summary: Complaint Investigation - Unsubstantiated - 3 allegations

raw_content:
Narrative:
Page During the course of the investigation SI Munoz obtained Bakersfield Police Department (BPD) records on 6/14/24 and interviewed confidential witnesses on 6/20/24. Between 09/16/24 and 01/24/25, LPA Larios conducted interviews with two facility residents, one placing agency social worker and seven facility staff. In addition, on 05/12/24, the facility provided LPA Larios copies of the LIC9020, LIC500 and staff contact information. The Department received a complaint regarding allegations of General Neglect/Lack of Supervision and Personal Rights violations on youth in placement. The investigation did not provide sufficient evidence to support the allegations. It was alleged a resident in care was hospitalized due to consuming drugs. Statements obtained from staff, the resident and law enforcement records indicate the hospitalizations resulted from the resident being a danger to self or others. It was alleged that due to lack of supervision a resident had access to vape pens and alcohol. Information gathered from interviews conducted with staff revealed the facility does not conduct searches. In addition, staff denied observing the resident consume drugs or alcohol in their presence. Instated, staff reported the resident would emerge from her bedroom and state she consumed substances. LPA Larios obtained a photograph of the resident consuming alcohol, allegedly while being transported back to the facility by a staff member, however, it was unable to be determined where or when the photograph was taken. It was alleged two staff pulled a resident out of her bedroom by her legs. The resident stated on the date of the incident she refused to surrender her vape pen to staff. During the incident staff attempted to escort her out of the room, the resident struggled, and fell on her back. Staff then grabbed her legs and pulled her out of the room. One of the two staff denied grabbing the resident by the legs and stated the resident began kicking at the staff which did not permit them to escort the resident. The other staff was unresponsive to attempted telephone contacts and resigned prior to providing a statement. The resident roommate is nonverbal and did not provide a statement. Continued on page Page It was alleged staff did not provide a safe environment for a resident. The multitude of allegations made during the complaint were unable to be corroborated. Although one of the residents presented with behaviors, including harm to self and others and incidents of consuming substances, there was no evidence to suggest this was due to lack of supervision by staff. It was alleged a staff member yelled at a facility resident and did not treat the resident respectfully after the resident reported she was handled roughly by said staff. The contact information provided by the facility was out of service and the staff member resigned during the course of the investigation, thus a statement was not obtained. The resident was interviewed and stated staff treat her with respect and denied the allegations were valid. Based on information obtained from interview conducted and record review the allegations are unsubstantiated. Although the allegations may have happened or are valid, the standard of the preponderance of evidence was not met. A copy of this report was provided to the above-mentioned facility representative. Exit interview conducted. No deficiencies were cited.

Investigation Findings:
13An unannounced follow up complaint inspection was conducted on 01/24/25, at 10: AM, by Licensing Program Analyst (LPA) Christopher Larios. During the inspection LPA Larios met with Administrator Ayan Hill. 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) Romelia Munoz and LPA Larios. During the course of the investigation SI Munoz obtained Bakersfield Police Department (BPD) records on 6/14/24 and interviewed confidential witnesses on 6/20/24. Between 09/16/24 and 01/24/25, LPA Larios conducted interviews with two facility residents, one placing agency social worker and seven facility staff. In addition, on 05/12/24, the facility provided LPA Larios copies of the LIC9020, LIC500 and staff contact information. UnsubstantiatedEstimated 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: HILL SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 01/24/2025

Allegations:
- UnsubstantiatedEstimated Days of Completion:
- Unsubstantiated Estimated Days of Completion:
- Unsubstantiated Estimated Days of Completion: 0


state: CA

facility_name: HILL SMALL FAMILY HOME

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
The Administrator and facility director are the ones who received training how to change g-tube at the hospital and they are the only ones changing the g-tube. Administrator stated she never provided false information to CCL. Administrator stated that is false accusation. The facility notify within 24 hours and written reports are submitted within seven days to CCL. The LPA was unable to interview children due to children being either non-verbal or unavailable. The statements obtained from the confidential interviews did not provide sufficient information to corroborate the allegations. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that alleged violations occurred, therefore the allegations are unsubstantiated. There were no deficiencies cited during this inspection. An exit interview was conducted. Appeal rights explained and a copy of this report, and Appeal Rights were provided to the facility representative.

Investigation Findings:
13On February 24, 2025, at 2: PM, Licensing Program Analyst (LPA), Karen Suh, conducted a follow-up complaint inspection with the facility above to deliver the findings of a complaint investigation. The LPA met with the representative named above and discussed the findings. The investigation included confidential interviews that consisted of but were not limited to: Administrator (see Confidential Names, LIC811 dated February 24, 2025), two staff on August 1, 2024, one staff on August 13, 2024. The LPA attempted to contact social workers. The LPA reviewed clients' roster and trainings provided to all staff. It was alleged staff do not have proper training to care for minor and licensee provides false information to CCL. Administrator and staff denied the allegations. Staff stated the facility provides adequate training and have enough staff on duty to assist with clients' needs and behaviors. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Yan Yeung LICENSING EVALUATOR NAME: Karen Suh LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: HILL SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 02/24/2025

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

report_type: Complaint Investigation

met_with: Asia Armstrong, Facility Director

complaint_status: unsubstantiated


facility_name: HINTON SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On 6/10/21, at 1:02 pm Licensing Program Analyst (LPA) Belinda Gilmer made an announced required annual inspection and met with Linda Hinton licensee. At 1:21 pm Licensee and LPA toured inside and outside of the home. During the outside tour LPA observed a blue nose pit bulldog. Currently there are no foster children placed in this home. There are five adults residing in the home at the time of this visit. (see confidential name form (LIC 811) dated 6/10/10. There were no foster children placed in the home at the time of this inspection. The home is set up as follows: This is a one-story home three bedrooms (the family room was converted into a bedroom approved by the city of West Covina making it a four bedroom, 1.5 bathrooms, kitchen, dining area/ living room. Bedroom # 1 - Sleeps licensee son that's pending conservator ship (medical bed, twin bed, dresser and portable closet space). Bedroom # 2 - occupied by licensee adopted daughter (twin bunk beds, dresser and closet space). Bedroom # 3 - occupied by licensee fourteen-year-old grandson and adopted son (one twin bed, dresser and closet space). Bedroom # 4 - occupied by licensee and caregiver share bedroom # 4 (king bed, dresser and closet space). There were appropriate furnishings in the home. There is a fireplace in bedroom/family room that's blocked off. The bathrooms were checked and were in operating condition. The home had adequate food supply. The kitchen trash can was covered. The gas stove was tested and working, the combination smoke detector/ carbon monoxide was tested in the bedrooms. The smoke detectors in the hallway was not tested as it's connected to the alarm system and goes directly to the fire department. The home had a locked container where medications will be stored. The disinfectants, cleaning solutions and other dangerous items were stored in a cabinet in the garage inaccessible to children. There are no foster children placed in home at the time of this inspection. Licensee has not completed her required training, nor did she have a current first aid CPR during this visit. In accordance with California Code of Regulation, Title 22, Division 6, a technical assistance advisory note alone with the licensee forms was emailed to licensee during this inspection. Exit interview was conducted with Licensee

report_type: Facility Evaluation

visit_type: Annual

met_with: Linda Hinton


summary: Facility Evaluation

raw_content:
Narrative:
On May 9, 2022, Licensing Program Analyst (LPA), Claudia Portillo conducted an unannounced inspection at the small family home (SFH) above for the purpose of conducting an annual inspection. LPA met with the licensee of the home, Linda Hinton. There were no clients in care. A physical plant inspection was completed and included the following checks: small family home grounds are free of observable hazards. There is adequate indoor and outdoor activity space, including an outdoor yard. The smoke and carbon monoxide detectors are in working order. Knives and sharps are locked in a kitchen drawer. LPA observed the State License, Emergency Plan (LIC 601); and facility sketch throughout the facility. LPA obtained and reviewed the following updated documentation: · LIC Personnel · Approved Fire Clearance · Plan of operation/Program Design Continued on page 2.......... Continued page 2....... The Small Family Home (SFH) program was in full compliance with 3 applicable areas of the Compliance and Regulatory Enforcement (CARE) Tools, for Children's Residential licensees. Annual compliance Review consisted of the following domains: physical plant, operations, and staffing. Community care licensing (CCL) focuses its efforts on three priority areas: prevention, compliance, and enforcement. Due to the SFH not having clients in care, some domains were excluded. The Administrator was interviewed as part of this review. No citations were issued during this inspection. All staff members are associated to the SFH. An exit interview was conducted and the SFH Administrator, Linda Hinton. LPA provided a signed copy of this report (LIC 809) and LIC 811 (Confidential Names) was provided to the facility representative.

met_with: Linda Hinton, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Inspection Tool Didn't Final Print During Annual 05/9/22

