summary: Facility Evaluation

raw_content:
Narrative:
On 07/25/202 @ 8: AM Licensing Program Analyst (LPA) Zena Phillips made an unannounced visit to Vista Del Mar Family Services for the purpose of an Annual Required Licensing Inspection. LPA met with Alma Marquez/Supervisor and conducted a tour of the facility. There are currently fifteen (15) children placed in the facility. This STRTP is licensed to serve 16 children ages 12-17 years of age, ambulatory only. This facility will also provide care to non-minor dependents. The facility has cameras that monitors both cottages/wings (Handler #1 and #2), living room, the rotunda room (also known as the lobby), and kitchen. The facility is located in a residential area with three cottages/wings, 18 bedrooms, several bathrooms, kitchen/dining room, 2 laundry rooms, and one clinician offices in each unit (three in total). Handler #1 is designated for the co-ed wing with boys and girls. Handler #2 is designated for the girls. The third wing is the administrative wing with offices for the administrators, clinician and all other staff. There was adequate closet and storage space for the clients. There are washers and dryers that were operable in Handler #1 and Handler # Handler #1- Bedrooms with 1 twin bed, with closet space, and desks. Bedroom with 1 twin bed, and with closet space and desk currently not occupied. Handler #2- Bedrooms with 1 twin bed, has closet space, and desks. Bedroom with 1 twin size bed, with closet space, and desk currently not occupied. A physical plant inspection was completed and included the following checks: Facility is clean, safe, and sanitary All beds are in good repair. Each client has adequate closet and ample clothing. Each client has complete sets of towels, sheets, blankets and bedspreads. There is adequate hygiene and grooming supplies in both Handler #1 and #2. The kitchen is sanitary and in good repair. cont on 809c LPA reviewed the following during the inspection: Five (5) staff records review; the information regarding the Emergency Preparedness. LPA reviewed Criminal Records and confirmed that all current and former staff were also cleared. LPA reviewed The Administrator, Social Worker and Direct Care staff records. LPA reviewed the facility binder that included specific training's. Specific Training's include the following: Policies & Procedures; Health & Safety: Emergency Procedures: Medication; Trauma-Informed Care; Boundaries; Job Duties; and information about the Stakeholders. LPA observed one week supply of non-perishable and two days of perishable foods, including nutritious snacks. All prescribed medications are locked and centrally stored in the Health Center; Medications are accessible only to employees supervising stored medications. No firearms or weapons are present in the facility. Medications and cleaning supplies are kept locked. The first aid kit is fully stocked. The hot water temperature is within the mandated range. The home is equipped with a fire alarm system; smoke alarm/carbon monoxide detector. All fire extinguishers are charged. There are working telephone service for client's personal use. All trash cans have tight-fitting lids. All exits are free of hazards and all doors open freely. Facility posts child's rights if licensed to provide for six or more children. Clients in care are supervised and protected at all times. Facility operates within license conditions and limitations including capacity limitations. Clients are accorded dignity in personal relationships with staff and others. Clients live in a safe, healthy, comfortable facility and are treated with respect. Clients can contact the licensing agency or Foster Care Ombudsman person in confidence without threats or punishment for making complaints. The following documents or records are posted in the facility: facility license, complaint procedures, emergency disaster plan, facility sketch, menu, chores, house rules, children's personal rights. The following logs are maintained: daily log, awol log, visitors log, allowance log and fire drill log. cont on 809 c LPA observed cracked window in Handler Unit Bedroom 4. LPA discussed with Administrator Amy Jaffe and was advised a work order ticket has been placed. Glass company will come on site to measure and repair window. Amy Jaffe advised work would take approximately two weeks and will send LPA a picture of completed work. LPA was advised maintenance staff will cover window with board to protect clients in care. The cracked window does not pose an immediate health and safety risk to clients in care. LPA was advised of the plan to repair window and Amy Jaffe will provide LPA with photos once work is completed. LPA will return to check facility vehicles and kitchen area. There were no deficiencies observed or cited at the time of the Annual Random Inspection. At the time of the inspection, the facility was clean and safe. An exit Interview was conducted, and a copy of this report will be emailed Amy Jaffe.

met_with: Alma Marquez/Supervisor


state: CA

facility_name: VISTA DEL MAR CHILD AND FAMILY SERVICES

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Raymond Canal, Licensing Program Analyst Dina Camara, and Licensing Program Manager Angela King conducted a case management inspection on 11/2/23 at 12:00 pm based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. During this inspection, 6 out of Direct Care Staff and 6 out of 14 youth files were reviewed. 3 out of Direct Care Staff and 2 out of 14 youth were interviewed. (See the Confidential Names List, LIC 811, 9/14/23). The Plan of Operation including policies and procedures were reviewed. Based on the analysis of the confidential interviews and youth file review including the needs and service assessments, treatment plans, and safety plans, the licensee uses trauma-informed and evidence-based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. LPM King observed documentation of completed training on policies and procedures on when and how to involve law enforcement in response to an incident. Training records show staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance to their Emergency Intervention Plan when there is an immediate risk of serious harm to a child or others. There are no deficiencies cited at this time. A copy of this report was discussed and provided to Administrator Amy Jaffe.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Administrator, Amy Jaffe


summary: Facility Evaluation

raw_content:
Narrative:
On 01/18/24 at 9: AM, Licensing Program Analyst Andrew Upshaw arrived at the above facility to interview a resident regarding allegations at a previous placement. LPA met with Lead Staff, Stephanie Sykes who granted access to the facility. Per California Code of Regulations, Title Regulations, Division 6, Chapter 7, there are no deficiencies cited during this Collateral Visit. An exit interview was conducted, and a copy of this report was left with staff.

met_with: Stephanie Sykes Lead Staff


summary: Facility Evaluation

raw_content:
Narrative:
On January 30, 2024, at 9:58am, Licensing Program Analyst (LPA) Daphne Edison arrived at the above facility to conduct an interview with a resident regarding allegations from a previous placement. LPA met with Alma Marquez, Supervisor, who granted access to the facility. Based on the observations made during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and a copy of this report will be emailed to the Supervisor.

met_with: Alma Marquez-Supervisor


summary: Facility Evaluation

raw_content:
Narrative:
On 07/24/2025, Licensing Program Analyst (LPA) Andrea Aceves made an announced visit to Vista Del Mar STRTP for the purpose of a Case Management- Incident Report. LPA met with Supervisor Jimmie Tyler, to discuss an incident regarding client supervision. The department received a Special Incident Report (SIR) dated 07/22/25. The SIR reported that four (4) clients left the facility without permission. During the investigation LPA obtained copy of LIC 500, client roster, and interviewed Facility Manager. Staff confirmed that the incident did occur, and three of the four clients returned to the facility later that night. The fourth client returned to the facility the following night. LPA was able to interview one (1) staff and the four (4) clients that left the facility. Additional information is needed to resolve this incident. LPA to return to conclude investigation. Exit interview was conducted and a copy of this report was provided to Supervisor Jimmie Tyler.

met_with: Supervisor Jimmie Tyler


summary: Facility Evaluation

raw_content:
Narrative:
On 08/05/2025, Licensing Program Analyst (LPA) Andrea Aceves made an unannounced visit to Vista Del Mar- STRTP for the purpose of a follow up in a Case Management visit regarding an incident report that was received on 07/21/25. LPA Andrea met with Supervisor, Alma Marquez to conclude the investigation and deliver the findings. LPA obtained copy of LIC 500-Personnel Report, client roster, and interviewed two (2) staff. Based on interviews, staff confirmed that all four (4) clients returned to the facility. All clients have been spoken to regarding their safety when leaving the facility without permission. Treatment teams for each client have set a plan to help and to prevent them from leaving the facility. Facility staff continue to engage clients in activities, outings and community resource events to prevent clients from leaving the facility without permission. Based on the information obtained, further information is not needed, and this incident is being closed. No deficiencies were cited at this time. Exit interview was conducted and a copy of this report was provided to Supervisor, Alma Marquez.

