summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
However, the statements obtained from other confidential interviews did not provide sufficient information to corroborate the allegations. Based on the information gathered, although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that alleged violations occurred, therefore the allegations are unsubstantiated. There were no deficiencies cited during this inspection. An exit interview was conducted. A copy of this report, Confidential Names Form, and Appeal Rights were provided to the facility representative via electronic mail.

Investigation Findings:
13On March 16, 2023, at PM, Licensing Program Analysts (LPA) Karen Suh and Joe Martinez conducted a follow-up complaint inspection to deliver the findings of an investigation concerning to the allegations above. LPAs met with the representative named above and discussed the findings. During the investigation, LPA Suh conducted a record review and obtained copies of Individual Program Plan, Daily Notes of September, and October. LPA also conducted confidential interviews with Administrator, two staff on October 19, 22 and March 8, 2023, Kern Regional Center Case Manager on March 7, 2023, and Reporting Party (RP) on March 8, 2023. It was alleged that Ref. #1 (see Confidential Names, LIC Ref. #1 dated March 16, 2023) was left soiled for an extended period of time. The facility Administrator and staff denied the allegation stating clients are sent to school with five diapers. When facility receives a call from school requesting more diapers, a package of diapers are dropped off at school immediately by a staff. The school has the Administrator's telephone number and facility number. All staff responds to school whenever they receive a call from school. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Yan Yeung LICENSING EVALUATOR NAME: Karen Suh LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: PTS ONEFACILITY NUMBER: VISIT DATE: 03/16/2023

met_with: Judith Gonzalez


state: CA

facility_name: PTS ONE

summary: Facility Evaluation

raw_content:
Narrative:
On 02/17/2022 at 8: AM, Licensing Program Analyst (LPA) Pamela Silva conducted an unannounced Annual Licensing Inspection at the facility. LPA met with Administrator, Judith Gonzalez. The facility currently has a Group Home (GH) license. The GH is licensed to serve up to three (3) clients ages 3 to 17. The facility serves ambulatory developmentally disabled clients, level 4- Regional Center Clients and provide one on one care. There are currently three (3) clients in placement. The LPAs requested the following: Personnel Report LIC500, Client Roster, Board of Meeting Minutes, Clients and Staff Files. The facility is a single-story home with 3 bedrooms, living room, kitchen, backyard and one (1) full bathroom with two toilets. There are no firearms or ammunition in the facility. There are no bodies of water in the facility premises. At 9: AM, LPA conducted a walkthrough of the entire facility. Physical Plant The license, facility sketch, personal rights, emergency disaster form, complaints poster, emergency phone numbers and food menu are posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are kept inaccessible and locked in a cabinet located in the garage. Sharps/knives are inaccessible and stored in a locked cabinet in the hallway. Facility has non-perishable food for at least one week and perishable food for at least two days. Medications are centrally stored in a locked cabinet in the hallway. Smoke and carbon monoxide detectors were tested and in proper working order. Fire extinguisher was fully charged. First Aid Kits were checked and found to be complete. Room temperatures are maintained at 76 degrees F. The hot water temperature was tested and measured at 112 degrees F. All sinks, showers and toilets are in working order. No more than 2 children share a bedroom. All beds are in good repair; equipped with good springs, clean mattresses and pillows. Adequate supply of beddings and linens were observed. Facility provides age-appropriate clothing items and hygiene products. Overall, facility is clean, safe, sanitary and in good repair. Operations Facility maintains a register of clients and the register is available upon request. The board of directors regularly conduct meeting to review and discuss the GH's operation. The facility administrator and manager are the responsible and capable staff for communicating with emergency personnel in the facility. The facility has developed, maintained and implemented written complaint procedures. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill at least monthly for each shift. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Needs and Services Plan for each client, medication records, and contact information for each client's responsible party and physician. Emergency Intervention Plan LPA reviewed the facility's emergency intervention plan. Facility have not used any manual restraints yet but will keep a monthly log of each use of manual restraints that contains all required information when needed. Facility has an emergency intervention training curriculum. All five (5) staff members are trained on the facility's emergency intervention procedures. Client Records LPA reviewed three (3) client records. All client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to, consent forms, court orders, needs and services plan, removal/discipline/complaint procedures; medical assessment; safeguards for cash resources, personal property and valuables; education records; personal rights forms; and medication administration records. Staff Records LPA reviewed two (2) staff records. All staff have been subjected to criminal records review and have been fingerprinted and cleared with DOJ, FBI and CACI. The administrator meets the required qualifications and/or experience. Documentation of the required education and experience requirements are maintained in the personnel file. Facility Manager meets requirements. LPA verified 20 hours of annual training for direct care staff. Clients with Special Health Care Needs LPA reviewed the section of Children with Special Health Care Needs; no deficiencies were observed. There are currently no clients in care with special health care needs. LPA interviewed two (2) staff members. There are no citations assessed during this inspection. The administrator was provided information on where to locate the Provider Information Notices (PINs), guidance to the new CARE Tools inspection process and Guardian. An exit interview was conducted, and a signed copy of this report, LIC811 and appeal rights were provided to the facility administrator.

report_type: Facility Evaluation

visit_type: Annual


summary: Facility Evaluation

raw_content:
Narrative:
On 03/23/23 at 8: AM, Licensing Program Analyst (LPA) Pamela Silva conducted an unannounced Annual Inspection at the facility. LPA met with Administrator, Judith Gonzalez. The facility currently has a Group Home (GH) license. The GH is licensed to serve up to three (3) clients ages 3 to 17. The facility serves ambulatory developmentally disabled clients, level 4- Regional Center Clients and provide one on one care. There are currently three (3) clients in placement. The LPAs requested the following: Personnel Report LIC500, Client Roster, Board of Meeting Minutes, Clients and Staff Files. The facility is a single-story home with 3 bedrooms, living room, kitchen, backyard and one (1) full bathroom with two toilets. There are no firearms or ammunition in the facility. There are no bodies of water in the facility premises. At 9: AM, LPA conducted a walk-through of the entire facility. Physical Plant The license, facility sketch, personal rights, emergency disaster form, complaints poster, emergency phone numbers and food menu are posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are kept inaccessible and locked in a cabinet located in the garage. Sharps/knives are inaccessible and stored in a locked cabinet in the hallway. Facility has non-perishable food for at least one week and perishable food for at least two days. Medications are centrally stored in a locked cabinet in the hallway. Smoke and carbon monoxide detectors were tested and in proper working order. Fire extinguisher was fully charged. First Aid Kits were checked and found to be complete. Room temperatures are maintained at 76 degrees F. The hot water temperature was tested and measured at 117 degrees F. All sinks, showers and toilets are in working order. No more than 2 children share a bedroom. All beds are in good repair; equipped with good springs, clean mattresses and pillows. Adequate supply of beddings and linens were observed. Facility provides age-appropriate clothing items and hygiene products. Overall, facility is clean, safe, sanitary and in good repair. Operations Facility maintains a register of clients and the register is available upon request. The board of directors regularly conduct meeting to review and discuss the GH's operation. The facility administrator is the responsible and capable staff for communicating with emergency personnel in the facility. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill at least monthly for each shift. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Individual Treatment Plan for each client, medication records, and contact information for each client's responsible party and physician. Emergency Intervention Plan Facility does not use manual restraints. However, all five (5) staff members are trained on emergency intervention procedures. Client Records LPA reviewed three (3) client records. All client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to, consent forms, individual treatment plans, medical assessment, safeguards for cash resources, personal property and valuables, education records; personal rights forms; and medication administration records. Staff Records LPA reviewed two (2) staff records. All staff have been subjected to criminal records review and have been fingerprinted and cleared with DOJ, FBI and CACI. The administrator meets the required qualifications and/or experience. Documentation of the required education and experience requirements are maintained in the personnel file. LPA verified 20 hours of annual training for direct care staff. Clients with Special Health Care Needs There are currently no clients in care with special health care needs. LPA interviewed one (1) staff member. There are no citations assessed during this inspection. An exit interview was conducted, and a signed copy of this report, and LIC811 were provided to the facility administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 06/15/23 at 1: P.M. Licensing Program Analyst (LPA) Demetris Teal conducted an unannounced case management inspection at PTS ONE. LPA met with Arturo Gonzalez- Direct Care Staff. Purpose of the visit was to follow up on a incident report. LPA discussed bruising to C1. During my visit, Judith Gonzalez-Administrator arrived. Interviewed Administrator. Reviewed file for C Further Interviews will be conducted as necessary. Additional time is needed to resolve this case. An exit interview was conducted and a signed copy of this report along with 811 (Confidential Name List), was left with administrator.

