facility_name: DESTINED 4 GREATNESS SFH

summary: Complaint Investigation - Substantiated - 3 allegations

raw_content:
Narrative:
Page The Department received a complaint alleging a foster child in placement sustained unexplained injuries while in care. Facility personnel provided inconsistent statements to the Department, placement agency social workers and law enforcement regarding the incident. Initially, the facility reported a plastic highchair accidentally fell over and struck the foster child's (FC1) face on or about 9/02/24, 7: PM, causing no injury. The following morning, daycare staff observed FC1 with an abrasion on the left eye and nose, which later worsened to a bruising with swelling. Daycare staff requested the licensee pick up FC1 and suggested medical follow up. On 9/06/24, a forensic medical exam was conducted on FC1. The exam findings concluded FC1 sustained a nose fracture, facial contusion injuries and swelling of the facial area. The extent of the injuries was inconsistent with the explanation provided by licensee. In addition, the facility failed to seek timely medical attention for the child until they were advised to do so by daycare staff. On 9/3/24, FC1 was treated by a doctor for facial injuries. The doctor observed the child with bruising to his nose, cheek and eye areas and recommended completing x-rays to assess for broken bones or other damage. The doctor reviewed the child's record on 9/27/24 and x-ray results were not on file, indicating it was not completed. Also, the doctor who conducted the forensic exam on 9/6/24 noted the delay in seeking medical care for the child is consistent with neglect. Furthermore, the facility failed to follow reporting requirements. Until advised by the Department on 9/11/24, the facility failed to report the extent of the child's injuries as observed by daycare staff on 9/3/24 and the child's medical visit. Based on information gathered from interviews conducted and record review the allegations are substantiated. The facility is cited for violation of California Code of Regulation, Title Div. 6 regulation 83072(d)(1) Personal Rights, regulation 80061(b)(1)(D) Reporting Requirements and regulation 83075(b) Health Related Services. Continued on page Page Per the new Civil Penalty laws, Health and Safety (H&S) Code section 1548(E), an Enhanced Civil Penalty (ECP) determination is pending due to the substantiated allegations. If an ECP is warranted, a Community Care Licensing (CCL) representative will return to the facility to deliver the penalty assessment. Exit interview conducted. A copy of this report, LIC811, LIC9099D and appeals rights were provided to the above-mentioned staff.

Investigation Findings:
13An unannounced follow up complaint inspection was conducted by Licensing Program Analysts (LPAs) Christopher Larios and Juliet Robles on 3/28/25 at 2: PM. During the inspection LPAs Larios and Robles met with Administrator Kyis Jeter. The purpose of the inspection was to deliver findings regarding the above-mentioned complaint allegations. The investigation was conducted by Community Care Licensing Division (CCLD) Investigations Branch (IB) State Investigator (SI) Shawniece Poinsette and LPAs Joseph Vargas and Brent Lockhart. During the course of the investigation SI Poinsette conducted interviews with a San Bernardino County Sheriff's (SBCS) Detective on 9/30/24, interviewed a daycare staff and attempted to interview three facility staff on 10/25/24, obtained a SBCS report on 12/09/24, attended an attempted interview of FC2 on 01/07/25 and interviewed a former foster child on 02/05/25. In addition, LPA Vargas and Lockhart interviewed a facility staff, a daycare staff and others on 9/11/24. A record review was conducted by LPAs Vargas and Lockhart on 9/11/24 and copies of medical reports, incident reports and photographs were obtained. (Continued on page 2) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Christopher Larios 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: DESTINED GREATNESS SFHFACILITY NUMBER: VISIT DATE: 03/28/2025

Allegations:
- SubstantiatedEstimated Days of Completion:
- Estimated Days of Completion:
- Estimated Days of Completion: 0

met_with: Kyis Jeter


state: CA

summary: Facility Evaluation

raw_content:
Narrative:
On August 04, 2023 at 9: AM, a Component II was conducted at the Monterey Park Children's Residential Program office with Destined Greatness Small Family Home. Present at the Component II from Destined Greatness Small Family Home was applicant Kyis Jeter and Licensing Program Analyst (LPA) Juliet Robles. During the meeting the LPA went over the facility application and supporting documents. The applicant provided the following updated documents: 1. Current Health Screening and TB test for the applicant 2. Written permission from the landlord to open a SFH in the property. 3. Facility sketches with labels of the window, exit and potential client's room with diameter. 4. Surety Bond LPA reviewed and discussed the following revisions to be made to sections of the facility's Program Statement to be submitted by August 11, 2023. 1. Disaster Plan Procedures. *Applicant to provide letters of acknowledgement from planned relocation sites. Here's the Program website that you can review the SFH tool: www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process Applicant was also advised to begin contacting placement agencies. An exit interview was conducted, and a signed copy of this report was provided to the Applicant.

report_type: Facility Evaluation


summary: Facility Evaluation

raw_content:
Narrative:
On November 06, 2023 at approximately 9: AM, Licensing Program Analysts (LPAs) Juliet Robles and Pamela Silva conducted an announced pre-licensing inspection at the above address. Upon arrival, LPAs met with Kyis Jeter, Applicant. Together they toured the external and internal areas of the home. The following was observed at the time of inspection: Physical Plant This facility is a two story house located in a quiet residential community. The facility consists of four (4) bedrooms, three and one half (3.5) bathrooms, office, kitchen, family room, dining area, loft upstairs, laundry room in a 2-car garage, and backyard. Overall, the facility is clean, sanitary and in excellent condition. Passageways are free from obstruction. Knives and sharps are kept locked and secured in the kitchen drawer while disinfectants and cleaning solutions are kept locked and secured in cabinets inside the kitchen. Drawers and cabinets have child locks in the kitchen. Per applicant, there are no firearms on the premises. The facility has a centralized heat and air-conditioning unit. Temperatures throughout the home during the inspection were comfortable. Carbon monoxide and smoke alarms were tested and observed to be operational. The home has two fire extinguisher one upstairs and one downstairs. The home has a working telephone that is available for client use. A fire inspection was conducted by the Rancho Cucamonga Fire Department on 09/28/23 and a fire clearance was granted for ambulatory clients. Fixtures, Furniture, Equipment, and Supplies The home has toilets, wash basins, and one shower/bath for clients' use. Client bedroom #2 & #3 was observed to be clean, orderly, and contained a bunk bed, twin bed and queen bed. LPA observed clean pillows, bed sheets and blankets. The client's bedroom has adequate closet and drawer space to accommodate client's clothing and personal belongings. Heath Related Services and Record Keeping Medications, the first aid kit will be centrally stored and locked in a cabinet by the hallway. The kit contains all required supplies. The client and staff files will be stored in a locked file cabinet in the office. LPA also conducted Component III - Category Specific Orientation with the applicant. The following items were discussed and provided to the applicant: -Title 22 regulations on Small Family Homes - Continuing Requirements (General Licensing Requirements) - Buildings and Grounds requirements - Personnel Records (forms) - Client Records (forms) -Reporting Requirements - Other administrative forms LPA requested applicant to submit a waiver for the cameras installed at home in the common areas. LPA requested applicant to submit the final Program Statement and Plan of Operation on or before 11/13/23. No deficiencies were observed on this date. An exit interview was conducted, and a copy of this form was emailed to the Applicant.

visit_type: Prelicensing


summary: Facility Evaluation

raw_content:
Narrative:
On August 19, 2024 at 8: AM Licensing Program Analysts (LPAs) Juliet Robles and Caitlin Chambers conducted an unannounced inspection at the Small Family Home facility and met with the licensee. The purpose of the inspection was in regard to post licensing and a capacity increase, previously requested from three (3) to four (4) children. Currently the facility has two (2) children in care. The Department received the following documents from the licensee: LIC 200 (application), the appropriate licensing fee and an approved Rancho Cucamonga fire clearance dated 08/05/2024. At 8: AM LPAs, and licensee toured the internal and external areas of the home. The following was observed at the time of inspection: This facility is a two-story house located in a quiet residential community. The facility consists of four (4) bedrooms, three and one half (3.5) bathrooms, office, kitchen, family room, dining area, loft upstairs, laundry room in a 2-car garage, and backyard. Overall, the facility is clean, sanitary and in excellent condition. Passageways are free from obstruction. Knives and sharps are kept locked and secured in the kitchen drawer while disinfectants and cleaning solutions are kept locked and secured in cabinets inside the kitchen. Drawers and cabinets have child locks in the kitchen. Per applicant, there are no firearms on the premises. The facility has a centralized heat and air-conditioning unit. Temperatures throughout the home during the inspection were comfortable. Carbon monoxide and smoke alarms were tested and observed to be operational. The home has two fire extinguisher one upstairs and one downstairs. The home has a working telephone that is available for client use. Medications, the first aid kit is centrally stored in a cabinet by the hallway. The first aid kit contains all required supplies. The client and staff files are in a locked file cabinet in the office. The home has toilets, wash basins, and one shower/bath for clients' use. The water temperature was tested at 105 degrees which is within regulatory guidelines. The following sleeping arrangements were noted: Bedroom #1 (Sister) it has, twin bed, closet. Bedroom #2 (Client 1 and Client 2) it has a crib/toddler bed, twin bed, closet, drawer space. Bedroom #3 free for possible Clients (2) - it has 2 twin beds, closet, and drawer space for 2 and a bathroom. Bedroom #4 - Licensee Licensee has space for the increase and LPA will submit file to LPM for approval of the capacity increase request. LPA reviewed two (2) client records and two (2) staff files. Licensee and staff have current first aid and CPR certificates. LPA checked required criminal record and child abuse index check clearance or exemption for all adults in the home. The client's files contained: Admission Agreement, Medical Assessment, Consent Forms, Emergency Information, Individual Family Service Plan, Immunization Record and Personal Rights. LPA provided licensee/administrator with PIN 24-09-CRP Video Cameras in Children's Residential Congregate Care Facilities. LPA advised administrator/licensee to start reviewing and update the Program Statement to reflect new guidelines for video surveillance due to cameras installed or if planning to install cameras in the facility. Based on the facility inspection and file reviews this date, there are no deficiencies found at this time. An exit interview was conducted with the licensee. LPA provided a copy of the following reports: LIC 809, LIC 809C, LIC 811, were provided to Mr. Jeter.


