facility_name: AMEEN SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On November 17, 2021 at 10: AM, Licensing Program Analyst (LPA) Charmetha White arrived at Ameen Small Family Home for the purpose of conducting an Annual Random Inspection. LPA met with the Licensee, who granted access to the home and together a tour of the entire home was conducted. The facility is licensed to provide care and supervision services for three (3) developmentally disabled children, ages 3-17 years old, ambulatory only. The census today is zero (0) and living in the home currently are the Licensee, the Licensee's Adopted son, and Licensee's Legal Guardian Child. The program accepts Regional Center Placement Children. The facility is set up as follows: This is a single-story 3 bedrooms 1 bathroom, home located in a residential area. The home has a living room, dining room, kitchen, and a backyard. Living Room: is equipped with a sofa, bookshelves, a small wooden table, and a mounted flat screen television. Dining Room: is equipped with a table and four (4) chairs. Kitchen: is equipped with a four (4) burner stove/oven, a refrigerator/freezer, a toaster oven, and a microwave. There is also an exit door leading to the side of the home. Bedroom #1: is occupied by Licensee's Legal Guardianship child. The room is furnished with a two-tier bunk beds with appropriate railing to prevent falling, closet, drawer space, working light, and an exit window equipped with security bars. Bedroom #2: is occupied by Licensee's Adopted son. The room is furnished with a two-tier bunk beds with appropriate railing to prevent falling, drawer, closet space, working light, and an exit window equipped with security bars. Bedroom #3 is occupied by the Licensee. The room is furnished with a Futon, drawers, closet space, working light, bookshelves, a small desk, and an exit window with security bars. All security bars were tested and found to be in working order. Report continued on LIC 809C. LPA observed one (1) fully charged fire extinguisher in the home. The smoke and carbon monoxide detectors were tested and found to be in working order. Medications are stored in a locked box inside a locked kitchen cabinet and made inaccessible to children in care. Disinfectants and cleaning solutions are kept in a locked cabinet under the kitchen sink. Sharp knives are kept in a locked box located in Licensee's bedroom. The hot water was tested and found to be at a safe temperature. The home has a working telephone readily accessible to children in care. The First Aid Kit was checked and found to be complete. LPA observed the home to be clean, safe, and sanitary. Passageways, stairways, inclines, ramps and open porches are unobstructed. The front and backyard were clean and free of debris. There are no firearms or dangerous weapons in the home. There was no swimming pool, hot tub, spas, nor similar bodies of water located at the facility. Emergency numbers are posted in a prominent place. Licensee has completed three hours of annual training. Licensee has a current CPR/First Aid card which expires 10/06/2023. LPA reminded Licensee to ensure the following when children are in placement: Children are accorded personal rights and the corresponding form is in their file. Children are supported and encouraged to participate in extracurricular activities. Children are allowed and encouraged to contact the licensing agency, in confidence, without threats or punishment for making complaints. Children are accorded dignity in personal relationships with others in the home. Licensee acknowledges abuse reporting requirements. During the visit, LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. All posting requirements for Small Family Home Licensure and Emergency Plan were met. The home currently has no staff or clients placed in the home. Licensee was issued an advisory note regarding ongoing training hours. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTER 4 no deficiencies were cited during this visit. An exit Interview was conducted, and a copy of this report was left with the Licensee.