visit_type: Case Management

met_with: Arturo Gonzalez-Direct Care Staff


summary: Facility Evaluation

raw_content:
Narrative:
On February 21, 2024 at 12: P,M., Licensing Program Analyst (LPA) Demetris Teal conducted an unannounced Annual Inspection at the above named facility. LPA met with Administrator, Judith Gonzalez. The facility currently has a Group Home (GH) license. The GH is licensed to serve up to three (3) clients ages 3 to 17. The facility serves ambulatory and non-ambulatory developmentally disabled clients, level 4- Regional Center Clients and provide one on one care. There are currently three (3) clients in placement. The LPA requested the following: Personnel Report LIC500, Client Roster, Board of Meeting Minutes, Clients and Staff Files. The facility is a single-story home with 3 bedrooms, living room, kitchen, backyard and one (1) full bathroom with two toilets. There are no firearms or ammunition in the facility. There are no bodies of water in the facility premises. At 1: P.M., LPA conducted a walk-through of the entire facility. Physical Plant The license, facility sketch, personal rights, emergency disaster form, complaints poster, emergency phone numbers and food menu are posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are kept inaccessible and locked in a cabinet located in the garage. Sharps/knives are inaccessible and stored in a locked cabinet in the hallway. Facility has non-perishable food for at least one week and perishable food for at least two days. Medications are centrally stored in a locked cabinet in the hallway. Smoke and carbon monoxide detectors were tested and in proper working order. Fire extinguisher was fully charged. First Aid Kits were checked and found to be complete. Room temperatures are maintained at 76 degrees F. The hot water temperature was tested and measured at 116 degrees F. All sinks, showers and toilets are in working order. No more than 2 children share a bedroom. All beds are in good repair; equipped with good springs, clean mattresses and pillows. Continued.... ...Continued Adequate supply of beddings and linens were observed. Facility provides age-appropriate clothing items and hygiene products. Overall, facility is clean, safe, sanitary and in good repair. Operations Facility maintains a register of clients and the register is available upon request. The board of directors regularly conduct meeting to review and discuss the GH's operation. The facility administrator is the responsible and capable staff for communicating with emergency personnel in the facility. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill quarterly and fire drill monthly for each shift. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Individual Treatment Plan for each client, medication records, and contact information for each client's responsible party and physician. Emergency Intervention Plan Facility does not use manual restraints. However, all five (4) staff members are trained on emergency intervention procedures. Client Records LPA reviewed three (3) client records. All client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to, consent forms, individual treatment plans, medical assessment, safeguards for cash resources, personal property and valuables, education records; personal rights forms; and medication administration records. Comtinued..... .....Continued Staff Records LPA reviewed two (4) staff records. All staff have been subjected to criminal records review and have been fingerprinted and cleared with DOJ, FBI and CACI. The administrator meets the required qualifications and/or experience. Documentation of the required education and experience requirements are maintained in the personnel file. LPA verified at least 20 hours of annual training for direct care staff. Clients with Special Health Care Needs There are currently no clients in care with special health care needs. LPA interviewed one (3) staff member. There are no citations assessed during this inspection. A Technical Advisory was given to keep all licensing reports for the past 3 years, accessible.

met_with: Judith Gonzalez- Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On February 27, 2025 at 12: P.M., Licensing Program Analyst (LPA) Demetris Teal conducted an unannounced Annual Inspection at the facility. LPA met with Judith Gonzalez- Administrator. The facility currently has a Group Home (GH) license. The GH is licensed to serve up to three (3) clients ages 3 to 17. The facility serves ambulatory/ non- ambulatory developmentally disabled clients, level 4-I Regional Center Clients and provide one on one care. There are currently three (3) clients in placement. The LPAs requested the following: Personnel Report LIC500, Client Roster, Board of Meeting Minutes, Clients and Staff Files. The facility is a single-story home with 3 bedrooms, living room, kitchen, backyard and one (1) full bathroom with two toilets. There are no firearms or ammunition in the facility. There are no bodies of water in the facility premises. At 1: P.M., LPA conducted a walk-through of the entire facility. Physical Plant The license, facility sketch, personal rights, emergency disaster form, complaints poster, emergency phone numbers and food menu are posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are kept inaccessible and locked in a cabinet located in the garage. Sharps/knives are inaccessible and stored in a locked cabinet in the hallway. Facility has non-perishable food for at least one week and perishable food for at least two days. Medications are centrally stored in a locked cabinet in the hallway. Smoke and carbon monoxide detectors were tested and in proper working order. Fire extinguisher was fully charged. First Aid Kits were checked and found to be complete. Room temperatures are maintained at 76 degrees F. The hot water temperature was tested and measured at 120 degrees F. All sinks, showers and toilets are in working order. There is no bedroom sharing. All beds are in good repair; equipped with good springs, clean mattresses, and pillows. Continued... ...continued Adequate supply of beddings and linens were observed. Facility provides age-appropriate clothing items and hygiene products. Overall, facility is clean, safe, sanitary and in good repair. Operations Facility maintains a register of clients and the register is available upon request. The board of directors regularly conduct meetings to review and discuss the GH's operation. The facility administrator is the responsible person and there is capable staff for communicating with emergency personnel in the facility. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill at least monthly for each shift. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Individual Treatment Plan for each client, medication records, and contact information for each client's responsible party and physician. Emergency Intervention Plan Facility does not use manual restraints. However, all five (5) staff members are trained on emergency intervention procedures. Client Records LPA reviewed three (3) client records. All client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to, consent forms, individual treatment plans, medical assessment, safeguards for cash resources, personal property and valuables, education records; personal rights forms; and medication administration records. Staff Records LPA reviewed five (5) staff records. All staff have been subjected to criminal records review and have been fingerprinted and cleared with DOJ, FBI and CACI. The administrator meets the required qualifications and/or experience. Documentation of the required education and experience requirements are maintained in the personnel file. LPA verified 20 hours of annual training for direct care staff. continued... ...continued Clients with Special Health Care Needs There are currently no clients in care with special health care needs. LPA interviewed three (3) staff member. LPA was unable to interview clients due to their non-verbal status. There were two (2) technical violations issued during this inspection. An exit interview was conducted, and a signed copy of this report, and LIC811 were provided to the facility administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On September 18, 2025, at 6: P.M.,Licensing Program Analyst (LPA) Demetris Teal went to the above named facility to drop off a personal rights poster. LPA left the poster with Arturo Gonzalez Jr.- support staff.

met_with: Arturo Gonzalez Jr.- Support Staff


summary: Facility Evaluation

raw_content:
Narrative:
On November 19, 2025, at 4: P.M. Licensing Program Analyst (LPA) Demetris Teal conducted an unannounced case management inspection at PTS One. LPA met with Arturo Gonzalez-Direct Care Staff. Purpose of the visit was to conclude a case management inspection conducted on June 15, 2023. LPA conducted a thorough investigation including interviews with PTS staff and school staff. LPA received documents and medical information regarding C1. C1 obtained a bruise away from and outside of the facility care. LPA did not observe any neglect or personal rights violations. The investigation is concluded No deficiencies noted at this time and no citations issued. An exit interview was conducted and a signed copy of this report along with appeal rights, was left with Direct Care Staff


summary: Facility Evaluation

raw_content:
Narrative:
On February 12, 2026 at 11: A,M., Licensing Program Analyst (LPA) Demetris Teal conducted an unannounced Annual Inspection at the above named facility. LPA met with Administrator, Judith Gonzalez. The facility currently has a Group Home (GH) license. The GH is licensed to serve up to three (3) clients ages 3 to 17. The facility serves ambulatory and non-ambulatory developmentally disabled clients, level 4- Regional Center Clients and provide one on one care. There are currently three (3) clients in placement. The LPA requested the following: Personnel Report LIC500, Client Roster, Board of Meeting Minutes, Clients and Staff Files. The facility is a single-story home with 3 bedrooms, living room, kitchen, backyard and one (1) full bathroom with two toilets. There are no firearms or ammunition in the facility. There are no bodies of water in the facility premises. At 12: P.M., LPA conducted a walk-through of the entire facility. Physical Plant The license, facility sketch, personal rights, emergency disaster form, complaints poster, emergency phone numbers and food menu are posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are kept inaccessible and locked in a cabinet located in the garage. Sharps/knives are inaccessible and stored in a locked cabinet in the hallway. Facility has non-perishable food for at least one week and perishable food for at least two days. Medications are centrally stored in a locked cabinet in the hallway. Continued on page 2... ...page Smoke and carbon monoxide detectors were tested and in proper working order. Fire extinguisher was fully charged. First Aid Kits were checked and found to be complete. Room temperatures are maintained at 76 degrees F. The hot water temperature was tested and measured below 120 degrees F. All sinks, showers and toilets are in working order. No more than 2 children share a bedroom. All beds are in good repair; equipped with good springs, clean mattresses and pillows. Adequate supply of beddings and linens were observed. Facility provides age-appropriate clothing items and hygiene products. Overall, facility is clean, safe, sanitary and in good repair. Operations Facility maintains a register of clients and the register is available upon request. The board of directors regularly conduct meeting to review and discuss the GH's operation. The facility administrator is the responsible and capable staff for communicating with emergency personnel in the facility. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill quarterly and fire drill monthly for each shift. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Individual Treatment Plan for each client, medication records, and contact information for each client's responsible party and physician. Emergency Intervention Plan Facility does not use manual restraints. However, all five (5) staff members are trained on emergency intervention procedures. Continued on page 3 .....page Client Records LPA reviewed three (3) client records. All client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to, consent forms, individual treatment plans, medical assessment, safeguards for cash resources, personal property and valuables, education records; personal rights forms; and medication administration records. Staff Records LPA reviewed five (5) staff records. All staff have been subjected to criminal records review and have been fingerprinted and cleared with DOJ, FBI and CACI. The administrator meets the required qualifications and/or experience. Documentation of the required education and experience requirements are maintained in the personnel file. LPA verified at least 20 hours of annual training for direct care staff. Clients with Special Health Care Needs There are currently no clients in care with special health care needs. LPA interviewed three (3) staff member. There are no citations assessed during this inspection. Exit interview conducted. A copy of the LIC 809 and Appeal Rights were left with Licensee.