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On August 8, 2023, Licensing Program Analyst (LPA), Claudia Portillo conducted an unannounced inspection at the small family home (SFH) above for the purpose of conducting an annual inspection. LPA met with the licensee of the home, Linda Hinton. There were no clients in care. A physical plant inspection was completed and included the following checks: small family home grounds are free of observable hazards. LPA observed the State License, Emergency Plan (LIC 601); and facility sketch throughout the facility. The Small Family Home (SFH) program was in full compliance with 3 applicable areas of the Compliance and Regulatory Enforcement (CARE) Tools, for Children's Residential licensees. Annual compliance Review consisted of the following domains: physical plant and operations. Community care licensing (CCL) focuses its efforts on three priority areas: prevention, compliance, and enforcement. Due to the SFH not having clients in care, some domains were excluded. The Administrator was interviewed as part of this review. No citations were issued during this inspection. An exit interview was conducted and the SFH Administrator, Linda Hinton. LPA provided a signed copy of this report (LIC 809) and LIC 811 (Confidential Names) was provided to the facility representative


summary: Facility Evaluation

raw_content:
Narrative:
On January 31, 2024, Licensing Program Analyst (LPA), Claudia Portillo conducted an unannounced visit at the small family home (SFH) above for the purpose of conducting an annual inspection. LPA met with the licensee of the home, Linda Hinton. There were no clients in care.. An annual was conducted on August 8, 2023. The Small Family Home (SFH) program was in compliance with 3 applicable areas of the Compliance and Regulatory Enforcement (CARE) Tools, for Children's Residential licensees: physical plant, operations, and staff files. Community care licensing (CCL) focuses its efforts on three priority areas: prevention, compliance, and enforcement. NMDs weren't able to be interview due to being non-verbal. Based on observations and record review, no citations were issued on today's annual inspection. An exit interview was conducted with the SFH Administrator. LPA provided a signed copy of this report (LIC 809) and LIC 811 (Confidential Names) was provided to the facility representative.


summary: Facility Evaluation

raw_content:
Narrative:
On January 30, 2025, Licensing Program Analyst (LPA), Claudia Portillo conducted an unannounced visit at the small family home (SFH) above for the purpose of conducting an annual inspection. LPA met with the licensee of the home, Linda Hinton. There were no clients in care.. The Small Family Home (SFH) program was in compliance with 3 applicable areas of the Compliance and Regulatory Enforcement (CARE) Tools, for Children's Residential licensees: physical plant, operations, and staff files. The LPA has informed the the provider that she must update the POO/PS. Community care licensing (CCL) focuses its efforts on three priority areas: prevention, compliance, and enforcement. Based on observations and record review, no citations were issued on today's annual inspection. An exit interview was conducted with the SFH Administrator. LPA provided a signed copy of this report (LIC 809) and LIC 811 (Confidential Names) was provided to the facility representative.


summary: Facility Evaluation

raw_content:
Narrative:
On January 30, 2026, Licensing Program Analyst (LPA), Claudia Portillo conducted an unannounced visit to the small family home (SFH) above for the purpose of conducting an annual inspection. LPA met with the licensee of the home, Linda Hinton. There were no clients in care. LPA reviews the following sections using the Compliance and Regulatory Enforcement (CARE) Tools: physical plant, operations, and staff files. Community care licensing (CCL) focuses its efforts on three priority areas: prevention, compliance, and enforcement. LPA was conducting an inspection and interview with licensee; it was revealed that an Adult Resident (AR) has resided in the home without having obtained the required criminal record clearances. This poses an immediate, safety or personal rights risk to the children placed in care. Under Title 22, Section 80019 (2)(B) Criminal Record Clearance. These standard states that the Department shall conduct a criminal record review of all individuals specified in Health and Safety Code Section 1522(b) and shall have the authority to approve or deny a facility license, or employment, residence, or presence in the facility, based upon the results of such review. Any person, other than a client, residing in the facility. AR obtained his live scanned and last week which is still pending in the guardian system. A signed copy of this report, LIC811, LIC809-D, and appeal rights were provided to Ms. Hinton. Exit interview conducted.


facility_name: HOLDING HEARTS SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On 08/07/2024 at 2: PM, the COMPONENT II of the application process for Holding Hearts, located at S Vermont Ave Unit #1, Gardena, CA 90247, was held at the California Department of Social Services, Community Care Licensing Division - Children's Residential Program - Regional Office in El Segundo. In attendance were Licensing Program Analysts (LPAs) Dennis Jarmin and Justine Armstrong, and applicant Meagan Gossett. The purpose of this Component II meeting was to review the submitted application and Program Statement, specifically to address and resolve any outstanding items or concerns. The discussion focused on several incomplete application forms: 1. Designation of Administrative Responsibility (LIC 308): A designated individual is required to be authorized to act in the licensee's absence. 2. Health Screening Report - Facility Personnel (LIC 503): The tuberculosis (TB) test section of the form needs to be completed, including results, or a separate test verification must be provided. 3. Facility Sketch (LIC 999): The sketch must include the dimensions of all rooms, designate their use, and show door and window exits. Exit routes should be indicated by number, as shown on the LIC 610/LIC 610A. Emergency Disaster Plan. Rooms used by non-ambulatory clients/residents and staff need to be identified, along with two evacuation sites for emergencies. (Cont) Program Statement Discussions: - Detailed discussions included topics such as medication destruction procedures, dietary options with a sample meal plan for school, and the process for a 30-day client post-admission assessment. Important Dates: The applicant, Ms. Gossett, was advised that revisions and/or corrections to the application are due by August 13, 2024. A Pre-Licensing Inspection is scheduled to be conducted on August 14, 2024, at 9: AM. A copy of this report will be provided to Ms. Gossett.

met_with: Meagan Gossett


summary: Facility Evaluation

raw_content:
Narrative:
On 08/14/2024 at 09: AM, Licensing Program Analyst (LPA) Dennis Jarmin and LPA Justine Armstrong conducted a Pre licensing visit with the Applicant Meagan Gossett at the above address. The following was observed. This is a three story home with 3 bedrooms and 3 full bath and 1 half bathroom. Currently there are no children residing in the home. The furniture in the home appears to be in good condition. The living room has sofa, wall mounted television, overhead lighting and recessed lighting in good repair. The family room is complete with sofa, TV, and appropriate amount of space for family time. There are appropriate amount food and water observed which includes all four food groups. LPA's confirmed operable smoke detectors in bedrooms and hallways, fire extinguisher is located in kitchen- wall mounted next to the kitchen sink. First Aid kit is available and will be maintained in the locked cabinet. There is a two car garage in the first floor of the home. The home has surplus of cabinets for use and 6 burner stove with microwave on top. The home has a Medication lock box stored in the staff bathroom. Hot water temperature is between 105 to 120 degrees. Central air and heat, free of debris and other hazardous items. There is locked shed in the garage and applicant was advised must keep locked and inaccessible to clients in care. There are no bodies of water on the premises. LPA's observed no camera at this time and Applicant confirmed no firearms in the home. Bedroom #1, not occupied by applicant, twin size bed, night stand with drawers. Bedroom #2 is currently not occupied by Applicant and observed two twin beds, and overhead lighting with night stand with four drawers. Bedroom #3 is occupied by applicant with king bed and has a full bathroom inside. All window observed with blinds that is in good repair inclduing window screens. Bathroom has shower and sink. Hot water was tested and found to be between 105-120 degrees (F). Cont. The following items were identified and recommended: 1. Applicant was advised to replaced bathrooms trashcan with a trashcan with a lid. 2. Bedroom #1 wall behind door needs to be repaired. 3. Applicant advised to send a copy of the CA ID of the designee employee and the criminal statement LIC 508D. The home is extremely clean and organized and had appropriate furnishing throughout the home. Exit interview conducted with applicant.

visit_type: Prelicensing

met_with: Maegan Gossett


summary: Facility Evaluation

raw_content:
Narrative:
On 10/25/2024 at 09: AM, Licensing Program Analyst (LPA) Dennis Jarmin conducted a Pre-licensing visit with Applicant Meagan Gossett at the above address. The following was observed. This is a one story home with 3 bedrooms 2 full bathroom. Currently, there are no children residing in the home. The furniture in the home appears to be in good condition. The living room has a sofa, wall-mounted television, overhead lighting, and recessed lighting in good repair. The family room is complete with a sofa, TV, and an appropriate amount of space for family time. There is an open faced fireplace not in use with covering but needs to be secured and inaccessible. There are appropriate amount of food and water observed which includes all four food groups. LPA's confirmed operable smoke detectors in bedrooms and hallways, and a fire extinguisher is located in the kitchen- wall mounted next to the kitchen sink. First Aid kit is available and will be maintained in the locked cabinet. There is a two-car garage in the front area of the home. The home has a surplus of cabinets for use and a 4-burner stove, a dual conventional oven and large refrigerator with freezer. The home has a Medication lock box stored in the staff applicant bedroom. The hot water temperature is between 105 to 120 degrees. Central air and heat, free of debris and other hazardous items. There is a locked shed in the backyard that is inaccessible. There are no bodies of water on the premises. LPA's observed two camera inoperable at the living room and dining area at this time. Applicant confirmed no firearms in the home. Bedroom #1, occupied by applicant, queen size bed, nightstand with drawers. Bedroom #2 is currently not occupied by Applicant and observed two twin beds and overhead lighting with two nightstand/cabinet with four drawers. Bedroom #3 is not occupied by applicant with two twin bed and a built cabinet for each future client. All windows observed with blinds that are in good repair including window screens. The bathroom has a shower and sink. Hot water was tested and found to be between 105-120 degrees (F). Cont. The following items were identified and recommended: 1. Open fireplace must be must have covering and inaccessible. The home is extremely clean and organized and had appropriate furnishing throughout the home. Exit interview conducted with applicant.


