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Narrative:
The first allegation is whether "Direction Following" and timeouts outside during days of extreme heat were inappropriate forms of discipline. Online research concluded there were 12 days in August and 9 days in September 2022 that temperatures exceeded 100 degrees, of which 10 were consecutive days. However, resources did not conclude on a specific duration that was unhealthy to be outside but identified other risk factors to consider like water intake, type of clothing, and specific time of day. The facility's program statement regarding their "Positive Discipline Policies" does not include specifics on direction following and timeouts. In addition, the agency does not have an extreme weather policy that addresses how their program will adjust client discipline or other outdoor activities. All client interviews reported generally being outside up to 20 minutes for disciplinary type reasons. However, due to the other risk factors are unknown like water intake, type of clothing, and specific time of day, it is not possible to determine if the regular discipline practices were inappropriate during this specific time. The next allegation is whether staff is rude or yells at clients. All staff and client interviews lacked any specific details or situations that could be compared or corroborated. Interviews were consistent that some clients and staff talk loudly in the facility, but less clear if the yelling is directed at clients. Some interviews said there were no incidents of disrespectful or rude behavior or language by staff. However, since inadequate details were available, it is not possible to confirm whether the allegation occurred or not. Based on the investigation, records reviewed and interviews conducted, the complaint finding is UNSUBSTANTIATED at this time meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted. A copy of all reports and appeal rights were provided to the facility via email. The allegation is whether the facility meets the staff to client ratio of 1:3 during morning and evening shifts. Client interviews included a variety of details when only one staff was present: during "1:1" (specific supervision of unsafe clients), and when a staff leaves to follow a client who has left the facility without permission. The interviews did not clearly indicate a violation of staffing ratio since additional details were unknown, like when additional staff arrive. However, four of eight staff interviews confirm the staffing ratio was not 1:3, during various escalations and additional staff either was not scheduled or available. Some staff believed the approved ratio was 1:4. Escalation that result in restraints can also result in staffing ratio not being met. Based on the investigation, records reviewed and interviews conducted, this allegation is SUBSTANTIATED at this time meaning that the allegation is valid because the preponderance of the evidence standard has been met. The facility is cited on the attached LIC 9099D for the violations of Interim Licensing Standard, Article 6, 87065.5 (a)(1) which are an immediate risk to the health and safety or personal rights of minors in care. Exit interview was conducted. A copy of all reports and appeal rights were provided to the facility via email.

Investigation Findings:
13Licensing Program Analyst (LPA) Cindy Johnson arrived at the facility to conduct an unannounced complaint investigation inspection on 10/25/2022 at 2: PM. LPA Johnson spoke with Misty Jackson, Administrator and Tara Silafau, Program Director to discuss the findings of the complaint investigation and allegations stated above. LPA Johnson informed Ms. Jackson this case was investigated by LPA Johnson. The investigation included: an initial 10-day unannounced complaint investigation inspection was conducted at the facility on 9/13/2022, subsequent unannounced complaint investigation inspections were conducted on 9/15/2022 and 9/16/2022. Facility documents obtained include client rosters, facility menus and " Client Phone Policy and Procedures". Facility documentation obtained were youth Needs & Service Plans. Online research of extreme heat resources including the Department's Provider Information Notice (PIN) 21-07-CCLD, which included California Department of Public Health links and resources were reviewed. Interviews were conducted with eight facility staff and six youth, from 9/13/2022- 9/22/2022. (See LIC 811, dated on 10/25/2022). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Cindy Johnson 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 23-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, NATOMAS PARK DR., STE FACILITY NAME: MOUNTAIN VALLEY CHILD AND FAMILY-GERBERFACILITY NUMBER: VISIT DATE: 10/25/2022

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


state: CA

facility_name: MOUNTAIN VALLEY CHILD AND FAMILY-GERBER

summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
LPA found that sometimes, "Animal Direction Following," is employed, which consists of various relatively quick tasks the clients have to do to tend to the animals to make up for time out of program, specific to the animals. Based on interviews with all staff and clients, LPA learned this is not done for an excessive amount of time. Additionally, staff will take off more time the clients have to work off, than the client actually worked off doing the extra chore. Direction Following in general is when a client is out of program, they accrue time they then have to work off by doing another chore. Based on interviews with all staff and clients, LPA learned that during, "barn chores," staff help the clients clean the animal stalls and tend to the animals. These tasks take about 45 minutes to an hour, and the duty is rotated between the two Mountain Valley houses. Some clients felt that barn chores was a punishment because they did not like doing the tasks. Based on information gathered from all interviews, the barn chores and Animal Direction Following are not inappropriate discipline, and are not unreasonable. LPA found during interviews with the clients, staff, and Clinicians that an SLL is utilized when a client harms themselves or are generally being unsafe. When asked what consequences/punishments are given to clients, one Facility Manager (FM) first stated, "a safety level lower--anything that's self-harming, cutting, dangerous behaviors, that's a red. So, that just means like if we go on outings, they're not safe enough to go on outings for that week." LPA asked that FM why clients are punished for being unsafe and the FM stated that it is not a punishment, but restrictions put on the client because they are not being safe to go on an outing. FM stated that some clients do take it as a punishment. During LPA's interview with one Clinician, when asked what consequences are given, the Clinician also mentioned the SLL, and one of the reasons given for how a client can get that is by self-harming. LPA found that the way an SLL is framed, it can be perceived as a punishment for being unsafe. During interviews, three clients felt that a SLL for self-harm behavior was a punishment/consequence. Due to this ambiguity, LPA has found the allegation that staff inappropriately disciplined children in care to be unsubstantiated. While the SLL itself is not inappropriate, nor is it disciplinary, it has been perceived as such by the clients. LPA is issuing an advisory note to the facility to modify this framework and language used surrounding SLLs. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted with Administrator and a copy of this report along with appeal rights was left with her. One client stated S2 makes them scared when S2 gets upset, another client stated S2 makes the clients scared when S2 yells at them, and three other clients stated that S2 yells or screams at them. One client stated S2 makes them feel stupid. The Administrator confirmed that S2's frustrations have come to her attention from the clients and Administrator will be meeting with S2 to discuss this. Based on confidential interviews with one staff and 4 clients, LPA also found that staff S1 has made comments to at least two clients which were not appropriate, nor dignified. LPA found that S1 has made comments to at least one client such as, "you're a spoiled brat," / "you're a selfish and entitled brat," calling them a, "devil child," telling them, "you shouldn't have woken up today," and, "you should have never come back from your home visit." Three clients confirmed S1 has said these phrases, among others, to one client in particular. At first when LPA asked S1 about calling a client a, "devil child," S1 denied it. When informed that multiple people have confirmed S1 said this, S1 admitted to it, however stated it was in a playful way. Afterwards, S1 did admit to thinking S1 probably said, "you shouldn't have woken up today," in the context of the client's behavior being poor, so they may as well have not woken up yet. Two clients stated that S1 would make jokes about at least two clients, but they would be hurtful. Two clients claimed that they think S1 was just being playful, or that it was hard to tell. Based on this information, even if what S1 said was in a playful manner, this was not received as such, and is not trauma-informed. All staff, Administrator, and Clinicians denied ever witnessing or having knowledge of S1 shaking a client, throwing objects at a client, yanking the blankets and headphones off of a client, and dragging any client out of bed. S1 denied doing any of these acts as well, but did state that S1 would shake the client's bed to wake the client up, which would be unsuccessful. When asked if she has ever lashed out physically to a client, S1 did admit that she may have held onto a client tighter. Two clients stated that they witnessed S1 yanking the covers off of a client, and throwing pillows at the client. One client stated they witnessed S1 dragging a client out of bed by their feet. That client stated they believed S1 throwing the pillows was in a playful way, but was unsure, and that they did not know if S1 was being playful when dragging the client out of bed, but S1 was laughing when she did it. Of the 10 clients LPA interviewed, LPA interviewed five former clients from the Mountain Valley Bar Du facility for a matter unrelated to this complaint. During those interviews however, statements were made regarding S1 which support the allegations of this complaint being true. Four clients stated S1 made hurtful and inappropriate comments to them and others, one client stated S1 grabbed another client's wrist hard, one client stated S1 dragged clients to their room by holding them under their arms, one client stated S1 called a client an, "evil child," and two clients stated S1 yelled at them and other clients. Additionally, On 12/23/ LPA Burgess concluded a case management investigation regarding an accusation that staff were mentally abusing clients at Mountain Valley's Bar Du facility. S1 is a Bar Du staff, however, has worked at both facilities and interacts with clients from both facilities. LPA found during that Case Management in 2020 that S1 had spoken to clients in a way that made them feel mentally abused. LPA issued a citation at the time: 87072(d)(11). Regarding the allegations that staff spoke inappropriately to minor in care, and staff handled minor in a rough manner: both current and past statements from Bar Du clients support the statements from clients in this investigation regarding the way S1 has spoken to them, and physically handled them. Based on LPA's conducted interviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Short Term Residential Therapeutic Program Interim Licensing Standards, Version 4, Section 87072(c)(10) is being cited on the attached LIC 9099D. An exit interview was conducted with Administrator and a copy of this report along with appeal rights were left with her.

