summary: Facility Evaluation

raw_content:
Narrative:
On April 9, Licensing Program Analyst (LPA) Angelica Borja conducted an unannounced Annual/Required inspection at The Shannon House Group Home. LPA met with Facility Manager Jaterica McDowell. An inspection of the facility was conducted inside and out and the following was observed: LPA reviewed five client files and five staff files. A review of LIS on 04/07/2025, indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index check clearances. LPA attempted to interview two clients, but due to clients being non-verbal it was unsuccessful. LPA interviewed two staff. The facility was inspected indoors and outdoors. Hot water temperature measured at 121.8 degrees. LPA observed at least one week supply of nonperishable and at least a five day supply of perishable foods. Individual beds were observed with appropriate clean linens and are in good repair. Cleaning chemicals inaccessible to clients. The facility is maintained at 68 degrees. All facility smoke and carbon monoxide detectors were tested and appear to be in appropriate working order, fire extinguisher is properly charged and was last serviced in May 2023. LPA reviewed the outcome of annual inspection. Medications centrally stored and locked. Per Licensee, there are no weapons at the facility. No deficiencies are being issued today. A copy of this report and appeal rights was left at the facility.

met_with: Program Manager Jaterica McDowell


state: CA

facility_name: SHANNON HOUSE, THE

summary: Facility Evaluation

raw_content:
Narrative:
On April 29, 2025, Licensing Program Analyst (LPA) Angelica Borja conducted a Case Management inspection at The Shannon House main office, Serenity Group Homes Inc, located in Fresno, Ca and met with Administrator Ashleigh Garrett. The purpose of this inspection was to discuss concerns with an incident report that was received by the Department on 04/18/2025, the incident in question happened on 04/18/2025. LPA conducted an interview with the Administrator who stated that it was an isolated incident. (See 811 and 812). It was determined this was an isolated incident and there was no citation warranted. An exit interview was conducted, a copy of the report and LIC 811 were discussed and provided to the facility at the conclusion of the inspection.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Administrator, Ashleigh Garrett


summary: Facility Evaluation

raw_content:
Narrative:
On May 14, 2025, Licensing Program Analyst (LPA) Angelica Borja conducted a Case Management inspection at The Shannon House Group Home located in Fresno, Ca and met with Darryl Johnson. The purpose of this inspection was to discuss concerns with an incident report that was received by the Department on 5/2/2025, the incident in question happened on 05/1/2025. LPA conducted an interview with the Lead Facility Manager who gave more clarification regarding the incident. (See 811 and 812). It was determined this was an isolated incident and there was no citation warranted. An exit interview was conducted, a copy of the report and LIC 811 were discussed and provided to the facility at the conclusion of the inspection.

met_with: Lead Facility Manager Darryl Johnson


summary: Facility Evaluation

raw_content:
Narrative:
On July 29, 2025, Licensing Program Analyst (LPA) Angelica Borja conducted a Case Management inspection at The Shannon House Group Home located in Fresno, Ca and met with Jaterica McDowell. The purpose of this inspection was to discuss concerns with an incident report that was received by the Department on 07/13/2025, the incident in question happened on 07/14/2025. LPA conducted an interview and collected documentation. Facility Manager (FM) states that staff is fairly new. Client #1 (C1) is private placement.(See 811 and 812). It was determined this was an isolated incident and there was no citation warranted. A copy of this report was left at the facility.

met_with: Facility Manager, Jaterica McDowell


summary: Facility Evaluation

raw_content:
Narrative:
On July 29, 2025, Licensing Program Analyst (LPA) Angelica Borja conducted a Case Management inspection at The Shannon House Group Home located in Fresno, Ca and met with Jaterica McDowell. The purpose of this inspection was to discuss concerns with an incident report that was received by the Department on 07/09/2025, the incident in question happened on 07/07/2025. LPA conducted an interview and collected documentation. Facility Manager (FM) states that staff is fairly new. Client #1 (C1) is private placement.(See 811 and 812). It was determined this was an isolated incident and there was no citation warranted. A copy of this report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On October 6, 2025, Licensing Program Analysts (LPAs) Angelica Borja and Briana Placencia conducted a Case Management inspection at The Shannon House Group Home located in Fresno, Ca and met with Desiree Nevarez. The purpose of this inspection was to discuss an incident report that was submitted to the Department 9/26/25 for an incident that occurred on 9/25/25. The Department determined this to be an isolated incident, therefore no citation is warranted. LPAs educated staff on reporting requirements. A copy of this report will be left at the facility.

met_with: Desiree Nevarez, Direct Care Staff


summary: Facility Evaluation

raw_content:
Narrative:
On October 15, 2025, Licensing Program Analyst (LPA) Angelica Borja conducted a Case Management inspection at The Serenity Group, main office for The Shannon House located in Fresno, Ca and met with Brenda McBee (Garrett). The purpose of this inspection was to discuss an incident report that was submitted to the Department 10/03/25 for an incident that occurred on 10/03/25. The facility is being issued a Technical Assistance for Reporting Requirements. LPA discussed reporting requirements specific to restraints with Administrator. An exit interview was conducted, and a copy of this report and appeal rights were left with Brenda McBee (Garrett) at the conclusion.

met_with: Brenda McBee (Garrett) , Administrator


summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On December 18, 2025, Licensing Program Analyst (LPA) Angelica Borja conducted a complaint inspection for The Shannon House at the main office, Serenity Group Homes, Inc located in Fresno, Ca and met with Ashleigh Garrett. The purpose of the inspection was to deliver the findings for the above complaint allegations. During the investigation, LPA conducted confidential interviews, a records review and reviewed supporting documents provided by the facility. Based on confidential interviews and other information obtained, the department has made the following determination. Although the allegations may have happened or are valid, there is not a preponderance of evidence to provide the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tamara Melikian LICENSING EVALUATOR NAME: Angelica Borja LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

report_type: Complaint Investigation

met_with: Ashleigh Garrett, Administrator

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On October 6, 2025, Licensing Program Analysts (LPAs) Angelica Borja and Briana Placencia conducted a Case Management inspection at The Shannon House Group Home located in Fresno, Ca and met with Desiree Nevarez. The purpose of this inspection was to discuss concerns with late reporting. There was an incident report that was submitted to the Department on 9/29/25, the incident occurred on 9/03/25. The Department determined this to be a risk to the health and safety of the children in care at this time, therefore California code of Regulations is being cited on the attached LIC809D. A copy of this report and appeals rights will be left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On October 6, 2025, Licensing Program Analysts (LPAs) Angelica Borja and Briana Placencia conducted a Case Management inspection at The Shannon House Group Home located in Fresno, Ca and met with Desiree Nevarez. The purpose of this inspection was to discuss an incident report that was submitted to the Department 10/03/25 for an incident that occurred on 10/03/25. The Department determined this to be a risk to the health and safety of the children in care at this time, therefore California code of Regulations is being cited on the attached LIC809D. A copy of this report and appeals rights will be left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On May 4, 2022, Licensing Program Analyst (LPA) contacted facility administrator, Brenda McBee to conduct a facility covid assessment of the facility. The facility is Covid free and clear to enter. LPA conducted a Case Management inspection due to an incident that occurred at the facility on January 30, 2022. LPA was met by facility representative, Ms. Lewis. The incident in question is regarding the Care and Supervision of the minors in care on that date which resulted in a sexual assault between the two minors. Staff left his post of supervising the minors outside which resulted in the sexual assault by the perpetuator M1 on the victim M2. The staff was terminated on February 1, 2022 and all staff were trained on 2/4/22 due to this incident. The facility is cited for violation of CCR, Title 22, Division 6, regulation 80078(a) Responsibility for Providing Care and Supervision, California Code of Regulations is being cited on the attached LIC 9099D. Exit interview and Appeals Rights were provided to Ms. Lewis.

met_with: Ms. Lewis


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On 08/09/2022, an unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Tamara Melikian and Wayne Aoki at 10:00AM. During the inspection, LPA met with Administrator Brenda McBee and House Managers Jave Mcintyre and Ashleigh Garrett and inspected the facility inside and out. LPAs reviewed one children's record and reviewed two staff personnel records for the facility. LPA interviewed two staff at 11: AM. The child is nonverbal and unable to be interviewed. A medication review was conducted at 11: AM. LPA conducted exit interview with Brenda McBee, Administrator at 12:30PM. Deficiency on the attached page.

Deficiencies:
84070(b): A separate log for each psychotropic medication prescribed to the child.

met_with: Brenda McBee, Jave Mcintryre, Ashleigh Garrett

title:
1
2
3
4
5
6
784070 (b) Children's Records. (13) The following information regarding the child shall be obtained and maintained in the child's record


summary: Facility Evaluation

raw_content:
Narrative:
On April 23, Licensing Program Analyst (LPA) Angelica Borja conducted an unannounced Annual/Required inspection at The Shannon House Group Home, located in Fresno Ca and met with Administrator, Brenda McBee (Garrett). An inspection of the facility was conducted inside and out and the following was observed: LPA reviewed five client files and five staff files. A review of LIS on 04/23/2026, indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index check clearances. LPA interviewed two staff and one client. The facility was inspected indoors and outdoors. Hot water temperature measured at 122.4 degrees. LPA observed at least one week supply of nonperishable and at least a five day supply of perishable foods. Individual beds were observed with appropriate clean linens and are in good repair. Cleaning chemicals inaccessible to clients. The facility is maintained at 68 degrees. All facility smoke and carbon monoxide detectors were tested and appear to be in appropriate working order, fire extinguisher is properly charged and was last serviced in December 2025. LPA reviewed the outcome of annual inspection. Medications centrally stored and locked. Per Licensee, there are no weapons at the facility. No deficiencies are being issued today. A copy of this report and appeal rights was left at the facility.

visit_type: Annual

met_with: Brenda McBee (Garrett), Administrator


facility_name: SHINING ANGELS CARE HOME, INC

summary: Facility Evaluation

raw_content:
Narrative:
On September 16, 2025 at approximately 3: PM Licensing Program Analyst (LPA) Zaria Turner and Licensing Program Manager (LPM) Connie Goldie conducted an in-person Component II Meeting in the office for the purposes of reviewing the A Documents, and Program Statement. Present during the meeting were LPA Zaria Turner, LPM Connie Goldie, Kylie Ann Paguio, Facility Administrator, Alma Paguio, Assistant Administrator, and Rodante Paguio, Facility Manager. Below is a summary of the topics that were discussed and the answers that were provided by the applicant: A Documents - LPA, LPM, and attendees present reviewed the A Documents. LPA and LPM informed the applicants of adjustments and additional information that needed to be included. Facility Administrator provided updated documentation during today's meeting. Program Statement Sections to be Revised/Updated - LPA, LPM and the attendees present reviewed the program statement. Sections reviewed and corrections needed included: (report continued on LIC 809-C) SECTION 3 · Missing Methods/Goals. · How will the program be accomplished? · How Children will be assessed? · What types of treatment will be provided? · How will results be measured? How often? · Include Sexual Orientation, Gender Identity, and Gender Expression (SOGIE) resources. SECTION 4 · Provide a sample daily activity schedule for one week, including weekends and holidays. (Must include social, recreational, and educational activities). SECTION 5 · Description of Services to Be Provided: Trauma Informed services, training goals, materials provided, education plan, number of hours per day, etc. SECTION 6 · Description of procedures used to identify and handle, medical, dental, and health care needs. · Administering psychotropic medications. SECTION 10 · Procedures for emergency discharge. SECTION 11 · Describe rules and regulations regarding visitation. SECTION 12 · Elaborate on program policy? SECTION 14 · Include a copy of your agency's Emergency Intervention Plan. · Include the name and qualifications of individual who designed the plan. · Include Emergency Response Services. (report continued on LIC 809-C) SECTION 15 · Include intervention. · Actions to locate youth. · Staff training plan. · Plan to notify youth's authorized representative. SECTION 16 · Include how youth and authorized representatives are informed of their rights to file a complaint. · Include how youth and authorized representatives receive copies of the written complaint and grievance procedures. · Outline the plan to have the Foster Youth Bill of Rights and information about the Foster Care Ombudsperson always visibly posted without obstructions in areas accessible to children and visitors in facility. · Establish procedures to periodically check in with children to remind them of their personal rights. · Explicitly call out the Foster Youth Bill of Rights instead of saying "youth's rights as spelled out in Section 87072 of the ILS." SECTION 17 · Include safeguard form. SECTION 20 · Please provide a copy of the inventory form . SECTION 21 · Missing section. · Specify hours the administrator will be at the home. · Address how you will notify CCL of any personnel changes. · Address how often. · Reminder: submit an LIC500 (Every time there is a schedule change/personnel change). SECTION 22 · Missing Section. · Include copies of resumes or job applications for all staff roles, provide letter of acceptance/commitment if they have not started the position. (report continued on LIC 809-C) SECTION 24 · Include trainee qualifications. · Include how special training needs are identified and met. SECTION 25 · Missing Section. · Include the LIC 309 form. SECTION 26 · Will you be accepting volunteers. SECTION 28 · Missing section. · Include LIC 999. SECTION 30 · Missing two board of director statements. LPA Turner and LPM Goldie offered up the opportunity for discussion and questions. Facility Administrator, Kylie Ann Paguio, provided physical revisions during today's meeting and advised that they would be sending updated digital copies of the program statement sections that needed revisions. LPA, LPM, and applicants present, coordinated a Pre-Licensing date of October 7, 2025, at 10: AM. LPA and LPM will be enrolling attendees in the online Component III meeting on October 8, 2025, at 1: PM. LPA and LPM thanked the attendees for their time and concluded the Component II Meeting.


summary: Facility Evaluation

raw_content:
Narrative:
On October 7, 2025 at approximately 10: AM, Licensing Program Analyst (LPA) Zaria Turner made an announced visit with the purpose of conducting a pre-licensing inspection to the above Group Home (GH). LPA met with Facility Administrator, Kylie Ann Paguio, and a walk through of the interior and exterior was completed. The facility was clean, safe and kept free of obstruction. LPA observed the posting of License, Personal Rights, and Emergency Disaster Plan. The facility consists of 3 bedrooms, 1 client bathroom, 1 staff bathroom, office, kitchen, living room, dining room/family room, staff lounge, laundry room, utility room, and garage. Client room 1 is equipped with 1 twin size bed, bedding, 1 bedside table, 1 bedside drawer, and closet space for clothing and personal belongings. Client room 2 is equipped with 2 twin size beds, bedding, 2 bedside tables, 2 bedside drawers, and closet space for clothing and personal belongings. Client room 3 is equipped with 1 twin size bed, bedding, 1 bedside table, 1 bedside drawer, and closet space for clothing and personal belongings. The client and staff bathrooms at the facility are equipped with working toilets, shower/tub, and running water. Upon entry, there is a desk and chair, a medication cabinet, four filing cabinets, and an electric fireplace. The living room is equipped with two sofas, a coffee table, a storage stand, and two side tables.The dining room/family room is equipped with four bar stools, a dining table and six chairs, two sofas, a chair and foot rest, a side table, a TV, entertainment center, and electric fireplace. The utility room is equipped with a shelf where extra linens are stored. The garage is equipped with a TV and five filing cabinets where extra linen, toiletries, cleaning supplies, and toxic items are kept and locked away.There is one hall closet used for extra toiletries, linens, and supplies. Continue summary of inspection on 809-C There is one hall closet equipped with the HVAC (Heating Ventilation and Air Conditioning Unit). There is a washer and dryer located in the hallway with shelving on either side where extra linen, toiletries, and cleaning supplies are kept and locked away. Disinfectants/cleaning solutions are inaccessible to clients in care and locked, under the kitchen sink and shelves next to the laundry unit. The refrigerator temperature is at or below 45 degrees F. There is nonperishable food for one week and fresh perishable food for three days minimum. There are containers to place leftover food. Carbon monoxide and smoke detectors are in working order. Hot Water between 105-120 degrees F. Fire Extinguishers are up to date and in working order. The toilets, bathtubs, and shower fixtures are in good repair. Soap and paper towels are available to clients in care. The facility is free of vermin. The backyard contains a concrete area with a grill, 3 lawn chairs, a garden area, and the staff lounge. The staff lounge is equipped with a sofa and two filing cabinets. There is no pool on the premises. The following adjustments need to be made: Facility telephone on premises. Facility thermometer in First Aid Kit An exit interview was conducted with Facility Administrator, Kylie Ann Paguio, and a copy of this report was discussed and provided during today's inspection.

visit_type: Prelicensing

met_with: Kylie Ann Paguio, Facility Administrator


facility_name: SHIRLEY'S HOME

summary: Facility Evaluation

raw_content:
Narrative:
On October 28, 2021 at 8: AM, Licensing Program Analysts (LPAs) Timika Martin and Jenny Mundo conducted an unannounced Annual Licensing Inspection at the facility. LPAs met with Administrator, Michael White. The facility currently has a Group Home (GH) license. The GH is licensed to serve up to four (4) ambulatory clients age 12 to 17 that provides services to developmentally disabled clients. There are two (2) ambulatory minors and currently in placement. The LPAs requested the following: Personnel Report LIC500, Client Roster, Board of Meeting Minutes, Clients and Staff Files. This facility is a two-story home with two (2) bedrooms upstairs, three (3) bathrooms, a kitchen, a staff office area located in the kitchen, a living room/dining room and a laundry room located in the garage. There are no bodies of water on the premises. There are no firearms or ammunitions in the facility. At 8: AM, LPAs conducted a walkthrough of the entire facility. Physical Plant The license, facility sketch, personal rights, emergency disaster form, complaints poster, emergency phone numbers and food menu are posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are kept inaccessible stored and locked in the garage. Sharps/knives were also inaccessible and stored in downstairs cabinet. Facility has non-perishable food for at least one week and perishable food for at least two days. Medications are centrally stored in a locked cabinet downstairs which had a locked door. Smoke and carbon monoxide detectors were tested and in proper working order. Fire extinguishers were fully charged. First Aid Kits were checked and found to be complete. Room temperatures are maintained at 76 degrees F. The hot water temperature was tested and measured at 116.6 degrees F. All sinks, showers and toilets were in working order. No more than 2 children share a bedroom. All beds are in good repair; equipped with good springs, clean mattresses and pillows. Adequate supply of beddings and linens were observed. Facility provides age-appropriate clothing items and hygiene products. Overall, facility is clean, safe, sanitary and in good repair. Operations Facility maintains a register of clients and the register is available upon request. The board of directors regularly conducts meeting to review and discuss the GH's operation. The facility administrator and manager are the responsible and capable staff for communicating with emergency personnel in the facility. The facility has developed, maintained and implemented written complaint procedures. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill at least monthly for each shift. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Needs and Services Plan for each client, medication records, and contact information for each client's responsible party and physician. Emergency Intervention Plan LPA's reviewed the facility's emergency intervention plan. Facility have not used any manual restraints yet but will keep a monthly log of each use of manual restraints that contains all required information when needed. Facility has an emergency intervention training curriculum. All five (5) staff members are trained on the facility's emergency intervention procedures. Client Records LPAs reviewed two (2) client records. All client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to, consent forms, court orders, needs and services plan, removal/discipline/complaint procedures; medical assessment; safeguards for cash resources, personal property and valuables; education records; personal rights forms; and medication administration records. Staff Records LPAs reviewed three (3) staff records. All staff have been subjected to criminal records review and have been fingerprinted and cleared with DOJ, FBI and CACI. The administrator meets the required qualifications and/or experience. Documentation of the required education and experience requirements are maintained in the personnel file. Facility Managers meet requirements. LPAs verified 40 hours of annual training for direct care staff. Clients with Special Health Care Needs LPA's reviewed the section of Children with Special Health Care Needs; no deficiencies were observed. There are currently no clients in care with special health care needs. LPAs interviewed one (1) staff. There are no citations assessed during this inspection. The administrator was provided information on where to locate the Provider Information Notices (PINs), guidance to the new CARE Tools inspection process and Guardian. An exit interview was conducted, and a signed copy of this report, LIC811 and appeal rights were provided to the facility administrator.

met_with: Michael White, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Gilbert Gutierrez and Pamela Silva on July 25, 2022. During the inspection, LPAs met Michael White, Administrator who provided the tour of the facility. At the time of the inspection, there were two clients present in the facility. LPAs conducted a tour of the facility at 9:10AM. The facility is clean, safe, sanitary and in good repair. All medications are centrally stored, locked in inside a cabinet in the hallway and accessible only to staff responsible for medications. Out of two (2) clients, only C1 is dual placement. LPAs reviewed C1's file at 9:30am. LPAs observed during records inspection that each psychotropic medication is not documented on a separate PMAR. However the psychotropic medications are being tracked on the MAR. LPAs reviewed a total of two staff records at 10:00am. LPAs interviewed two staff at 10:45am. C1 was not interviewed due to cognitive disability. No deficiency citations issued at the time of the inspection. However, one technical violation was issued (see LIC TV). An exit interview was conducted and copy of this report, LIC TV and LIC 811 were provided to Administrator, White

met_with: Michael White


summary: Facility Evaluation

raw_content:
Narrative:
On September 7, 2023 at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez, conducted an annual/required inspection to the facility and met Michael White, Administrator. The facility is a two--story condominium unit with two bedrooms and three bathrooms and attached garage. Currently there are two clients placed in this facility. LPA obtained a copy of clients' roster, LIC 500 (Personnel Report), Emergency Disaster Plan. Surety Bond, Board Meeting MInutres. LPA reviewed the Property and Incidental (P&I), and Emergency Drills log. Physical Plant LPA started the inspection at about 9: AM. Administrator White toured this LPA inside the facility. LPA observed the following: the posted license, emergency disaster plan, personnel schedule, client personal rights, Foster Youth's Bill of Rights. The disinfectants, cleaning solutions, sharp objects are locked inside a cabinet. The facility maintains supplies of non-perishable foods for at least a week and perishable foods for at least two days. Each bedroom has a single bed in good repair with clean sheets and linens, five drawers and closet space for the client's clothing. There were extra linens, adequate towels and hygiene supplies. Only one client sleeps in a room. No room commonly used for other purposes is being used as a bedroom. The window screens are in good repair and free of dirt. There were lights in the rooms and throughout the facility. All medications were stored locked in a cabinet located in the hallway. There was a working land phone in the facility. The first aid kit was complete and readily available. The smoke/carbon monoxide detectors were in working order. The water temperature was tested using a digital thermometer and registered 107.1 degrees. cont. Staff Records At 9: AM, LPA reviewed three staff records. All staff subject to criminal records review have been fingerprinted and cleared. There is documentation of the required education and experience requirements and training in the personnel file. The administrator and facility managers meet the required qualification and/or experience. Client Records At around 11: AM, LPA reviewed two client records. All client records are available to LPA to inspect, audit upon demand. Client records contain required information including, but not limited to, consent forms, Individual Program Plan (IPP), medical assessment, safeguards for cash resources, personal property and valuables, personal rights forms, and medication administration records. LPA interviewed 1 staff in the facility. A deficiency citation is issued at the time of the inspection. A copy of the LIC 809, LIC 809C LIC 809D, LIC 811s, and LIC 9102 were provided to the administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On October 9th, 2024 at 9:15AM, Licensing Program Analyst (LPA) Olena Maico and Licensing Program Manager Tira Logan, conducted an annual/required inspection to the facility and met with Michael White, the Administrator. The facility is a two-story condominium unit with two bedrooms and three bathrooms and attached garage. Ther is a small outdoor area with the table and chairs for clients' use. The facility currently has a Group Home (GH) license. The GH is licensed to serve up to four (4) ambulatory clients age 12 to 22 with developmental disabilities. There are two (2) ambulatory minors and currently in placement. This facility is a two-story home with two (2) bedrooms and 2 bathrooms upstairs, one staff bathroom downstairs, a kitchen, a staff office area located in the kitchen, a living room/dining room and a laundry room located in the garage. There are no bodies of water on the premises. There are no firearms or ammunition in the facility. LPA obtained a copy of clients' roster, LIC 500 (Personnel Report), Emergency Disaster Plan and LPA reviewed Emergency Drills log. Physical Plant LPA started the inspection at about 9: AM. Administrator White toured with LPA inside the facility. The license, facility sketch, personal rights, emergency disaster form, complaints poster, emergency phone numbers and food menu are posted in a prominent, publicly accessible location in the facility's kitchen/hallway area. The disinfectants, cleaning solutions, sharp objects are locked inside a cabinet. The staff and clients' files are securely locked in the cabinets. The facility maintains supplies of non-perishable foods for at least a week and perishable foods for at least two days. Each bedroom has a single bed in good repair with clean sheets and linens, five drawers dressers and closet space for the client's clothing. There were extra linens, adequate towels and hygiene supplies. Only one client sleeps in a room. The window screens are in good repair and free of dirt. There were lights in the rooms and throughout the facility. All medications were stored locked in a cabinet located in the hallway. There was a working land phone in the facility. The first aid kit was complete and readily available with all required non-expired items. The smoke/carbon monoxide detectors were in working order. Fire extinguisher is up to date (renewed January 2024) and fully charged. The water temperature was tested using a digital thermometer and registered 107.1 degrees. Operations Facility maintains a register of clients and the register is available upon request. The board of directors regularly conducts meeting to review and discuss the GH's operation. Meeting minutes were not available for LPA to review, and the Administrator will email those to the LPA. The facility has developed, maintained and implemented written complaint procedures, which is documented in clients' files. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill at least monthly for each shift. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, IPP for each client, medication records, and contact information for each client's responsible party and physician. Emergency Intervention Plan LPA's reviewed the facility's emergency intervention plan. Facility have not used any manual restraints yet but keeps log of use of manual restraints if need arises. Facility has an emergency intervention training curriculum. All five (5) staff members are trained on the facility's emergency intervention procedures (CPI training ). LPA interviewed 1 staff in the facility. A copy of the LIC 809, LIC 809C , was provided to the Administrator. No deficiencies noted. LPA Will return to interview clients.

met_with: Michael White, Adiministrator


summary: Facility Evaluation

raw_content:
Narrative:
On October 15th, 2024 at 16:40PM, Licensing Program Analyst (LPA) Olena Maico conducted a continuation of annual/required inspection to the facility and met with LAToya Gurley, Facility Manager. Note from the prior inspection: Administrator e-mail Board of Directors meeting minutes to the LPA for review. Also facility has 2 cameras - one is outdoor ring camera and one is in the common area/ living room. Living room camera is facing away from the private areas. Administrator was notify to add the camera information to the program statement and sent it to their LPA for review. Staff records LPA reviewed five staff records. All staff have been subjected to criminal records review and have been fingerprinted and cleared with DOJ, FBI and CACI. The administrator meets the required qualifications and experience. Documentation of the required education and experience requirements are maintained in the personnel file. Facility Managers meet requirements. LPA verified initial hours of training upon hire for direct care staff and 20 hours of annual training. Facility carries a log with hours logged for the staff training available to the LPA for review ( record were reviewed during the prior visit) Client Records LPA reviewed two client records. All client records are available to LPA to inspect and audit upon demand. Client records contain required information including, but not limited to, consent forms, court orders, IPP plans from the Regional center, removal/discipline/complaint procedures; medical assessment; safeguards for cash resources (including allowance distribution and expense records), personal property and valuables; education records; personal rights forms; and medication administration records (files were reviewed during prior visit) LPA returned for clients' interviews. LPA interviewed 2clients. A copy of the LIC 809, LIC 811 was given to the Facility Manager. No deficiencies have been found.

met_with: LAToya Gurley, Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Pamela Silva, Timika Martin and Juliet Robles on 11/18/24 at 9: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPAs met with Administrator, Michael White and inspected the facility inside and out. LPAs reviewed zero (0) of child's records and three (3) of staff personnel files on site at the facility. LPAs reviewed zero (0) of child's psychotropic medications and medication records due to child being over the age of 18. LPAs interviewed one (1) of staff on site to discuss the facility's policies and procedures of operation. LPAs interviewed zero (0) of child currently prescribed psychotropic medication. No deficiencies are being cited at this time. LPAs conducted exit interview with Michael White, Administrator and provided a copy of this licensing report.


summary: Facility Evaluation

raw_content:
Narrative:
On October 31, 2025, Licensing Program Analyst (LPA) Johanna Aracena conducted an annual/required inspection to the facility and met with Michael White, Facility Administrator. The facility is a two-story condominium unit with two bedrooms, two and a half bathrooms and an attached garage. There is a small patio area with a picnic table for clients' use. The facility is currently licensed as a Group Home to serve up to four (4) ambulatory clients age 12 to 22 with developmental disabilities. There are two (2) ambulatory clients in placement at the age of 20 years old each. This facility is a two-story home with two (2) bedrooms and 2 full bathrooms upstairs, one half downstairs, a kitchen, a staff office area located in the kitchen, a living room/dining room and a laundry room located in the garage. There are no bodies of water on the premises. There are no firearms or ammunition in the facility. LPA obtained a copy of clients' roster, LIC 500 (Personnel Report), Emergency Disaster Plan and LPA reviewed Emergency Drills log. The license, facility sketch, personal rights, emergency disaster form, complaints poster, emergency phone numbers and food menu are posted in a prominent, publicly accessible location in the facility's kitchen/hallway area. The disinfectants, cleaning solutions, sharp objects are locked inside a cabinet and in the garage. The staff and clients' files are securely locked in the cabinets. The facility maintains supplies of non-perishable foods for at least a week and perishable foods for at least two days. Each bedroom has a single bed in good repair with clean sheets and linens, five drawers dressers and closet space for the client's clothing. There were extra linens, adequate towels and hygiene supplies. Only one client sleeps in a room. The window screens are in good repair and free of dirt. There are lights in the rooms and throughout the facility. All medications are stored locked in a cabinet located in the hallway. There is a working land phone in the facility. The first aid kit is complete and readily available with all required non-expired items. The smoke/carbon monoxide detectors were in working order. Fire extinguisher is up to date (renewed March 2025) and fully charged. The water temperature was tested using a digital thermometer and registered 107.1 degrees. Facility maintains a register of clients and the register is available upon request. The board of directors regularly conducts meeting to review and discuss the GH's operation. Meeting minutes were not available for LPA to review, and the Administrator will email those to the LPA. The facility has developed, maintained and implemented written complaint procedures, which is documented in clients' files. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill at least monthly for each shift. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, IPP for each client, medication records, and contact information for each client's responsible party and physician. The facility has 2 cameras - one is outdoor ring camera and one is in the common area/ living room. Living room camera facing towards the facility entrance and away from the private areas. LPA received facility's program statement amendment for review. LPA reviewed three (3) staff records. All staff have been subjected to criminal records review and have been fingerprinted and cleared with DOJ, FBI and CACI. The administrator meets the required qualifications and experience. Documentation of the required education and experience requirements are maintained in the personnel file. Facility Managers meet requirements. LPA verified initial hours of training upon hire for direct care staff and 20 hours of annual training. Facility carries a log with hours logged for the staff training available to the LPA for review. LPA reviewed two client records. All client records are available to LPA to inspect and audit upon demand. Client records contain required information including, but not limited to, consent forms, court orders, IPP plans from the Regional center, removal/discipline/complaint procedures; medical assessment; safeguards for cash resources (including allowance distribution and expense records), personal property and valuables; education records; personal rights forms; and medication administration records. LPA will return to conduct interviews due to clients not being at the facility at the time of the visit. Exit interview was conducted and a copy of this report provided to the Facility Administrator.

met_with: Michael White- Facility Administrator


facility_name: SIGNS OF LIFE GROUP HOME II

summary: Facility Evaluation

raw_content:
Narrative:
On December 17, 2021 at 2:41pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Signs of Life Group Home II for the purpose of conducting an inspection to determine control of property by the licensee. LPA observed that no one was home. LPA observed property looks abandoned, No cars in the driveway. Window blinds closed. Outside neat and well kept. No access to enter through front gate. Gate locked. Observed trash cans on side of house. Documentary evidence (photos) Called licensee at (323) 756-7783 at 2:48pm. No answer. Only a busy signal. Does not appear to have control of property.


facility_name: SLEEPY CREEK

summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
Confidential interviews stated a witness observed the office door open, noticed "skin" of an individual lying on the office floor in front of the office bathroom door and also observed another figure with a deep voice. Confidential interviews stated S1 had sexual intercourse with C1 and charges will be filed against S1. Based on confidential interviews, the allegation that C1 was sexually abused while in care is substantiated. The preponderance of evidence standard has been met. Facility is cited for violation of California Code of Regulations, Title Division Six, regulation Personal Rights: (d)The licensee shall ensure that each child, regardless of whether the child is in foster care, is accorded the personal rights specified in Welfare and Institutions Code section 16001.9, as applicable. In addition, the licensee shall ensure that each child is accorded the following personal rights: (11)To be free from physical, sexual, emotional, or other abuse, and corporal punishment A copy of the report was discussed and provided along with appeal rights to Program Representative Selene Acosta.

Investigation Findings:
13On 06/01/2022, at 9:45 a.m. Licensing Program Analyst (LPA) Marisol Lopez arrived at the facility unannounced and met with Program Representative Selene Acosta, of Sleepy Creek to discuss the investigative findings for the allegation noted above. LPA Lopez spoke with Facility Director Tiffany Mileda, who authorized Program Representative Selene Acosta to sign. On 03/01/2022, Community Care Licensing's (CCL) Investigations Branch Bureau, Investigator Thomas Smith was assigned the investigation. On 3/02/ Investigator Smith conducted an initial complaint investigation and met with Facility Manager Devyn Moore. The investigation consisted of confidential interviews with one detective, six facility staff, one of two clients and review of documents: Incident reports and law enforcement documents. On 02/24/2022, the Department received an allegation that a minor was sexually abused while in care. It was reported that staff #1 walked client #1(C1) to the shower and raped C1. Confidential interviews stated S1 escorted C1 to an office bathroom which is off limits to clients, instead of the client bathroom in the hallway. (see continuation form LIC9099-C dated 06/01/2022) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Marisol Lopez 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 08-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, METROPOLITAN DR. # FACILITY NAME: SLEEPY CREEKFACILITY NUMBER: VISIT DATE: 06/01/2022

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

met_with: Selene Acosta

complaint_status: SUBSTANTIATED


summary: Facility Evaluation

raw_content:
Narrative:
On October 18, 2021 at 11: AM, Licensing Program Manager (LPM), Natasha Dunlap and Licensing Program Analysts (LPAs) Jazmond Harris and Sarah Smith conducted a pre licensing inspection and component III orientation. LPM and LPAs met with Director of Operations, Tiffany Pineda, Director of Nursing, Clara Mahmoudi, Program Director, Melanie Morones Walker, and Facility Manager, Devyn Moore. The applicant is applying for a group home with the capacity of 6 ambulatory clients, mixed genders, ages 12-17 years old. This program provides services for private placement clients. The facility is a two story house with four bedrooms, six bathrooms, kitchen, dining room, two living rooms, laundry room, two staff offices, two private rooms, medical room, a gym and recreation room, which is located in the garage area. Sports equipment/toys/books/games were observed for client's recreation time. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris. Emergency exits were free from obstruction. There is adequate indoor and outdoor activity space. The facility has a basketball and volleyball court. Medications will be locked in a closet in the medical room. The facility smoke detectors and carbon monoxide detectors were tested and were observed to be in working order; fire extinguisher is properly charged and serviced. The fire clearance has been approved. The facility has a fully equipped first aid kit and first aid manual. The facility does not have cameras. The applicants stated there were no weapons in the home. Cleansers/chemicals were stored and locked in laundry area and storage hallway. Sharp knives were made inaccessible and stored in the staff office. The following required forms were posted in the facility: Personal Rights, Grievance Procedures, Emergency Response, and Covid-19 related information. Per applicant, client and personnel files will be available electronically at all times for licensing request or review. All bedrooms are located upstairs and are set up as follows: Bedroom 1: designated for one client; has one full bed, one dresser drawer, and a night stand, Bedroom 2: designated for one client; one full bed, one dresser drawer, and a night stand. Bedroom 3: designated for two clients; has two full beds, two dresser drawers, and two night stands. Bedroom 4: designated for two clients; has two full beds, two dresser drawers, and two night stands. This is an amended 809C page to the original issued 10/18/2021. LPM and LPAs discussed with the applicant the need for portable closets to be installed in each room designated for clients. Applicant provide proof of closets prior to licensure. Due to the facility having separate floors and all client bedrooms are located upstairs, LPM and LPAs discussed signal system in accordance with Title 22 regulation 84088(e)(2). Per applicant, staff will be on each floor whenever children are present in lieu of installing a signal system. Each room has adequate clean linens, pillows, blankets, comforters, mattress pads, and mattresses. The hot water in the children's bathroom was measured and deemed to be safe. Facility has a pool which is appropriately and secured with a mesh fence. The enclosure was measured to be over 5 feet tall, with a self-latching gate that swings outward. The pool appeared to be cleaned and free of excessive debris. The facility has one van that will provide transportation for the clients. The applicant has been informed that the address to this facility is available to the public. All special incident reports (SIR's) will be sent via e-mail to: cclpaccr@dss.ca.gov. The reporting requirements were reviewed with the applicant on this date. The applicant was provided with an updated Facility Personnel Report Summary at the time of this visit and understands that once the license is approved, all employees and volunteers shall have an approved criminal record clearance for Community Care Licensing and be associated to this facility. All documents have been received according to Title 22 regulations. An exit interview was conducted with applicants and a copy of this report was printed and provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On December 07, 2021 at 12: PM, Licensing Program Analyst (LPA), Marisol Lopez conducted a post licensing inspection. LPA met with Program Director, Melanie Morones Walker. The group home has a capacity of 6 ambulatory clients, mixed genders, ages 12-17 years old. This program provides services for private placement clients. The facility is a two story house with four bedrooms, six bathrooms, kitchen, dining room, two living rooms, laundry room, three staff offices, one treatment room, medical room, a gym and recreation room, which is located in the garage area. LPA observed sports equipment/toys/books/games for client's recreation time. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris. Emergency exits were free from obstruction. There is adequate indoor and outdoor activity space. The facility has a basketball and volleyball court. Medications are locked in a closet in the medical room. The facility smoke detectors and carbon monoxide detectors were tested and were observed to be in working order; fire extinguisher is properly charged and serviced. The facility has a fully equipped first aid kit and first aid manual. The facility does not have cameras. The applicants stated there were no weapons in the home. Cleansers/chemicals were stored and locked in laundry area and storage hallway. Sharp knives were made inaccessible and stored in the staff office. The facility has a pool with a fence at least five -feet high and meets requirements. All bedrooms are located upstairs and are set up as follows: Bedroom 1: designated for one client; has one full bed, one dresser drawer, and a night stand, Bedroom 2: designated for one client; one full bed, one dresser drawer, and a night stand. Bedroom 3: designated for two clients; has two full beds, two dresser drawers, and two night stands. Bedroom 4: designated for two clients; has two full beds, two dresser drawers, and two night stands. The following required forms were posted in the facility: Personal Rights, Grievance Procedures, Emergency Response, food menu plan and Covid-19 related information. Client and personnel files are available electronically at all times for licensing request or review. LPA reviewed Physical Plant, Operations, Disaster Preparedness, and Emergency Intervention. Due to time constraints, the annual inspection is being extended for staff and client file reviews and interviews. LPA conducted 0 of 3 staff interviews, 0 of 6 staff file reviews, 0 of 4 client interviews and 0 of 4 client file reviews. An exit interview was conducted, and this report was reviewed with Program Director Melanie Walker and a copy of this report was provided.

met_with: Melanie Walker


summary: Facility Evaluation

raw_content:
Narrative:
On December 08, 2021 at 10: AM, Licensing Program Analyst (LPA), Marisol Lopez conducted a continuation post licensing inspection. LPA met with Program Director, Melanie Morones Walker. The group home has a census of 4 ambulatory clients, mixed genders, ages 12-17 years old. This program provides services for private placement clients. . During the inspection, LPA conducted 3 of 3 staff interviews, 6 of 6 staff file reviews, 4 of 4 client interviews and 4 of 4 client file reviews. LPA reviewed the client electronic medication documents. LPA will follow-up to ensure that the electronic logs are in compliance with Title Regulations. An exit interview was conducted, and this report was reviewed with Program Director Melanie Walker and a copy of this report was provided.


summary: Facility Evaluation

raw_content:
Narrative:
On December 08, 2021 at 3: PM, Licensing Program Analyst (LPA), Marisol Lopez conducted a continuation post licensing inspection. LPA met with Program Director, Melanie Morones Walker. The group home has a census of 4 ambulatory clients, mixed genders, ages 12-17 years old. This program provides services for private placement clients. . On 12/08/21 at 3:30 pm, LPA completed the inspection tool. LPA will follow-up to ensure that the medication electronic logs are in compliance with Title Regulations. An exit interview was conducted, and this report was reviewed with Program Director Melanie Walker and a copy of this report was provided.


summary: Facility Evaluation

raw_content:
Narrative:
On October 26, 2022 at 10:00 a.m., Licensing Program Analyst (LPA) Marisol Lopez and LPA Lucero Jauregui conducted an unannounced inspection at the facility above and met with Program Director (P1) Evelyn Vasquez. The purpose of the inspection is to conduct a required annual inspection. The group home has a capacity of 6 ambulatory clients, mixed genders, ages 12-17 years old. This program provides services for private placement clients. The facility is a two story house with four bedrooms, six bathrooms, kitchen, dining room, two living rooms, laundry room, four staff offices, two treatment room, medical room, a gym and recreation room. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. There is sufficient linens, blankets, towels and pillows. All hazardous items have been properly stored and made inaccessible. LPA observed sports equipment/toys/books/games for client's recreation time. Emergency exits were free from obstruction. There is adequate indoor and outdoor activity space. The facility has a basketball and volleyball court. Medications are locked in a closet in the medical room. The facility smoke detectors and carbon monoxide detectors were tested and were observed to be in working order; fire extinguisher is properly charged and serviced. The facility has a fully equipped first aid kit and first aid manual. The facility does not have cameras. The applicants stated there were no weapons in the home. Sharp knives were made inaccessible and stored in a locked container in a locked cabinet. The facility has a pool with a locked self latching gate and the fence is at least five -feet high and meets requirements. The hot water temperature was tested and noted to be at 114 degrees and maintained within the regulation range of 105-120 degrees. Trash cans for storage of solid waste had tight fitting lids. (see continuation form LIC809-C dated 10/26/22) The following required forms were posted in the facility: Personal Rights, Grievance Procedures, Emergency Response, food menu plan and Covid-19 related information. Client and personnel files are available electronically at all times for licensing request or review. LPA's reviewed the physical plant, operations, disaster preparedness, emergency intervention, 6 of 6 staff file reviews, 3 of 3 client file reviews, 3 of 3 staff interviews and 3 of 3 client interviews. Based on record review, the licensee did not comply as 3 out of 3 clients (C1-C3) files did not have the current court order, or written authorization of the child's parent or guardian, for each psychotropic medication which poses a potential health, safety or personal rights risk to persons in care. The facility is being issued a citation in accordance with the Title 22, CCR 84070(b)(12). (See LIC809-D dated 10/26/22 for the cited deficiency.) An exit interview was conducted, and this report, appeal rights and LIC 811 was reviewed with Program Director Evelyn Vasquez and a copy of this report was provided.