summary: Facility Evaluation

raw_content:
Narrative:
On 01/23/2025 at 09: AM, LPA Licensing Program Analyst - Dennis Jarmin and LPA Justine Armstrong arrived at the Holding Hearts to conduct the Post Licensing inspection. LPA's conducted a walk through of the home to verify compliance with SFH standards. The following were observed: This is a one story home with 3 bedrooms and 2 full bathroom. Currently, there are no child residing in the home. The furniture in the home appears to be in good condition. The living room has a sofa, wall-mounted television, overhead lighting, and recessed lighting in good repair. The family room is complete with a sofa, TV, and an appropriate amount of space for family time. There is one open faced fireplace not in use but secured and inaccessible. There are appropriate amount of food and water observed which includes all four food groups. LPA's confirmed 6 operable smoke/carbon monoxide detectors in bedrooms and hallways, and a fire extinguisher located in the kitchen and garage mounted in the wall. First Aid kit is available and will be maintained in the locked cabinet. There is an outside space accessible to the minor in the rear side of the home that is free of debris and/or hazards. The home has a surplus of cabinets for use and a 4-burner stove, a dual conventional oven and large refrigerator with freezer and a dishwasher that is operable and in good repair. The home has a Medication lock box stored in the licensee's bedroom. The hot water temperature is between 105 to 120 degrees. There are natural air and plenty of windows that has screen covering in good repair. There is also central air and heat around the home. There is a locked shed in the backyard that is inaccessible. There are no bodies of water on the premises. The Facility license, emergency contact numbers, monthly planner and meal menu posted and available for review LPA observed camera inside the dining area close to the kitchen that is not operable. Applicant confirmed no firearms in the home. Bedroom #1 not occupied and has two twin size bed, night stands with drawers. Bedroom #2 is not occupied with two twin size bed with two closet space for each client and bedroom 3 is occupied by the licensee with a queen bed. All windows observed with blinds that are in good repair including window screens. The bathroom has a shower and sink. Currently, there is no client in the facility and no files were reviewed except staff 1. The home is extremely clean and organized and had appropriate furnishing throughout the facility. Exit interview conducted with the licensee.


facility_name: HOME AWAY

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Itzel Suarez and Licensing Program Manager (LPM) Lakescia Smith met in person with applicant Kefelegn Yeshiharge for the Component II Interview. The meeting was to review the application and program details for her small family home, Home Away. What Was Reviewed and Discussed: 1. Component I Certificate: The team confirmed that the applicant completed the required orientation. 2. Identification: A copy of the applicant's ID was made for the records. 3. Background Check: The applicant and her son's the criminal background is pending. 4. Forms: LIC 200: Title needs to correct, e-mail, landline needs be installed, and county added. LIC 400: The applicant added the required date. LIC 500: The applicant was asked to correct the job title listed for herself and son. LIC 308: The person designated will be changed to her son. Emergency Evacuation: Address for locations were missing. Continuation on LIC 809-C 5. Facility Sketch: The layout needs to be revised to meet guidelines. 6. Fire Clearance: Approval is still pending. The applicant must install proper fire alarms and a pool fence. · B7 - Program Design (Needs Revisions): Several parts of the program design are not in compliance and must be updated. The following items must be revised or added: · Remove references to caring for "non-ambulatory" clients. · Include a one-month activity schedule for the children. · Add a weekly food menu. · Provide clear procedures for handling medical emergencies. · Describe how transportation to doctor and dental appointments will be arranged. · List community resources and consultants the home will use. Add procedures for how incidents and complaints will be handled. B8 - Discipline Policy: Must remove all references to "Nate House." Admission Policies (B9): Several documents were incomplete or incorrect, including: · Needs and Services Plan · Medical Assessment Continuation on LIC 809-C - Emergency Information · Sign-in/sign-out procedures · Admission agreement, refund policy, and modification conditions The application and Program Design were returned to the applicant for corrections. The revised documents, including the updated LIC 200 form, are due by July 7, 2025. Additional Notes: LPA and LPM discussed which placement agency the applicant plans to work with to receive clients. They also reviewed licensing responsibilities, especially Small Family Home Regulation Section 83064. LPA and LPM provided Applicant with forms 200, 400, 500, and Application Instructions for A Facility License. · Copy of Orientation/ Application Process Certificate of Completion was provided to the Applicant. · Sketch was provided to the Applicant. · Copy on Buildings and Grounds was given to the Applicant. · Sample of activities and menu was given to the Applicant. Next Step: A Pre-Licensing Visit for Home Awayis scheduled for July 14, 2025, at 9: AM.

met_with: Applicant


summary: Facility Evaluation

raw_content:
Narrative:
On July 14, 2025 at 9: AM, Licensing Program Analyst (LPA) Itzel Suarez and Licensing Program Manager Lakescia Smith arrived at the above facility, for the purpose of conducting a Pre- licensing inspection for a Small Family Home License. LPA met with applicant, Kefelegn Yeshiharge who granted access into the home. The applicant and LPA and LPM toured the facility both inside and out. Currently residing in the home is applicant and adult son. Applicant is requesting to be licensed for 3 clients ages 3-17 ambulatory only. The home was inspected and the following was observed: The home is a one-story residence with a two-car garage and a fenced backyard that includes a swimming pool. Living Room: There is adequate furniture which is in good condition. The area is equipped with a sofa, two chairs, and a small table. There is vinyl flooring with an area rug located in the living room in front of the sofa. Family Room: Furnished with a sofa, one straight-back chair, a coffee table, and a mounted 77" television. A fireplace is located beneath the television; it is enclosed with doors and a safety screen. Adjacent dining area includes a six-seat dining table with six straight-back chairs. Six smoke detectors and one carbon monoxide detector were tested and found to be operational. Continuation on 809-C Each bedroom contains one smoke detector, with additional detectors located in the hallway and dining area. Formal Dining Area: Contains a six-seat dining table. Kitchen: with a mounted, operable fire extinguisher. Functional five-burner stove, refrigerator/freezer, and small kitchen appliances. The menu is not available. Cleaning supplies and sharps are stored and inaccessible to clients. The kitchen island has three chairs for additional seating. Bedroom #1: is equipped with 1 king sized bed and it occupied by applicant. There is one bathroom inside the room with one shower, toilet, and sink. Bedroom #2: is located to the right of hallway and is equipped with 1 queen size bed, clean bedding, adequate closet, computer and desk, operation ceiling fan and this room is occupied by applicant's adult son. Bedroom #3: Queen size bed, bed frame has drawers, 1 nightstand and closet. The bed had clean bed sheets and linens. Applicant will add to twin beds for two clients to occupy the room. Bedroom #4: 1 full size bed, bed frame has drawers, 1 nightstand and one closet. The bed had clean bed sheets and linens. The room will be available for one client. All rooms are clean, safe, sanitary and have operable windows. Outdoor: Pool is gated. The backyard needs to be clean. Wood and cleaning tools need to be removed. Safety Items: The first aid kit checked and is missing tweezers. Fire Extinguisher available in the home and fully charged. Continuation on 809-C Telephone: Applicant will be using a cellphone that will always remain in the facility. Applicant will keep the phone in the kitchen area. The cellphone number is (424) 360-7091. Cameras: There are two cameras in the home. One is in the backyard and one in the front of the home that monitors the exterior of the property. The applicant monitors the camera through her phone. Vehicles: The home will utilize Toyota Prius to transport clients in care. Current automobile registration is valid until March 2026 and car insurance is with Allstate Insurance Company and is current until 9/12/2025. Vehicle was inspected and is in good operating order. Prior to being licensed the following is required: · Water temperature must measure between 105-120 in bathroom. -Tweezers need to be added to the First Aid Kit. -In bedroom# 3 applicant will add two twin size beds. · Cleaning tools, wood, and trash must be remove from the backyard and made inaccessible which poses a potential safety hazard. -Linen closet locks need to be fixed and organized. -Heater closet lock needs to be fixed with a proper hook to make it inaccessible. -Pool fence locking mechanism door needs to swing outward without having to unlock it from the outside. -Nails protruding from the bricks needs to be remove. -Emergency Disaster Plan needs to be printed and posted - Menu needs to be available and accessible. - Applicant will purchase additional non-Perishable food for the home. Exit Interview was conducted and a copy of this report was left with the applicant