met_with: Supervisor- Alma Marquez


summary: Facility Evaluation

raw_content:
Narrative:
On 12/17/2025, Licensing Program Analyst (LPA) Andrea Aceves made an unannounced visit to Vista Del Mar for the purpose of a Case Management- Incident Report. LPA met with Unit Director, Javier Rodriguez to discuss an incident report the department received on 12/11/25 regarding inappropriate sexual behavior between clients. During the investigation LPA requested and obtained copy of LIC 500, client roster, the Needs and Services plan for C1 and C2 and camera footage of the day of the incident. C1 was discharged from facility and C2 was not present during the visit, therefore, clients could not be interviewed. LPA was able to interview two (2) staff and two (2) clients. LPA informed Javier Rodriguez that more information is needed. LPA will return at a later date to conclude the investigation. Exit interview was conducted and a copy of this report was provided to Unit Director, Javier Rodriguez.

met_with: Unit Director-Javier Rodriguez


summary: Facility Evaluation

raw_content:
Narrative:
On 12/31/2025, Licensing Program Analyst (LPA) Andrea Aceves made an unannounced visit to Vista Del Mar for the purpose of a Case Management- Incident Report. LPA met with Supervisor Jimmie Tyler to discuss an incident report the department received on 12/11/25 regarding inappropriate sexual behavior between clients. During the investigation LPA requested and obtained copy of LIC 500, client roster and camera footage of the day of the incident was reviewed. C2 was discharged as of the day of the incident, therefore, client could not be interviewed. LPA was able to interview two (2) staff. LPA informed Jimmie Tyler that more information is needed. LPA will return at a later date to conclude the investigation. Exit interview was conducted and a copy of this report was provided to Supervisor Jimmie Tyler.


summary: Facility Evaluation

raw_content:
Narrative:
On 01/15/26, Licensing Program Analyst (LPA) Andrea Aceves made an unannounced visit to Vista Del Mar-STRTP for the purpose of conducting a Case Management for Incident Report dated 12/11/25. LPA Andrea met with Supervisor Jimmie Tyler. During the investigation, LPA Andrea interviewed all available parties, requested and received LIC500-Personnel Report, client roster, client Needs and Services Plans, and review of video footage. The incident occurred on 12/10/25 and the report was received on 12/11/25. Per interview statements and video footage, LPA was able to confirm that C2 entered C1's bedroom while staff left the hallway unsupervised. Based on a police report and video footage, LPA was able to confirm that an incident did occur between C1 and C2. Per video footage, C2 was in C1's bedroom for approximately forty (40) minutes with staff unaware that C1 is in C1's room. During that course of time, no room checks were conducted, and staff are seen leaving the hallway unsupervised prior to C1 entering C1's room. No further investigation or interviews are required on the above incident. As a result, the facility is being cited (see LIC809D). Exit interview was completed and copy of the report and appeal rights were discussed and provided to Supervisor Jimmie Tyler.


summary: Facility Evaluation

raw_content:
Narrative:
On June 24, 2022@ 11: AM, Licensing Program Analyst (LPA) Zena Phillips conducted a Case - Management inspection visit. LPA Phillips met with Jimmy Tyler to discuss the video footage of an incident on 02/15/2022, SIR # 797766. Brief Summary: On February 16,2022 , Community Care Licensing received an incident report for 02/15/2022 reporting restraint of Child #1 by Staff #3 & Staff #4 . LPA Phillips obtained video footage of the incident and observed Staff #3 initiate a a Pro Act restraint by grasping Child #1's left arm and pushed toward wall. LPA Phillips observed Staff # 4 grasp Child #1 right arm to begin wall restraint. During the investigation LPA Phillips conducted confidential interview, reviewed facility Pro Act certificates and video footage. Requested copies of Pro Act trainers current certification. Based on gathered information there is corroborating evidence that reveals Child #1 was improperly restrained by Staff # 3. The preponderance of evidence standard has been met and the Department has therefore determined the facility is cited for violating Child #1's personal rights. cont on 809c . the preponderance of evidence standard has been met and the Department has therefore determined substantiated findings for violation of personal rights by Staff #3 on Child #1 as evidence revealed Staff # 3 failed to perform correct Pro Act Restraint on Child #1. Staff #3s actions on Child #1 poses an immediate health, safety and personal rights risk of harm to children placed in care. The facility is issued a citation in accordance with the Short-Term Residential Therapeutic Program (STRTP) Interim Licensing Standards, Chapter 1; 80072 (a)(3) Personal Rights. See page 809D for deficiencies Exit interview conducted; Appeal Rights issued, and a copy of this report will be emailed to Administrator.

met_with: Jimmy Tyler/Facility Manager


facility_name: WAKE FOREST

summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Lidia Tinoco conducted an unannounced visit to the Foster Family Agency, Creative Alternatives, in order to deliver the findings of the above allegations for Wake Forest STRTP and met with Gaudencio Flores. The above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, interviews and a review of facility and foster children's records. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegations occurred. Therefore, the allegations are UNSUBSTANTIATED at this time. A copy of this report was discussed and provided to Gaudencio Flores along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

report_type: Complaint Investigation

met_with: Gaudencio Flores

complaint_status: unsubstantiated


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Lidia Tinoco conducted an unannounced visit to the Foster Family Agency, Creative Alternatives, in order to deliver the findings of the above allegations for Wake Forest STRTP and met with Gaudencio Flores. The above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, interviews and a review of facility and foster children's records. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegations occurred. Therefore, the allegations are UNSUBSTANTIATED at this time. A copy of this report was discussed and provided to Gaudencio Flores along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco 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 3


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Lidia Tinoco conducted an unannounced visit to the Wake Forest STRTP, in order to deliver the findings of the above allegations and met with Assistant Supervisor, Walter Martin. The above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, interviews and a review of facility and foster children's records. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegations occurred. Therefore, the allegations are UNSUBSTANTIATED at this time. A copy of this report was discussed and provided along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco 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 3

met_with: Walter Martin


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Reyna Martinez conducted a complaint inspection and met with Walter Martin. The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the complaint alleging staff choked minor. LPA conducted interviews and obtained documentation.There were inconsistencies in the confidential interviews. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Reyna Martinez 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


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Reyna Martinez conducted a complaint inspection and met with Walter Martin. The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the complaint alleging minor was touched inappropriately by another minor. LPA conducted interviews and obtained documentation.There were inconsistencies in the confidential interviews. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Reyna Martinez 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


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA), Lidia Tinoco, conducted a complaint inspection and met with Administrator, Aaron Holloway. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department investigated the allegations. LPA conducted confidential interviews and reviewed documentation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Aaron Holloway


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA), Lidia Tinoco conducted an unannounced visit to the Wake Forest STRTP in order to deliver the findings of the above allegations and met with Administrator, Aaron Holloway. On 9/19/24, the above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, confidential interviews, and review of records. Based on the investigation conducted the department found that there was not sufficient information regarding these issues. Although the allegations may have happened of are valid, there is not a preponderance of evidence to prove the allegations occurred. Therefore, the allegations are Unsubstantiated at this time. A copy of this report was provided at the conclusion of the inspection along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco 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


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA), Lidia Tinoco conducted an unannounced visit to the Wake Forest STRTP in order to deliver the findings of the above allegations and met with Facility Supervisor, Daniel Flores. On 08/04/25, the above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, confidential interviews, and review of records. Based on the investigation conducted the department found that there was not a preponderance of information to prove that Staff engaged in inappropriate behaviors towards youth, Staff did not prevent youths from engaging in inappropriate behaviors towards other youths and that staff did not follow reporting requirements.Therefore, the allegations are Unsubstantiated. A copy of this report was provided at the conclusion of the inspection along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Daniel Flores


