summary: Facility Evaluation

raw_content:
Narrative:
On August 30, 2024, at AM, Licensing Program Analyst (LPA) Kenrick Ellis arrived at the above facility for the purpose of conducting an Annual/Required Inspection. LPA met with Claudia Rice, Administrator. A tour of the facility was conducted. A health and safety assessment was conducted. LPA reviewed client records and conduct two client interviews. LPA reviewed five staff records and conducted three staff interview. Facility is located in a residential area and set up as follows: Three bedrooms, four bathrooms, Living room, TV room/game area, staff office, dining room and kitchen. Living Room: Equipped with a sofa, table, and TV. TV Room/Game Area: Equipped with two chairs, books, TV, and table. Dining Room: Equipped with a table and seven chairs. Staff Office: All office furniture and equipment is in good repair. Staff Bathroom: Equipped with a toilet and shower. Basement: Equipped with a hot water heater. Kitchen: Equipped with a stove/oven with four burners, microwave oven, and a refrigerator/freezer. Garage: Clean and used for storage. Equipped with two refrigerator/freezers with extra food. Bedroom #1: Occupied. Equipped with two twin size beds. There is adequate lighting, drawer and closet space. Bathroom #1: Located inside of bedroom. Equipped with a toilet and shower. Bedroom #2: Occupied Equipped with two twin size beds. There is adequate lighting, drawer and closet space. Bathroom #2: Located inside of Bedroom #2. Equipped with a tub/shower combination. Bedroom #3: Occupied Equipped with two twin size beds. There is adequate lighting, drawer and closet space. Bathroom #3: Located inside of Bedroom #3. Equipped with a toilet and shower. Backyard: Clean and free from hazardous items and debris. The home was inspected, and the following was observed: Passageways, stairways, and open porches are unobstructed. Knives, disinfectants, cleaning solutions, and poisons are kept locked in the staff office and made inaccessible to clients. Facility has perishable and non-perishable foods available. Medications are kept locked/accessible only to employees responsible for stored medications. Smoke detectors/ carbon monoxide tested audible and were working properly in the home. The facility is equipped with two regulation fire extinguishers. Hot water was tested and found to be within a safe temperature range. First Aid kit is complete with required items. Facility vehicle is in good repair with valid and current California vehicle registration and insurance. Children can contact the licensing agency or Foster Care Ombudsperson in confidence without threats or punishment for making complaints. Caregiver(s)/adults working/residing in the facility have DOJ/FBI criminal record clearances and Child Abuse Index Checks. Emergency Mass Disaster Casualty Plan was available for review. There were deficiencies cited at this time.

met_with: Cathy Pidfigurny, Administrator


state: CA

facility_name: FIVE ACRES - SOLITA HOME

summary: Facility Evaluation

raw_content:
Narrative:
On September 12, 2025 at 9: AM Licensing Program Analysts LPA, Kenrick Ellis made an announced visit to Five Acres Solita Home STRTP to conduct the Psychotropic Case Medication Inspection. LPA conducted a Health and safety risk assessment upon arriving at the facility. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9(a)(2). During the inspection, LPA Kenrick Ellis met with the Administrator, Claudia Rice and conducted a brief walk through of the physical plant inside and out. LPA reviewed 2 client files and conducted 2 client interview at the facility. LPA reviewed two staff personnel files on site at the facility. LPA interviewed two staff members. LPA reviewed the LIC500 to confirm the shift which starts in the evening and ends early morning and reviewed the staff Criminal Records Clearances. The Administrator provided a physical hard copy of the psychotropic medication training topics during the training for LPA's to review. No deficiencies were cited per Interim Licensing Standards for STRTP Version 5. An exit interview was conducted, and a copy of this report was emailed to Administrator.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Claudia Rice, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On January 24, 2023 at 11:47am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Five Acres (Solita) for the purpose of conducting a Case Management for Special Incident Report #840982, Unauthorized Overnight Guest. LPA met with Claudia Rice, Division Director and discussed the incident. During this visit, confidential interviews were conducted. LPA was informed unauthorized overnight guest is an ex-client of Five Acres (Solita). LPA was informed that there was video footage of unauthorized guest entering client bedroom. LPA requested but was unable to review video footage of the incident due to hard drive only retains video footage for one (1) week) and the cut-off was 1/22/2023 for retention. LPA requested and was provided with a LIC 500. LPA provided facility with a new Foster Youth Bill of Rights poster. Facility cited on the attached LIC 809-D for violation of California Code of Regulations, Title 22, Division 6, regulation 80078(a) Responsibility for Providing Care and Supervision. Facility staff failed to ensure clients room was properly secured during client room check and free of unauthorized guests. Appeal rights were discussed with Division Director. Exit interview was conducted, and a copy of this report will be emailed to the Division Director.

met_with: Claudia Rice-Division Director


summary: Facility Evaluation

raw_content:
Narrative:
On March 2, 2023 at 9:39am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Five Acres (Solita) and spoke with Cathy Pidfigurny, STRTP Manager. The purpose of this visit was to deliver the findings for Case Management for SIR #802331. During the investigation, one (1) staff and one (1) client were interviewed. Consistent statements made by Client #1 (C1) to LPA Edison and law enforcement revealed C1 was hit on the right side of C1's face with a closed fist by Staff #1 (S1) on 3/15/2022. Documentary evidence revealed redness on C1's right jaw. LPA obtained photographic evidence of C1's face from Pasadena Police Department and Pasadena Police Report #22002884 dated 3/16/2022. LPA made several unsuccessful attempts to interview S1. Although LPA was unable to interview S1, confidential interviews with staff who witnessed S1 hitting C1 and statements made by S1 to law enforcement revealed S1 admitted to hitting C1. Documentary evidence revealed statements made by S1 to law enforcement. LPA obtained Pasadena Police Report #22002884 dated 3/16/2022. Documentary evidence also revealed S1 was arrested on 3/16/2022 for PC 273a(a), Child Abuse. Due to S1 exiting Five Acres (Solita) on 3/15/2022 after hitting C1, LPA Edison obtained a termination report from Five Acres (Solita) dated 3/15/2022 which states the employment relationship between Five Acres (Solita) and S1 ended effective 3/15/2022. Based on the interviews conducted, information gathered, and documentary evidence, the preponderance of standard has been met, and is therefore is found to be substantiated. Facility cited on the attached LIC 809-D for violation of STRTP ILS version 4, 87072(11) Personal Rights. Staff #1 (S1) hit Client #1 (C1) with a closed fist on the right side of C1's face. Appeal rights were discussed with STRTP Manager. Exit interview was conducted, and a copy of this report will be emailed to the Division Director.

met_with: Cathy Pidfigurny-STRTP Manager


facility_name: FIVE ACRES STRTP COLBY

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
During confidential interviews, it was revealed that staff mishandled a minor in care by "dragging" Client #1 (C1) out of bed to give C1 their medication, however, inconsistent statements did not corroborate the allegation. Additional confidential interviews revealed C1 had a history of medication refusal. LPA obtained a copy of C1's medication log and Needs and Services Plan. Documentary evidence and consistent statements revealed that staff do not force but instead encourage clients to take their medication as prescribed. LPA obtained Five Acres policy on client medication. Inconsistent statements and documentary evidence did not corroborate C1 had visible marks or bruises on their neck. LPA obtained Special Incident Report #815299 (SIR). Based on the interviews conducted, the information gathered did not produce corroborating evidence to support the above said allegation. LPA Edison was unable to determine if the above said allegation occurred, therefore the allegation is determined to be unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. If any additional information is received, this complaint can be amended, and the finding can be changed. Based on the observations made during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Division Director.