met_with: Licensee - Faaidah Ameen


state: CA

summary: Facility Evaluation

raw_content:
Narrative:
On October 31, 2023 at 09:30AM, Licensing Program Analyst (LPA) Donald Martin arrived at Ameen Small Family Home for the purpose of conducting an Annual Random Inspection. LPA met with the Licensee, who granted access to the home and together a tour of the entire home was conducted. The facility is licensed to provide care and supervision services for three (3) developmentally disabled children, ages 3-17 years old, ambulatory only. There are currently no minors housed in the home. The facility is set up as follows: This is a Newly remodeled single-story 3 bedrooms 1 bathroom, home located in a residential area. The home has a living room, dining room, kitchen, three bedrooms and a backyard. Each bedroom complies with licensing regulations. The backyard is spacious and free of hazardous materials. The shut off valves are located on the side of the structure. LPA observed one (1) fully charged fire extinguisher in the home. The smoke and carbon monoxide detectors were tested and found to be in working order. Medications are stored in a locked box inside a locked kitchen cabinet and made inaccessible to children in care. Disinfectants and cleaning solutions are kept in a locked cabinet under the kitchen sink. Sharp knives are kept in a locked box located in Licensee's bedroom. The hot water was tested and found to be at a safe temperature. The home has a working telephone readily accessible to children in care. The First Aid Kit was checked and found to be complete. LPA observed the home to be clean, safe, and sanitary. Passageways, stairways, inclines, ramps and open porches are unobstructed. The front and backyard were clean and free of debris. There are no firearms or dangerous weapons in the home. There was no swimming pool, hot tub, spas, nor similar bodies of water located at the facility. Cont 809-C LPA reminded Licensee to ensure the following when children are in placement: Children are accorded personal rights and the corresponding form is in their file. Children are supported and encouraged to participate in extracurricular activities. Children are allowed and encouraged to contact the licensing agency, in confidence, without threats or punishment for making complaints. Children are accorded dignity in personal relationships with others in the home. Licensee acknowledges abuse reporting requirements. During the visit, LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. All posting requirements for Small Family Home Licensure and Emergency Plan were met. The home currently has no staff or clients placed in the home. An exit Interview was conducted, and a copy of this report was left with the Licensee. There were no deficiencies cited at the time of the visit.

report_type: Facility Evaluation

visit_type: Annual

met_with: Faaidah Ameen-Administrator


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On December 2, 2025 at 8:40AM, Licensing Program Analyst (LPA) Lanice White arrived at Ameen Small Family Home for the purpose of conducting an Annual Random Inspection. LPA met with the Licensee, who granted access to the home and together a tour of the entire home was conducted. The facility is licensed to provide care and supervision services for three (3) developmentally disabled children, ages 3-17 years old, ambulatory only. There are currently no minors housed in the home. The facility is set up as follows: Single-story 3 bedrooms 1 bathroom, home located in a residential area. The home has a living room, dining room, kitchen, three bedrooms and a backyard. Each bedroom complies with licensing regulations. The backyard is spacious and free of hazardous materials. The shut off valves are located on the side of the structure. Living Room: is equipped with a sofa, bookshelves, a small wooden table, and a mounted flat screen television. Dining Room: is equipped with a table and four (4) chairs. Kitchen: is equipped with a four (4) burner stove/oven, a refrigerator/freezer, a toaster oven, and a microwave. There is also an exit door leading to the side of the home. Bedroom #1: is occupied by Licensee's Legal Guardianship child. The room is furnished with a queen bed, closet, drawer space, working light, and an exit window equipped with security bars. Bedroom #2: is occupied by Licensee's Adopted son. The room is furnished with a two-tier bunk beds with appropriate railing to prevent falling, drawer, closet space, working light, and an exit window equipped with security bars. (Continued see 809-C page 2) (page 2) Bedroom #3 is occupied by the Licensee. The room is furnished with a Futon, drawers, closet space, working light, bookshelves, a small desk, and an exit window with security bars. Vehicle: Silver Kia Optima four-door, Registration valid until 1/2/2027, Insurance valid 4/27/2026. Car is in good working condition. All security bars were tested and found to be in working order. LPA observed one (1) fully charged fire extinguisher in the home. The smoke and carbon monoxide detectors were tested and found to be in working order. Medications are stored in a locked box inside a locked kitchen cabinet and made inaccessible to children in care. Disinfectants and cleaning solutions are kept in a locked cabinet under the kitchen sink. Sharp knives are kept in a locked box located in Licensee's bedroom. The hot water was tested and found to be at a safe temperature of. The home has a working telephone readily accessible to children in care. The First Aid Kit was checked and found to be complete. LPA observed the home to be clean, safe, and sanitary. Passageways, stairways, inclines, ramps and open porches are unobstructed. The front and backyard were clean and free of debris. There are no firearms or dangerous weapons in the home. There was no swimming pool, hot tub, spas, nor similar bodies of water located at the facility. LPA reminded Licensee to ensure the following when children are in placement: Children are accorded personal rights and the corresponding form is in their file. Children are supported and encouraged to participate in extracurricular activities. Children are allowed and encouraged to contact the licensing agency, in confidence, without threats or punishment for making complaints. Children are accorded dignity in personal relationships with others in the home. Licensee acknowledges abuse reporting requirements. During the visit, LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. (Continued see 809C page 3) (Page 3) Client Records: LPA reviewed 0 client records, no clients in care. Staff Records: LPA reviewed 0 staff records, not available during inspection . Staff Interview: LPA conducted a confidential interview with Licensee. Client Interviews: None, no clients in care One deficiency was cited at the time of inspection. (See LIC809-D) Two Technical violations was issued at the time of inspection (see LIC9102-AN) LPA Lanice White and concluded the Annual/Required Inspection. An exit interview was conducted, and a copy of this report was emailed to the Licensee.