summary: Facility Evaluation

visit_type: Annual


summary: Facility Evaluation

raw_content:
Narrative:
On 04/15/25 at 9: AM Licensing Program Analysts (LPA)s, Juliet Robles and Christopher Larios conducted a Plan of Correction inspection and met with Administrator/Licensee, Kyis Jeter. The POC is for licensee to submit health screening report, LIC 500 for the following staffs: S2, S4 and S5. And a TB test for S5 on or before 04/11/25. Licensee/Administrator emailed LPA on 04/10/25 that he will remove the staffs in his LIC 500. LPA Robles emailed Licensee/Administrator to provide a separation letter for each staff involved in the POC with their signatures on or before the due date on 04/11/25. On today's visit, Administrator/Licensee stated that S4 remains in his LIC 500 and has an appointment on 04/24/25 for the health exam, however, did not request an extension POC for S4. Administrator/Licensee did not provide the separation letter for S2 and S5. LPA Robles assessed civil penalties due to the deficiency was not corrected by the Plan of Correction due date, 4/11/25. A 421FC is assessed from dates 04/12/25 to 04/15/25 for a total of $400. And another 421FC is assessed from dates 04/12/25 to 04/15/25 for a total of $400, for a total of $800.00. An exit interview was conducted and LPA provided this report, two (2) LIC 421FC and appeal rights.


summary: Facility Evaluation

raw_content:
Narrative:
On March 28, 2025 at 12: PM Licensing Program Analysts (LPAs) Juliet Robles and Christopher Larios conducted an unannounced inspection at the Small Family Home facility and met with the licensee. The purpose of the inspection was in regard to an Annual/Required inspection. Currently the facility has zero (0) children in care. This facility is license to provide services to four (4) ambulatory clients for developmentally disabled children aged 2-17 years old. At 12: PM LPAs, and licensee toured the internal and external areas of the home. The following was observed at the time of inspection: This facility is a two-story house located in a quiet residential community. The facility consists of four (4) bedrooms, three and one half (3.5) bathrooms, office, kitchen, family room, dining area, loft upstairs, laundry room in a 2-car garage, and backyard. Passageways are free from obstruction. Knives and sharps are kept locked and secured in the kitchen cabinet while disinfectants and cleaning solutions are kept locked and secured in the laundry room. Per licensee, there are no ammunition and firearms on the premises. The facility has a centralized heat and air-conditioning unit. Temperatures throughout the home during the inspection were comfortable. Carbon monoxide and smoke alarms were tested and observed to be operational. The home has two fire extinguisher one upstairs and one downstairs. The home has a working telephone that is available for client use. Medications, the first aid kit is centrally stored in a cabinet by the hallway. The first aid kit contains all required supplies. The staff files are in a locked file cabinet in the licensee's bedroom. The home has toilets, wash basins, and one shower/bath for clients' use. The water temperature was tested at 115 degrees which is within regulatory guidelines. Copy of facility license, facility sketch, emergency phone numbers, emergency disaster form were all prominently displayed in the home. The following sleeping arrangements were noted: Bedroom #1 (possible client) it has, twin bed, closet. Bedroom #2 (possible client) it has a twin bed, closet, drawer space. Bedroom #3 (adult sister) it has a twin bed, closet, drawer space. Bedroom #4 - Licensee with own bathroom LPAs were provided with LIC 500, there are five (5) staffs at the facility. LPAs reviewed five (5) staff files. Five out of five staffs have current first aid and CPR certificates. Five out of five Licensees is current with ongoing training hours. LPAs checked required criminal record and child abuse index check clearance or exemption for all adults in the home. Per licensee, he does not have any cameras or ring doorbells at his facility. During the inspection the LPAs observed deficiencies (see attached LIC809D). Plans of corrections were discussed, LPAs provided a copy of the following reports: LIC 809, LIC 809C, LIC 809D, LIC 811 and appeal rights were provided to Mr. Jeter, licensee.

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced case management inspection was conducted by Licensing Program Analysts (LPAs) Christopher Larios and Juliet Robles on 3/29/25 at 2: PM. During the inspection LPAs Larios and Robles met with Administrator Kyis Jeter. The purpose of the inspection was to follow up on information obtained by law enforcement while investigating the facility. On 9/24/24, at 12: PM, San Bernardino County Sherriff's Department Detectives served a search warrant to Destined Greatness SFH located at Sicilian Dr. Rancho Cucamonga, Ca 91730. During the search detectives located at .40 caliber XD magazine, a 9mm caliber Smith and Wesson loaded with seven rounds of 9mm cartridge case ammunition in a dresser in the master bedroom. In addition, law enforcement conducted interviews that concluded the facility administrator provided false identification information regarding facility personnel. The administrator provided law enforcement with the name, description and contact information of a reported witness (Ref. #1, See Confidential Names form LIC811 dated Date) whose identity detectives determined was being utilized by Ref. #2. In addition, law enforcement obtained records from a daycare utilized by the facility. The daycare records revealed an identification card with Ref. #1's information was on file however, the individual photographed on the card was Ref. #2. Per statements obtained from daycare staff, identification is required to sign enrollment forms and pick up the children from daycare. Continued on page Page On 3/13/25, at 2: PM, LPA Larios attempted an inspection for the purpose of delivering investigation findings. A staff (Ref. #2) did not allow LPA Larios to enter the facility and advised LPA Larios to return later when the facility administrator was available. The facility is cited for violation of California Code of Regulations Title Div. 6 regulation 80087(g)(1) Buildings and Grounds, regulation 80087(g)(3) Buildings and Grounds, regulation 80046(a)(1)(a)(2) Exclusions and 80044(a)(2) Inspection Authority of the Licensing Agency. A copy of this report, LIC809D, LIC811 and appeals rights were provided to the above-mentioned facility representative. Exit interview conducted.


facility_name: DETOY COMFORT CARE SFH

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
On December 12, 2024, Community Care Licensing received information alleging that the licensee refused to provide foster child's medication to school personnel and that licensee did not administer foster child's medication. It was specifically alleged that C1 had a seizure at school and AMR had administered Diazepam and stabilized C1. It was further reported that C1's school is supposed to have "rescue" medication on site, but licensee refused to bring it. A confidential interview stated that C1 was placed in the home on November 12, 2024, and C1 did not have all C1's medication from C1's previous caregiver. The same interview reported that licensee was reaching out to C1's medical insurance provider to get all the medication necessary for C1. The same interview indicated that school personnel did not want to take C1's medication without a doctor's note. Another confidential interview stated licensee continued to reach out to the medical insurance provider to make all the necessary appointments for C1's medication. Out of Home Investigator stated not having concerns on the care and supervision from licensee she stated that obtaining the medication for C1 during the transition was a long process. Other interviews did not have any information regarding the administration of medications in the SFH. Regarding the allegation that licensee did not administer foster child's medication it was alleged that C1 is also supposed to be taking another medication twice a day but there are concerns that licensee may not be giving it. One confidential interview stated that C1 came in placement with no Medication Administration Records and the medication was in a bag with nothing else. The same interview added that licensee was trying to get a hold of the medical insurance provider to make an appointment for C1 to receive all the right medication. Out of Home Investigator stated not having concerns on the care and supervision from licensee she stated that obtaining the medication for C1 during the transition was a long process. Other interviews did not have any information regarding the administration of medications in the SFH. Based on confidential interviews, the allegations that licensee refused to provide Client #1's (C1's) medication to school personnel and that licensee did not administer C1's medication may have occurred, however, there was not a preponderance of evidence to support or deny the alleged violations. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted and a copy of this report, LIC 811, and appeal rights were provided to licensee.