facility_name: PTS SIX

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
The LPA is unable to corroborate the allegation as it relates to the facility. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that alleged violation occurred at the facility, therefore the allegation is unsubstantiated. There are no deficiencies to be cited regarding these allegation. A copy of this complaint was provided to the facility representative.

Investigation Findings:
On March 25, 2022 at 1:30 p.m., Licensing Program Analyst (LPA), Karen McGee, delivered the findings of the complaint investigation to Administrator, Luis Raya. On September 16, 2021, the Monterey Park Children's Residential Program (MPCRP), received a complaint with the above mentioned allegation. The LPA conducted confidential interviews that included, but were not limited to: the Administrator at the facility on September 24, 2022; and the County Social Worker via telephone on September 22, 2021. The LPA did not interview the client, Ref. #1, because Ref. #1 is non- verbal. The LPA reviewed the following documents: Unusual Incident/Injury Report, General Event Reports, Medical Report, Daily Communication Sheet, Continuous Notes, email from school, Record of Medical and Dental Care Form. The investigation revealed that Ref. #1 had no bruising when Ref. #1 left the facility for school on that date. It revealed that while attending to Ref. #1's hygiene after Ref. #1 returned from school in preparation for a family visit, staff observed bruising on Ref. #1. Based upon the documents, Ref. #1 attempted to put Ref. #1's arm through a gate at school, through self on the ground and sustained visible marks on Ref. #2's neck all while at school. The documents did not indicate any occurences at the facility or in the transportation to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tira Logan LICENSING EVALUATOR NAME: Karen McGee LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: PTS SIXFACILITY NUMBER: VISIT DATE: 03/25/2022

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

report_type: Complaint Investigation

met_with: Luis Raya

complaint_status: unsubstantiated


raw_content:
Narrative:
Also, that the child rode a small toy truck and bruised near the anus. The note included that the child had a diaper rash as well. LPA Chavez reviewed medical records for FC1, and the child was diagnosed with Intellectual Disability, Severity Mild and Autism Spectrum Disorder Level 2 & Attention Deficit Hyperactivity disorder. FC1 is legally blind and child's hearing may be impaired as well. FC1 is a non-ambulatory child. Also, FC1 is not toilet trained and requires full assistance with toileting and wears diapers. Staff 1 stated that FC1 has very sensitive skin and bruises easily. S1 stated that FC1 wears pull up diapers and is changed every hour and a half or sooner depending on the amount of liquids consumed. S1 stated that FC1 rides the school bus to and from the facility and tthe ride is approximately 30 minutes long. During the bus ride FC1 must wear a harness for protection that covers his upper body. S1 stated that diaper rashes are common due to child's sensitive skin. Also, FC1 likes to ride and sit on small toys. S1 and S2 have witnessed FC1 on top of small toys and this causes bruising on the child's body. S1 and S2 redirect FC1 when child is on top of any small toy to prevent further bruising on the child's body. Due to FC1 being diagnosed with autism and blindness child is easily injured or bruised. S1 and S2 keep a daily log of the child's bruises, clusters, rashes or any other mark on the child's body (Continuous Notes & Body Chart 12/02/21). S1 stated that on 12/02/21 it was disclosed to the child's school via a note about the bruising near the anus and the diaper rash so that ointments can be applied to FC1 at school. S1 and S2 stated that due to the long bus ride and protective harness, FC1 is prone to bruising and diaper rashes. S1 and S2 stated that FC1 has returned from school with a soiled diaper and even a diaper rash. S1 and S2 do their best at maintaining the school informed of any accidental bruising or diaper rashes. LPA interviewed Director and stated that the staff sends notes to school regarding any bruising or rashes to the child's body. This is a common practice and the staff keeps a log of this information as well. LPA attempted to interview FC1, FC2 and FC3 but was unable because all three children are non-verbal. LPA observed the facility clean and the children seemed comfortable around the staff. After reviewing medical records, FC1 is prone to accidental bruising due to blindness, autism and attention deficit hyperactivity disorder. Based on the information gathered, although the allegation may have happened or is valid, the preponderance of evidence to prove the allegation was not met, therefore the allegation is unsubstantiated. An exit interview was conducted. A copy of this report Confidential Names Form, and Appeal Rights were provided to the facility representative. There were no deficiencies cited during this visit.

Investigation Findings:
13On August 29, 2022 @ 11:40AM, Licensing Program Analyst (LPA) Janeth Chavez conducted a follow-up inspection to deliver the findings of a complaint investigation concerning the above allegations. LPA Chavez met with the above representative and discussed the complaint findings. During the investigation, LPA Chavez interviewed: Reporting Party on 05/20/22, Staff 1 & 2, Attempted Foster Child 1, 2 & 3 on 04/29/2022 and Director on 05/18/22. LPA attempted to contact Kern Regional Center on 04/24/22, 04/25/22 & 04/26/22 (see confidential names list dated August 29, 2022). LPA Chavez reviewed records not limited to:Individual Treatment Plan, Daily Communications Sheet, Continuous Notes, General Events Report & Body Chart records. It was alleged that minor sustained injury while in care & minor sustained a diaper rash while in care. Reporting Party stated that it was disclosed to the school via a note that FC1 has old cluster of bruises on leg, and harness marks on his shoulders. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Janeth Chavez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION LA & TRI-COASTAL CR, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: PTS SIXFACILITY NUMBER: VISIT DATE: 08/29/2022

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

met_with: Luis Raya, Administrator


raw_content:
Narrative:
C1 has been sick, and staff did not attend to C1's health needs. Staff denied the allegation. C1's mother is very active in seeking medical attention when needed and taking C1 to medical appointments. C1's mother took C1 for medical attention on September 21, 2023, and October 4, 2023, for not feeling well. The doctor's notes were provided stating that C1 was seen by the physician and excuse C1 for being absent from school. For September 21, 2023, it also stated C1 is cleared to return to school on the same day. On October 4, 2023's visit, C1 was prescribed with medication and provided with doctor's note but it did not state C1 can return to school on the same day. C1 was dropped off at the school by C1's mother; mother thought C1 was excused for the hours C1 missed, not for the whole day. C1 was picked up early from school because C1 was not feeling well. Interview with RCW indicated that there are no concerns of C1 mother seeking and meeting the medical needs of C1. Based on records reviewed and the information obtained, there is not sufficient evidence to substantiate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that alleged violation occurred, therefore the allegation is unsubstantiated. There were no deficiencies cited during this inspection. An exit interview was conducted. A copy of this report, Confidential Names Form, and Appeal Rights were provided to the facility representative via electronic mail.