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced annual inspection was conducted by Licensing Program Analysts (LPA's) Lidia Tinoco and Vanessa Galvan and Cynthia Galindo traveled to the Wake Forest STRTP in Merced, CA. LPA's met with Administrator Gaudencio Flores and inspected the facility, inside and out. A physical plant inspection was completed and included the following checks. Facility grounds are clean and free of debris. Adequate indoor and outdoor activity space and materials observed. The facility is maintained at 75 degrees. All facility smoke detectors and carbon monoxide detectors are in appropriate working order. Facility maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. All required forms are posted. No client requires medications currently, facility has the ability to keep Medications locked and centrally stored. Individual beds were observed with appropriate clean linens and are in good repair. Licensee has obtained Mental Health Certification Including the following: Mental Health Program Approval valid through September 24, 2021, a review was conducted on August 16-23, 2021 and have not been issued. Licensee has obtained National Accreditation through CARF valid through September 30, 2023. The facility has a county contract valid through June 30, 2022. Medical Certification valid through April 26, 2022. No firearms or weapons are allowed in the facility. Facility appears to be meeting the terms and conditions of their license. LPA's reviewed client files and conducted staff and client interviews. No Deficiencies were cited on today's visit. A copy of this report was left with Gaudencio Flores.

visit_type: Annual


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA's), Lidia Tinoco and Vanessa Galvan traveled to the Creative Alternatives main office in order to continue conducting the Annual Inspection for Wake Forest STRTP and met with Program Director, Brandi Boehme. LPA's conducted 10 staff file reviews. A technical violation was issued. No other deficiencies were cited. A copy of this report was left with Brandi Boehme at the conclusion of inspection.

met_with: Brandi Boehme


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced annual inspection was conducted by Licensing Program Analyst (LPA), Lidia Tinoco traveled to the Wake Forest STRTP in Merced, CA. LPA met with Facility Supervisor Gaudencio Flores and Administrator Aaron Holloway. A physical plant inspection was completed and included the following checks. Facility grounds are clean and free of debris. Adequate indoor and outdoor activity space and materials observed. The facility is maintained at 75 degrees. All facility smoke detectors and carbon monoxide detectors are in appropriate working order. Facility maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. All required forms are posted. 4 clients require medications currently, facility has the ability to keep Medications locked and centrally stored. Individual beds were observed with appropriate clean linens and are in good repair. Licensee has obtained Mental Health Certification Including the following: Mental Health Program Approval valid through September 24, 2022. Licensee has obtained National Accreditation through CARF valid through September 30, 2023. The facility has a county contract valid through June 30, 2025. Medical Certification Visit conducted on February 18, 2022. No firearms or weapons are allowed in the facility. Facility appears to be meeting the terms and conditions of their license. LPA reviewed 4 client files. One Type A Deficiency was cited on today's visit for CCR 80076(a)(1) Food Service. A copy of this report was left at the conclusion of the inspection.

met_with: Aaron Holloway, Gaudencio Flores


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco met with Administrator Aaron Holloway for the purpose of continuing the Annual inspection for the Wake Forest Facility. LPA reviewed 5 staff files and conducted Administrator Interview. No Deficiencies were observed or cited on todays visit. A copy of this report was provided to Aaron Holloway at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco met with Assistant Facility Supervisor, Walter Martin for the purpose of continuing the Annual inspection for the Wake Forest Facility. LPA Interviewed Clients and Staff. LPA also conducted a file review of remaining binders and documents pertinent to the Annual Inspection. No Deficiencies were observed or cited. A copy of this report was provided at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco arrived at the Wake Forest STRTP and met with Gaudencio Flores for the purpose of addressing an incident that occurred on 11/21/22. LPA addressed the incident report with Gaudencio who shared that the client had retracted the allegations to Law Enforcement when he was questioned. Gaudencio informed LPA that a 14-day notice was issued for this client on 11/8/22 and his last day at the facility was 11/23/22. Client was pending a new placement with a CVRC home and was moved once a home was located for him. No deficiencies were cited on todays visit. A copy of this report was provided at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On May 31, Licensing Program Analyst (LPA), Lidia Tinoco met with Aaron Holloway for the purpose of discussing an incident regarding a youth placed at the Wake Forest Facility. Administrator informed LPA Tinoco that on 5/30/23 while conducting a reasonable search of a youths tablet it was found that the youth was seeking a firearm to harm another youth in the home. Law enforcement was contacted and arrived at the home to complete a report. An emergency CFT was called and an emergency removal was put in place. Youth has been removed as of 1pm on 5/31/23 and is being taken to San Francisco County. A copy of this report was provided at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Reyna Martinez on May 5, 2024 at 10: AM. This case management inspection is conducted pursuant to Health and Safety Code 1538.9(a)(2). During the inspection, LPA met with Aaron Holloway, Administrator and inspected the facility inside and out. LPA reviewed 0 child's records and 2 staff personnel files on site at the facility. There are no children that quailfy under the SB 484 criteria for psychotropic medications review. LPA did not interview any children. LPA interviewed 2 staff on site to discuss the facilities policies and procedures of operation. LPA provided a copy of the licensing report to Administrator, Aaron Holloway No deficiencies are being cited at this time. LPA conducted exit interview with Aaron Holloway, Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco arrived at the Wake Forest STRTP for the purpose of conducting an unannounced Annual/Random inspection. LPA met with Facility Assistant Supervisor, Walter Martin and inspected the facility, inside and out. Centrally stored medications are maintained in a locked cabinet. Sharps and Toxic chemicals are kept locked. The facility has a written emergency disaster plan. All facility smoke detectors appear to be in appropriate working order, the fire extinguisher is properly charged. Individual beds were observed with appropriate clean linens and are in good repair. There is at least one-week supply of nonperishable and a two-day supply of perishable foods. Facility has a pool which is appropriately fenced and secured. No firearms or weapons are allowed in the facility. Administrator, Aaron Holloway is present at the facility a minimum of 20 hours a week. Appropriate staff/client ratios were observed during this inspection. The facility employs Social Worker, 2 facility managers and 8 direct care staff. Licensee has obtained Mental Health Certification Including the following: Mental Health Program Approval valid through September 24,2024. Agency had a Mental Health Program Approval inspection the week of September 16-20, 2024 and are pending results. Licensee has obtained National Accreditation through CARF. The Accreditation is valid through September 30, 2026. 5 records of clients were reviewed. (See LIC811 confidential names list) A staff record review will be conducted at a later date. Staff and Client interviews will be conducted at a later date. Continued on LIC809-C... LPA Tinoco discussed the plan for C1 (See Confidential names list LIC811). LPA Tinoco requested that a plan is created to address C1's placement moving forward including compatibility with other youth in care. A Technical Violation was discussed and an LIC9102 was provided. A work order was submitted on todays date. No Deficiencies were cited on today's date. A copy of this report was provided at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco met with Administrator, Aaron Holloway for the purpose of continuing the Annual Inspection for the Wake Forest STRTP. LPA Reviewed 5 staff files (See LIC Confidential Names List). No Deficiencies were observed or cited. Staff and client interviews are still required to be conducted to complete this inspection, interviews will be conducted at a later date. A copy of this report was provided at the conclusion of the inspection to Administrator, Aaron Holloway.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco arrived at the Wake Forest Short Term Residential Therapeutic Program (STRTP), for the purpose of conducting an unannounced Annual Required 2-year inspection. LPA met with Administrator, Aaron Holloway. 5 records of personnel/staff members were reviewed with the Administrator to ensure staff meet regulatory requirements. All personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. Personnel Files are maintained at the Creative Alternatives Turlock office. LPA Tinoco conducted a review of Guardian on 9/26/2025 to verify that all staff on the LIC500 provided were cleared and associated. Administrator is present at the facility a minimum of 20 hours a week. The facility employs Social Worker, Head of Service, Clinician, 2 facility supervisors and 6 direct care staff. Licensee has obtained Mental Health Certification Including the following: Mental Health Program Approval valid from September 24, 2024 through September 24, 2025. Licensee has obtained National Accreditation through CARF (Commission on Accreditation of Rehabilitation Facilities), valid through September 30, 2026. LPA Tinoco amended this report on 10/3/25 to correct the facility name on the original report. No deficiencies were cited on today's date. An annual continuation will be conducted at a later time. A copy of this report was provided at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco arrived at the Wake Forest STRTP for the purpose of conducting an unannounced continuation of the 2-year Annual inspection. LPA met with Administrator, Aaron Holloway and inspected the facility, inside and out. Centrally stored medications are maintained in a locked cabinet. Sharps and Toxic chemicals are kept locked. The facility has a written emergency disaster plan. All facility smoke detectors were tested and appear to be in appropriate working order, fire extinguisher is properly charged. Individual beds were observed with appropriate clean linens and are in good repair. There is at least one-week supply of nonperishable and a two-day supply of perishable foods. The facility is maintained at 71 degrees. Facility does not have cameras. Facility has a pool which is appropriately fenced and secured. 5 records of clients were reviewed. Staff interview was conducted. Additional staff and Client interviews interviews are to be conducted to finalize the annual inspection and will be conducted at a later time. One Technical Violation was issued on today's date. No Deficiencies were cited. A copy of this report was provided at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco conducted an unannounced visit to the Wake Forest STRTP in order to conclude the Annual and met with Facility Supervisor, Daniel Flores. LPA Tinoco addressed concerns that were brought up during confidential interviews. LPA Tinoco was given permission to address the concerns with the agency. LPA also addressed the air filter in the home, and issued a technical violation for CCR 80087(a) Buildings and Grounds. A copy of this report was provided at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco arrived at the Wake Forest STRTP for the purpose of conducting an unannounced Case Management inspection and met with Administrator, Aaron Holloway. The purpose of the inspection was to discuss an incident report received by the department on 10/2/25. The incident dated 9/29/25, involved a youth being placed in an attempted restraint. During the attempt, a staff involved and the youth fell. No injuries were observed by staff on the date of the incident according to the report. This incident is pending County CPS investigation. Further information is being gathered. No deficiencies were cited on this date. An exit interview was conducted, and a copy of this report was provided at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco arrived at the Wake Forest STRTP for the purpose of conducting a Case Management inspection and met with Administrator, Aaron Holloway. The purpose of the inspection was to discuss an incident received by Creative Alternatives on 11/14/25 regarding C1. LPA Tinoco spoke with Program Director, Brandi Boehme on 11/17/25 over the phone and was provided facility documentation via email. At this time the incident is being investigated by Law Enforcement. LPA Tinoco is documenting the incident details but no formal investigation is being conducted as the location of the incident has not been confirmed to have happened at the STRTP. LPA informed the agency that this may become a formal investigation at a later time. No deficiencies were cited on this date. An exit interview was conducted, and a copy of this report was provided at the conclusion of the inspection.