Investigation Findings:
13On February 26, 2025, at 9: AM, Licensing Program Analyst (LPA) Adaleyci Caballero met with Detoy Comfort Care Small Family Home (SFH) Licensee Oluwatoyosi Aderonmu to discuss the investigation finding for the above stated allegations involving client #1 (C1) listed on the Confidential Names List (LIC811) dated 02/26/25. On December 18, 2024, at 9:25AM, LPA initiated the investigation at the SFH, and a safety inspection was conducted. There were no immediate hazards observed. During the investigation, LPA interviewed licensee, C1, Adult #1(A1), Adult #2(A2), and County Investigator. LPA obtained pertinent documents from SFH and C1's files. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Adaleyci Caballero 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 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: DETOY COMFORT CARE SFHFACILITY NUMBER: VISIT DATE: 02/26/2025

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

report_type: Complaint Investigation

met_with: Licensee-Oluwatoyosi Aderonmu

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On September 3, 2024, Licensing Program Analyst (LPA) Adaleyci Caballero met with Applicant Oluwatoyosi Aderonmu via Microsoft Teams Meeting for a Component II of the application process. Lpa a. Caballero went over revisions needed for the application prior to license. Revisions are due Tuesday, September 17, 2024. Lpa a. Caballero gave a copy of this report and the LIC 184, Notice of Incomplete Application to assist with the revisions needed to the application. A copy of this report was provided to applicant via email. Original signed copy of this report will be placed in the facility file.

met_with: Applicant-Oluwatoyosi Aderonmu


summary: Facility Evaluation

raw_content:
Narrative:
On September 18, 2024, at 9:45AM, Licensing Program Analyst (LPA) Adaleyci Caballero completed a pre-licensing inspection of Detoy Small Family Home (SFH). LPA met with Applicant Oluwatoyosi Aderonmu who led a tour of the home. The facility was toured both inside and out with the applicant. There are no clients in placement. The home is a two-story building with five bedrooms and three full bathrooms which are set up as follows: Bedroom #1- It consisted of a king bed and a bassinet. It serves as a guest room and possible infant client room. Bedroom #2- It consisted of two single beds. The beds had linen, comforters, and pillows. It will sleep applicant's bio child and visitors. Bedroom #3- It consisted of two single beds. The beds had linen, comforters, and pillows. It will sleep two clients. Bedroom #4- It consisted of two single beds. The beds had linen, comforters, and pillows. It will sleep two clients. Bedroom #5- It consisted of a king bed and a crib. It will sleep applicant, husband, and infant bio daughter. A living room, dining room, kitchen, laundry room, three car garage, and a backyard. The applicant's bedroom will be utilized as an office space inaccessible to clients in care. The garage will be utilized for storage. The clients' bedrooms were arranged so that no more than two clients will be in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the clients' belongings. There was a smoke detector in every bedroom. The nine smoke and four carbon monoxide detectors were checked and working properly. The home's central air conditioning module was in the backyard. The water heater was in the garage. The appliances were in working order. The clients' files, allowance, and medications will be locked inside a filing cabinet in the storage closet in the first floor hallway. There was adequate food storage space and a supply of three days of perishable foods and a week of non-perishable foods. The home had a trash can for storage of solid waste with a tight-fitting lid. The sharp knives were locked in a kitchen drawer. The hot water was at a temperature of 112.8 degrees Fahrenheit. The First Aid kit was accessible and was placed in a cabinet in the kitchen. There was five fire extinguishers present in the home located in the kitchen and common areas throughout the home. They were observed to be properly charged and inspected by the fire department. There are no firearms in the home. There is no pool or other bodies of water at the home. The backyard is fully fenced and free of debris. The home has three cameras. One camera in front of the garage, one camera on the door bell, and a camera in bedroom #2 to monitor applicant's bio child's bedtime. Corrections to be made: The living room window screen needs to be repaired. Component III was conducted. An exit interview was conducted, and a copy of this report was provided to applicant Oluwatoyosi Aderonmu. Application will be forwarded to Licensing Program Manager Jennifer Smith for licensure.


summary: Facility Evaluation

raw_content:
Narrative:
On December 4, 2024 at 11:30AM, Licensing Program Analyst (LPA) Adaleyci Caballero attempted to conduct a post-licensing inspection of the Small Family Home. LPA was unable to conduct the inspection because Licensee Oluwatoyosi Aderonmu had a medical emergency. LPA will attempt the inspection at a later time. Licensee gave verbal authorization for Idowu Aderonmu to sign this report. A copy of this report was provided to Licensee Oluwatoyosi Aderonmu via email.

met_with: Adult-Idowu Aderonmu


summary: Facility Evaluation

raw_content:
Narrative:
On February 19, 2025 at 10:00AM, Licensing Program Analyst (LPA) Adaleyci Caballero completed a post-licensing inspection of Detoy Small Family Home (SFH). LPA met with Licensee Oluwatoyosi Aderonmu who led a tour of the home. The facility was toured both inside and out with the licensee. There is one client in placement. The home is a two-story building with five bedrooms and three full bathrooms which are set up as follows: Bedroom #1- It consisted of a king bed and a bassinet. It serves as a guest room and possible infant client room. Bedroom #2- It consisted of two single beds. The beds had linen, comforters, and pillows. It sleeps applicant's bio child and visitors. Bedroom #3- It consisted of two single beds. The beds had linen, comforters, and pillows. It sleeps one client. Bedroom #4- It consisted of two single beds. The beds had linen, comforters, and pillows. It will sleep two clients. Bedroom #5- It consisted of a king bed and a crib. It sleeps applicant, husband, and toddler bio daughter. A living room, dining room, kitchen, laundry room, three car garage, and a backyard. The garage is utilized as an office space and storage. The clients' bedrooms were arranged so that no more than two clients are in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the clients' belongings. There was a smoke detector in every bedroom. The nine smoke and four carbon monoxide detectors were checked and working properly. The home's central air conditioning module was in the backyard. The water heater was in the garage. The appliances were in working order. The clients' files, allowance, and medications are locked inside a filing cabinet in the storage closet in the first floor hallway. There was adequate food storage space and a supply of perishable foods and non-perishable food. The home had a trash can for storage of solid waste with a tight-fitting lid. The sharp knives were locked in a kitchen drawer. The hot water was at a temperature of 112.8 degrees Fahrenheit. The First Aid kit was accessible and was placed in a cabinet in the kitchen. There was five fire extinguishers present in the home located in the kitchen and common areas throughout the home. They were observed to be properly charged and inspected by the fire department. There are no firearms in the home. There is no pool or other bodies of water at the home. The backyard is fully fenced and free of debris. The home has three cameras. One camera in front of the garage, one camera on the door bell, and a camera in bedroom #2 to monitor applicant's bio child's bedtime. LPA interviewed the licensee as part of the post-licensing inspection interview requirements. An exit interview was conducted and a copy of this report and LIC 811 was provided to licensee.


summary: Facility Evaluation

raw_content:
Narrative:
On July 29, 2025, at 09: AM, Licensing Program Analyst (LPA) Raina Perez-Diaz completed a random inspection of Detoy Small Family Home (SFH). LPA met with Licensee Oluwatoyosi Aderonmu who led a tour of the home. Licensee's current capacity is four, licensee recently requested an increase capacity for six. LPA toured both inside and out with the licensee for the random annual and capacity increase. There is one client in placement. The home is a two-story building with five bedrooms and three full bathrooms which are set up as follows: Bedroom #1- It consisted of a king bed and a bassinet. It serves as a guest room and possible infant client room. Bedroom #2- It consisted of two single beds. The beds had linen, comforters, and pillows. It will sleep two clients. Bedroom #3- It consisted of two single beds. The beds had linen, comforters, and pillows. It sleeps one client and can sleep an additional client. Bedroom #4- It consisted of two single beds. The beds had linen, comforters, and pillows. It will sleep two clients. Bedroom #5- It consisted of a king bed and a crib. It sleeps applicant and husband. A living room, dining room, kitchen, laundry room, three car garage, and a backyard. The garage is utilized as an office space and storage. The clients' bedrooms were arranged so that no more than two clients are in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the clients' belongings. There was a smoke detector in every bedroom. The four smoke and four carbon monoxide detectors were checked and working properly. The home's central air conditioning module was in the backyard. The water heater was in the garage. The appliances were in working order. The clients' files, allowance, medications, and sharp knives are located in the first floor hallway lock closet accessible by keypad lock and locked inside a filing cabinet. There was adequate food storage space and a supply of perishable foods and non-perishable food. The home had a trash can for storage of solid waste with a tight-fitting lid. The hot water was at a temperature of 106.3 degrees Fahrenheit, which is within regulations. The First Aid kit, which contains all required items, was accessible and placed on the kitchen counter top. There was four fire extinguishers present in the home located in the kitchen and common areas throughout the home. They were observed to be properly charged and inspected by the fire department. There are no firearms in the home. There is no pool or other bodies of water at the home. The backyard is fully fenced and free of debris. The home has three cameras. One camera in front of the garage, one camera on the door bell, and a camera in the upstairs hallway not pointed at any private room area. LPA Perez-Diaz reviewed files for one client (C1) in care. Client file was found to have Cash/Property/Valuable records, Medical Consent form and signed needs and services plan. LPA also reviewed two staff files [Staff #1(S1) and Staff #2 (S2)]. All staff files reviewed have Department of Justice (DOJ), Federal bureau of Investigation (FBI) and Child Abuse Clearance Index (CACI) clearance, proof on file of acknowledging the child abuse reporting requirements and meet the minimum qualifications and training requirements per Community Care Licensing Regulations. A review of administrative records indicate that the facility has paid their current licensing fees. LPA interviewed one staff member and one client. Based on the facility inspection and file reviews on this date, there are no deficiencies found at this time. An exit interview was conducted and a copy of this report and LIC 811 was provided to licensee.