Investigation Findings:
13Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced complaint investigation inspection at the facility and met with Administrator who assisted LPA with the inspection. LPA investigated this complaint by conducting confidential interviews with 10 clients, two Facility Managers, two Clinicians, five staff, and the Administrator on 6/20/2023, 6/22/2023, 6/26/2023, 6/27/2023, 6/29/2023, 7/3/2023, 7/28/2023, 8/2/2023, and 8/3/2023. The main client related to this complaint declined to be interviewed, and one client was unable to be located due to age. Based on confidential interviews with five clients, one staff, and the Administrator, it was revealed that one staff (S2 - See Confidential Names List dated 8/11/2023) has yelled at clients, and on at least two different instances demontrated behavior that is not trauma-informed. The staff admitted to two separate incidents of this. One incident is S2 becoming frustrated at a client and slamming a laptop closed and throwing it away from S2, and the other is telling a client that their pain from a surgery was their fault. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Alyssa M Burgess 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE This is an official report of an unannounced visit/investigation of a complaint received in our office on 03/20/2023 and conducted by Evaluator Alyssa M Burgess PUBLICCOMPLAINT CONTROL NUMBER: 23-CR- FACILITY NAME:MOUNTAIN VALLEY CHILD AND FAMILY-GERBERFACILITY NUMBER: ADMINISTRATOR:TARA SILAFAUFACILITY TYPE: ADDRESS: SWEET ACACIA WAYTELEPHONE: (916) 896- CITY:SACRAMENTOSTATE: CAZIP CODE: CAPACITY:6CENSUS: 5DATE: 08/11/ UNANNOUNCEDTIME BEGAN: 02: PM MET WITH:Misty JacksonTIME COMPLETED:02: PM 9Staff inappropriately disciplined children in care. INVESTIGATION FINDINGS: 13Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced complaint investigation inspection at the facility and met with Administrator Misty Jackson who assisted LPA with the inspection. LPA investigated this complaint by conducting confidential interviews with five clients, two Facility Managers, two Clinicians, five staff, and the Administrator on 6/22/2023, 6/26/2023, 6/27/2023, 6/29/2023, 7/3/2023, 8/2/2023, and 8/3/2023. The main client related to this complaint declined to be interivewed, and one client was unable to be located due to age. Based on confidential interviews with staff, the Administrator, and the five clients, LPA learned that consequences clients receive are: resets, Safety Level Lowers (SSL), yellow flags, and "Direction Following." There are also several chores at the facility, including caring for the farm animals. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Alyssa M Burgess 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: 6 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: MOUNTAIN VALLEY CHILD AND FAMILY-GERBERFACILITY NUMBER: VISIT DATE: 08/11/2023

report_type: Complaint Investigation

visit_type: Case Management

met_with: Misty Jackson

complaint_status: unsubstantiated


raw_content:
Narrative:
The incident of this complaint was said to have potentially occurred during class time when the two Mountain Valley facilities combined clients for school for a period of time, where C1 touched another client's thigh and near their private parts. LPA learned that this class arrangement was due to the Teacher at the Gerber facility being out on leave from October 2023, and returning in the beginning of January 2024. During that time, the Bar Du teacher covered classes for about a month until another staff obtained their Teaching credentials and took over. During interviews with the staff and two teachers, one teacher stated C1 will, "push the limit," of the boundaries with other clients. One teacher informed LPA that when they observed C1 tickle another client's upper back, they immediately stopped it from happening and had C1 removed from the setting. The staff and two teachers all stated the clients from both houses were rarely at the same house at the same time. If the Bar Du house was in one room for class, the Gerber house was in another room. The staff stated that occasionally they would have joint times where they might watch a movie together. Both teachers and the staff have knowledge of C1's propensity to touch other clients. The staff did not have any knowledge of C1 inappropriately touching the other client, and neither teacher remembered a time they were together. One client who was affected during the previous incidents in 2023 informed LPA that since that time, C1 has not been touching other clients inappropriately. The client informed LPA that staff do intervene and tell any client pushing boundaries to stop, however the clients do not listen. Additionally, C1, "usually does it when staff aren't looking." Staff follow clients around, and clients have to ask staff before going anywhere, including the hall and to their room, to maintain supervision. C1 denied having any connection with the other client they were alleged to have touched inappropriately for this complaint, that they rarely saw them, and staff would separate them, and be more watchful of C1; staff would have more staff present and make sure no one gets too close. C1 denied inappropriately touching the other client and informed LPA that since the previous incidents that were investigated in 2023, C1 has not been touching any clients. C1 informed LPA when other clients go into each others' rooms, staff tells them to get out of their room, and staff watch in the hallway. C1 stated that when dating, there is no touching, no boundary crossing, and staff are, "extra watchful." C1 stated if they are sitting too close, they have to move apart, and they cannot be alone with each other. Also, staff listen to the conversations they have with each other. C1 is romantic-relationship-focused and regularly seeks out clients to form relationships with. During an interview with a client who has been recently romantically involved with C1, the client informed LPA that staff were aware of their relationship and enforced heightened rules of keeping boundaries, no sitting close, no note passing, no reading each others' things, no sitting on the same couch, and no whispering to each other. LPA was informed of one incident in which C1 touched their leg and they later informed the Clinician, who addressed it with C1. Additionally, C1 tickled their upper back one time, which the Teacher immediately addressed. The client stated staff watched them, "24/7." The client had no knowledge of C1 touching the other client inappropriately. Despite multiple attempts, LPA was unable to interview the client who was alleged to have been touched inappropriately. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted with Facility Manager and a copy of this report, confidential names list, and appeal rights were provided to FM and Administrator Misty Jackson.

Investigation Findings:
13Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced complaint investigation inspection at the facility and met with staff Marsean Simmons and Facility Manager Sydeny Barber, who assisted with the inspection. LPA investigated this complaint by conducting confidential interviews with three children, two teachers, one staff, and the Facility Manager on 1/18/2024, 4/19/2024, 5/15/2024, and 5/20/2024. Relevant background: Some content of this complaint is related to incidents which were previously investigated in 2023. During those investiagtions, LPA learned that staff, Clinicians, and Administrators are aware of the client's inappropriate tendencies with other clients. In summary, there were incidents in which the client did touch clients inappropriately and the facility responded by enacting and enforcing stricter rules with clients about closeness and contact, no note passing, heightened supervision, and switched clients between facilities to maintain safety. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Alyssa M Burgess 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: MOUNTAIN VALLEY CHILD AND FAMILY-GERBERFACILITY NUMBER: VISIT DATE: 05/31/2024

met_with: Marsean Simmons & Sydney Barber


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Narrative:
The Administrator informed LPA that staff do not physically assist when clients self-harm unless it is severe. All staff denied that medical treatment was not provided when needed. All staff informed LPA that staff use verbal interventions when clients are self-harming. Three clients do not remember any time staff did not assist a client when they self-harmed, two clients stated when they self-harmed staff were there using verbal interventions, two clients stated staff clean the self-harm injuries and bandage them; staff do not ignore self-harm. One client stated staff did not take them to get treated for a hurt ankle, however this client struggled with having consistent memories during the interview. Pertaining to the allegations that staff speak inappropriately to clients and staff yell at clients, interviews with four clients informed LPA that staff did not bully a client or say anything mean, rude, or disrespectful to them. One client stated staff used to be harsh, but not anymore. Three clients stated staff will raise their voice, but do not yell. One client described S1 as being strict, but they are just enforcing rules and looking out for the clients. One client stated S1 will act mad, but not with the clients. Three clients stated staff can be stern or assertive, including S1. During interviews with staff and the Administrator, LPA was informed that S1 is a staff that holds clients accountable to the rules, and they do not like that. The Administrator and three staff informed LPA that S1 can be stern when giving directions, and three stated this can come off as rude or mean to the clients. Three staff informed LPA that clients do not like S1 because S1 upholds the rules. One staff informed LPA that themself and S1 have been frustrated at the clients before, but when staff are frustrated, they are just less playful and more assertive. Five staff deny that any staff has bullied any client. Two staff stated staff raise their voice to get clients' attention but do not yell, and all staff deny that staff yell at clients. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted with FM and Administrator, and a copy of this report, confidential names list, and appeal rights were provided to FM.