Investigation Findings:
13On March 22, 2024, at 10: AM, Licensing Program Analyst (LPA) Karen Suh conducted a follow-up complaint inspection to deliver the finding of an investigation concerning to the allegation above. The LPA met with Luis Raya, Administrator, and discussed the finding. The investigation included confidential interviews that consisted of but were not limited to: one staff and client's (C1) mother on October 19, 2023; one staff on October 26, 2023; Kern Regional Center Case Worker (RCW) on March 7, 2024. No statement was obtained from C1 due to being developmentally disabled. The LPA reviewed youth's Medication Administration Records, activities notes from 10/4/23 to 10/12/23, doctor's visitation notes, patient clinical summary, excuse notes from doctor's office, and Quarterly IPP Report. It was alleged that on October 4, 2023, client (C1, see Confidential Names LIC811 dated March 22, 2024), was taken to school even though C1 had the doctor's note stating C1's excused for the day. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Yan Yeung LICENSING EVALUATOR NAME: Karen Suh LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: PTS SIXFACILITY NUMBER: VISIT DATE: 03/22/2024

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


summary: Facility Evaluation

raw_content:
Narrative:
On 06/14/21 at 10: AM, Licensing Program Analyst (LPA) Pamela Silva conducted an unannounced required annual inspection at the above facility and met with Facility Administrator, Luis Raya.. This is a 24-hour facility which offers services and supervision to disabled, ambulatory and non-ambulatory clients. The facility is licensed for a capacity of four (4) clients, male or female ages 7 to 17 years old. There are currently two (2) clients in placement. LPA conducted a walk-through of the facility with the Administrator. The facility is clean, safe and in good repair. All exits and hallways were observed to be free and clear of hazards and obstruction. There is a swimming pool on the premises. The pool is made inaccessible to clients by a fence and a locked gate, which met Department regulations. There are no weapons or firearms in the facility. Smoke detectors and carbon monoxide alarms were tested and are operable at the time of the inspection. Hot water temperatures are maintained between 105 and 120 degrees (F). Temperature in clients' rooms are maintained between 68 and 85 degrees (F). All sinks, showers and toilets were clean and in working order. First aid kit was readily available and complete. Medications were observed to be centrally locked and are accessible only to staff responsible for stored medications. Psychotropic Medication Administration Records (PMAR) versus medication logs were checked. The facility has perishable food supplies for at least 2 days and non-perishable food supplies for two weeks. The facility provides nutritious snacks between meals. Food menu is posted in the kitchen. Activity schedule is posted. Knives and other sharps were observed to be locked in the closet along the hallway. Disinfectants, cleaning solutions and toxins are locked and inaccessible to clients. Children live in a safe, healthy and comfortable home. All children attend school when school is in session. The facility's Emergency Disaster Plan needs to be updated per Provider Information Notice (PIN) 21-03-CRP 2020 (see Advisory Note LIC9102TA). Facility operates within license capacity and limitations. Children's Personal Rights, facility license, facility sketch, emergency phone numbers, emergency disaster form are all prominently displayed in the home. All facility staff or other individuals who require caregiver background checks have received DOJ/FBI criminal record and child abuse index check clearances or exemptions. LPA reviewed two (2) client files (See Client/Resident's Records Review- LIC858- dated 06/14/21) and three (3) facility staff files (See Review of Staff/Volunteer Records- LIC859 dated 06/14/21). At the time of this inspection, there were no deficiencies observed or citations assessed to the facility. An exit interview was conducted. A copy of this report, the LIC858 and LIC859 were provided to the Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 8/23/2 at 9: AM, an unannounced SB (Senate Bill) Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Jean Herring and Jenny Mundo at PTS SIX Group Home (GH). LPAs met Luis Raya, Administrator. Currently, there are three (3) children placed at the facility. Two (2) of the three (3) children taking psychotropic medications are placed by Kern County Department of Human Services (DHS) and at the same time receiving services from Kern Regional Center (KRC). LPA Herring conducted a review of 2 children's file at 10: AM. LPA inspected Individual Program Plans (IPPs); Court Orders; Medication Destruction Record; and Psychotropic Medication Administration Records (PMARs) for the last 3 months. A count of the psychotropic medications being taken by each child for the current month was also completed. LPA Mundo conducted a review of 2 staffs' file at 11: AM. LPA reviewed initial and on-going medication training. LPA Herring conducted a facility tour with the Administrator at 11: AM. The facility is clean, safe, sanitary and in good repair. All medications are centrally stored, locked and accessible only to employees responsible for stored medications. LPA Herring reviewed the facility's Program Statement at 11: AM. LPA Mundo conducted an interview with the administrator at 11: AM and a facility staff at 1: PM. LPAs were not able to interview clients because both C1 and C2 are non-verbal. Both clients are also at school at the time of inspection. An exit interview was conducted at 1: PM. A copy of this report was provided to the facility representative along with Confidential Names list (LIC 811). No deficiencies are being cited at this time. LPAs provided Advisory Notes - Technical Assistance (LIC 9102TA) and Advisory Notes - Technical Violation (LIC 9102TV).


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Jenny Mundo and Pamela Silva on August 23, 2022 at 9: AM. During the inspection, LPAs met with Luis Raya, Administrator. LPAs and the Administrator inspected the facility inside and out. LPAs reviewed one (1) child's record on site at the facility at 9: AM. LPAs reviewed two (2) staff personnel files on site at the facility at 9: AM. LPAs reviewed one (1) child's psychotropic medications and medication records at 11: AM. LPAs interviewed one (1) staff on site at 10: AM. LPAs were unable to interview one (1) child due to child not being present at the facility at the time of the inspection. LPAs conducted exit interview with Luis Raya, Administrator at 11: AM. LPAs provided the Summary Report to the Administrator upon completion. No deficiencies are being cited at this time.


summary: Facility Evaluation

raw_content:
Narrative:
On July 21, 2023, Licensing Program Analyst (LPA) Johanna Lofton, conducted an unannounced Annual Inspection at the above named facility and met with Facility Administrator Luis Raya. LPA stated the purpose of the visit to the Group Home. During the inspection the annual compliance review consisted of the following domains: Physical Plant, Operations, Disaster Preparedness, and Clients Records review. LPA will resume the inspection on a different date. An exit interview was conducted and a signed copy of this report LIC809 and LIC811 were provided to the facility administrator via email.

met_with: Luis Raya- Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 7/26/23, Licensing Program Analyst Johanna Lofton conducted a follow up annual inspection at the above named facility. LPA met with Facility Administrator Luis Raya and Facility Manager Bernadette Candelaria. During the annual inspection continuation, the following domains were covered: Staff files review, Specialized in Home Care, and Emergency Intervention. An exit interview was conducted and a signed copy of this report was provided to the facility representative along with LIC 811 (Confidential Name/s list). No citations were given during the annual inspection. Appeal rights explained.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Juliet Robles 02/08/24 at 10: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA met with Luis Raya, Administrator and inspected the facility inside and out. LPA reviewed one (1) of child's record and three (3) of staff personnel files on site at the facility. LPA reviewed one (1) of child's psychotropic medications and medication records. LPA interviewed one (1) staff on site to discuss the facility's policies and procedures of operation. LPA interviewed 0 of child currently prescribed psychotropic medication due to child being non-verbal. LPA provided a copy of this licensing report to Administrator, Luis Raya. No deficiencies are being cited at this time. LPA Robles conducted exit interview with Luis Raya, Administrator, .


summary: Facility Evaluation

raw_content:
Narrative:
On July 25, 2024 at 1: P,M., Licensing Program Analyst (LPA) Demetris Teal conducted an unannounced Annual Inspection at the above named facility. LPA met with Luis Raya- Administrator and Bernadette Candelaria-Facility Manager. LPA wan not able to finish the annual on July 25 and returned on August 1, 2024, to complete. The facility currently has a Group Home (GH) license. The GH is licensed to serve up to four (4) clients ages 7 to 17. The facility serves ambulatory and non-ambulatory developmentally disabled clients, level 4I Regional Center Clients and provide one on one care. There are currently four (4) clients in placement. The LPA requested the following: Personnel Report LIC500, Client Roster, Board of Meeting Minutes, Clients and Staff Files. The facility is a single-story home with 4 bedrooms, living room, kitchen, gated pool, backyard and two (2) full bathrooms with two toilets. There are no firearms or ammunition in the facility. At 1: P.M., LPA conducted a walk-through of the entire facility. Physical Plant The license, facility sketch, personal rights, emergency disaster form, complaints poster, emergency phone numbers and food menu are posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are kept inaccessible and locked in a cabinet located in the garage. Sharps/knives are inaccessible and stored in a locked cabinet in the hallway. Facility has non-perishable food for at least one week and perishable food for at least two days. Medications are centrally stored in a locked cabinet in the hallway. Smoke and carbon monoxide detectors were tested and in proper working order. Fire extinguisher was fully charged. First Aid Kits were checked and found to be complete. Room temperatures are maintained at 76 degrees F. continued.... ...Continued The hot water temperature was tested and measured at 118 degrees F. All sinks, showers and toilets are in working order. No more than 1 child share a bedroom. All beds are in good repair; equipped with good springs, clean mattresses and pillows. Adequate supply of beddings and linens were observed. Facility provides age-appropriate clothing items and hygiene products. Overall, facility is clean, safe, sanitary and in good repair. Operations Facility maintains a register of clients and the register is available upon request. The board of directors regularly conduct meeting to review and discuss the GH's operation. The facility administrator is responsible and capable for communicating with staff and emergency personnel in the facility. License is posted in a prominent location. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill quarterly and fire drill monthly for each shift. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Individual Treatment Plan for each client, medication records, and contact information for each client's responsible party and physician. Emergency Intervention Plan Facility uses manual restraints when needed. However, all five (5) staff members are trained on emergency intervention procedures. Client Records LPA reviewed four (4) client records. All client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to, consent forms, individual treatment plans, medical assessment, safeguards for cash resources, personal property and valuables, education records; personal rights forms; and medication administration records. Facility will start to add signed copies of removal and discharge policies. Continued..... .....Continued Staff Records LPA reviewed two (3) staff records. All staff have been subjected to criminal records review and have been fingerprinted and cleared with DOJ, FBI and CACI. The administrator meets the required qualifications and/or experience. Documentation of the required education and experience requirements are maintained in the personnel file. LPA verified at least 20 hours of annual training for direct care staff. Administrator will ensure that all staff understand prudent parenting standards. Clients with Special Health Care Needs There are currently four (4) clients in care with special health care needs. LPA interviewed three (3) staff member. There were citations issued. A copy of the 809, 809D's, 9102's, 811 and appeal rights were left with facility manager. Exit Interview conducted.