Investigation Findings:
13On April 13, 2023, at 9:47am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Five Acres (Colby) and spoke with Jalissa McFee, Crisis Intervention Specialist (CIS). The purpose of this visit was to deliver the findings for the above complaint allegation. During the investigation LPA Edison interviewed and accounted for all available relevant parties; and gathered pertinent information regarding the allegations. LPA made several unsuccessful attempts to speak with Staff #2 (S2) regarding the allegations. Based on the interviews and statements obtained during the investigation process, the allegation could not be corroborated. Continued on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Daphne Edison LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: FIVE ACRES STRTP COLBYFACILITY NUMBER: VISIT DATE: 04/13/2023

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

report_type: Complaint Investigation

met_with: Jalissa McFee-Crisis Intervention Specialist

complaint_status: unsubstantiated


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
This is an amended report from the original dated 5/4/2023. LPA obtained Special Incident Report #822278, S1 termination report, and Needs and Services Plan for C1. LPA requested video footage of the incident but was informed by Division Director that Five Acres (Colby) does not have cameras, therefore, video is not available for LPA review. Based on the interviews conducted and documentary evidence, the preponderance of standard has been met, therefore the above allegation is found to be substantiated. Facility cited on the attached LIC 9099-D for violation of Interim Licensing Standards(v4), Article 06, 87072(c)(11) Personal Rights. Staff used inappropriate language towards C1 and handled C1 in a rough manner. Appeal rights were discussed with Division Director. Exit interview was conducted, and a copy of this report will be emailed to the Division Director.

Investigation Findings:
13On May 4, 2023, at 11:21am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Five Acres (Colby) and spoke with Claudia Rice, Division Director. The purpose of this visit was to deliver the findings for the above complaint allegations. During the investigation LPA Edison interviewed and accounted for all available relevant parties; and gathered pertinent information regarding the allegations. Based on the documentary evidence, interviews, and statements obtained during the investigation process, LPA was able to corroborate the allegations, Staff member handled minor in a rough manner and Staff member used inappropriate language toward minor. Although Client #1 (C1) threw the remote control at the television because staff threw away C1's cereal, confidential interviews, consistent statements, and documentary evidence revealed S1 grabbed C1 by their neck and pushed C1 to the floor. S1 used inappropriate language toward C1 while holding C1 on the back of the neck on the floor. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Daphne Edison LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: FIVE ACRES STRTP COLBYFACILITY NUMBER: VISIT DATE: 05/04/2023

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

complaint_status: SUBSTANTIATED


raw_content:
Narrative:
Based on records review and confidential statements, the allegation cannot be substantiated due to a lack of evidence. Information obtained revealed inconsistencies as confidential statements indicate admission of making false statements in efforts to get a minor in trouble. Law enforcement report determined no abuse occurred and results from DCFS determined inconclusive findings. Records reviewed indicate the facility is operating within appropriate staff to client ratios. The investigation found no evidence at this time to support neglect/lack of supervision leading to C1 being sexually assaulted by another minor; therefore, the allegation is determined Unsubstantiated. A finding that the complaint is unsubstantiated means 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. There are no deficiencies cited per California Code of Regulations, Title 22 at this time. Exit interview completed. A copy of this report and LIC811 was provided to Facility Administrator.

Investigation Findings:
13On May 24, 2023, at 12: PM, Licensing Program Analyst (LPA), Regina Martin conducted a follow-up complaint inspection to deliver findings concerning the above-mentioned allegation. LPA met with Angie Wilbur, Residential Supervisor, to discuss the outcome. The investigation was referred and conducted by Community Care Licensing Investigations Bureau, Investigator Peter Zertuche. On April 26, 2023, the El Segundo Children's Residential Program Regional Office received a complaint referral alleging neglect/lack of supervision as C1 was reportedly sexually assaulted by another minor while in care [see Confidential Names form, LIC 811, dated 5/24/2023]. On May 3, 2023, LPA Regina Martin met with Facility Director, Claudia Rice, informed receipt of allegation and obtained client/facility records. The investigation further included review of associated Los Angeles Sheriff's Department report, related reports from the Department of Children and Family Services (DCFS), client file history and confidential interviews with related parties including, but not limited to C1. (Continued on page LIC9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Regina Martin LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: FIVE ACRES STRTP COLBYFACILITY NUMBER: VISIT DATE: 05/24/2023

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

met_with: Angie Wilbur, Residential Supervisor


raw_content:
Narrative:
It was reported that staff yelled at children, however, confidential interviews and documentary evidence revealed that on the day of the incident, children were being disruptive and chaotic, and staff used verbal re-direction to restore order among the children in the cottage. LPA obtained a copy of Special Incident Report # 816605 and Client #1 (C1) Needs and Services Plan. Based on the interviews conducted and documentary evidence, the information gathered did not produce corroborating evidence to support the allegations, Staff handled minor in a rough manner resulting in injury to minor and Staff yelled at children. LPA was unable to determine if the above said allegations occurred, therefore the allegations are determined to be unsubstantiated, meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. If any additional information is received, this complaint can be amended, and the finding can be changed. Based on the observations made during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Division Director.

Investigation Findings:
13On June 13, 2023, at 1:04pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Five Acres (Colby) and spoke with Claudia Rice, Division Director. The purpose of this visit was to deliver the findings for the above complaint allegations. During the investigation LPA Edison interviewed and accounted for all available relevant parties; and gathered pertinent information regarding the allegations. Based on the documentary evidence, interviews, and statements obtained during the investigation process, the allegations, Staff handled minor in a rough manner resulting in injury to minor and Staff yelled at children could not be corroborated. Although it was reported that staff grabbed and banged minor's head against a wall and pulled minor's arm back, there was insufficient evidence to support the allegation, Staff handled minor in a rough manner resulting in injury to minor. Continued on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Daphne Edison LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: FIVE ACRES STRTP COLBYFACILITY NUMBER: VISIT DATE: 06/13/2023

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


raw_content:
Narrative:
LPA Edison was not able to determine if the above said allegation occurred, therefore the allegation is determined to be unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. There were no witnesses or physical evidence to corroborate that the allegation occurred. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and a copy of this report will be emailed to the Division Director.

Investigation Findings:
13On February 1, 2024, at 1: PM, Licensing Program Analyst (LPA) Deborah Lee made an unannounced visit to Five Acres (Colby) and spoke with Claudia Rice, Division Director. The purpose of this visit was to deliver the findings regarding the above complaint allegation. During the investigation, inconsistent statements and documentary evidence did not produce corroborating evidence to support staff hit child and caused injury. Documentary evidence and statements indicate the client became upset at staff and began destroying property. LPA obtained Special Incident Report #831049. Statements indicate the client ran into the bedroom after grabbing a necklace from around the staff's neck. Statements indicate the client was throwing objects at staff and staff tried to use the bedroom door as a barrier to avoid being hit by the objects. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Bernice Karnsrithong LICENSING EVALUATOR NAME: Deborah Lee LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: FIVE ACRES STRTP COLBYFACILITY NUMBER: VISIT DATE: 02/01/2024

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

met_with: Claudia Rice, Divison Director


raw_content:
Narrative:
LPA Edison was not able to determine if the above said allegations occurred, therefore the allegations are determined to be unsubstantiated, meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. There were no witnesses or physical evidence to corroborate that the allegations occurred. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and a copy of this report will be emailed to the Division Director.