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13Complaint Specialist C.K. Kinney(CS) traveled to Wake Forest and met with Aaron Holloway to deliver findings of investigation. Investigator Munoz conducted investigation that included review of documentation and confidential interviews and found a preponderance of the evidence demonstrating the allegation occurred. The allegation is substantiated and the facility is being cited for violation of Interim Licensing Standards STRTP Version Section 87072(c )(16) Personal Rights and Health & Safety Code Section 1558(a)(2) Conduct Inimical. This case is being referred to Legal for determination if Enhanced Civil Penalties will be assessed. Copy of this report, Deficiency Citations, LIC Confidential Names, LIC Appeal Rights left at the facility at conclusion of inspection. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Charles Kinney 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 24-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FRESNO RO, E SHAW AVE FACILITY NAME: WAKE FORESTFACILITY NUMBER: 247203412

complaint_status: SUBSTANTIATED


summary: Facility Evaluation

raw_content:
Narrative:
On January 7, 2026, Licensing Program Analyst (LPA) Danny Macias arrived at Wake Forest Short Term Residential Treatment Program (STRTP) for the purpose of conducting an unannounced Case Management Inspection and met with Facility Administrator, Aaron Holloway. The purpose of the inspection was to discuss concerns with buildings and grounds as a walk through was completed. During the facility walk through LPA observed several windows to be without window screens, a hole in a bedroom door, a leaking shower head, a shower floor missing a drain cover, and the fence in need of repair due to rotting planks. The facility has initiated work orders for these items to be completed. A review of the Licensing Information System on this date indicates that all facility staff are associated to the STRTP and had DOJ, FBI, and child abuse index check clearances. A copy of this report was provided to Aaron Holloway at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco arrived at the Wake Forest STRTP for the purpose of conducting a Case Management regarding medication errors, LPA met with Gaudencio Flores. LPA informed Gaudencio about the medication errors due to staff in the current month dated 11/8/22 - 2 incidents and 11/20/22 - 1 incident. Facility Administrator Aaron Holloway is aware of the errors and addressed it with the staff who were at fault and completed a counseling form for both staff at which time the five rights were reviewed with staff. The facility will have a staff meeting on 11/30/22 and Administrator will complete a retraining with attending staff. Any staff not available during the meeting will be retrained on the date of their next shift. Proof of training will be provided to LPA by 12/01/22. As a result of the incidents mentioned above, The Agency is being cited for the Interim Licensing Standards Section 87075(c) Health Related Services. A copy of this report was provided at the conclusion of the inspection along with appeal rights.


summary: Facility Evaluation

raw_content:
Narrative:
On March 13, 2024, Licensing Program Analyst (LPA) Lidia Tinoco met with Administrator, Aaron Holloway and Program Director, Brandi Boehme for the purpose of conducting a Case Management. The purpose of the inspection is to discuss two incidents dated 2/27/24, that indicated medication errors made by staff. LPA Tinoco reviewed incident reports from Wake Forest Facility (See LIC812 for details). LPA Tinoco discussed with Administrator the incidents. LPA highlighted the importance of administering medications appropriately. Administrator stated that there have been conversations with the staff responsible. Per Administrator, the errors were due to staff communication. Administrator will provide LPA with the training and conversations that have been conducted with staff by 03/20/24. The agency will bring on a nurse that will begin conducting audits and meeting with small groups of staff for a period of time to potentially reduce the errors. As a result of the incidents mentioned above, The Agency is being cited for the Interim Licensing Standards Section 87075(c) Health Related Services. An exit interview was conducted, and a copy of the report and appeal rights were provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On May 1, 2024, Licensing Program Analyst (LPA) Lidia Tinoco met with Administrator, Aaron Holloway for the purpose of conducting a Case Management. The purpose of the inspection is to discuss an incident dated 4/14/24 through 4/15/24, that indicated medication errors made by staff. LPA Tinoco discussed with Administrator the incident. LPA highlighted the importance of administering medications appropriately. Administrator stated that they had a conversation with the staff responsible. The error made was due to the medication not being refilled in a timely manner. As a result of the incidents mentioned above, The Agency is being cited for the Interim Licensing Standards Section 87075(c) Health Related Services, See LIC809D. A civil penalty was also issued for a repeat violation. An exit interview was conducted, and a copy of the report and appeal rights were provided at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On December 10, 2024, Licensing Program Analyst (LPA) Lidia Tinoco met with Administrator, Aaron Holloway for the purpose of conducting a Case Management Inspection. The purpose of the inspection is to discuss an incident dated 11/11/24. LPA Tinoco reviewed the incident report from Wake Forest Facility, involving C1 being restrained by S1 (See LIC Confidential Names List). LPA Tinoco discussed with Administrator the incident. Administrator stated that S1 was retrained and provided LPA Tinoco with the plan of corrections. As a result of the incident mentioned above, The Agency is being cited for the Interim Licensing Standards 87095.00(b)(1) GENERAL PROVISIONS. The deficiency was issued and cleared on this date. An exit interview was conducted, and a copy of the report and appeal rights were provided to the facility at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On February 4, 2026, Licensing Program Analyst (LPA) Danny Macias traveled to Wake Forest Short Term Residential Therapeutic Program (STRTP) located in Merced, CA to conduct an unannounced inspection and met with Facility Administrator Aaron Holloway. The purpose of the inspection was to discuss a manual restraint incident on September 29, 2025. Staff involved admitted to using a prone restraint on a client(see 812s), therefore the STRTP is being cited on the attached LIC809-D under Interim Licensing Standards, Article 10. General Requirements, 87095. Emergency Interventions Prohibition. A review of the Licensing Information System on this date indicates that all facility staff are associated to the STRTP and had DOJ, FBI, and child abuse index check clearances. A copy of this report and appeal rights was left with Aaron Holloway at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Sonia Sanchez traveled to Wake Forest and met with Aaron Holloway, Administrator to conduct a Case Management Inspection, in order to assess an Enhanced Civil Penalty (ECP). LPA conducted an entrance interview and reviewed details of the substantiated complaint. On 12/16/2025, the Department concluded a complaint investigation for the STRTP. The allegation of staff engaged in a inappropriate relationship with a minor was substantiated. Therefore the STRTP was cited for violation of Interim Licensing Standards STRTP Version Section 87072(c)(16) Personal Rights and Health & Safety Code Section 1558(a)(2) Conduct Inimical. Pursuant to the Enhanced Civil Penalty law, H&S Code Section 1548(f)(1)(C)(i), the Department will be issuing an immediate civil penalty of $2500.00. An exit interview was completed, and appeal rights discussed. A Copy of this report, LIC Confidential Names List, LIC Appeal Rights and a Civil Penalty Assessment - Serious Bodily Injury/Physical Abuse (Form 421D) were provided to at conclusion of inspection.