met_with: Bernadette Candelaria- Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On July 25, 2025 at 1: P,M., Licensing Program Analyst (LPA) Demetris Teal conducted an unannounced Annual Inspection at the above named facility. LPA met with Luis Raya- Administrator and Bernadette Candelaria-Facility Manager. The facility currently has a Group Home (GH) license. The GH is licensed to serve up to four (4) clients ages 7 to 17. The facility serves ambulatory and non-ambulatory developmentally disabled clients, level 4I Regional Center Clients and provide one on one care. There are currently three (3) clients in placement. One (1) of the clients is over eighteen (18). The LPA requested the following: Personnel Report LIC500, Client Roster, Board of Meeting Minutes, Clients and Staff Files. The facility is a single-story home with 4 bedrooms, living room, kitchen, gated pool, backyard and two (2) full bathrooms with two toilets. There are no firearms or ammunition in the facility. At 1: P.M., LPA conducted a walk-through of the entire facility. continued.... .....continued Physical Plant The license, facility sketch, personal rights, emergency disaster form, complaints poster, emergency phone numbers and food menu are posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are kept inaccessible and locked in a cabinet located in the garage. Sharps/knives are inaccessible and stored in a locked cabinet in the hallway. Facility has non-perishable food for at least one week and perishable food for at least two days. Medications are centrally stored in a locked cabinet in the hallway. Smoke and carbon monoxide detectors were tested and in proper working order. Fire extinguisher was fully charged. First Aid Kits were checked and found to be complete. Room temperatures are maintained at 76 degrees F. The hot water temperature was tested and measured at 115 degrees F. All sinks, showers and toilets are in working order. No more than one (1) child share a bedroom. All beds are in good repair; equipped with good springs, clean mattresses and pillows. Adequate supply of beddings and linens were observed. Facility provides age-appropriate clothing items and hygiene products. Overall, facility is clean, safe, sanitary and in good repair. Operations Facility maintains a register of clients and the register is available upon request. The board of directors regularly conduct meeting to review and discuss the GH's operation. The facility administrator is responsible and capable for communicating with staff and emergency personnel in the facility. License is posted in a prominent location. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill quarterly and fire drill monthly for each shift. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Individual Treatment Plan for each client, medication records, and contact information for each client's responsible party and physician. continued.... .....continued Emergency Intervention Plan Facility uses manual restraints when needed. However, all five (5) out of six (6) staff members are trained on emergency intervention procedures. Administrator will ensure that one (1) out of six (6) staff receive training. Administrator is aware that the staff without manual restraint training (CPI) can not work at the facility without two (2) other staff who are trained, present. Client Records LPA reviewed three (3) client records. All client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to, consent forms, individual treatment plans, medical assessment, safeguards for cash resources, personal property and valuables, education records; personal rights forms; and medication administration records. Staff Records LPA reviewed seven (7) staff records. Six (6) out of seven (7) staff have been subjected to criminal records review and have been fingerprinted and cleared with DOJ, FBI and CACI. One (1) out of seven (7) staff was not cleared and showed as "in process". Staff was at the facility during the annual Administrator was advised that the staff was not cleared to work at the facility and staff was asked to leave until clearance was achieved. The administrator meets the required qualifications and/or experience. Documentation of the required education and experience requirements are maintained in the personnel file. LPA verified at least 20 hours of annual training for direct care staff. Clients with Special Health Care Needs There are currently three (3) clients in care with special health care needs. LPA interviewed two (2) staff member. There were citations issued. A copy of the 809, 809D's, 9102's, and appeal rights were left with the administrator. Exit Interview conducted.

met_with: Luis Raya-Administrator


summary: Facility Evaluation


summary: Facility Evaluation

raw_content:
Narrative:
On September 18, 2025, at 6: P.M.,Licensing Program Analyst (LPA) Demetris Teal went to the above named facility to drop off a personal rights poster. LPA met with Bernadette Candelaria-Facility Manager and was advised that they ordered a poster. LPA observed poster posted in the facility.

met_with: Bernadette Candelaria-Facility Manager


facility_name: QUAIL CANYON

summary: Facility Evaluation

raw_content:
Narrative:
On March 23, 2023, at 10: AM, Licensing Program Analyst (LPA) Carol Anderson conducted an announced pre-licensing inspection. LPA met with Director of Operations, TiffanyPineda Sanchez, Clara Mahmoud, RN, Director of Nursing, and Evelyn Vasquez, PsyD, Program Director. The facility is six-bedrooms and four and half bathrooms, single-family, two-story home. The applicant is applying for a group home with the capacity of six ambulatory clients' ages 12-17 years old. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris. Living room, group room, laundry room, nursing station, classrooms, kitchen, dining room and two staff offices located downstairs. Telephones will be installed throughout the facility for clients to receive and make confidential telephone calls. Medications and first aid will be locked in the locked cabinet located in the nursing office. Sharps will be locked in a locked box located in the kitchen area. Disinfectants and cleaning solutions will be stored in the intake offices located in the backyard. The facility smoke detectors and carbon monoxide detectors tested and were observed to be in working order; fire extinguisher is properly charged and serviced. equipped first aid kit and first aid manual. The facility has cameras in the common areas. The applicants stated there were no weapons in the facility. The staff and client files will be maintained electronically stored. that staff and client files to be accessible to Community Care Licensing (CCL) at any time. There is adequate indoor and outdoor activity space. The staff and client files will be maintained electronically stored. that staff and client files to be accessible to Community Care Licensing (CCL) at any time. The following required posted items were observed accessible to clients: Grievance Procedures, Personal Rights form, and California "See Something Say Something Poster" and Disaster plans at the facility. Bedroom 1: designated for two clients, two twin beds, one eight cubic feet dresser drawers and closet space. Bedroom 2: designated for two clients, two twin beds, one eight cubic feet dresser drawers and closet space. Bedroom 3: designated for two clients, two twin beds, one eight cubic feet dresser drawers and closet space Each room has adequate clean linens, pillows, blankets, comforters, mattress pads, and mattresses. Staff station will be in the hallway upstairs. Hot water temperature reading at 107. The Backyard is set up as follows: Facility has a pool which is appropriately fenced and secured with a mesh fence. The enclosure was measured to five-foot-high feet, self-closing access gate that opened away from the pool, with a self-latching device. The backyard is fully fenced and there is a covered patio with patio furniture. Intake administrative office is in the back yard. Storage shed located in the backyard. The applicant has been informed that the address to this facility is available to the public. All special incident reports (SIR's) will be sent via e-mail to: cclpaccr@dss.ca.gov. The reporting requirements were reviewed with the applicant on this date. The applicant was provided with an updated Facility Personnel Report Summary at the time of this visit and understands that once the license is approved, all employees and volunteers shall have an approved criminal record clearance for CCL and be associated to this facility. The fire clearance has been approved. Based on the facility pre-licensing inspection and facility records' review, no deficiencies were noted at time of the inspection Upon managers final review, the license will be provided. The facility has demonstrated compliance with Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report was provided to Director of Operations, Tiffany Pineda- Sanchez.

visit_type: Prelicensing

met_with: Tiffany Pineda-Sanchez, Director of Operation


summary: Facility Evaluation

raw_content:
Narrative:
On May 28, 2024, at 10:00AM, Licensing Program Analyst (LPA) Carol Anderson conducted an unannounced required/annual inspection. LPA met with Facility Manager Devyn Moore. The facility is six-bedrooms and four and half bathrooms, single-family, two-story home. Group Home is licensed to serve six clients 12- 17 years. Currently there are no clients residing at this facility. LPA inspected the interior and exterior of the facility: Facility grounds are clean and free of debris. Living room, group room, laundry room, nursing station, classrooms, kitchen, dining room and two staff offices located downstairs. Telephones located throughout the facility for clients to receive and make confidential telephone calls, Medications and first aid locked in the locked cabinet located in the nursing office, sharps will be locked in a locked box located in the kitchen area, Disinfectants and cleaning solutions stored in the intake offices located in the backyard. The facility smoke detectors and carbon monoxide detectors tested and were observed to be in working order; fire extinguisher is properly charged and serviced. equipped first aid kit and first aid manual. Per Facility Manager Devyn Moore, there were no weapons in the facility. The staff and client files are maintained electronically stored accessible to Community Care Licensing (CCL) at any time. The following required posted items were observed accessible to clients: Grievance Procedures, Personal Rights form, and California "See Something Say Something Poster" and Disaster plans at the facility Bedrooms are located upstairs: Bedroom 1: designated for two clients, two twin beds, one eight cubic feet dresser drawers and closet space. Bedroom 2: designated for two clients, two twin beds, one eight cubic feet dresser drawers and closet space. Bedroom 3: designated for two clients, two twin beds, one eight cubic feet dresser drawers and closet space. Each room has adequate clean linens, pillows, blankets, comforters, mattress pads, and mattresses. Staff station will be in the hallway upstairs. Hot water temperature reading at 108. The Backyard is set up as follows: LPA observed the pool with a mesh fence. The enclosure was measured to five-foot-high feet, self-closing access gate that opened away from the pool, with a self-latching device. The backyard is fully fenced and there is a covered patio with patio furniture. Intake administrative office is in the back yard. Storage shed located in the backyard. A review of Guardian on May 28, 2024, indicates that all facility staff associated to the facility had DOJ, FBI, and child abuse index check clearances. Based on observations made during today's inspection, there are no deficiencies. An exit interview was conducted, and a copy of this report was provided to Facility Manager Devyn Moore.

