Washington, applicant.

met_with: Marquice Washington & Banesa Torres, Licensees


summary: Facility Evaluation

raw_content:
Narrative:
On December 4, 2025, at 10: AM, Licensing Program Analyst (LPA) Julian Lucas conducted an unannounced visit at M & B (Small Family Home) (SFH) to conduct an unannounced two year required inspection. LPA Lucas met with Administrator Marquice Washington and completed a walk through of the facility. LPA began a physical plant inspection at 10: AM assisted by the Administrator Marquice Washington. During the physical plant inspection, LPA observed the facility to be a two story home. A formal entry with a dining room consisting of pool table. In the formal entry the LPA observed postings of Title Personal Rights, and visitation policies were posted.The client and facility files were reviewed. The backyard is completely fenced and free of debris.The living room consisted of two sofas, the dining room consisted of a formal table with five chairs and one formal bench. The kitchen includes The Emergency Disaster Plan with exit map, a refrigerator/freezer, and a pantry for food storage. There is an adequate supply of perishable and non-perishable foods, and the food menu is posted. All sharps are kept in a lock closet. There is an entrance to the garage. There is a restroom with restroom sink reading above 105 degrees Fahrenheit. Upstairs there are three bedrooms. There is one restroom at top of the stairs upstairs, the restroom sink reads above 105 degrees Fahrenheit. The master bedroom is to the left of the stairs has with one bathroom with a sink reading above 105 degrees Fahrenheit. There are two other bedrooms for children, one bedroom is being occupied, and the other bedroom is empty with no children. The bedroom being occupied has a bunk bedroom, with appropriate linens, pillows, comforters, and mattresses in good repair. There is dresser drawer space for the client's clothing and closet. There is a drawer that is used to keep staff and client files and client medicine that is locked in a medicine cabinet. LPA reviewed one client's record and two Foster parent files. LPA interviewed two foster parents. Based on the annual required inspection on this date, there were no deficiencies found. An exit interview was conducted with the Administrator, Marquice Washinton and a copy of this report was given to the Administrator Exit interview conducted and a copy of this report was discussed and provided to Marquice Washington, Administrator.

met_with: Marquice Washington, Administrator


facility_name: MAKING MIRACLES HAPPEN SFH

summary: Facility Evaluation

raw_content:
Narrative:
On October 6, 2023 at 10: AM, a pre-licensing inspection was conducted by Licensing Program Analyst (LPA) Babatunde Aborchie. LPA met with applicant Miesha Hale. The purpose of the visit was to evaluate the home for a possible license for a small family home with capacity of two ambulatory children as requested by applicant. The applicant is requesting to be licensed for a small family home with capacity to serve a total of two ambulatory children ages 0-17. During this inspection, LPA and applicant inspected the facility inside and out. The apartment consists of: Bedroom #1, It was furnished with a King sized bed, it has a bathroom; it sleeps the applicant. Bedroom #2, It was furnished with two twin beds. One bed is currently occupied by one foster-child, age 5 years. There were also a living room, dining area, a closet, a kitchen, cabinets and one bathroom for clients. Bedroom is arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate drawer and closet space for children's belongings. The smoke detectors were checked and were working properly. Inside the facility, there is no fireplace. Telephone service and appliances were in a working order. All hazardous items have been properly made inaccessible to areas where children will have access. The medication will be locked in a locked box in applicant's bedroom. Cleansers/chemicals were locked and stored in applicant's bedroom closet. Sharp knives were inaccessible and stored in applicant's bedroom closet. There were no guns or weapons as stated by applicant at this time. The hot water temperature was tested and noted to be 110 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit was accessible with all required items, and it was in the kitchen cabinet. A Fire extinguisher was observed and properly charged. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. The patio where children will have access to play was free of hazards. There are no deficiencies to be cited at this time. The request to be licensed for a small family home will be forwarded to Licensing Program Manager for final approval. A component III orientation was conducted with applicant Miesha Hale. An exit interview was conducted. A copy of this report was provided to Applicant/Licensee

met_with: Miesha Hale


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Continued from LIC Regarding licensee threaten to hit FC1 with the shoe, a confidential interview stated denied that FC1 was threatened to be hit with a shoe. The confidential interview indicated that FC1 threw FC's shoe into the fan and the shoe landed on the licensee who told FC1 that such action was dangerous while holding the shoe. Additionally, the confidential interview stated that FC1 was acting out and throwing things around the house and jumping on the furniture. A confidential interview disclosed that licensee was mean to FC1, and foster mother attempted to hit FC1 with a shoe. In regard to licensee not allowing the foster child to leave the home, a confidential interview stated that FC1 attempted the leave the home by attempting to exit out the garage door. The confidential interview stated the door was blocked to prevent FC1 from exiting the home. However, FC1 was able to run to the front door and exit. Confidential interview stated the FC1 was not able to be located and the police was called and FC1 was later found by the police. A confidential interview stated that licensee/foster mother was mean to FC1 which resulted in FC1 running out of the house. Based on confidential interviews, the allegations that licensee threaten to throw an object at FC1 and licensee is not allowing FC1 to leave the home may have occurred or may be valid, however, there was not a preponderance of evidence to support or deny the allegation. Therefore, the allegation is unsubstantiated at this time. Copy of this report, Confidential Names (LIC 811) and appeal rights were discussed and provided to Licensee Miesha Hale.

Investigation Findings:
13On November 8, 2024 at 8: AM, Licensing Program Analyst (LPA) Karen Beal arrived at Making Miracles Happen (SFH) met with Licensee Miesha Hale to deliver the investigative finding of the complaint involving the small family home and the foster child listed on the Confidential Names (LIC 811). On July 29, 2024, Community Care Licensing (CCL) received a complaint alleging that licensee threaten to throw an object at a foster child and licensee is not allowing foster child to leave the home. It was specified that the Licensee threaten to hit foster child (FC1) with a shoe and the licensee blocked the door to prevent FC1 from leaving the home. On August 7, 2024, at 9: AM, LPA K. Beal initiated the investigation at the small family home and gathered pertinent documents from FC1 file. In addition, LPA conducted a health and safety inspection, interviewed licensee and FC1. LPA was unable to contact the County Social Worker (CSW). Continued on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Karen Beal 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 PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: MAKING MIRACLES HAPPEN SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 11/08/2024