Deficiencies:
80066(c): Personnel Records

(c) All personnel records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the following requirements

met_with: Faaidah Ameen - Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On January 15,2026 at 11:30AM, Licensing Program Analyst (LPA) Lanice White arrived at Ameen Small Family Home for the purpose of conducting clearing plan of corrections for violations that was observed during Annual Inspection on 12/02/2025. LPA met with the Licensee, who granted access to the home and together a tour of the entire home was conducted. The facility is licensed to provide care and supervision services for three (3) developmentally disabled children, ages 3-17 years old, ambulatory only. There are currently no minors housed in the home. The facility is set up as follows: Single-story 3 bedrooms 1 bathroom, home located in a residential area. The home has a living room, dining room, kitchen, three bedrooms and a backyard. Each bedroom complies with licensing regulations. The backyard is spacious and free of hazardous materials. The shut off valves are located on the side of the structure. LPA reviewed: Client Records: LPA reviewed 0 client records, no clients in care. Staff Records: LPA reviewed 1 staff records . Deficiency given on 12/02/2025 has been corrected (See LIC809-D) Two Technical violations given on 12/02/2025 has been corrected ((see LIC9102-AN)


facility_name: AMOR FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On June 24, 2025 at 10:30AM, Licensing Program Analyst (LPA) Adaleyci Caballero met with applicant Belinda Addo for a Component II of the application process. Lpa a. Caballero went over revisions needed for the application prior to license that are due no later than July 24, 2025. LPA gave a copy of the LIC 184, Notice of Application Revision, and additional correspondence to assist with the revisions needed to the application. A copy of this report was provided to applicant via email. Original signed copy of this report will be placed in the facility file.

met_with: Applicant-Belinda Addo


summary: Facility Evaluation

raw_content:
Narrative:
On July 16, 2025 at 9:45AM, Licensing Program Analyst (LPA) Adaleyci Caballero completed a pre-licensing inspection of Amor Small Family Home (SFH). LPA met with Applicant Belinda Addo who led a tour of the home. The facility was toured both inside and out with the applicant. There are no clients in placement. The one-story building with four bedrooms and two full bathrooms which are set up as follows: Bedroom #1- It consisted of one queen. The bed had linen, comforters, and pillows. It will sleep applicant and significant other. Bedroom #2- It consisted of two single beds. The beds had linen, comforters, and pillows. It will sleep two clients. Bedroom #3- It consisted of two single beds. The beds had linen, comforters, and pillows. It will sleep two clients. Bedroom #4- It consisted of two single beds. The beds had linen, comforters, and pillows. It will sleep two clients. A living room, kitchen, dining area, laundry room, three car garage, backyard, and a patio. The garage will be utilized for storage. The clients' bedrooms were arranged so that no more than two clients will be in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the clients' belongings. There was a smoke detector in every bedroom. The five smoke detectors were checked and working properly. The Carbon Monoxide detectors were combined with the smoke alarms. The home's central air conditioning module was in the backyard. The water heater is located in the outside of the house. The appliances were in working order. Medications will be locked in a filing cabinet in the licensee's bedroom. The home had a trash can for storage of solid waste with a tight fitting lid. Emergency Disaster Plan (LIC 610), Personal Rights, Grievance procedures, Facility Sketch, House Rules, and Visitation Policies were posted and accessible to the public. There were three fire extinguishes present in the home located in the kitchen, entrance, and the garage. They were observed to be properly charged and inspected by the fire department. The First Aid Kit was located in the dining area accessible to clients in care. There are no firearms in the home. There is no pool or any body of water in the home. The hot water temperature was at 119.4 degrees Fahrenheit. Corrections: Toys, games, books, and recreational and educational materials. Client bedrooms emptied and cleaned ready for placement Extra linen and towels A supply of perishable food and non-perishable food. Licensee's bedroom with belongings to reflect licensee residing in the home Component III was conducted. An exit interview was conducted, and a copy of this report was provided to applicant Belinda Addo via email due to technical difficulties. The application will be forwarded to Licensing Program Manager Abdoulaye Traore once corrections are submitted to LPA.