met_with: Devyn Moore


facility_name: QUAILRIDGE GROUP HOME

summary: Facility Evaluation

raw_content:
Narrative:
On Friday October 08 2021 at 10: AM Licensing Program Analyst (LPA) Linda Haynes conducted an annual inspection of the facility. At time of inspection LPA met with facility administrator Aries Parchejo. The facility was toured inside and out with facility administrator, Aries Parchejo. The home is a one-story residence has four bedrooms and one bathroom. No client was present at time of inspection. Bedrooms are arranged so that no more than one client is in a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. The bathroom was clean and in good repair. The hot water in the client bathroom was measured to be 113.3 degrees. All hazardous items have been properly made inaccessible to areas where clients will have access. The medications were stored and locked in a cabinet in the living room. Cleansers/chemicals are locked and stored in the cabinet under the kitchen sink. Sharp knives are inaccessible and stored in a locked drawer in the kitchen. The First Aid Kit is located in the living room and contained all required supplies. The facility's smoke detectors in each bedroom were checked and were operable. The smoke detectors are also the carbon monoxide detectors. There are no guns or weapons in the facility as stated by facility administrator Aries Parchejo. LPA observed a minimum 7-day non-perishable and a 2-day perishable supply of food. There was a variety of snacks available for clients as well. The following required posted items were observed accessible to clients: Grievance Procedures, Personal Rights, Visitation policies, and current menu. The facility outside grounds was also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. () Four of four client files and six of six staff files were reviewed during the inspection and noted to have documents required per regulations in file. There were no clients present at time of inspection to be interviewed. All staff that work at the facility have Department of Justice, FBI and Child Abuse Index clearances. Based on the facility inspection and file reviews this date, are no deficiencies found at this time. A copy of this report was reviewed and given to facility administrator Aries Parchejo.

met_with: Aries Parchejo


summary: Facility Evaluation

raw_content:
Narrative:
On November 08, 2022 at 8: AM, Licensing Program Analysts (LPA) Jessica Peete conducted an unannounced annual inspection at Quailridge Group Home. LPA was met at the facility by Administrator Aries Parchejo at 8: AM LPA began a physical plant inspection at 8: AM assisted by the Administrator. The physical plant inspection included the following checks: The facilities kitchen area, dining room, living room, family room, one staff room, refrigerator/freezers, food storage areas, garage, two client bathrooms, and four client bedrooms, labeled #B1,#B2,#B3,and #4. Bedrooms are arranged so that no more than one client is in a room, and there is one client per bed. Each client room has the appropriate linens, pillows, comforters, and mattresses are in good repair. Additionally, there is adequate drawer space for each client's belongings. Cleansers, chemicals, and cooking knives are inaccessible to clients. Cleaners and chemicals are locked in the kitchen cabinet under the sink. The cooking knives are locked in the kitchen drawer. The Licensee maintains an adequate supply of food and a variety of snacks for clients. LPA observed a minimum seven day non-perishable and a two day perishable supply of food. Additionally, LPA observed the following postings: facility license, grievance procedures, personal rights, visitation policies, and current menu. Age appropriate toys, games and books were observed for client's recreation time. The facility's outside grounds (front yard, backyard, and side yard) were also inspected and were found to be clean, well maintained. There is adequate indoor and outdoor activity space; all exits, and walkways were free from obstruction. Per Administrator there are no guns or weapons on facility grounds. All facility smoke detectors and carbon monoxide detectors are in appropriate working order and located throughout the facility. The fire extinguishers, located in the dining room and family room, are properly charged, and serviced. Medications are centrally stored inside a locked cabinet in the family room. The laundry room is located in the hallway and all detergents are kept locked in a cabinet and are inaccessible to clients. (Continued on LIC C) At 9: AM LPA observed the licensee was not in compliance with California Code of Regulation (CCR) 80087(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. LPA observed the dresser drawer in #B1 was broken. Licensee stated a new dresser will be purchased for #B1 and the broken dresser removed. At 9: AM LPA observed the licensee was not in compliance with CCR 80088(e)(1). Faucets used by clients for personal care such as shaving, and grooming shall deliver hot water. (1) Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures used by clients to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C). LPA observed the water temperature in client bathroom # 2 measured 83.2 degrees Fahrenheit. Licensee corrected the water temperature during the visit and the temperature measured 113.6 degrees Fahrenheit. The water. in client bathroom one was regulation measuring between 105-120 degrees Fahrenheit. At 9: AM LPA observed the licensee was not in compliance with CCR 84087.2(a) Children shall have access to safe outdoor activity space. LPA observed a swing set in the backyard, no longer in use, a discarded mattress, propane grill, and electric lawn mower. Additionally, LPA observed wood planks and various other debris along the fence. During the visit the licensee placed the propane tank and lawn mower in the locked garage inaccessible to clients. At 10: AM LPA began the review of the Operational Requirements assisted by the Administrator. Per Administrator the Board of directors' meetings are not performed on a quarterly basis and there were no available minute's meetings to review. At 10: AM LPA began the review of the Operational Requirements assisted by the Administrator. Per Administrator the Board of directors' meetings are not performed on a quarterly basis and there were no available minute's meetings to review. At 10: AM LPA observed the licensee was not in compliance with the following CCR regulations: (Continued on LIC C) CCR 84063(a)(8) (a) The board of directors shall be active in ensuring accountability, and shall perform, at a minimum, the following duties: (8) Conduct board of directors or governing body meetings at least on a quarterly basis... CCR 84063(a)(9) a) The board of directors shall be active in ensuring accountability, and shall perform, at a minimum, the following duties: (9) Ensure that minutes are kept for all board of directors meetings and retained as a permanent record... CCR 84063(a)(10) (a) The board of directors shall be active in ensuring accountability, and shall perform, at a minimum, the following duties: (10) Ensure that all minutes of board of directors' meetings are available to the licensing agency to inspect, audit, and copy upon demand during normal business hours... At 11: AM At 10: AM LPA began the review of the Disaster Preparedness assisted by the Administrator. At 11: AM it was observed the licensee was not in compliance with Health and Safety Code (HSC) 1565(d). A facility shall review the plan annually and make updates as necessary, including changes in floor plans and the population served. The licensee, administrator, or regulated individual shall sign and date the documentation to indicate that the plan has been reviewed and updated as necessary. At the time of observation, the licensee did not have an updated LIC 610C Emergency Disaster Plan. The licensee provided an updated LIC C during the visit; correcting the violation. At 11: AM LPA began the review of the Emergency Interventions. The Administrator provided all the documentation pertaining to this area of the inspection and no deficiencies were noted. At 12: PM LPA reviewed five staff files (S1-S5). The Administrator provided all documentation pertaining to this area of the inspection and no deficiencies were noted. At 1: PM LPA reviewed four client records (C1-C4). The Administrator provided all documentation pertaining to this area of the inspection and no deficiencies were noted. Due to time constraints, LPA will return to complete the inspection at a later date. An exit interview was conducted, and a copy of this report and appeal rights was emailed provided to Administrator Aries Parchejo.

met_with: Aries Parchejo Administrator


facility_name: RAMONA HOME

raw_content:
Investigation Findings:
13On 4/30/2025 at 12: PM, Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced inspection to the above facility. The purpose of this inspection was to inform the facility representative, Manjinder Kaur, of the findings for the complaint investigation regarding the allegations above. Ms. Kaur assisted this LPA with the inspection, and provided this LPA with a tour of the facility. During the inspection, no clients or staff were present as all the clients were in school. Based on confidential interviews conducted, although the allegations may have happened or is is valid, there is not a preponderance of the evidence to support that violations of the aforementioned allegations occurred. Therefore, these allegations are Unsubstantiated. An exit interview was conducted at 1: PM, and a copy of this report was provided to Ms. Kaur. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Joel Segura LICENSING EVALUATOR NAME: Vaishali Singh-Sood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Manjinder Kaur


raw_content:
Narrative:
LPA observed a video of staff finding unopened, sealed condoms within the facility trash bin located outside on 07/26/25. LPA observed a video of staff pulling out garbage from personal vehicle and disposing it on the facility's exterior on 07/25/25. Video evidence submitted confirmed garbage was not produced from the facility. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations occurred. Therefore, the allegation is UNSUBSTANTIATED. A copy of this report was given to Majinder Nijjar prior to exiting the facility.