met_with: Licensee Oluwatoyosi Aderonmu


summary: Facility Evaluation

raw_content:
Narrative:
On September 5, 2025 at 10:20AM, Licensing Program Analysts (LPAs) Rachel Vanegas and Carrisa Aviles arrived at Detoy Comfort Care Small Family Home (SFH) to conduct a review of the Non Minor Dependent (NMD) Program Statement Addendum. LPAs met with the Licensee - Oluwatoyosi Aderonmu. LPAs conducted a health and safety inspection and no immediate deficiencies were observed. These revisions are due by the close of business (5:00pm) on September 19, 2025. B7: Facility Program Description: Describe more information about how the Licensee shall provide access to information in preparing the NMD for emancipation from foster care, including educational options, employment options, etc. Describe the bedroom sharing for a NMD and minor. Describe how the Licensee will use the Pre-Placement Appraisal to determine compatibility with the other residents in the home. Describe how the NMD youth will be provided with Independent Living Skills assistance and training. Identify the specific community resources for NMD's Describe how the NMD, to the extent of their ability, shall be entitled to select and participate in activities of their own choosing. Describe how the Licensee will assist the NMD with developing the skills necessary for self-sufficiency. These skills may include, but are not limited to, the following: Financial literacy; **** Nutrition and healthy food choices, grocery shopping, food and meal preparation; Identifying a suitable home and home maintenance; Child care; Automotive maintenance; Educational and career development; Obtaining medical, dental, vision, and mental health care; Access to community resources; Developing and reaching goals; Self-care, including performing the nonminor dependent's own laundry, including but not limited to washing, drying, and ironing his or her personal clothing; Drug and alcohol abuse awareness and prevention; and Safe sex and reproductive health information. Identify transportation availability for NMD's, such as, are they allowed to provide their own transportation? For example, owning their own car, using public transportation, etc. What are the house rules for NMD's, how are they different. Describe the written expectations, alternatives, and consequences for living in the home and how the NMD will participate in the review. Describe Reporting Requirements as they pertain to NMDs. For example, runaway situations: Attempting to contact NMD and Authorized Representative. A NMD is considered absent without leave after a prolonged period of time lasting more than 72 hours. Describe the discharge policy and procedures for unplanned and planned discharges and how the NMD will be notified. Describe what records will be given to the NMD and their Authorized Representative upon discharge. Describe how the NMD will be notified of their personal rights and be given a copy upon time of placement. Describe how the NMD will safeguard their personal belongings and financial resources Describe how the NMD will have the opportunity to plan meals, grocery shop, and store and prepare food. **** Describe how, unless restricted by the Transitional Independent Living Plan, the Licensee will encourage an NMD to select, seek, and maintain permanent connections between the nonminor dependent, the family and non- relative extended family members of the nonminor dependent, and caring and committed adults. LPA Vanegas and LPA Aviles conducted an exit interview and a copy of this report and appeal rights were reviewed and provided to the Licensee, Oluwatoyosi Aderonmu.

met_with: Licensee - Oluwatoyosi Aderonmu


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On August 20, 2025 at 1:27PM, Licensing Program Analysts (LPAs) Rachel Vanegas and Carissa Aviles arrived at Detoy Comfort Care Small Family Home (SFH) for the purpose of conducting a case management visit regarding the SFH. LPAs met with the Licensee, Oluwatoyosi Aderonmu to discuss the case management. On August 20, 2025, at 10:25AM, LPAs conducted an unannounced site visit and health and safety inspection at the identified SFH in regard to an incident that occurred on or around August 15, 2025. During the site visit, LPAs observed that Staff 1 (S1) was left alone providing care and supervision for Client 1 (C1). Based on observations, interviews, and records review, LPAs identified that S1 did not have a complete background clearance at the time of the site visit. The facility is being cited one Type A violation in accordance with California Code of Regulations (CCR) 80019(e) Criminal Record Clearance due to S1 not having a criminal record review pursuant to Health and Safety Code Section 1522 prior to working, residing or volunteering in the licensed facility. The facility will be issued an immediate civil penalty of $100 ($100 per day for each day the violation occurred). An exit interview was conducted, a copy of this report, LIC 809D, LIC421BG, and appeal rights were reviewed and provided to the Licensee - Oluwatoyosi Aderonmu.

Deficiencies:
80019(e): All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility:

title:
1
2
3
4
5
6
780019(e)


facility_name: DIAZ SMALL FAMILY HOME

summary: Facility Evaluation

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Narrative:
On February 18, 2022, Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an unannounced Annual inspection to the Diaz Small Family home. LPA Almaraz met with licensee Connie Diaz who let a tour of the home. The facility was toured inside and out at 9:30am. There are currently one client in the home. The home is a seven bedrooms and 4 1/2 bathrooms home. The home is set up as follows: • Bedroom 1 # Master bedroom has Cal king bed sleeps licensees. • Bedroom 2 has a hospital bed - sleeps adopted daughter • Bedroom 3 has a twin bed- sleeps bio-son • bedroom 4 has a twin bed and sleeps 1 bio daughter Bedroom 5 has a twin sixe bed and one crib Bedroom 6 has a twin bed and sleeps adopted son. Bedroom 7 has twin bed sleeps adopted son Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate drawer and closet space for children's belongings. The fireplace is properly screened. All hazardous items have been properly made inaccessible to areas where children will have access. Medications are locked in the hallway closet next to the master bedroom. Cleansers/chemicals are locked and stored in the laundry room and under the kitchen sink with tot locks. The first aid kit contains all required items. Sharp knives are inaccessible and stored in the kitchen cabinet. Licensees had current CPR/ First Aid certificates. Licensee provided proof of 8 hours of continued education training. There are no guns or weapons as stated by licensee at this time. Water temperature was tested and is safe and within regulation requirements. Smoke detectors & carbon monoxide detector in hallways are all rooms were tested and operable. Proper storage of all food was noted. Trash cans for storage of solid waste have tight fitting lids. The Emergency Disaster Plan with exit map, Title Personal Rights, and visitation policies are posted at this time. The back yard is safe and free of hazards. There is a huge trampoline, barbecue area, lounging area next to the gym in the backyard. Toys are safe, clean, and age appropriate for the age group of children being cared for. Three (03) children files and three (03) staff files were reviewed. Children and staff records are organized and up to date. Medications and log was reviewed. Administrative records included: A review of staff records on this date indicates that all facility staff have received criminal record and child abuse index check clearances. In accordance with Title 22, Division 6, Chapters 1 & 4 there are no deficiencies being cited at this time. Based on this annual inspection, the home was operating within the limitations of the license. Exit interview conducted and copies of this report, appeal rights given and explained to the licensee.

met_with: Connie Diaz


facility_name: DIVINE BLESSINGS SMALL FAMILY

summary: Facility Evaluation

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Narrative:
On May 28, 2025, at 4:00 pm, Licensing Program Analyst (LPA) Charmaine Linley, met with applicant Daniell Mitchell for Component II Orientation via Microsoft Teams Meetings. LPA went over revisions needed for the application prior to licensure. LPA sent a copy of the LIC 184, Notice of Incomplete Application, and additional correspondence to assist with the revisions needed to the application via email. A copy of this report was provided to the applicant along with the signed Orientation form indicating Component II has been completed via email. A copy of this report will be placed in the facility file.

met_with: Daniell Mitchell


summary: Facility Evaluation

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Narrative:
On the date listed above, Licensing Program Analyst (LPA) Charmaine Linley conducted Component III - Category Specific Orientation Training for Small Family Homes with applicant, Daniell Mitchell, via Microsoft Teams. The Pre-Licensing Inspection has been scheduled for August 7, 2025, at 11:00 am. LPA sent a copy of this report to the applicant via email for signature. A copy of the signed Orientation Certificate for completing Component III was also emailed to the applicant. A copy of the signed report will be placed in the applicant's facility file.