facility_name: MAKING MIRACLES HAPPEN SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On May 15, 2024, at 2:05AM, Licensing Program Analyst (LPA) Karen Beal a Pre-Licensing inspection for a location change. LPA met with license Miesha Hale who led a tour of the home. The home was toured both inside and out with the licensee. The home consists of: Downstairs: There is a family room, living room, dining area, kitchen, laundry room and one bathroom. Upstairs: Bedroom #1, It was furnished with one twin bed. It will sleep client - Vacant. Bedroom #2, Master bedroom, sleeps the licensee Bedroom #3, It was furnished with a twin and will sleep a foster child currently in care Bedroom #4, It was furnished with two twins bed. It will sleep two clients - Vacant. Loft area is setup as a theater room. Bedrooms are arranged so that no more than two children share a room, and one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawer and closet space for the children's belongings. The smoke detectors were checked and were working properly. ***Continued LIC 809-C*** ****Continued from LIC 809**** Inside the facility there is a fireplace properly screened. Telephone service and appliances were in a working order. Medications, cleansers/chemicals, and sharp items will be locked in master bedroom closet. There will no weapons in the home as stated by licensee. The hot water temperature was tested and noted to be 118 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit was accessible with all required items. A Fire extinguisher was observed and properly charged. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request to be licensed for small family home will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to Applicant/License

met_with: Miesha Hale , Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On June 26, 2024, at 2: PM Licensing Program Analyst (LPA) Karen Beal began an announced inspection for the Small Family Home license. LPA met with licensee Miesha Hale, who led a tour of the home. The facility was toured both inside and out with the licensee. Licensee is applying for a change of capacity from 2 ambulatory clients to 4 ambulatory clients between the ages between 6-17. Downstairs: There is a family room, living room, dining area, kitchen, laundry room and one bathroom. Upstairs: Bedroom #1, It was furnished with one twin bed. It will sleep 1 client - Vacant. Bedroom #2, Master bedroom with a king bed, it will sleep the licensee Bedroom #3, It was furnished with a twin and will sleep a foster child currently in care Bedroom #4, It was furnished with two twins bed. It will sleep two clients - Vacant. Loft area is setup as a theater room. Bedrooms are arranged so that no more than two children share a room, and one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawer and closet space for the children's belongings. The smoke detectors were checked and were working properly. ***Continued to LIC 809-C*** ***Continued from LIC 809*** Inside the facility there is a fireplace properly screened. Telephone service and appliances were in a working order. Medications, cleansers/chemicals, and sharp items will be locked in master bedroom closet. There will no weapons in the home as stated by licensee. The hot water temperature was tested and noted to be 116 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit was accessible with all required items. A Fire extinguisher was observed and properly charged. There is a fire extinguisher located upstairs in the hallway and one downstairs in the living room. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request for capacity change will be forwarded to the Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to the licensee.

visit_type: Case Management

met_with: Miesha Hale, Licensee


facility_name: MAMA'S KIDS SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On September 30, 2021 at 8:28pm Licensing Program Analyst (LPA), Daniel Mena conducted an annual inspection at the facility. The home was toured inside and out with licensees, Angie & Sheny Sanabria. The home is a one story residence with 5 bedrooms and 3 bathroom, home with an attached "casita" which included one bathroom. The home is set up as follows: Bedroom #1- Was furnished with a twin-size bed. Sleeps C1. Bedroom #2- Was furnished with a full-size bed. Sleeps C Bedroom #3- Was furnished with a full-seize bed Sleeps C3. Bedroom #4- Resource Parents bedroom. Bedroom #5- Currently used to store clothing. Bedrooms are arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawer and closet space for children's belongings. The smoke detectors were checked and were working properly. There was also a plenty of space for children to play. The fireplace was located in the family room area and it was properly screened. Telephone service and appliances were in a working order. All hazardous items have been properly made inaccessible to areas where children will have access. Cleansers/chemicals were locked and stored in the laundry rooms. Sharp knives were inaccessible and stored in a locked cabinet in the kitchen area. The hot water temperature was tested and noted to be 110 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit was accessible and contained all required items. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. Licensee's stated that there are no weapons in the home. There were no pool or other bodies of water. The backyard where children will have access to play was completely fenced and free of hazards. Facility is licensed to serve ambulatory developmentally disabled children ages 2- 17 years old. The Licensee's meet the requirements for the 8 hours of annual foster care training. Licensee's First Aid and CPR cards expire on July 02, 2022. A review of staff records on this date indicates that all adults residing in the home or providing care and supervision to children have received fingerprint and child abuse index check clearances. Exit interview conducted and a copy of this report was discussed and provided this date.

met_with: Licensees


summary: Facility Evaluation

raw_content:
Narrative:
On September 21, 2022 at 1: PM Licensing Program Analyst (LPA) Anne Visaya conducted unannounced annual inspection required at the facility (SFH). Lpa a. Visaya met with licensee Angie Scarberry who let a tour of the home. The home was toured inside and out and currently there are 3 clients at this time. The home is a one story residence with 5 bedrooms and 3 bathrooms, home with an attached "casita" which included one bathroom. The home is set up as in the front door area it has a large covered area with a large table and chairs facing the front yard. Upon entry to the home a living room with secured, enclosed fireplace. Dining room and a den with kids toys, a walk-in pantry and a kitchen. Bedroom #1- furnished with full size bed, a closet and plenty of storage space, it sleeps an 18 year old male client Bedroom #2- furnished with full size bed, a closet and plenty of storage space, it sleeps a 17 year old female client Bedroom #3- furnished with 1 twin size bed, a closet and plenty of storage space, it sleeps a 15 year old female client Bedroom #4- Resource parent's bedroom. Bedroom #5 (Casita) - Currently used to store clothing, supplies at this time. Bedrooms are arranged so that no more than two children share a room and there is one child per bed. No room commonly used for other purposes, is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate shelf and closet space. Bathroom number one hot water temperature measured to be 107.6 degrees Fahrenheit, bathroom number 2 hot water temperature measured to be 103.5 degrees Fahrenheit , bathroom number three is the bathroom that the licensee uses and bathroom number in the casita is not accessible by the clients. The smoke detectors and carbon monoxide detectors were checked and are working properly. All hazardous items have been properly made inaccessible to areas where children will have access. Medications are locked in the kitchen cabinet. Cleansers/chemicals are locked and stored in the hallway closet. The first aid kit contains all required items. Sharp knives are inaccessible and stored in the kitchen locked drawer. Telephone service and appliances are all in working order. There are no guns or weapons as stated by Licensee Angie Scarberry. The Facility Sketch, Emergency Disaster Plan and visitation policy are posted at this time. Personal Rights is posted. The backyard where children will have access to play is completely fenced and free of hazards. There is no pool or other body of water. A review of four of four staff records indicates that all facility staff have received criminal record and child abuse index check clearances and CPR and first aid is up to date. Licensees had current CPR/ First Aid certificates. Licensee provided proof of 8 hours of continued education training. A review of three of three clients files are noted to have documents required per regulations in file. (b) For each child in the home, the licensee shall maintain a separate, complete, and most up to date record or file that includes the following: (12) A separate log for each psychotropic medication prescribed to the children... LPA provided the correct LIC 622B as Licensee stated that she was not aware of the form. Lpa a.Visaya provided Licensee and updated the medication record to reflect the correct form (LIC 622B for Psychotropic Medication). Based on the facility inspection and file reviews this date, there are no deficiencies found at this time. Exit interview conducted and a copy of this report was discussed and provided to Licensee Angie Scarberry this date.