Investigation Findings:
13On August 25, 2025 at 10: AM Licensing Program Analyst (LPA) Mona Lam made an unannounced inspection to the above listed facility. The purpose of this inspection is to deliver the findings for the above allegation. Majinder Nijjar, Licensee and Amar Nijjar assisted LPA with the inspection. Based on confidential interviews and photos, statements and photos indicated sexual gummies enhancement were sealed and located on a high shelf in an open area. In addition, some interviews were inconsistent regarding if the package had stayed within the facility for multiple days. Although the presence of the package was in the facility, they were sealed and placed on a high shelf in the kitchen. Interviews revealed that the package had been destroyed after it had arrived at the facility. The ingredients of the product were deemed not hazardous based on the company's website and inquiry. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Joel Segura LICENSING EVALUATOR NAME: Mona Lam 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 26-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN JOSE RO, N. First Street, Ste. FACILITY NAME: RAMONA HOMEFACILITY NUMBER: VISIT DATE: 08/25/2025

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

met_with: Majinder Nijjar, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On June 7, 2023, Licensing Program Analyst (LPA) Monica Pavia conducted a pre-licensing inspection. Ramona Home has submitted an application for a Group Home license, for a capacity of 4 ambulatory children. This inspection was conducted with Manjinder and Amarvir Nijjar and included observation of the following: The facility is a one story home. The home includes three client bedrooms; two client bathrooms; kitchen and living room; and two living room areas. The facility and grounds are in good repair, and free of obstructions; chemicals are stored and locked in the closet; locked and centrally stored medication room/cabinet observed; observed medication logs and discussed procedures for psychotropic medications; first aid kit complete; individual beds are in good repair; food storage space observed; emergency foods observed; perishable foods and nonperishable foods will be bought as soon as licensed; dining room equipped with tables and chairs accommodating all clients; washer and dryer are in the garage; all smoke detectors were tested by a fire inspector and appear to be in proper working order; carbon monoxide detector observed; fire extinguishers are properly charged; appropriate forms are posted in view of facility clients; there is no swimming pool on the premises; and, no firearms or weapons are allowed in the facility or on premises. The water temperature was 110 degrees Fahrenheit. The Plan of Operation/Program Statement were discussed. This facility is ready to be licensed pending Licensing Program Manager (LPM) review and approval of the application. License will be emailed, once approved.

met_with: Manjinder Nijjar


summary: Facility Evaluation

raw_content:
Narrative:
On May 16, 2024 at 12: PM, Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted a post-licensing inspection. Ramona Home has submitted an application for a Group Home license, for a capacity of 4 ambulatory children. Currently, there are no placements in care. This inspection was conducted with Manjinder and Amarvir Nijjar and included observation of the following: The facility is a one story home. The home includes three client bedrooms; two client bathrooms; kitchen and living room; and two living room areas. The facility and grounds are in good repair, and free of obstructions; chemicals are stored and locked in the closet; locked and centrally stored medication room/cabinet observed; observed medication logs and discussed procedures for psychotropic medications; first aid kit complete; individual beds are in good repair; food storage space observed; emergency foods observed; perishable foods and nonperishable foods will be bought as soon as licensed; dining room equipped with tables and chairs accommodating all clients; washer and dryer are in the garage; all smoke detectors were tested by a fire inspector and appear to be in proper working order; carbon monoxide detector observed; fire extinguishers are properly charged; appropriate forms are posted in view of facility clients; there is no swimming pool on the premises; and, no firearms or weapons are allowed in the facility or on premises. The water temperature was 113 degrees Fahrenheit. Due to the Annual inspection being conducted at the same date and time, a tools kit was only used for the annual inspection. An exit interview was conducted on May 16, 2024 at 4: PM.


summary: Facility Evaluation

raw_content:
Narrative:
On May 16, 2024, at 11: AM, Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted a post-licensing inspection with Manjinder Nijjar. Ramona Home has submitted an application for a Group Home license, for a capacity of 4 ambulatory children. Currently, there are no placements in care so client interviews could not be conducted. Ms. Nijjar is hoping to have placements in the next month or so. This inspection was conducted with Ms. Nijjar and included observation of the following: The facility is a one story home. The home includes three client bedrooms; two client bathrooms; kitchen and living room; and two living room areas. The facility and grounds are in good repair, and free of obstructions; chemicals are stored and locked in the closet; locked and centrally stored medication room/cabinet observed; observed medication logs and discussed procedures for psychotropic medications; first aid kit complete; individual beds are in good repair; food storage space observed; emergency foods observed; perishable foods and nonperishable foods will be bought as soon as there are clients in care; dining room equipped with tables and chairs accommodating all future clients; washer and dryer are in the garage; all smoke detectors were tested by a fire inspector and appear to be in proper working order; carbon monoxide detector observed; fire extinguishers are properly charged; appropriate forms are posted in view of facility clients; there is no swimming pool on the premises; and, no firearms or weapons are allowed in the facility or on premises. The water temperature was 116 degrees Fahrenheit. An exit interview was conducted on May 16, 2024 at 3: PM.


summary: Facility Evaluation

raw_content:
Narrative:
On July 2, 2025 at 11: AM, Licensing Program Analyst (LPA) Mona Lam conducted an unannounced annual inspection. During the time of the inspection, there were no clients on site due to attending their schools. Majinder Nijjar, Facility Manager and Amarvir Nijjar, Administrator assisted LPA during the inspection. The facility is a one story home. The home included three client bedrooms; two client bathrooms; kitchen and living room; and two living room areas. The facility and grounds were in good repair, and free of obstructions. LPA observed disinfectants located at a shelf out of reach of clients in the kitchen. In addition, LPA observed bleach located in a locked garage. Staff immediately locked chemicals away. LPA issued a technical violation under 80087(g) Buildings and Grounds. Room temperature was 70 degrees F. Fridge temperature was 40 degrees F. Freezer temperature was 4 degrees F. Staff immediately corrected freezer temperature to -1 degrees F. LPA issued a technical violation under 84076(c)(2) Food Service. LPA recommended in labeling dates of food within refrigerator. LPA observed food storage space for perishable food and nonperishable foods. Sharps were locked in a secure location with centrally stored medication. Individual beds were in good repair. Clean linen and additional toiletries were observed. First aid kit was complete. Appropriate forms were posted in view of facility clients. Complaint procedures were present, but not directly hung in visible location. LPA issued a technical assistance under 84070.2(a)(3) Children's Records. (Continued on LIC 809-C) Medication records were in compliance. LPA inspected three client files. LPA observed child's personal rights were not signed by clients, but were signed by authorized representatives. LPA advised facility to notate client's ability to sign or refusal to sign due to blank spaces. LPA issued a technical assistance under 84070(b)(17) Children's Records. LPA inspected a portion of the staff files, but has not finished. In addition, LPA have not reviewed disaster preparedness information. At this time the inspection, it is not complete and it will be concluded at a later date. Two (2) technical violations and two (2) technical assistances were issued at the time of the inspection. An exit interview was conducted a copy of this report was discussed, printed, and delivered to Majinder Nijjar prior to leaving the facility.

met_with: Manjider Nijjar, Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On July 11, 2025 at 11: AM, Licensing Program Analyst (LPA) Mona Lam conducted an unannounced annual continuation inspection. During the time of the inspection, there were no clients on site due to attending their schools. Majinder Nijjar, Facility Manager and Amarvir Nijjar, Administrator assisted LPA during the inspection. Two clients are non-verbal and one client is verbal. Hot water measured to 106 degrees Fahrenheit. LPA inspected the disaster and preparedness information. Information is complete in emergency and disaster preparedness plan. LPA inspected staff files. LPA was not able to view specific training topics in staff files. LPA issued a technical violation under 84065(i)(5) Personnel Requirements and 84065(d)(3) Personnel Requirements. LPA was unable to observe documented assessment in multiple staff files. LPA issued a technical violation under 84065(i)(1)(D)(2) Personnel Requirements. LPA conducted two staff interviews and no client interviews. One client was present at the site, however they are non-verbal. Three (3) technical violations were issued at the time of the inspection. An exit interview was conducted a copy of this report was discussed, printed, and delivered to Majinder Nijjar prior to leaving the facility.