met_with: Evelyn Vasquez


summary: Facility Evaluation

raw_content:
Narrative:
On February 9, 2023 at 12: AM, Associate Governmental Program Analyst (AGPA) Kim Robinson met with the group home (GH) program director, Dr. Evelyn Vasquez, in order to assess an Enhanced Civil Penalty (ECP). Administrator, Tiffany Mileda, attended the meeting via Teams. On June 1, 2022, the Department concluded a complaint investigation alleging that Staff #1 (S1) engaged in sexual acts with a child, resulting with sexual assault of seventeen-year-old client #1 (C1). These allegations were determined substantiated, and the GH was cited for Personal Rights from the Title 22, California Code of Regulations Section 84072 (d)(11). See the Confidential Names List, LIC 811, dated February 9, 2023. Based on the analysis of the interviews, medical reports and findings from the San Diego Sheriff report the Department has determined that an enhanced civil penalty is warranted for the sexual abuse of C1. The Penal Code Section 11165.1 defines sexual conduct with a minor as physical abuse. This section describes a number of more or less direct and (always) willful acts that constitute physical abuse. Pursuant to the Enhanced Civil Penalty law, Health & Safety Code section 1548 (f)(1)(C), the Department will be issuing an immediate civil penalty of $2,500.00. An exit interview was completed and appeal rights discussed. A copy of this report, the Confidential Names List, and a Civil Penalty Assessment - Serious Bodily Injury/Physical Abuse (Form 421-D) were provided to the program director. The signed copy will be retained in the facility file.

met_with: Program Director & Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On December 1, 2023 at 9: AM, Licensing Program Analyst (LPA) LPA Lucero Jauregui conducted an unannounced inspection at the facility above and met with Nathaniel Lindborg, Program Director who provided LPA with a guided tour of the facility. The purpose of the inspection is to conduct a required annual inspection. The group home has a capacity of 6 ambulatory clients, mixed genders, ages 12-17 years old. This program provides services for private placement clients. The facility is a two story house with four bedrooms, six bathrooms, kitchen, dining room, two living rooms, laundry room, four staff offices, two treatment room, medical room, a gym and recreation room. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. There is sufficient linens, blankets, towels and pillows. All hazardous items have been properly stored and made inaccessible. LPA observed sports equipment/toys/books/games for client's recreation time. Emergency exits were free from obstruction. There is adequate indoor and outdoor activity space. The facility has a basketball and volleyball court. Medications are locked in a closet in the medical room. The facility smoke detectors and carbon monoxide detectors were tested and were observed to be in working order; fire extinguisher is properly charged and serviced. The facility has a fully equipped first aid kit and first aid manual. The facility does not have cameras. The applicants stated there were no weapons in the home. Sharp knives were made inaccessible and stored in a locked container in a locked cabinet. The facility has a pool with a locked self latching gate and the fence is at least five -feet high and meets requirements. The water temperature was measured higher than 120 and adjusted by Program Director. Trash cans for storage of solid waste had tight fitting lids. (see continuation form LIC809-C dated 12/01/23) The following required forms were posted in the facility: Personal Rights, Grievance Procedures, Emergency Response, and Meal Menu. Client and personnel files are available electronically at all times for licensing request or review. LPA reviewed the physical plant, operations, disaster preparedness, and emergency intervention. LPA reviewed 3 of 3 staff file reviews with Administrator Devyn Moore, 6 of 6 client file reviews with Administrator and Program Director. LPA conducted 3 of 3 staff interviews and 3 of 3 client interviews. An exit interview was conducted, a copy of this report was provided to Nathaniel Lindborg, Program Director and Devyn Moore, Administrator..

met_with: Nathaniel Lindborg, Program Director


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On October 24, 2024 at 8: AM, Licensing Program Analyst (LPA) LPA Lucero Jauregui conducted an unannounced inspection at the facility above and met with Nathaniel Lindborg, Program Director who provided LPA with a guided tour of the facility. The purpose of the inspection is to conduct a required annual inspection. The group home has a capacity of 6 ambulatory clients, mixed genders, ages 12-17 years old. This program provides services for private placement clients. The facility is a two story house with four bedrooms, six bathrooms, kitchen, dining room, two living rooms, laundry room, four staff offices, two treatment room, medical room, a gym and recreation room. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. There is sufficient linens, blankets, towels and pillows. All hazardous items have been properly stored and made inaccessible. LPA observed sports equipment/toys/books/games for client's recreation time. Emergency exits were free from obstruction. There is adequate indoor and outdoor activity space. The facility has a basketball and volleyball court. Medications are locked in a closet in the medical room. The facility smoke detectors and carbon monoxide detectors were tested and were observed to be in working order; fire extinguisher is properly charged and serviced. The facility has a fully equipped first aid kit and first aid manual. The facility does not have cameras. Per Director of Operations stated there are no weapons in the home. Sharp knives were made inaccessible and stored in a locked container in a locked cabinet. The facility has a pool with a locked self latching gate and the fence is at least five -feet high and meets requirements. The hot water temperature was measured in client bathroom higher than 120 and adjusted by Maintenance. (see continuation form LIC809-C dated 10/24/24) LPA observed Personal Rights, Grievance Procedures, and Emergency Response posted. Client and personnel files are available electronically at all times for licensing request or review. LPA reviewed the physical plant, operations, disaster preparedness, and emergency intervention. LPA reviewed five of five staff files and six of six client files with Nathaniel Lindborg, Program Director. LPA conducted three staff confidential interviews and three client confidential interviews. Based on todays observations and file review, the facility is being cited for 84064(b) Administrator Qualifications and Duties, 80069(c)(1) Client Medical Assessments, and 84065(d) Personnel Requirements [See LIC9099D]. Additionally, the facility is being cited Technical Violations for Children's Records 84070(c)(2) and 84070(c)(3) [SEE LIC 9102]. An exit interview was conducted, and plan of corrections was developed with Toni Jackson- Rainey, Director of Operations. A copy of this report, LIC 9099D, LIC9102 and appeal rights were provided to Toni Jackson- Rainey, Director of Operations.

Deficiencies:
84065(d): Personnel Requirements

(d) The licensee shall designate at least one facility manager to be present at the facility at all times when children are present


facility_name: SMALL STEPS GROUP HOME

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Based on confidential interviews, the Department determined there was not sufficient information to determine that staff spoke inappropriately towards C1 while in care, staff mishandled C1 while in care, staff threatened C1 while in care and C1 sustaining unexplained injuries while in care. Although the allegations may have happened or may be valid, there was not a preponderance of evidence to support or deny the allegations. The Department's finding was that these allegations are unsubstantiated. A copy of this report was reviewed and provided to agency administrator. Regarding the allegation that staff speak inappropriately towards a minor while in care, it was disclosed that no staff spoke inappropriately to C1 while in care. Other confidential interviews disclosed that staff treated C1 with respect and provided C1 with an environment of cordial relationship with staff. Another confidential interview stated that C1 was treated well and did not believe staff spoke inappropriately to C1. A confidential interview disclosed that staff did not speak inappropriately toward C1 or any other client while in care, it was added that staff were not rude to C1 while in care. A confidential interview denied the allegation that staff mishandled minor while in care. Confidential interview stated that group home was praised by C1's school for the care provided for C1 while in care and that staff would not mishandle C1. It was specified that C1 was grabbed by the neck and pushed against the door. A confidential interview stated that C1 had very well-trained support staff and would not mishandle C1. Other confidential interviews disclosed that it was not observed staff grabbing C1 by the neck and pushed against the wall. Another confidential interview stated that C1 was not mishandled while in care that C1 liked living the group home. A confidential interview also denied the allegation that staff threatened C1 while in care, it was disclosed that C1 threatened to jump out of a moving van during transportation. Other confidential interviews denied ever threatening C1 or observed C1 being threatened while in care. Another confidential interview denied C1 was threatened and added that C1 liked being at the group home and would consider returning to the group home. Regarding the allegation that C1 sustained unexplained injuries while in care, a confidential interview disclosed that C1 had long nails and used nails to self-scratch. Other confidential interviews stated that C1 refused to go for nail trim at the salon. A confidential interview stated that injuries were self-inflicted. Another confidential interview disclosed that C1 exhibited manipulative behaviors and C1 would go any length to implicate staff.

Investigation Findings:
13On May 12, 2022, Licensing Program Analyst (LPA) Babatunde Aborchie and Rafael Enquez arrived at Small Steps Group Home to deliver investigative finding involving the group home and minor (client #1) while in care. Identified in the Confidential Names List (LIC 811). LPA met with Chief Executive Officer Yvonne Pierre of the group home. On December 23, 2021 at 9: AM, LPA arrived at the group home to initiate the investigation regarding the above allegations. LPA conducted a safety inspection, there were no deficiencies found. LPA conducted interviews with CEO, facility manager, C1, S1, S2 and S3. In addition, LPA interviewed Psychologist (PS) via telephone, but LPA could not reach County Social Worker. On December 17, 2021, a complaint report was referred to Community Care Licensing (CCL) alleging that staff speak inappropriately towards a minor while in care, staff mishandled a minor while in care, staff threatened a minor while in care and minor sustained unexplained injuries while in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: SMALL STEPS GROUP HOMEFACILITY NUMBER: VISIT DATE: 05/12/2022

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

met_with: Chief Executive Director


raw_content:
Narrative:
The FD stated that they had taken FY1 to the hospital and sent DD to the hospital to monitor FY1. DD was sent home by the Doctor. FD stated that she contacted the hospital a few hours later and they told her not to worry about FY1. Confidential interviews deny receiving any call from the hospital about FY1's discharge from the hospital on that day. Confidential interviews stated that the Doctor asked DD to leave and when DD arrived back to the facility the same information was delivered to FD who contacted the hospital to check on FY1. Additional information obtained from confidential interviews disclosed that FD took them to the hospital and brought them back. Confidential interviews stated FD loved them and would always care for them but was unable to recall the time frame of how long FY1 was dropped off and picked up from the hospital. Regarding the allegation that staff mishandled a minor while in care. During the investigation LPA Ajaero made an unannounced visit on 3/2/23 and interviewed the FD. Confidential interviews stated that FY1 has resided at the home for eight and half years. Confidential interviews stated that the home has a policy that staff are not to put their hands on the clients. Although confidential interviews deny staff mishandled a client in care, other information reported stated that the allegation is true. LPA received inconsistent information regarding the allegations. Based on interviews and confidential information obtained during the course of this investigation, the allegations that Staff unlawfully removed a minor while in care and staff mishandled a minor while in care, may have occurred, however is not supported or proven by evidence. Therefore, the above allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13On 3/3/23, Licensing Program Analyst, (LPA) Uchenna Ajaero made an unannounced complaint investigation visit to Small Steps Group Home to deliver findings for this investigation. LPA Ajaero met with Yvonne Pierre, Facility Director(FD), and informed her of the reason for the visit. During the investigation, LPA Linda Haynes visited the facility on 2/25/2022 and met DD. LPA Haynes interviewed Donna Daniels (DD) the Facility Manager and requested relevant documents including copies of Client (FY1) Progress notes, and Individual Program Plans. On 02/17/2022, Community Care Licensing received allegations that staff unlawfully removed a minor while in care and staff mishandled a minor while in care. Regarding the allegation that staff unlawfully removed a minor while in care, during the investigation LPA Ajaero made an unannounced visit on 3/2/23, and interviewed the Facility Director, (FD) Yvonne Pierre and the Care giver Donna Daniels, (DD). FD stated that FY1 was not abandoned at the hospital. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Christina Barnes LICENSING EVALUATOR NAME: Uchenna Ajaero 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: SMALL STEPS GROUP HOMEFACILITY NUMBER: VISIT DATE: 03/03/2023

met_with: Yvonne Pierre, Facility Director


raw_content:
Narrative:
Confidential interviews provided inconsistent statements regarding the alleged incident and/or any injury to C1's nose having occurred. Confidential interviews and record review were unable to confirm or dispute the allegation. A second allegation was received by CCL alleging Staff member (S1) made inappropriate comments to minor (C1). Specifically, it was reported S1 made derogatory remarks towards C1 by saying C1 was gay and/or retarded. Confidential interviews provided inconsistent statements regarding the allegations. Confidential interviews denied hearing any staff make inappropriate comments towards or in the presence of any residents in the facility. Conflicting statements reported, statements used to be made but are no longer being made. Other confidential information received was unable to clearly identify who allegedly made the comments and who the comments were made to. Confidential interviews and record review were unable to confirm or dispute the allegation. Based on record review and confidential interviews the allegations alleging Staff member (S1) handled minor (C1) in a rough manner causing injuries and Staff member (S1) made inappropriate comments to minor (C1) 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 Small Steps Group Home,House parent, Vicki Harris.

Investigation Findings:
13On January 18, 2024 at 9:02 am Licensing Program Analyst (LPA), Nicole Strickland met with Small Steps Group Home, House parent, Vicki Harris to deliver the findings for the above stated allegations. LPA spoke with Licensee, Ms. Yvonne Pierre who gave permission for Ms. Harris to sign on behalf of the facility. A Health and safety inspection of the facility was conducted on July 5, 2023, and no immediate hazards were observed. The investigation included interviews with two of two foster youth (Child #1 [C1], and Child #2 [C2]), two staff (Staff #1 [S1] and Staff #3 [S3], and two County Social Workers (CSW #1 [CSW1] and CSW #2 [CSW2). One confidential witness's whereabouts is unknown and therefore was unable to be interviewed. In addition, county records and facility records were reviewed. On June 27,2023, Community Care Licensing (CCL) received an allegation alleging Staff member (S1) handled minor (C1) in a rough manner causing injuries. Specifically, it was reported S1 became frustrated with C1 and S1 then smashed and rubbed a cookie into C1's face causing two cuts on C1's nose. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap 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 CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: SMALL STEPS GROUP HOMEFACILITY NUMBER: VISIT DATE: 01/18/2024

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

met_with: Vicki Harris


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Narrative:
The allegation that staff hit minor while in care specifically refers to C1 getting hit by S1 while S1 was trying to restrain C1. Confidential interviews revealed that S1 was not trying to restrain C1 but did put their hands up to cover their face as C1 tried to hit S1. Other confidential interviews stated that the allegation occurred. Based on confidential interviews and record reviews, the allegations that S1's behavior poses as a risk to C1 and that S1 hit C1 while in care, may have occurred, however, they are not supported or proven by evidence. Therefore, the above allegations are unsubstantiated. A copy of this report, LIC 811, and appeal rights were given to House Manager Sharon Jackson.

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: Sharon Jackson


raw_content:
Narrative:
The allegation that facility staff inappropriately disciplines minors specifically refers to C1 being made to stay in a room until bedtime as a form of punishment and C1 was required to stand in a corner for long periods of time. Confidential interviews revealed that the clients are not made to go into any room and they are not made to stand in a corner. Other information obtained stated that the allegation occurred. The allegation that facility staff threatened minor specifically refers to S1 telling the clients S1 cannot wait until they misbehave so S1 can beat them. Confidential interviews revealed that S1 does not threaten the clients. Other information obtained stated that the allegation occurred. Based on confidential interviews and record reviews, the allegations that S1 hits C1, that S1 inappropriately disciplines minors, and that S1 threatens minors, may have occurred, however, they are not supported or proven by evidence. Therefore, the above allegations are unsubstantiated. A copy of this report, and appeal rights were given to Licensee Yvone Pierre.

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: Yvonne Pierre


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Narrative:
Confidential interviews further revealed that the staff did not know that C1 had left the facility until an announcement on the police's loudspeaker was heard asking if anyone is missing a child. Confidential interviews revealed that when this was heard by staff, they went to C1's room and noticed C1's bed was empty. Based on confidential interviews and record review, the preponderance of evidence standard has been met and the allegation staff did not provide adequate supervision resulting in C1 wandering away from facility is substantiated. Facility is cited for violation of Health and Safety Code 84065.2 (b)(1) Personnel Duties. A copy of this report was reviewed and provided to Direct Care Staff Shawntee Dawson per Administrator Yvonne Pierre, along with the Appeal Rights.

Investigation Findings:
SubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:

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

met_with: Shawntee Dawson


raw_content:
Narrative:
The Department received a second allegation alleging staff (S3) choked C1. Specifically, it was reported after S3 came behind C1 and choked C1 hard. Confidential interviews and record review provided conflicting statements regarding the alleged incident. Confidential interviews and record review could not confirm or dispute this allegation with a preponderance of evidence. A third allegation was received by the Department alleging staff do not treat minors with dignity. This allegation specifically refers to C1 being called different names. Confidential interviews and record review provided conflicting statement regarding the allegation. Confidential interviews and record review could not confirm or dispute this allegation with a preponderance of evidence. Based on confidential interviews and record reviews, the allegations staff (unknown) that slapped a minor (C1), Staff (S3) choked a minor (C1), and staff did not treat minors with dignity, may or may not have occurred, however, they are not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. A copy of this report, LIC 811, and appeal rights were given to Licensee Yvonne Pierre.

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:


summary: Facility Evaluation

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Narrative:
On March 30, 2022, Licensing Program Analyst (LPA), Linda Haynes, conducted an unannounced inspection at the group home above for the purpose of conducting a required two year inspection. LPA met with the Program Director, Yvonne Pierre. During the inspection there was one other staff at the facility and no clients as they were in school. A physical plant inspection was completed and included the following checks: facility grounds are clean and free of debris and observable hazards. There is adequate indoor and outdoor activity space, including an outdoor basketball court. All facility smoke detectors and carbon monoxide detectors are in appropriate working order. There is no menu posted as there is only one child and he picks out what he wants to eat the night before. All required forms were available. Medications are locked inside combination lock box located in the staff room. Upon a physical inspection of the facility, chemicals and cleaning products are locked in the staff room and are only accessible by staff. Ms. Yvonne confirmed there are no weapons and/or ammunition on facility grounds. Knives and sharps are also locked in lock box located in the kitchen cabinet. There are three bedrooms: room 1 has two twin beds, room 2 has one queen bed and is used as the staff room, and room 3 has a twin bed. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good condition. Each bedroom has a dresser for each client that provides drawers for storage and a closet for additional storage. Bedrooms are arranged so that no more than two clients share a room and there is one client per bed. There is one full bathroom in the home. The water in the bathroom measured to be 113.6 degrees. There is currently one client in care at the group home. Client files are locked in a cabinet in the staff room. Files were provided to LPA upon request. One client file was reviewed during the inspection and noted to have documents required per regulations in file. There were no clients present at time of inspection to be interviewed. LPA reviewed four staff files during the inspection and noted to have documents required per regulations in their files. LPA reviewed this report with facility administrator Yvonne Pierre and provided a copy to facility administrator.


summary: Facility Evaluation

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Narrative:
On December 5th, 2023, at 9:30am, Licensing Program Analyst (LPA) Cynthia Robinson and Licensing Program Manager (LPM) Cheraki Davis, conducted an unannounced inspection at the Small Steps Group Home above for the purpose of conducting a required two-year inspection. LPA met with the Administrator Yvonne Pierre. During the inspection there was one other staff at the facility and one client home from school due to being sick. Upon arrival, staff Vickie Harris had just finished making breakfast for the client and home was in clean conditions. There is a camera indoors located in the dining/ living room. A physical plant inspection was completed at 10:20am and included the following checks: facility grounds are clean and free of debris and observable hazards. There is adequate indoor and outdoor activity space, including an outdoor basketball court. All facility smoke detectors and carbon monoxide detectors were tested and are in appropriate working order. Fire extinguisher was in working order with a full charge and last checked on March 31st, 2023. Menu available upon request in folder. All required forms were available. Medications are locked inside combination lock box located in the staff room. Upon a physical inspection of the facility, chemicals and cleaning products are locked in the staff room and are only accessible by staff. Ms. Yvonne confirmed there are no weapons and/or ammunition on facility grounds. Knives and sharps are also locked in lock box located in the kitchen cabinet. LPA observed one carbon monoxide located in the hallway and all smoke detectors were operable during the time of visit. There are three bedrooms: room 1 has two twin beds, room 2 has one queen bed and is used as the staff room, and room 3 has twin bed. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good condition. Each bedroom has a dresser for each client that provides drawers for storage and a closet for additional storage. Bedrooms are arranged so that no more than two.. Continued On August 23, LPA Linda Haynes amended this report. clients share a room and there is one client per bed. There is one full bathroom in the home. The water in the bathroom measured to be 105.06 degrees. There are currently three clients in care at the group home. Client files are locked in a cabinet in the staff room. Files were provided to LPA upon request. All client files were reviewed during the inspection and noted to have documents required per regulations in file. LPA reviewed three staff files during the inspection and noted to documents required per regulations in their files. LPA will return to complete the annual inspection at a later date. LPA reviewed this report with facility administrator Yvonne Pierre and provided a copy to facility administrator.


summary: Facility Evaluation

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Narrative:
On December 18, Licensing Program Analysts (LPA's) Cynthia Robinson and Leslie Covarrubias arrived unannounced at Small Steps Group Home for the purpose of continuing an annual inspection initiated on 12/05/2023 at 1: PM. During the inspection, LPA's met with Lead Staff, Sharon Jackson. LPA's interviewed two staff and one client that were present during time of inspection to go over the facility policies and procedures. One client was home but is non-verbal therefore, LPA's could not complete client interview. All staff were able to provide sufficient information in relation to the facility's Program Statement, Emergency Intervention Plan, and Reporting Requirements. Based on interviews with staff, the facility appears to be meeting Core Services/Supports requirements. LPA's reviewed the facilities Special Needs for client files. All the documentation pertaining to this area of the inspection was provided, and no deficiencies were noted. A copy of this report along with appeal rights were provided and discussed with Lead Staff, Sharon Jackson.


summary: Facility Evaluation

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Narrative:
On January 31, 2025, at 1:00 pm , Licensing Program Analyst (LPA) Jacob Ortega and Licensing Program Manager (LPM) Nicole Strickland, conducted an unannounced inspection at the Small Steps Group Home above for the purpose of conducting a required two-year inspection. LPA met with the Administrator Yvonne Pierre. Currently there are no staff or clients at the facility. There is a camera indoors located in the dining/living room. A physical plant inspection was completed at 1:05 pm and included the following checks: facility grounds are clean and free of debris and observable hazards. There is adequate indoor and outdoor activity space, including an outdoor basketball court. Fire extinguisher was in working order with a full charge and last checked on April 2024. All required forms were available. Medications are locked inside combination lock box located in the staff room. Upon a physical inspection of the facility, chemicals and cleaning products are locked in the staff room and are only accessible by staff. Ms. Yvonne confirmed there are no weapons and/or ammunition on facility grounds. Knives and sharps are also locked in lock box located in the kitchen cabinet. LPA observed one carbon monoxide detector located in the hallway and all smoke detectors were operable during the time of visit. There are three bedrooms: room 1 has two twin beds, room 2 has one queen bed and is used as the staff room, and room 3 has a twin bed. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good condition. Each bedroom has a dresser for each client that provides drawers for storage and a closet for additional storage. Bedrooms are arranged so that no more than two clients share a room and there is one client per bed. There is one full bathroom in the home. The water in the bathroom measured to be 107 degrees F. There are currently no clients in care at the group home. Client files are locked in a cabinet in the staff room. LPA informed licensee upon acceptance of clients licensee shall notify case caring LPA, so an inspection of staff and client records can be inspected at that time. LPA reviewed this report with facility administrator Yvonne Pierre and provided a copy to facility administrator.

met_with: Ms. Yvonne


summary: Facility Evaluation

raw_content:
Narrative:
On May 14, 2025 at 4: PM Licensing Program Analyst (LPA) Linda Haynes arrived at Small Steps Group Home and met with Licensee Yvonne Pierre to sign an amended LIC 9099.


summary: Facility Evaluation

raw_content:
Narrative:
On January 15, 2026, at 01: PM Licensing Program Analyst (LPA) Linda Haynes conducted an annual inspection of Small Steps Group Home. At time of inspection LPA met with Administrator (AD) Yvonne Pierre. The facility was toured inside and out with AD. The home is a one story residence with three bedrooms and one bathrooms. There are currently no clients in placement. Bedrooms are arranged so that no more than two clients are in a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. The bathrooms were clean and in good repair. The facility's smoke detectors in each bedroom were checked and were operable. The carbon monoxide detector is located in the hallway and was operable. There are no guns or weapons in the facility as stated by AD. The following required posted items was accessible to clients: Grievance Procedures, Personal Rights, and Visitation policies. The facility outside grounds was also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. There is no pool or other body of water. Exit interview conducted and a copy of this report and appeal rights was discussed and provided to AD.


summary: Facility Evaluation

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Narrative:
On September 27, Licensing Program Analyst (LPA) Linda Haynes met with Administrator (AD) Yvonne Pierre for a Case Management inspection. LPA informed AD that they were there to discuss the incident that happened on 9/6/2024 while meeting with the Lawyers Advocate. On September 18, 2024, a Special Incident Report was received stating that Staff 1 (S1) took Clients 1 and 2 (C1, C2) to a Lawyer Advocate meeting. S1 had C1 on a child leash. C1 tried to run and S1 pulled on the leash to bring C1 towards S1. Based upon record review and interviews The facility is being cited for Title Division Chapter Section 84072(d)(24)(G) Personal Rights. A copy of this report was given and explained to Yvonne Pierre along with appeal rights.