Investigation Findings:
13On March 5, 2024, at 10:49am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Five Acres (Colby) and spoke with Claudia Rice, Division Director. The purpose of this visit was to deliver the findings regarding the above complaint allegations. During the investigation, consistent statements and documentary evidence did not produce corroborating evidence to support facility is isolating minor from family, facility is withholding records from minor's mother, facility forced minor to get vaccinated, facility is making decisions on behalf of minor without obtaining consent, facility did not notify parent of minor's removal from school, and minor's mental health needs are not being met. LPA Edison conducted confidential interviews and reviewed documentary evidence: Client Needs and Services Plan (NSP), Child and Family Team (CFT) notes, Special Incident Reports (SIR), client Individualized Education Program (IEP), client Authorization for General Medical Care, and Superior Court of California documentation. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Bernice Karnsrithong LICENSING EVALUATOR NAME: Daphne Edison LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: FIVE ACRES STRTP COLBYFACILITY NUMBER: VISIT DATE: 03/05/2024

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


raw_content:
Investigation Findings:
13On October 29, 2024, at 10: AM, Licensing Program Analyst (LPA), Cheri Wilkerson and Licensing Program Manager, JoAunne Griffin arrived at the above facility for the purpose of concluding a complaint investigation for the above allegation. LPA met with Claudia Rice, Administrator and discussed the complaint investigation. A health and safety assessment was conducted. During this investigation, LPA conducted staff and client confidential interviews, obtained current LIC Personnel Report (LIC 500), client roster, staff Pro-Act training certificate, and Child 1 (C1) Needs and Service Plan and Child and Family Team notes and medication logs. Statements indicated that C1 was not observed to be hit by staff. C1 was not observed to have any bruising or scarring consistent with being physically disciplined or hit by staff. Statements indicated that injuries sustained by C1 were a result of riding and falling off bike and climbing trees. There were no deficiencies cited at this time. Exit Interview was conducted with Claudia Rice, Administrator and a copy of this report will be emailed to crice@5acres.org. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Cheri Wilkerson LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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


raw_content:
Narrative:
Documentary evidence revealed Y1 resided at the facility from December 2023 through July 2024. Records indicate on February 18, 2024, Y1 suffered accidental injuries when hiding from staff and a door/closet closed on minor's thumb. Facility staff called 911 immediately upon occurrence and Y1was sent to the hospital for treatment. Information reviewed revealed no documentation of any suspicion of child abuse within the Medical Records. On June 19, 2024, Y1 sustained an injury (bruise on his genital area). Records reviewed revealed youth sustained the injury during an outing at the local park while riding their bike. Facility nurses completed an assessment of client's genital area after the incident. Client observed with bruising to scrotum area. Youth was offered an ice pack however client declined. Confidential interviews and review of documentary evidence including client file history produced a lack of evidence to prove allegations that staff physically abused Y1, resulting in severe injury or that staff did not prevent minor from being harmed by another minor. Evidence obtained was not sufficient to substantiate the allegations. Therefore, the allegations are determined Unsubstantiated. A finding that the complaint is unsubstantiated means 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. There are no deficiencies cited at this time. Exit interview completed. A copy of this report and LIC811 was provided to Facility Representative.

Investigation Findings:
13On January 28, 2025, at 10: AM, Licensing Program Analyst (LPA), Regina Martin conducted a follow-up complaint inspection to deliver findings concerning the above-mentioned allegations. LPA Martin met with Claudia Rice Administrator to discuss the investigative outcome. On June 28, 2024, Community Care Licensing Division (CCLD) received a complaint referral alleging neglect/lack of supervision as a youth (Y1) reportedly sustained several injuries, including a black eye, an injured thumb, a cut on the forehead, and black bruising to the scrotum area, while in care. The allegation was referred and accepted for assignment to CCLD Investigator Dennis Seng. On July 3, 2024, LPA Kenrick Ellis, and Licensing Program Manager, JoAunne' Griffin conducted the initial complaint notification and obtained requested documents. The investigation further included review of client records, incident reports and review of facility file history as well as, review of related police reports, and medical records concerning Y1. Confidential interviews were conducted with complainant, two youth, assigned Department of Children and Family Services (DCFS) Social Workers, assigned DCFS Out of Home Care Investigations Section Administrator, eight staff members including two Supervisors, and facility Division Director. (Continued on page LIC9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Regina Martin LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: FIVE ACRES STRTP COLBYFACILITY NUMBER: VISIT DATE: 01/28/2025

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

met_with: Claudia Rice Administrator


raw_content:
Narrative:
Due to a lack of evidence obtained during the investigation, LPA determined that the allegations are Unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. There are no deficiencies cited at this time. An exit interview was conducted and copy of this report was left at the facility with the School Coordinator Vanessa Perez

Investigation Findings:
13On March 22,2024 at 2:30PM Licensing Program Analyst (LPA), Rosslyn Gray made an unannounced visit to FIVE ACRES STRTP COLBY to conclude the investigation. Prior to entering the facility LPA Gray conducted a health and safety risk assessment. During the investigation, LPA Gray interviewed all available parties and gathered pertinent information in reference to the allegations. Confidential statements and evidence obtained indicated that Child and Family Team (CFT) meetings were held at the Department of Children and Family Services (DCFS) office and the Individualized Education Plan (IEP) meetings are held off campus at the C1's school. DCFS staff is responsible for determining who will attend these meetings and not facility staff. There was no evidence that facility staff did not allow an individual to attend these meetings. Statements indicated that service dogs are not permitted on campus or in the cottage with children in care, and C1s needs were met by other means, such as, participating in meetings, individual and group therapy, and extracurricular activities on and off campus grounds. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray 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 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: FIVE ACRES STRTP COLBYFACILITY NUMBER: VISIT DATE: 03/22/2024

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

met_with: School Coordinator Vanessa Perez


summary: Facility Evaluation

raw_content:
Narrative:
On September 7, 2021 at 1:30PM Licensing Program Analyst (LPA) Meghan McGee and Daphne Edison arrived at the above facility for conducting a Pre-Licensing Inspection of Five Acres - Colby. LPA met with Claudia Rice, Cathy Pidfigurny, and Elizabeth Gonzalez who granted access and provided LPA with a tour of the facility. Five Acres - Colby will provide care and supervision for a capacity of 14 male children, ages 6-14 years of age, ambulatory only. There were zero clients present during inspection. Colby is constructed as follows: The facility is 2 story building with a total of 7 bedrooms and 2 bathrooms for clients. All client bedrooms and client bathrooms are located on the second floor. All bedrooms contain 2 twin beds and personal storage space. All bedrooms have comfortable mattresses, clean linens, and adequate storage space. There are 2 bathrooms equipped with a sink, toilet and shower. Hot water was measured within a safe temperature. On the first floor, the living / dining room is equipped with two TV's, adequate seating, and furniture was observed to be in good repair. The living/dining room is equipped with two wooden tables with 14 chairs. The entrance of Colby has books, board games, and DVDs for clients. The Kitchen was observed to be clean and is equipped with refrigerator/ freezer, toaster and a microwave. The kitchen trash can is covered with a lid. Meals are provided through Huntington Culinary. Three meals and snacks will be provided for the clients and will be brought to Colby from Ketch. Laundry area is equipped with a stackable washer and dryer on the second floor in a locked closet. Closet has a locked cabinet. Hall closet on the first-floor stores linen and blankets. Staff office is located on the first floor. All medications will be double locked in the staff office, accessible and administered only by nursing staff. The smoke detectors and carbon monoxide alarms were tested and are operable. Two fire extinguishers were available and last checked January 2021 and August 2021. Facility also has a Fire Alarm Pull System. First aid kit located in staff office. Outdoor space has a bench. Continued on LIC 809C LPA will follow up with the following: Blankets and pillows for all beds, curtains and screens for all bedrooms. LPA will follow up regarding the kitchen needing a stove. Kitchen needs dishes, perishable and nonperishable foods. An additional first aid kit fully stocked and physical address will be added to the front of building. LPA and LPM will follow up on badge system to enter in and out of facility. LPA was notified the system is currently deactivated and can be done manually. LPA and LPM notified that the facility cannot be a locked facility. Broken glass on the catwalk needs to be removed. An exit interview was conducted, and a copy will be emailed to facility staff.