summary: Facility Evaluation

raw_content:
Narrative:
On August 7, 2025, at 11:13 am, Licensing Program Analyst (LPA) Charmaine Linley arrived at the home to conduct a pre-licensing inspection of the facility. LPA met with Applicant, Daniell Mitchell, who led a tour of the facility. The facility was toured inside and outside with Daniell Mitchell. Currently, there are no clients in placement. The facility is a one-story building with three bedrooms and two bathrooms which is set up as follows: Bedroom #1 (Master) has one queen-size bed and sleeps the Licensee and their spouse. Bedroom #2 (Personal) has one single bed and will sleep only a family member at this time. Bedroom #3 (Clients) has two single beds and will sleep two clients. The facility also consists of a family room, kitchen, dining room, two bathrooms, a laundry room located in the hallway next to bedroom #1, a three car garage, and the backyard. There is a properly secured fire place in the living room. There is no swimming pool at the home at the time of this inspection. The Client's bedrooms were arranged so that no more than two client's will be in a room. No room commonly used for other purposes is used as a bedroom and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There were four smoke/carbon monoxide detectors in every bedroom and family room. The combo detectors were checked and in properly functioning *** order. The home's central air conditioning module was located on the side of the house. The home's water heater was located in the garage. The home appliances were in working order at the time of this inspection. The Client and Staff files will be stored in a locked file cabinet located in the Licensee's bedroom. There was adequate food storage space. LPA observed a seven day supply of non-perishable food. A trash can for storage of solid waste had a tight-fitting lid and was present in the kitchen. The sharp knives are in a locked file cabinet, inaccessible to the clients, stored in the Licensee's bedroom. The medications will be located in a locked file cabinet in the Licensee' bedroom. The hot water in the kitchen was measured and registered at 109 degrees at 11:50 am, which is within the regulatory requirements. The home's First Aid kit was accessible and is located on top of the locked file cabinet in the dining room and contained all the required supplies. There was one fire extinguisher present in the home located in the kitchen near the sink. It was observed to be properly charged and inspected by the fire department. There are no firearms or weapons in the home as stated by the applicant. The backyard where clients will have access to play is fenced. The home has three security cameras located on the outside perimeter of the home (door bell, front driveway, and backyard) and three cameras on the inside of the home located in the dining room, living room, and hallway. The applicant will purchase additional games and educational supplies necessary to meet the needs of the children before the Post-Licensing inspection visit. An exit interview was conducted, and a copy of the report was provided to Daniell Mitchell. A copy of this report will be placed in the facility file. The Licensing Program Manager will review the application and this report and once approved, the Facility License will be printed out and emailed to the applicant.


facility_name: DIVINE KINDNESS SMALL FAMILY HOME

summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
During the investigation, LPA conducted interviews with the foster mother (FM), foster child (FC1), (FC2), (FC3), a Grand Son GS and Adult in the home (AD). A confidential interview disclosed that FC1 had weight issues from birth, and the primary doctor was aware of FC1's weight issues, therefore, the doctor made a referral to Loma Linda "Failure to Thrive Clinic". It was added that Desert Regional Center was concerned about FC1's weight in comparison to FC1's age and doctor asked why primary Doctor has not referred FC1 to Loma Linda yet. The confidential interview stated that an appointment was missed on October 14, 2021 due to another foster child in the home was sick and the hospital was contacted to reschedule another appointment. Confidential interview reported on November 10, 2021 that a call was received from the hospital to reschedule FC1's appointment; FM notify Desert Regional Center that FC1's primary physician has made a referral to Failure to Thrive Clinic in Loma Linda. A confidential interview stated that the appointment at Desert Regional Center was a follow up for FC1's weight loss. LPA verified that the referral document was in the child's file. Other confidential interview did not disclose any information regarding the medical appointments, Regarding uncleared adults living the home allegation, a confidential interview stated that the adult came to repair a car in the garage for short period of time and denied any other adults living in the home besides foster mother's sixteen-year-old grand son. Other confidential witnesses stated that they were not aware of an adult living in the home. LPA was unable to verify that uncleared adults were living in the home at this time. Based on confidential interviews and record review, the allegations that foster parent had not been bringing FC1 to medical appointments and uncleared adults are living in the foster home may have occurred, however, are not supported or proven by evidence. Therefore, the allegations are unsubstantiated.

Investigation Findings:
13On March 9, Licensing Program Analyst (LPA), Babatunde Aborchie arrived at Divine Kindness Small Family Home (SFH) to deliver the finding of the investigation involving the small family home and foster children listed on the confidential names list (LIC 811). LPA met with Licensee who granted LPA access into the home. On November 17, 2021 a complaint report was referred to Community Care Licensing (CCL) alleging that foster parent has not been bringing foster child to medical appointments and uncleared adults are living in the foster home. On November 19, 2021 at 9: AM, LPA conducted a safety inspection with Licensee. There were no immediate safety hazards observed at the time of inspection. LPA reviewed children's files and obtained copies from the files. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: DIVINE KINDNESS SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 03/09/2022

met_with: Licensee


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Narrative:
Regarding the allegation that FM did not ensure FC1 was taken to scheduled medical treatments, a confidential interview denied not taking FC1 to a scheduled medical appointment. Confidential interview stated that medical appointment was rescheduled due to illness of another foster child in care. A confidential witness denied observing FC1 was not taken to scheduled medical appointment. Confidential witness was not aware FM did not ensure FC1 was not taken to scheduled medical appointment. Regarding FC1's dietary needs not being met, a confidential interview denied FC1's dietary needs were not met. Confidential interview added that there was a conflict of information when FM tried to notify physician office of the need to substitute FC1's prescribed Pedi sure. A confidential witness observed FM provided FC1 with prescribed Pedi sure. Confidential witness believed physician orders were being followed by FM. LPA received a conflicting information regarding the allegations. Based on the confidential interviews, the allegation that FM does not ensure minor is taken to scheduled medical appointments, FC1's dietary needs is not being met, FM not following Doctor's orders, may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the allegations are unsubstantiated at this time. A copy of this report and LIC 811 was reviewed and provided to the SFH

Investigation Findings:
13On December 29, Licensing Program Analyst (LPA) Babatunde Aborchie arrived at Divine Kindness Small Family Home (SFH) to deliver findings of the investigation involving the small family home and foster children listed on the confidential names list (LIC 811). LPA met with Foster Mother (FM) who granted LPA access into the home. On May 18, 2022 a complaint report was referred to Community Care Licensing (CCL) alleging that resource parent does not ensure minor is taken to scheduled medical appointments, minor's dietary needs is not being met, resource parent not following Doctor's orders. On May 23, 2022 at 1: PM, LPA conducted a safety inspection with FM. There were no immediate safety hazards observed at the time of inspection. LPA interviewed Foster Mother (FM), LPA was unable to interview foster child 1 (FC1) due to FC1's developmental age. On May 10, LPA interviewed County Social Worker (CSW). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: DIVINE KINDNESS SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 12/29/2022

met_with: Foster Mother


summary: Facility Evaluation

raw_content:
Narrative:
On the above date Licensing Program Analysts (LPAs) Babatunde Aborchie, Cindy Hamilton and Sarah Smith met with licensee Ms. Hannah, who granted access to the home. The purpose of this visit is to conduct an annual inspection of the small family home. Presently there are three foster children in placement and two of the three were present during time of inspection (See LIC 811). The home is a two story with five bedrooms and four bathrooms. During the inspection LPAs reviewed the children and licensee's files. LPAs observed the licensee's First Aid and CPR cards expired on August 19, 2021. A review of staff records on this date indicates that all adults residing in the home or providing care and supervision to children have not received fingerprint and child abuse index check clearances. During the review of the children's files, LPAs observed Client #1 (C1) did not have a separate Psychotropic Medication Administration Record (PMAR) for the prescribed psychotropic medications. Also, licensee did not have accurate written directions for administering the prescribed psychotropic medication to C1. Licensee did not have a file for Volunteer #1 (V1) and no documentation of a Tuberculosis test, criminal background clearance, health screening or Statement of Criminal Record History. In addition, licensee did not have any documentation of completion of required trainings for V1. Based on interviews and record review the facility was cited for violation of Title 22, Division 6, Chapter 1, Section 80066(b)(3)(A), 80066(b)(3)(B) Personnel records. V1 did not have a statement of criminal record history and also did not have a criminal record clearance or exemption which poses an immediate health, safety or personal rights risk to persons in care. Licensee also cited for violation of Title 22, Division 6, Chapter 1, Section 80066(b)(2) Personnel Records, V1 did not have proof of a Tuberculosis test which poses a potential health, safety or personal rights risk to persons in care. In addition, facility was cited for violation of Small Family Homes, Title 22, Division 6, Chapter 4 section 83064(f), 83064(g) and 83064(h) Licensee Duties and Requirements, Licensee did not have any proof of completion of any of the required training for V1. Licensee also cited for 83075(g) and 83075(e) Health Related Services. Licensee did not have written directions from physician stating when not to administer psychotropic medications. Based on records review the facility was issued LIC Technical Violations 80071(a)(1)(A), 80071(a)(1)(B) 80071(a)(1)(C), 80071(a)(2), Register of Clients, licensee did not have a register of clients prepared or displayed. Also issued for 83070(b)(12)(A) Child Records, licensee did not have separate Psychotropic Medication Administration Records for C1's medications. Exit interview conducted and a copy of this report was reviewed and given to Ms. Hannah along with the LIC 811.