Investigation Findings:
13Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced complaint investigation inspection at the facility and met with Facility Manager (FM) De'jana Crockett, and Administrator Misty Jackson via phone who assisted with the inspection. LPA investigated this complaint by conducting confidential interviews with the Reporting Party, seven clients, two Facility Managers, the Administrator, and four staff between 4/19/2024 and 10/8/2024. LPA also reviewed client records, and incident reports. The complaint alleges that S1 and S2 (See Confidential Names List dated 10/18/2024) spoke inappropriately to a client/bullied them, when one client self-harmed on one occassion they did not get medical treatment and staff did not address it, and that staff yell at clients. During LPA's interview with the client alleged to have been bullied by S1 and S2, they denied that it happened. During LPA's interview with the client alleged to have self-harmed and not recieved medical treatment/staff intervention, they denied remembering this occurring, stating instead that the staff always helped them when they self-harmed. The Reporting Party's (RP) credibility is questionable due to specific clients stating what the RP said happened to them by staff is not true. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Alyssa M Burgess 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: MOUNTAIN VALLEY CHILD AND FAMILY-GERBERFACILITY NUMBER: VISIT DATE: 10/18/2024

met_with: De'Jana Crockett and Misty Jackson


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
That staff also informed IB that they observed a bag in the staff office that one of the clients informed them was left there for them by S1; the bag contained a "wood"/"leaf" paper which is used to roll a, "joint," or, "blunt." When S1 was interviewed by Mountain Valley about the allegations, S1 denied them. During that interview, S1 had a lack of concern for the allegations and was rude and unprofessional, so Mountain Valley terminated S1. IB made 10 separate attempts at communication with S1, all with no response. To this date S1 has not made contact with the Department. During the investigation, one client stated that S1 also showed them a gun S1 kept in their car. IB followed up on this claim by conducting follow-up interviews and there was not substantial evidence to prove whether this did or did not occur. The claim is therefore unsubstantiated. Based on IB's records review and conducted interviews, the preponderance of the evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Short Term Residential Therapeutic Program Interim Licensing Standards, Version 5, Section 87072(c)(1) is being cited on the attached LIC 9099D. An exit interview was conducted with FM and Administrator and a copy of this report, confidential names list, and appeal rights were provided to FM.

Investigation Findings:
13Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced complaint investigation inspection at the facility and met with Facility Manager (FM) De'jana Crockett, and Administrator Misty Jackson via phone, who assisted with the inspection. The Department's Investigations Branch Investigator (IB) Juan Barajas investigated this complaint by reviewing facility incident reports and the facility's internal investigation report, and by conducting interviews with three clients, three staff, and the Administrator between 4/25/2025 and 8/28/2024. IB made 10 attempts at contact with the staff (S1) related to these allegations between 7/16/2024 and 8/14/2024 with no response from the staff. IB was informed during interviews with two clients that over the course of approximately three months, S1 provided them with marijuana and nicotine to smoke while in care. S1 and the two clients would smoke in the barn area and no other clients were involved. One staff informed IB that they overheard the two clients discussing getting "high" in care during a weekend. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Alyssa M Burgess 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: MOUNTAIN VALLEY CHILD AND FAMILY-GERBERFACILITY NUMBER: VISIT DATE: 10/18/2024

met_with: De'Jana Crockett

complaint_status: SUBSTANTIATED


summary: Facility Evaluation

raw_content:
Narrative:
On 05/27/22, at 9: AM,, Licensing Program Analyst (LPA), Connie Goldie, met with Mental Health Worker (MHW) Anthony Tran to conduct an unannounced Annual/ Required inspection of a single story, four bedroom, 2 bath home. At 10: AM, MHW Tran greeted LPA Goldie and shared that Program Manager (PM) Misty Jackson was shopping.MHW stated that the census was 6 clients. PM arrived at 10: AM and stated that the current census was six clients. An Entrance Checklist was provided to the PM Licensing Program Analyst (LPA) Connie Goldie conducted a tour with Misty of a 4 bedroom, two bath house that began at 10: AM outside.. LPA Goldie observed outdoor area free of debris and window screens in good repair. In the entry way LPA Goldie observed Foster Youth Rights were posted along with youth in care schedules. LPA Goldie advised PM to obtain updated Foster Youth Rights posters. We proceeded to the office area, where LPA Goldie observed the license, the emergency intervention plan, and locked and appropriately stored medication. LPA observed two shared bedrooms with clean linen, a closet and cubbies for personal belongings. Bedroom two had a non-functioning smoke detector and no batteries on had to replace. LPA Goldie stated this is an immediate safety risk and PM agreed. The tour continued to the kitchen where PM opened all cabinets, perishable food for two days and non-perishable food for five days, adequate table ware and clean sink and stove were observed. Cleaning supplies were inaccessible and compliant. The living room/ dining area were spacious and allowed seating for clients and visitors and clear pathways were observed. Fire extinguisher pin in place, besides bedroom 2 smoke detectors were tested and compliant. The home temperature was a comfortable 73 degrees. Bedrooms 3 and 4 had single beds with clean linens, dresser storage, and closet space. Water temperature tested at only 90 degrees in bathroom which is outside of compliant range. PM does not have access to water heater to check setting. Two bathrooms were observed to have soap and paper towels. Clients hygiene and extra linens available. LPA Goldie observed classroom with adequate space for students. The three vehicles all contained first aid kits and were clean. The physical plant inspection concluded at 11: AM. Continued on LIC809C Title 22 violation deficiencies are being issued today. LPA Goldie and PM Jackson reviewed MAR records , prescription bottles and first aid kit. Additionally, LPA Goldie interviewed three staff and five clients. LPA Goldie conducted an exit interview with Lead Mental Health Worker Jimmy Fargo. LPA Goldie left a copy of the reports along with the appeal rights with the facility.

report_type: Facility Evaluation

visit_type: Annual

met_with: Program Manager Misty Jackson


facility_name: MOUNTAIN VALLEY CHILD AND FAMILY -BRADSHAW

summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cindy Johnson made an unannounced annual inspection on 5/18/2022 at 10: AM to Mountain Valley's Administrative Office and made arrangements to meet Misty Jackson, Facility Administrator at the location to conduct the inspection. The following items were reviewed for compliance in the regional office prior to the facility inspection or provided during the inspection: · Annual fees are current and due by 6/24/2022. · Accreditation with COA- expired 12/31/2021; site visit occurred on 5/2/2022, waiting for updated certificate. · Mental Health Program Approval- expired on 5/16/2022; site visit/review was conducted on 4/18-4/20 2022, waiting for updated certificate. · Personnel Roster/ LIC 500, Facility Sketch, and Fire Clearance are current · Forms that need to be updated/ provided are: LIC 308 with the term ending date; 309 for Misty Jackson, Board Meeting Minutes for the past 2 meetings; clarification regarding Control of Property- Lease agreement expired 6/30/2018 · Forms that will need to be updated prior to re-opening the facility are: LIC 610C LPA Johnson conducted a walk-through of the facility inside and out with Ms Jackson. This facility does not currently have any clients and no staff are assigned to this facility. The following was inspected and/or reviewed: I. Physical Plant License was not posted; Personal Rights was posted. Facility telephone is working. All combined carbon monoxide and smoke detectors work. Fire Extinguishers were inspected on 2/2/2022. First Aid Kit was present. No Medications were present, but the designated area is locked and inaccessible to clients. Office is locked and provides privacy. Laundry Facilities are available and operable. Disinfectants/Cleaning solutions are inaccessible and stored in the staff bathroom. Wood Burning stove is not operational. Common Room available has enough seating, furniture in good condition, not broke or damaged. The facility has well water and a septic tank, an updated bacteriological report is requested. The exterior south side of the home has missing stucco (approx. 10 feet x 10 feet). Facility has bird and cow feces on the premises due to being non-operational. Exterior storage areas on the property are kept locked and were inspected. In addition, Exterior storage areas on the property are also locked but were inaccessible for inspection. Facility has one designated vehicle, but it is not on-site, due to being non-operational. Kitchen Refrigerator Temperature was slightly below 45 degrees F. Freezer Temperature appeared to be -5 degrees. Nonperishable & perishable foods were not present, due to being non-operational. Hot water did not exceed 120 degrees. Menu are not posted, due to being non-operational. Dining area has enough seating and furniture in good condition. Bathroom- 3 bathrooms (2 for clients and 1 for staff) Hot water did not exceed 120 degrees. Toilets, sink, bath and shower fixtures in good repair; Tub faucet had a visible leak. Bedrooms # 3 bedrooms (double occupancy) All bedrooms had the required furniture. However, the required bedding was not present, due to being non-operational. II. Operations Complaint Procedures for youth were reviewed; Copy of Board Meeting minutes were requested. III. Disaster Preparedness Drills have not been conducted, due to the facility is non-operational. IV. Emergency Intervention Manual restraint log & Staff training was not reviewed due to being non-operational V. Staffing/Volunteers No staff are assigned to/working at this facility, due to being non-operational. No files were reviewed. VI. Client Records No clients are currently placed at this facility, due to being non-operational. VII. Core/Therapeutic Services Trauma Informed Practices were reviewed. Viii. Special Health Care Needs (SHCN) No special health care clients are currently placed at this facility, due to being non-operational. An exit interview was conducted with Tara Silafau and a copy of all reports were emailed to facility management.