raw_content:
Investigation Findings:
13On February 4, 2026, Licensing Program Analyst (LPA) Danny Macias traveled to Wake Forest Short Term Residential Therapeutic Program (STRTP) located in Merced, CA to conduct an unannounced inspection and met with Facility Administrator Aaron Holloway. The purpose of the inspection was to deliver findings for the above complaint allegations. During the investigation, LPA conducted confidential interviews, records review and reviewed supporting documents provided by the facility. Based on confidential interviews and records reviewed, the department has made the following determination. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. No deficiencies or citations issued. An exit interview was conducted and a copy of this report was left with Aaron Holloway. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tamara Melikian LICENSING EVALUATOR NAME: Danny Macias 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


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco met with Administrator, Aaron Holloway for the purpose of conducting a Case Management inspection regarding an incident that occurred at the Wake Forest STRTP. The incident occurred began on 3/7/26 and it involved a medication error. A technical violation was issued for 87075(b) Health Related Services on the attached LIC9102. This report was discussed and signed at the time of the visit. A copy of this report was provided at the conclusion of the inspection.


facility_name: WALT'S HOME FOR YOUNG MEN

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Investigation revealed the following: It was alleged that staff are not treating a resident with dignity and staff encouraging residents to fight. Interviews conducted with C2-C4 denied the allegations of ever being mistreated or staff encouraging residents fight. Interview conducted with C2 stated that they recalled an incident with C1 being rude to Administrator and that C1 would talk down to others but stated they did not recall staff retaliating negatively to C1. Interviews conducted with S1-S4 had similar statements that they all received training in LGBTQI and did not recall seeing or hearing of any staff members not treating children with dignity or enticing children to fight. LPAs were unable to interview C1 due to C1 being reunited with biological family. LPA Mahecha and LPA Smith spoke with county social worker (CSW) who made similar statements in that C1 likes to be in control of situations and had challenges being in the home. However, LPAs obtained no specific information from interviews conducted of dates, times or occurrences of alleged allegations. Based on the information gathered, although the allegation may have happened or is valid, the preponderance of evidence to prove the allegation was not met, therefore the allegation is unsubstantiated. An exit interview was conducted. A copy of this report Confidential Names Form and Appeal Rights were provided to the facility representative via electronic mail. There were no deficiencies cited during this inspection.

Investigation Findings:
13On 9/22/ Licensing Program Analyst (LPA) Dawn Mahecha made an announced visit to the Walt's Home for Young Men for the purpose of a concluding the above complaint investigation. LPA met with Administrator Carlene Logan and discussed the identified findings. Investigation consisted of the following: On 4/9/ LPA interviewed Senior House Manager (see LIC811, Confidential names, dated 4/9/2021) and requested the following documents: Current staff/client roster, recent discharged clients list, Needs and Service plans for children in placement, Special incident report (SIRs) pertaining to C1 and allegations made against staff, in-house investigations against staff and current staff training. Additionally, LPA requested copies of any complaints made to staff from clients or C1 from January 2021 to present date. On 8/20/ LPA Elnora Smith interviewed four (4) children and on 8/20/2021 and 8/23/ LPA Smith interviewed (4) staff. On 9/8/ LPA Mahecha reviewed documents received and interviews conducted. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Yan Yeung LICENSING EVALUATOR NAME: Dawn Mahecha LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: WALT'S HOME FOR YOUNG MENFACILITY NUMBER: VISIT DATE: 09/22/2021

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

met_with: Carlene Logan, Administrator


raw_content:
Narrative:
The Department received a complaint alleging a client (C1) sustained bruising on his back. The bruises were reportedly observed on 7/15/21 during a visit. Statements obtained from interviews conducted with staff revealed C1 has a one on one staff. The duties of the one on one staff include assisting C1 with hygiene and getting dressed. Staff interviewed denied observing a bruise on C1's lower back. Statements obtained from C1's CSW indicated a follow up visit was conducted the day after the reported incident, 7/16/21. During the visit, CSW reported no bruises were observed on C1. Statements obtained from confidential interviews conducted did not provide corroborating evidence to support the allegation. Based on information obtained through interviews conducted and records reviewed the allegation is found Unsubstantiated. Although the allegation may have happened or is valid the standard of the preponderance of evidence was not met. No deficiencies were cited. Exit interview conducted and a copy of this report was provided to the facility representative.

Investigation Findings:
13An unannounced follow up complaint inspection was conducted by Licensing Program Analyst (LPA) Christopher Larios on 11/12/21 at 11: AM. During the inspection LPA Larios met with Administrator Carlene Logan and delivered findings for the above mentioned complaint allegation. During the course of the investigation LPA Larios conducted interviews with three clients on 9/8/21, two staff on 11/1/21, two staff on11/2/21, three County Social Worker (CSW) on 11/1/21 and one CSW on 11/2/21. LPA Larios conducted a records review on 9/8/21 and obtained copies of the client roster, staff roster and contact information, shift logs, special incident reports and needs and services plans. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Deborah A Santos LICENSING EVALUATOR NAME: Christopher Larios LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: WALT'S HOME FOR YOUNG MENFACILITY NUMBER: VISIT DATE: 11/12/2021

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

met_with: Carlene Logan


raw_content:
Narrative:
One alleged victim/client insisted being hit but could not recall why and if client sustained any injuries. The same alleged victim/client denied all the other personal rights allegations. Another alleged victim/client was not interviewed due to leaving placement and confidential records show that this client is AWOL. There were no witnesses found who can corroborate the allegations. Staff denied the allegations. Staff reported clients are redirected and not verbally or physically abused. One staff in charge denied any complaints or grievances from the alleged victim/clients. Staff in charge explained that inappropriate behavior by staff toward clients are not tolerated. No food or water is withheld from any client. Based on the above information, the allegations are closed as unsubstantiated. Although the allegations may have happened or are valid, there was no preponderance of evidence found. An exit interview was conducted. A copy of this signed report, the Confidential Names Form and Appeal Rights forms were provided to the facility representative. There were no deficiencies cited during the inspection.