met_with: ANGIE SCARBERRY


summary: Facility Evaluation

raw_content:
Narrative:
On February 28, 2024, at 10: AM Licensing Program Analyst (LPAs) Karen Beal and Maya Chavez conducted unannounced annual inspection required at the facility (SFH). LPAs met with licensee Angie Scarberry who let a tour of the home. The home was toured inside and out and currently there are 2 clients at this time. The home is a one-story residence with 5 bedrooms and 3 bathrooms, home with an attached "Casita" which included one bathroom. The home is set up as in the front door area it has a large covered area with a large table and chairs facing the front yard. Upon entry to the home a living room with secured, enclosed fireplace. Dining room and a den with kids toys, a walk-in pantry and a kitchen. Bedroom #1- furnished with full size bed, a closet and plenty of storage space, it sleeps an 19 year old male client Bedroom #2- furnished with full size bed, a closet and plenty of storage space, it sleeps a 16 year old female client Bedroom #3- furnished with 1 twin size bed, a closet and plenty of storage space, it is vacant Bedroom #4- Resource parent's bedroom. Bedroom #5 (Casita) - Currently used to store clothing, supplies at this time. Bedrooms are arranged so that no more than two children share a room and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate shelf and closet space. Continued on LIC 809-C Hot water temperature measured to be 108.7 degrees Fahrenheit, the Casita is not accessible by the clients. The smoke detectors and carbon monoxide detectors were checked and are working properly. Medications are locked in the kitchen cabinet. Cleansers/chemicals are locked and stored in the hallway closet. The first aid kit contains all required items. Sharp knives are inaccessible and stored in the kitchen locked drawer. Telephone service and appliances are all in working order. There are no guns or weapons as stated by Licensee Angie Scarberry. The Facility Sketch, Emergency Disaster Plan and visitation policy are posted currently. Personal Rights is posted. The backyard where children will have access to play is completely fenced and free of hazards. There is no pool or other body of water. A review of four of four staff records indicates that all facility staff have received criminal record and child abuse index check clearances and CPR and first aid is up to date. Licensees had current CPR/First Aid certificates. Licensee provided proof continued education training. A review of three two of two clients files are noted to have documents required per regulations in file. Based on the facility inspection and file reviews this date, there are no deficiencies found at this time. Exit interview conducted and a copy of this report was discussed and provided to Licensee Angie Scarberry this date.

met_with: Angie Sanabria, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On September 25th, 2025 at 2:25PM, Licensing Program Analyst (LPA) Cynthia Ramos met with Licensee Angie Sanabria who led a tour of the home. Licensee granted LPA access to the home. The purpose of the visit was to conduct an annual required inspection of Mama's Kids Small Family Home (SFH). The facility was toured inside and out with the Licensee.The home is a single-story home with 5 bedrooms and 3 bathrooms, home has an attached "Casita" which included one bathroom and one bedroom used as storage and was locked. The left wing of the home is occupied by Licensee and spouse, this side of the house remains locked at all times and is not accessible to clients in care. The home was set up as follows: Upon entering the home, there is the living room area with couches and television, next there was a large dinning table and additional couch. LPA observed board games and activities in the dinning table area that are accessible to clients. The kitchen was located next to the dinning table, kitchen was inspected and organized. Bedroom #1 consisted of full size bed and adequate closet and drawer space, this room was occupied by adult male client (21 years old). Bedroom #2 contained a twin size bed and was vacant. Bedroom #3 consisted of a full size bed and adequate closet and drawer space and was occupied by adult female client (18 years old). All bathrooms in the home were inspected and were working properly. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. All hazardous items have been properly made inaccessible to clients. The medications were locked in a kitchen cabinet. Cleansers/chemicals were locked in the hallway closet. Sharp knives were inaccessible and stored in the kitchen's drawer. ... The first aid kit was inspected and contained all necessary items. Per Licensee, there are no guns or weapons in the home. The hot water temperature was tested and noted to be 113.7 degrees Fahrenheit. Proper storage of all food was noted. Trash cans for storage of solid waste have tight fitting lids. The Emergency Disaster Plan with exit map, Title Personal Rights, and visitation policies were posted. The backyard where clients have access to play is completely fenced and free of hazards. There is no pool or bodies of water in the home. The carbon monoxide and smoke alarms were tested and were in good working conditions at the time of inspection. A total of 4 staff records and 2 client records were reviewed and were in compliance. Based on today's inspection, there are no deficiencies to be cited at this time An exit interview was conducted, and a copy of this report was provided to the Licensee Angie Sanabria.

met_with: Licensee, Angie Sanabria


facility_name: MAPENDO SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On September 14, 2021 at 1:19 pm Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an annual inspection at the facility. The home was toured inside with licensee's Julie and Morisho Amisi. The home is a two story residence with six bedrooms and 3 bathrooms. The home is a two-story home and consists of: Downstairs: a living room, a family room, a kitchen, a dining area and two bedrooms. Bedroom # 1, the room was furnished with a queen size bed. It was vacant. It will sleep a caregiver Bedroom #2, the room was furnished with two cribs/toddler beds and it will sleep two foster children age 0-2, Upstairs: Bedroom #3, master bedroom. The room was furnished with of a king bed. It sleeps the licensee's. Bedroom #4, the room was furnished with a king size bed. It was vacant Bedroom #5, the room was furnished with a queen bed It sleeps Amisi's 10-year-old son Bedroom #6, The room was furnished with a king bed. It was vacant. There was another room used as exercise which contained sporting equipment's such as treadmill's and a stationary bike. Bedrooms are arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawer and closet space for children's belongings. The smoke detectors were checked and were working properly. Outside the upstairs bedrooms were a loft designated office area which contained cabinets to store children records. There was also a plenty of space for children to play. The fireplace was located in the family room area and it was properly screened. Telephone service and appliances were in a working order. All hazardous items have been properly made inaccessible to areas where children will have access. Cleansers/chemicals were locked and stored in the laundry rooms. Sharp knives were inaccessible and stored in a locked cabinet in the kitchen area. The hot water temperature was tested and noted to be 110 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit was accessible and contained all required items. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. Licensee's stated that there is one weapon in the home and that the weapon/gun is locked and stored in the master bedroom closet , and the ammunition is locked and stored separately in the garage. There were no pool or other bodies of water. The backyard where children will have access to play was completely fenced and free of hazards. Facility will accept only two ambulatory developmentally disabled children and licensed for a capacity of 2 foster children age 0-17. Facility prefers to serve children that are medically fragile and with special health care needs 0-2. The Licensee's meet the requirements for the 8 hours of annual foster care training. Licensee's First Aid and CPR cards expire on March 18, 2023. A review of staff records on this date indicates that all adults residing in the home or providing care and supervision to children have received fingerprint and child abuse index check clearances. Exit interview conducted and a copy of this report was discussed and provided this date.

