raw_content:
Narrative:
Confidential interviews reported that the residents of the facility often had on and off again sexual relationships with one another. Confidential interviews reported when staff would observe inappropriate sexual behavior occurring between residents' staff would attempt to separate the residents by giving verbal directions. Confidential interviews also reported if staff caught the residents having sexual interactions, staff would not follow up on the incidents. Confidential interviews could not confirm, or dispute staff attempted to separate C1 and C3 during this incident nor were confidential interviews able to confirm or dispute C1 was a consenting participate during the incident. Based on confidential interviews the allegation lack of supervision resulted in minor (Child #1 [C1]) being sexually abused by another minor (Child #3 [C3]) while in care, however it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights to with VE & Daughters Facility Administrator Rushel Brooks.

Investigation Findings:
13On February 28,2022 at 5:30PM, Licensing Program Analyst (LPA), Carol Anderson, met with VE & Daughters Facility Administrator Rushel Brooks, to deliver the finding for the above stated allegation. A health and safety inspection did not occur when the complaint was opened with the facility on 7/14/2021 due to the licensee's-initiated closure of the facility occurring on June 24, 2021. The investigation was conducted by Special Investigator Ernestina Bellucco and LPA Strickland and included interviews with Administrator (ADM), Staff #1 (S1), three former foster youth placed at the facility (Child #1 (C1), Child #2 (C2), Child #3 (C3). County Social Worker #1 (CSW1), County Social Worker #2 (CSW2). In addition, county records and facility records were reviewed. On July 8, 2021, Community Care Licensing (CCL) received an allegation alleging lack of supervision resulted in minor (Child #1 [C1]) being sexually abused by another minor (Child #3 [C3]) while in care. Specifically, it was reported on an unknown date C1 was under the influence when C1 was sexually abused by C3. Confidential interviews reported that the residents of the facility often had on and off again sexual relationships with one another. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Carol Anderson LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, METROPOLITAN DR. # FACILITY NAME: VE & DAUGHTERS HAPPY HOME #2FACILITY NUMBER: VISIT DATE: 02/28/2022

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


state: CA

facility_name: VERA'S SANCUARY I

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
in care. Specifically, it was reported on March 29, 2021, S1 was in C1's room before bedtime when the S1 held C1's hands over C1's head and began kissing C1. Confidential interviews and record review could not confirm or dispute an incident had occurred. Confidential interviews deny witnessing any inappropriate interactions between S1 and C1. Confidential interviews could only provide that there was a weird vibe between C1 and S1. Confidential interviews further reported S1 had reported concerns with boundaries regarding C1. Confidential interviews were unable to provide what the boundary concerns were and what if anything was done regarding the concerns. Record review could neither confirm nor dismiss S1's concerns regarding boundary issues with C1 were reported or addressed. Based on record review and confidential interviews, the allegation of Staff (Staff #1 (S1) sexually abused a minor (Child #1 (C1), may or may not have occurred, however it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. Licensing Program Analyst (LPA) received email authority from Anasheh Sarfarian to allow Morgan Salmans, Facility Manager to sign on behalf of the facility. A copy of this report and appeal rights was discussed and provided to Morgan Salmans.

Investigation Findings:
13On July 6, 2021, Licensing Program Analyst (LPA) Nicole Strickland met with faciity manager Morgan Salmans to deliver Amended findings of a report that was initally delivered on July 2, 2021, at 11:30am. Licensing Program Analyst (LPA) Nicole Strickland met with Vera's Sancuary Head of Service Michellle Menke to deliver the finding of the complaint investigation for the above allegation involving client (C1) as identified on the Confidential Names List (LIC 811). The investigation was conducted by Special Investigator Annette Renquist with Community Care Licensing's (CCL) Investigations Branch Bureau. The investigation included interviews with eight staff (Staff #1 (S1), Staff #2 (S2), Staff #3 (S3), Staff #4 (S4), Staff #5 (S5), Staff #6 (S6), Staff #7 (S7), and Staff #8 (S8), and Child #1 (C1), In addition, county records and facility records were reviewed. On April 1, 2021, CCL received an allegation Staff (Staff #1 (S1) sexually abused a minor (Child #1 (C1) while UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: VERA'S SANCUARY IFACILITY NUMBER: VISIT DATE: 07/02/2021