Investigation Findings:
13On March 30, 2022 at 11: AM, Licensing Program Analyst (LPA) Irene Yamamoto conducted a complaint inspection at the facility to deliver the finding of the allegations. LPA met with the facility representative named above. The allegations were investigated by the undersigned LPA by conducting confidential interviews with current and former clients, staff and other related parties. LPA reviewed documents pertinent to the complaint investigation. The complaint alleged multiple personal rights violations. Three clients denied the allegations and explained that they did not experience or witness any physical altercation between the alleged victims/clients and any staff who work at the facility. Clients reported they are not talked to inappropriately by staff but are either counseled or redirected. Clients denied any staff withholding water from a client; clients can drink and eat when they want to, there is no permission needed from staff. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Irene Yamamoto LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: WALT'S HOME FOR YOUNG MENFACILITY NUMBER: VISIT DATE: 03/30/2022

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


raw_content:
Narrative:
Staff denied the alleged allegations however further disclosed that in the past there have been some incidents where clients have been involved in physical altercations with one another, however, the staff is quick to get involved and separate clients. Staff indicated that they are always encouraging clients not to fight and advising them on other ways to communicate their feelings and or manage their stress by exercising, walking, or separating themselves from their direct environment. Staff providing mental health services met or exceeded the requirements required by the STRTP Interim Licensing Standards. Staff indicated that they work hand and hand with different agencies to provide the best treatment that benefits and helps their clients succeed. Information obtained from clients did not corroborate the above allegations and further disclosed that they felt safe and felt that they were receiving the care they needed furthermore clients stated that they had no concerns to their health and safety. Therefore, based on the information received, the above allegations are determined to be unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegations are found to be unsubstantiated. Appeal Rights were provided and discussed with the facility Administrator. There are no deficiencies to be cited at this time. Exit interview was conducted and a copy of the report along with the (LIC 811) was left with the STRTP Administrator.

Investigation Findings:
13On May 18, 2022, at 3: PM., Licensing Program Analyst (LPA) Winston Moroney, conducted a complaint inspection to the above Short Term Residential Therapeutic Program Facility (STRTP) and met with the Facility Administrator Carlene Logan. The purpose of the inspection was to deliver findings for the above complaint allegations. On October 15, 2022, the California Department of Social Services Community Care Licensing Division received a complaint from Centralized Complaint and Information Bureau (CCIB) with the following allegations: Minors engaging in physical altercations, Staff encouraging physical altercations between minors in care, Unqualified staff facilitating mental health services and Facility unable to provide the level of care required by minors. The investigation of the above allegations was conducted by this LPA and it consisted of but not limited to a review of records, including the children's needs and services plans, medical records, and interviews with 3 staff members on 11/2/21, 3 of Clients (C1, C2, C3) on 11/2/21 (C4 declined to be interviewed), (Reference Confidential Names Form LIC 811, dated May 18, 2022). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Winston Moroney LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: WALT'S HOME FOR YOUNG MENFACILITY NUMBER: VISIT DATE: 05/18/2022

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

met_with: Carlene Logan - Administrator


raw_content:
Narrative:
It was alleged that staff allow clients to smoke marijuana inside and outside of the facility. Three staff were interviewed, and all three staff denied the above allegation. There are six (6) clients placed at the facility, all six (6) clients denied the above allegation and stated that they have never witnessed staff allowing clients to smoke marijuana. It was also alleged that staff did not treat clients with dignity. It was alleged that staff threatens clients and uses profanity towards clients. Three staff denied the above allegation. All six (6) clients denied the above allegation and stated that they have never witnessed staff using profanity or threatening clients. It was alleged that staff illegally evicted client. It was alleged that staff denied clients re-entry into the facility due to Covid-19 after awoling. Three staff denied the above allegation. All three staff stated that clients are allowed back into after awoling and that clients are not denied entry the facility. All six (6) clients denied the above allegation and stated that staff allows them to enter the facility after awoling. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted and a copy of this report as well as the LIC 811 was provided to the facility.

Investigation Findings:
13On June 15, 2022 at 11: AM Licensing Program Analyst (LPA) Timika Martin conducted a follow-up complaint inspection to deliver the findings of a complaint investigation concerning the allegations listed above. LPA Martin met with the facility representative named above and discussed the findings. During the investigation, LPA Timika Martin conducted a record review on 4/29/22 and obtained copies of client's needs and services plan (NSP's) and special incident reports (SIR's). LPA also requested copies of the LIC 500, staff contact information, staff trainings and protocols on clients returning to the facility after AWOL status. Confidential interviews were conducted by LPA Martin with Administrator and Staff 1 (S1) on 5/11/22; Staff 2 (S2), Client 1 (C1), Client 2 (C2), Client (3), Client 4 (C4), Client 5 (C5), and Client 6 (C6) on 5/12/22 via telephone (See Confidential Names List Form LIC 811 dated June 15, 2022). LPA Martin was unable to interview Client 7 (C7) due to the child no longer placed at the facility. LPA Martin made multiple attempts to contact C7. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Timika Martin LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: WALT'S HOME FOR YOUNG MENFACILITY NUMBER: VISIT DATE: 06/15/2022

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


summary: Complaint Investigation - Unsubstantiated - 3 allegations

raw_content:
Narrative:
The Department received a complaint alleging facility staff are smoking marijuana with clients. Staff denied the allegation. The investigation revealed a client was asked where he obtained marijuana and responded with a smirk. The client did not verbalize facility staff smoke with clients. Confidential interviews conducted did not provide evidence to support the allegation and maintained staff do not provide clients with, or smoke, marijuana. The complaint alleged the facility was not providing 2:1 staff to client ratio for a client in care. It was reported the facility was required to provide the 2:1 ratio while Client (C1) was at school. Records review and statements obtained from an interview conducted with C1's school administrator revealed a Child Family Team (CFT) meeting was held and the facility offered to provide two staff during school hours but, the school did not approve it. The complaint claimed the 2:1 ratio was not met due to C1 allegedly walking to school during the month of January 2022. Statements obtained from confidential interviews conducted revealed C1 was transported to school by the facility and did not walk. During an unannounced inspection to the facility on 5/12/ LPA Larios observed C1, two clients and three staff, meeting the required ratio. The complaint further alleged Client (C2) was run away from January 2, 2022 until January 5, 2022. Record review and statements obtained from an interview conducted with C2's CSW, and others, revealed the facility contacted Law Enforcement, CSW and the Department regarding the runaway as required by regulations. It was reported the facility declined to conduct a welfare check or send staff to retrieve C2. At the time of the runaway, per C2's CSW, C2's roommate tested positive for COVID-19 and C2 was unwilling to return to the facility to quarantine. CSW returned C2 to the facility. Based on information obtained through interviews conducted and records reviewed the allegations are unsubstantiated. Although the allegations may have happened or are valid, the standard of the preponderance of evidence was not met. Exit interview conducted and a copy of this report and Confidential Names Form LIC 811 dated 6/24/22 were given to the above-mentioned facility representative. No deficiencies were cited.

Investigation Findings:
An unannounced follow up complaint inspection was conducted by Licensing Program Analyst (LPA) Christopher Larios on 6/24/22 at 12: PM. During the inspection LPA Larios met with Administrator Carlene Logan. The purpose of the inspection was to deliver findings for the above-mentioned complaint allegations. The complaint was investigated by Community Care Licensing Division (CCLD) Investigations Branch (IB) Investigator Maria Barragan and LPA Larios. During the course of the investigation Investigator Barragan conducted interviews with a school staff and a client on 1/19/22, a County Social Worker (CSW) on 1/31/22, a facility staff and two facility managers on 2/3/22, two clients, a facility administrator and two facility staff on 2/16/22, others on 1/19/22 and obtained Law Enforcement (LE) reports regarding the investigation on 1/31/22. Investigator attempted to interview a client on 2/2/22. LPA Larios conducted interviews with one CSW on 4/25/22, others on 5/9/22, one CSW and one Supervising CSW on 5/10/22, three clients and one school administrator on 5/12/22, one Facility Manager and one Adminstrator on 6/23/22 and others on 2/16/22. LPA Larios attempted to interview one client during May 2022. (CONTINUED) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Christopher Larios LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: WALT'S HOME FOR YOUNG MENFACILITY NUMBER: VISIT DATE: 06/24/2022

Allegations:
- UnsubstantiatedEstimated Days of Completion:
- Unsubstantiated Estimated Days of Completion:
- Unsubstantiated Estimated Days of Completion: 30

met_with: Ms. Carlene Logan


raw_content:
Narrative:
It was alleged that the facility staff is allowing the minors in care to smoke marijuana in the facility, are over-medicating minors in care, and speaking inappropriately to the youths in care. Information obtained from (S1, S2, and S3) denied the alleged allegations indicating that they have worked at the facility for several years and have never observed or heard of any staff member allowing any client in care to smoke anything at the facility. Staff further disclosed that in the past they have had clients that would AWOL after school or from the facility and would return to the facility smelling like marijuana. Staff indicated that upon returning to the facility from AWOL, clients are instructed to conduct a self-search to prevent any contraband from entering the facility. Staff denied knowing or observing any client being over-medicated or using the medication as a chemical restraint. Staff indicated that type of behavior will not be tolerated and will be handled accordingly. Staff further indicated that all medications are in the form of pill packs that are properly labeled and stored individually with each client's medication logbook to prevent any confusion. As to the allegation of staff speaking inappropriately to minors in care, staff denied the allegation indicating that all staff members are trauma-informed and have a great relationship with the clients. Staff further disclosed that from time to time they (staff) have had to raise their voices with clients to redirect them or prevent physical altercations between clients. Information obtained from Clients (C1, C3, and C5) denied the alleged allegations further indicating that they have never seen or heard of any clients smoking anything at the facility, however, have observed clients returning to the facility after AWOLING smelling of marijuana. Clients denied knowing or hearing of anyone being over-medicated by staff. C1 indicated that their medication is given at certain times and gets logged by staff in the medication logbook. As to the allegation of staff speaking inappropriately to youth in care, clients denied the allegation further stating that the staff is very supportive and provide them with whatever is needed. Information obtained from County Social Workers (CSW's) (CSW1, CCSW2, and CSW4) indicated that they don't have any concerns about the care and supervision that the facility staff is providing their clients. CSWs further disclosed that staff maintains great communication with them and are quick to complete whatever is requested in a timely manner. Therefore, based on the information received, the above allegations are determined to be unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegations are found to be unsubstantiated. Appeal Rights were provided and discussed with the Facility Administrator. There are no deficiencies to be cited at this time. An exit interview was conducted and a copy of the report along with the (LIC 811) was left with the above staff member.

Investigation Findings:
13On December 8, 2022, at 5: PM, Licensing Program Analyst (LPA) Winston Moroney conducted a complaint inspection of the above Facility and met with the above staff member. The purpose of the inspection was to deliver the findings for the above complaint allegations. On August 30, 2022, the California Department of Social Services Community Care Licensing Division received a complaint from Centralized Complaint and Information Bureau (CCIB) with the following allegations: Minors are smoking marijuana in the facility; Staff is over-medicating a minor in care and Staff speak inappropriately to youth in care. The investigation of the above allegations was conducted by this LPA and it consisted of but was not limited to a review of records, including the client's needs and services plans, medical records, and interviews with three staff members (S1, S2) on 10/20/22, S3 on 10/26/22, 3 of 5 clients (C1) on 10/20/22, (C3, C5) on 10/26/22. (No statements were obtained from C2 or C4 due to their declining to be interviewed). Three County Social Workers (CSW1, CSW2, and CSW4) on 10/26/22. (Reference Confidential Names Form LIC 811, dated December 8, 2022). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Yan Yeung LICENSING EVALUATOR NAME: Winston Moroney LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION LA & TRI-COASTAL CR, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: WALT'S HOME FOR YOUNG MENFACILITY NUMBER: VISIT DATE: 12/08/2022

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

met_with: Ryann Kidd - Lead Staff


raw_content:
Narrative:
It was alleged the facility has video cameras throughout the facility that records audio too, which could pose a violation of the client's personal rights. Information obtained from S1, and S2 indicated that the cameras were installed prior to them working with the facility and provide security to the clients and staff. S1 and S2 were unable to provide any incidents where the client's privacy has been violated nor have the clients reported any such violations to them. S1 further disclosed that all cameras are visible and are only placed in the facility's common areas and on the exterior of the facility. Information obtained from S3 indicated that the cameras were added to the facility due to a previous incident that had occurred involving a client attacking their Social Worker and cash missing from the staff office. Furthermore, an addendum to the facility Program Statement was made and approved by Community Care Licensing (CCL). S3 indicated that all video that is recorded is kept for forty-five days and discarded unless required during an investigation. As to the camera in the staff office if needed due to privacy concerns staff can disconnect the camera, however, the facility also provides a room where the Social Workers and clients can have a private conversation. Therefore, based on the information received, the above allegation is determined to be unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the allegation is found to be unsubstantiated. Appeal Rights were provided and discussed with the Facility Administrator. There are no deficiencies to be cited at this time. An exit interview was conducted and a copy of the report along with the (LIC 811) was left with the Facility Administrator.

Investigation Findings:
13On May 19, 2023, at 11: AM, Licensing Program Analyst (LPA) Winston Moroney conducted a complaint inspection of the above Facility and met with Samantha Combs, Facility Manager. The purpose of the inspection was to deliver the finding for the above complaint allegation. On December 13, 2022, the California Department of Social Services Community Care Licensing received a complaint with the following allegation: The facility has video cameras throughout the facility that records audio too. The investigation of the above allegation was conducted by this LPA, and it consisted of but was not limited to a review of records, including the facility Program Statement Addendums, and interviews with three staff members (S1, S2) on 12/21/22, and S3 on 1/25/23. (Reference Confidential Names Form LIC 811, dated May 19, 2023). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Yan Yeung LICENSING EVALUATOR NAME: Winston Moroney LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION LA & TRI-COASTAL CR, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: WALT'S HOME FOR YOUNG MENFACILITY NUMBER: VISIT DATE: 05/19/2023

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

met_with: Samantha Combs, Facility Manager


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Narrative:
LPA Yamamoto conducted additional interviews with two staff on 5/19/23, one placement agency social worker on 6/6/23, one client and a family member on 6/9/23, three minors on 6/23/23 and two additional placement agency social workers on 6/30/23. LPA attempted to interview additional minors and placement agency social workers between 5/19/23 to 8/7/23 but the attempts were unsuccessful. Confidential interviews reveal that minors "played wrestle" with each other during placement. One minor, who refused to provide a statement, engaged in "body shots" with other minors. There was a video recording shown by one minor to support this. Information obtained by Investigator Munoz indicates that one minor sustained bruises during these mutual plays. Staff denied witnessing the identified minor being assaulted by other minors. The minor never reported sustaining any injuries to staff. In regard to personal belongings of one minor being stolen, staff were not aware that one minor had a phone. Staff encourage minors to keep certain personal belongings and allowance in the office for safekeeping. The minor never reported to staff any personal items being stolen or missing. Minor admitted to not reporting any personal belongings that went missing. Based on information obtained during the investigation, there is no preponderance of evidence found to support the allegations, so the allegations are unsubstantiated. A copy of the following reports were provided at the conclusion of today's inspection: LIC9099, LIC9099-C and LIC Confidential Names. Appeal rights were provided and explained. There was no deficiency citation issued.

Investigation Findings:
13On August 10, 2023 at 9: AM, Licensing Program Analyst (LPA) Irene Yamamoto conducted an unannounced complaint inspection at the facility. LPA met with the facility representative named above. The purpose of the inspection is to deliver the finding for the above allegations. The investigation was conducted by the Department's Investigations Branch (IB) Investigator Ruben Munoz and the undersigned LPA. The investigation includes the following: On 5/19/23, LPA Yamamoto conducted an inspection at the facility and obtained copies of pertinent documents, including, but not limited to, the incident reports, law enforcement contact reports, discharge reports, and needs and services plans. Those documents were reviewed by Investigator Munoz, including a report provided to him by Bakersfield Police Department on 5/23/23. Investigator Munoz conducted confidential interviews with two placement agency social workers on 5/17/23, family members of one minor on 5/22/23 and four minors and three staff on 5/26/23. Investigator Munoz made attempts to obtain statements from two other minors, but those attempts were unsuccessful. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Irene Yamamoto LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: WALT'S HOME FOR YOUNG MENFACILITY NUMBER: VISIT DATE: 08/10/2023

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


raw_content:
Narrative:
Staff are informed either by social worker or the Administrator of clients' needs and services plan. Staff try to work on each client's needs and goals according to needs and services plan. Staff cannot work at the facility unless they receive their clearances. All staff did not work until their clearances before they started working. LPA Suh verified that all personnel obtained criminal record clearances. Regarding the staffing ratio, a review of Personnel Report (LIC 500) and staff schedule indicates that the facility meets the staff child ratio. Clients are taken for their clothes shopping at least once a month by a staff. Clients are provided with clothes allowance of $100 per month. Statements obtained from the confidential interviews did not provide sufficient information to corroborate the allegations. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that alleged violations occurred, therefore the allegations are unsubstantiated. There were no deficiencies cited during this inspection. An exit interview was conducted. Appeal rights explained and a copy of this report, and Appeal Rights were provided to the facility representative.

Investigation Findings:
13On January 9, 2024, at 11: AM, Licensing Program Analyst (LPA) Karen Suh conducted a follow-up complaint inspection to deliver the findings of a complaint investigation. The LPA met with the representative named above and discussed the findings. The investigation included confidential interviews that consisted of but were not limited to: Administrator, four staff, and three clients on July 19, 2023. The LPA was unable to contact the County Social Workers (CSW) after several attempts. The LPA reviewed the Needs & Services Plan, Personnel Report, and weekly schedule. It was alleged that staff bullied youth and staff did not prevent youth from being bullied by another youth. Staff denied the allegations stating staff do not bully clients. Staff redirects clients if any client is being bullied by another client. Staff do not allow clients to skip school. Staff transport and drop off clients at school but clients leave the school grounds and come back to the facility as if they had not missed any classes. (cont.) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Yan Yeung LICENSING EVALUATOR NAME: Karen Suh LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: WALT'S HOME FOR YOUNG MENFACILITY NUMBER: VISIT DATE: 01/09/2024

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


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Investigation Findings:
13On May 31 , 2024, at 1: P.M., Licensing Program Analyst (LPA) Ashley Ruacho completed the investigation on the above allegation. LPA Teal delivered the findings on behalf of LPA Ruacho and met with the above representative. LPA reviewed documents including Client Roster, Staff Roster, and the Needs and Services Plan for Client (C1). LPA interviewed Administrator (AD) on 3/12/24, County Social Worker (CSW) on 3/18/24, C2 on 3/12/24, C1, C3, and C4 on 5/7/24. LPA conducted interviews with Staff (S1) and S2 on 5/13/24, S3 on 5/16/24 and S4 on 5/20/24 (See Confidential Names LIC 811 dated May , 2024). During confidential interviews it was revealed that the above allegations did occur. However, during other confidential interviews it was revealed that the above allegations did not occur. Based upon the interviews, the complaint findings are unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the allegation occurred. A copy of this report given to the above representative. No deficiencies were cited. Exit Interview conducted. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tira Logan LICENSING EVALUATOR NAME: Demetris Teal LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Carlene Logan- Administrator


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Narrative:
Page The Department received a complaint alleging facility clients are involved in drug activities, had access to a firearm, and smoke marijuana on the facility premises. Staff denied the allegations. The investigation revealed the reported gun that was in possession of a facility client was not a firearm, but a toy BB Gun. Statements obtained from interviews conducted with clients indicate a client hid a BB Gun on his waist and brought it into the facility, where he later used it to shoot pellets at a neighbor's property. The neighbor complained to the facility and the client surrendered the BB Gun to staff. Furthermore, the investigation did not provide evidence to corroborate the allegation that minors are involved in drug activities and smoke marijuana on the premises. All clients denied involvement in selling drugs and that staff permit clients to consume marijuana on the premises. Clients interviewed stated they are verbally counseled by staff or lose privileges if they are observed smoking marijuana. Interviews conducted with staff corroborated the client's statements. Social workers interviewed denied observing clients under the influence or the odor of substances when visiting the facility. Based on information gathered from interviews conducted and record review, the allegation are unsubstantiated. Although the allegations may have happened or is valid the standard of the preponderance of evidence was not met. Exit interview conducted and copy of this report was given to Administrator Logan. No deficiencies were cited.

Investigation Findings:
13An unannounced follow up complaint inspection was conducted by Licensing Program Analyst (LPA) Christopher Larios on June 11, 2024 at 2: PM. During the inspection LPA Larios met with Administrator Carlene Logan. The purpose of the inspection was to deliver findings regarding the above mentioned complaint allegations. The investigation was conducted by Community Care Licensing Division (CCLD) Investigations Branch (IB) State Investigator (SI) Jorge Jauregui and LPA Larios. During the course of the investigation SI Jauregui completed a record review on 4/5/24 and obtained copies of the client and staff rosters and a behavioral note dated 4/3/24. On 4/9/24, SI Jauregui obtained an incident report. Between 4/5/24 and 4/16/24, SI Jauregui conducted interviews with three facility staff and five clients. Between 4/17/24 and 6/6/24, LPA Larios conducted interviews with five clients, three staff and three placing agency social workers. LPA Larios attempted to interview three other social workers, but telephone contact attempts were unsuccessful. (Continued on page 2) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Christopher Larios LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: WALT'S HOME FOR YOUNG MENFACILITY NUMBER: VISIT DATE: 06/11/2024

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


raw_content:
Narrative:
Due to the information obtained during the investigation, it cannot be determined whether the above allegations occurred. Based on the compiled information, the complaint findings are unsubstantiated. Although the allegations may have happened or is valid, there not a preponderance of the evidence to prove that the allegations occurred. No deficiencies were cited. An exit interview was conducted, and a copy of this report emailed to the facility administrator.

Investigation Findings:
13On 6/22/24, Licensing Program Analyst (LPA) Johanna Lofton conducted an unannounced visit to Walt's Home for Young Men STRTP with the purpose of delivering findings for the above complaint allegations. LPA Lofton met with Facility Manager Cherrelle Wilson and discussed the findings. During the investigation LPA interviewed facility staff and clients. LPA did not interview the complainant. During the investigation the allegations were denied. Facility staff denied any falsification of fingerprints. Staff must present their identification card when they go to get fingerprinted. Furthermore, the fingerprinting is conducted by a third party which is not controlled by the facility. Interviewed parties denied staff engage in verbal altercations with clients. Facility staff reported not engaging in any kind of altercations with the clients. It was reported the staff does use their stern voice when the clients are not listening or following directives. Clients denied getting in altercations with the staff. Clients denied having any issues with the staff. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tira Logan LICENSING EVALUATOR NAME: Johanna Lofton LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: WALT'S HOME FOR YOUNG MENFACILITY NUMBER: VISIT DATE: 06/22/2024

met_with: Cherrelle Wilson- Facility Manager


raw_content:
Narrative:
Due to the information obtained during the investigation, it cannot be determined whether the above allegations occurred. Based on the compiled information the complaint allegation is unsubstantiated. Although the allegations may have happened or is valid, there not a preponderance of the evidence to prove that the allegations occurred. No deficiencies were cited. An exit interview was conducted, and a copy of this report provided to the above-named staff.

Investigation Findings:
13On October 28, 2024, Licensing Program Analyst (LPA) Johanna Aracena conducted an unannounced visit to Walt's Home for Young Men Short Term Residential Program (STRTP) with purpose of delivering findings for the above complaint allegations. LPA Aracena met with Facility Administrator Carlene Logan and discussed the findings. During the investigation of the allegations, LPA Aracena conducted confidential interviews with facility staff, facility clients, and County Social Workers. LPA Aracena was not able to interview the complainant. While conducting confidential interviews the allegation of staff handled minor in a physically inappropriate manner was denied. The allegation of staff spoke to minor in an inappropriate manner was denied and the allegation of staff threatened minors was also denied. the allegation of abuse was denied by interviewed parties. Confidential interviews raised no concerns of abuse from facility staff to any of the clients. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tira Logan LICENSING EVALUATOR NAME: Johanna Aracena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION MONTEREY PARK CRP RO, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: WALT'S HOME FOR YOUNG MENFACILITY NUMBER: VISIT DATE: 10/28/2024