met_with: Renell Hannah


summary: Facility Evaluation

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Narrative:
On September 24, 2021 at 8:50 am, Licensing Program Analysts (LPAs) Babatunde Aborchie and Shanae Pharaoh arrived at Divine Kindness Small Family Home (SFH) and met with licensee Renell Hannah. The purpose of the inspection was to complete the continuation inspection for the SFH annual inspection that was initiated on September 1, 2021. LPAs already completed the file reviews. The home is set up as follows: · Bedroom #1- Downstairs, guest bedroom - vacant · Bedroom #2- Upstairs, was furnished with two twin beds. Sleep FC1 and FC2 · Bedroom #3- Upstairs, was furnished with two cribs and two toddler beds. Sleeps FC3 · Bedroom #4- Upstairs, was furnished with King-size bed. Sleeps Licensee · Bedroom #5 -Upstairs, was furnished with desk - Office Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate drawer and closet space for children's belongings. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. The fireplace is properly screened. All hazardous items have been properly made inaccessible to areas where children will have access. The medications are locked and stored in the office cabinet. Cleansers/chemicals are locked and stored in the laundry room cabinet. Sharp knives are inaccessible and stored upstairs in office cabinet. The first aid kit is in the office. There are no guns or weapons as stated by Licensee at this time. The hot water temperature was tested and noted to be 110 degrees. All facility smoke detectors and carbon monoxide detectors are in appropriate working order; fire extinguisher is properly charged and serviced. LPAs observed major construction in the kitchen that was not reported to The Department. Proper storage of all food was noted and menu was available for review. Trash cans for storage of solid waste have tight fitting lids.The Emergency Disaster Plan with exit map, Personal Rights, and visitation policies are posted at this time. The backyard where children will have access to play is completely fenced. LPAs observed gardening tools that are a potential hazard. There is no pool or other body of water. The gate is self-latching and opens outward with the latch located at least 54 inches from the ground. LPAs observed the gate to the backyard to be locked. Interview with licensee confirmed she did not have the key to the lock. Toys are safe, clean, and age appropriate for the age group of children being cared for. Based on observation, the following pages note the deficiencies cited in accordance with Title 22, Division 6, Chapters 1 & 4. 83087.2(a) Outdoor Activity Space, 80087(a) Building and Grounds 80087(c) Building and Grounds. The facility is also being assessed a civil penalty in accordance with 800866(b)(3)(A) Personnel Records cited during the initial inspection. Exit interview conducted and a copy of this report was reviewed and given to Ms. Hannah along with the LIC 811.


summary: Facility Evaluation

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Narrative:
On June 10, 2022 at 2: PM, Licensing Program Analyst (LPA) Babatunde Aborchie began a pre-licensing inspection for a Small Family Home license. Divine Kindness Small Family Home was previously licensed and has relocated to the above address for a new license. LPA met with applicant Renell Hannah who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there are three children placed in the home. The applicant is applying to serve six children ages 2 to 17. The home is a story building with four bedrooms and three baths home which is set up as follow: · Bedroom #1 has no beds, will sleep licensee, has a bathroom, kitchenette; it was vacant · Bedroom #2 had two twin-sized beds; it was vacant. It will sleep two foster children. · Bedroom #3 had a twin-sized bed and a baby bed. It was vacant. It will sleep two foster children. · Bedroom #4 had two baby beds. It was vacant. It will sleep two foster babies. · A living room, two kitchens, dining area, storage, three bathrooms, three car garage and the patio/backyard, a laundry room. Bedrooms were arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. The smoke detectors and carbon monoxide detectors were checked, and they were working properly. Inside the facility there was no fireplace. Telephone service and appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients/children will have access. Sharp knives and sharp objects were locked in a cabinet in the kitchen. Cleansers/chemicals were inaccessible and stored a locked cabinet in the kitchen. There was adequate food storage space and a supply of two days of perishable foods and a week of non-perishable food. A proper storage of all food was discussed. Trash cans for storage of solid waste had tight fitting lids. The water temperature was observed to be at 107.5 degrees. First Aid kit were accessible with all required items and it was in the kitchen pantry. A Fire extinguisher was observed and properly charged. All the appropriate forms were posted in view of facility clients. As stated by applicant, there were no weapons/firearms and there were no pool or other body of water. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request for relocation and license capacity increase will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to licensee

met_with: LIcensee


raw_content:
Narrative:
Regarding the allegation that FM did not use car seat while transporting FC1 and FC2, a confidential interview denied not using car seats while transporting FC1 and FC2. A Confidential interview stated that car seats were used during transportation. Another confidential interview disclosed that car seats were used to transport foster children. A confidential witness had seen car seats in the van, believed car seats were used for transportation of foster children. LPA received a conflicting information regarding the allegation. Regarding the allegation that FM did not provide a comfortable temperature in vehicle for FC1 and FC2, It was specifically stated that "when the children got out of the car, FC1 and FC2 were hot and their faces and hair was sweaty". A confidential interview denied that FM did not provide a comfortable temperature in the vehicle for FC1 and FC2. A confidential interview stated the van was cool during transportation. Another confidential interview stated the air-condition was working properly during transportation. A confidential witness believed air-condition in the van was working and was used during transportation. Based on the confidential interviews, the allegation that FM did not use car seat while transporting FC1 and FC2,FM did not provide a comfortable temperature in vehicle for FC1 and FC2, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the allegations are unsubstantiated at this time. A copy of this report and LIC 811 was reviewed and provided to the SFH

Investigation Findings:
13On December 29, Licensing Program Analyst (LPA) Babatunde Aborchie arrived at Divine Kindness Small Family Home (SFH) to deliver findings of the investigation involving the small family home and foster children listed on the confidential names list (LIC 811). LPA met with foster mother (FM) who granted LPA access into the home. On August 16, 2022 a complaint report was referred to Community Care Licensing (CCL) alleging that Foster mother did not use car seat while transporting minors, Foster mother did not provide a comfortable temperature in vehicle for minors. On August 24, 2022 at 3: PM, LPA conducted a safety inspection with Foster Mother (FM). There were no immediate safety hazards observed at the time of inspection. LPA interviewed Foster Mother (FM); Foster Children (FC3, FC4, FC5) LPA was unable to interview Foster child 1 (FC1, FC2) due to FC1 and FC2's developmental age. On August 26, LPA interviewed County Social Worker (CSW). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: DIVINE KINDNESS SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 12/29/2022


summary: Complaint Investigation - Unsubstantiated - 1 deficiency

raw_content:
Narrative:
Continued from LIC The licensee stated the children in care would get bruises from playing or having tantrums daily, however, she didn't know that she needed to report those injuries. Based on confidential interviews, the preponderance of evidence standard has been met and the allegation that licensee did not report child's injury is substantiated. Facility is cited for violation of Title California Code of Regulations (CCR) Division Chapter 1 80061 (b)(1) Reporting Requirements (see LIC 9099D). Continued from LIC 9099-A During the investigation, confidential interviews stated FC2 would have a tantrum whenever school ended. FC2 enjoyed being at school and did not want to leave. FC2 would have a tantrum and fall on the ground. Once FC2 is placed in the car, FC2 would continue to have a tantrum. FC2 would fall in between the seats, refuse to get into the car seat and scream and kick the seats once FC2 buckled in the car seat. FC2 would obtain bruises from the tantrums. Licensee stated that she didn't know how to prevent FC2's behaviors because they occur only during school pick up times. Based on confidential interviews, the allegation that licensee did not manage FC2's behavior to prevent injury, may have occurred or may be valid, however, there was not a preponderance of evidence to support or deny the allegation. Therefore, the allegation is unsubstantiated at this time. Copy of this report, Confidential Names (LIC 811) and appeal rights were discussed and provided to Licensee Renell Hannah. Reporting Requirements. An exit interview was conducted and a copy of this report LIC 9099 along with the appeal rights were discussed and provided to the Licensee, Renell Hannah

Investigation Findings:
13On October 19, 2023, at 2: PM Licensing Program Analyst (LPA) Karen Beal arrived at Divine Kindness Small Family Home (SFH) and met with Licensee Renell Hannah. The purpose of this visit was to deliver the investigative finding of the complaint involving the licensee and the foster children listed on the Confidential Names (LIC 811). On June 6, 2023, Community Care Licensing (CCL) received a complaint alleging licensee did not report child's injury. On June 12, 2023, LPA initiated the investigation at the SFH. Additionally, LPA reviewed licensee files and obtained copies of incident reports, needs and service plans and placement agreements from the files. LPA conducted a health and safety inspection and there were no immediate hazards observed. LPA interviewed the licensee and S1. During the confidential interview it was stated that staff will report all incidents to the licensee. It was also indicated that staff do not completed incident, only licensee does it. Licensee admitted she did not submit incidents report in a timely manner. Licensee stated the intent was there to submit them but never had time. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Karen Beal LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: DIVINE KINDNESS SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 10/20/2023

Deficiencies:
00611: 80061(a) (b) Each licensee... shall furnish to the licensing agency reports as required by the Department...(b) Upon the occurrence..., of any of the events ... report shall be made to the licensing agency... next working day...In addition, a written report... shall be submitted to the licensing agency within seven days...

met_with: Licensee, Renell Hannah

title:
2
3
4
5
6
7Reporting requirement


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Narrative:
Regarding the allegation that LS did not report an incident involving minor in care as required. A Confidential interview stated FC1 was playing on the kitchen chair when FC1 fell. Confidential interview did not see injury on FC1's knee. Confidential interview did not report the incident involving FC1 in care as required. LS disclosed that an incident report was written but it did not get sent to the appropriate parties. County Social Worker reiterated that she was not notified or received any written reports regarding the incident. Based on confidential interviews and record review, the preponderance of evidence standard has been met and the allegation that LS did not report FC1's injury is substantiated. Facility is cited for violation of Title 22, Division Chapter Article 06 80061(a)(E) Reporting Requirements (see LIC 9099D). A copy of this report and LIC 811 was reviewed and provided to the SFH along with the appeal right. Regarding the allegation that LS did not properly supervise FC1 resulting in FC1 sustaining an injury while in care. It was specifically stated that FC1 had bruises on both knees. A Confidential interview denied not properly supervising FC1 resulting in FC1 sustaining an injury. LS stated FC1 was playing and got injured. CSW did not observe or witnessed FC1 sustaining injuries, however, she reported that FC1 was very playful and could be injured while playing. Based on the confidential interviews, the allegation that LS did not properly supervise foster child (FC1) resulting in FC1 sustaining an injury while in care may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. A copy of this report and LIC 811 was reviewed and provided to the SFH along with the appeal right.