met_with: Licensee's


summary: Facility Evaluation

raw_content:
Narrative:
On November 9, 2023 at 9:35 am, Licensing Program Analyst (LPA) Karen Beal conducted a pre-arranged random annual. LPA met with Amisi and Julie Morisho. The Facility was toured both inside and out with Julie. The home is a two-story home and consists of: Downstairs: a living room, a family room, a kitchen, a dining area and two bedrooms. Bedroom # 1, is used for storage Bedroom #2, the room was furnished with two cribs/toddler beds and it will sleep two children. Currently vacant. Upstairs: Bedroom #3, master bedroom. The room was furnished with of a king bed. It sleeps the applicants. Bedroom #4, the room was furnished with a queens size bed. Its occupied by 12 year old bio-child. Bedroom #5, the room is used as an office. Bedroom #6, The room is currently a workout room. It may be used for placement children. There was another room used as exercise which contained sporting equipment's such as treadmill's and a stationary bike. Bedrooms are arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawer and closet space for children's belongings. The smoke detectors were checked and were working properly. Upstairs the loft area is an office area which contained cabinets to store children records and is used as an office. A trash can for storage of solid waste had a tight fitting lid. The sharp knives are in a locked cabinet in the kitchen. Cleaning supplies are located in the locked laundry room. The hot water in the kitchen measured at 120F measured at and the bathroom measured at 118F. ***Continued to LIC 9099-C*** The home's First Aid kit was accessible and is located in the kitchen it had all required supplies. One fire extinguisher available in the home. It is located on the wall outside of the dining area. The fire extinguisher was properly charged but was not inspected by the fire department. The fire alarm/carbon monoxide were tested as working properly. There is no pool or other body of water. The backyard is fenced in with plenty of space for children to play. CPR and the First Aid cards expires on 3/1/25. Exit interview conducted and a copy of this report was given.

met_with: Licensee, Julie Morisho


summary: Facility Evaluation

raw_content:
Narrative:
On December 8, 2025, Licensing Program Analyst (LPA) Babatunde Aborchie arrived at Mapendo Small Family Home (SFH) for required 2-year inspection. There are no clients in placement. The home was licensed for a capacity of two clients (non-ambulatory). The Facility was toured both inside and out with the licensee. The home is a two-story building with seven bedrooms and three full bathrooms. During the inspection, LPA observed that downstairs consisted of the kitchen, a living room, a den, a dining area and two bedrooms. Bedroom #1 was furnished with two cribs; it would sleep two clients. Bedroom #2 was furnished with a queen-sized bed. It was vacant. Sharp knives were inaccessible and stored in a locked cabinet in the kitchen. The First Aid Kit was in the kitchen cabinet and contained all required items. The garage was inspected and used for cars and storage. The water temperature was tested and measured at 115 degrees F. LPA observed a minimum of seven-day non-perishable and a three-day perishable supply of food. There was a variety of snacks available for clients. In addition to the downstairs space, there was also one full bathroom fully functioning. A trash can was observed to have tight fitting cover. The following required posted items were observed accessible to clients: personal rights, visitation policy, and current menu. Medications will be stored in a locked kitchen cabinet by the refrigerator. Two fire extinguishers were observed and operable. Upstairs was bedroom #3 furnished with a treadmill, used as a gym room. Bedroom #4, it was fully furnished with a king-size bed. It was vacant. Bedroom #5 was fully furnished with one king-sized bed, a closet and plenty of storage space. It was used as a guest room. Bedroom #6, it was fully furnished with a queen-sized bed, it sleeps biological son age fourteen years. Bedroom #7 was furnished with a king-sized bed; master bedroom, it sleeps the licensee and the spouse. The licensee's bedroom is not accessible to the clients. All bedrooms were arranged for one child per bed. No room was commonly used for other purposes other than a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for each child's belongings. The smoke and carbon monoxide detectors were checked and working. Cleansers/chemicals were locked and stored in the laundry room. The upstairs space includes additional storage, an office, and an additional bathroom. All hazardous items have been properly made inaccessible to areas where clients have access. All windows and screens were in good repair. Licensee states that there was a gun/weapon in the home and that the gun is locked and stored separately in a locked coded safe, and the ammunition is locked and stored separately in a box. The licensee was reminded that the gun must be locked and stored separately in a coded safe, and the ammunition was locked and stored separately in a box. There was a total of four cameras, located outdoors, which met the title 22 camera policy. The facility outside grounds were also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. Based on today's inspection and observations, there are no deficiencies being cited at this time. A copy of this report will be provided to the licensing program manager for final approval. An exit interview was conducted, and a copy of this report was discussed and provided to Licensee.

met_with: Licensee


facility_name: MARGARET AND HENRY SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On September 10, 2024, Licensing Program Analyst (LPA) Rafael Enriquez met with applicant Margaret Mwangi & Henry Benson for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the notification of incomplete application (LIC 184), letter of Incomplete Application, and additional correspondence to assist with the revisions needed to the application. Copy of this report was emailed to applicant and a signed copy will be placed in the facility file.

met_with: Applicants Margaret Mwangi & Henry Benson


summary: Facility Evaluation

raw_content:
Narrative:
On October 07, 2024, at 12: PM, Licensing Program Analyst (LPA) Rafael Enriquez began a pre-licensing inspection for Margaret & Henry Small Family Home for an initial license. LPA met with applicant Margaret Mwangi & Henry Benson who led a tour of the home. The facility was toured both inside and out with the applicants. Currently there are no children placed in the home. The applicants were approved to serve three children ages 0 to 17. The home is a Two-story building with four bedrooms and three bathrooms which is set up as follows: Downstairs: · Bedroom #1 will sleep two foster children; it was furnished with two twin sized beds. It was vacant. · There was also a living room, a dining area, a kitchen, two pantry closets, a laundry room, a bathroom and a storage closet. Upstairs: · Bedroom #2, the master bedroom, it was furnished with a Cal-king sized bed and a crib, it had a bathroom and a walk-in closet. It sleeps the applicants. · Bedroom #3, sleeps applicant's 22-year-old son, it was furnished with a queen-sized bed. · Bedroom #4, sleeps applicant's 25-year-old daughter, it was furnished with a queen-sized bed. There was also a linen closet, and a bathroom. Bedrooms were arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. The smoke detectors and carbon monoxide detectors were checked, and they were working properly. Telephone service and appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients/children will have access. Sharp knives and sharp objects were locked in a kitchen drawer. Cleansers/chemicals were inaccessible and stored in a locked kitchen cabinet underneath the sink. There was adequate food storage space and a supply of three days of perishable foods and a week of non-perishable food. A proper storage of all food was discussed. Trash cans for storage of solid waste had tight fitting lids. The water temperature was observed to be at 105.8 degrees. First Aid kit was accessible with all required items, and it was in a kitchen cabinet. A Fire extinguisher was observed and properly charged. The fireplace was in the living room area, and it was properly screened. All the appropriate forms were posted in view of facility clients. As stated by applicant, there were no weapons/firearms and there were no pools or other bodies of water. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request for licensure will be forwarded to Licensing Program Manager for final approval. Applicants were advised to contact the department within 30 days of their first placement. An exit interview was conducted. A copy of this report was provided to applicant Margaret Mwangi & Henry Benson.