facility_name: RANCHO SAN ANTONIO - HOPE'S HOUSE UCP

raw_content:
Investigation Findings:
13On May 16, 2025 at 12:30PM Licensing Program Analyst (LPA) Justine Armstrong conducted an unannounced visit to RANCHO SAN ANTONIO - HOPE'S HOUSE UCP to conclude the investigation of the above allegations and deliver the findings. LPA met with Krystel Berio the Program Director, who granted access to the facility, and together, they discussed the investigation During the investigation process, all relevant parties have been accounted for. It was reported that Staff are not meeting minor's grooming needs and Staff threatened minors. Confidential interviews indicated that the facility meets grooming needs and that there have been no concerns regarding staff mistreating minors. After conducting confidential interviews and reviewing all documents, there was insufficient evidence or testimony to substantiate the allegations. Although the allegation may have happened or could be valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has decided that the allegation is Unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies cited. An exit interview was completed, and a copy of this report was provided to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Enrique M Hernandez LICENSING EVALUATOR NAME: Justine Armstrong LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Krystel Berio


raw_content:
Investigation Findings:
13On May 16, 2025 at 12:30pm Licensing Program Analyst (LPA) Justine Armstrong conducted an unannounced visit to RANCHO SAN ANTONIO - HOPE'S HOUSE UCP to conclude the investigation of the above allegations and deliver the findings. LPA met with Krystel Berio the Program Director , who granted access to the facility, and together, they discussed the investigation During the investigation process, all relevant parties have been accounted for. It was reported that Staff did not provide minor with adequate meals, Staff did not ensure minor was provided with a safe and comfortable environment, and Minor was not accorded privacy while in care. After conducting confidential interviews and reviewing documents, there was insufficient evidence or testimony to substantiate the allegations C1 admitted to receiving three meals a day and C2 expressed no safety or privacy concerns. Although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has decided that the allegation is Unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies cited. An exit interview was completed, and a copy of this report was provided to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Enrique M Hernandez LICENSING EVALUATOR NAME: Justine Armstrong LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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


raw_content:
Narrative:
Interviews did not produce evidence that clients do not receive food options if they have specific dietary needs. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred; therefore, the above allegation is Unsubstantiated. There are no deficiencies being cited at this time.

Investigation Findings:
13On June 10, 2025 at 1:30pm Licensing Program Analyst (LPA) Donald Martin arrived at the above facility. LPA met with Residential Director, Troy McNair and was allowed into the facility. The purpose of this visit is to deliver findings for the above complaint investigation. During the course of investigation the allegations, interviews were conducted and documents obtained. The interviews did not produce corroborating evidence to support said allegations. Interviews revealed inconsistent statements and no witnesses to suggest allegations occurred. There was no evidence that facility staff are not providing meals that meet youth's dietary needs. LPA received documentation which reveiled a menu created by the facility which supports all clients dietary needs. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Donald C Martin 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: RANCHO SAN ANTONIO - HOPE'S HOUSE UCPFACILITY NUMBER: VISIT DATE: 06/10/2025

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

met_with: Troy McNair-Residential Director


summary: Complaint Investigation - Substantiated - 1 deficiency - 1 allegation

raw_content:
Narrative:
Although S3 claimed this was a system oversight, Staff members S1 and S2 agreed that S3 would still be held responsible, as staff are expected to regularly review medical documentation and follow up on appointments. It was determined that staff did not adhere to health services policies or procedures. Based on the confidential interviews and record reviews, the preponderance of evidence standard has been met; therefore, the allegation is Substantiated. The evidence supports that staff did not ensure that the minor was taken to their medical appointments and that a minor in care did not receive prescribed medications as required. A deficiency was cited at the facility regarding Health Related Services Title 22, Division Chapter Article 06. Continuing Requirements 80075(a). (Continued on LIC9099D)

Investigation Findings:
13On October 23, 2025, Licensing Program Analyst (LPA) Justine Armstrong made an unannounced visit to Rancho San Antonio - Hope's House UCP and met with Krystel Berio the Program Director, who granted access to the facility. The purpose of this visit was to conclude the complaint investigation regarding the following allegations: 1. Staff did not ensure that a minor was taken to their medical appointments. 2. Staff did not ensure that a minor in care received prescribed medications. LPA Armstrong and the facility administrator discussed the details of the investigation. During the investigation, LPA Armstrong conducted confidential interviews with all relevant parties and gathered information related to the allegations. After reviewing all the statements and evidence obtained, LPA Armstrong confirmed that during a previous site inspection from the Office of Refugee Resettlement (ORR), it was documented that Clients 1 and 2 were not provided with medical follow-up appointments. The medication administration records (MARS) for Client 1 did not indicate the utilization of a rescue inhaler. Staff member S3 neglected medical recommendations concerning the scheduling of follow-up doctor appointments for clients in care. (Report Continue on LIC9099C) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Enrique M Hernandez LICENSING EVALUATOR NAME: Justine Armstrong 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: RANCHO SAN ANTONIO - HOPE'S HOUSE UCPFACILITY NUMBER: VISIT DATE: 10/23/2025

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

Deficiencies:
80075(a): 1
2
3
4
5
6
7Prior to the complaint findings being delivered, the facility conducted internal interviews, provided a refresher training on Health-Related Services, provided field and vehicle safety, and updated its medication and health service policies.

complaint_status: SUBSTANTIATED

title:
Health Related Services - The licensee shall ensure that each client receives necessary first aid and other needed medical or dental services, including arrangement for and/or provision of transportation to the nearest available services. ...This requirement is
not met as evidenced by


summary: Facility Evaluation

raw_content:
Narrative:
On May 10, 2022 at 10am Licensing Program Analyst (LPA) Donald Martin arrived at the above facility for the purpose of conducting a Pre Licensing Inspection of the facility's ORR dorms Jose Antonio and Pedro Gabriel. The capacity as stated is 40 clients and will be reduced to 32. The facility layout is as follows: Jose: There are Four bedrooms. Each room contains two beds and two stand up closets that contain a clothes hanging are, two dresser drawers and a pull out desk. There are two large windows in front of each bed that have large pull down window covers. Note: None of the beds have linen or pillows on them at the time of the visit. The facility uses a linen service that provides a fitted sheet, top sheet and pillow cover. Antonio: There are Four bedrooms. Each room contains two beds and two stand up closets that contain a clothes hanging are, two dresser drawers and a pull out desk. There are two large windows in front of each bed that have large pull down window covers. Note: None of the beds have linen or pillows on them at the time of the visit. The facility uses a linen service that provides a fitted sheet, top sheet and pillow cover. Pedro: There are Four bedrooms. Each room contains two beds and two stand up closets that contain a clothes hanging are, two dresser drawers and a pull out desk. There are two large windows in front of each bed that have large pull down window covers. Note: None of the beds have linen or pillows on them at the time of the visit. The facility uses a linen service that provides a fitted sheet, top sheet and pillow cover. Gabriel: There are Four bedrooms. Each room contains two beds and two stand up closets that contain a clothes hanging are, two dresser drawers and a pull out desk. There are two large windows in front of each bed that have large pull down window covers. Note: None of the beds have linen or pillows on them at the time of the visit. The facility uses a linen service that provides a fitted sheet, top sheet and pillow cover. Cont. 809-C Each hallway has an exit door at the end of the hallway. The hallways also have working smoke detectors. Note: At the beginning of each hallway there is a camera which faces down the hallway. A program statement addendum regarding the cameras, placement, maintenance and view was presented to LPA during the visit. Residential Director, Troy McNair was advised that CCL does not provided camera waivers for facilities at this time. Bathrooms: There is one bathroom separating each hallway located in the "Anti-Lobby" of each dorm (Two Bathrooms). There are 4 sinks, three seated toilets, three stand up toilets and a utility sink in both bathrooms. Each bathroom has a shower area. The showers each contain 3 separate shower heads. There are dividers in on shower area and no dividers in the other. Each bathroom has an exit door that leads to the outside area. Note: LPA was notified that the clients shower alone despite there being three shower heads in the shower area. Residential Director, Troy McNair was advised to remove the brackets from the wall where the dividers were located prior to repairs that were made in the shower area. Anti-Lobby: The Anti-Lobby area contains a desk for staff, a small kitchen area that contains a microwave for client use, and a locked room where the refrigerator, perishables and Non-perishables will be kept for clients. There is a locked cabinet stated to be used for cleaning supplies. Note: LPA informed Residential Director, Troy McNair that food cannot be kept in the same area as cleaning supplies and that the snacks need to be accessible to the clients. Lobby: There are two lobby areas, both of which are identical. There is a dining table, a sectional seating area and a TV. There are books and games next to the TV and a covered fireplace which is no operable. There are Therapists/Direct Care Staff offices surrounding the Lobby areas. There is a bathroom that is used for the therapists offices only. Note: Lic 200 was received on Ap;ril 25, 2022 to reduce capacity to 32. The facility uses a custodial service to clean the dorms. No defences cited at the time of this inspection.