Investigation Findings:
13On February 23, 2024, Licensing Program Analyst (LPA) Babatunde Aborchie arrived at Divine Kindness Small Family Home (SFH) to deliver finding of the investigation involving the small family home and foster children (FC1 and FC2) listed on the confidential names list (LIC 811). LPA met with licensee (LS) who granted LPA access into the home. On April 28, 2023, a complaint report was referred to Community Care Licensing (CCL) alleging provider did not report an incident involving FC1 in care as required. On May 8, 2023, at 9: AM, LPA conducted a safety inspection with LS. There were no immediate safety hazards observed at the time of inspection. LPA interviewed LS. LPA was unable to obtain information from foster FC1 and FC2 due to their developmental ages. Additionally, LPA interviewed County Social Worker (CSW). SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: DIVINE KINDNESS SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 02/23/2024


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Narrative:
Continued from LIC In regard to the allegation, it was specified that while in care FC1 had a rash in the private area that had an odor. During the investigation, confidential interview reported that FC1 was in the process of being potty trained. It was added that FM would check FC1 underwear/pull up to prevent FC1 from wearing soiled underwear. Out of Home Investigations (OHI) had no concerns with the way the FM was caring for FC1. LPA was unable to gather additional information due to FC1's developmental age. Based on confidential interviews, the allegation that FC1 sustained unexplained rash while in care may have occurred or may be valid, however, there was not a preponderance of evidence to support or deny the allegation. Therefore, the allegation is unsubstantiated at this time. Copy of this report, Confidential Names (LIC 811) and appeal rights were discussed and provided to licensee, Renell Hannah.

Investigation Findings:
13On October 11, 2024, Licensing Program Analyst (LPA) Karen Beal arrived at Divine Kindness Small Family Home (SFH) and met with Renell Hannah to deliver the investigative finding of the complaint involving the small family home and the foster child listed on the Confidential Names (LIC 811). On January 19, 2024, Community Care Licensing (CCL) received a complaint alleging that a foster child sustained unexplained rash while in care. On January 26, 2024, at 10: AM, LPA Beal initiated the investigation at the SFH. LPA conducted a health and safety inspection and interview foster mother. There were no immediate hazards observed. LPA Beal interviewed foster child (FC1), Foster Mother (FM), and Staff (S1). LPA were unable to contact the County Social Worker. Continued to LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Karen Beal LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: DIVINE KINDNESS SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 10/11/2024

met_with: Renell Hannah, Licensee


summary: Facility Evaluation

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Narrative:
On June 27, 2022 at 11: AM, Licensing Program Analyst (LPA) Babatunde Aborchie began a pre-licensing inspection for a Small Family Home license. Divine Kindness Small Family Home was previously licensed and has relocated to the above address for a new license. LPA met with applicant Renell Hannah who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there are three children placed in the home. The applicant is applying to serve six children ages 2 to 17. The home is a story building with four bedrooms and three baths home which is set up as follow: · Bedroom #1 has no beds, will sleep licensee, has a bathroom, kitchenette; it was vacant · Bedroom #2 had two twin-sized beds; it was vacant. It will sleep two foster children. · Bedroom #3 had a twin-sized bed and a baby bed. It was vacant. It will sleep two foster children. · Bedroom #4 had two baby beds. It was vacant. It will sleep two foster babies. · A living room, two kitchens, dining area, storage, three bathrooms, three car garage and the patio/backyard, a laundry room. Bedrooms were arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings The smoke detectors and carbon monoxide detectors were checked, and they were working properly. Inside the facility there was no fireplace. Telephone service and appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients/children will have access. Sharp knives and sharp objects were locked in a cabinet in the kitchen. Cleansers/chemicals were inaccessible and stored in a locked cabinet in the kitchen. There was adequate food storage space and a supply of two days of perishable foods and a week of non-perishable food. A proper storage of all food was discussed. Trash cans for storage of solid waste had tight fitting lids. The water temperature was observed to be at 107.5 degrees. First Aid kit were accessible with all required items and it was in the kitchen pantry. A Fire extinguisher was observed and properly charged. All the appropriate forms were posted in view of facility clients. As stated by applicant, there were no weapons/firearms and there were no pool or other body of water. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request for relocation and license capacity increase will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to licensee


summary: Facility Evaluation

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Narrative:
On September 7, 2023, at 12: PM, Licensing Program Analyst (LPA), Karen Beal met with licensee Renell Hannah, who led a tour of the home. The purpose of the visit was to conduct an annual inspection of the Divine Kindness Small Family Home (SFH). The SFH was toured inside and out with Renell Hannah. The home is a single level home with a three car garage. The home is set up as follows: · Master Bedroom #1- Licensee · Bedroom #2- Aiyana Sudyka · Bedroom #3- Bow Kalke and Oliver · Bedroom #4- Solana · Casita Studio- is vacate Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate drawer and closet space for children's belongings. All hazardous items have been properly made inaccessible to areas where children will have access. The medications are locked and stored in the kitchen cabinet. At 3: PM LPA ended the annual inspection due to the time . LPA will continue the inspection on September 8, 2023. ****Continued on LIC 809-C*** ***Continued from LIC 809 dated 09/07/2034*** On September 8, 2023 at 9:19AM, LPA returned to Divine Kindness to continue the annual inspection. All hazardous items have been properly made inaccessible to areas where children will have access. The medications are locked and stored in the kitchen upper cabinet. Cleansers/chemicals are locked and stored in the laundry room. Sharp knives are inaccessible and stored in a locked cabinet in the kitchen. The first aid kit is located in the dining area on a bookshelf. There are no guns or weapons as stated by Renell Hannah at this time. There is no fireplace located in the home. The hot water temperature was tested and noted to be 108 degrees. Proper storage of all food was noted. Trash cans for storage of solid waste have tight fitting lids. The Emergency Disaster Plan with exit map, Title Personal Rights, and visitation policies are posted. The backyard where children will have access to play is completely fenced and free of hazards. There is no pool or other body of water. Toys are safe, clean, and age appropriate for the age group of children being cared for. One foster child was interviewed due to the developmental ages of the other three foster children. CPR card expires 09/24/23, and the First Aid card expires 09/24/23. Children and staff records are organized. Administrative records included: A review of staff records on this date indicates that all facility staff have received criminal record and child abuse index check clearances. Exit interview conducted and copy of the annual inspection and appeal rights given and explained.


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Narrative:
Regarding the allegation that licensee handled minor in a rough manner, it was specifically alleged that foster mother grabbed C1 by the back of C1's neck and put foster mother's hand over C1's mouth. During the investigation, confidential interview denied grabbing C1 from the back of the neck. It was added that foster mother put her arm around C1's shoulders to guide C1 inside the SFH to talk to C1's relative. An additional confidential interview stated that foster mother had not grabbed C1 by the back of the neck or put foster mother's hand over C1's mouth. LPA was unable to interview C2, C3 and C4 due to them refusing to be interviewed. LPA was unable to gather additional information. Based on confidential interviews, the allegation that licensee handled C1 in a rough manner may have occurred, however, there was not a preponderance of evidence to support or deny the allegations. Therefore, the above allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with the appeal right were reviewed and provided to facility representative.