met_with: Applicants- Margaret Mwangi & Henry Benson


summary: Facility Evaluation

raw_content:
Narrative:
On July 7, Licensing Program Analyst (LPA) Maryjane Perez arrived at Margaret and Henry Small Family Home (SFH) for a post licensing visit. LPA met with licensee Henry Benson who led a tour of the home. The facility was toured both inside and out. Currently there is one client placed in the home. Licensees were approved for a capacity of three children ages 0 to 17 years old. The home is a two- story building with four bedrooms and three bathrooms. The downstairs consisted of an entry way with all required postings such as emergency disaster plan, facility sketch, personal rights, visitation policy, and license. There was fire extinguisher #1 that was operable and a living room with couches, TV, and a telephone land line service. The kitchen was clean and sanitary with locked sharps/ knives, a locked cabinet storing medication, and client files/ personnel records. The pantry and refrigerator were fully stocked with perishable and non perishable foods. There was bathroom #1 that was fully functioning with water temperature measuring 114.6 degrees Fahrenheit and trash cans with tight fitting lids. There was bedroom #1 that had two twin size beds, dresser/ drawer space and was utilized for two clients (one ambulatory and one non-ambulatory) one bed was occupied by an ambulatory client while the other one was vacant. There was a laundry room that was accessible to clients. The garage stored laundry detergents, extra house hold items such as paper towels, and a locked cabinet with gardening tools. The upstairs consisted of bedroom #2 that was the master bedroom for licensees that had a crib for a client currently vacant and bathroom #2 fully functioning. There was bathroom #3 that had a trash can with a tight fitting lid and fully functioning. Bedroom #3 was for licensees biological son and had a queen size bed and fully furnished. Bedroom #4 was for licensees biological daughter and had a queen size bed and was fully furnished. There was a hallway with fire extinguisher #2 that was operable and a closet storing extra linen and towels. Bedrooms were arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. The smoke detectors and carbon monoxide detectors were checked, and they were working properly. Telephone service and appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients/children will have access. As stated by licensees, there were no weapons/firearms and there were no pools or other bodies of water. The backyard where children will have access to play was completely fenced and free of hazards. The client and facility files were reviewed as well as two staff and one client were interviewed. The home was also inspected for a non-ambulatory status change for one client and meets regulations. Exit interview conducted and a copy of this report and 10 technical assistances were discussed and provided to licensees MARGARET MWANGI & HENRY BENSON.

met_with: Licensee- Henry Benson


facility_name: MARSHALL SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On 01/27/2021 at 10:00AM Licensing Program Analyst (LPA) Olivia made an announced to Marshall Small Family Home for the purpose to conduct the Annual/Required licensing inspection. LPA Rosas met with Adult#1 (A1) who granted access to the home and an inspection of the facility was conducted together. Individuals mention in this report are identify on the Confidential Names List (LIC811) dated 01/26/21. This is a single-story family home in a residential neighborhood, and it has three (3) bedrooms, (2) two bathrooms, living room, kitchen, dining area, backyard, working fireplace with a secured screen on. There is an attached garage and pond in the backyard with a fence around it. The facility has alarm system on the doors. The home is licensed to serve four (4) developmentally disabled children, ages 2-17 years, ambulatory only. The annual fee is current. Currently in placement are three (2) clients from Child Welfare Services. A1 confirmed that there are no firearms or dangerous weapons in the home. LPA Rosas inspected the following: Bedroom #1: Is occupied by Adult#1 (A1) and also used as an office. It has one queen size bed, adequate drawer and closet space adequate drawer space, closet space and lighting, comfortable mattress, and clean lines, blankets and pillows. The room has a walk-in closet and bathroom #1. Bedroom #2: Is occupied by Client#3 (C3) It has two twin beds, and adequate drawer space, closet and lighting, comfortable mattresses, and clean lines, blankets, and pillows. Bedroom #3: Is occupied by Client#1 (C1) and Client #2 (C2). It has two twin beds, adequate drawer space, closet space and lighting, comfortable mattress, and clean lines, blankets and pillows. Bathrooms: Bathroom #1 is located inside the master bedroom, equipped with a tub, shower, toilet and sink. Bathroom #2 is located near bedroom #2 and #3 equipped with a tub, shower, toilet and sink. Water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Report continues on LIC 809-C Page 1 of Outdoor Area: There are bodies of water on the premises; a fish pond located in the back yard. The fish pond has two (2) gold fishes and its covered with a fence around the pond. The activity space is free of hazard materials and debris. LPA observed the utility shut-off valves in the side of the home. The facility is surrounded by wooden fence and is observed to be good condition. Garage: The attached two car garage is used as storage and is kept locked. here is a vehicle available to transport foster children; make and model Toyota Sienna Van. The vehicle has full coverage auto insurance with Farmers Insurance. The washer and dye are located inside of the garage. The laundry 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 inside of the garage making inaccessible. Living Room: There is adequate furniture which appears to be in good condition. The living room has dining table with six (6) chairs and television. Additional disinfectants, chemicals, and medication are locked in storage closet in the living room making inaccessible. Dining Area/Kitchen/Family Room (Den): There is adequate furniture which appears to be in good condition. There is a television and working fireplace with a cover. One table with six (6) chairs is next to the Kitchen: There is a gas stove/oven with four (4) burners, all operating. There is a dishwasher, microwave, refrigerator/freezer and a toaster oven. LPA's observed adequate perishable/nonperishable food supplies. Sharp knives, disinfectants/cleaning solutions made inaccessible to the children locked in cabinet under the sink. Water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Additional LPA observed a key locked closet that stored hygiene supplies, and cleaning solutions. All windows were in good condition with screens and blinds. There were no security bars on the windows. LPA observed ample towels and linen closet. The passageways and porches are unobstructed. All posting requirements were met, (food menu, regulations, licenses, emergency disaster plan, Children's Personal Rights, and Ombudsman). The home has a working telephone and youths can use the telephone unless restricted by court order. The Emergency Evacuation Plan is posted. All posting requirements were met. Report continues on LIC 809-C Page 2 of Medications, disinfectants, and cleaning solutions are inaccessible to children and kept locked in a storage closet. The home has a functioning carbon monoxide detector that meet the statutory requirements. All smoke detectors were tested and operable at the time of inspection. LPA Rosas observed a fire extinguisher at the time of inspection. Perishable and non-perishable food is adequate in the home. The Facility operates within license conditions and limitations including capacity limitations. Facility has a current, written plan of operation. Facility personnel are instructed to report violations of personal rights. Licensee will report changes in the plan of operation affecting service to youths. Licensee will report youth injuries requiring medical treatment. All the children prescribed medications are locked in the closed and children files are kept in a lock cabinet inside Bedroom#1. Staff office is located inside Bedroom#1. The First Aid kit has the required items inside age-appropriate, and scissors, tweezers, thermometer, and gauzes, antiseptic and First Aid Manual Guide and is kept in the kitchen. LPA Rosas reviewed three (3) clients record currently in care. There are three (3) individual client folders. The Facility maintains client's cash resources, personal property, and valuables. Client's records contain authorization for medical care signed by each client's authorized representative. Client's records contain copies of the original Needs and Services plan signed by each child and their authorized representative (County Social Worker (CSW). LPA was not able to interview youth as they were in school at time of inspection. LPA Rosas reviewed one (1) staff file. A1 has parenting training for 2019 and is enrolled in Casa Pacifica but due to the COVID-19 pandemic has not been able to obtain training hours for 2020. Licensee has current First Aid and CPR training; expiration date of 3/2021 and training was obtained from an accredited agency. LPA Rosas interviewed A1. A review of Facility's Personnel Report Summary on 01/26/2021 indicates that all personnel have criminal record clearance has obtain the necessary clearances with DOJ, FBI, and Child Abuse Response. Report continues on LIC 809-C Page 3 of LPA Rosas provided the following PIN 21-20-CRP: Statewide Launch of New Inspection Tools for Children's Residential Licensees, and PIN 20- CPR New Background Check Requirements and copy of MAR, Emergency Disaster Plan for Children Residential Facilities (LIC 610). LPA Rosas issued Advisory Technical Assistance Note for 80087(a) (a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors for the living room to be organized and store all extra supplies. Technical Assistance Advisory Note for 83070(b) (12) (b) For each child in the home, the licensee shall maintain a separate, complete, and most up to date record or file that includes the following: (12) A separate log for each psychotropic medication prescribed to the child documenting. LPA Rosas provided a copy MAR for logging each psychotropic medication. There were no deficiencies observed or cited at this time. Exit interview was conducted with A1 and a copy of this report was left in the facility.