visit_type: Prelicensing

met_with: Claudia Rice, Cathy Pidfigurny, Elizabeth Gonzalez


summary: Facility Evaluation

raw_content:
Narrative:
On September 30, 2021 at 9:30AM Licensing Program Analyst (LPA) Meghan McGee and Daphne Edison arrived at the above facility for conducting a follow up Pre-Licensing Inspection of Five Acres - Colby. LPA met with Claudia Rice and Elizabeth Gonzalez who granted access and provided LPA with a tour of the facility. Five Acres - Colby will provide care and supervision for a capacity of 14 male children, ages 6-14 years of age, ambulatory only. There were zero clients present during inspection. LPAs completed a walk through to address concerns from previous inspection. All 7 bedrooms had screens and curtains on the windows and the broken glass on the catwalk has been removed. Bedrooms had blankets and pillows on all beds. Food service waiver request has been granted. The waiver applies to regulations section 80076(a)(7) due to staff informing CCL that meals (breakfast, lunch and dinner) will be transported from one facility (Ketch) to another (Colby). Food service Procedure in Plan of Operations has been submit to CCL for review. LPAs completed a walk of how meals will be transported to the facility. There is walk way once you exit the backyard of the facility that leads to Ketch which has access to the kitchen. Kitchen has labeled carts that are covered for the meals to be transported to Colby. Colby kitchen has the following: stove, utensils, and dishes. According to ILS version 3.1 for STRTPs it states the following: Fixtures, Furniture, Equipment, and Supplies (e) The following facilities shall maintain a signal system which meets the requirements specified in (e) and (f) below. Such system shall be used by children to summon staff during an emergency: (2) All facilities having separate floors and not providing full-time staff on each floor whenever children are present. Colby will not install a signal system on the second floor and acknowledges they must maintain a staff on the 1st and 2nd floor at all times when children are present. An exit interview was conducted, and a copy will be emailed to facility staff.

met_with: Claudia Rica and Elizabeth Gonzalez


summary: Facility Evaluation

raw_content:
Narrative:
On April 5, 2022 at 1:12pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Five Acres (Colby) for the purpose of conducting a Post Licensing Inspection. LPA met with Kockac Gordon, Unit Program Coordinator (UPC) who granted access into facility and together a tour was conducted. The home is licensed to provide care and supervision for fourteen (14) male children, ages 6-14 years of age, ambulatory only. Food service waiver on file. The census today is twelve (12). Five Acres (Colby) is set up as follows: This is a two-story building with a total of seven (7) bedrooms and two (2) bathrooms for client use. All client bedrooms and bathrooms are located on the second floor. The entrance of Colby has books, board games, and DVDs for clients. First Floor: Living Room: Equipped with three (3) televisions, adequate seating, and furniture was observed to be in good repair. Dining Area: Equipped with two (2) wooden tables with a total of fourteen (14) chairs. Kitchen: Equipped with a refrigerator/ freezer, toaster and a microwave. The kitchen trash can is covered with a lid. Meals are provided through Huntington Culinary and are brought to Colby from Ketch. Hall Closet: Storage for linens and blankets. Staff Office: Clean and in good repair. Continued on LIC 809-C Second Floor: Bedrooms: All bedrooms are equipped with two (2) twin size beds, adequate lighting, and personal storage space in good repair. All beds have comfortable mattresses, clean linens, and adequate storage space. Bathroom #1: Equipped with a sink, toilet, and shower. Bathroom is clean and in good sanitary condition. Bathroom #2: Equipped with a sink, toilet, and shower. Bathroom is clean and in good sanitary condition. Laundry Area: Equipped with a stackable washer and dryer in a locked closet. Closet has a locked cabinet which contains laundry supplies. LPA observed the facility to be clean, safe, sanitary and in good repair. Passageways, stairways, inclines, and ramps are unobstructed. Disinfectants, cleaning solutions, and poisons are made inaccessible to clients. All knives and sharp objects are made inaccessible to the clients in care. Hot water was measured within a safe temperature range. All medications are double locked in the staff office, accessible and administered only by nursing staff. There are no weapons located in the facility. All smoke detectors and carbon monoxide detectors tested audible and are working properly. The facility is equipped with two (2) regulation fire extinguishers. Facility also has a Fire Alarm Pull System. First aid kit located in staff office. Outdoor space has a bench. LPA will review client records and conduct client interviews on a later date. Children in care are supervised and protected at all times. Children are accorded dignity in personal relationships with staff and others. Children can contact the licensing agency or Foster Care Ombudsperson in confidence without threats or punishment for making complaints. It was reported that children attend school, extracurricular, cultural, and personal enrichment activities. LPA will review staff records and conduct staff interviews on a later date. Caregiver(s)/adults working/residing in the facility have DOJ/FBI criminal record clearances and Child Abuse Index Checks. Emergency Mass Disaster Casualty Plan was available for review. LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. The facility is operating within the capacity and limitations of the license. Continued on LIC 809-C Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit Interview was conducted, and a copy of this report will be emailed to the Division Director.

met_with: Kockac Gordon-Unit Program Coordinator


summary: Facility Evaluation

raw_content:
Narrative:
On May 2, 2022 at 1:15pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Five Acres (Colby) for the purpose of conducting a Case Management for a Post Licensing Inspection which took place on April 5, 2022. LPA met with Kockac Gordon, Unit Program Coordinator (UPC) who granted access into facility and together a tour was conducted. The home is licensed to provide care and supervision for fourteen (14) male children, ages 6-14 years of age, ambulatory only. Food service waiver on file. The census today is twelve (12). Five Acres (Colby) is set up as follows: This is a two-story building with a total of seven (7) bedrooms and two (2) bathrooms for client use. All client bedrooms and bathrooms are located on the second floor. The entrance of Colby has books, board games, and DVDs for clients. LPA observed the facility to be clean, safe, sanitary and in good repair. Passageways, stairways, inclines, and ramps are unobstructed. Disinfectants, cleaning solutions, and poisons are made inaccessible to clients. All knives and sharp objects are made inaccessible to the clients in care. Hot water was measured within a safe temperature range. All medications are double locked in the staff office, accessible and administered only by nursing staff. There are no weapons located in the facility. All smoke detectors and carbon monoxide detectors tested audible and are working properly. The facility is equipped with two (2) regulation fire extinguishers. Facility also has a Fire Alarm Pull System. First aid kit located in staff office. Outdoor space has a bench. During this visit, LPA conducted three (3) client interviews and reviewed three (3) client records which contained copies of Needs and Service Plans and Medical Authorizations signed by each child and their authorized representative. Children in care are supervised and protected at all times. Children are accorded dignity in personal relationships with staff and others. Continued on LIC 809-C Children can contact the licensing agency or Foster Care Ombudsperson in confidence without threats or punishment for making complaints. It was reported that children attend school, extracurricular, cultural, and personal enrichment activities. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit Interview was conducted, and a copy of this report will be emailed to the Division Director.


summary: Facility Evaluation

raw_content:
Narrative:
On June 2, 2022 at 9:49am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Five Acres (Colby) for the purpose of conducting a Case Management for a Post Licensing Inspection which took place on April 5, 2022. LPA met with Claudia Rice, Division Director who granted access into facility. The facility is licensed to provide care and supervision for fourteen (14) male children, ages 6-14 years of age, ambulatory only. Food service waiver on file. The census today is twelve (12). Five Acres (Colby) is set up as follows: This is a two story building with a total of seven (7) bedrooms and two (2) bathrooms for client use. All client bedrooms and bathrooms are located on the second floor. The entrance of Colby has books, board games, and DVDs for clients. LPA observed the facility to be clean, safe, sanitary and in good repair. Passageways, stairways, inclines, and ramps are unobstructed. Disinfectants, cleaning solutions, and poisons are made inaccessible to clients. All knives and sharp objects are made inaccessible to the clients in care. Hot water was measured within a safe temperature range. All medications are double locked in the staff office, accessible and administered only by nursing staff. There are no weapons located in the facility. All smoke detectors and carbon monoxide detectors tested audible and are working properly. The facility is equipped with two (2) regulation fire extinguishers. Facility also has a Fire Alarm Pull System. First aid kit located in staff office. Outdoor space has a bench. Children in care are supervised and protected at all times. Children are accorded dignity in personal relationships with staff and others. Children can contact the licensing agency or Foster Care Ombudsperson in confidence without threats or punishment for making complaints. It was reported that children attend school, extracurricular, cultural, and personal enrichment activities. Continued on LIC 809-C LPA reviewed three (3) staff records and conducted three (3) staff interviews. Caregiver(s)/adults working/residing in the facility have DOJ/FBI criminal record clearances and Child Abuse Index Checks. Emergency Mass Disaster Casualty Plan was available for review. LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. The facility is operating within the capacity and limitations of the license. Facility vehicle is in good repair with current and valid vehicle registration and insurance. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit Interview was conducted, and a copy of this report will be emailed to the Division Director.