visit_type: Prelicensing


summary: Facility Evaluation

raw_content:
Narrative:
On October 7, 2025 at 12:04PM, Licensing Program Analyst (LPA) Cynthia Ramos completed a post-licensing inspection at Amor Small Family Home (SFH). LPA met with Licensee Belinda Addo who led a tour of the home. The facility was toured both inside and out with the Licensee. There are three clients in placement. The one-story home with four bedrooms and two full bathrooms are set up as follows: Bedroom #1- It consisted of one queen bed. This room sleeps Licensee and spouse. Bedroom #2 consisted of two twin size beds, the beds had linen, comforters, and pillows. It currently sleeps one male client age 11 year old. Bedroom #3 consisted of two twin beds that had linen, comforters, and pillows. This room was currently occupied by two male clients, ages nine and 12. Bedroom #4 was currently used as a Licensee's office. This room is locked and vacant. A living room, kitchen, dining area, three car garage, backyard, and a patio were inspected and no hazard was observed. A supply of perishable food and non-perishable food was observed. The garage was locked and is used for storage. All bathrooms in the home were inspected and were working properly. Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for client's belongings. The fireplace is properly screened. All hazardous items have been properly made inaccessible to clients. The medications were locked in Licensee's office. Cleansers/chemicals and knives were locked and stored in the laundry room which remains locked at all times. The first aid kit was located in the kitchen. Per Licensee, there are no guns/weapons in the home at this time. The hot water temperature was tested and noted to be 106.7 degrees Fahrenheit. Smoke alarms/carbon monoxide alarms were tested and working properly. Proper storage of all food was noted. Trash cans for storage of solid waste have tight fitting lids. The Emergency Disaster Plan with exit map, Title Personal Rights, and visitation policies were posted. ... There were a total of 3 fire extinguishers throughout the home. A total of 7 cameras were observed through out the home, 4 were in the exterior and 3 inside the home in common areas (kitchen, hallway and living room). A total of 3 staff records and 3 client records were reviewed and were in compliance. Based on today's inspection, there are no deficiencies to be cited at this time. An exit interview was conducted, and a copy of this report was provided to Licensee Belinda Addo.

met_with: Licensee-Belinda Addo


facility_name: AMOR SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On 3/13/25, LPA (Licensing Program Analyst) Carrie Palmer conducted an announced visit to the above Small Family Home for the purpose of relocating. The applicant has not moved into the facility. LPA Palmer will return to complete a 2nd licensing inspection prior to issuing a license. LPA Palmer took a tour of the facility. The facility is a one story single family residence with 5 bedrooms, 2 bathrooms, kitchen, living room, laundry room, backyard, front yard and garage. The facility appears to be clean and safe. At this time, the facility is not ready to be licensed. The facility representative states the anticipated move in date will be determined at a later date and will email LPA Palmer said date. LPA Palmer will return to complete the licensing inspection at a later date. .

met_with: Arianna Sattiewhite, Licensee


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On 3/27/25 at 1pm, Licensing Program Analyst (LPA) Palmer conducted an announced visit to the above named facility to conduct a pre-licensing inspection for Amor Small Family Home located at Aurora Valley Ave, Bakersfield, CA 93312. This is the 2nd attempt to license the facility. LPA Palmer took a tour of the facility and observed the following: The facility has two sofas and a table (with 5 chairs and a bench) in the living room/dinning area to include a TV mounted on the wall, an enclosed fire place and curtains hanging on the sliding patio doors. The kitchen has a refrigerator, stove and microwave. First bedroom has 1 queen size bed, 8 drawers, two closets and one bathroom in the room. The 2nd bedroom has 2 twin beds, 8 drawers and one closet. The hallway bathroom, which will be labeled as bathroom #2 has 1 sink, a toilet and a bathtub with a shower. The 3rd bedroom has 2 twin beds, 8 drawers and one closet with a curtain. The 4th bedroom has one twin bed, 8 drawers and one closet. The 5th bedroom has one twin bed, 8 drawers and one closet. The laundry area has a washer and dryer. Disinfectants and cleaning agents are stored in the laundry area under lock and key. Sharps and medication are stored in the kitchen closet under lock and key. Smoke detectors appear to be dual (carbonmonoxide and smoke) and are working. One fire extinguisher is present on the wall in the living room. The facility has a well equipped first aid kit. Each room has an ample amount of lighting and are at the appropriate temperatures. The facility does have hot water. Page 1 of The following Technical Assistance was issued: - TA - Personal Rights Poster developed by the Office of Obbudsperson was not posted - TA - Menu was not posted. Not more than 15 hours shall elapse between the third meal of one day and first meal of the following day. Menus should be written at least 1 week in advance. - TA - There were no toys, games, books and recreational and education materials present TA - Emergency personnel contact information was not posted. No further inspection is needed at this time. A copy of this report was provided to the Small Family Home representative. An exit interview was conducted. Page 2 of 2

Deficiencies:
11804: Aurora Valley Ave, Bakersfield, CA 93312.  This is the 2nd attempt to license the facility.  LPA Palmer took a tour of the facility and observed the following


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Based on confidential interviews and record review, the preponderance of evidence standard has been met and the allegation staff did not treat minor with respect is substantiated. Facility is cited for violation of Title 22, Division 6, Chapter Section 83072(d)(10) Personal Rights. A copy of this report, Appeal Rights, and LIC 811 were given and explained to Licensee Arianna Sattiewhite. Confidential interviews provided different descriptions of how C1 was placed on the ground such as a restraint or flipped on the ground. Other information obtained stated the allegation occurred Based on confidential interviews and record reviews, the allegations that staff pulled minor's hair/slammed minor on ground may have occurred however, they are not supported or proven by evidence. Therefore, the above allegation is unsubstantiated at this time. A copy of this report, LIC 811, and appeal rights were given to Licensee Arianna Sattiewhite.

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

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:

report_type: Complaint Investigation

complaint_status: unsubstantiated


raw_content:
Narrative:
had an unauthorized absence from the home. Other confidential interviews stated the allegation occurred. Based on confidential interviews and record reviews, the allegations that staff does not prevent minor from engaging in inappropriate behaviors may have occurred, however, is not supported or proven by evidence. Therefore, the above allegation is unsubstantiated at this time. A copy of this report, LIC 811, and appeal rights were given to Licensee Arianna Sattiewhite.

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: Arianna Sattiewhite


raw_content:
Narrative:
Based on confidential interviews and record review, the allegation that Licensee had a minor family member supervising the minors in the home may have occurred, however, is not supported or proven by evidence. Therefore, the above allegation is unsubstantiated at this time. A copy of this report and appeal rights were reviewed and provided to Licensee Arianna Sattiewhite. Licensee reported going to school and taking care of their elderly father and that Licensee is at the SFH 4-5 days a week. Confidential interviews stated that Licensee has not been at the home for months and/or since August 2024. Confidential interviews also stated that Licensee was unresponsive to placing agencies and licensing. The allegation that Licensee is not meeting the minors needs specifically refers to appropriate care not being provided to the clients. Confidential interviews revealed that C1 often bullies C3, there were ongoing physical altercations between the children, law enforcement reports they are dispatched to the home daily, and C1 and C2 have been observed unsupervised smoking on the porch of the facility. Based on confidential interviews and record review, the preponderance of evidence standard has been met and the allegations Licensee is not regularly present in the home and Licensee is not meeting the minors' needs are substantiated. Facility is cited for violation of Title 22, Division 6, Chapter Section 83064(b) Licensee Duties and Responsibilities and Tittle 22, Division Chapter Section 80078(a) Responsibility for Providing Care and Supervision. A copy of this report, appeal Rights, and LIC 811 were given and explained to Licensee Arianna Sattiewhite.

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


raw_content:
Narrative:
S1 brought C1 back into the home and called the police. Some confidential interviews stated this was not a sexual incident. Other confidential interviews and information obtained stated the allegation occurred. Based on confidential interviews and record review, the allegation that due to lack of supervision staff did not prevent minor from being sexually abused may have occurred, however, is not supported or proven by evidence. Therefore, the above allegation is unsubstantiated at this time. A copy of this report, LIC 811, and appeal rights were given to Licensee Arianna Sattiewhite.

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

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


summary: Facility Evaluation

raw_content:
Narrative:
On Monday February 26, Licensing Program Analyst (LPA) Linda Haynes met with Applicant Arianna Sattiwhite via Microsoft Teams to complete a Component II interview. A pre-licensing was scheduled for 3/11/2024. A signed copy of this LIC 809 will be placed in facility file.


summary: Facility Evaluation

raw_content:
Narrative:
On March 11, 2024 at 1: PM, Licensing Program Analyst (LPA) Linda Haynes completed a pre-licensing inspection of Amor Small Family Home. LPA met with Applicant Arianna Sattiewhite who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there are no clients in placement at this time. The home is a one story building with four bedrooms and three bathrooms which are set up as follows: · Bedroom #1 (Master) has one bed will sleep the applicant. · Bedroom #2 (Client's) has two twin beds, it will sleep two clients. · Bedroom #3 (Client's) has two twin beds, it will sleep two clients. · Bedroom #4 (Client's) has two twin beds, it will sleep two clients. · A great room/living room, kitchen, dining area, three bathrooms, an attached two car garage, laundry room, and the backyard. The Client's bedrooms were arranged so that no more than two clients will be in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There was a smoke detector / carbon monoxide detector in every bedroom. The six smoke detectors / carbon monoxide detectors were checked, and they were working properly. The home's central air conditioning module was located in the back yard. The home's tank less hot water heater was located inside the garage. The appliances were in working order. The client's files will be locked inside a cabinet in the kitchen. There was adequate food storage space and a supply of two days of perishable foods and a week of non-perishable foods. A trash can for storage of solid waste had a tight-fitting lid and was present. The sharp knives will be in a locked cabinet in the kitchen. The medications will be located in a locked cabinet in the kitchen. The hot water in the master bathroom measured to be 106.2 degrees Fahrenheit, in bathroom 2 106.5 degrees Fahrenheit, and in bathroom 3 106.5 degrees Fahrenheit. The home's First Aid kit was accessible and is located in cabinet in the kitchen and contained all required supplies. two fire extinguishers were present in the home both are located in the laundry room. They were observed to be properly charged and inspected by the fire department. Licensee stated there were no weapons/firearms in the home. There is no pool or other body of water at the home. The backyard where clients will have access to play was completely fenced. The following corrections need to be made: · Lock needs to be installed on the kitchen cabinet where medications will be stored A component III was conducted at 2: PM with Applicant. An exit interview was conducted. Application will be forwarded to the Licensing Program Manager for Licensing.