met_with: Adult#1 (A1)


summary: Facility Evaluation

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Narrative:
On 04/09/2024 at 11:33pm, Licensing Program Analyst (LPA) Christine Wilson met with Licensee who granted access to the home and an inspection of the home was conducted together with the licensee, for the purpose of conducting a 2-Year required Inspection. The facility is a single-story family home in a residential neighborhood and it has three (3) bedrooms, (2) two bathrooms, living room, kitchen, family room, dining area, backyard, non-working fireplace with a secured screen on, and attached two car garage. The home is licensed to serve (4) four developmentally disabled children, ages 10-17 years, ambulatory only. The annual fee is current. Currently in placement are (4) four clients from Child Welfare and Tri-counties Regional Center. Individuals mentioned in this report are identify on the Confidential Names List (LIC811) dated 04/09/24. LPA Wilson observed the follow during the inspection: Outdoor Area: There is no swimming pool. There is a small body of water (fish pond) on the premises. Outdoors activity space free of obstructions. The front and backyard are cleared from hazards. Bedroom #3: Is occupied by licensee and used as an office. It has one queen size bed, adequate drawer and closet space. The room has a walk-in closet and bathroom.Bathroom Bedroom #: Is occupied by client C1 and client C4. It has two twin beds, adequate drawer and closet space. Bedroom #2: Is occupied by Client C2 and Client C3. It has two twin beds, adequate drawer and closet space. Bathroom 2: Is used by all clients. Water temperature was at 99 degrees. The licensee adjusted the temperature in front of the LPA. Hallway Closet: Contains client medications in a locked box in a locked closet, and sharps. LPA observed a complete first aid kit. There are no weapons in the home. Report continues on LIC809C Pg. Page Kitchen: LPA Wilson observed a posted menu and a fire extinguisher in the kitchen that was operable at the time of inspection. Clients in care are supervised and protected at all times. Facility has non-perishable foods for one week and perishable foods for two days. Facility provides nutritious snacks between meals. Living Room: has seating for 6 persons and fireplace is not in working condition. Family Room: has seating for (8) persons and features a wall with information and emergency numbers and a TV. Dining Room: has a table and (4) chairs. There is a motion sensor which LPA observed is in working condition. Garage:Is joined to the living room by a door. There is a non-operable Chevrolet Suburban and other items. Clients are not allowed access to the garage. The home has comfortable mattresses, clean linens, blankets, and pillows, all in good repair. The home is clean, safe, sanitary, and in good repair. Medications: are locked and accessible only to employees responsible for stored medications. Medication, disinfectants, and cleaning solutions are inaccessible to children and kept in a lock closet. The home has multiple (2) functioning carbon monoxide detectors that meet the statutory requirements. There are (4) smoke detectors that were tested and operable at the time of inspection. Postings: All posting requirements were met. Facility posts child's rights in dining area adjacent to kitchen. Vehicle: Licensee has current registration, and insurance with State Farm Insurance which expires in August 2024 for Toyota Sienna Van. Vehicle is in good condition. LPA Wilson was not able to inspect staff and client files, medication records or conduct client interviews and will return to complete the inspection at a later date There are no deficiencies cited today. Exit Interview was conducted, and a copy of this report was emailed to the licensee.


summary: Facility Evaluation

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Narrative:
On 04/09/2024 at 10:02am, Licensing Program Analyst (LPA) Christine Wilson made an unannounced visit to the Marshall Small Family Home for the purpose of conducting a 2-Year Required Inspection. The licensee (S1), nor any other persons were at the home. At 10:23am, LPA Wilson called the licensee, who stated she was at a doctor's appointment, and would return to meet with LPA Wilson shortly after 12:00pm. LPA Wilson stated the inspection will begin on this day, when the licensee returns, and will conclude on a different day.