summary: Facility Evaluation

raw_content:
Narrative:
On July 24, 2025 at 9: AM, Licensing Program Analyst (LPA) Itzel Suarez arrived at the above facility, for the purpose of conducting a Pre- licensing inspection for a Small Family Home License. LPA met with applicant, Kefelegn Yeshiharge who granted access into the home. The applicant and LPA and LPM toured the facility both inside and out. Currently residing in the home is applicant and adult son. Applicant is requesting to be licensed for 3 clients ages 3-17 ambulatory only. The home was inspected and the following was observed: The home is a one-story residence with a two-car garage and a fenced backyard that includes a swimming pool. Living Room: There is adequate furniture which is in good condition. The area is equipped with a sofa, two chairs, and a small table. There is vinyl flooring with an area rug located in the living room in front of the sofa. Family Room: Furnished with a sofa, one straight-back chair, a coffee table, and a mounted 77" television. A fireplace is located beneath the television; it is enclosed with doors and a safety screen. Adjacent dining area includes a six-seat dining table with six straight-back chairs. Six smoke detectors and one carbon monoxide detector were tested and found to be operational. Each bedroom contains one smoke detector, with additional detectors located in the hallway and dining area. Telephone: Applicant will be using a cellphone that will always remain in the facility. Applicant will keep the phone in the kitchen area. The cellphone number is (424) 360-7091. Cameras: There are two cameras in the home. One is in the backyard and one in the front of the home that monitors the exterior of the property. The applicant monitors the camera through her phone. Vehicles: The home will utilize Toyota Prius to transport clients in care. Current automobile registration is valid until March 2026 and car insurance is with Allstate Insurance Company and is current until 9/12/2025. Vehicle was inspected and is in good operating order. Prior to being licensed the following is required: · Water temperature must measure between 105-120 in bathroom. -Tweezers need to be added to the First Aid Kit. -In bedroom# 3 applicant will add two twin size beds. · Cleaning tools, wood, and trash must be remove from the backyard and made inaccessible which poses a potential safety hazard. -Linen closet locks need to be fixed and organized. -Heater closet lock needs to be fixed with a proper hook to make it inaccessible. -Pool fence locking mechanism door needs to swing outward without having to unlock it from the outside. -Nails protruding from the bricks needs to be remove. -Emergency Disaster Plan needs to be printed and posted - Menu needs to be available and accessible. - Applicant will purchase additional non-Perishable food for the home. Exit Interview was conducted and a copy of this report was left with the applicant Formal Dining Area: Contains a six-seat dining table. Kitchen: with a mounted, operable fire extinguisher. Functional five-burner stove, refrigerator/freezer, and small kitchen appliances. The menu is not available. Cleaning supplies and sharps are stored and inaccessible to clients. The kitchen island has three chairs for additional seating. Resource Parent did have perishable and l non-perishable food available. Bedroom #1: is equipped with 1 king sized bed and it occupied by applicant. There is one bathroom inside the room with one shower, toilet, and sink. Bedroom #2: is located to the right of hallway and is equipped with 1 queen size bed, clean bedding, adequate closet, computer and desk, operation ceiling fan and this room is occupied by applicant's adult son. Bedroom #3: Queen size bed, bed frame has drawers, 1 nightstand and closet. The bed had clean bed sheets and linens. Applicant will add to twin beds for two clients to occupy the room. Bedroom #4: 1 full size bed, bed frame has drawers, 1 nightstand and one closet. The bed had clean bed sheets and linens. The room will be available for one client. All rooms are clean, safe, sanitary and have operable windows. Outdoor: Pool is gated and backyard was clean. Safety Items: The first aid kit checked and it had all the requirement items. Fire Extinguisher available in the home and fully charged. Continuation on 809-C


summary: Facility Evaluation

raw_content:
Narrative:
On July 24, 2025, at 1: PM, Licensing Program Analyst (LPA) Itzel Suarez met in person with applicant Kefelegn Yeshiharge to conduct the Component II Interview. The purpose of the meeting was to review the application and program details for her small family home, Home Away. During the meeting: LPA Suarez informed the applicant that several required forms that need correction and need to be submitted. These include: LIC 200, LIC 610C, LIC 999, and LIC 9054. LPA Suarez reviewed the revised Program Design submitted on July 12, 2025. However, it still does not meet the requirements of the Small Family Home Regulations and General Licensing Rules. The applicant will need to update documents B7-B9 according to the application instructions. LPA Suarez went over the application and Program Design Instructions with the applicant and requested additional revisions. The applicant agreed to submit the updated and corrected documents by July 28, 2025. The meeting concluded with an exit interview.

met_with: Kefelegn Yeshiharge


summary: Facility Evaluation

raw_content:
Narrative:
On July 24, 2025, at 1: PM, Licensing Program Analyst (LPA) Itzel Suarez met in person with applicant Yeshiharge Kefelegn to conduct a Small Family Home (SFH) Component III office meeting. LPA Itzel Suarez. met with Applicant to discuss forms required to be maintained, available, and posted at the facility for inspections. We discussed child and personnel records that are required to be documented, retained and available for inspection. We also discussed specific requirements, concerns and issues operating a Small Family Home (SFH), such as, reporting requirements, finances, basic services, accountability, personnel requirements, admission agreements, client medical assessment, client records, telephone usage, transportation, health services, food services, responsibility for providing care and supervision, building and grounds, licensing inspections, waivers and exceptions, civil penalties, reasonable and prudent parenting standards, needs and services plan, children's records, personal rights, discipline, and activities. Licensing of facility is pending final approval due to revisions needed for the application LIC forms and Program Design as well as the final inspection visit. A copy of this report was provided to the Applicant,Yeshiharge Kefelegn .


summary: Facility Evaluation

raw_content:
Narrative:
On 12/16/25, Licensing Program Analyst (LPA) Andrea Aceves and Licensing Program Manager (LPM) Lakescia Smith met with applicant Kefelegn Yeshiharge at the El Segundo Regional Office to follow up on her pending Small Family Home application During a review of the application, there is a confusing information that pertains to the operation of a group home. LPA and LPM discussed compliance concerns and requested that applicant to submit revisions to CCL. LPA would like to remind the applicant regarding the following responsibilities to operate a Small Family Home: Licensee Duties and Responsibilities (a) The licensee shall be responsible for: (1) Participating with the child in activities. (2) Participating with agencies and other responsible persons in planning for the needs of the child. (3) Ensuring that the child is clean and providing the child with training in personal cleanliness and hygiene. (4) Protecting the child from home accidents. See LIC809-C (5) Making provisions for the child to attend available community treatment or training programs when the child has needs which can be met by such programs. (6) Participating in activities which increase the licensee's own understanding of, and skill in, caring for children. (7) Providing for and meeting service needs of the child as identified in the needs and services plan required by Section 83068.2. (8) Assisting the child in the development of goals and encouraging them to reach those goals. (9) Supervising the provision of basic services within the home. (10) Unless restricted by the case plan adopted by the court or other court order, the licensee shall permit and facilitate connections between the child and the child's siblings, family members, relatives, and non-relative extended family members. Nothing in this section shall be interpreted to require a provider to take any action that would impair the health and safety of children in out-of-home placement (b) The licensee shall be regularly present in the home when children are in the home full time. (1) If all children are involved in out of home programs, such as school or day care, the licensee shall be permitted to be regularly absent during those hours. (2) When the licensee is absent from the home while children are present the licensee shall provide for supervision of the children by a responsible adult unless otherwise agreed to in advance by the licensing and placing agencies. Applicant agreed to submit revision to CCL by Friday, December 19, 2025. Exit interview conducted and a copy of this report was provided to applicant.

met_with: Applicant-Kefelegn Yeshiharge


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On March 26, 2026 at 8: AM, Licensing Program Analyst (LPA) Lanice White arrived at the above facility, for the purpose of conducting a post-licensing inspection for a. LPA met with licensee, Kefelegn Yeshiharge who granted access into the home. LPA toured the facility both inside and out. Currently residing in the home is licensee and adult son. The home was inspected and the following was observed: The home is a one-story residence with a two-car garage and a fenced backyard that includes a swimming pool. Living Room: There is adequate furniture which is in good condition. The area is equipped with a sofa, two chairs, and a small table. There is vinyl flooring with an area rug located in the living room in front of the sofa. Family Room: Furnished with a sofa, one straight-back chair, a coffee table, and a mounted 77" television. A fireplace is located beneath the television; it is enclosed with doors and a safety screen. Dining Area: includes a six-seat dining table with six straight-back chairs. Kitchen: with a mounted, operable fire extinguisher. Functional five-burner stove, refrigerator/freezer, and small kitchen appliances. The menu is available. Sharps are stored and inaccessible to clients. The kitchen island has three chairs for additional seating. (Continued see 809-C page 2) (Page 2) Bedroom #1: is equipped with 1 king sized bed and it is occupied by the licensee. There is one bathroom inside the room with one shower, toilet, and sink. Bedroom #2: is located to the right of hallway and is equipped with 1 queen size bed, clean bedding, adequate closet, computer and desk, operation ceiling fan and this room is occupied by the Licensee adult son. Bedroom #3: Occupied by C Queen size bed, bed frame has drawers, 1 nightstand and closet. The bed had clean bed sheets and linens. Bedroom #4: Is vacant: full size bed and Twin-size bed, one closet. All rooms are clean, safe, sanitary and have operable windows. Hot water temperatures measure between F Back yard: Pool is gated and backyard was clean. Garage: is equipped with washer and dryer is used for extra storage. Cleaning supplies is located in the garage and inaccessible to clients Vehicles: The home will utilize Toyota Prius to transport clients in care. Current automobile registration is valid until 03/08/2027 and car insurance is with Allstate Insurance Company and is current until 9/12/2026. Vehicle was inspected and is in good operating condition. Cameras: There are two cameras in the home. One is in the backyard and one in the front of the home that monitors the exterior of the property. The licensee monitors the camera through her phone. (Continued see 809-C page 3) (page 3) Client Records: LPA reviewed 1 client records, Staff Records: LPA reviewed 0 staff records, not available during inspection . Staff Interview: LPA conducted a confidential interview with Licensee. Client Interviews: None, clients was in school during inspection. LPA observed the home to have a fully charged fire extinguisher in the kitchen. A complete First Aid Kit, and medication storage was locked and inaccessible. The homes hallway cabinets store extra linen and hygiene products. The smoke and carbon monoxide detectors were tested and found to be in working order. Each bedroom contains one smoke detector, with additional detectors located in the hallway and dining area. A cell phone is available and assessable for the children in care located in the kitchen. LPA observed the home to be clean, safe, and sanitary. Passageways, stairways, and open porches are unobstructed. The front, backyard, and pool were clean and free of debris. There is a pool located on the premises. There are no firearms or dangerous weapons in the home. There are no animals on site. Deficiencies was cited at the time of inspection. (See LIC809-D) LPA Lanice White and concluded the post-licensing Inspection. An exit interview was conducted, and a copy of this report was left with the Licensee.