Deficiencies:
95833: Mountain Valley Child and Family -Bradshawfacility Number: 347000093 Visit Date: 05/18/2022 Narrative 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32i. Physical Plant
License was not posted; Personal Rights was posted. Facility telephone is working.
All combined carbon monoxide and smoke detectors work. Fire Extinguishers were inspected on 2/2/2022. First Aid Kit was present. No Medications were present, but the designated area is locked and inaccessible to clients. Office is locked and provides privacy. Laundry Facilities are available and operable. Disinfectants/Cleaning solutions are inaccessible and stored in the staff bathroom.
Wood Burning stove is not operational.  Common Room available has enough seating, furniture in good condition, not broke or damaged.

met_with: Misty Jackson & Tara Silafau - Facility Administrators

title: Facility Name


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced annual inspection at the facility and met with Administrator Misty Jackson and Maintenance Staff/Supervisor Toby Briglia, who assisted with the inspection. The facility has not had any clients or staff in about four years. The facility has been empty and in-operational since then. LPA observed a kitchen, a dining room area, a living room, three bathrooms, classroom/office, staff office/laundry area, three client bedrooms, linen closets, and the outside areas which included the pool, the two storage structures, and the grounds. The facility does have a current Accreditation and Mental Health Approval, as well as a fire clearance. The license was present in the facility, but not posted. Clients personal rights were posted as required. The fire extinguisher was up to date. The rooms had all required equipment and furniture. There was bedding and other linens kept in bags in the closets. The mattresses were clean and in good repair. There was dust on surfaces throughout the house, along with some minute mouse droppings in several locations. There was some small dead gnats on the window sills. The electricity is operational and the sinks delivered hot water. The pool is surrounded by a fence which meets requirements, and has a lock to secure it. The outdoor activity space was in generally safe condition, however the wooden decking on the balcony had some planks which were sticking up and nails not fully nailed in. There was a swing-set which was anchored to the ground, however there was no protective material underneath it. The facility's board is meeting as required, and minutes were made available during the annual inspection at the Bar Du facility on 10/29/2024 & 10/30/2024. The facility has a program statement, and understands that all client and staff records need to be maintained as required if and when children are placed. LPA is issuing advisory notes, which are not citations. An exit interview was conducted with Administrator and a copy of this report and appeal rights were provided to her, via email at her request.


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Narrative:
The complaint alleges that facility failed to report an incident to the appropriate parties. On 10/21/21, C1 was involved in a restraint that resulted in an injury which required a trip to the emergency room. LPA obtained emails that show the placing agency was not notified of the incident from the agency until 10/25/21. Documentation shows the district contacted the agency and requested the report. Based on the documentation and interviews, the agency did not report the incident to the appropriate parties according to regulation. The complaint alleges the client's mental health needs are not being met. Consistent statements in interviews indicate there was an incident where S2 allowed C1 to use her Amazon account. The incident resulted in S2 owing C1 the unused funds on the account and taking multiple weeks to return the money. This resulted in C1 being upset with his therapist. Statements in interviews and documentation show that C1 did not participate in therapy sessions and often refused. IEP team meeting notes show that C1's lack of participation in therapy could have been a result from the incident involving the Amazon account. IEP notes show that on 09/28/21 the incident was discussed, and a new therapist was requested by C1 and legal guardian which was denied. On 10/20/21 documentation shows C1 was still requesting a new therapist and sessions were not improving. During the meeting on 10/20/21 placing county requested a new therapist. Agency stated that they do not have any other therapist available. Placing agency requested services be contracted out which agency did not provide. C1 was discharged from the program on 11/19/21. Based on documentation and corroborated statements in interviews, the agency did not ensure mental health supports as appropriate to the needs of the child. Based on the information provided during interviews and gathered from documentation, it is determined the preponderance of evidence had been met therefore the allegations have been substantiated. On this date the facility is being cited for violations of the California Code of Regulation, Title 22, Division 6, Sections 87095. Documentation and Reporting Requirements and 87089.1(d) Mental Health. Exit interview conducted and appeal rights provided. Complaint alleges that a restraint resulted in further injury. C1 had a prior injury that occurred while skateboarding. C1 stated he fractured his wrist while skateboarding. On 09/30/ C1 was taken to the emergency room due to wrist pain following a restraint. A case management was conducted on 10/08/21 to follow up on the incident. Agency sent LPA an email which stated the team was reviewing alternatives to restraints but had concerns over safety. On 10/21/ C1 was again taken to the emergency room due to shoulder pain following a restraint. During the restraint, C1 threw his head back causing staff to sustain a bloody and swollen nose. Consistent statements in interviews show that C1 was a difficult child to restrain and seem to escalate during the process. C1 was discharged from the agency due to agency no longer being able to meet his needs and safely restrain him. Due to the prior injury and the behavior of C1, the allegation that a restraint resulted in further injury is unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted and appeal rights given.

Investigation Findings:
13Licensing Program Analyst (LPA) Danielle Walker-Flores conducted a complaint investigation inspection met with Rene van der Meer - Administrator to discuss the findings of the complaint investigation. LPA Danielle Walker-Flores conducted the complaint investigation. On 10/29/ LPA interviewed client (C1, see confidential names titled 03/11/22) and staff, conducted a file review and obtained documentation at the facility. The following documents were collected and reviewed during the investigation; foster child's intake information, Needs and Service plans, medical reports regarding injury, incident reports, and discharge report. LPA interviewed reporting party on 10/29/21. LPA obtained documentation from witness on 10/29/22. LPA interviewed mental health therapist staff (S2) on 02/11/22. (continued on 9099-C) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Daniel Allmon LICENSING EVALUATOR NAME: Danielle Walker 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 23-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, FACILITY NAME: MOUNTAIN VALLEY CHILD & FAMILY LIMA/SHADYFACILITY NUMBER: VISIT DATE: 03/14/2022

met_with: Rene van der Meer - Administrator


facility_name: MOUNTAIN VALLEY CHILD & FAMILY LIMA/SHADY

summary: Facility Evaluation

raw_content:
Narrative:
An annual required inspection was conducted by Licensing Program Analyst (LPA) Danielle Walker-Flores on 6/25/2021. Lima and Shady are separate homes located on the same property; both homes had five clients during the time of inspection. The facility was inspected jointly with Gwena McCarthy, previous Administrator and current Human Resource Representative. Copy of the license, personal rights, menu, daily schedule and emergency exit plan are prominently posted in both homes. First Aid box contained sufficient supplies and is located in the staff office in each house. LPA observed cleaning supplies and disinfectants to be locked during inspection. Medications are stored in the medical office and distributed by the nurse; the office is not accessible to clients. The passageways from the front to the back of the homes are unobstructed. Smoke detectors were tested and are in working order. LPA observed carbon monoxide monitors. Fire extinguishers are located in several locations within the facility, and are up-to-date. LPA observed both homes to be clean, safe, sanitary and in good repair. LPA Walker-Flores reviewed staff files and all which were reviewed were complete and up to date. Criminal record clearances were reviewed, and the facility is in compliance. Staff files reviewed have required training hours, education, and fingerprint clearances. Staff files contained Child Abuse, DOJ and FBI clearances. Child files were also reviewed. Medical consent forms were signed by authorized representative and current. Additionally, each child's file had a record of vaccinations and contained Identification and Emergency Information. Children's Needs and Services plans were reviewed. Foster Child (FC)5 and FC6 files did not contain Needs and Services plans and could not be produced or located during inspection. Administrator sent the Needs and Services plans to LPA via email after the LPA left the facility, however, these service plans did not contain required signatures. continued on 809C Facility cited per Interim Licensing Standards (ILS) 87070(c)(1) The following additional information shall be maintained in the child's record: a copy of the child's original needs and services plan; verification, signed by the child and his/her authorized representative(s), that they were offered the opportunity to participate in plan development and verification that the authorized representative(s) have approved the plan. Exit interview conducted and discussed with Rene Van Der Meer, Administrator. Due to technical difficulties, a copy of this report was emailed to Administrator.