summary: Facility Evaluation

raw_content:
Narrative:
Claudia Rice - Division Director (DD) Calvin Holmes - DOB: 7/10/ Client #1 (C1) On 6/2/2022 at 12:46pm, Licensing Program Analyst (LPA) Daphne Edison met with Division Director (DD) in person for the purpose of a case management incident regarding Special Incident Report # 815517, Assaultive Behavior (Caregiver). During the investigation, LPA discussed with DD SIR #815517 which was reported as staff restraining C1 due to C1's physical aggression towards staff for not being able to play a video game before school. LPA interviewed DD regarding the incident and actions taken. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit Interview was conducted, and a copy of this report will be emailed to the Division Director.


summary: Facility Evaluation

raw_content:
Narrative:
On August 16, 2022 at 9:47am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Five Acres (Colby) for the purpose of conducting an Annual Required Inspection. LPA met with Claudia Rice, Division Director who granted access into facility and together a tour was conducted. The home is licensed to provide care and supervision for fourteen (14) male children, ages 6-14 years of age, ambulatory only. Food service waiver on file. The census today is nine (9). Five Acres (Colby) is set up as follows: This is a two-story building with a total of seven (7) bedrooms and two (2) bathrooms for client use. All client bedrooms and bathrooms are located on the second floor. The entrance of Colby has books, board games, and DVDs for clients. First Floor: Living Room: Equipped with three (3) televisions, adequate seating, and furniture was observed to be in good repair. Dining Area: Equipped with two (2) wooden tables with a total of fourteen (14) chairs. Kitchen: Equipped with a refrigerator/ freezer, toaster, and a microwave oven. The kitchen trash can is covered with a lid. Meals are provided through Huntington Culinary and are brought to Colby from Ketch. Hall Closet: Storage for linens and blankets. Staff Office: Clean and in good repair. Continued on LIC 809-C Second Floor: Bedrooms: All bedrooms are equipped with two (2) twin size beds, adequate lighting, and personal storage space in good repair. All beds have comfortable mattresses, clean linens, and adequate storage space. Bathroom #1: Equipped with a sink, toilet, and shower. Bathroom is clean and in good sanitary condition. Bathroom #2: Equipped with a sink, toilet, and shower. Bathroom is clean and in good sanitary condition. Laundry Area: Equipped with a stackable washer and dryer in a locked closet. Closet has a locked cabinet which contains laundry supplies. LPA observed the facility to be clean, safe, sanitary and in good repair. Passageways, stairways, inclines, and ramps are unobstructed. Disinfectants, cleaning solutions, and poisons are made inaccessible to clients. All knives and sharp objects are made inaccessible to the clients in care. Hot water was measured within a safe temperature range. All medications are double locked in the staff office, accessible and administered only by nursing staff. There are no weapons located in the facility. All smoke detectors and carbon monoxide detectors tested audible and are working properly. The facility is equipped with two (2) regulation fire extinguishers. Facility also has a Fire Alarm Pull System. First aid kit located in staff office. Outdoor space has a bench. LPA will review client records and conduct client interviews on a later date. Children in care are always supervised and protected. Children are accorded dignity in personal relationships with staff and others. Children can contact the licensing agency or Foster Care Ombudsperson in confidence without threats or punishment for making complaints. It was reported that children attend school, extracurricular, cultural, and personal enrichment activities. LPA will review staff records and conduct staff interviews on a later date. Caregiver(s)/adults working/residing in the facility have DOJ/FBI criminal record clearances and Child Abuse Index Checks. Emergency Mass Disaster Casualty Plan was available for review. LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. The facility is operating within the capacity and limitations of the license. LPA advised Division Director of licensing fees of $681.00 due by October 5, 2022. Continued on LIC 809-C Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit Interview conducted, and a copy of this report will be emailed to the Division Director.

visit_type: Annual


summary: Facility Evaluation

raw_content:
Narrative:
On August 30, 2022 at 10:11am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Five Acres (Colby) for the purpose of conducting a Case Management for an Annual Required Inspection which took place on August 16, 2022. LPA met with Claudia Rice, Division Director who granted access into the facility. The home is licensed to provide care and supervision for fourteen (14) male children, ages 6-14 years of age, ambulatory only. Food service waiver on file. The census today is ten (10). Five Acres (Colby) is set up as follows: This is a two story building with a total of seven (7) bedrooms and two (2) bathrooms for client use. All client bedrooms and bathrooms are located on the second floor. The entrance of Colby has books, board games, and DVD's for clients. LPA observed the facility to be clean, safe, sanitary and in good repair. Passageways, stairways, inclines, and ramps are unobstructed. During this visit, LPA reviewed four (4) client records which contained copies of Needs and Service Plans and Medical Authorizations signed by each child and their authorized representative. Children in care are supervised and protected at all times. Children are accorded dignity in personal relationships with staff and others. LPA will conduct client interviews on a later date. LPA reviewed five (5) staff records and conducted five (5) staff interviews. Caregiver(s)/adults working/residing in the facility have DOJ/FBI criminal record clearances and Child Abuse Index Checks. Emergency Mass Disaster Casualty Plan was available for review. LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. The facility is operating within the capacity and limitations of the license. Facility vehicles are in good repair with current and valid vehicle registration and insurance. Continued on LIC 809-C LPA advised Division Director of licensing fees of $681.00 due by October 5, 2022. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit Interview was conducted, and a copy of this report will be emailed to the Division Director.


summary: Facility Evaluation

raw_content:
Narrative:
On November 1, 2022 at 10:33am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Five Acres (Colby) for the purpose of a Case Management (Incident) for Special Incident Report #831049. LPA Edison met with Claudia Rice, Division Director and discussed the incident. During this investigation, confidential interviews were conducted. Additional interviews will be conducted on a later date. LPA requested a copy of the Health/Injury Report for Client #1 (C1). Division Director stated will email requested document to LPA. Based on the interviews and information gathered during today's visit, there was insufficient information provided at this time. This incident needs further investigation. Based on the observations made during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Division Director.


summary: Facility Evaluation

raw_content:
Narrative:
On March 28, 2023 at 1:15pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Five Acres (Colby) for the purpose of conducting a Case Management for Referral 0150-8926-3065-1069899. LPA met with Jalisa McFee, Crisis Intervention Specialist and discussed the referral. LPA was informed Claudia Rice, Division Director, is not in the office today. During this visit, confidential interviews were conducted. Additional interviews will be conducted on a later date. LPA requested a copy of the current LIC 500, Emergency Intervention Training for Staff #1 (S1), discipline policy, copy of Needs and Service Plan for Client #1 (C1), and video footage, if available, of incident. CIS stated will advise Division Director of the requested documents to be emailed to LPA. This Case Management needs further investigation. Based on the observations made during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Division Director.