Deficiencies:
80066(c): Personnel Records

(c) All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements

met_with: Yeshiharge Kefelegn


summary: Facility Evaluation

raw_content:
Narrative:
On April 28, 2026 at 9:00am Licensing Program Analyst LPA, Lanice White arrived at the above facility, for the purpose of conducting a Plan of Correction (POC) inspection for the deficiencies observed during the post-licensing inspection held on March 26, 2026. LPA met with licensee, Kefelegn Yeshiharge who granted access into the home. The following deficiencies were observed during Post-licensing inspection held on March 26,2026: CCR 80066(c): Licensee did not comply with the section cited above in due to not having personal records available for review for Licensee, S1, and S2 which poses/posed a potential health, safety or personal rights risk to persons in care. CCR 80065(e)(2): Licensee did not comply with the section cited above because there is a pool on the facility grounds the licensee does not have a water safety certificate which poses/posed a potential health, safety or personal rights risk to persons in care. CCR 80065(g)(1): Licensee did not comply with the section cited above the Licensee does not have health screening, including a test for tuberculosis for S1 and S2 on file which poses/posed a potential health, safety or personal rights risk to persons in care. HSC 11165.7(c)(1): Licensee did not comply with the section cited above because S1 and S2 staff do not have mandated reporters training which poses/posed a potential health, safety or personal rights risk to persons in care. CCR 80070(b)(6): Licensee did not comply with the section cited above in the client in care does not have an admission agreement on file which poses/posed a potential health, safety or personal rights risk to persons in care. CCR 83068.2(a): Licensee did not comply with the section cited above, Licensee does not have a copy of C1 needs and services plan which poses/posed a potential health, safety or personal rights risk to persons in care. (Continued see 809-C page 2) (page 2) CCR 83070(b)(9): Licensee does not have a copy of the client in care needs and services plan which poses/posed a potential health, safety or personal rights risk to persons in care. CCR 83068.2(c): Licensee did not comply with the section cited above in the licensee does not have proof of written request of C1 needs and services plan which poses/posed a potential health, safety or personal rights risk to persons in care. LPA review staff and client files Client Records: LPA reviewed 1 client records, - Met requirements Staff Records: LPA reviewed 3 staff records, - Met requirements LPA Lanice White observed the corrections made for the following deficiencies listed above all POC has been cleared. Copy of the report was left with the Licensee.

met_with: Yeshihareg Kefelegn - Licensee


facility_name: HOOKS FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On April 15, 2025 at 3:00PM, Licensing Program Analyst (LPA) Adaleyci Caballero met with Applicant Steven Joseph Hooks Sr for a Component II of the application process. Lpa a. Caballero went over revisions needed for the application prior to license and are due no later than May 13 , 2025. Lpa a. Caballero provided applicant with a copy of the LIC 184, Notice of Incomplete Application and additional correspondence to assist with the revisions needed to the application. A copy of this report was provided to applicant via email. The original signed copy of this report will be placed in the facility file.

met_with: Applicant- Steven Joseph Hooks Sr


summary: Facility Evaluation

raw_content:
Narrative:
On June 4, 2025, at 9:45AM, Licensing Program Analyst (LPA) Adaleyci Caballero completed a pre-licensing inspection of Hooks Small Family (SFH). LPA met with Applicant Steven Hooks Sr. 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(first floor)- It consisted of one single bed. The beds had linen, comforters, and pillows. It will sleep adult son. Bedroom #2- It consisted of one single bed. The bed had linen, comforters, and pillows. It will sleep applicants' bio daughter. 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 a set of bunk beds and a single bed. The beds had linen, comforters, and pillows. It will sleep three biological sons. Bedroom #5- (applicant) It consisted of one king bed. It will sleep applicant. A living room, dining room, kitchen, family room, laundry room, three car garage, and a backyard. 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 eight smoke detectors were checked and working properly. The three Carbon Monoxide detectors were connected to the smoke detectors in the first floor. The home's central air conditioning modules were in the backyard. The water heater was in the garage. The appliances were in working order. There was adequate food storage space and a supply of perishable food and non-perishable food. The home had a trash can for storage of solid waste with a tight fitting lid. The client and staff files will be locked inside a locked filing cabinet in the applicant's bedroom. The sharp knives and chemicals were locked in a storage closet in the downstairs hallway inaccessible to children in care. Medications will be locked in a lock box in the downstairs bathroom. The hot water was at a temperature of 117.5 degrees Fahrenheit. There were two fire extinguishers present in the home located in the kitchen and upstairs hallway. The First Aid Kit was accessible and placed in the kitchen wall. There are no firearms in the home. There is no pool at the home. The backyard is fully fenced and free of debris. The home has four cameras on the outside premise of the home and six cameras in the common areas and hallways of the home. Corrections: Window screens need to be repaired. Pending Fire Inspection approval The Facility Sketch, Emergency Disaster Plan, Personal Rights, Visitation policies, and House Rules need to be posted. Component III was conducted. An exit interview was conducted, and a copy of this report was provided to applicant Steven Hooks Sr. via email due to technical difficulties. Application will be forwarded to Licensing Program Manager Abdoulaye Traore for licensure once corrections are received.

met_with: Applicant-Steven Hooks Sr.


summary: Facility Evaluation

raw_content:
Narrative:
On August 19, 2025 at 3:45PM, Licensing Program Analysts (LPAs) Adaleyci Caballero and Maya Chavez met with Applicant Steven Joseph Hooks Sr to go over revisions that are still needed for the application prior to license and are due no later than September 19, 2025. A copy of this report and additional correspondence to better assist applicant with the corrections were provided to applicant via email. The original signed copy of this report will be placed in the facility file.

met_with: Applicant-Steven Hooks


facility_name: HOPE HARBOR SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On June 25, 2025 at 11:05 am, Licensing Program Analysts (LPAs) Charmaine Linley and Stefanie Mutialu met with applicant Stephen Barimah for Component II Orientation for a Small Family Home. Mr. Barimah confirmed the acknowledgement of the revisions needed and will submit the revisions and training certificates via email to LPA by end of day of July 10, 2025. Due to printer difficulties, a copy of this report was emailed to the applicant along with the signed Orientation form indicating Component II has been completed. A copy of this report will be placed in the facility file.

met_with: Stephen Barimah


summary: Facility Evaluation

raw_content:
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 Stephen Barimah, via Microsoft Teams. The Pre-Licensing Inspection has been scheduled for August 18, 2025, at 10:00 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 18, 2025, at 10:10 am, Licensing Program Analyst (LPA) Charmaine Linley arrived at the home to conduct a pre-licensing inspection of the facility. LPA met with Applicant, Stephen Barimah, who led a tour of the facility. The facility was toured inside and outside with the Applicant. Currently, there are no clients in placement. The facility is a two-story building with five bedrooms and three bathrooms which is set up as follows: Bedroom #1 (Master) has a King-Sized bed and sleeps the Licensee and his spouse. Bedroom #2 (Client) has one queen-sized bed and will sleep one client. Bedroom #3 (Client) has one queen-sized bed and will sleep one client. Bedroom #4 (Client) has one full-sized bed and will sleep one client. Bedroom #5 (Personal) has one queen-sized bed and is used for a personal bedroom. No clients will sleep in this bedroom. If this bedroom is going to be used as a client bedroom, the Licensee will provide an updated facility sketch and communicate with their LPA before making any changes. 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. The facility also consists of a great room, dining room, kitchen, a loft on the second floor, a laundry room located in the hallway on the second floor, a two car garage, and the backyard. *** There is no pool at the home at the time of this inspection. There was adequate closet space for the client's belongings. There were seven smoke/carbon monoxide detectors in every bedroom and the downstairs hallway and upstairs hallway. The combo detectors were checked and in properly functioning order. The home's central air conditioning module was located in the backyard. 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 locked in a cabinet located in the kitchen. There was adequate food storage space. LPA observed some non-perishable food, however, will return for a follow up inspection to check if the food available is sufficient for three meals over three days and snacks. 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 cabinet over the stove, inaccessible to clients. The medications will be located in a locked cabinet in the kitchen. The hot water in the kitchen was measured and registered at 111 degrees at 10:29 am, which is within the regulatory requirements. The home's First Aid kit was accessible and is located in the front hallway and contained all required supplies. The facility did not have a first aid manual. There were two fire extinguishers present in the home located in the front hallway and one fire extinguished located upstairs next to the laundry room. They were 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 two security cameras located on the inside perimeter of the home (kitchen, upstairs loft and to be reinstalled in the front driveway, and backyard). The following corrections need to be made to the home: Drawer space for the client's bedrooms, linens on each of the bed, a mattress in bedroom #4, food sufficient for three meals over three days, and the posted grievance/complaint form, menu, LIC 610, first aid manual, and additional recreational activities for the clients. LPA will return to check for the corrections on August 28, 2025 at 12:00 pm. An exit interview was conducted, and a copy of the report was provided to Stephen Barimah. A copy of this report will be placed in the facility file.

met_with: Stephen Bamirah


summary: Facility Evaluation

raw_content:
Narrative:
On August 26, 2025, at 12:05 pm, Licensing Program Analyst (LPA) Charmaine Linley arrived at the home to conduct a continuation of the pre-licensing inspection of the facility. LPA met with Applicant, Stephen Barimah, who led a tour of the facility. The facility was toured inside of bedrooms #2, #3, #4, entryway, kitchen and dining room with the Applicant. Currently, there are no clients in placement. The facility is a two-story building with five bedrooms and three bathrooms which is set up as follows : Bedroom #2 (Client) has one queen-sized bed and will sleep one client. There is adequate drawer space for the client's belongings. Bedroom #3 (Client) has one queen-sized bed and will sleep one client. There is adequate drawer space for the client's belongings. Bedroom #4 (Client) has one double-sized bed and will sleep one client. There is adequate drawer space for the client's belongings. The mattress was replaced and now has a double sized bed. There is sufficient linens to allow changing of the linens at least once a week on each of the client's beds. There is non-perishable food sufficient for three meals over three days. LPA observed the posted forms: Menu, Activity Calendar, Grievance/Complaint form, and LIC 610: Emergency Disaster Plan. LPA observed the first aid manual in the entryway next to the first aid kit. *** 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. An exit interview was conducted, and a copy of the report was provided to Stephen Barimah. A copy of this report will be placed in the facility file.