met_with: No one


summary: Facility Evaluation

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Narrative:
On 04/15/24 at 9:55am, Licensing Program Analyst (LPA) Christine Wilson made an unannounced visit to the Marshall Small Family Home for the purpose of concluding an Annual 2-Year Inspection. LPA Wilson met with Licensee who granted access to the home and an inspection of the home was conducted together with the licensee. Postings: All posting requirements were met. Facility posts child's rights in dining area adjacent to kitchen. Clients are not restricted in telephone use except by court order. Clients are accorded dignity in personal relationships with staff and others. Clients live in a safe, healthy, comfortable home and are treated with respect. Clients can contact the licensing agency or Foster Care Ombudsperson in confidence without threats or punishment for making complaints. LPA Wilson conducted the following: Client Interviews: LPA WIlson conducted (2) client interviews with (C1) and (C4). LPA Wilson reviewed the follow during the inspection: Clients Records: Facility maintains client's cash resources, Per licensee" I have four consumers only and I am not obligated to give them allowance but I do give them money fort he things they want. I will start a log with each boy." personal property, and valuables. Client's records contain authorization for medical care signed by each client's authorized representative. Client's records contain copies of the original needs and services plan signed by each child and their authorized representative. Clients attend school, extracurricular, cultural, and personal enrichment activities.' Staff Records: Staff files for (S1) was reviewed and and (S2) will be removed from Guardian, as per licensee :she lives out of state." Licensee does not have a current First Aid and CPR training; Licensee stated that she will obtain a current training from an accredited agency and will complete 4 hours CPR/First Aid/AED training hours for this year. There is (1) deficiency and (1) TV noted today. Exit Interview was conducted, and a copy of this report was emailed the licensee.


facility_name: BRENDA'S FAMILY HOME

summary: Facility Evaluation

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Narrative:
On January 21, 2025, at PM, a Component II Office Visit was held to discuss the application received for Brenda's Family Home located at Vose Street Van Nuys, CA 91406. Attending Component II were the following individuals: Brenda Cano, and Britney MartinezApplicants, Erika Butler. Licensing Program Analyst, and JoAunne Griffin, Licensing Program Manager. The purpose of this Component II meeting was to review and discuss the incomplete application and Program Statement and to resolve any outstanding concerns that may have existed. The following incomplete application forms were discussed at the meeting: Brenda's Family Home Small Family Home Section A Documents 1. Application (LIC 200) 2. Applicant Information (LIC 215) 3. Personnel Report (LIC 500) 4. LIC Budget Information Form 5. Personnel Record (LIC 501) 6. Emergency Disaster Plan (LIC C) 7. Criminal Record Clearance Associated to facility 8. Out of State Disclosure (LIC D) continued on 809C .First Aid Certiﬁcate - Brenda Cano and Britney Martinez needs Infant, Pediatric First Aid/CPR cards. Program Statement Sections B7, B8, and B9. The Applicants was advised of the following revision and/or corrections needed to the application and/or Program Statement. Revisions are due February 11, 2025, Email revisions to erika.butler@dss.ca.gov. Pre-Licensing visit is scheduled for February 19, 2025, at AM. A copy of this report was provided to the Applicants Brenda Cano and Britney Martinez.

met_with: Brenda Cano and Brittney Martinez


summary: Facility Evaluation

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Narrative:
On February 19, 2025, at 10: AM Licensing Program Analyst (LPA) Erika Butler, and Licensing Program Manager (LPM) JoAunne' Griffin arrived at Brenda's Family Home for the purpose of conducting a Pre-Licensing Inspection. LPA and LPM met with Applicants Brenda Cano, and Britney Martinez who granted access to the home and together a tour of the interior and exterior home was conducted. Currently living in the home is the Applicants and their biological son and daughter. The home is set up as follows: This is a three bedroom, two bathroom home located in a residential area. The home consists of a living room, dining room, kitchen, den, laundry space, backyard area, and garage. Living room: is equipped with mounted TV, two chairs, two children chairs, couch, ottoman, and covered fireplace. Dining room: is equipped with a table with three chairs. Den area: is equipped with a sectional couch, three chairs, coffee table, fish tank, and screen for watching television/movies. Kitchen: is equipped with a refrigerator/freezer, a five burner gas stove (all burners were operational at the time of the inspection), and microwave. Sharp knives are kept inaccessible in a box on top of the refrigerator. LPA observed a covered trash can, dishes, and eating utensils. LPA observed ample and non-perishable food items. The Applicants will ensure that three nutritious meals and snacks will be provided to the clients. 809 continued on page Bedroom #1: Applicants bedroom is equipped with a queen size bed, adequate closet space, television, adequate lighting, and windows. Bedroom #2: client's bedroom equipped with a crib, and toddler bed, adequate closet and dresser space, adequate lighting, and windows. Bedroom #3: Applicants biological children's room equipped with bunk beds, adequate closet and dresser space, adequate lighting, and windows. Applicants were informed that children of the opposite sex over five years of age can not share a bedroom. Bathroom: Bathroom #1 is located in hallway, and bathroom #2 is located near the garage entrance. Applicants states that bathroom #2 is not used. Bathrooms were observed to be clean and in working condition. Vehicle: The Applicants will use a Range Rover to transport client. Insurance is valid from December 12, 2024 - June, 14 2025. The vehicle was observed to be in good condition. The home's temperature is maintained by central air/heating. LPA observed one fully charged fire extinguisher which is located in the entrance to the garage. Extra linens are stored in the linen closet located in the clients bedroom. Applicants were advised to only keep the towels/linen for the clients in bedroom #2. All other towels/linen are to be kept in the Applicants bedroom. The smoke alarm and carbon monoxide detectors were tested and found to be in working order. First Aid kit was found to be be complete with required items. Disinfectants and cleaning solutions are kept in a locked cabinet in the bathroom. Report continued on LIC 809C. (Page 2 of 3) LPA reminded Applicants to ensure the following when children are in placement: Children are accorded personal rights and the corresponding form is in their file. Children are supported and encouraged to participate in extracurricular activities. Children are allowed and encouraged to contact the licensing agency, in confidence, without threats or punishment for making complaints. Children are accorded dignity in personal relationships with others in the home. Applicant acknowledges abuse reporting requirements. Applicant will ensure grievance process, Disaster Plan, discipline policies and procedures will be posted in dining room area. During the inspection, LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. Purchase a mobile phone for client's use, Door need to be replaced on the shed Dog feces need to be removed out of the backyard Wood, toilet, chairs, water heater, cabinet, and exercise equipment needs to be removed. Cabinet's and sink will be placed in the kitchen, Lighting will be completed in the dining room. Bathroom cabinet and bidet will be placed in the garage. Licensee will repair all torn screens on the windows Licensee with post her posters on the dining room wall. Licensee will remove all alcohol form the refrigerator. LPA received Out of State Disclosure Form (LIC 508D), Applicant Information Form (LIC 215), Budget Information Form (LIC 420). LPA informed Applicant that a Component III meeting will be held March 27, 2024 at AM. An exit interview was conducted. A copy of report will be emailed to Applicants Brittney Martinez and Brenda Cano.