Investigation Findings:
13On August 12, 2024, Licensing Program Analysts (LPAs) Rafael Enriquez and Maryjane Perez arrived at Divine Kindness Small Family Home (SFM) and met with Licensee Renell Hannah to deliver the finding for the allegation stated above involving the SFM's staff and clients (C1, C2, C3, and C4) as listed on the Confidential Names List (LIC 811) dated August 12, 2024. On April 25, 2024, LPA Enriquez initiated the investigation at the SFH and obtained pertinent documents. Additionally, LPA conducted a safety inspection of the SFH, no immediate health and safety hazards were observed. During the inspection, LPA interviewed Licensee and C1. LPA was not able to interview C2, C3 and C4 because they refused to be interviewed. On April 17, 2024, Community Care Licensing (CCL) received a complaint alleging that licensee handled minor in a rough manner. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Rafael Enriquez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: DIVINE KINDNESS SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 08/12/2024

met_with: Licensee- Renell Hannah


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Narrative:
Regarding the allegation that minor in care was transported by vehicle in an unsafe manner, it was specified alleged that C2 reported the licensee's teenage relative drove C2 in the car the other day. Confidential interviews stated licensee's granddaughter drove C2 to the swap meet to buy a hat that C2 had been asking for. It was added that Licensee's granddaughter is 17, has a drivers permit and has only driven C2 once, however, the licensee's granddaughter does not have a driver license to drive independently, therefore, she was not an authorized driver to transport a minor by herself in car without an adult supervision. Based on confidential interviews and file reviews, the preponderance of evidence standard has been met, therefore, the allegation that C2 was transported by vehicle in an unsafe manner is substantiated. The facility is being cited for violation of Title Regulation 80074 (a) Transportation. (See LIC 9099D). An exit interview was conducted, and a copy of this report along with the appeal right were provided to facility representative Regarding the allegation that licensee did not seek appropriate medical attention for minor in care, it was specifically alleged that C1 stated that C1 was sick and not feeling good and asked to call an ambulance. During the investigation, confidential interview stated that C1 was not feeling well and was taken back to the home from the pool. It was added that C1 was watched over by S1 and did not have a fever or any other symptoms that would require C1 receiving medical attention. Additionally confidential interviews stated that Child Protective Services (CPS) and the police came to the SFH to check on C1 and did not request C1 to be taken to the hospital. LPA was unable to interview C3 and C4 due to them refusing to be interviewed. LPA was unable to gather additional information. In regard to the allegation that facility staff yelled at minor in care, it was specifically alleged that C2 was getting yelled at for "starting trouble". Confidential interviews denied that staff yelled at C2 or any of the other children. It was added that staff might have a sterner tone in their voice if the children were not listening but know not to yell at them. Additionally confidential interviews concurred that sometimes staff speak more sternly if the children are not listening. LPA was unable to interview C3 and C4 due to them refusing to be interviewed. LPA was unable to gather additional information. Based on confidential interviews, the allegations that that licensee did not seek appropriate medical attention for C1 and facility staff yelled at C2 may have occurred, however, there was not a preponderance of evidence to support or deny the allegations. Therefore, the above allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with the appeal right were reviewed and provided to facility representative.

Investigation Findings:
13On August 12, 2024, Licensing Program Analysts (LPAs) Rafael Enriquez and Maryjane Perez arrived at Divine Kindness Small Family Home (SFM) and met with Licensee Renell Hannah to deliver the finding for the allegation stated above involving the SFM's staff and clients (C1, C2, C3, and C4) as listed on the Confidential Names List (LIC 811) dated August 12, 2024. On July 17, 2024, LPA Enriquez initiated the investigation at the SFH and obtained pertinent documents. Additionally, LPA conducted a safety inspection of the SFH, no immediate health and safety hazards were observed. During the inspection, LPA interviewed Licensee 1 (L1), staff 1 (S1), C1 and C2. LPA was not able to interview C3 and C4 because they refused to be interviewed. On July 15, 2024, Community Care Licensing (CCL) received a complaint alleging that minor in care was transported by vehicle in an unsafe manner. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Rafael Enriquez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: DIVINE KINDNESS SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 08/12/2024


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Narrative:
Continued from LIC Another confidential interview stated that FC1 was smacked in the face by the scooter when FC1 was attempting to throw the scooter over the gate and the confidential interview noted that the marks on FC1 face aligned with getting smacked with the edge of a scooter. Regarding foster parent hit foster child in care, confidential interviews denied that FC1 was hit by FM or any other staff in the facility. Another confidential interview stated the children are disciplined by taking their play and television time away, or they will spend time out in their bedrooms. LPA was unable to obtain additional information. Based on confidential interviews and file reviews, the allegations that FC1 sustained unexplained injury and foster parent (licensee) or staff hit FC1 may have happened or may be valid, however, there was not a preponderance of evidence to support or deny the allegation, therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report was reviewed and provided to the licensee.

Investigation Findings:
13On October 11, 2024, at 12:21PM, Licensing Program Analyst (LPA) Karen Beal arrived at Divine Kindness Small Family Home (SFM) and met with Foster Mother (FM) Renell Hannah to deliver the finding for the above allegation. On May 6, 2024, LPA initiated the investigation at the SFH and obtained pertinent documents. Additionally, LPA conducted a safety inspection of the SFH, no immediate health and safety hazards were observed. During the inspection, LPA interviewed FM, staff 1 (S1), and foster child (FC1). County Social Worker was not able to be contacted. On April 29, 2024, Community Care Licensing (CCL) received a complaint alleging a foster child sustained unexplained injury while in care and foster parent (Licensee) hit foster child in care. Regarding the allegation that FC1 sustained unexplained injury while in care, a confidential interview stated foster mother (licensee) was inside the home and was monitoring FC1 through a window. Continued on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Karen Beal LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: DIVINE KINDNESS SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 10/11/2024

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

met_with: Renell Hannah, Foster Mother


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Narrative:
Information obtained during investigations did not confirm the allegation as there were no eyewitness statements regarding the licensee engaging in drug use in the present of the foster children or appearing under the influence of a controlled substance. CCL received an allegation that alleged a lack of supervision resulted in a missing child (FC3). It was reported that FC3 had multiple unauthorized absences from the SFH. Special Incident Reports submitted to the Department indicated that FC3 left the SFH without permission and had a history of similar behavior in other facilities. However, confidential statements provided to the Licensing Program Analyst (LPA) denied inadequate supervision in the home and reported that FC3 would leave late at night or after the scheduled bedtime. Additionally, it was noted that, due to FC3's behavior, supervision during evening hours was increased. Confidential interviews also reported that the licensee took the necessary precautions to ensure FC3's safety while in care. Alarms were installed on the windows and doors, which would alert the licensee to any attempts by FC3 to leave the facility. Further, there were no concerns regarding FC3's continued placement in the SFH, as it was reported that FC3's authorized representative is aware of the behavior and a safety plan will be created specifically to address FC3's tendency to leave the home without permission. CCL also received allegations that the licensee did not provide adequate meals to children (FC1-FC4), licensee did not ensure children had clean clothing, and licensee did not ensure hygiene needs of children were met. Documentation reported that multiple unannounced visits were conducted at the SFH, and the home was observed to have adequate food and the foster children (FC1-FC4) were reported to have sufficient clean, and appropriate clothing. Hygiene products were also observed in the home, and it was reported the children bathed daily. Further, documentation of other confidential interviews consistently reported that the needs of the foster children (FC1-FC4) were being met. Based on confidential interviews and pertinent documentation, the allegations the licensee used methamphetamine in the home while children (FC1-FC4) were present, a lack of supervision resulted in missing child (FC3), licensee did not provide adequate meals to children (FC1-FC4), licensee did not ensure children (FC1-FC4) had clean clothing, and licensee did not ensure hygiene needs of children (FC1-FC4) were met may have happened or be valid, but there is not preponderance of evidence to prove that the alleged violations occurred. Therefore, these allegations are unsubstantiated at this time. An exit interview was conducted. A copy of this report, the LIC 811, and appeal rights were explained and given to Renell Hannah.

Investigation Findings:
13On December 27, 2024, at 10: AM, Licensing Program Analyst (LPA) Jessica Peete made an unannounced visit to Divine Kindness Small Family Home (SFH) and met with Resource Parent, Renell Hannah, to deliver the investigative finding for the allegations mentioned above. The investigation was conducted by Special Investigator Sonia Torre of the Community Care Licensing (CCL) Investigations Bureau. The investigation included interviews with the foster children (FC1-FC4), the licensee, licensees' relatives (A1, A2), an unrelated adult (A3), County Social Workers (CSW), and facility staff (S1 and S2). On June 27, 2024, Community Care Licensing (CCL) received allegation that licensee used methamphetamine in the home while children (FC1-FC4) were present. During the investigation, there was no corroborating evidence to support the allegation. Multiple confidential interviews consistently denied drugs or alcohol were present in the SFH. (Continued on LIC 9099C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Jessica M Peete LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: DIVINE KINDNESS SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 12/27/2024

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

met_with: Renell Hannah, Resource Parent


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Narrative:
****Continued from LIC 9099**** Other confidential interviews indicated that the Licensee does supervise the foster children. LPA received conflicting statements and could not determine if the allegation had occurred. Based on inconsistent confidential interviews, the allegation that the Licensee did not adequately supervise minors in care, resulting in the minor harming other minor while in care, is unsubstantiated. The allegations may have happened or be valid, but there is not a preponderance of evidence to prove that the alleged violations occurred. An exit interview was conducted. A copy of this report, LIC 811, and appeal rights were explained and given to Mary Wellington.

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

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

met_with: Mary Wellington