met_with: Rene Van Der Meer - Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Danielle Walker-Flores arrived at the facility on today's date for a case management inspection. On 06/30/21 foster child (FC1, see confidential names list titled 07/16/21), was administered the wrong psychotropic medication. Staff administered FC2's medication to FC1. S1 was not following agency protocol when administering the medications and thought FC1 was actually FC2. FC1's guardian was contacted and facility was told FC1 has taken the medication in the past. Psychiatrist was also notified and instructed staff to monitor FC1. FC1 was monitored for the remainder of the day with no side effects observed. LPA interviewed Administrator, S1 and FC1. At this time, Interim Licensing Standards (ILS) Section 80075(b)(5)(B) Health Related Services is being cited.

met_with: Rene van der Meer - Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Danielle Walker-Flores arrived at the agency to conduct a case management inspection to issue citation for failure to report. Foster child (FC1, see confidential names titled 10/29/21) was in an altercation with another client on 10/07/21. This altercation resulted in FC1 being taken to the emergency room the following day due to headaches and at the request of the placing agency. Community Care Licensing was not notified of the incident involving the altercation. This agency is being cited under Reporting Requirements Upon the occurrence, during the operation of the facility, of any of the events specified in (1) below, a report shall be made to the licensing agency within the agency's next working day during its normal business hours. In addition, a written report containing the information specified in (2) below shall be submitted to the licensing agency within seven days following the occurrence of such event. Any unusual incident or client absence which threatens the physical or emotional health or safety of any client. Exit interview conducted and appeal rights provided. Due to technical difficulties, this deficiency was finalized with David Smith - Supervisor on 12/10/21.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Danielle Walker-Flores arrived at the facility on today's date for a case management inspection. On 10/27/21 foster child (FC1, see confidential names list titled 07/16/21), was administered the wrong psychotropic medication. Staff was distracted during medication distribution and accidentally administered psychotropic medications to FC1. Staff then directed FC1 to vomit. Initially, client was asked to stick his fingers down his throat to induce vomiting which client either refused or failed to vomit. Client was then given water and milk to induce vomiting. Client vomited and was monitored for side effects. FC1's guardians were contacted immediately. FC1's evening medications were held for safety concerns and FC1 was monitored with no side effects observed. LPA interviewed FC1 and Staff. At this time, Interim Licensing Standards (ILS) Section 80075(b)(5)(B) Health Related Services and 87072(d)(11) Personal Rights are being cited. Civil penalty assessed for repeat medication violation. Exit interview conducted.

met_with: David Smith - Ranch Support Supervisor


facility_name: MT. LASSEN TREATMENT CENTER

raw_content:
Narrative:
Regarding the allegation that staff inappropriately restrained a minor resulting in injuries and staff handled minor in a rough manner, LPA obtained photos of a minor who sustained bruising and fingernail mark injuries from staff after being in a restraint. No full serious incident report was submitted to the Department regarding the restraint to detail staff's involvement. The client indicated they were running away, which does not provide justification for use of physical restraint. Regarding a lack of supervision for the clients resulting in unsafe behaviors, there was an incident in which four clients were able to sneak out of their dorm rooms during the night unnoticed, to break into a principal's office. During the months of July-September 2024, 19 (24) hour serious incident reports were submitted to the Department without corresponding final reports being submitted. There were two reports involving the use of a restraint with no final report submitted to the Department. Staff interviewed were unable to explain to the LPA what the process is to report incidents. Based on LPA's observations, interviews which were conducted, and records reviewed, the preponderance of evidence standard has been met, therefore the above allegations are found to be Substantiated. Four citations are being issued for violating Interim Licensing Standards (ILS) Section 87061(i)(7)(E ):Incident Reports, ILS Section 87072(c)(17), Title 22, Section 80028(a): Responsibility for Providing Care and Supervision, and Title Section 80061(b): Reporting Requirements. A signed copy of this LIC-9099 report, the LIC-9099C, and LIC-9099D were provided to the facility. An exit interview was conducted. Appeal rights were provided. Regarding allegations of staff not addressing minors' health care needs, interviews with staff and clients indicated the facility has a medic on site. However, some interviews denied medical care as being available for clients when asked. Staff and clients reported that clients had access to three meals and a snack daily, but statements differed regarding the quality and quantity of the snacks, and the process for how to address when a client misses a meal. One staff reported that if a client acts up, they are not given a meal. Regarding the allegation of staff hitting a minor with a vehicle resulting in injuries, interviews were inconsistent. One staff reported that one client was hit by a golf cart and appeared to be injured, but when asked about their injuries, the client denied it. When LPA conducted additional client and staff interviews, none had knowledge of the incident. No incident report was submitted to confirm any other client or staff involvement. Regarding the allegation of staff not intervening when a minor engaged in self-harm, interviews were inconsistent. An incident did occur in the stabilization room involving electrical wiring. Client and staff interviews provided inconsistent statements regarding whether the wiring was exposed or not, and accessible to clients. LPA reviewed a video of a client pulling the electrical wire and getting shocked; however, interviews were inconsistent regarding whether there were holes or cracks in the electrical casing. Based on LPA's observations, interviews which were conducted, and records reviewed, although the allegations may have happened, or are valid, there is not a preponderance of evidence to prove the violations did, or did not, occur. Therefore, the allegations are UNSUBSTANTIATED. A signed copy of this LIC-9099 report, the LIC-9099C, and appeal rights were provided to the facility. An exit interview was conducted.

Investigation Findings:
13Licensing Program Analyst (LPA) Tina Thorn arrived unannounced at the facility on 12.19.24 for the purpose of delivering findings for the complaint investigation. LPA met with NAME, TITLE. LPA Thorn and LPA Lyta Vue conducted the complaint investigation. LPA opened the investigation with the facility on 10.11.24 and met with Paige Woodard, Program Director and conducted a Health and Safety Inspection. During the course of the investigation, LPA interviewed One Probation Officer, six staff, and three clients, LPA reviewed records including: Needs and Services Plan for three clients, Intake forms for three clients, LIC 500, Placing Agency Contacts, Staff Training Log, Incident Reports, a video, and photographs. It was alleged that staff made inappropriate comments toward the minors. Client and staff interviews corroborated that on occasion, staff speak inappropriately to the clients, or with a derogatory tone. Two staff spoke of this being an ongoing problem and staff need more training. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Tina Thorn 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: MT. LASSEN TREATMENT CENTERFACILITY NUMBER: VISIT DATE: 12/19/2024

met_with: Paige Woodard, Program Director


raw_content:
Narrative:
The SIR's that were sent and reviewed for the months of October-December reflect an understanding by staff of emergency intervention strategies. There was not enough information provided from interviews and records to demonstrate whether the facility contacted law enforcement when specifically directed by the placing agency, in accordance with their Emergency Intervention Plan. The facility did follow policies in their Program Statement indicating law enforcement is contacted as a last resort when all other de-escalation measures are ineffectual. Based on LPA's observations, interviews which were conducted, and records reviewed, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. A signed copy of this LIC-9099 report, the LIC-9099C, and appeal rights were provided to the facility. An exit interview was conducted. During the months of October-December 2024, 25 incident reports were submitted to the department without corresponding final reports being submitted. There were no incident reports submitted with information about the youth escaping their room, the incident stated above. Program Director admitted to not being aware of reporting requirements. Interviews with the County Social worker and Probation indicated that incident reports are also not being sent consistently to their respective departments from the facility. Based on LPA's interviews which were conducted, and records reviewed, the preponderance of evidence standard has been met, therefore the above allegations are found to be Substantiated. Citations were issued previously for the same allegations on December 19, 2024. No repeat citation is issued as a Plan of Correction was completed by January 17, 2025. A signed copy of this LIC-9099 report, the LIC-9099C were provided to the facility. An exit interview was conducted. Appeal rights were provided.