met_with: Brenda Cano and Britney Martinez


summary: Facility Evaluation

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Narrative:
On April 4, 2025, at 10: AM Licensing Program Analyst (LPA) Erika Butler arrived at Brenda's Family Home for the purpose of conducting a follow-up Pre-Licensing Inspection. The following corrections were made: Purchase a mobile phone for client's use, Door need to be replaced on the shed Dog feces need to be removed out of the backyard Wood, toilet, chairs, water heater, cabinet, and exercise equipment needs to be removed. Cabinet's and sink will be placed in the kitchen, Lighting will be completed in the dining room. Bathroom cabinet and bidet will be placed in the garage. Licensee will repair all torn screens on the windows Licensee with post her posters on the dining room wall. Licensee will remove all alcohol form the refrigerator. An exit interview was conducted. A copy of report will be emailed to Applicant Britney Martinez

met_with: Britney Martinez


summary: Facility Evaluation

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Narrative:
On July 16, 2025, at 9: AM Licensing Program Analyst (LPA) Miguel Gomez arrived at Brenda's Family Home for the purpose of conducting a self-initiated case management visit. LPA Gomez conducted an inspection of the facility and observed the following: Kitchen The kitchen is an open kitchen with an island sink. Cabinets are clean and stored with food, chemicals are stored properly. Kitchen has two refrigerators with sufficient food. Dinning Area Dining area contains a table with four chairs. Foster poster is placed on the wall. Living Room The living room contains couches, TV, fire place with cover and working fire extinguisher. Smoke detector is properly working. The area is clean and sanitary. Den The den contains couches, TV and fish tank. The area is clean and sanitary. Room 1- Licensee's Room Licensee's room contains a queen size bed, baby crib, TV, closet space and cabinet space. Smoke detector is properly working. The area is clean and sanitary. Room 2- Unoccupied Unoccupied room is contains two twin beds, TV, cabinets and closet space. The room is designed for clients ages (6-17). Smoke detector is properly working. The area is clean and sanitary. Room 3- Daughters Room (Age 4) Room contains a twin bunk bed, cabinets and closet space. Two small dogs were observed in the room with gate enclosed. Smoke detector is properly working. The area is clean and sanitary. Bathroom Bathroom contains a shower, tub, toilet and sink. The bathroom is clean and sanitary. The bathroom is working properly. Bathroom 2- Not is use Licensee stated that the half bathroom is not being used and not available for use. Front Yard Front is clean and debri free. Back Yard Front is clean and debri free. Two large (Great Dane) dogs were observed in the backyard. Dogs are placed in a gated area. Shed with the enclosed gate is used as a dog house for the two large dogs. Garage Garage contains a laundry room and is used for storage. Exit interview was conducted and a copy of this report was provided to Licensee.


summary: Facility Evaluation

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Narrative:
On August 7, 2025, at 9: AM Licensing Program Analyst (LPA) Miguel Gomez arrived at Martinez Family Care for the purpose of conducting a post licensing visit. LPA Gomez met with Licensee Britney Martinez who granted access into the home. The facility is licensed to provide care and supervision for ambulatory developmentally disabled children ages 6-17. The census on the date of this visit is one The home is set-up as follows: The home contains garage, living room, dining area, kitchen, three bedrooms, two bathrooms, den,laundry room, front yard and backyard. Kitchen The kitchen is an open kitchen with an island sink. Cabinets are clean and stored with food, chemicals are stored properly. Kitchen has two refrigerators with sufficient food. Dinning Area Dining area contains a table with four chairs. Foster poster is placed on the wall. Living Room The living room contains couches, TV, fire place with cover and working fire extinguisher. Smoke detector is properly working. The area is clean and sanitary. Den The den contains couches, TV and fish tank. The area is clean and sanitary. Room 1- Licensee's Room Licensee's room contains a queen size bed, baby crib, TV, closet space and cabinet space. Smoke detector is properly working. The area is clean and sanitary. Room 2- Client Bedroom is contains two twin beds, TV, cabinets and closet space. The room is designed for clients ages (6-17). Smoke detector is properly working. The area is clean and sanitary. Room 3- Daughters Room (Age 4) Room contains a twin bunk bed, cabinets and closet space. Two small dogs were observed in the room with gate enclosed. Smoke detector is properly working. The area is clean and sanitary. Bathroom Bathroom contains a shower, tub, toilet and sink. The bathroom is clean and sanitary. The bathroom is working properly. Bathroom 2- Not is use Licensee stated that the half bathroom is not being used and not available for use. Front Yard Front is clean and debri free. Back Yard Front is clean and debri free. Two large (Great Dane) dogs were observed in the backyard. Dogs are placed in a gated area. Shed with the enclosed gate is used as a dog house for the two large dogs. Garage Garage contains a laundry room and is used for storage. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit Interview was conducted, and a copy of this report will be provided to Britney Martinez.


summary: Facility Evaluation

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Narrative:
On August 27, 2025, at 9: AM Licensing Program Analyst (LPA) Miguel Gomez arrived at Martinez Family Care for the purpose of conducting and continuing the post licensing visit. LPA Gomez met with Licensee Britney Martinez who granted access into the home. LPA Gomez interviewed Licensee and Client 1 (C1).Based on the inspection conducted, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit Interview was conducted, and a copy of this report will be provided to Britney Martinez.


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Narrative:
During the family gatherings, Licensee stated that she did not drink alcohol, transport children while being under the influence of alcohol, or offer C1 alcohol during the gatherings . One of the three interviewees admitted the allegations. Additional interviews revealed that the interactions made C1 uncomfortable when others would visit the home and greet C1 with a hug. Due to past trauma, C1 does not like to be touched. It was reported that the Licensee was aware of past trauma. The Licensee was made aware that it was uncomfortable for C1 to greet other adults in that fashion. Furthermore, it was reported that the Licensee smacked C1 on the back of C1's head and pushed C1 once during placement, but there were no witnesses to the incident. Based on the information collected, conflicting statements have been made that cannot validate the allegations. Although the allegations may have occurred or be valid, there is not a preponderance of evidence to prove that the alleged violations actually occurred. These allegations are being closed unsubstantiated. No deficiencies cited. Exit interview completed. Witnesses revealed that the Licensee did not properly secure the hazardous items during Client 1's (C1's) placement. Additional information provided confirmed that Licensee did not have hazardous items locked. Based on the information provided, there is enough evidence to support that Licensee did not properly secure hazardous items during C1's placement. The preponderance of the evidence standard has been met; therefore, the allegations of are found to be substantiated. Deficiency cited, see LIC 9099-D. Exit Interview Complete. A copy of this report was given to the Licensee.

Investigation Findings:
13On 11/07/2025 at 12: PM Licensing Program Analyst (LPA) Miguel Gomez arrived at the above facility and met with Licensee Britney Martinez for the purpose of delivering complaint findings regarding the above allegation. During this investigation, LPA Gomez conducted confidential interviews with available individuals concerning the allegation. The following are the findings based on the information taken into evidence: The Licensee stated that she does have hazardous items stored in the home. The kitchen cabinet stores alcohol, and the garage stores chemicals. Licensee confirms that the items are locked. LPA Gomez inspected the home and observed the kitchen cabinet with alcohol to be locked, and the garage chemical cabinet to be locked. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Miguel A Gomez 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 EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: MARTINEZ FAMILY CAREFACILITY NUMBER: 198209822

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: