raw_content:
Narrative:
On July 6, 2023, Community Care Licensing (CCL) received a complaint alleging that due to lack of supervision youth sustained injuries while in care. It was reported to CCL that C1 sustained multiple injuries due to an altercation with other clients in placement. During investigation, there was no corroborating evidence to support the allegation that lack of supervision by staff was a result of C1 sustaining injuries while in care. Although it was revealed that an altercation involving C1 and C2 resulted from C1 taking C2's property the department received inconsistencies with statements provided during confidential interviews. Some confidential interviews denied that C1 was "jumped" by multiple clients in care and added that there were no visible injuries observed on C1 after the altercation involving C2. While other confidential interviews reported that staff were aware that C2 was going to fight C1 upon C1's return to the facility due to C1 taking C2's property. Confidential interviews further reported that staff did not intervene on a timely manner during the altercation rather than allowed the clients to fight each other prior to intervening. Other confidential interviews denied that staff allowed the altercation and maintained that C1 had no injuries that required medical attention. Confidential interviews further reported that C1 was absconding from the facility daily and was in placement for a short time. Confidential interviews further maintained that the altercation only involved C1 and C2 and injuries were not observed on C1 due to C1 leaving the facility after the incident. C2 could not be reached for comment regarding the allegation where C2 was identified as the alleged aggressor. LPA received inconsistent information regarding the allegation. Based on confidential interviews, the allegation that due to lack of supervision C1 sustained injuries while in care, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report along with the appeal rights will be emailed to Facility Manager, Janet Winkfield due to technical difficulties.

Investigation Findings:
13On November 15, 2023, 8: AM, Licensing Program Analyst (LPA), Cynthia Urena met with Achieve Residential Center Short Term Residential Therapeutic Program (STRTP) Facility Manager, Janet Winkfield to deliver the investigative finding for the above stated allegation. On July 13, 2023, at 3: PM, LPA Daniel Mena initiated the investigation at the STRTP and collected pertinent documents from the STRTP staff and client files. A health and safety inspection was conducted, and no deficiencies were observed. LPA Mena informed the facility that Special Investigator (SI) Phillipe Miles would be conducting the investigation. Interviews were conducted with four clients (C1, C3, C4, C5), a witness, two staff member (S1, S2) and a County Social Worker. LPA Urena made multiple attempts to reach C2 for an interview but due to a runaway status and unknown whereabouts C2 could not be interviewed regarding the allegation. (**Continued on LIC C**) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Cynthia Urena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: ACHIEVE RESIDENTIAL CENTERFACILITY NUMBER: VISIT DATE: 11/15/2023

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

met_with: Facility Manager, Janet Winkfield


state: CA

facility_name: ACHIEVE RESIDENTIAL CENTER

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
A confidential interview reported that the facility did receive a call from the school, and school personnel informed S1 of the emergency involving C1. A confidential interview reported the school was supposed to call back with an update on C1. However, when the school failed to do so, S1 called the school and was informed that C1 was being transported to the hospital accompanied by school staff. A confidential interview reported that S1 was the only staff working; therefore, S1 could not leave the STRTP, as other clients were on facility grounds. Confidential interviews reported that S2 was called into work and immediately went to the hospital to meet C1 and school staff. In addition, confidential interviews reported that S2 remained with C1 until C1 was discharged and transported C1 back to the facility. The Department also received an allegation that staff are not addressing youth's (C1) self-harming behaviors. It was reported that C1 admitted to self-harming and had visible marks on both arms. Confidential interviews reported that staff are responsive, provide emergency interventions, and utilize C1's safety plan. Confidential interviews reported that C1 does not always respond to staff interventions and will refuse mental health services. Documentation obtained as part of the investigation reports that C1's authorized representative was made aware of C1's behaviors, and a meeting was held to address the issue. Confidential interviews reported staff do not ignore C1's self harming behaviors and increased supervision of C1. In addition, to ensure the safety of all clients in care, during the inspection, LPA observed that all knives, scissors, and sharp objects were locked in a lockbox, locked in the hall closet, and inaccessible to clients Based on inconsistent confidential interviews and pertinent documentation, the allegations that staff did not respond in a timely manner to emergency calls regarding youth (C1) and staff are not addressing youth's (C1) self-harming behaviors are unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of evidence to prove that the alleged violations occurred. An exit interview was conducted. A copy of this report and appeal rights were explained and given to Facility Manager, Janet Winkfield. This is an amended report of a report that was originally issued on 01/12/2024

Investigation Findings:
13This is an amended report of a report that was originally issued on 01/12/ On January 12, 2024, at 10: AM, Licensing Program Analyst (LPA) Jessica Peete conducted an unannounced visit to Achieve Residential Center Short Term Residential Therapeutic Program ( STRTP) to deliver the investigative findings for the allegations listed above. On 09/12/2023, LPA Peete inspected the physical plant, and no immediate safety hazards were observed. During the investigation, LPA obtained documents pertinent to the investigation. LPA also interviewed clients (C1, C2, C3, and C6) and staff (S1 and S2). LPA attempted to interview C4 and C5 but was unsuccessful because C4's whereabouts were unknown, and C5 declined the interview. On 09/11/2023, Community Care Licensing received an allegation that staff did not respond in a timely manner to emergency calls regarding youth (C1). It was alleged that the facility did not respond to emergency calls from C1's school. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Jessica M Peete LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: ACHIEVE RESIDENTIAL CENTERFACILITY NUMBER: VISIT DATE: 01/12/2024

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

report_type: Complaint Investigation

met_with: Facility Manager Janet Winkfield

complaint_status: unsubstantiated


raw_content:
Narrative:
There were concerns that C1 was not being appropriately supervised in the STRTP. It was reported that C1 used their cell phone to make and send inappropriate videos. Confidential interviews reported that C1's behavior was addressed with their (C1's) authorized representative during Child Family Team meetings. Confidential interviews also reported staff have increased supervision of C1 and provided C1 with additional services and resources. Information from confidential interviews reported adequate supervision at the STRTP, and staff completed room checks every ten to thirty minutes. To ensure clients practice safe habits while online, confidential interviews reported group sessions on internet safety are conducted continuously, and staff actively discourage clients from using cell phone applications to talk to strangers online. Confidential interviews also reported that the facility's WIFI is only accessible to clients from 2PM to 9PM. Clients can use the shared devices (laptop and tablet) in the common area under staff supervision. Additionally, confidential interviews reported the facility provided services from other organizations to further educate clients about the potential dangers of social media. Based on confidential interviews the allegation that staff does not adequately monitor minor's (C1) internet usage is unsubstantiated. The allegations may have happened or are valid, but there is not a preponderance of evidence to prove that the alleged violations occurred. An exit interview was conducted. A copy of this report and appeal rights were explained and given to Janet Winkfield. This is an amended report of a report that was originally issued on 01/25/2024

Investigation Findings:
13This is an amended report of a report that was originally issued on 01/25/ On January 25, 2024, at 9: AM, Licensing Program Analyst (LPA) Jessica Peete conducted an unannounced visit to Achieve Residential Center Short Term Residential Therapeutic Program ( STRTP) to deliver the investigative findings for the allegation listed above. On 09/15/2023, LPA Peete inspected the physical plant, and no immediate safety hazards were observed. During the investigation, LPA obtained documents pertinent to the investigation. LPA also interviewed clients (C4, C5, and C6), staff (S1, S2, and S3), and the County Social Worker (CSW). LPA attempted to interview C1, C2, and C3; both clients (C1 and C3) declined the interview, and C2's whereabouts are unknown. On 09/15/2023, Community Care Licensing received an allegation that staff does not adequately monitor the minor's (C1) internet usage. (Continued on LIC 9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Jessica M Peete LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: ACHIEVE RESIDENTIAL CENTERFACILITY NUMBER: VISIT DATE: 01/25/2024

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


raw_content:
Narrative:
Confidential interviews reported while on unauthorized leave from the STRTP, C1 engaged in consensual inappropriate behavior with an unnamed youth, resulting in a mark on the left side of C1's neck. Regarding the mark on the right side of C1's neck, LPA received inconsistent statements; a confidential interview reported that C2 caused the mark through inappropriate consensual contact on facility grounds. Another confidential interview denied that C2 and C1 had an inappropriate relationship and reported the marks on C1's neck were caused by the unknown youth. In addition, multiple confidential interviews reported clients in care receive adequate supervision. Confidential interviews reported staff complete room checks regularly and do not allow or encourage room visiting amongst the clients. Furthermore, confidential interviews reported staff continuously instruct clients to maintain appropriate boundaries and will increase supervision of clients as needed. Based on inconsistent confidential interviews and documentation, the allegation that staff did not adequately supervise minor (C1), resulting in minor (C1) sustaining unexplained injuries while in care, is unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of evidence to prove that the alleged violation occurred. An exit interview was conducted. A copy of this report and appeal rights were explained and given to Facility Manager Janet Winkfield.

Investigation Findings:
13On February 29, 2024, at 12: PM, Licensing Program Analyst (LPA) Jessica Peete conducted an unannounced visit to Achieve Residential Center Short Term Residential Therapeutic Program (STRTP) to deliver the investigative findings for the allegation listed above. LPA obtained documents pertinent to the investigation and interviewed Clients (C1, C2, and C5) and staff (S1 and S2). LPA attempted to interview C3 and C4; both clients (C3 and C4) declined the interview, and C6's whereabouts are unknown. On 10/26/2023, Community Care Licensing received an allegation that staff did not adequately supervise minor (C1) resulting in minor (C1) sustaining unexplained injuries while in care. It was reported that C1 had bruises around their (C1's) neck. Confidential interviews reported C1 had marks on the left and right side of their (C1's neck). Information from confidential interviews and documentation reported that C1 admitted to leaving the facility without permission and returning with marks (hickeys) on their (C1's) neck. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Jessica M Peete LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: ACHIEVE RESIDENTIAL CENTERFACILITY NUMBER: VISIT DATE: 02/29/2024

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


raw_content:
Narrative:
LPA received inconsistent statements regarding the relationship between C1 and C2. Confidential interviews reported that C1 and C2's involvement was consensual. However, another confidential interview reported that C1 and C2 maintained the appropriate boundaries and denied inappropriate behavior. In addition, confidential interviews reported staff do not encourage or allow "romantic" relationships between the youth in care. When staff become aware the clients have become involved, the behavior is addressed with the clients and the assigned CSW, and if required, staff change bedroom sharing arrangements. Furthermore, information from confidential interviews denied a lack of supervision at the STRTP. Multiple confidential interviews reported staff regularly complete room checks and do not permit clients to visit other clients' bedrooms. A confidential interview reported that staff instruct clients to visit each other in the common areas under staff supervision. However, if the clients are in the room together, staff will increase supervision as needed. Based on inconsistent confidential interviews and documentation, the allegation that due to a lack of care and supervision, staff did not prevent inappropriate interactions between minors (C1 and C2) in care is unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of evidence to prove that the alleged violation occurred. An exit interview was conducted. A copy of this report and appeal rights were explained and given to Youth Counselor, Lucy Smith.

Investigation Findings:
13On March 4, 2024, at 9: AM, Licensing Program Analyst (LPA) Jessica Peete conducted an unannounced visit to Achieve Residential Center Short Term Residential Therapeutic Program (STRTP)) to deliver the investigative findings for the allegation listed above. LPA obtained documents pertinent to the investigation and interviewed Clients (C1, C2, and C3), staff (S1 and S2), and the County Social Worker (CSW). LPA attempted to interview C4 and C5; both clients (C4 and C5) declined the interview, and C6's whereabouts were unknown. On 10/20/2023, Community Care Licensing received an allegation that due to a lack of care and supervision, staff did not prevent inappropriate interactions between minors (C1 and C2) in care. It was reported that C1 and C2 engaged in inappropriate sexual behavior and had marks (hickeys) on their (C1 and C2) necks. The Special Incident Report (SIR) received by the Department reported that the clients (C1 and C2) were seen in the bedroom together. The SIR reported that the staff on-site completed room checks and acted appropriately to redirect C1 and C2's behavior. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Jessica M Peete LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: ACHIEVE RESIDENTIAL CENTERFACILITY NUMBER: VISIT DATE: 03/04/2024

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

met_with: Youth Counselor, Lucy Smith


raw_content:
Narrative:
LPA received inconsistent information to support the allegation. Although it was reported that S3 tried to prevent C1 from reporting the incident, LPA did not obtain additional statements from those who allegedly witnessed S3's instruction to staff or threat to C1. Some confidential interviews reported hearing about S3's actions and S3's rule of clients not reporting other clients. However, other confidential interviews denied S3 or other staff preventing clients from reporting incidents or having knowledge of staff, discouraging clients from reporting or pressing charges if they are victimized. Information from a conditional interview also reported that clients are made aware of their personal rights and are encouraged to talk to staff or submit written reports if they have concerns or need to report an incident. Furthermore, a confidential interview reported that staff understand they are mandated reporters; in addition, clients and staff can make a report to the required authorities without fear of facing disciplinary or retaliatory action. Based on inconsistent confidential interviews, the allegation staff (S3) are preventing a minor (C1) from reporting the incident to authorities is unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of evidence to prove that the alleged violation occurred. An exit interview was conducted. A copy of this report and appeal rights were explained and given to Assistant Facility Manager, Lucy Smith.

Investigation Findings:
13On April 4, 2024, at 10: AM, Licensing Program Analyst (LPA) Jessica Peete conducted an unannounced visit to Achieve Residential Center Short Term Residential Therapeutic Program (STRTP) to deliver the investigative findings for the allegation listed above. LPA Peete obtained documents pertinent to the investigation. LPA Choi interviewed clients (C1, C3 and C4) and staff (S1 and S2). LPA Peete interviewed C2, C6 and S3. LPA Peete attempted to interview C5, but C5 declined the interview. On 12/20/2023, Community Care Licensing received an allegation that staff (S3) are preventing a minor (C1) from reporting the incident to authorities. More specifically, it was alleged that S3 threatened C1 would lose their (C1's) placement at the STRTP if C1 pressed charges against C6. Confidential interviews reported that C1 informed STRTP staff that C6 had been inappropriate with C1; staff then assisted C1 with reporting the incident to law enforcement. The confidential interview reported that upon learning of the incident, S3 told staff to inform law enforcement that C1 had made a false report. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Jessica M Peete LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: ACHIEVE RESIDENTIAL CENTERFACILITY NUMBER: VISIT DATE: 04/04/2024

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

met_with: Assistant Facility Manager, Lucy Smith


raw_content:
Narrative:
residents, search their rooms and the amount of supervision that is provided when there are suspicions a resident may be under the influence or have contraband. A second allegation alleging due to lack of supervision minor (C1) participated in self-harming behaviors. Specifically, it was reported that C1 was observed to have "fresh cuts all over both sides of [their] forearms." Confidential interviews and record review could not confirm or dispute if C1 self-harmed while at the facility or at another location. Based on record review and confidential interviews the allegations alleging minor (C1) has been smoking and drinking alcohol while in care due to lack of supervision and due to lack of supervision minor (C1) participated in self-harming behaviors may have occurred, however they are not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights to Achieve Residential Center, Mental Health Specialist, Vickye Poindexter-Wilson.

Investigation Findings:
13On May 21, 2024 at 10:21am Licensing Program Analyst (LPA), Nicole Strickland met with Achieve Residential Center Mental Health Specialist, Vickye Poindexter-Wilson to deliver the findings for the above stated allegations. A health and safety inspection of the facility was conducted on March 13, 2024, and no immediate hazards were observed. The investigation included interviews with four of five foster youth [Child #1 (C1), Child #3 (C3), Child #5 (C5), and Child #6 (C6)], two staff members [Staff #1 (S1) and Staff #2 (S2)] and one County Social Worker (CSW). In addition, county records, facility records were reviewed. On March 8, 2024, Community Care Licensing (CCL) received an allegation alleging minor (C1) has been smoking and drinking alcohol while in care due to lack of supervision. Confidential interviews reported consistent statements of residents returning to the facility with various types of contraband hidden on their person. Confidential interviews reported there are inconsistencies with when and how staff search UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION ORANGE COUNTY RO, THE CITY DR., SUITE FACILITY NAME: ACHIEVE RESIDENTIAL CENTERFACILITY NUMBER: VISIT DATE: 05/21/2024

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


raw_content:
Narrative:
Based on confidential interviews, the allegation that due to lack of care and supervision C2 was inappropriately touched while in care, may have occurred, however, is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with appeal rights was provided to Achieve Residential Center Short Term Residential Therapeutic Program (STRTP), Janet Winkfield, Facility Manager.

Investigation Findings:
13On May 01, 2025 at 12: PM, Licensing Program Analyst (LPA) Sarah Lo met with Janet Winkfield, Facility Manager, to deliver the finding for the above complaint allegation at Achieve Residential Center Short Term Residential Therapeutic Program (STRTP). On January 31, 2025, LPA inspected the facility's physical plant, and no immediate health and safety hazards were observed. The investigation included interviews with two staff (S1, S2), four clients (C1, C2, C4, C5) and two County Social Workers (CSW1, CSW2). Clients' Needs and Services Plans were reviewed. On January 23, 2025, Community Care Licensing received an allegation that due to lack of care and supervision minor (C2) was inappropriately touched while in care. Specifically, it was reported that C2 was sexually assaulted by C1 while C2 was asleep. During the investigation, there was no corroborating evidence to support the above allegation, and the confidential interviews revealed conflicting statements. Additionally, there were no witnesses as to if the incident had occurred. (continued on LIC 9099c) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Sarah Lo LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: ACHIEVE RESIDENTIAL CENTERFACILITY NUMBER: VISIT DATE: 05/01/2025

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

met_with: Janet Winkfield, Facility Manager


raw_content:
Narrative:
Specifically, it was reported that C1 could only do laundry three days per week and therefore did not have clean clothes. Also, it was reported that something sexually inappropriate occurred between C2 and C5 and the staff did not remove C2 from the house. During the investigation, there was no corroborating evidence to support the above allegations, and the confidential interviews revealed conflicting statements to if the incidents occurred. Based on inconsistent confidential interviews, the allegations that facility staff are not providing C1 with adequate clothing and facility staff are not intervening between C2 and C5 and inappropriate behavior, may have occurred, however, is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with appeal rights was provided to Achieve Residential Center Short Term Residential Therapeutic Program (STRTP), Janet Winkfield, Facility Manager.

Investigation Findings:
13On May 21, 2025 at 02: PM, Licensing Program Analyst (LPA) Sarah Lo met with Janet Winkfield, Facility Manager, to deliver the finding for the above complaint allegation at Achieve Residential Center Short Term Residential Therapeutic Program (STRTP). On 02/13/25, LPA inspected the facility's physical plant, and no immediate health and safety hazards were observed. The investigation included interviews with two staff (S1, S2), four clients (C1, C2, C5, C6) and one County Social Worker (CSW). In addition, clients' files and County Investigation Narrative were reviewed. On February 11, 2025, Community Care Licensing received complaint allegations that facility staff are not providing children (C1) with adequate clothing and facility staff are not intervening between minors (C2, C5) and inappropriate behavior. (continued LIC 9099c) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Sarah Lo LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: ACHIEVE RESIDENTIAL CENTERFACILITY NUMBER: VISIT DATE: 05/21/2025

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


raw_content:
Narrative:
During the investigation, there was no corroborating evidence to support the above allegation, and the confidential interviews revealed conflicting statements to if the incident occurred. Confidential interviews revealed that S2 is respectful and have never heard them speak to C5 inappropriately. Confidential interviews revealed that they have heard S2 called S2 fat. Confidential interviews revealed that S2 did not call C5 fat, however, made a statement to C5 to watch their weight. Based on inconsistent confidential interviews, the allegations that S2 speak inappropriately to C5, may have occurred, however, is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with appeal rights was provided to Achieve Residential Center Short Term Residential Therapeutic Program (STRTP), Facility Manager, Janet Winkerfield.

Investigation Findings:
13On September 09, 2025 at 02: PM, Licensing Program Analyst (LPA) Sarah Lo met with Facility Manager, Janet Winkfield, to deliver the finding for the above complaint allegation at Achieve Residential Center Short Term Residential Therapeutic Program (STRTP). On 05/12/25, LPA inspected the facility's physical plant, and no immediate health and safety hazards were observed. The investigation included interviews with three staff (S1, S2, S3), five clients (C1, C2, C3, C4, C5) and two County Social Workers (CSW4, CSW5). In addition, the clients' files and County Investigation Narrative were reviewed. On May 08, 2025, Community Care Licensing received a complaint allegation that staff (S2) speak inappropriately to minor (C5). Specifically, it was reported that S2 calls C5 fat and that C5 refused food so they can lose weight. (continued on LIC 9099c) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Sarah Lo LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: ACHIEVE RESIDENTIAL CENTERFACILITY NUMBER: VISIT DATE: 09/09/2025

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

met_with: Janet Winkerfield, Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On December 22, 2022 at 8: AM, Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera arrived at Achieve Residential Therapeutic Program (STRTP). LPA was greeted and granted access by Ms. Vickye Poindexter-Wilson. The purpose of the visit is to conduct an annual inspection of the facility. There were two staff and four clients present at the time of the inspection. Appropriate staff/client ratios were verified during the inspection. At 9: AM, Mrs. Vickye Poindexter-Wilson led the physical inspection of the facility with LPA. The facility consists of four bedrooms and two bathrooms. The facility has a dining area, kitchen area, living room, open common area/formal living room, a clinician's office for therapeutic services, an entertainment room, and a garage where the washer and dryer are located. One bedroom is used at the staff office and has the staff restroom. All bedrooms have individual beds and drawer space for each client. There is also another staff office with an adjacent room off of the kitchen. The facility ensures that there is one client per bed with appropriate linens, pillows, comforters, and mattresses in good repair. Facility grounds are clean and free of debris and observable hazards. During the inspection, it was observed that the basketball hoop in the backyard has fallen over and is on the ground, creating a potential hazard. The facility has a pool which is appropriately fenced and secured with a rod iron fence. The enclosure was measured to be five feet tall and met Title 22 regulations. It has a self-latching gate that swings outward. The fence is also locked when pool is not in use. There is adequate indoor and outdoor activity space. Televisions, speakers, computer, board games, and basketball hoop, were observed for client's recreation time. Recent outings and activities were mentioned. Carbon monoxide detector is in appropriate working order and facility smoke detectors are also in working order. Fire extinguisher is properly charged and serviced. The facility maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. All required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster. Medications are locked and stored in a locked box within a locked cabinet in the hallway. The hot water in the kitchen was deemed to be at a safe temperature. Per facility staff, no firearms or weapons are allowed in the facility. Chemicals and/or poisons are locked in a cabinet in the garage. Sharp objects are locked and stored in the locked cabinet in the hallway. First Aid Kits are also stored locked hallway cabinet and are complete. Four of four client files and nine staff files were reviewed during time of inspection. All files of the client files reviews had required documents in the files. All staff that work at the facility have Department of Justice and Child Abuse Clearance Index clearances. A review of administrative records indicate that the facility has paid their current licensing fees. All staff that work at the facility have Department of Justice and Child Abuse Clearance Index clearances. Based on the facility inspection and file reviews this date, are no deficiencies found at this time. Exit interview conducted and a copy of this report was reviewed and given to facility representative Ms. Vickye Poindexter-Wilson.

report_type: Facility Evaluation

visit_type: Annual

met_with: Mrs. Vickye Poindexter-Wilson


summary: Facility Evaluation

raw_content:
Narrative:
On March 14, 2023 at 8: AM, Licensing Program Analyst (LPA) Jessica Peete arrived at Achieve Short Term Residential Therapeutic Program (STRTP). LPA was greeted and granted access by Facility Manager Janet Winkfield. The purpose of the visit is to conduct an annual inspection of the facility. However, an annual inspection was completed 12/22/2022; therefore an annual is not required at this time. A copy of this report was provided to the Facility Manager.

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On 01/29/2024 at 10: AM Licensing Program Analyst (LPA) Peete arrived unannounced at Achieve Residential Short Term Residential Therapeutic Program (STRTP) . The purpose of the visit was to amend the LIC 9099 and LIC 9099-C reports originally issued on 01/25/2024. A copy of this report was given to Case Manager, Vickye Pointdexter-Wilson.

met_with: Case Manager, Vickye Pointdexter-Wilson


summary: Facility Evaluation

raw_content:
Narrative:
On March 7, 2025 at 9: AM, Licensing Program Analyst (LPA) Jacob Ortega arrived at Achieve Residential Therapeutic Program (STRTP). LPA was greeted and granted access by Ms.Ward Direct staff and Ms.Vickye Mental Health Specialist. The purpose of the visit is to conduct an annual inspection of the facility. There were two staff and three clients present at the time of the inspection. Appropriate staff/client ratios were verified during the inspection. At 9: AM, Mrs. Ward led the physical inspection of the facility with LPA. The facility consists of four bedrooms and two bathrooms. The facility has a dining area, kitchen area, living room, open common area/formal living room, a clinician's office for therapeutic services, an entertainment room, and a garage where the washer and dryer are located. One bedroom is used at the staff office and has the staff restroom. All bedrooms have individual beds and drawer space for each client. There is also another staff office with an adjacent room off of the kitchen. Staff office adjacent to kitchen has two rooms with each one having a desk and two chairs. The facility ensures that there is one client per bed with appropriate linens, pillows, comforters, and mattresses in good repair. Facility grounds are clean and free of debris and observable hazards.The facility has a pool in the back which has a fence that is locked when pool is not in used, additionally pool is covered up when not in used, for regulatory maintenance. There is adequate indoor and outdoor activity space. Televisions, speakers, computer, were observed for client's recreation time. Carbon monoxide detector is in appropriate working order and facility smoke detectors are also in working order. Fire extinguisher is properly charged and serviced. The facility maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. All required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster. Medications are locked and stored in a locked box within a locked cabinet in the hallway. The hot water in the bathroom was deemed to be at a safe temperature of 110 degrees. Per facility staff, no firearms or weapons are allowed in the facility. Chemicals and/or poisons are locked in a cabinet in the garage. Sharp objects are locked and stored in the locked cabinet in the hallway. First Aid Kits are also stored locked hallway cabinet and are complete. Five of five client files and five staff files were reviewed during time of inspection. All files of the client files reviews had required documents in the files. All staff that work at the facility have Department of Justice and Child Abuse Clearance Index clearances. Based on the facility inspection and file reviews this date, are no deficiencies found at this time. Exit interview conducted and a copy of this report was reviewed and given to facility representative Ms. Vickye.

met_with: Ms. VIckey


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Rachel Vanegas on April 15, 2025 at 09:15AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Vanegas met with Janet Winkfield, Facility Manager and inspected the facility inside and out. LPA reviewed 1 child's records and 5 staff personnel files on site at the facility. LPA reviewed 1 of 1 child's psychotropic medications and medication records. LPA interviewed 2 of 5 staff on site to discuss the facilities policies and procedures of operation. LPA interviewed 1 of 1 children currently prescribed psychotropic medication. During the inspection the LPA observed deficiencies (see attached 809D), plan of corrections were discussed and appeal rights were provided. LPA provided a copy of this licensing report to Facility Manager, Janet Winkfield.

met_with: Janet Winkfield - Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On June 24, 2021 at 9: AM, Licensing Program Analyst (LPA) Carmen Escobar arrived at Achieve Residential Therapeutic Program (STRTP). LPA was greeted and granted access by Ms. Janet Winkfield. The purpose of the visit is to conduct an annual inspection of the facility. There were two staff and four clients present at the time of the inspection. Appropriate staff/client ratios were verified during the inspection. At 9: AM, Ms. Janet Winkfield led the physical inspection of the facility with LPA Escobar. The facility consists of four bedrooms and two bathrooms. The facility has a dining area, kitchen area, living room, open common area/formal living room, a clinician's office for therapeutic services, an entertainment room, and a garage where the washer and dryer are located. One bedroom is used at the staff office and has the staff restroom. All bedrooms have individual beds and drawer space for each client. The facility ensures that there is one client per bed with appropriate linens, pillows, comforters, and mattresses in good repair. Facility grounds are clean and free of debris and observable hazards. During the inspection, it was observed that the basketball hoop in the backyard has fallen over and is on the ground, creating a potential hazard. The facility has a pool which is appropriately fenced and secured with a rod iron fence. The enclosure was measured to be five feet tall and met Title 22 regulations. It has a self-latching gate that swings outward. The fence is also locked when pool is not in use. There is adequate indoor and outdoor activity space. Televisions, speakers, computer, board games, and basketball hoop, were observed for client's recreation time. There is no activities calendar posted, however, staff advise due to COVID-19, they are just getting back to scheduling outings and outside activities. Recent outings and activities were mentioned. Carbon monoxide detector is in appropriate working order and facility smoke detectors are also in working order. Fire extinguisher is properly charged and serviced. The facility maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. All required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster. Medications are locked and stored in a locked box within a locked cabinet in the hallway. The hot water in the kitchen was deemed to be at a safe temperature. Per facility staff, no firearms or weapons are allowed in the facility. Chemicals and/or poisons are locked in a cabinet in the garage. Sharp objects are locked and stored in the locked cabinet in the hallway. First Aid Kits are also stored locked hallway cabinet and are complete, however, a First Aid Manual was unavailable. The facility employs one Facility Administrator, three Facility Managers, two Case Managers, seven direct care/youth counselor staff, one Head of Service and one Program Director. Facility has not yet obtained Mental Health Certification, however, have submitted the application and are awaiting approval. Facility has obtained National Accreditation through CARF effective through February 28, 2022. Currently, there is a balance of $681.00 in Licensing fees for the facility. At 9: AM, six of six client files were reviewed during time of inspection. Client 1 (C1), client 2 (C2), client 3 (C3), client 4 (C4), client 5 (C5), and client 6's (C6) (See LIC 857) dated June 24, 2021. C4 and C6 do not have medical consent form in files. Facility will be cited under Interim Licensing Standards (ILS) section Children's Records. Needs and service plans for all clients were not up to date. The facility will be cited under the Interim Licensing Standards (ILS) section 87068. Modifications to the Needs and Service Plan. All clients did not have proof of current TB test. C2 and C4 did not have proof of immunizations. C3 did not have a signed copies of the personal rights, removal/discharge procedures, the facility complaint/grievance process, and house discipline/rules. C3 and C4 did not have a medical assessment on file. LPA Escobar requested that the current needs and service plans, immunization records, signed facility policies, and medical consents for mentioned clients, be sent to LPA Escobar as soon as possible. Technical Assistance Advisory Notes (TA) will be issued. LPAs conducted client interviews. Clients indicated that their basic needs are being met at the facility and core services are being provided. LPA Escobar began the review of staff files, however, due to time constraints, was not able to conclude the review. LPA Escobar will return to complete staff file review and interviews at a later date. An exit interview was conducted and a copy of this report and appeal rights were provided to Facility Manager, Ms. Janet Winkfield.

met_with: Facility manager-Janet Winkfield


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On June 25, 2021, at 9: AM, Licensing Program Analyst (LPA) Carmen Escobar arrived at Achieve Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to complete the continuation inspection for STRTP annual inspection that was initiated on June 24, 2021. LPA already completed the physical inspection of the facility and reviewed facility client files on the first day of the annual inspection. During this annual inspection continuation, LPA Escobar reviewed eleven personnel files to ensure they contained all required documentation per Title Regulations and Interim Licensing Standards (ILS). Personnel Files are usually maintained in a locked closet by the front door. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. Nine of the eleven files that were reviewed were for employees who converted from group home personnel to STRTP personnel. LPA observed the converted staff members were trained according to the STRTP training requirements. Files for staff 1 (S1), staff 2 (S2), staff 3 (S3), staff 7 (S7), staff 8 (S8), and staff 10 (S10) did not have current job evaluations. Staff 4 (S4), staff 5 (S5), staff 6 (S6) and staff 11 (S11) did not have employer verification form in files. S6 is fingerprinted and cleared per Guardian background check system, however, S6 is associated to sister facility, Home of Excellence, not Achieve STRTP. Facility will be cited under Title 22 section 80019: Criminal Record Clearance. S5, S6, and S10, did not have proof of current CPR/first aid in files, facility will be cited under Title 22 section 80075: Health Related Services. S8 did not have proof of TB test in file. Technical advisories will be issued for the aforementioned file issues. Administrator Tiffany Merritt is present at the facility a minimum of 20 hours a week, as verified by staff schedule and interviews. Appropriate staff/client ratios were verified during this inspection. LPA discussed the following with the Administrator and Facility Manager: incident reporting, including incidents related to Assembly Bill 388 law enforcement contacts as well as incidents involving emergency interventions. LPA discussed procedures for Child and Family Team (CFT) meetings, including an overview of required Core Services and Supports. Two youth counselors (direct care staff), one Facility Manager, and facility Administrator, present during annual inspection were interviewed in regard to their job duties, training, and services provided at the facility. All staff were able to provide sufficient information in relation to the facility's STRTP program. Staff have no issues or concerns regarding the facility. Based upon the inspection of facility records and interviews with staff and clients, the Licensee appears to be meeting CFT and Core Services/Supports requirements. LPA requested the recent board meeting minutes be provided via email by June 30, 2021. Additionally, it should be noted that during the physical inspection of the facility on 06/24/21, it was observed that the licensee has cameras in common areas of the facility. There is an exception on file for the facility to use the cameras and the facility continues to meet the terms and conditions of the exception. A copy of this report, the advisory notices, and appeal rights, were provided to Facility Administrator, Tiffany Merritt.

Deficiencies:
80075(f): (f)	Staff responsible for providing direct care and supervision shall receive training in first aid from persons qualified by agencies including but not limited to the American Red Cross.

met_with: Facility manager Ms. Janet Winkfield and Administrator Ms. Tiffany Merritt

title:
1
2
3
4
5
6
780075(f) Health Related Services


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Shanae Pharaoh and Licensing Program Manager (LPM) Cheraki Davis on 02/03/2022 at 9: AM. During the inspection, LPA Pharaoh met with Janet Winkfield, Facility Manager, and inspected the facility inside and out. LPA reviewed 1 of 1 child's records on site at the facility at 9: AM. During the review of children's records, LPA Pharaoh observed 1 out of 1 child (C1) did not have a current JV 223. The facility manager contacted the prescribing physician to follow-up on the request for the JV223 for the use of psychotropic medication (M1). LPA reviewed 3 of 3 staff personnel files on site at the facility at 12: PM). LPA interviewed 2 of 3 staff on site at 11: AM. LPA interviewed 1 of 1 child currently taking psychotropic medication at 12:15PM. LPA conducted exit interview with Janet Winktfield, Facility Manager at 2: PM. LPA provided the Summary Report to Janet Winkfield, Facility Manager upon completion. Five deficiency were observed (refer to LIC 809D) and cited from the Interim Licensing Standards during the inspection.

Deficiencies:
87068.2(a): Social work staff shall obtain the information specified... and shall develop an individual needs and service plan within 30 days of placement.

met_with: Facility Manager - Janet Winkfield

title: Needs and Services Plan


summary: Facility Evaluation

raw_content:
Narrative:
On March 30, at 1: PM Licensing Program Analysts (LPA), Jessica Peete arrived unannounced at Achieve Residential Center Short Term Residential Therapeutic Program (STRTP). LPA was at the facility to conduct a client interview. While at the facility LPA observed a hole in wall of bedroom three. The hole is located above a client bed. Per the Facility Managers statement a work order has been placed and the wall will be repaired on 03/31/2023. The hole poses a health and safety risk to clients in care. Therefore, the facility is being cited under California Code of Regulations (CCR), Title Division Six, regulation 80087(a) Buildings and Grounds. The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. LPA a conduct a physical walk through of the facility to inspect the building and grounds. LPA did not observe any other immediate health and safety hazard's or deficiencies. An exit interview was conducted and a copy of this report and appeal rights, were provided to Facility Manager Janet Winkfield via facility email due to technical difficulties.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst's (LPA's) Leslie Covarrubias and Joon Choi on May 1, 2023 at 9: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Covarrubias and Choi met with Facility Manager, Janet Winkfield and inspected the facility inside and out. LPA's reviewed two of child's records and two of staff personnel files on site at the facility. LPA's reviewed two of child's psychotropic medications and medication records. LPA's interviewed two staff on site to discuss the facilities policies and procedures of operation. LPA's interviewed two children currently prescribed psychotropic medication. Clients were present at the facility During the inspection LPA's observed deficiencies (see attached 809D), plan of corrections were discussed and appeal rights were provided. LPA provided a copy of this licensing report to Facility Manager, Janet Winkfield.


summary: Facility Evaluation

raw_content:
Narrative:
On November 9, 2023, at 11: AM, Licensing Program Analyst (LPA) Jessica Peete met with Achieve Residential Center Short Term Residential Therapeutic Program (STRTP) Administrator/Facility Manager, Janet Winkfield to deliver a case management deficiencies report. According to information obtained by Community Care Licensing (CCL), Staff 3 (S3) and Staff 4 (S4) were involved in a physical altercation on facility grounds on 08/07/2023. Confidential interviews disclosed S3 and S4 fought over a cell phone. The incident was witnessed by clients (C3 and C4). It was disclosed that no clients were injured, and S3 and S4's employment at the facility was terminated. LPA collected all the pertinent documentation, and Interviews were conducted with the Administrator, S3, S4, C3, and C4. See Confidential Names List (LIC 811) dated November 9, 2023. Based on document review, staff, and client interviews, the facility is being cited for violation of Interim Licensing Standards Version 4 section 87065.2 (b)(1) Personnel Duties (b) Direct care staff shall perform the following duties: (1) Supervision, protection, and care of children at all times... and a Technical Violation is being issued. Facility staff (S3 and S4) did not provide adequate supervision, protection, and care of clients (C3 and C4) at all times, which poses an immediate Health, Safety, or Personal Rights risk to children in care. A copy of the report was discussed and provided along with appeal rights and LIC 811 to Achieve Residential Facility Manager Janet Winkfield


facility_name: ADVENT GROUP MINISTRIES-ST. JOHN HOME

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) SIngh-Sood conducted a complaint investigation. Due to COVID-19 updated policies and procedures, no in-person inspections will be made at the facility. Therefore, on April 26, 2021 at 9: AM a FaceTime tele-inspection was conducted with Administrator, Abigail Rivera, to deliver findings for the complaint investigation. LPA conducted an unnanounced inspection at the facility on January 25, 2021. Additionally, LPA reviewed the Foster Child and Facility records on January 25, 2021. This complaint report was investigated by the Investigations Bureau (IB), who conducted interviews with the foster children, facility staff, and other confidential parties. Based on the documents reviewed regarding the interviews conducted, the allegation was unsubstantiated. Although there may have been a violation of neglect/lack of supervision, there is not enough evidence to prove or disprove the lack of neglect/supervision allegation. Therefore, the above allegation is unsubstantiated. An exit interview conducted, and a copy of the report was emailed to Ms. Rivera at 11: AM. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Saxon Turner LICENSING EVALUATOR NAME: Vaishali Singh-Sood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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

met_with: Abigail Rivera


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) SIngh-Sood conducted a complaint investigation. Due to COVID-19 updated policies and procedures, no in-person inspections will be made at the facility. Therefore, on April 26, 2021 at 9: AM a FaceTime tele-inspection was conducted with Administrator, Abigail Rivera, to deliver findings for the complaint investigation. LPA conducted an unnanounced inspection at the facility on January 25, 2021. Additionally, LPA reviewed the Foster Child and Facility records on January 25, 2021. This complaint report was investigated by the Investigations Bureau (IB), who conducted interviews with the foster children, facility staff, and other confidential parties. Additionally, IB also requested and reviewed documents in relation to the aformentioned allegation. During a review, it was observed that staff had failed to properly document an incident regarding minors in care leaving the facility without permission on January 10, 2021. As such, the above allegation is substantiated. Deficiencies were cited and Appeal Rights were provided and discussed. An exit interview conducted, and a copy of the report was emailed to Ms. Rivera at 11: AM. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Saxon Turner LICENSING EVALUATOR NAME: Vaishali Singh-Sood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 26-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. First Street, Ste. San Jose, CA Facility Name: Advent Group Ministries-st. JOHN HOMEFACILITY NUMBER: 430707436

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

complaint_status: SUBSTANTIATED


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) SIngh-Sood conducted a complaint inspection at the facility at 10: AM, to deliver findings for the complaint investigation. LPA met with Assistant Facility Manager , Carina Gill who assisted with the inspection. LPA conducted an unnanounced inspection at the facility on May 19, 2021. Additionally, LPA reviewed the Foster Child and Facility records on May 19, 2021. This complaint report was investigated by the Investigations Bureau (IB), who conducted interviews with the foster children, facility staff, and other confidential parties. Based on the documents reviewed regarding the interviews conducted, the allegation was unsubstantiated. Although there may have been a violation of neglect/lack of supervision, there is not enough evidence to prove or disprove the lack of neglect/supervision allegation. Therefore, the above allegation is unsubstantiated. An exit interview conducted, and a copy of the report was emailed to Ms. Rivera at 1: PM. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Saxon Turner LICENSING EVALUATOR NAME: Vaishali Singh-Sood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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

met_with: Carina Gill


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) SIngh-Sood conducted a complaint inspection at the facility at 10: AM, to deliver findings for the complaint investigation. LPA met with Assistant Faciliy Manager, Carina Gill, who assisted with the inspection. LPA conducted an unnanounced inspection at the facility on May 10, 2021. Additionally, LPA reviewed the Foster Child and Facility records on May 10, 2021. This complaint report was investigated by the Investigations Bureau (IB), who conducted interviews with the foster children, facility staff, and other confidential parties. Based on the documents reviewed regarding the interviews conducted, the allegation was unsubstantiated. Although there may have been a violation of neglect/lack of supervision, there is not enough evidence to prove or disprove the lack of neglect/supervision allegation. Therefore, the above allegation is unsubstantiated. An exit interview conducted, and a copy of the report was emailed to Ms. Rivera at 1: PM. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Saxon Turner LICENSING EVALUATOR NAME: Vaishali Singh-Sood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) SIngh-Sood conducted a complaint inspection at the facility at 10: AM, to deliver findings for the complaint investigation. LPA met with Facility Manager , Brian Phillips, who assisted with the inspection. LPA conducted an unnanounced inspection at the facility on August 26, 2021. Additionally, LPA reviewed the Foster Child and Facility records on the same date. This complaint report was investigated by the Investigations Bureau (IB), who conducted interviews with the foster children, facility staff, and other confidential parties. Based on the documents reviewed, as well as the interviews conducted, the allegation was unsubstantiated. Although there may have been a violation of , sexual abuse, there was not enough evidence to prove or disprove the allegation. Therefore, the above allegation is unsubstantiated. An exit interview conducted, and a copy of the report was emailed to Ms. Rivera at 11: AM. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Vaishali Singh-Sood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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

met_with: Brian Phillips


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) SIngh-Sood conducted a complaint inspection at the facility at 11: AM, to deliver findings for the complaint investigation. LPA met with Facility Manager , Brian Phillips, who assisted with the inspection. LPA conducted an unnanounced inspection at the facility on October 8, 2021. Additionally, LPA reviewed the Foster Child's file, and records. During the investigation, this LPA conducted interviews with facility staff, as well as with other confidential parties. Additionally, other various documents were reviewed . Based on the interviews conducted with staff as well as other confidential interviews, the allegations were confirmed. It is noted there are some very serious concerns regarding the lack of supervision in this incident, coupled with the fact that the facility has been failing to timely report serious incidents to parties who should be knowing immediately. As such, the above allegations are substantiated. Deficiencies were cited and Appeal Rights were provided and discussed. An exit interview conducted, and a copy of the report was emailed to Ms. Rivera at 12: PM. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Vaishali Singh-Sood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 26-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. First Street, Ste. San Jose, CA Facility Name: Advent Group Ministries-st. JOHN HOMEFACILITY NUMBER: 430707436

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


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Michelle Kyane conducted a case management inspection on November 18, 2021 at 11: AM, based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. 4 of 13 direct care staff and 3 of 3 youth files as identified on the LIC 811 confidential names dated November 18, 2021, were reviewed. 1 of 13 direct care staff and 3 of 3 youth were also interviewed. The Plan of Operation including policies and procedure were reviewed. A copy of this report was discussed and provided to Abigail R. Anokwuru, Facility Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Manager (LPM) Carolyn Flynn conducted a Teams Tele-Visit office meeting for the above listed facility at 1: PM on 2/4/2022. LPM Flynn was joined by Licensing Program Manager (LPM) Helga Wong, Regional Manager (RM) Nelson Martinez, LPA Shikya Belfield, LPA Vaishali Sing Sood, Executive Director, Daniel Mahan, DHCS Representatives, Sandi Snelgrove, Alexandra Andrews, and DSS Representatives, D. Gutierrez, . The purpose of this meeting was to discuss the Mental Health Status Approval (MHSA) Update, and the required items for permanent licensure for Advent. During this meeting ED Mahan stated that after speaking to Mental Health certification representative, the soonest they could get a letter from them stating they would be contracting with Advent would not be given until the middle of the month. A discussion was held on November 18, 2021 with RPM Martinez, LPM Wong and LPA Singh-Sood, DHCS Representatives, S. Snelgrove, and Michele Jimenez, and DSS Representatives, D. Gutierrez, and S. Kinney. regarding the time it has taken to send their application for the mental health approval. The time frame that ED Mahan provided during the meeting was submission on 11/29/2021 or 11/30/2021. DHCS stated they received the application on December 23, 2021. The expiration date for the provisional license is March 8, 2022. Due to the time frame of completing the process for the mental health approval being so short ( approximately 30 days) it was discussed with ED Mahan, the possibility of the program surrendering their license. It was also discussed with ED Mahan that there is no possibility to receive and extension due to the requirements of the statute. ED Mahan expressed that the pandemic has impacted his ability to complete the requirements in the timely manner. Although the department sympathizes with this, extensions have been given and consistent follow up has been conducted with Advent. During this meeting the following options were discussed; withdrawal of STRTP application by the program, this would prevent CCL ( Community Care Licensing) from taking legal action against the program. Also, DHCS Snelgrove agreed to reach out to the county representatives Nancy Nation and Margaret Ledesma from MHA and find out what their status was and where the program is in the process. ED Mahan was informed that if the program is not able to obtain their Mental Health approval by the date of March 8, 2022 the department will have to take legal action. ED Mahan was also informed that they could withdraw their STRTP application and submit a plan of closure. A follow up meeting will be conducted on 2/18/2022. The meeting was concluded, and a copy of this report will be sent to ED Mahan

met_with: Daniel Mahan


facility_name: ADVENT GROUP MINISTRIES - SUMMIT RANCH

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted a complaint inspection at 10: AM, for the purpose of re-delivering the findings for the above allegations. LPA met with Staff, Suzanne Lopez , who assisted with the inspection. LPA investigated this complaint by interviewing confidential parties who confirmed the allegations were true. After the Additionally, this LPA reviewed documents that revealed the facility had been negligent with medication, and failed to provide requested documentation not only to this LPA, but to other confidential parties who are to remain apprised of significant incidents. It was determined when the facility was asked to provide the necessary documentation, they were unable to do so. It is further noted this is not the first time the facility has failed to provide Incident Reports when asked for specific ones. As such, this LPA found the allegation to be substantiated, or true. Moreover, there is a preponderance of the evidence to prove the above allegations. An exit interview was conducted at 11: AM with Ms. Lopez, and a copy of this report, along with appeal rights, was emailed to her. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Vaishali Singh-Sood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 26-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. First Street, Ste. FACILITY NAME: ADVENT GROUP MINISTRIES - SUMMIT RANCHFACILITY NUMBER: 430707151

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

met_with: Suzanne Lopez


facility_name: AGAPE HOMES ORCUTT

raw_content:
Narrative:
Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has decided that the allegations Neglect/Lack of Supervision are unsubstantiated but if any additional information is received this complaint can be amended and findings can be changed. Per California Code Regulation, Title 22, Division 6, Chapters 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), there are no deficiencies to be cited at this time. Exit interview conducted, and a copy of this report was left at the facility.

Investigation Findings:
13On August 24, 2021, at 11:30 am, Licensing Program Analyst (LPA) Enrique Hernandez made an unannounced visit to the above facility for the purpose of concluding the investigation on the above allegations and to deliver the findings. LPA met with the licensee, and together discussed the investigation details. Based on the confidential interviews conducted and file review the allegations cannot be subtasntioned, because although the interviews confirmed that C1 was smoking marijuana in C1's room. the staff always tried to intervene to stop C1 from smoking marijuana, which C1 refused to do and even blew them in the staff's faces. The staff said they will always wait for C1 to give them the vape and C1 always ignore them. During interviews with staff, they said that they always search the facility inside and out, for any type of contraband and found bottles of alcohol and confiscated them immediately. The staff even has a chair in the hallway to make sure clients are okay at night and check every 15 minutes that they are in their room. Furthermore, the SW stated that they never observed C1 smoking marijuana but, the times SW visited C1 in the facility, there was a smell of marijuana in C1's room and in C1. SW stated that the facility did a great job with everything that was happening with C1. SW does not know what else the facility could have done for C1. The facility had multiple CFT meetings and always informed SW of everything that was happening with C1's behavior. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Enrique M Hernandez 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: AGAPE HOMES ORCUTTFACILITY NUMBER: VISIT DATE: 08/24/2021

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

met_with: Licensee


raw_content:
Narrative:
Due to a lack of evidence, it has been determined that the allegation of sexual abuse 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 or disprove that a violation occurred. There were no deficiencies cited at this time. Exit Interview conducted with Facility Representative and a copy of this report and appeal rights will be emailed to Facility Administrator.

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

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

met_with: Amber Greene, Case Manager/Treatment Specialist


raw_content:
Narrative:
Based on LPA observation and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Facility is cited for violation of California Code of Regulations, Title 22 Buildings and Grounds: (refer to page 9099D for deficiency). A copy of this report and appeal rights were discussed and left with the administrator of the facility whose signature on this form confirm receipt of these documents.

Investigation Findings:
13On September 14, 2021 at 11:30 am, Licensing Program Analyst (LPA) Enrique Hernandez made an announce inspection at the above said facility, and met with Breanna McCormick Facility Administrator (FA), who granted access into the facility. The purpose of the inspection is to conclude the complaint investigation on one of the allegations and to deliver the findings. LPA and facility administrator together discussed the investigation details. During the investigative process, LPA Hernandez conducted a tour of the facility with the facility administrator and LPA observed several areas in the backyard and the side of the house that were deemed to be hazards. The following were observed, broken and loose wood with nails exposed on the side of the house, bricks (blocks) and rocks on the side of the house and plaxy glass window broken with sharp edges exposed. LPA took pictures of the deficiencies during the time of the inspection. The Administrator and licensee accompanied LPA in the inspection of the exterior and front of the home and the licensee was able to remove and / clean up some of the affected areas. The licensee also informed LPA that everything will be clean today and that the front window will be boarded up and secured with plywood until they get the glass window that the facility already ordered. Continue on LIC 9099-C SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Enrique M Hernandez 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: AGAPE HOMES ORCUTTFACILITY NUMBER: VISIT DATE: 09/14/2021

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


raw_content:
Investigation Findings:
13On 11/10/2021, at 12:00pm, Licensing Program Analyst (LPA) Enrique Hernandez made an announce inspection at the above said facility, and met with Breanna McCormick Facility Administrator (FA), who granted access into the facility. The purpose of the inspection is to conclude the complaint investigation on one of the allegations and to deliver the findings. LPA and facility administrator together discussed the investigation details. It was confirmed during confidential interviews with all relevant parties, that when HS arrived at the facility, HS put the keys on top of the kitchen counter and walked away for a few minutes. When HS returned to collect the keys, they were gone from the kitchen counter. S1, S2, FA and HS searched for the keys all over the facility and could not find them. C1 got into the vehicle and drove away from the facility. Based on LPA interviews and record reviews, the preponderance of evidence standard has been met, therefore the allegation is found to be SUBSTANTIATED. A deficiency was cited to the facility for Neglect Lack of supervision. Due to repeat deficiency 80078(a) within 12 months, a civil penalty will be issue of $250 and $100 a day until the violation is corrected. (refer to page 9099D for deficiency). A copy of this report and appeal rights were discussed and left with the administrator of the facility whose signature on this form confirm receipt of these documents. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Enrique M Hernandez 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: AGAPE HOMES ORCUTTFACILITY NUMBER: 428209702

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

met_with: Facility Administrator


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Based on the confidential interviews conducted and file review the allegations cannot be substantiated, Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has decided that the allegations Personal Rights are unsubstantiated, but if any additional information is received this complaint can be amended and findings can be changed. Per California Code Regulation, Title 22, Division 6, Chapters 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), there are no deficiencies to be cited at this time. Exit interview conducted, and a copy of this report will be emailed to the facility Administrator due to technical difficulties with LPA's printer.

Investigation Findings:
13On January 26, 2022 am, Licensing Program Analyst (LPA) Enrique Hernandez made an unannounced visit to the above facility for the purpose of concluding the investigation on the above allegations and to deliver the findings. LPA met with Karina Delgado Case Manger (CM), and together discussed the investigation details. On August 24, 2021, the Department received a complaint alleging Staff gives minors money to buy marijuana, Staff drives minors to buy marijuana and Staff allows minors to smoke marijuana in the vehicle. During confidential interviews it was stated that no one gives the clients marijuana at the facility. Confidential interviews also indicated that no staff member drives clients or lends them money to buy drugs. It was also confirmed that no staff allows the clients to smoke any type of drug in the facility's vehicle. A confidential witness claimed that the staff took them to buy drugs and let them smoke in the facility's vehicle. The allegations were not corroborated during the investigation process. Continue on LIC9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Enrique M Hernandez 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: AGAPE HOMES ORCUTTFACILITY NUMBER: VISIT DATE: 01/26/2022


raw_content:
Narrative:
The Department has decided that the allegation of Neglect Lack of Supervision is unsubstantiated, but if any additional information is received this complaint can be amended and findings can be changed. Per California Code Regulation, Title 22, Division 6, Chapters 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), there are no deficiencies to be cited at this time. Exit interview conducted, and a copy of this report will be emailed due to technical difficulties with LPA's printer

Investigation Findings:
13On January 26, 2022 am, Licensing Program Analyst (LPA) Enrique Hernandez made an unannounced visit to the above facility for the purpose of concluding the investigation on the above allegation and to deliver the findings. LPA met with the Breanna Facility Administrator (FA), and together discussed the investigative findings. On December 8, 2020, the Department received a complaint alleging Lack of supervision resulting in inappropriate interactions between minors. During the confidential interviews there were conflicting statements about what happened between the two clients. Confidential interviews were conducted, and documentation obtained that the facility acted immediately by separating clients from sleeping in the same room. The facility followed protocol and immediately reported the social worker, Law Enforcement and also wrote a Serious Incident Report (SIR). Based on the confidential interviews conducted and file review the allegations cannot be substantiated, Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Enrique M Hernandez 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: AGAPE HOMES ORCUTTFACILITY NUMBER: VISIT DATE: 01/26/2022

met_with: Program Manager


raw_content:
Narrative:
Based on the confidential interviews conducted and file review the allegations cannot be substantiated, Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has decided that the allegation of Neglect Lack of Supervision is unsubstantiated, but if any additional information is received this complaint can be amended and findings can be changed. Per California Code Regulation, Title 22, Division 6, Chapters 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), there are no deficiencies to be cited at this time. Exit interview conducted, and copy of this report will be emailed due to technical difficulties with the LPA's printer.

Investigation Findings:
13On January 26, 2022 am, Licensing Program Analyst (LPA) Enrique Hernandez made an unannounced visit to the above facility for the purpose of concluding the investigation on the above allegation and to deliver the findings. LPA met with Karina Bernal Case Manager (CM), and together discussed the investigative findings. On August 17, 2021, the Department received a complaint alleging Facility staff does not adequately supervise residents and Facility staff are not properly trained. Confidential interviews and documentation received indicated that facility staff is always supervising the clients and have all the necessary training to work in the facility. Interviews also revealed that there have been incidents on the premises, but the facility is always in ratio during the time of the incidents. The facility has been following the protocol and informing all the pertinent parties every time there is an incident in the facility. The facility has also tried to have more communication with the neighborhood in regard to the issues with the clients. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Enrique M Hernandez 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: AGAPE HOMES ORCUTTFACILITY NUMBER: VISIT DATE: 01/26/2022


raw_content:
Narrative:
continued from Licensing Program Analyst (LPA) Enrique Hernandez and Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted the investigation into the personal rights and lack of supervision allegations. LPA Hernandez conducted the initial 10-day complaint inspection on February 10, 2022 and conducted confidential interviews with two clients. AGPA Woodard conducted subsequent visits to the facility on April 9, 2022 and May 1, 2022; confidential interviews were conducted with four staff members, and four clients. Additional phone interviews were conducted on April 23, April 25, April 27, and May 12, 2022. The investigation revealed that C2 does have a history of self-harm. Based on confidential interviews and a review of supportive documentation there has only been one incident where knives were left out on the counter that occurred on April 1, 2022 and there were no incidents on file for knives being left out or C2 having to go to the hospital to get stitches for self-harm. In the initial report, it stated knives were left out on the kitchen counter, and client cut here wrist deeply and she had to have stitches. In other interviews, contradicting statements of occurrences were given by client, that a knife was left on the table after dinner and she cut herself on the leg. In another interview with the same client knives were left on the counter after breakfast and she cut herself on the leg. Clients are not allowed to dye or cut their hair without parent or the courts permission. At or around 11PM, C1 was in the bathroom bleaching her hair with product that was stolen from a local store. Bedtime at the facility is 10PM. NOC staff knocked on the door several times and repeatedly asked C1 to answer the door. C1 ignored it and NOC forcefully opened the door. There were contradicting stories as to whether C1 was naked. Based on interviews and review of supportive documentation, AGPA Woodard determined that the preponderance of evidence standard was not met and did not prove that the alleged personal rights and lack of supervision violations occurred, therefore the allegations are found unsubstantiated. A copy of this report was left with facility representative.

Investigation Findings:
13On May 14, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted a follow-up inspection at the facility for the purpose of delivering findings on the above allegations. Upon arrival, AGPA Woodard was greeted by Jesse Alvarado, Facility Manager. On February 1, 2022, Community Care Licensing Division (CCLD) received a call from reporting parties who reported that on January 30, C1 and C2 got into a silly fight and Staff (PM1) started hitting C1 on her head and neck instead of pulling C1 and C2 apart. On January 25, 2022, C1 was in the bathroom naked dying her hair when Staff (NOC) kept banging on the bathroom door to make C1 come out. NOC opened the door and stood in the doorway watching C1. C1 gathered her things together and went into her room. C2 was going through depression and got ahold of knives that were left on the kitchen counter and cut her wrist deeply. C2 reportedly got stitches. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Tonya Barnes-Woodard 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: AGAPE HOMES ORCUTTFACILITY NUMBER: VISIT DATE: 05/14/2022

met_with: Lexy Trice


raw_content:
Narrative:
continued from Licensing Program Analyst (LPA) Enrique Hernandez and Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted the investigation into the personal rights and lack of supervision allegations. LPA Hernandez conducted the initial 10-day complaint inspection on February 10, 2022 and conducted confidential interviews with two clients. AGPA Woodard conducted subsequent visits to the facility on April 9, 2022 and May 1, 2022; confidential interviews were conducted with four staff members, and four clients. Additional phone interviews were conducted on April 23, April 25, April 27, and May 12, 2022. The investigation revealed that youth in the home have a history of not getting along, threatening one another and accusing each other of theft. A review of supportive documentation reveals that C2 has made threats and is verbally aggressive with other youths. There are incident reports for the two occasions of physical assault of C2. Youth in the home belongings were taken due to clients going into each other's room when clients are not home. C2 was reimbursed for her missing/destroyed items. Confidential interviews revealed that there was a lot of animosity and theft happening in the home. As a result, C2 was jumped. When issues occur, staff will redirect youths, use de-escalation techniques and intervene immediately. The facility provides lockers for client's use which are located in the garage; however most clients will not use them because of location and size of lockers. Client's did have access to fart spray, and it was used in pranks. Staff verified that the substance on minor's bed was not urine and was water which was minimal. Staff removed client's linen which was washed immediately. C2 was in possession of scissors and had them hidden behind her back based on observations of other clients in the home. In statements made by clients, staff were informed but didn't do anything about it. SIR dated February 5, 2022, C2 admitted to having the scissors because she was being verbally attacked by C1. Based on confidential interviews and review of supportive documentation, AGPA Woodard determined the preponderance of evidence standard has not been met, therefore the personal rights allegations are found to be unsubstantiated.A copy of this report was left with facility representative.

Investigation Findings:
13On May 14, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted a follow-up inspection at the facility for the purpose of delivering findings on the above allegations. Upon arrival, AGPA Woodard was greeted by Jesse Alvarado, Facility Manager. On February 1, 2022, Community Care Licensing Division (CCLD) received a call from reporting party that C1 is being harassed and staff are not doing anything about it. C1 does not feel safe or respected by staff. A substance was poured on top of C1's bed that smelled really bad (mixture of urine mixed with "fart" spray). C1's room was searched by other clients and belongings were not safeguarded. C1 retrieved her belongings from C2's room. C2 busted into C1's room accusing her of taking her clothing that belonged to C1. C2 threatened to stab C1 with a pair of scissors. Staff did not report the incident. Staff threatened to confiscate client's personal belongings because C1 and other minors are going into each other's rooms. A subsequent CAHL referral was received on February 14, 2022 that C2 was attacked on two separate occasions and received injuries. RP stated that male staff (DCS2) did not intervene or protect C2 because C2 filed a complaint against him before the incident(s). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Tonya Barnes-Woodard 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: AGAPE HOMES ORCUTTFACILITY NUMBER: VISIT DATE: 05/14/2022