Investigation Findings:
13Licensing Program Analyst (LPA) Tina Thorn arrived unannounced at the facility on 02.07.25 for the purpose of delivering findings for the complaint investigation. LPA met with Paige Woodard, Program Director.LPA Thorn and LPA Aleza Ruiz conducted the complaint investigation. LPA opened the investigation with the facility on 11.14.24 and met with Paige Woodard, Program Director. During the course of the investigation, LPA interviewed 4 staff, 6 clients, a Probation Officer, and a County Social Worker. LPA reviewed records from the facility including Placement Roster, Training logs, prior complaint history, staff schedule, client roster, placing agency contact information, and Serious Incident Reports. It was alleged that lack of supervision resulted in inappropriate interactions between youth. Staff and Client interviews corroborated that on one evening bed checks were not properly performed and that two youth were able to escape their dorm room and engage in inappropriate and destructive activities. Interviews were inconsistent regarding a lack of supervision as the cause of two youth being inappropriate in the showering room. Continued on 812C SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Tina Thorn 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE This is an official report of an unannounced visit/investigation of a complaint received in our office on 11/08/2024 and conducted by Evaluator Tina Thorn COMPLAINT CONTROL NUMBER: 23-CR- FACILITY NAME:MT. LASSEN TREATMENT CENTERFACILITY NUMBER: ADMINISTRATOR:BROWN, ALVINFACILITY TYPE: ADDRESS: FRICOT CITY ROAD UNIT MTELEPHONE: (209) 639- CITY:SAN ANDREASSTATE: CAZIP CODE: CAPACITY:16CENSUS: DATE: 02/07/ UNANNOUNCEDTIME BEGAN: 11: AM MET WITH:Paige Woodard, Program DirectorTIME COMPLETED:01: PM 9Facility did not follow emergency intervention plan INVESTIGATION FINDINGS: 13Licensing Program Analyst (LPA) Tina Thorn arrived unannounced at the facility on 02.07.25 for the purpose of delivering findings for the complaint investigation. LPA met with Paige Woodard, Program Director. LPA Thorn and LPA Aleza Ruiz conducted the complaint investigation. LPA opened the investigation with the facility on 11.14.24 and met with Paige Woodard, Program Director. During the course of the investigation, LPA interviewed 4 staff, 6 clients, a Probation Officer, and a County Social Worker. LPA reviewed records from the facility including Placement Roster, Training logs, prior complaint history, staff schedule, client roster, placing agency contact information, and Serious Incident Reports. Regarding the allegation that the facility did not follow the Emergency Intervention Plan, upon LPA's review of the facility's Program Statement, the staff interviewed named various emergency situations and were able to explain the emergency intervention plan. Due to all full serious incident reports not being submitted to the Department, evaluating whether staff always used emergency interventions was not possible. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Tina Thorn 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: 2 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: MT. LASSEN TREATMENT CENTERFACILITY NUMBER: VISIT DATE: 02/07/2025


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
Continued from The facility subsequently drug tested the youth which resulted in positive tests for marijuana. During interviews there was no mention of clients having access to marijuana before this incident took place. Based on LPA's observations, interviews which were conducted, and records reviewed, the preponderance of evidence standard has been met, therefore the above allegations are found to be Substantiated. Citation is being issued for violating Interim Licensing standards Section Personal Rights: (c)(16) A signed copy of this LIC-9099 report, the LIC-9099C, and LIC-9099D were provided to the facility. An exit interview was conducted. Appeal rights were provided.

Investigation Findings:
13Licensing Program Analyst (LPA) Aleza Ruiz arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Paige Woodard, Program Director. LPA Aleza Ruiz and LPA Elena Gonzalez-Soto conducted the complaint investigation. LPA Gonzalez-Soto initiated the investigation with the facility on 12/30/2024 and met with Paige Woodard, Program Director. During the course of the investigation, LPA Ruiz interviewed three youth, one probation officer, and six staff members. LPA reviewed records including: Placement Roster, Training logs, prior complaint history, drug test findings, Serious Incident Reports, and video footage. Regarding the allegations listed, the facility submitted an incident report to the department alleging a staff member provided a marijuana pen to clients and participated in marijuana use with clients. Two youth present during the incident reported the staff did provide marijuana to the clients and participated in marijuana use with the clients. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Aleza Ruiz 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: MT. LASSEN TREATMENT CENTERFACILITY NUMBER: VISIT DATE: 03/13/2025

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


raw_content:
Narrative:
Continued from During interviews two individuals stated a marijuana pen was used, one denying nicotine was in the pen at all, one denying a pen was given to clients at all and one denying witnessing any other clients smoke and denying they smoked at all. Regarding the inappropriate comments made to clients, there were conflicting interviews stating this did or did not happen along with an incident report that staff refused to sign and hand-printed that they did not make the statements alleged on the incident report. Based on LPA's observations, interviews which were conducted, and records reviewed, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. A signed copy of this LIC-9099 report, the LIC-9099C, and appeal rights were provided to the facility. An exit interview was conducted.

Investigation Findings:
13Licensing Program Analyst (LPA) Aleza Ruiz arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Paige Woodard, Program Director. LPA Aleza Ruiz and LPA Elena Gonzalez-Soto conducted the complaint investigation. LPA Gonzalez-Soto initiated the investigation with the facility on 12/30/2024 and met with Paige Woodard, Program Director. During the course of the investigation, LPA Ruiz interviewed three youth, one probation officer and six staff members. LPA reviewed records including: Placement Roster, Training logs, prior complaint history, Serious Incident Reports, and video footage. The facility submitted an incident report to the department alleging staff provided a nicotine vape pen to clients and that staff made inappropriate comments to clients. While observing the video footage that was provided by the facility from the events that took place there is no clear visual of what type of 'pen' is handed to clients. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Aleza Ruiz 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: MT. LASSEN TREATMENT CENTERFACILITY NUMBER: VISIT DATE: 03/13/2025


raw_content:
Narrative:
It was alleged that one youth was sexually abused multiple times while in care, with the extent of the abuse being that one staff allegedly asked the youth to undress. Interviews with five staff and three youth provided inconsistent statements regarding these inappropriate interactions between the youth and the one staff member, with only one individual reporting these inappropriate interactions. No physical contact was reported between the staff and youth. Camera footage from one of the reported incidents, shows that the staff did not even enter the youth's room on the date and time of one of the alleged interactions. Interviews conducted with five staff were consistent that they have no knowledge of the youth being handled in a rough manner by any staff members. Three youth interviewed spoke of a staff member breaking up a physical altercation between the three youths. Two of the three youth stated that a staff member performed a restraint on one youth in order to separate this youth from the altercation. One youth was unsure if a restraint was used or whether the staff was holding the youth to break up the fight. An Incident Report received by the department explains that the youth were separated physically, but that no restraint was secured and that no injuries were sustained as a result of the staff member. Based on LPA's observations, interviews which were conducted, and records reviewed, although the allegations may have happened, or are valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegations are UNSUBSTANTIATED. A signed copy of this LIC-9099 report, the LIC-9099C, and appeal rights were provided to the facility. An exit interview was conducted

Investigation Findings:
13Licensing Program Analyst (LPA) Tina Thorn arrived unannounced at the facility on 07.25.25 for the purpose of delivering findings for the complaint investigation. LPA met with Paige Woodard, Program Director. LPA Thorn conducted the complaint investigation along with the Investigations Branch (IB's). LPA opened the investigation with the facility on 04.28.25 and met with Paige Woodard, Program Director and conducted a Health and Safety Inspection. During the course of the investigation, LPA was present during IB's interviews with 5 staff members and 3 youth. LPA reviewed records from the facility including: prior complaint history, Serious Incident Reports, CFT notes, Case plan for 1 youth, fingerprint clearance roster, LIC 500-personnel roster, Client roster, Youth intake face sheet, a Calaveras County Sheriff's report, and camera footage of one incident. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Tina Thorn 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: MT. LASSEN TREATMENT CENTERFACILITY NUMBER: VISIT DATE: 07/25/2025


summary: Facility Evaluation

raw_content:
Narrative:
On 1/17/2024, Licensing Program Analyst (LPA) Tina Thorn and Licensing Program Manager (LPM) Hillary Hall arrived unannounced at the facility and met with Paige Woodard, Administrator for Yosemite Treatment Facility, which shares the campus. The purpose of the visit was to conduct a Required Annual Inspection of the facility. The facility was licensed on 12/22/2022 but has not opened and has not placed any clients since being licensed. The facility has no staff, aside from Corporate staff who are not on site. LPA and LPM utilized the CARE Tool to complete the Annual inspection. LPA and LPM conducted an inspection of the physical property, which is a large campus consisting of multiple buildings. The dormitory, which would be used for clients is mostly empty and currently locked and kept inaccessible due to no clients. The capacity of the facility is sixteen and there is a bedroom for each client. A separate dining hall is shared by Mt Lassen and Yosemite Treatment facility. In the dormitories, each client will have a closet and dresser. A fenced pool is shared by the two facilities. The campus property allows for clients to access a variety of sports equipment. LPA observed the proper postings including: facility license, complaint hot-line, client personal rights, and emergency disaster plan. As there are no clients, no client files were observed or reviewed. The facility has no outstanding fees. As there are no clients or staff, no interviews were conducted. No citations were given on this date. A signed copy of this LIC-809 and LIC-809C report was provided to Paige Woodard. An exit interview was conducted.

met_with: Paige Woodard, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 12.19.24, Licensing Program Analyst (LPA) Tina Thorn arrived unannounced at the facility and met with Paige Woodard, Administrator. The purpose of the visit was to conduct a Required, Two-year Annual Inspection of the facility. The inspection was completed on 12.20.24. The facility was licensed on 12.23.22. LPA utilized the CARE Tool to complete the inspection. LPA conducted an inspection of the physical plant and checked for all necessary requirements. The facility was clean and organized and maintained an acceptable room temperature. The facility is on a large campus with many buildings. There are no more than 2 clients sharing a bedroom in a dorm like setting. The facility has 3 client bathrooms. All bathrooms were observed to be clean and fully functioning. The dining hall is separate from the dorms. Each client had a closet and dresser in good repair. Mattresses and bedding were observed to be clean. Clients were able to decorate their rooms with their personal belongings. The facility has a properly fenced pool, and opportunities for clients to access sports equipment. LPA observed the proper postings including facility license, complaint hotline, client personal rights, and emergency disaster plan. Smoke alarms, fire extinguishers and a first aid kit were observed to be current and within regulations. LPA observed the kitchen to have 3 restaurant sized refrigerators and freezers with at least 2 days of perishable food and 7 days of non-perishable food on hand. LPA observed client medications were stored in a locked file cabinet in the locked medical office. Client files are primarily electronic with paper files for clients locked in the Head of Service's office. The facility has no outstanding fees. The facility currently has 13 clients, with a licensed maximum capacity of 16. Staff to client ratio is 1 to 4. LPA reviewed 3 staff files. Staff files had completed criminal record clearances, and all required initial and annual training. All first Aide and CPR certifications were up to date for staff. Continued C LPA reviewed 3 client files. All clients had signed Admission Agreements on file. Client files had completed initial Needs and Services Treatment Plans, signed by clients and staff, and updated Needs and Service plans every 30 days. Needs and Service Plans detailed adequate supportive services the facility offers to the clients. Clients were current on physical and dental exams. Six were taking court ordered psychotropic medications and had current JV-220's on file. LPA interviewed 3 clients and 3 staff. No citations were given on this date. A signed copy of this LIC-809 and LIC 809C report was provided to Administrator An exit interview was conducted.

met_with: Paige Woodard, Program Direcdtor


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Aleza Ruiz arrived unannounced at the facility for the purpose of a case management following an incident report received by the department regarding an incident that took place on 2/25/2025 that required follow up. This incident involved a staff member pushing a client away from them "instead of placing [them] in a Safe Crisis Management." LPA conducted two staff interviews and one client interview. No citations given at this time. Further follow up is needed. Exit interview was conducted and a copy of this report was left with the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 05.08. Licensing Program Analyst (LPA) TIna Thorn arrived at the facility to follow-up on reported concerns about staff conduct. LPA conducted three staff interviews and reviewed one staff file. The facility did their own internal investigation and the staff was terminated. No citation is being issued due to the facility's actions. Exit interview was conducted and a copy of this 809 report was given to the facility

met_with: Eddie McCall, Program Manager, Yvonne Busch, Human Resources Asst.


raw_content:
Narrative:
It was alleged that a staff member directed youths to engage in a physical altercation with each other. Interviews with five youths were consistent that the staff member did not use any language to incite them to fight. Interviews with staff were inconsistent. Two of 8 staff members reported having heard a term "Green Light" being yelled out at the youth by this staff right before the altercation began. This term was inferred to mean the youth were allowed to start fighting. The other six staff within the vicinity of the fight stated they did not hear those words or any other words that may have provoked the youths to engage in the incident. Based on LPA's interviews which were conducted, and records reviewed, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. A signed copy of this LIC-9099 report, the LIC-9099C, and appeal rights were provided to the facility. An exit interview was conducted.

Investigation Findings:
13Licensing Program Analyst (LPA) Tina Thorn arrived unannounced at the facility on 05.08.26 for the purpose of delivering findings for the complaint investigation. LPA met in person with Eddie McCall, Program Manager, Yvonne Busch, Human Resources Asst. and Paige Woodard, Program Director by phone. LPA Thorn conducted the complaint investigation. LPA initiated the investigation with the facility on 02.25.26 and met with Columbus Bender, Compliance Manager and Paige Woodard, Program Director and conducted a Health and Safety Inspection. During the course of the investigation, LPA interviewed 5 youths, 9 staff and one county social worker. LPA reviewed records including Staff schedule, Client Placement Roster, prior complaint history, Serious Incident Reports, Child and Family Team notes, Needs and Service Plans for 2 youth, facility incident investigation report, and Disciplinary Action Documents for one staff member. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Tina Thorn 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: MT. LASSEN TREATMENT CENTERFACILITY NUMBER: VISIT DATE: 05/08/2026


facility_name: MUNCIE HOUSE

raw_content:
Investigation Findings:
13On this date, Licensing Program Analyst (LPA) Jessica Rodriguez conducted a follow up complaint inspection for the Muncie Group Home and met with Administrator, Dekeydra Mothershed. The purpose of the inspection was to deliver the findings for the above complaint allegations. During the investigating, LPA conducted interviews with residents and staff. The statements provided to LPA by both residents and staff were inconsistent. Due to the conflicting information revealed in the interview process, the agency has deemed the allegations to be unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of evidence to provide the alleged violations did or did not occur, therefore the allegations are unsubstantiated. Exit interview conducted and a copy of the report was left with the agency. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Jessica Rodriguez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

met_with: Dekeydra Mothershed


raw_content:
Investigation Findings:
13On this date, Licensing Program Analyst (LPA) Jessica Rodriguez conducted a follow up complaint inspection for the Muncie Group Home and met with Administrator, Dekeydra Mothershed. The purpose of the inspection was to deliver the findings for the above complaint allegation. During the investigating, LPA conducted interviews with residents and staff and reviewed incident reports. Due to the conflicting information revealed in the interview process, the agency has deemed the allegation to be unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Exit interview conducted and a copy of the report was left with the agency. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Jessica Rodriguez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2


summary: Facility Evaluation

raw_content:
Narrative:
On October 22, 2021, Licensing Program Analyst (LPA) Jessica Rodriguez conducted an unannounced case management at the corporate offices of KYJO, two discuss two deficiencies for the above facility. LPA was met with Administrator, Virginia Hernandez. After reviewing incident reports, and interviews conducted by LPA Barragan with staff and clients, LPA Rodriguez noted a lack of supervision. LPA Rodriguez noted several incident/ encounters were C1 hit and bullied C2, yet staff continuously seemed unaware. During those incidents C1 and C2 were the only two residents at the facility at that time therefore, there was no reason for the clients to not be supervised. Interviews conducted by LPA Barragan with staff confirmed that both staff were in the office together during many of these occasions, yet staff was aware that C1 was hitting and bullying C2. LPA also discussed a second deficiency regarding the inappropriate discharge for C2. C2 was not discharged from the program in a trauma informed way. As these requirements were not met, the facility is receiving two deficiencies. A copy of the deficiency log with appeal rights was provided to the Agency See attached LIC Confidential Names List.

met_with: Virginia Hernandez


facility_name: NABEA FAMILY YOUTH SERVICES INC

summary: Facility Evaluation

raw_content:
Narrative:
On Frebruary 5. 2026, Licensing Program Analyst (LPA) Babatunde Aborchie and Licensing Program Manager (LPM) Abdoulaye Traore met with applicant Tiara Johnson and Tiyon Johnson for component II. LPA and LPM went over revisions needed for the application prior to licensure. Applicant is applying for STRTP license. LPA and LPM gave a copy of the LIC 184, Notice of Incomplete Application, and additional correspondence to assist with the revisions needed to the application. Copy of this report was provided to applicant.

met_with: Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On February 12, 2026, Licensing Program Analyst (LPA) Babatunde Aborchie began a pre-licensing inspection for a Short Term Residential Therapeutic Program (STRTP) license. LPA met with administrator, Tiara Johnson at the facility. The facility was toured both inside and out with the applicant. The applicant is applying to serve six minor and nonminor dependent (NMD) children. The residence is a six-bedroom two story-house with three and half bathrooms. The downstairs area consists of a living room, a kitchen, dining area, laundry room, storage down the stairs, one and a half bathrooms, the garage, and the backyard. There were two rooms downstairs. Bedroom #1 was fully furnished with office furniture, a desk, chair, office cabinets and used as an office. Bedroom #2 was fully furnished; it consists of one Cal-King-sized bed; it will sleep one client. In addition to the downstairs, medication will be locked in the office cabinet. Upstairs consist of four bedrooms and two bathrooms. Bedroom #3 was furnished with a full-sized bunked bed; it will sleep two clients. It was vacant. Bedroom #4 was furnished with one twin-sized bunk bed, it will sleep two clients. Bedroom#5 was furnished with two twin-sized beds; it will sleep two clients. It was vacant. Bedroom #6 was furnished with a king-sized bed, fully furnished; Licensee stated it will be used as a lounge for clients to use. Bedrooms were arranged so that no more than two clients share a room, and there was one child per bed. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawers and closet space for children's belongings. Towels and linens were stored in a cabinet by the clients' bedrooms. Two smoke and carbon monoxides detectors were checked and were working properly. All hazardous items have been properly made inaccessible to areas where clients would have access. Sharp objects/knives were locked and stored in the kitchen cabinet. Cleansers/chemicals were locked and stored in the closet upstairs. The first aid kit was in the laundry room area, accessible and contained all required items. There were no guns or weapons as stated by the administrator at this time. The hot water temperature was tested and noted to be 118 degrees. There was adequate food storage supply of two days of perishable foods and a week of non-perishable food. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. There were no pool or other body of water and the backyard where clients would have access to play was completely fenced and free of hazards. There was a total of four cameras, all located indoors which met the title 22 camera policy. LPA conducted a component III during the visit. The facility is appropriate for a capacity of six ambulatory clients, ages ten to seventeen and non-minor dependents. All requirements were met at this time. Licensing Program Manager will complete a final review prior to issuing a provisional license. A copy of this report was reviewed and provided to the administrator.

visit_type: Prelicensing

met_with: Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On May 20, 2026, Licensing Program Analyst (LPA) Babatunde Aborchie met with Nabea Family Youth Short Term Residential Therapeutic Program (STRTP), Facility Manager Tiyon Johnson to conduct a case management visit following the incident report dated April 19, 2026. LPA interviewed Client 2 (C2) facility manager (FM) and, Administrator (A1). LPA was unable to complete the case management due to network connectivity. LPA will review documentation and interviews and return on May 21, 2026 for final determination of findings.

met_with: Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On May 21, 2026, at 10:26 a.m., Licensing Program Analyst (LPA) Babatunde Aborchie met with Nabea Family Youth Short-Term Residential Therapeutic Program (STRTP) Administrator/Facility Manager, Tiyon Johnson, to deliver a case management report regarding an incident. According to information obtained by Community Care Licensing (CCL), Nabea Family Youth STRTP did not provide adequate supervision, leading to clients (C1 and C2) engaging in inappropriate sexual behaviors of touching and online. Based on the information received, the facility did not provide adequate supervision, allowing clients (C1 and C2) to engage in repeated inappropriate touching and online sexual behavior without intervention. The staff was downstairs when the incident occurred around 8:00 pm, when C2 went into C1's bedroom. Per facility staff, they conduct 15-minute bedroom checks, and a staff member is usually sitting in the hallway; however, the staff member was not monitoring the hallway and was doing other tasks around the house when C2 went to C1's bedroom for about six minutes. The facility is being cited for violation of Short-Term Residential Therapeutic Program Interim Licensing Standards, Version 5, Section Responsibility for Providing Care and Supervision. Continues on LIC809C (a) The licensee shall provide care and supervision as necessary to meet the client's needs. The facility failed to provide adequate supervision, redirection, or intervention to prevent the client's repeated inappropriate sexual touching and online activities using electronic devices, which poses an immediate Health, Safety, or Personal Rights risk to clients in care. A copy of the report, along with appeal rights and LIC 811, was discussed and provided to the Nabea Family Youth STRTP/Administrator, Tiara Johnson

met_with: Tiyon Johnson


facility_name: NEW ALTERNATIVES, INC #5

raw_content:
Narrative:
(SIR) to Orange County Social Services (OCSSA) and the Department via OCSSA's FYI Reporting System. Confidential interviews revealed C1's authorized representative is not included in that system. Confidential interviews and documents obtained revealed that SIR's involving C1 included the use of manual restraints. Confidential interviews revealed that C1's authorized representative was not notified in writing or by telephone when the use of a manual restraint was used on C1. Confidential interviews revealed that C1's authorized representative had requested SIR's and other documents related to C1 and the facility did not provide the requested documents. Based on confidential interviews, the preponderance of evidence standard has been met regarding the allegation that that the facility is failing to notify the authorized representative of incidents involving C1. This poses a potential Health, Safety or Personal Rights risk to the children in care. The facility will be cited for violating Short-Term Residential Therapeutic Program Interim Licensing Standards, Version 3.1, Section 87061(b)(3) Reporting Requirements - The licensee shall ensure that the child's authorized representative is notified no later than the next business day if the following circumstances have occurred without the authorized representative's participation: Each time the child has been placed in a manual restraint, to be reported as required in Section 87095.61. Exit interview was conducted and a copy of this report, along with a Confidential Names List (LIC 811 dated 07/09/2021), and the appeal rights were explained and provided to Program Director Meaghan Critchlow.

Investigation Findings:
13On July 09, 2021, at 9: AM, Licensing Program Analyst (LPA) Jesus Cervantes made an unannounced visit at the facility. LPA met with Program Director Meaghan Critchlow, to issue the investigative findings of the allegations listed above. On June 07, 2021, Licensing Program Analyst (LPA), Jesus Cervantes, inspected the facility, and no deficiencies were noted. LPA Cervantes conducted interviews with Staff 1 (S1) and the County Social Worker (CSW). During the investigation, LPA reviewed facility records and obtained copies of the following documents: Special Incident Reports (SIR's) associated with Foster Child #1 (C1). On June 02, 2021, Community Care Licensing received an allegation that the facility is failing to notify the authorized representative of incidents involving C1. Confidential interviews revealed the authorized representative of C1 has not been receiving incidents reports involving C1. However, confidential interviews and documents obtained revealed the facility has been submitting Special Incident Reports ... SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Jesus Cervantes LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, THE CITY DR., SUITE FACILITY NAME: NEW ALTERNATIVES, INC #5FACILITY NUMBER: VISIT DATE: 07/09/2021

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

met_with: Meaghan Critchlow


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
S2 intervened and began to attempt to redirect C1's behavior verbally. C1 refused to listen to S2 and began to verbally and physically assault S2. Confidential interviews revealed that in the process of C1 attacking S2, C1 fell on C1's back and began to scoot on C1's back towards S2 to kick S2. S2 would move around to avoid being kicked by C1, and C1 continued to try to kick S2, C1 obtained rug burns in the process. However, other confidential interviews revealed that C1 was dragged by S2 to C1's bedroom and received rug burns while being dragged. Based on confidential interviews and records reviewed, the allegations that C1 sustained injuries while in care, and S2 handled C1 in a rough manner may have occurred; however, it 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 along with appeal rights was provided to Administrator Meaghan Critchlow.

Investigation Findings:
13On December 09, 2021, at 1: PM, Licensing Program Analyst (LPA) Jesus Cervantes made an unannounced visit at the facility. LPA met with Administrator Meaghan Critchlow, to issue the investigative findings of the allegations listed above. On May 21, 2021, Licensing Program Analyst (LPA), Jesus Cervantes, conducted an inspection of the facility, and no deficiencies were noted. LPA Cervantes conducted interviews with a Confidential Witness, three staff members (S1, S2, and S3), and Foster Child #1 (C1). During the investigation, LPA reviewed facility records and obtained copies of the following documents: facility case notes, special incident reports, photographs of injuries, and foster child files. On May 11, 2021, Community Care Licensing received the allegation that C1 sustained injuries while in care, and S2 handled C1 in a rough manner. Confidential interviews revealed C1 was refusing to get ready for bedtime and began to physically assault S3. SEE PAGE TWO UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Jesus Cervantes LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, THE CITY DR., SUITE FACILITY NAME: NEW ALTERNATIVES, INC #5FACILITY NUMBER: VISIT DATE: 12/09/2021

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