met_with: Jalisa McFee-Crisis Intervention Specialist


summary: Facility Evaluation

raw_content:
Narrative:
An announced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Rosslyn Gray and Zena Phillips, on April 11, 2023 at 9:30AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPAs Gray and Phillips met with Claudia Rice, Division Director and inspected the facility inside and out. LPAs reviewed #5 of child's records and #3 of staff personnel files on site at the facility. LPAs reviewed #5 of child's psychotropic medications and medication records. LPAs interviewed #3 of staff on site to discuss the facilities policies and procedures of operation. LPAs interviewed #2 of the children currently prescribed psychotropic medication. The other three (3) children were not available for interviews. LPAs provided a copy of this licensing reports to Claudia Rice. No deficiency were cited per Interim Licensing Standards for STRTP Version 4. An exit interview was conducted, and a copy of this report was left with Claudia Rice / Division Director

met_with: Claudia Rice/ Division Director


summary: Facility Evaluation

raw_content:
Narrative:
On May 9, 2023 at 12:44pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced follow-up visit to Five Acres (Colby) for the purpose of conducting additional staff and client interviews for a Case Management for Referral 0150-8926-3065-1069899. LPA met with Claudia Rice, Division Director. LPA conducted a confidential interview with Staff #2 (S2). LPA requested a copy of the termination report for Staff #1 (S1). Division Director stated will email requested document to LPA. This Case Management needs further investigation. Based on the observations made during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Division


summary: Facility Evaluation

raw_content:
Narrative:
On June 13, 2023 at 12:17pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced follow-up visit to Five Acres (Colby) for the purpose of conducting a client interview with Client #1 (C1) for a Case Management for Referral 0150-8926-3065-1069899. LPA met with Claudia Rice, Division Director, and discussed the referral. During this visit, LPA was unable to conduct confidential interview with C1. This Case Management needs further investigation. Based on the observations made during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Division Director.


summary: Facility Evaluation

raw_content:
Narrative:
On July 12, 2023 at 10:56am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced follow-up visit to Five Acres (Colby) for the purpose of conducting a client interview for a Case Management for Referral 0150-8926-3065-1069899. LPA met with Julian White, Crisis Intervention Specialist. LPA was informed that Claudia Rice, Division Director is not at the facility today. LPA was unable to conduct client interview. LPA requested a copy of the current LIC 500. Crisis Intervention Specialist stated that requested document will be emailed to LPA by Division Director. This Case Management needs further investigation. Based on the observations made during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Division Director.

met_with: Julian White-Crisis Intervention Specialist


summary: Facility Evaluation

raw_content:
Narrative:
On 08/04/23 at 1: PM, Licensing Program Analyst Andrew Upshaw arrived at the above facility to interview a resident regarding allegations at a previous placement. LPA met with Division Director/Administrator, Angela Wilbur who granted access to the facility. Per California Code of Regulations, Title Regulations, Division 6, Chapter 7, there are no deficiencies cited during this Collateral Visit. An exit interview was conducted, and a copy of this report was left with the Administrator.

met_with: Division Director/Administrator - Angela Wilbur


summary: Facility Evaluation

raw_content:
Narrative:
On November 7, 2023 at 11:04am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced follow-up visit to Five Acres (Colby) for the purpose of conducting a client interview for a Case Management for Referral 0150-8926-3065-1069899. LPA met with Claudia Rice, Division Director. LPA conducted a confidential interview with Client #1 (C1). LPA requested and received a copy of the current LIC 500. This Case Management needs further investigation. Based on the observations made during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Division Director.


summary: Facility Evaluation

raw_content:
Narrative:
On December 20, 2022 at 12:50pm, Licensing Program Analyst (LPA) Deborah Lee and Licensing Program Manager (LPM) made an unannounced visit to Five Acres main campus for the purpose of conducting an Annual Required Inspection for the Colby site. LPA met with Claudia Rice, Division Director who granted access into facility. The home is licensed to provide care and supervision for fourteen (14) male children, ages 6-14 years of age, ambulatory only. Food service waiver on file. The census today is eight (8). During this visit, LPA reviewed two (2) client records. 2 out of the 2 client files met licensing requirement. The following will be reviewed at a later date: Physical Plant (due COVID clients) staff records, client and staff interviews. Adults working/residing in the facility are cleared in the following: DOJ/FBI and Child Abuse Index Checks. LPA obtained the following during the visit: LIC 500, Personnel report and client roster. Exit Interview was conducted, and a copy of this report will be emailed to the Division Director.

met_with: Claudia Rice, Division Director


summary: Facility Evaluation

raw_content:
Narrative:
On January 16, 2024 at 9:52am, Licensing Program Analyst (LPA) Deborah Lee made an unannounced visit to Five Acres (Colby) for the purpose of conducting an Case Management Annual Continuation. LPA met with Claudia Rice, Division Director who granted access into facility and together a tour was conducted. The home is licensed to provide care and supervision for fourteen (14) male children, ages 6-14 years of age, ambulatory only. Food service waiver on file. The census today is eight (8). Five Acres (Colby) is set up as follows: This is a two-story building with a total of seven (7) bedrooms and two (2) bathrooms for client use. All client bedrooms and bathrooms are located on the second floor. The entrance of Colby has books, board games, and DVDs for clients. First Floor: Living Room: Equipped with two (2) televisions, adequate seating, and furniture was observed to be in good repair. Dining Area: Equipped with two (2) wooden tables with 4 chairs at each table for a total seating for (8). Kitchen: Equipped with a refrigerator/ freezer, toaster, and a microwave oven. The kitchen trash can is covered with a lid. Meals are provided through Huntington Culinary and are brought to Colby from Ketch. Hall Closet: Storage for linens and blankets. Staff Office: Clean and in good repair. Continued on 809C LPA observed the facility to be clean, safe, sanitary and in good repair. Passageways, stairways, inclines, and ramps are unobstructed. LPA reviewed four (4) staff records (2) staff interciews and (2) cleint interviews. Caregiver(s)/adults working/residing in the facility have DOJ/FBI criminal record clearances and Child Abuse Index Checks. Emergency Mass Disaster Casualty Plan was available for review. The there are 4 functioning smoke detector/carbon monoxide in facility tested and found to be in working order. The facility is operating within the capacity and limitations of the license. Facility vehicles are in good repair with current and valid vehicle registration and insurance. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit Interview conducted, and a copy of this report will be emailed to the Division Director.


summary: Facility Evaluation

raw_content:
Narrative:
On December 5, 2025 at 9: AM Licensing Program Analyst (LPA) Connie Jones-Steward made an announced visit to Five Acres Home Colby to conduct the Psychotropic Case Medication Inspection. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9(a)(2). During the inspection, LPA Jones-Steward met with the Administrator, Claudia Rice who assisted with the inspection. LPA reviewed 3 client files and conducted 1 client interview at the facility. The other two clients were not available. LPA reviewed three nursing staff files and interviewed two members of the nursing staff. LPA reviewed the facility's procedure for sending medication with clients on home passes and outings and for the destruction of unused medications. LPA also verified that staff are receiving psychotropic medication training as part of their initial and annual training At the conclusion of the inspection, an exit interview was held with the administrator. No citations were issued as a result of this inspection. This concludes the SB Inspection for 2025

met_with: Claudia Rice, administrator


summary: Facility Evaluation

raw_content:
Narrative:
On November 28, 2023, at 10:45am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Five Acres (Colby) and spoke with Claudia Rice, Division Director. The purpose of this visit was to deliver the findings for Case Management for Referral 0150-8926-3065-1069899. During the investigation, confidential interviews were conducted, and documentary evidence was reviewed. It was reported that staff slapped minor. Statements indicate, minor was upset and began cursing at staff. Statements indicate staff intervened to stop minor's behavior and in doing so, slapped minor. Statements and documentary evidence indicate staff termination of employment with Five Acres ended on 3/22/2023. Based on the interviews conducted, information gathered, and documentary evidence, the preponderance of standard has been met, and is therefore found to be substantiated. Facility cited on the attached LIC 809-D for violation of STRTP ILS version 5, 87072(c)(15) Personal Rights. Staff slapped minor. Appeal rights were discussed with Division Director. Exit interview was conducted, and a copy of this report will be emailed to the Division Director.


summary: Facility Evaluation

raw_content:
Narrative:
On February 6, 2026, at 9:00am, Licensing Program Analyst (LPA) Lanice White conducted a Case Management - Incident inspection at Five Acres STRTP Colby and met with the Facility Administrator (FA), Claudia Rice. The purpose of this inspection is in response to a Special Incident Report, submitted to Community Care Licensing (CCL) on December 29, 2025, in order to document a medication administration violation. The incident, which occurred on 12/29/2025, involved a client (C1) who missed medication, because facility staff forgot to back C1's medication before going on home pass. The following deficiency cited at the time of this inspection. (See LIC809-D) Exit Interview conducted, and a copy of this report was left at the facility.