facility_name: HOPE HAVEN

summary: Facility Evaluation

raw_content:
Narrative:
On June 27, 2025, at 12:50PM, Licensing Program Analyst (LPA) Rachel Vanegas met with Hope Haven Small Family Home Applicant, Mayra Gaona, at the Riverside Children's Residential Program Regional Office for the purpose of conducting a Component II meeting. LPA discussed corrections and revisions needed for the Program Statement. The following is a summary of the corrections and revisions discussed and requested. These revisions are due by close of business on July 14, 2025. A2. Applicant Information (LIC 215) - Please review and revise to include additional experience and certificates for child development training, reference letters supporting childcare and supervision experience, etc. A3. Applicant Information (LIC 308) - Please review and revise Title of the authorized representative for this document A10. Personnel Report (LIC 500) - Please review and revise to provide days and times for 24hr/7days per week childcare and supervision - Please provide LIC 500 for identified Adult Residential Facility A11. Personnel Records (LIC 501) Please complete and provide this document for identified support personnel on LIC 308 and any additional staff identified on the LIC A14. Emergency Disaster Plan (LIC 610C) - Please review and provide permission letters from the identified relocation sites A15. Facility Sketch (LIC 999) - Please review and revise to include identification for doors and dimensions for all rooms **** Program Statement Corrections Needed B7. Facility Program Description - Please review and include corresponding page numbers to the Table of Contents - Please remove "eviction" from Page 3 on Table of Contents - Please review and remove mention of Group Home Program Statement on Page 3 of Table of Contents - Please review and revise "LIC 604" under Sample Forms of the Table of Contents on Page 4. This document is only a guide and not to be used as the Admission Agreement for the home. - Please identify source of placement clearly on Page 5 - Please review and remove "as necessary" for 24hr 7 days a week care and supervision for children in care, Page 6. - Please review and clarify special care needs identified on Page 6. - Please review and identify house rules and expectations mentioned on Page 6 - Please review and revise how behavior and punishment will be documented, Page 6. - Please review and clarify the use and monitoring of identified "Goals", whether that is on a Needs and Services Plan, etc., Page 7. Days and Hours of Operation - Please review and revise statement of "if the children are present" in reference to hours of operation, Page Basic Services Provided - Please describe how the facility will obtain consent forms for the facility to authorize medical care Optional Services - Please review and revise that the authorized representative or placing agency will sign the written agreement, Page 12. Assistance with Bedside Care and Medication - Please review, include, and provide information regarding where medication administered will be logged, Page 13. Medication Procedures - Please review and identify the use of the appropriate Medication Administration Record (MAR) (LIC 622A or LIC 622B) that will be used to log medication administration, Page 15. **** - Please review and identify that any medication refusal by a client is considered a "Special Incident" and a report needs to be completed and submitted to Community Care Licensing (CCL), per reporting requirements timeframes, Page 15. - Provide a statement that medication errors will need to be reported and documented to CCL, per reporting requirements timeframes. - Please review and identify the use of the appropriate MAR on #11, Page 16. - Please review and revise the responsible party to purchase over the counter medication for children in care, Page 16. Self-Administered Medications - Please review and clearly state that medication will be locked AND "inaccessible to the children..." Page, 17. - Please include that there can be temporary administration of psychotropic medication authorized on the JV220(A) Physician's Statement while the JV223 is pending - Please review and include policy for psychotropic medication use, documentation (LIC622B), administration, how the facility will obtain a copy of the current court order, or written authorization for each psychotropic medication, Page 17. - Please review and provide more information regarding documentation for medication refusal policy, etc. Transportation: - Please review and revise that smoking any substances in a vehicle used to transport children in care is prohibited whether or not children are present, Page 18. - Please review and revise reference to the California Car Seat Law requirements for child seat belt requirements to include the use of booster seats, etc., Page 18. Community Resources and Consultants - Please review and include the name of your home to remove the (Name of my Home) template, Page 19. - Please note the foster youth's right to attend their school of origin when identifying the public schools on Page 20. **** Immediate Response to Incidents and Complaints - Please include the complaint hot line number and information in this section as well, Page 21. - Please review and include a timeline for review of internal incident investigations, Page 21. - Please identify the documentation that will be utilized for incident reporting (LIC 624, etc.), Page 21. Please include a statement regarding notification to CCL if the Licensee will be out of the home for longer than 48hrs. Procedures for Reporting Abuse - Please review and revise reporting requirements to ensure compliance as a mandated reporter, Page 22. Water of Bodies/Pools and Supervision - Please review and clarify if there is an identified body of water at your home location, etc., Page 23. If there is, please update your facility sketch as well. B8. Discipline Policies and Personal Rights - Please review and remove reference to "eviction", Page 24. - Please include Personal Rights, they are not identifiable in this section as titled. - Please describe how the child and authorized representative will sign the personal rights form at intake and each time a new right has been added. You may utilize the LIC 613B (06/22). House Rules - Please review and clarify #8 to align with Page 9's identified schedule regarding bedtime, Page 25. Enforcement of House Rules - Please review and remove reference to "eviction", Page 26. Children's Personal Rights - Please review and revise this section to align with Page 24, as discussed, (Page 27). Runaway Plan - Please review and revise reference to restraint, Page 28. Please include documentation of an incident report for unauthorized absence and law enforcement contact to CCL and Authorized Representative as per reporting requirements, Page 29. Handling Complaints from the Children and Grievance Procedure - Please review and include contact numbers for identified Ombudsperson and CCL, Page 29. **** - Please identify the documentation that will be utilized for incident reporting (LIC 624, etc.), Page 29. Handling Complaints from Staff - Please identify what "immediately" will be in response to reporting concerns, etc. Page 30. CCL Investigative/Complaints on Second Chances Small Family Home Please review and revise "Second Chances Small Family Home", Page 30. Special Incident Reports - Please review and revise reference to "immediately" reporting incidents and contradiction statement for "by the working next business day", Page 30. - Please review and identify who the written report will be sent to, Page 30. Ground of Dismissal/Discharge and 14-Day Notice - Please review and revise the repeated information on Page 31 to maintain alignment with Page 43. #1 and #6 do not match on Page 31. Remove if not applicable. Eviction/Relocation/Removal from Placement - Please review and remove reference to eviction, Page 32. Health Related Services - Please review and identify the type of documentation that will be used in this section and where the documentation will be stored, Page 37. Loss of Placement/ Day-Notice - Please review and revise the repeated information on Page 43 to maintain alignment with Page 31. #1 and #6 do not match on Page 43. Remove if not applicable. Sample Menu - Please review and revise the sample menu provide to align with the weekday schedule provided on Page 9, Page 44. Admission Agreement - Please review and remove "Eviction Procedures" and revise the admission agreement to align with previous B16. First Aid Card - Please provide first aid and cardiopulmonary resuscitation card for the applicant, Mayra Gaona. Please review and include information regarding Camera Uses and Locations in accordance with Children's Residential Program Provider Information Notice 24-09. LPA Vanegas conducted an exit interview and a copy of this report along with the signed LIC 281C, Care Tools Pre-licensing form, and Children's Residential Program Provider Information Notice 24-09 were reviewed and provided to the applicant, Mayra Gaona.

met_with: Applicant - Mayra Gaona


summary: Facility Evaluation

raw_content:
Narrative:
On August 15, 2025 at 10:50am, Licensing Program Analysts (LPAs) Rachel Vanegas, Carissa Aviles and Valerie Wilson completed a pre-licensing inspection of Hope Haven Small Family Home (SFH). LPAs met with the Applicant - Mayra Gaona who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there are no clients in placement. The home is a one story building with five bedrooms and four bathrooms which are set up as follows: Bedroom #1 (Applicant's Child) has one single bed and sleeps the applicant's child. The room is locked and inaccessible to client's in care. Bedroom #2 (Master) has one bed and one bathroom and sleeps the applicant and spouse. The room is locked and inaccessible to client's in care. Bedroom #3 (Applicant's Child) has one single bed and sleeps the applicant's child. The room is locked and inaccessible to client's in care. Bedroom #4 (Clients) has one bed will sleep one client. Bedroom #5 (Clients) has two single beds and will sleep two clients. There is also a great room/living room, kitchen, dining area, four bathrooms, a locked laundry room, garage, and the backyard. There is a properly secure electric fire place in the living room. The client's bedroom is 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. *Continued on the next page* There was adequate closet space for the client's belongings. There was a combo/smoke detector in every bedroom and hallway. The combo carbon/smoke detectors were checked and they were working properly. The home's central air conditioning module was located on the backyard. The home appliances were in working order at the time of this inspection. The client and staff files will be in the locked laundry room. There was adequate food storage space. LPAs observed a two day supply of perishable and a seven day supply of non-perishable food. A trash can for storage of solid waste was present in the kitchen. All sharp knives are securely stored in the locked laundry room, inaccessible to clients. The medications will be located in a cabinet in the locked laundry room. Cleaning chemicals and laundry detergent are located in cabinet under the sink in the locked laundry room. The hot water in the kitchen was measured and registered at 112.8 degrees Fahrenheit. The home's tankless hot water heater is located in the garage and set at 119 degress Fahrenheit. The home's first aid kit was accessible and is located in the kitchen and contained all required supplies. There are four fire extinguishers present in the home. Two are located in the kitchen and two are located in the garage. They were observed to be properly charged and inspected by the fire department. There is one firearm in a secured safe located in the master bedroom, which is locked and inaccessible to clients in care. The ammunition is stored in a separate safe in the applicant's locked master bedroom closet, separate from the firearm. There is no pool at the home at the time of this inspection. There is one above ground hot tub. The hot tub is properly secured with a latched hard cover that is securely locked and has appropriate latches along the perimeter of the cover. The backyard where clients will have access to play is fenced. There are three large storage containers located on the property that are securely stored and inaccessible to clients in care. The home has an enclosed farm in the backyard which is secured and inaccessible to clients. The home has 10 security cameras located on the outside perimeter of the home and 3 security cameras located on the inside of the home. Based on this inspection, there are no corrections needed to be made to the home. Component III was completed during this visit. An exit interview was conducted a copy of this report and appeal rights were reviewed and provided to the applicant, Mayra Gaona. Application will be forwarded to the Licensing Program Manager for Licensing.


summary: Facility Evaluation

raw_content:
Narrative:
On November 13, 2025 at 01:20PM, Licensing Program Analyst (LPA) Rachel Vanegas arrived at Hope Haven Small Family Home (SFH). LPA met with the Staff/Facility Designee - Elyssa Quinonez who led a tour of the home. The home was toured both inside and out. The home is a one story building with five bedrooms and four bathrooms which are set up as follows: Bedroom #1 (Licensee's Child) has one single bed and sleeps the Licensee's child. The room is locked and inaccessible to client's in care. Bedroom #2 (Master) has one bed and one bathroom and sleeps the Licensee and spouse. The room is locked and inaccessible to client's in care. Bedroom #3 (Clients) has two single beds and will sleep two clients. Both beds are vacant at the time of this visit. Bedroom #4 (Licensee's Child) has one single bed and sleeps the Licensee's child. The room is locked and inaccessible to client's in care Bedroom #5 (Clients) has one bed and sleeps one client. There is also a great room/living room, kitchen, dining area, four bathrooms, a locked laundry room, garage, and the backyard. There is a properly secure electric fire place in the living room. The client bedrooms are 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. **Continued on the next page** There was adequate closet space for the client's belongings. There are combo/smoke and carbon detectors in every bedroom and hallway. The combo carbon/smoke detectors were checked and they were working properly. The home's central air conditioning module was located on the backyard. The home appliances were in working order at the time of this inspection. The client and staff files are stored in the locked laundry room. LPA observed a two day supply of perishable and a seven day supply of non-perishable food. Sharp knives, cleaning chemicals, medications, and laundry detergent are securely stored in the locked laundry room, inaccessible to clients. The hot water in the kitchen was measured and registered at 113.3 degrees Fahrenheit. The home's tankless water heater is located in the garage and set at 120 degress Fahrenheit. The home's first aid kit was accessible and is located in the kitchen and contained all required supplies. There are four fire extinguishers present in the home. Two are located in the kitchen and two are located in the garage. They were observed to be properly charged and inspected by the fire department. There is one firearm in a secured safe located in the master bedroom, which is locked and inaccessible to clients in care. The ammunition is stored in a separate safe in the Licensee's locked master bedroom closet, separate from the firearm. There is one above ground hot tub. The hot tub is properly secured with a latched hard cover that is securely locked and has appropriate latches along the perimeter of the cover. The backyard where clients have access to play is fenced. There are three large storage containers located on the property that are inaccessible to clients in care. The home has an enclosed farm in the backyard which is secured and inaccessible to clients. The home has 10 security cameras located on the outside perimeter of the home and 3 security cameras located on the inside of the home (one in the living room, one in the hallway near the garage, one in the hallway near the master bedroom). LPA reviewed three staff files for Staff 1 (S1), Staff 2 (S2), and Staff 3 (S3). LPA observed required documents including CPR/First Aid certificates, Drivers License, Criminal Background Clearance Forms, documentation/verification of tuberculosis (TB) screening, etc. S1, S2, and S3 files did not contain duties of the employee. LPA reviewed one client file for Client 1 (C1). LPA observed required documents including signed placement agreements, Authorization of Medical Care Form signed by the Authorized Representative, etc. Client file for C1 did not contain a signed Personal Rights Form (LIC 613B). **Continued on the next page** Based on observation and record review, the facility is issued two Technical Violations in accordance with California Code of Regulations (CCR) Section 83070(b)(13) for not having a signed acknowledgment of Personal Rights signed by the authorized representative and client on file and CCR Section 80066(a)(8) for not having duties of employees included in staff files (S1, S2, and S3). An exit interview was conducted a copy of this report and appeal rights were reviewed and provided to the Staff/Facility Designee - Elyssa Quinonez.

met_with: Staff - Elyssa Quinonez


summary: Facility Evaluation

raw_content:
Narrative:
On January 16, 2026, Licensing Program Analyst (LPA), Val Wilson met with Licensee, Mayra Goana, at Hope Haven Small Family Home (SFH) for the purpose of conducting a Case Management inspection visit regarding the Plan of Operation (POO). On November 25, 2025, CCL was made aware by the Licensee via phone call that the C1 would be turning 18 in January 2026. LPA Rachel Vanegas provided the Licensee with AB12 regulatory information to assist the Licensee with required Program Statement (PS) revisions. LPA Vanegas informed the Licensee that an updated LIC 200 and Program Statement would need to be completed, submitted and approved to include the Nonminor Dependents population on the facility license. LPA further informed the Licensee that the aforementioned should be submitted at least 30 days prior to the client turning 18 years old. On December 22, 2025, the Licensee notified CCL via email that C1 will be 18 years of age on January 8, 2026, and San Diego County approved extending care in the SFH. The Licensee acknowledged LPA Rachel Vanegas had indicated the PS would need Nonminor dependent additions reviewed for approval prior to Nonminor dependent placement. The Licensee indicated via email that they hoped to have the documents submitted by the end of the week. On January12, 2026, the Licensee submitted the LIC 200 and revised PS to CCL for review and approval to add the Nonminor dependent population to their program. **Continued on page 2** **Continued from page 1** On January 16, 2026, LPA reviewed facility files and observed C1 is residing in the SFH and the Licensee's POO has not been approved for Nonminor dependents. Based on interviews, record review and observation, the Licensee is being cited one Technical violation in accordance with California Code of Regulations (Title 22, Division 6) (CCR) Section 80022 (k) Plan of Operation for not operating in accordance with the terms specified in the facility Plan of Operation. An exit interview was conducted, a copy of this report, LIC 809TV, LIC 809G, LIC 811, and appeal rights were reviewed and provided to the Licensee.

met_with: Mayra Gaona


facility_name: HORIZON OF BRIGHTER DAYS

raw_content:
Narrative:
During the investigation, there was no corroborating evidence to support the above allegations, and the confidential interviews revealed conflicting statements to if the incidents occurred. Based on conflicting confidential interviews, the allegations that LI physically abused C1 and an LI spoke to C1 in an inappropriate manner, may have occurred, however, is not supported or proven by evidence. 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, Demetrius Williams.

Investigation Findings:
13On April 17, 2025, at 10: AM, Licensing Program Analyst (LPA) Sarah Lo met with Horizon of Brighter Days Small Family Home (SFH), Licensee, Maxine Williams, to deliver the finding for the above-stated allegations. On 01/16/25, LPA Adaleyci Caballero inspected the SFH, and no immediate health and safety hazards were observed. The investigation included interviews with Licensee (LI), Adults (AD1, AD2), Foster Children (C1, C2), and County Social Worker (CSW). In addition, Foster Children's Needs and Services Plans and case notes and County Investigation Narrative were reviewed. On January 10, 2025, Community Care Licensing received a complaint alleging that an adult (LI) physically abused minor (C1) and an adult (LI) spoke to minor (C1) in an inappropriate manner. Specifically, it was reported that LI was upset at C1 for eloping from school and LI called C1 names and LI slapped C1 on the face and dragged C1 by their hair. (continued on LIC 9099c) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Sarah Lo 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: HORIZON OF BRIGHTER DAYSFACILITY NUMBER: VISIT DATE: 04/17/2025

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

met_with: Licensee, Demetrius Williams


summary: Facility Evaluation

raw_content:
Narrative:
On March 27, Licensing Program Analyst (LPA) Linda Haynes met with Applicant Demetruis Williams via microsoft teams for a Component II interview. LPA scheduled the pre-licensing inspection with Applicant. A signed copy of this LIC 809 will be placed in the facility file.