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

report_type: Complaint Investigation

met_with: Morgan Salmans

complaint_status: unsubstantiated


summary: Complaint Investigation - Unsubstantiated - 1 deficiency - 1 allegation

raw_content:
Narrative:
During the course of the investigation, the LPA conducted confidential interviews with seven staff. The LPA attempted to interview the three involved clients but they were not present when the LPA completed inspections to the facility, had been discharged from the facility or were on run away status. The LPA also completed a review of facility documentation. Allegation #1) It was alleged from April 2021-July 1, 2021, hot food was left out from 1: PM-9: PM. The LPA received corroborating information from staff that dinner would be prepared and placed on the kitchen counter or on top of the dryer by 3:30 p.m. There was no set time for dinner. The clients would serve themselves and eat when they wanted to. The food would not be refrigerated and left out overnight. When the staff arrived the next morning, they would dispose of the food. It was reported to the LPA this occurred multiple times. Allegation #2) It was alleged that staff #1 (S1) and staff #2 (S2) told client #1 (C1) to shut up and called C1, "Ghetto." S1 reported to the LPA, the incident occurred around 06/20/21. C1 was very aggressive, called S1 names and got in S1's face. S1 told C1 the way C1 was speaking to S1 was ghetto and C1 needed to stop calling S1 the, "Work Nigger," and "Work Nigga." C1 also called S1 a, "Fucking bitch," and "Bruh." S2 denied making the alleged statements and further denied being present during the incident. During confidential interviews, it was reported to the LPA S1 was constantly inappropriate with the clients. A client would yell at S1 and S1 would yell back, tell them to shut up and get in the client's face. It was further reported S1 admitted to the incident. S1 was frustrated about not receiving support from the administrator at the time. S1 apologized to the client. The LPA did not receive any evidence that S2 made the alleged comments. Allegation #3) It was alleged from April 2021-July 1, 2021, Anasheh Safarian (S3) was listed as the administrator of record. During this time, the facility had two administrators. S3 was the administrator during the day and Charmaine Linley (S9) was the administrator at night. S3 was present at the facility only four times from April 2021-July 1, 2021. S3 worked out the licensee's corporate office in Sun Valley, CA. During confidential interviews, the LPA received corroborating information that S3 was not on the facility premises each week. It was reported S3 was the administrator on paper only. S3's work was performed at the licensee's corporate office. The facility submitted a letter and supportive documents to CCL, dated 04/08/21, indicating S3 was the administrator effective 04/08/21. The facility did not report to CCL that S9 was hired or that S9 would be an administrator in addition to S3. *** *** Allegation #4) It was alleged that staff did not receive required training. There were multiple staff who supervised the clients in the facility swimming pool in May and June of 2021, but did not have water safety certificates. The facility was licensed on 09/15/20 but the licensee did not offer the water safety training prior to April of 2021. The LPA requested proof of completed water safety training from the facility for the staff who supervised the clients in the facility swimming pool in May and June of 2021. The facility submitted copies of the certificate of completion for the American Red Cross Water Safety for Parents and Caregivers for some of the staff but no proof was provided for S1 and staff #6 (S6). In addition, the certificate of completion for S2 was dated 07/15/21, after S2 had provided the supervision. Allegation #5) It was alleged from April 2021-July 1, 2021, the facility bathrooms and bedrooms were only cleaned on Monday (by a professional cleaning crew) and that on other days bathroom trash would be left overflowing and there were dirty counters and floors. On 6/10/2021, a client dyed their hair black and walked through the facility, staining floors in the hallway and bathroom. During confidential interviews, the LPA received corroborating information when the morning staff reported to work, the facility was dirty on a weekly basis. The trash was not taken out, the kitchen, living room and the clients' rooms were dirty. The LPA completed a safety inspection of the facility on 07/14/21 at 11: AM. Although the facility was clean, the LPA observed black dye on the door jam in the client bathroom. Based on confidential interviews, document review and the LPA's observation, the preponderance of evidence standard has been met and the allegations food was not stored in a safe manner, S1 spoke inappropriately to C1, facility administrator was not on the premises 20 hours a week, facility staff were not properly trained and the facility was not kept clean are substantiated. Facility is cited for violation of Title 22, Division 6, Chapter 1 80076(a)(14) Food Services, 80065(e)(2) Personnel Requirements, 80087(a) Buildings and Grounds and the Interim Licensing Standards Article 6 87072(c)(10) Personal Rights and 87064(b)(1) Administrator Qualifications and Duties on the next pages. A copy of this report, the LIC Confidential Names, and appeal rights were provided to Mariam Mott. Allegation #1) It was alleged from April 2021-July 1, 2021, the facility did not have enough milk or two days worth of perishable items. The staff would also feed the clients fast food. During the course of confidential interviews, it was reported to the LPA there was always a supply of fresh food. The food was purchased from Shamrock Foods Company (commercial food supplier) and delivered every Thursday. If the clients did not like what was on the menu, they were allowed to request other food items. The staff would then go purchase the requested food items. Four gallons of milk a were ordered each week. If the milk supply ran low, they would order through Instacart (grocery delivery service). The LPA completed a safety inspection of the facility on 07/14/21 at 11: AM and observed the food supply. There was an adequate supply of food and perishables. The LPA also obtained copies of invoices from Shamrock Foods Company from 05/01/21-7/8/21. The facility consistently ordered food each week, including milk and perishables. However, other information was received that the pantry was empty seven or eight times. One time was due to the house being bombed for bugs. Allegation #2) It was alleged from April 2021-July 1, 2021, that dated menu documentation was not available. The menus were posted a couple of times and they were outdated. During the course of confidential interviews, it was reported to the LPA the weekly menus were posted on the refrigerator. The menu copies were kept for months in the staff office. In addition, there were electronic copies of the menus. The LPA completed a safety inspection of the facility on 07/14/21 at 11: AM and observed four weeks of dated menus posted on the side of the refrigerator and the menu for the day on a decorative chalkboard on the kitchen counter. However, other information was received that the menus were not posted prior to 07/13/21. Allegation #3) It was alleged from April 2021-July 1, 2021, adults from the licensee's substance use disorder (SUD) site across the street from the facility were allowed to come into the facility with the clients and were left alone with clients and act as mentors to the clients. It was a regular practice to have staff working in the facility that did not have a criminal record clearance. It was alleged staff #10 (S10) did not have a criminal record clearance on 6/10/2021. S10 was allowed to supervise the clients prior to being fingerprint cleared. During the course of confidential interviews, it was reported to the LPA the clients were never left unsupervised with the adults from the SUD site. Vera's Sanctuary (VS) staff were always present. *** *** The adult clients and VS clients had group sessions together on the VS porch for approximately two months and the adult clients would come to the VS swimming pool to hang out. The group sessions and the adult clients visits to the swimming pool were stopped by the facility after LPA Torres completed the 10 day inspection for this complaint on 07/14/21. The LPA verified through the CCL database that S10 had a criminal record clearance and was associated to the facility on 05/10/21. However, other information was received stated the clients would go across the street to the SUD facility to play pool (billiards) in the garage. The adult clients were also present in the garage and no VS staff were supervising the clients. This happened five times. It was a regular practice to have staff working in the facility that had not received a criminal record clearance. Based on confidential interviews, the allegations the facility did not have enough milk or two days worth of perishable items, menus were posted a couple of times and they were outdated, adults from the SUD site were allowed to come into the facility with the clients and were left alone with clients and it was a regular practice to have staff working in the facility that did not have a criminal record clearance may have occurred, however, are not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. An exit interview was conducted and a copy of this report, the LIC Confidential Names and appeal rights were provided to Mariam Mott.

Investigation Findings:
13On 08/03/22 at 11: AM Licensing Program Analyst (LPA) Belinda Torres conducted a subsequent complaint inspection for the purpose of delivering the investigative finding to the allegations listed above. The LPA met with Mariam Mott, Clinical Director. The LPA received verbal authorization from Anasheh Safarian for Mariam to sign for this report. On 07/02/21, Community Care Licensing (CCL) received a complaint alleging facility staff would cook food and leave it out on the counter for the entire day and evening, staff told a client to shut up and called the client ghetto, the facility Administrator, Anasheh Safarain, is not at the facility 20 hours a week, staff members do not receive the "required outside training hours" and multiple staff who supervised the clients in the swimming pool did not have water safety certificates and the bathroom trash was overflowing and there were dirty counters and floors. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Belinda Torres LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, THE CITY DR., SUITE FACILITY NAME: VERA'S SANCTUARY IFACILITY NUMBER: VISIT DATE: 08/03/2022

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

Deficiencies:
80087(a): 1
2
3
4
5
6
7

met_with: Mariam Mott

title:
Buildings and Grounds. The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.

This requirement was not met as evidenced by

description:
1
2
3
4
5
6
7


raw_content:
Narrative:
Allegation #1) It was alleged there were no planned activities and in April and May of 2021 there was no outing/activity money available at the facility. Administration advised that they had forgotten to give the money to the facility. During the course of the investigation confidential interviews were conducted, it was reported to the LPA that S9 did not want to take the clients out because S9 was scared the clients would steal. The staff had the funds and ability to take the clients out but S9 did not want to. It was further reported to the LPA the staff did what they could given the COVID- Pandemic. The clients were provided the following activities: Taco Tuesday at Rosa's Cantina, movies in the park outside on the facility grounds, an ice cream truck would come to the facility each week, pool days with a barbecue, trips to the salon to get their nails done, trips to the hair shop, Knott's Berry Farm and Disneyland. However, other information was received that the clients would watch Tik Tok (social media) and videos all day. The staff and clients would go in the community and the clients would steal from the store. There was always plans for activities but there was never any money available. There were no funds for staff to use or petty cash. Allegation #2) It was alleged on a holiday between April 2021-July 1, 2021, one or two clients went to S4's house for a few hours because staff called off and the facility was short staffed. Reportedly S4 was advised by Orange County Children and Family Services the clients could not hang out with S4's 18 year old foster child. During the course of the investigation confidential interviews were conducted, the LPA did not receive any corroborating information on whether the clients went to S4's house and/or spent time with S4's foster child. It was further reported to the LPA, the clients were always in the staff's care. If the clients did go to S4's home, there would have been a staff present. Allegation #3) It was alleged from April 2021-July 1, 2021, client #2 (C2) was not required to attend therapy. During the course of the investigation confidential interviews were conducted, it was reported to the LPA C2 was supposed to go therapy before or after work but C2 refused to go. When C2 was not working on the weekends, C2 still refused to go to therapy. The staff would try to get C2 to go to therapy but they could not force C2 to participate. However, other information was received that C2 did not have to attend therapy and needed to focus on working. Based on confidential interviews, the allegations there were no planned activities in April and May of 2021, there was no outing/activity money available at the facility, clients spent unauthorized time with S4's foster child and clients who had jobs were not required to participate in therapy may have occurred, however, are not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. An exit interview was conducted and a copy of this report, the LIC Confidential Names and appeal rights were provided to Mariam Mott.

Investigation Findings:
13On 08/03/22 at 12: PM Licensing Program Analyst (LPA) Belinda Torres conducted a subsequent complaint inspection for the purpose of delivering the investigative finding to the allegations listed above. The LPA met with Mariam Mott, Clinical Director. On 07/02/21, Community Care Licensing (CCL) received a complaint alleging there were no planned activities and in April and May of 2021 there was no outing/activity money available at the facility, clients spent unauthorized time with S4's foster child and clients who had jobs were not required to participate in therapy. During the course of the investigation, the LPA conducted confidential interviews with seven staff. The LPA attempted to interview the three involved clients but they were not present when the LPA completed inspections to the facility, had been discharged from the facility or were on run away status. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Belinda Torres LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, THE CITY DR., SUITE FACILITY NAME: VERA'S SANCTUARY IFACILITY NUMBER: VISIT DATE: 08/03/2022

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


raw_content:
Narrative:
(C1) was observed with a hicky and notes C1 participated in sexualized behavior. Confidential interviews could not confirm or dispute this was a consensual interaction, or that this was the incident resulting in the allegation of sexual abuse. Confidential interviews could not confirm or dispute the allegation. An additional allegation was received by CCL, alleging staff purchased drugs for minors while in care. No specific information regarding which staff or which minors were involved in this allegation was provided. Record review and confidential interviews were unable to provide evidence confirming or disputing this allegation. Two additional allegations were received by CCL alleging minors are not allowed to leave the home and staff demonstrate inappropriate forms of punishment. Specifically it was reported staff did not let any of the minors leave the home and staff refused to allow (child #1 [C1]) to leave the facility to purchase hygiene supplies as a form of punishment for not attending class. Record review and confidential interviews reported that none of the residents had community passes approved by their County Social Workers at the time of the allegation. Confidential interviews reported the facility provided hygiene products for the residents and if the residents wanted to purchase special items staff would take them and accompany them to the store. Confidential interviews could not confirm, or dispute minors were not allowed to leave the home and staff refused to allow C1 to leave the facility as a form of punishment. An additional allegation alleging staff do not ensure the minors are properly fed while in care was also received by CCL. Specifically it was reported that food is not satisfactory, and the good food was locked up. Confidential interviews reported that the minors wanted more of the unhealthy fast food type of meals and would complain about what the chef had made for dinner. Confidential interviews could not confirm or dispute the allegation. Based on record review and confidential interviews the minors are sexually abused while in care, staff purchased drugs for minors while in care, minors are not allowed to leave the home, staff demonstrate inappropriate forms of punishment, and staff do not ensure the minors are properly fed while in care, may or may not have occurred, however they are not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights to Andrea "Dre" Carmona.

Investigation Findings:
13On October 13, 2022 at 2:00 pm Licensing Program Analyst (LPA), Nicole Strickland, arrived at the facility to deliver findings for the above allegations. LPA previously spoke with and received emailed permission from Vera's Sanctuary Administrator, Anasheh Safarian to meet with Andrea "Dre" Carmona and for "Dre" to accept and sign reports on behalf of Vera's Sanctuary 1. LPA conducted an inspection of the facility on September 28, 2021 at approximately 11:00 am and no immediate deficiencies were observed. The investigation included interviews with three staff (Staff #1 [S1], Staff #2 [S2], Staff #3 [S3]), four foster youth (Child #1 [C1], Child #2 [C2], Child #3 [C3], and Child #4 [C4]). In addition, county records and facility records were reviewed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: VERA'S SANCTUARY IFACILITY NUMBER: VISIT DATE: 10/13/2022

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

met_with: Andrea Carmona


raw_content:
Narrative:
Mena obtained conflicting information during interviews. Confidential interviews denied that any inappropriate sexual behavior had taken place between C1 and Child # 2 (C2). Confidential interviews also denied that staff did not fulfill reporting requirements or that S1 had engaged in an inappropriate relationship with C1. According to confidential interviews, S1's relationship with C1 was more of an older sibling or mother-daughter relationship. Confidential interviews also stated that although C1 had gained access to a knife and alcohol on separate occasions, it was not due to a lack of supervision, but due to C1 smuggling in contraband without staff's knowledge and C1 having taken or stolen key from staff where knives were stored. While other confidential information received by Licensing Office stated that these allegations had occurred. LPA Mena was unable to conduct a follow-up interview with Child # 1 (C1), due to C1's current whereabouts being unknown. There were no other known witnesses to these allegations. Based on confidential information obtained during the course of this investigation, the allegations that Child # 1 had access to alcohol and sharp object, and that facility staff did not fulfil reporting requirements, did not prevent inappropriate sexual behavior between clients while in care, and that Staff # 1 (S1) had engaged in an inappropriate relationship with C1, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Program Director, Andrea Carmona to discuss the investigative findings for the above stated allegations. LPAs Cheraki Davis and Daniel Mena conducted an inspection to the facility on December 13, 2021 at 9:00am and on May 12, 2021 at 11:21am. No immediate hazards observed. Special Investigator (SI), Charlotte Jackson and LPA Mena interviewed five Staff (S1, S2, S3, S4 & S8), two foster children (C1 & C2), County Social Worker (CSW), Probation Officer (PO), Facility Administrator (AD), as well as reviewed police, client and facility records. Community Care Licensing received information on December 07, 2021 alleging that Child # 1 had access to alcohol, as well as a sharp object. Allegation also claimed that facility staff did not fulfil reporting requirements, did not prevent inappropriate sexual behavior between clients while in care, and that Staff # 1 (S1) had engaged in an inappropriate relationship with C1. Information obtained in confidential interviews did not corroborate the allegation with a preponderance of evidence. IB investigator and LPA UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: VERA'S SANCTUARY IFACILITY NUMBER: VISIT DATE: 11/04/2022

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


raw_content:
Narrative:
(**Continued from LIC 9099**) Additionally, two staff members (S1, S3) could not be reached for an interview after multiple attempts made by LPA Urena for an interview. Due to an absence without leave (AWOL) status C1 could not be reached for comment regarding the allegations. During investigation, a confidential interview could not provide details about the allegations involving C1, and S1 due to being hired after C1 left the facility and due to little interaction with S1. Confidential interview further stated that some clients did smoke while in care and smoked outside of the facility premises, which was against the program's rules. Confidential interview denied hearing anything about S1 or C1 that pertained to the allegations. Additionally, S1, S3 and C1 could not be reached for comment. There were no other known witnesses to the allegations. LPA received inconsistent information regarding the allegations. Based on confidential interview and record review the allegation that a staff member took C1 to a smoking establishment, C1 smoked in the presence of staff members, staff members gave C1 a smoking device, and S1 inappropriately touched C1, may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report along with the appeal rights will be emailed to Administrator, Anasheh Safarian. Copies of the original signatures will be placed with the complaint file.

Investigation Findings:
13On May 2, 2023, at 1: PM, Licensing Program Analyst (LPA) Cynthia Urena spoke with Vera's Sanctuary I Short Term Residential Therapeutic Program (STRTP) Administrator, Anasheh Safarian to deliver the investigative finding of the above stated allegations. On April 21, Community Care Licensing received a complaint alleging that a staff member took minor to a smoking establishment, minor smoked in the presence of staff members, staff members gave minor a smoking device, and staff member inappropriately touched minor. Due to the facility's closure on March 9, 2022, no inspection was conducted. However, LPA Torres conducted an interview with a Facility Manager on April 26, 2022, and requested copies to be mailed out from the STRTP'S Programs staff, and client files. LPA Torres made attempts to contact client #1 (C1's) Authorized Representatives but LPA's Torres's messages were not returned. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Cynthia Urena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FACILITY NAME: VERA'S SANCTUARY IFACILITY NUMBER: VISIT DATE: 05/02/2023

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

met_with: Administrator, Anasheh Safarian


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Nicole Strickland arrived to the facility unannounced and met with Facility Manager Morgan Salmans to deliver an amended report that was initially delivered on July 2, 2021.

report_type: Facility Evaluation

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On 09/13/21 at 10: AM, Licensing Program Analyst (LPA) Belinda Torres met with Morgan Salmans, Facility Manager/Administrator Designee for the purpose of conducting a post licensing inspection of the facility. At 11: AM, Morgan led the physical inspection of the facility with the LPA. A physical plant inspection was completed and included the facility's building and grounds, kitchen area, refrigerator/freezers, food storage areas, client bedrooms, bathroom/showers and facility vehicles used to transport clients. The facility grounds were clean and free of debris and observable hazards. Sports equipment/toys/books/games/computers were observed for children's schooling and recreation time. There is adequate indoor and outdoor activity space. Facility smoke detectors and carbon monoxide detectors are in appropriate working order. Licensee maintains an adequate supply of perishable and non-perishable foods and the menu was posted. All other required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights, Emergency Disaster Plan and Foster Care Ombudsperson poster. Medications are locked and centrally stored inside staff's office. The facility ensures that there is one client per bed with appropriate linens, pillows, comforters, and mattresses in good repair. All bedrooms have individual beds and drawer space for each client. The hot water in the client's bathrooms was measured to be between 103 and 116 degrees. Per Morgan, no firearms or weapons are allowed in the facility. Chemicals and/or poisons are locked in the hallway closet. The LPA reviewed LIC 610C Emergency Disaster Plan, completed disaster training for staff and clients and completed emergency drills. Due to time constraints, the inspection will have to be completed on a subsequent day. A copy of this report was provided to Morgan Salmans.


facility_name: VICTOR TREATMENT CENTER - CLOVER HOUSE

summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Cheyenne McCambridge met with Assistant Executive Director Kristine Martinez regarding a complaint investigation at the facility. The purpose of the inspection was to deliver the findings for the above allegation. During the course of the investigation, LPA McCambridge interviewed youth and staff, and reviewed files. During confidential interviews it was determined that no statements were amde to support any of the allegations. A tour of the facility was conducted and there was adequate perishable and non-perishable food supply. This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the above allegations are true; therefore, the above allegations are unsubstantiated. Appeal Rights were provided and discussed and no deficiencies were cited. Exit interview was conducted and a copy of the report was left with the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: Cheyenne McCambridge 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: Kristine Martinez


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a annual/required and met with administrator Kristine Aphugh. Physical Plant was toured inside and out. Water temperatures were measured at 119 degrees. 7 day Non perishable food supply was inspected and was found to be adequate. 2 day perishable food supply was inspected and were found to be adequate and consistent with the alternate menu. Weeks menu was not posted and facility was reminded that this needed to be posted. LPAs inspected bedrooms and found that there was adequate linens and each bed had mattress pads. LPAs completed a tour of the home and outdoor activity area. The home is clean and in good repair. There are no firearms in the facility. There are no open bodies of water on the property. Healthy snacks are provided. Medications/toxics/cleaning solutions are locked. Required documents are posted. Fire drills are conducted monthly, there are charged operable fire extinguishers, hard wired smoke detectors are in the home. Staff and client files were reviewed at the administration office. Per Title Regulations, no deficiencies were cited during this inspection. An exit interview was conducted and a copy of the report was left at the facility.

visit_type: Annual

met_with: Kristine Aphugh


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheyenne McCambridge on the above date at 10: AM. During the inspection, LPA McCambridge met with Administrator Kelly Hernandez in the main office. LPA reviewed zero of child's records on site at the facility due to no clients currently being on psychotropic medication. LPAs reviewed zero of child's psychotropic medications and medication records. LPA interviewed zero of children currently taking psychotropic medication. LPA interviewed three of staff on site starting at 2:00 pm. LPA reviewed three of staff personnel files on site at the facility starting at 11: PM. LPA toured of the facility inside and out at 1: PM LPA provided the Summary Report to Kelly Hernandez, Administrator upon completion. No deficiencies are being cited at this time. LPA conducted exit interview with Administrator Kelly Hernandez.

met_with: Kelly Hernandez


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a annual/required and met with administrator Kristine Martinez. Physical Plant was toured inside and out. Water temperatures were measured at 119 degrees. 7 day Non perishable food supply was inspected and was found to be adequate. 2 day perishable food supply was inspected and were found to be adequate and consistent with the alternate menu. Weeks menu was not posted and facility was reminded that this needed to be posted. LPAs inspected bedrooms and found that there was adequate linens and each bed had mattress pads. LPAs completed a tour of the home and outdoor activity area. The home is clean and in good repair. There are no firearms in the facility. There are no open bodies of water on the property. Healthy snacks are provided. Medications/toxics/cleaning solutions are locked. Required documents are posted. Fire drills are conducted monthly, there are charged operable fire extinguishers, hard wired smoke detectors are in the home. Staff and client files were reviewed at the administration office. Per Title Regulations, no deficiencies were cited during this inspection. An exit interview was conducted and a copy of the report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheyenne McCambridge on the above date at 10: AM. During the inspection, LPA McCambridge met with Assistant Executive Director in the main office. LPA reviewed zero of child's records on site at the facility due to no clients meeting the criteria for inspection. LPAs reviewed zero of child's psychotropic medications and medication records. LPA interviewed zero of children currently taking psychotropic medication. LPA interviewed two of staff on site starting at 1:00 pm. LPA reviewed two of staff personnel files on site at the facility starting at 10: PM. LPA toured of the facility inside and out at 12: PM LPA provided the Summary Report to Kristine Martinez upon completion. No deficiencies are being cited at this time. LPA conducted exit interview and left a copy of the document at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/2/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a random annual inspection. LPA met with Residential Services Supervisor Juan Duran and informed of the purpose of the visit. LPA toured the facility site and observed no immediate safety risks. Bedrooms offer individual beds and are either single- or double-occupancy. Kitchen and bathrooms are maintained in sanitary condition. There is food to meet the requirements of the clients in care. Activity spaces are free of hazards. Knives and chemicals are locked away and made inaccessible to clients. LPA conducted interviews of 2 staff members. All clients were at school during LPA's visit. LPA obtained school address and bell schedule information from staff. LPA reviewed files maintained on site, including emergency drill logs and cash resources, and observed no deficiencies. The remaining client and personnel records are maintained electronically and accessible at the licensee's administrative office. A continuation visit will be conducted to complete this inspection. No deficiency citations were issued at today's visit. LPA observed one area in which technical support may beneficial. See LIC 9102. An exit interview was conducted, appeal rights were provided, and a copy of this report was left with Residential Services Supervisor.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/3/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a case management - annual continuation visit. LPA met with Assistant Director Kristine Martinez at the licensee's administrative office and informed of the purpose of the visit. LPA reviewed 5 personnel files. Using the CARE Inspection tool, no deficiencies were observed. Files were organized and observed to be complete. All staff have a valid background clearance and have valid first aid certifications. Staff have received training meeting licensing requirements, including intervention and restraint training. A continuation visit will be conducted to complete review of client records and conduct remaining interview(s). No deficiency citations were issued at today's visit. An exit interview was conducted, and a copy of this report was left with Assistant Director.

met_with: Residential Services Supervisor Juan Duran


summary: Facility Evaluation

raw_content:
Narrative:
On 10/16/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a case management annual continuation inspection. LPA met with Assistant Director Kristine Martinez and informed of the purpose of the visit, which was to continue the annual inspection initiated on 10/2/24. During today's inspection, LPA reviewed 5 client records. Using the CARE Inspection Tool, no deficiencies were observed. LPA observed files to be complete with emergency contact information, signed personal rights and facility policies forms, accurate cash/allowance and medication records, and up-to-date needs and services plans. The final portion of the inspection, client and staff interviews, will be conducted on a later date. An exit interview was conducted, and a copy of this report was left with Assistant Director.

met_with: Assistant Director Kristine Martinez


facility_name: VICTOR TREATMENT CENTER - COUNTRY CLUB HOUSE

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Brian Bertoli met with Administrator Katie Miller regarding a complaint investigation at the Short-Term Residential Treatment Program. The purpose of the meeting was to deliver the findings for the above complaint allegations. During the course of the investigation, LPA Bertoli inspected the facility, reviewed records, and conducted confidential interviews, which did not indicate conclusively that the above allegations occurred.There is a lack of evidence to make a determination as to whether a regulatory violation did occur. This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that Staff inappropriately restrained minors or Staff bullied minors in care; therefore, the above allegations are Unsubstantiated. Appeal Rights were provided and discussed, and no deficiencies were cited. An exit interview was conducted and a copy of the report was given to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Brian Bertoli 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: Katie Miller


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Brian Bertoli met with Administrator Katie Miller regarding a complaint investigation at the Short-Term Residential Treatment Program. The purpose of the meeting was to deliver the findings for the above complaint allegations. During the course of the investigation, LPA Bertoli inspected the facility, reviewed records, and conducted confidential interviews, which did not indicate conclusively that the above allegations occurred.There is a lack of evidence to make a determination as to whether a regulatory violation did occur. This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that Staff Handles minor roughly; therefore, the above allegations are Unsubstantiated. Appeal Rights were provided and discussed, and no deficiencies were cited. An exit interview was conducted and a copy of the report was given to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Brian Bertoli 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:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Aphugh LPA toured the facility, inside and out. Staff and client files were previously reviewed at the head office on Irwin Lane. The group home is licensed to serve six clients. It has four bedrooms, two rooms are single occupancy. Currently six clients are in placement. LPA observed at the time of this visit, the facility to be clean, safe, sanitary and homelike. Posted in the facility were the facility license, the menu, client's personal rights, facility sketch, facility rules, outing schedule, emergency services listing and other forms. All medications, sharps, personal valuables, client files, and a first aid kit are kept locked in the staff office. Medications are double locked inside the office. There are no fire arms. The facility has a pool with an approved pool cover. All staff are trained in water emergencies. There is a hard wired fire alarm, smoke alarms and a Co detector. The facility has ample fresh and non-perishable food and plentiful fresh fruit is provided for snacks. Residents have access to a land line phone in the house. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted, and a copy of the report was left at the facility with staff.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Hernandez. LPA toured the facility, inside and out. Staff and client files were previously reviewed at the head office on Irwin Lane. The group home is licensed to serve six clients. It has four bedrooms, two rooms are single occupancy. Currently six clients are in placement. LPA observed at the time of this visit, the facility to be clean, safe, sanitary and homelike. Posted in the facility were the facility license, the menu, client's personal rights, facility sketch, facility rules, outing schedule, emergency services listing and other forms. All medications, sharps, personal valuables, client files, and a first aid kit are kept locked in the staff office. Medications are double locked inside the office. There are no fire arms. The facility has a pool with an approved pool cover. All staff are trained in water emergencies. There is a hard wired fire alarm, smoke alarms and a Co detector. The facility has ample fresh and non-perishable food and plentiful fresh fruit is provided for snacks. Residents have access to a land line phone in the house. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted, and a copy of the report was left at the facility with staff.

met_with: Kristine Hernandez


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheyenne McCambridge on the above date at 1: PM. During the inspection, LPA McCambridge met with Administrator Kristine Martinez in the main office. LPA reviewed one child's records on site at the facility. LPAs reviewed one child's psychotropic medications and medication records. LPA interviewed one client currently taking psychotropic medication. LPA interviewed three of staff on site starting at 2:00 pm. LPA reviewed three of staff personnel files on site at the facility starting at 3: PM. LPA toured of the facility inside and out at 3: PM LPA provided the Summary Report to Kristine Martinez, Administrator upon completion. No deficiencies are being cited at this time. LPA conducted exit interview with Administrator Kristine Martinez.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date Licensing Program Analyst (LPA) Brian Bertoli conducted an unannounced inspection at the facility and met with Residential Services Supervisor Katy Miller regarding Special Incident Reports (SIR) that were submitted to Community Care Licensing. The incidents took place on 05/13/2024 and 05/19/2024, and the SIRs were written to report incidents regarding staff utilizing prone restraints. LPA Bertoli inspected the facility and then discussed the incidents with Supervisor Miller. In the course of reviewing the incidents, Supervisor Miller stated that staff had engaged in prone restraints. Facility was given a Technical Advisory for ILS Version Section 87095.01(a)(4) Emergency Interventions Prohibition. Based on records reviewed and interviews conducted on 06/10/2024, staff was found to have used prone restraints on the youth. The facility was also advised that their Program Statement would need to be revised for all their STRTP facilities to not allow prone restraints, and that staff needs to immediately be informed and re-trained so as not to utilize prone restraints. An exit interview was conducted and a copy of the report and appeal rights were provided to the facility.

met_with: Katy Miller


summary: Facility Evaluation

raw_content:
Narrative:
On 10/2/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a random annual inspection. LPA met with Residential Services Supervisor Katie Miller and informed of the purpose of the visit. LPA toured the facility site and observed no immediate safety risks. Bedrooms offer individual beds and are either single- or double-occupancy. Kitchen and bathrooms are maintained in sanitary condition. There is food to meet the requirements of the clients in care. Knives and chemicals are locked away and made inaccessible to clients. Activity spaces are free of hazards. The backyard pool has a firm, locked cover. LPA conducted interviews of 1 staff member. Clients returned from school at the end of LPA's visit. LPA obtained school address and bell schedule information from staff. LPA reviewed files maintained on site, including medication administration records and cash resources, and observed no deficiencies. The remaining client and personnel records are maintained electronically and accessible at the licensee's administrative office. A continuation visit will be conducted to complete this inspection. No deficiency citations were issued at today's visit. An exit interview was conducted, appeal rights were provided, and a copy of this report was left with Residential Services Supervisor.


summary: Facility Evaluation

narrative: On 10/3/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a case management - annual continuation visit. LPA met with Assistant Director Kristine Martinez at the licensee's administrative office and informed of the purpose of the visit. LPA reviewed 5 personnel files. Using the CARE Inspection tool, no deficiencies were observed. Files were organized and observed to be complete. All staff have a valid background clearance and have valid first aid certifications. Staff have received training meeting licensing requirements, including intervention and restraint training. A continuation visit will be conducted to complete review of client records and conduct remaining interview(s). No deficiency citations were issued at today's visit. An exit interview was conducted, and a copy of this report was left with Assistant Director.


facility_name: VICTOR TREATMENT CENTER - IRWIN HOUSE

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

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

met_with: Administrator, Kristine Martinez


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Aphugh. LPA toured the facility inside and out. The group home is licensed to serve six clients, ages 6-18 years old. There are currently no clients in placement. LPA observed the facility to be clean, safe and sanitary. The following documents were in the facility: facility license, emergency disaster plan, facility sketch, menu, chores, activity calendar and personal rights. Facility had adequate 7 day non-perishable food supplies. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted, and a copy of the report was left at the facility with staff. .


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Martinez. LPA toured the facility inside and out. The group home is licensed to serve six clients, ages 6-18 years old. There are currently no clients in placement. LPA observed the facility to be clean, safe and sanitary. The following documents were in the facility: facility license, emergency disaster plan, facility sketch, menu, chores, activity calendar and personal rights. Facility had adequate 7 day non-perishable food supplies. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted, and a copy of the report was left at the facility with staff.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheyenne McCambridge on the above date at 10: AM. During the inspection, LPA McCambridge met with Assistant Executive Director in the main office. LPA reviewed two of child's records on site at the facility due to no clients currently being on psychotropic medication. LPAs reviewed two of child's psychotropic medications and medication records. LPA interviewed one of children currently taking psychotropic medication. One client declined to be interviewed. LPA interviewed two of staff on site starting at 1:00 pm. LPA reviewed two of staff personnel files on site at the facility starting at 10: PM. LPA toured of the facility inside and out at 12: PM LPA provided the Summary Report to Kristine Martinez upon completion. No deficiencies are being cited at this time. LPA conducted exit interview and left a copy of the document at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/3/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a random annual inspection. LPA met with Assistant Director Christine Martinez and informed of the purpose of the visit. LPA toured the facility site and observed no immediate safety risks. Bedrooms offer individual beds with clean linens. Kitchen and bathrooms are maintained in sanitary condition. There is food to meet the requirements of the clients in care. Knives and chemicals are locked away and made inaccessible to clients. Indoor and outdoor activity spaces are free of hazards. LPA reviewed 5 personnel files. Using the CARE Inspection tool, no deficiencies were observed. Files were organized and observed to be complete. All staff have a valid background clearance and have valid first aid certifications. Staff have received training meeting licensing requirements, including intervention and restraint training. A continuation visit will be conducted to complete review of client records and conduct remaining interview(s). No deficiency citations were issued at today's visit. An exit interview was conducted, and a copy of this report was left with Assistant Director.

met_with: Assistant Director Christine Martinez


summary: Facility Evaluation

raw_content:
Narrative:
On 10/16/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a case management annual continuation inspection. LPA met with Assistant Director Kristine Martinez and informed of the purpose of the visit, which was to continue the annual inspection initiated on 10/3/24. During today's inspection, LPA reviewed 5 client records. Using the CARE Inspection Tool, no deficiencies were observed. LPA observed files to be complete with emergency contact information, signed personal rights and facility policies forms, accurate cash/allowance and medication records, and up-to-date needs and services plans. The final portion of the inspection, client and staff interviews, will be conducted on a later date. An exit interview was conducted, and a copy of this report was left with Assistant Director.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/30/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted an annual continuation visit to continue the inspection initiated on 10/2/24. LPA met with Assistant Director Kristine Martinez at the licensee's central administrative location and informed of the purpose of the visit. During the visit, LPA completed 2 staff interviews. LPA observed all staff to be knowledgeable of facility policies and procedures, mandated reporter status, and individual resident goals and service needs. Based on the staff interviews and record review, and utilizing the Care Inspection Tool, no deficiencies were observed. LPA provided technical assistance on resident medical assessment documentation. See LIC 9102 dated 10/30/24. There are no deficiency citations. An exit interview was conducted, and a copy of this report and the licensee's appeal rights were provided to Assistant Director Kristine Martinez, whose signature on this form confirms receipt.


facility_name: VICTOR TREATMENT CENTER - JUNIPER HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Aphugh. LPA toured the facility, inside and out. The group home is licensed to serve six clients. There are currently no clients in placement. No residents were present during the inspection. The facility has four bedrooms and two bathrooms. Medications and sharps are locked in the staff office. First aid was fully stocked. No firearms are present and there are no bodies of water. The facility was observed to be clean, safe and sanitary. There was sufficient non-perishable food supplies for clients. LPA observed the facility license, client's personal rights, facility sketch, and other forms posted on the walls throughout the facility. Water temperature measured to be 110 degrees. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted, and a copy of the report was left at the facility with staff.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Martinez. LPA toured the facility, inside and out. The group home is licensed to serve six clients. There are currently no clients in placement. No residents were present during the inspection. The facility has four bedrooms and two bathrooms. Medications and sharps are locked in the staff office. First aid was fully stocked. No firearms are present and there are no bodies of water. The facility was observed to be clean, safe and sanitary. There was sufficient non-perishable food supplies for clients. LPA observed the facility license, client's personal rights, facility sketch, and other forms posted on the walls throughout the facility. Water temperature measured to be 110 degrees. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted, and a copy of the report was left at the facility with staff.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/3/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a random annual inspection. LPA met with Assistant Director Christine Martinez and informed of the purpose of the visit. LPA toured the facility site and observed no immediate safety risks. The facility is currently out of operation, so there are no staff or clients. The licensee will restock the facility's refrigerator and pantry and replace bed linens prior to returning to operational status and will notify the licensing agency upon that return. Due to the facility's operational status, no files were reviewed, and no interviews were conducted. No deficiency citations were issued at today's visit. An exit interview was conducted, and a copy of this report was left with Assistant Director.


facility_name: VICTOR TREATMENT CENTER - LANE HOUSE

raw_content:
Investigation Findings:
UnsubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion: 0


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Aphugh LPA toured the facility, inside and out. The group home is licensed to serve six clients. Currently in placement are 5 clients. The facility has three bedrooms and two bathrooms. Medications, sharps, client files are locked in the staff office, No firearms are present and there are no bodies of water. The facility was observed to be clean, safe and sanitary. There was sufficient non-perishable and perishable food supplies for clients. LPA observed the facility license, client's personal rights, facility sketch, and other forms posted on the walls throughout the facility. Water temperature measured to be 110 degrees. Staff and client reviews were conducted at the administration office. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted, and a copy of the report was left at the facility with staff.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheyenne McCambridge on the above date at 2:00PM. During the inspection, LPA McCambridge met with Administrator Kristine Hernandez in the main office. LPA reviewed two of child's records on site at the facility. LPAs reviewed two of child's psychotropic medications and medication records. LPA interviewed two of the children currently taking psychotropic medication. LPA interviewed three of staff on site starting at 3:00 pm. LPA reviewed three of staff personnel files on site at the facility starting at 2: PM. LPA toured of the facility inside and out at 4: PM LPA provided the Summary Report to Kristine Hernandez, Administrator upon completion. No deficiencies are being cited at this time. LPA conducted exit interview with Administrator Kristine Hernandez.


summary: Facility Evaluation

narrative: Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Aphugh LPA toured the facility, inside and out. The group home is licensed to serve six clients. Currently in placement are 5 clients. The facility has three bedrooms and two bathrooms. Medications, sharps, client files are locked in the staff office, No firearms are present and there are no bodies of water. The facility was observed to be clean, safe and sanitary. There was sufficient non-perishable and perishable food supplies for clients. LPA observed the facility license, client's personal rights, facility sketch, and other forms posted on the walls throughout the facility. Water temperature measured to be 110 degrees. Staff and client reviews were conducted at the administration office. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted, and a copy of the report was left at the facility with staff.


summary: Facility Evaluation

narrative: On 10/3/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a random annual inspection. LPA met with Assistant Director Christine Martinez and informed of the purpose of the visit. LPA toured the facility site and observed no immediate safety risks. The facility is currently out of operation, so there are no staff or clients. The licensee will restock the facility's refrigerator and pantry and replace bed linens prior to returning to operational status and will notify the licensing agency upon that return. Due to the facility's operational status, no files were reviewed, and no interviews were conducted. No deficiency citations were issued at today's visit. An exit interview was conducted, and a copy of this report was left with Assistant Director.


facility_name: VICTOR TREATMENT CENTER - WRIGHT HOUSE

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Brian Bertoli met with Residential Counselor John McGriff regarding a complaint investigation at the Short-Term Residential Treatment Program Facility. The purpose of the inspection was to deliver the findings for the above allegation. The investigation was conducted by Investigations Bureau Investigator Austin Blatnick.. During the course of the investigation Investigator Blatnick conducted confidential interviews and reviewed records. LPA Bertoli inspected the facility and reviewed records. There was no conclusive evidence that the above allegation occurred. This department has investigated the allegation, and although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a Minor was sexually assaulted while in care; therefore, the above allegations are Unsubstantiated. An exit interview was conducted and no deficiencies were cited. A copy of this report was given to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Brian Bertoli 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: John McGriff


raw_content:
Investigation Findings:
13On 10//24/25 at 9:30AM, Licensing Program Analysts (LPA) Kimberly Hall and Brian Bertoli conducted an unannounced complaint investigation visit at the facility. LPA spoke with Kelly Hernandez, Executive Director and met with Sabrina Nesbit, Administrative Associate and informed of the purpose of the visit. The purpose of the visit was to deliver findings for the investigation of the above allegations. The allegation was investigated by the Community Care Licensing Division's Investigations Branch (IB) and reviewed by LPA Kimberly Hall. The investigation found that statements were inconsistent and conflicted with other statements and records. Although the allegation may have happened or is valid, based on confidential interviews, observations, and record review, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. Therefore, the allegations are Unsubstantiated. An exit interview was conducted, and a copy of this report was provided to Administrative Associate, Sabrina Nesbit. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Kimberly Hall 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:


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Aphugh. LPA toured the facility inside and out. The Group Home is licensed to serve eight clients. Currently in placement are eight clients. LPA observed the facility to be clean, safe and sanitary. LPA reviewed staff and client files at the main office. The following documents are posted in the facility: facility license, emergency disaster plan, facility sketch, food menu, chores, activity calendar and personal rights. There are no bodies of water and no firearms at the facility. The facility has adequate non-perishable and perishable food supply. There were no Title 22 deficiencies at today's inspection. An exit interview was conducted and a copy of the report was left at the facility.


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) Joel Segura and Cheyenne McCambridge conducted an announced psychotropic medication inspection of the facility. LPA Segura and McCambridge met with Danielle Stewart who facilitated the tour of the facility, inside and out. The group home is licensed to serve eight clients, children and non-minor dependents. Currently in placement are eight clients. There were no clients present during the initial inspection of the facility. There were only two clients who are subject to this inspection. The facility's buildings and grounds appeared to be in compliance, and no deficiencies were observed during the inspection of the grounds. The inspection of the grounds took place at approximately 9:15am. At 9:30am LPAs Segura and McCambridge conducted a review of two client files. In the course of conducting the file reviews LPAs also interviewed direct care staff Bruno Llerena due to availability later in the day. At approximately 11am LPAs conducted a medication count inspection with medical coordinator Debbie Thompson. In the course of conducting the medication count inspection LPAs found that the facility PMARs have a documentation conflict. The facility's practice is to have a weekly PMAR; however, the week begins at the after school dispensing window in the middle of the day. Continued on 809C The facility uses a PMAR printed and dated by the pharmacy. For C2 (C2, Client 2 see confidential names list LIC811 dated 08/17/2021) LPA found that the PMAR was dated for the week of 08/12-08/18 with columns labeled for the days of the week starting with Thursday through Wednesday. Medical coordinator indicated that since the medication weekly packs start effectively during the after school dosage, they end up documenting the last AM medication administered on Thursday the 19th on the space that corresponds for Thursday the 12th. The facility was advised to consider revising PMAR, see advisory note. At around 11:45pm LPA Segura conducted an interview with medical coordinator Debbie Thompson. Shortly after at approximately 12:30 an interview was also conducted with administrator Kristine Martinez. Staff file reviews were conducted by LPAs at around 12:30pm. No deficienceies were found during this inspection. There were no deficiencies noted at today's evaluation. Exit interview conducted and a copy of the report was left with the administrator Kristine Martinez.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Martinez. LPA toured the facility inside and out. The Group Home is licensed to serve eight clients. Currently in placement are five clients. LPA observed the facility to be clean, safe and sanitary. LPA reviewed staff and client files at the main office. The following documents are posted in the facility: facility license, emergency disaster plan, facility sketch, food menu, chores, activity calendar and personal rights. There are no bodies of water and no firearms at the facility. The facility has adequate non-perishable and perishable food supply. There were no Title 22 deficiencies at today's inspection. An exit interview was conducted and a copy of the report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheyenne McCambridge on the above date at 10:30AM. During the inspection, LPA McCambridge met with Assistant Executive Director Kristine Martinez in the main office. LPA reviewed two of child's records on site at the facility. LPA reviewed two of child's psychotropic medications and medication records. LPA interviewed two of the children currently taking psychotropic medication. LPA interviewed three of staff on site. LPA reviewed three of staff personnel files on site at the facility. LPA toured of the facility inside and out with Administrator Edward Webb. LPA provided the Summary Report to Kristine Martinez, upon completion. No deficiencies are being cited at this time. LPA conducted exit interview with Assistant Executive Director Kristine Martinez.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheyenne McCambridge on the above date at 1: PM. During the inspection, LPA McCambridge met with Administrator Edward Webb at the facility. LPA interviewed three of staff on site. LPA reviewed three of staff personnel files on site in the main office. LPA toured of the facility inside and out with Administrator Edward Webb. LPA did not interview or review client files due to none being in foster care placement. No deficiencies are being cited at this time. LPA conducted exit interview with Administrator Edward Webb.

met_with: Edward Webb


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheyenne McCambridge on the above date at 9:30AM. During the inspection, LPA McCambridge met with Director Kelly Hernandez at the facility. LPA interviewed three of staff on site. LPA reviewed three of staff personnel files on site in the main office. LPA toured of the facility inside and out. LPA did not interview or review client files due to none being in foster care placement. No deficiencies are being cited at this time. LPA conducted exit interview with Director Kelly Hernandez.


facility_name: VICTOR TREATMENT CENTERS- THE COTTAGE

raw_content:
Investigation Findings:
13On January 23, 2021, at 3:30PM Licensing Program Analyst (LPA), Rosslyn Gray concluded the investigation. During the investigation, There were no statements or documented evidence to support that the allegations occurred, "Staff not answering facility phone calls; Minors were without toiletries for a long period of time; Staff serving food that is not thoroughly cooked; Food served is not of the quality to meet the needs of the minors in care". LPA conducted confidential interviews that revealed that the direct phone line to the facility was operable; in addition, the child and children were accorded to have access to personal phones. The facility ensured that there was adequate supply of food for all clients; and that food menu was posted. All staff were trained to cook basic meals 3 times a day 7 days a week. The facility ensured that they were fully stocked with hygiene products and PPE's inspected by the department during the Pandemic. There were no deficiencies cited at this time. Based on the interviews conducted, the above allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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

met_with: UNAVAILABLE


facility_name: VICTOR TREATMENT CENTERS-GREEN HOUSE

raw_content:
Investigation Findings:
13On December 15, 2021, at 5: PM Licensing Program Analyst (LPA), Rosslyn Gray concluded the investigation. During the investigation, LPA conducted confidential interviews and reviewed documentary evidence. There was no evidence to support that Facility staff did not prevent youth from going AWOL. Documentary evidence and confidential interview revealed that the child had history of going AWOL and was on an Approved Home Pass when she went AWOL. There were no statements or evidence to corroborate the allegation. There were no deficiencies cited at this time. Based on the interviews conducted, the above allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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


raw_content:
Investigation Findings:
13On January 23, 2021, at 7:25PM Licensing Program Analyst (LPA), Rosslyn Gray concluded the investigation. During the investigation, there were not documented evidence to support that the allegations that "Staff did not properly supervise minors while in care; Staff did not properly report incidents involving a minor. LPA conducted confidential interviews that revealed that were no evidence to prove that inappropriate sexual behavior was displayed and the reporteed details in the allegations were denied. A Serious Incident Report (SIR) was written and submitted regarding the incident. LPA confirmed that staff met client ratio and was present to provide supervision at all times. It was determined that a Forensic Examination was not needed. Evidence confirm that an Emergency 3-Day removal was summitted and the authorize representative removed the child as requested. All parties involved including law enforcement were congruent with the outcome of the investigation. There were no deficiencies cited at this time. Based on the interviews conducted, the above allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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


facility_name: VICTOR TREATMENT CENTERS-ROMBERGER HOUSE

raw_content:
Investigation Findings:
13THIS REPORT WAS AMENDED DUE TO THE INCORRECT DATE OF COMPLETION On January 13, 2022, at 7: PM Licensing Program Analyst (LPA), Rosslyn Gray concluded the investigation. During the investigation, LPA conducted confidential interviews and reviewed documentary evidence. There was no evidence to support that "Facility staff did not prevent youth from engaging in CSEC activity". Documentary evidence and confidential interview revealed the facility implemented various plans in attempt to prevent child from engaging in CSEC behaviors. The child went AWOL follow ten (10) days of placement. The child's authorized representative closed the child's bed within 1-3 days. There were no statements or evidence to corroborate the allegation. There were no deficiencies cited at this time. Based on the interviews conducted, the above allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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

met_with: UNAVALABLE


facility_name: VISTA DEL MAR CHILD AND FAMILY SERVICES

raw_content:
Narrative:
The following deficiencies are cited per California Code of Regulations, Title Regulations, Division 6, chapters 1 & 5. due to the facility violating the same regulation subsection within a 12 month period. Exit interview was conducted with the administrative assistant, and appeal Rights were issued and a copy of this report was left at the facility. -Continue on 9099D Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has decided that the allegations of personal rights is Unsubstantiated. There were no deficiencies cited per California Code of Regulations, Title Regulations, Division 6, chapter 1 & 5. Exit interview was conducted with the Administrative Assistant and a copy of this report was left at the facility.

Investigation Findings:
13This is an amended report from the original report dated 03/09/18. Licensing Program Analysts (LPA) Esther Luna made an unannounced visit to the Vista Del Mar Child and Family Services or the purpose of concluding the investigation on the above allegations and to deliver the findings. LPAs met with adminstrative assistant to discuss the findings. During the investigation process, it was determined that Staff #1 and Staff #2 use inappropriate restraint on client #1. LPA review video surveillance of the restraint on client #1, and observed staff #1 laying over the client #1 lower leg as a form of restraint. It was also observed, that staff #2 was sitting on client #1 leg during the restraint. LPA also observe staff #1 conducted a one hand restraint and pulled client #1 to a sitting position on the sofa by himself for a period of time until staff #2 arrived. (See confidential name list LIC 811 dated 03/05/2018). Meanwhile LPA was unable to obtain a statement from client #1 due to her awol and whereabouts are unknown. Through the course interviews LPA was able to conclude that the allegation of personal rights violation occurred. The department has concluded, based on the preponderance of evidence this investigation is substantiated- Continue on 9099D SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Esther Luna LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, BRISTOL PARKWAY STE. CULVER CITY, CA FACILITY NAME: VISTA DEL MAR CHILD AND FAMILY SERVICESFACILITY NUMBER: 191600721

met_with: Unit Director- Lynn Cohen


raw_content:
Investigation Findings:
13On June 21, 2021 at 12:24 pm Out of State Group Home Anaylst Sarah Waklee called Vista Del Mar Child and Family Services Unit Director to discuss the above allegations. Analyst Waklee was unable to contact the youth named in the complaint due to the youth being AWOL. Based on confidential interviews with three staff, one youth and the Social Worker for the youth named in the complaint, Analyst Waklee determined that the allegation is unsubstantiated. An unsubstantiated finding means, although the allegation may have happened, the preponderance of evidence does not prove it. A copy of this report was provided to Vista Del Mar Director. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Sarah Waklee LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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

met_with: Unit Director, Suzie Jeon


raw_content:
Narrative:
.Based on the interviews conducted and documentary evidence obtained the information did not produce corroborating evidence to support the above said allegation. Due to inconsistent statements LPA Phillips was not able to determine if the above said allegations occurred, therefore the allegations are found to be Unsubstantiated meaning that although the allegations may have happened or is valid there is not a preponderance of evidence to prove that the alleged incidents occurred. No deficiencies cited at the time of this investigation. Exit interview was conducted, and copy of this report will be emailed to administrator.

Investigation Findings:
13On December 8, 2021 at 1: PM Licensing Program Analyst (LPA), Zena Phillips conducted a follow-up complaint investigation visit to Vista Del Mar Child And Family Services and met with Amy Jaffee, Administrator. The purpose of the visit was to deliver findings for the above complaint allegation. During the course of investigating the allegation: Facility staff did not prevent youths from engaging in a physical altercation. LPA Phillips conducted confidential interviews with related parties, reviewed facility records and Incident Reports. Based on the interviews conducted and statements obtained during the investigation the above allegations cannot be substantiated because LPA Phillips obtained inconsistent statements from staff and residents in care. Evidence obtained revealed that Staff tried multiple times to redirect children to stay inside facility, but children left facility. Also, confidential interviews with Child 2, Child 3 and Child 6 revealed that staff tried to prevent children from leaving facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290b El Segundo, CA Facility Name: Vista Del Mar Child and Family Servicesfacility Number: Visit Date: 12/08/ Narrative 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32.Based on the interviews conducted and documentary evidence obtained the information did not produce corroborating evidence to support the above said allegation. Due to inconsistent statements LPA Phillips was not able to determine if the above said allegations occurred, therefore the allegations are found to be Unsubstantiated meaning that although the allegations may have happened or is valid there is not a preponderance of evidence to prove that the alleged incidents occurred. No deficiencies cited at the time of this investigation. Exit interview was conducted, and copy of this report will be emailed to administrator. SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: LIC9099 (FAS) - (06/04)Page: 2 of 2

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

met_with: Alicia Hellum/Unit Supervisor


raw_content:
Narrative:
Also Staff 1 stated Teen Lounge is available for additional hours as late as 10: PM if needed. Residents can just ask and may go to Teen Lounge after 8: PM with staff in attendance. Child 2 & Child 3 stated phone service is no issue and wifi is available. Staff 1 stated residents have own phone line for use in Handler unit with permission from staff. Also phones in the open wing for use as necessary. Based on the interviews conducted and documentary evidence obtained the information did not produce corroborating evidence to support the above said allegation. Due to inconsistent statements LPA Phillips was not able to determine if the above said allegation occurred, therefore the allegation is found to be Unsubstantiated meaning that although the allegation may have happened or is valid there is not a preponderance of evidence to prove that the alleged allegation exist.. No deficiencies cited at the time of this investigation. Exit interview was conducted, and copy of this report will be emailed to Jimmy Tyler/ Supervisor.

Investigation Findings:
13On March 03, 2022 at 1: PM Licensing Program Analyst (LPA), Zena Phillips conducted a follow-up complaint investigation visit to Vista Del Mar Child And Family Services and met with Jimmy Tyler/ Supervisor. The purpose of the visit was to deliver findings for the above complaint allegation. During the course of investigating the allegation: LPA Phillips conducted confidential interviews with related parties, reviewed facility records and Incident Reports. Based on the interviews conducted and statements obtained during the investigation the above allegation cannot be substantiated because LPA Phillips obtained inconsistent statements from staff and residents in care. Evidence obtained revealed that facility has adequate phone service and wifi available for residents use. The Teen Lounge is availabe from 8: AM to 8: PM 7 (seven) days per week. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: VISTA DEL MAR CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 03/03/2022

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

met_with: Jimmy Tyler /Supervisor