met_with: Claudia Rice - Administrator


facility_name: FOR THE FUTURE, INC.

raw_content:
Narrative:
The internal Investigation revealed that there is no evidence to support the allegations Neglect and Lack of Supervision. LPA obtained statements from four (4) children; two (2) staff. All four (4) children interviewed denied that freely drank alcohol at the facility without consequences. The children also stated that the staff are not allowed to put hands on at time of placement. LPA reviewed several Unusual Incident Reports to confirm that the staff's effort to meet the needs of the children, by using crisis communication in effort encourage client to make better choices. Reports disclosed the effort of the staff that was present and attempted to defuse the situation and break up the fight before it escalated outside of the facility. Staff provided counseling based on the individual Safety Plan. LPA reviewed the facility Pro-Act Protocol and procedure that indicate "No Hands on policy". LPA reviewed the facilities Page: Emergency, Intervention Plan, Protocol and Procedures. LPA assessed that all statements were congruent with the method of interventions implemented to ensure that the facility provided proper supervision to support that met the needs of children in placement. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has determined that the allegation of Neglect/Lack of Supervision is unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There are no deficiencies noted or cited per California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 3. An exit interview was conducted in person and the report was provided to the Administrator on 06/15/2021 for signature.

Investigation Findings:
13On 06/15/2021 at 1:55PM Licensing Program Analysts (LPA) Rosslyn Gray conducted an unannounced complaint inspection to FOR THE FUTURE, INC- to conclude the investigation on the above allegation/s and to deliver the findings via email. LPA spoke with the Program Administrator of the (STRTP). During the investigation process LPA-Gray interviewed and accounted for all relevant parties; including the children who were in placement when the incident occurred. Based on the interviews and statements obtained during the investigation process, the allegation cannot be corroborated because supporting evidence for this complaint is as follows: LPA interviewed the RP who was identified as a third party reporter, witnessed the alleged allegations. RP did not identify a specific youth and chose not to disclose the neighbors information who was allegedly assaulted. Althought to the RP was adamant that there is lack of supervision, evidence and supporting documents indicate the effort of the program to use crisis communication according to the facilities Emergency Response plan. LPA gathered information in which it was stated that staff redirected the clients to a safe place and to protect the staff from possible injuries and or violating personal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290b El Segundo, CA Facility Name: for the Future, INC.FACILITY NUMBER: VISIT DATE: 06/15/2021

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

met_with: Staff #1


summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On 01/20/2022, Licensing Program Analyst (LPA) Bernice Karnsrithong arrived at the facility to conduct a follow up complaint investigation regarding the allegation that Facility staff touched child inappropriately. LPA Karnsrithong met with Administrator, Melissa Kagan to discuss the complaint investigation. During the investigation of the allegation, LPA conducted confidential interviews and reviewed documentary evidences. Statements were consistent and did not produce corroborating evidence to support that facility staff touched a child inappropriately. There were no witnesses, physical or documentary evidence to corroborate that a child was touched inappropriately by staff. This agency has investigated the complaint allegation and has found that the complaint was unsubstantiated, there is not a preponderance of the evidence to prove or disprove that a violation occurred. There were no deficiencies cited at this time. Exit interview conducted with administrator. Report will be emailed to the facility on a later date. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Bernice Karnsrithong LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Administrator


raw_content:
Narrative:
Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove or disprove that a violation occurred. Therefore, the allegations are unsubstantiated. There were no deficiencies cited at this time. Exit interview was conducted with the administrator and a copy of this report will be emailed to the facility. (Page 2 of 2)

Investigation Findings:
13On 01/20/2022, at 3:45pm Bernice Karnsrithong, Licensing Program Analyst (LPA) conducted a follow-up complaint inspection to the above facility and met with the administrator. The purpose of the inspection was to deliver findings for the above complaint allegations. During the investigation of the allegations that facility has a bug infestation, youth sustained an injury while in care and staff failed to prevent youths from engaging in a physical altercation, LPA conducted confidential interviews and reviewed documentary evidence. Action Pest Control Inspection report dated 10/20/2020 indicates that there was no evidence of bed bug infestation in the facility on that day. Incident reports and consistent statements suggest that appropriate emergency intervention protocols were observed, appropriate medical treatment was provided to clients who sustained injuries and that staff conducted appropriate safety and health measures to ensure the safety and well-being of clients in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Bernice Karnsrithong LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290b El Segundo, CA Facility Name: for the Future, INC.FACILITY NUMBER: VISIT DATE: 01/20/2022

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


raw_content:
Narrative:
Based on confidential interviews and the facility's positive discipline procedures; instances of bullying between clients may have occurred however interviews and incident report indicated that facility staff utilized emergency intervention protocols and follows through appropriate positive discipline procedures when such incidents occur in the facility. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove or disprove that a violation occurred. Therefore, the allegations are all unsubstantiated. There were no deficiencies cited at this time. Exit interview was conducted and copy of this report will be provided to the facility.

Investigation Findings:
13On 02/03/2022 at 12pm, Licensing Program Analyst (LPA) Bernice Karnsrithong conducted a follow-up complaint inspection and met with Facility Manager, Rubi Valerio. The purpose of the inspection was to deliver findings for the above complaint allegations. During the investigation of the allegations, that facility staff failed to obtain a restraining order against a known adult predator harassing the group home youth; youth was bullied by another youth in the group home; and lack of supervision resulted in inappropriate activities between group home youth; LPA Karnsrithong conducted confidential interviews and reviewed documentary evidences. Based on the confidential interviews and documentary evidences, the facility attempted to file a restraining order however, law enforcement was not able to complete this process this due to lack of biographical information. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Bernice Karnsrithong LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290b El Segundo, CA Facility Name: for the Future, INC.FACILITY NUMBER: VISIT DATE: 02/04/2022

met_with: Facility Manager


raw_content:
Narrative:
The facility staff conducted random room searches to confiscate illegal drugs and contraband. Evidence of Unusual Incident Reports were written, and authorized representatives were notified. There was no evidence to suggest children in care were not properly supervised. Due to lack of evidence and conflicting statements obtained during the investigation, LPA determines that the allegation is Unsubstantiated at this time meaning, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. There are no deficiencies cited at this time.

Investigation Findings:
13On August 5, 2022, at 9: AM Licensing Program Analyst (LPA), Rosslyn Gray made an unannounced visit to conclude the investigation and to deliver the findings. LPA conducted a Health and safety risk assessment upon arriving at the facility. During the investigation, LPA-Gray interviewed and accounted for all available relevant parties; and gathered pertinent information in reference to the allegations. The Licensee denied the allegations. Based on confidential interviews and review of documentary evidence there is no evidence or witnesses to support that the facility staff did not prevent youth from engaging in CSEC activity, minors have access to illegal drugs while in care, staff did not prevent minor from AWOL's. Documentary evidence show that staff implemented the proper protocol to prevent the children from going AWOL. Documentary evidence also showed that the Licensee provided individual services to meet the children's needs which included Child Family Team meetings, Alcohol and Drug Program, a CSEC Mentor Program and Incentives. Staff followed emergency interventions utilizing methods of crisis communication to redirect and encourage children to make better choices for the health and safety. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290b El Segundo, CA Facility Name: for the Future, INC.FACILITY NUMBER: VISIT DATE: 08/05/2022

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

met_with: ADMINISTRATOR


raw_content:
Narrative:
The facility staff conducted random room searches to confiscate illegal drugs and contraband. Evidence of Unusual Incident Reports were written, and authorized representatives were notified. There was no evidence to suggest children in care were not properly supervised. Documentary evidence also showed that the Licensee provided individual services to meet the children's needs which included Child Family Team meetings, Alcohol and Drug Program, a CSEC Mentor Program and Incentives. Staff followed emergency interventions utilizing methods of crisis communication to redirect and encourage children to make better choices for the health and safety. Due to lack of evidence and conflicting statements obtained during the investigation, LPA determines that the allegation is Unsubstantiated at this time meaning, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. There are no deficiencies cited at this time.