met_with: Demetrius Williams


summary: Facility Evaluation

raw_content:
Narrative:
On April 3, 2024 at 9: AM, Licensing Program Analyst (LPA) Linda Haynes completed a pre-licensing inspection of Horizon of Brighter Days Small Family Home. LPA met with Applicant Demetrius Williams who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there are no clients in placement at this time. The home is a one story building with four bedrooms and three bathrooms which are set up as follows: · Bedroom #1 (Master) has one bed will sleep the applicant. · Bedroom #2 (Client's) has one bed, it will sleep one client. · Bedroom #3 (Client's) has one bed, it will sleep one client. · Bedroom #4 (Client's) has one bed, it will sleep one client. · A great room/living room, kitchen, dining area, three bathrooms, an attached two car garage, laundry room, and the backyard. The Client's bedrooms were arranged so that no more than one client will be in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There was a smoke detector in every bedroom. The five smoke detectors were checked, and they were working properly. There is one carbon monoxide detector it is located in the hallway. The carbon monoxide detector was checked and it was working properly. The home's central air conditioning module was located on the back porch. The fire place had a glass door covering it. The home phone was not working as Spectrum was out in the area. The home's hot water heater was located in a closet in the hallway made for hot water heaters. The appliances were in working order. The client's files will be kept inside a locked file cabinet in the play room. There was adequate food storage space and a supply of two days of perishable foods and a week of non-perishable foods. A trash can for storage of solid waste had a tight-fitting lid and was present. The sharp knives are in a locked cabinet in the kitchen. The medications are in a locked cabinet in the kitchen. The hot water in the master bathroom measured to be 113.6 degrees Fahrenheit, in bathroom two the hot water measured to be 116 degrees Fahrenheit, and in bathroom 3 the hot water measured to be 114.8 degrees Fahrenheit. The home's First Aid kit was accessible and is located in the kitchen and contained all required supplies. One fire extinguisher was present in the home and is located in the pantry. It was observed to be properly charged and inspected by the fire department. Licensee stated there were no weapons/firearms in the home. There is no pool or other body of water at the home. The backyard where clients will have access to play was completely fenced. The following corrections needs to be made: · the home phone needs to be working and available. An exit interview was conducted. Application will be forwarded to the Licensing Program Manager for Licensing. A component 3 was conducted at 10: AM.


summary: Facility Evaluation

raw_content:
Narrative:
On May 19, 2025 at 10:55AM, Licensing Program Analyst (LPA) Rachel Vanegas completed a post-licensing/annual inspection at Horizon of Brighter Days Small Family Home. LPA met with the Licensee, Demetrius Williams who led a tour of the home. The facility was toured both inside and out. The home is a one story building with four bedrooms and three bathrooms that are arranged as follows: Bedroom #1 (Master) has one bed and sleeps the Licensee and spouse. Bedroom #2 (Client's) has one bed and sleeps one youth. Bedroom #3 (Client's) has one bed and will sleep one youth. It is currently vacant. Bedroom #4 (Client's) has one bed and will sleep one youth. It is currently vacant. A living room, kitchen, dining area, three bathrooms, an attached locked two car garage, laundry room that remains locked and inaccessible to youth in care where cleaning chemicals are securely stored, and the backyard. All bedrooms have adequate storage space for personal belongings in drawers and closets. All bedrooms are arranged so that no more than one client is in one room and there is one client per bed. No room commonly used for other purposes is used as a bedroom and no bedroom serves as a passageway to another room. There are smoke detectors in every bedroom that were checked and in properly functioning order. There is one carbon monoxide detector located in the hallway. The carbon monoxide detector was checked and was in properly functioning order. There is a fire place in the living room that is properly screened with a glass door covering. The home phone is accessible in the living room to client's in care and in functioning order. **** LPA observed an adequate supply of perishable and non-perishable foods and a posted meal menu in the kitchen. There was a trash can for storage of solid waste with a tight-fitting lid located in the kitchen. LPA observed required postings in the living room hallway including the facility license, foster youth personal rights, Complaint Hotline, etc. There is one fire extinguisher in the home that was observed to be properly charged. It is located in the kitchen pantry. The hot water temperature was checked in the kitchen and registered at 113.5 degrees Fahrenheit. The facility's first aid kit is stored in a kitchen cabinet and contained all of the required materials. The client medications are securely stored in a locked cabinet in the kitchen and refrigerated medication are stored in a lock box in the refrigerator. The facility outside grounds were also inspected and were observed to be clean and well maintained. Emergency exits were free from obstruction. There is no pool or other body of water at the facility. There are no fire arms or weapons on the facility grounds as stated by the Licensee. LPA conducted one client file review for Client 1 (C1) and observed necessary documents in the files including, consent to medical treatment authorization forms, placement agreements, signed personal rights form, documented results of tuberculosis (TB) screening, Needs and Services Plan, etc. LPA conducted two staff file reviews for Staff 1 (S1) and Staff 2 (S2). LPA observed that two out of two staff files contained necessary documents including CPR/First Aid certificates, Drivers License, Job Duties, Health Screening, etc. Based on observation and record review, there are no deficiencies cited at this time. An exit interview was conducted and a copy of this report and appeal rights were reviewed and provided to the Licensee - Demetrius Williams.

met_with: Licensee - Demetrius Williams


summary: Facility Evaluation

raw_content:
Narrative:
On January 16, 2025, at 9:30AM, Licensing Program Analyst (LPA) Adaleyci Caballero met with Horizon of Brighter Days Licensee Demetrius Williams to deliver a case management deficiencies report regarding deficiencies observed during an inspection at the SFH on January 16, 2025, for an incident that occurred on or before 01/10/25. Adult (Adult #1 [A1]) residing and/or regularly present in the home without a criminal background check clearance. LPA searched A1 on Guardian and it revealed A1 had a pending criminal record clearance pending since 06/27/24. A1 disclosed that A1 had lost the background check paperwork and went to re-fingerprint on 01/13/25. Record review revealed A1 did not have a background check which is a violation of Licensing General Licensing Requirements Title Regulations 80019(e)(3) 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 (3) Request a transfer of a criminal record clearance... Based on record review the facility is cited for violation of General Licensing Requirements Title Regulations 80019(e)(3) Criminal Record Clearance which poses an immediate Health, Safety risk to children in care. Civil penalties will be assessed. An exit interview was conducted and a copy of this report, LIC811, LIC809D, and appeal rights were provided to Licensee Demetrius Williams via email.

met_with: Licensee-Demetrius Williams


facility_name: HOUSE OF GRACE

summary: Facility Evaluation

raw_content:
Narrative:
On June 3, 2025 at 3:47PM, Licensing Program Analyst (LPA) Adaleyci Caballero met with Applicant Grace Damisah for a Component II of the application process. Lpa a. Caballero went over revisions on part portion of the application only due to time restraint. LPA will schedule a virtual Teams Meeting to go over the application's Program Statement. A copy of this report was provided to applicant via email. The original signed copy of this report will be placed in the facility file.

met_with: Applicant- Grace Damisah


summary: Facility Evaluation

raw_content:
Narrative:
On June 11, 2025 at 9:00AM, Licensing Program Analyst (LPA) Adaleyci Caballero met with Applicant Grace Damisah for a Component II of the application process. via Microsoft Teams Meeting. Lpa a. Caballero went over revisions of the Program Statement however; due to applicant not having the correct pages of her Program Statement LPA was unable to proceed. LPA will schedule a virtual Teams Meeting to go over the application's Program Statement another day. LPA will send scan a copy of the Program Statement submitted in the application to assist applicant. A copy of this report was provided to applicant via email. The original signed copy of this report will be placed in the facility file.


summary: Facility Evaluation

raw_content:
Narrative:
On August 27, 2025, Licensing Program Analyst (LPA) Adaleyci Caballero arrived at the Small Family Home (SFH) to conduct a pre-licensing inspection as scheduled with the applicant. Applicant Grace Damisah cancelled the inspection and LPA did not conduct a pre-licensing inspection of the home. No further action required at this time. A copy of this report was provided to applicant Damisah Grace and the original signed copy will be placed in the facility file.

met_with: Applicant-Damisah Grace


summary: Facility Evaluation

raw_content:
Narrative:
On September 10, 2025 at 1:15PM, Licensing Program Analyst (LPA) Adaleyci Caballero completed a pre-licensing inspection of House of Grace Small Family Home (SFH). LPA met with Applicant Grace Damisah 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 one single bed. The bed had linen, comforters, and pillows. It will be utilized for guests. Bedroom #2- (applicant) It consisted of one California King Bed. The bed had linen, comforters, and pillows. It will sleep applicant and husband. 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 one single bed. The bed had linen, comforters, and pillows. It will sleep one client. Bedroom #5- It consisted of two single beds. The beds had linen, comforters, and pillows. It sleeps biological daughter. A living room, family room, dining area, kitchen, loft, laundry room and office space, three car garage, backyard, and a pool. The garage will be utilized as storage. The Facility Sketch, Emergency Disaster Plan, Personal Rights, Visitation policies, and House Rules were posted at this time. 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 eight smoke detectors combined with the carbon monoxide detectors were checked and working properly. The home's central air conditioning modules were in the backyard. The water heater is located in the garage. The appliances were in working order. Client and staff files will be locked inside a cabinet in the kitchen. There was adequate food storage space and a supply of perishable food and non-perishable food. The home had a trash can for storage of solid waste with a tight-fitting lid. Sharp knives were locked in a drawer in the kitchen. Chemicals and cleaning supplies were locked in a cabinet inside the laundry room and in a cabinet below the kitchen sink. Medications will be locked in a container inside a cabinet in the kitchen area. The hot water was at a temperature of 114.8 degrees Fahrenheit. The First Aid Kit was accessible and placed in a kitchen drawer. There was one fire extinguisher present in the home located in the kitchen area. It was observed to be properly charged and inspected by the fire department. There are no firearms in the home. The home has a pool that is appropriately fenced. The pool fence was measured at five feet and three inches that surrounds the pool completely. The gate is self-latching and opens outwards. The backyard is fully fenced and free of debris. There are no cameras in the home. There are no corrections to be made. Component III was conducted. An exit interview was conducted, and a copy of this report was provided to applicant Grace Damisah via email. Application will be forwarded to Licensing Program Manager Abdoulaye Traore for licensure.

met_with: Applicant-Grace Damisah