Investigation Findings:
13On August 5, 2022, at 11: AM Licensing Program Analyst (LPA), Rosslyn Gray made an unannounced visit to conclude the investigation and to deliver the findings. LPA conducted a Health and safety risk assessment upon arriving at the facility. During the investigation, LPA-Gray interviewed and accounted for all available relevant parties; and gathered pertinent information in reference to the allegations. The Licensee denied the allegations. Based on confidential interviews and review of documentary evidence there is no evidence or witnesses to support that the facility staff did not prevent youth from smoking marijuana in the facility, engaging in CSEC activity, and that the facility staff do not ensure that youth attend school. Documentary evidence show that staff implemented the proper protocol to prevent the children from going AWOL and documented evidence of school refusal. Staff followed emergency interventions utilizing methods of crisis communication to redirect and encourage children to make better choices for the health and safety. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290b El Segundo, CA Facility Name: for the Future, INC.FACILITY NUMBER: VISIT DATE: 08/05/2022

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


raw_content:
Narrative:
LPA Rosas conducted interviews with staff, and pertinent parties regarding to allegations. LPA Rosas conducted a file review on Client#1 (C1) on 10/27/2022 and obtain copies of JV-220 dated 05/18/2022, Psychotropic Medication Administration Record (MAR) and Special Incident Reports (SIR). During the investigation, it was reported that C1 was placed on 5585 hold in the hospital and was schedule to be released on 10/31/2022. The facility placed 14-day discharge notice on 10/17/2022 to the safeguard the health and well-being of facility employees and residents in care. The 14-day discharge notice expired on 10/30/2022 and during Child Family Team (CFT) meeting the County of placement was informed to coordinate C1 transition as facility would not be able to pick up C1. The documentation and interviews with pertinent parities detail that 14-day was given but County of placement was seeking additional time to coordinate pick up of C1. File review, of JV-223 stated that C1 was prescribe five (5) psychotropic medications upon arrival to the facility. On 08/09/2022, C1 medication prescription was updated, and Psychotropic Medication #1 (SM1) was removed and JV-223 was pending update. Upon discharge, the facility provided the current psychotropic medication prescription that did not include SM1 as noted in JV-223. Confidential statements obtained produced no corroborating evidence to corroborate the allegations of Personal Rights and Medication. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has decided that the allegations of Personal Rights and Medication are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was left at the facility.

Investigation Findings:
13On March 21, 2023, at 1:00pm, Licensing Program Analyst (LPA) Olivia Rosas conducted an unannounced inspection to For the Future - Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegations and to deliver the finding. LPA Rosas, met with Staff#1 (S1) and together discussed the investigation details. During the investigation process, LPA Rosas interviewed witnesses and pertinent parties related to the investigation. Individuals mention in this complaint are identify on the Confidential Names List (LIC811) dated 03/21/2023. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the allegations of facility did not accept minor back after hospitalization and facility did not properly manage minor's medications are unsubstantiated. The allegation may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. Report continues LIC-9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Olivia Rosas LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: FOR THE FUTURE, INC.FACILITY NUMBER: VISIT DATE: 03/21/2023

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

met_with: Staff#1 (S1)


raw_content:
Narrative:
(Continued from 9099) Based on all interviews conducted, and documents obtained, the Department has found the above allegations to be unsubstantiated, meaning that, the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. There are no deficiencies to be cited at this time.

Investigation Findings:
13On 09/07/2023 at 12:13pm, Licensing Program Analyst (LPA) Christine Wilson made an unannounced inspection to the above listed facility, for the purpose of concluding the investigation on the above allegations. LPA Wilson was greeted by (S1) who provided access to the home. It was alleged that staff pushed minor, staff do not distribute minor's medication as prescribed, staff speak inappropriately to minor, staff do not meet minor's dietary needs, staff did not allow minor access to their personal belongings. Alleged victim (C1) did not choose to interview or give statements to LPA Wilson. During the course of this investigation, LPA Wilson conducted witness interviews, record reviews, and made observations. There was not enogh evidence to determine that the allegations occurred.. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Christine Wilson LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FACILITY NAME: FOR THE FUTURE, INC.FACILITY NUMBER: VISIT DATE: 09/07/2023

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

met_with: Administrator (S1)


raw_content:
Narrative:
Based on records reviewed and confidential statements, the allegations cannot be substantiated due to a lack of evidence. Information obtained revealed contradiction to alleged neglect as confidential statements determined knowledge of C1's medical condition was discovered approximately two days after their initial admission (5/26/2023) during a Child and Family Team (CFT) meeting. Upon notification, facility staff took immediate action, and after the CFT meeting, C1 was taken to a hospital for non-injury purposes to obtain a medical evaluation and medication. The investigation found no evidence at this time to support neglect/lack of supervision as alleged; therefore, the allegation is determined Unsubstantiated. A finding that the complaint is unsubstantiated means 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. There are no deficiencies cited per California Code of Regulations, Title 22 or Interim Licensing Standards (ILS) at this time. Exit interview completed. A copy of this report was provided to the Facility Administrator.

Investigation Findings:
13On September 15, 2023, at 3: PM, Licensing Program Analyst (LPA), Regina Martin conducted a follow-up complaint inspection at For the Future, Inc. to deliver findings concerning the above-mentioned allegations. LPA Martin met with Tessa Koziol, Administrator, to discuss the outcome. The allegations were referred to Community Care Licensing Investigations Branch for assignment. On June 2, 2023, the El Segundo Children's Residential Program Regional Office received a complaint referral alleging neglect/lack of supervision as it was reported that Staff did not seek medical attention for a youth in a timely manner resulting in hospitalization, and that Staff did not treat youth with dignity and respect [see Confidential Names form, LIC 811, dated 9/15/2023]. On June 6, 2023, LPA Regina Martin met with Rubi Valerio, Facility Administrator, informed receipt of allegation and obtained client/facility records. The investigation further included confidential interviews with Client #1 (C1), staff members, and review of client file history and associated medical reports (Continued on page LIC9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Regina Martin LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290b El Segundo, CA Facility Name: for the Future, INC.FACILITY NUMBER: VISIT DATE: 09/15/2023

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

met_with: Tessa Koziol, Administrator


raw_content:
Investigation Findings:
13On 03/22/2024, Licensing Program Analyst (LPA), Christine Wilson, concluded the investigation of the above allegations. During the course of this investigation, LPA Wilson conducted witness interviews, record reviews, and made observations. Based on all interviews conducted and documents obtained, the above allegation was found to be unsubstantiated, meaning that the allegations may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Supporting evidence includes the following: • Witness accounts substantially differed over how child in care was monitored during the outing. • Although there was a police report, there were no other witness accounts or documentation to support that reports or other forms of documentary validation available establishing the cause or the likelihood of abandonment by the alleged perpetrators. • Documentation substantially differed in that there was staff involvement in altercation between clients.. There are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report will be emailed the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Christine Wilson LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: FAcility Administrator


raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward investigated the above allegations. LPA interviewd C1, C2, C3 and C4. LPA also interviewed Staff 1, administrators and social workers. LPA reviewed incident reports, the facility's internal investigative report and the police report. There was no needs and services plan for the victim (C1) because she had only been at the facility for four days prior to the overdosing incident. The interviews and reports yielded conflicting information regarding the source of the pills on which C1 overdosed and also whether or not Staff 1 intervened when the other clients were fighting with and bullying C1. Therefore the allegations are resolved as unsubstantiated. Unsubstantiated means that although an allegation may have happened or is valid, there is not a preponderance of evidence to prove that it did happen. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Olivia Harvey, Administrator