summary: Facility Evaluation

raw_content:
Narrative:
On October 11, 2024, an informal conference was held with Amor Small Family Home (SFH) at the Riverside Children's Residential Program Office to discuss current Community Care Licensing (CCL) concerns. Present at the meeting were LaCresha Cook, Regional Manager, Jennifer Smith, Licensing Program Manager, Licensing Program Analysts (LPAs) Adaleyci Caballero and Rachel Vanegas, Amor Small Family Home (SFH) Licensee Arianna Sattiewhite, Attorney Robert Hahn (on call), Los Angeles Children and Family Services County Social Worker Krystal Green, and Los Angeles Children and Family Services County Social Worker Erin Wiley (on call) for the purpose of discussing several health and safety concerns observed during inspections conducted at the SFH on 10/2/2024 and 10/08/2024. The following concerns were addressed: · Lack of care and supervision. · Client records · Staff records · Facility records · Lack of licensee residing at the Small Family Home · Minor under the age of eighteen providing care and supervision to clients · Accountability On August 21, 2024, LPA Caballero arrived at the SFH to conduct a safety inspection regarding an incident that occurred on or around 8/14/24. Staff Indya Kuanda was at the facility and stated that the licensee was not available, staff did not know who the licensee was and believed it was Cynthia Alvarez. Staff also stated she did not know how many clients were in the home. The licensee advised that staff Alvarez is the Facility Director she helps with hiring, personnel records, and LiveScan. Licensee stated she resides in the facility four to five days a week. Licensee also advised that when she is away from the facility she is attending school, helping her father, and visiting friends. On October 2, 2024, LPA Caballero arrived at the SFH to conduct a safety inspection regarding an incident that occurred on or around 9/25/24. LPA encountered three escalated clients at the front entrance door of the SFH, that were yelling and not allowing LPA Caballero to enter the facility. LPA Caballero asked clients where staff was, and LPA was greeted by 17-year-old staff #1 (S1). Clients were not allowing S1 to talk and were surrounding S1 at the front entrance door. LPA asked if another staff was present and S1 stated no. LPA observed that S1 appeared to look very young and asked S1 her age. S1 stated that she was 17 years old and was turning 18 next week. S1 informed LPA that she had called law enforcement two hours ago and they still had not arrived. The clients continued to not allow LPA access to the facility and LPA walked back to her vehicle and informed LPM Smith of the situation. LPA attempted to returned to the facility and client #1 (C1) and client #2 (C2) were outside yelling and approaching LPA telling LPA to leave. Client #3 (C3) was crying and walking around the facility premises. For safety, LPA returned to her vehicle and tried to contact Licensee via phone but was unsuccessful. C1 and C2 walked towards LPA's vehicle telling LPA to leave. LPA spoke with C1 and C2 and they appeared to de-escalate, and LPA was able to enter the facility. C1 and C2 showed LPA the property destruction that had been made prior to LPA's arrival. S1 remained outside with C3 due to C1 and C2 threatening to assault C3. LPA advised S1 to call an adult staff for assistance. Staff called staff Cynthia Alvarez and staff Alvarez stated that she was in route to the facility. Law enforcement arrived at the facility and advised LPA he was dispatched to this home daily due to behaviors of the youth. According to staff, Licensee's whereabouts were unknown, and licensee was not responding. Upon staff Alvarez' arrival to the facility, C1 and C2 appeared content, however, C3 continued to be distressed. Law enforcement left the facility and C1 and C2 continued to make threats to C3 and C3 appeared agitated while crying. LPA Caballero advised staff Alvarez to call law enforcement again. LPA Vanegas arrived at the facility to assist LPA Caballero. Law enforcement arrived, the fire department was dispatched and C3 was taken to the hospital. Confidential interviews stated that S1 had been working at the SFH since August and works as an on call. S1 supervised the clients alone and with other staff. LPAs were also informed that Licensee does not live at the SFH. Licensee again stated that she resides in the facility and is a busy college student and has the bear necessities in her bedroom. Licensee also acknowledged that she had hired an underage (17year-old) staff member to provide care and supervision to the clients in care. RM Cook asked Licensee was she aware that Title Regulations require staff for SFHs to be at least eighteen years of age. Licensee admitted that neither she nor the Facility Director was aware of this requirement. RM Cook reminded Licensee that she is accountable for knowing SFH regulations and ensuring compliance. Licensee also acknowledge that she was aware that the underage staff was unable to manage the client's in care while she was away from the facility. On October 8, 2024, Licensing Program Analysts (LPAs) Adaleyci Caballero and Rachel Vanegas arrived at the SFH to conduct a safety inspection regarding an incident that occurred on or around 10/03/24. LPAs disclosed the purpose of the visit and were granted entry into the SFH by staff Brianna Israel. LPA Caballero asked staff Israel if Licensee Sattiewhite was home and staff Israel stated no. LPA Caballero requested staff Israel to contact Licensee and inform Licensee that Community Care Licensing was at the SFH. During the phone call, LPA Caballero heard staff Israel speaking to staff Cynthia Alvarez. Staff Israel informed LPAs that staff Alvarez was out sick. LPA Caballero asked staff Israel if she knew where the Licensee was, but staff Israel did not know where Licensee was. LPAs conducted a safety inspection of the SFH with staff Israel but were not able to inspect the Licensee's bedroom because staff Israel did not have access to Licensee's bedroom, as the bedroom was locked with a digital passcode lock. During the safety inspection, the Licensee arrived at the home stating that she was at her father's house for about an hour and a half. When asked why staff Israel reached out to staff Alvarez first instead of Licensee; the Licensee stated that she attends school on Mondays, Wednesdays, and Thursdays and Cynthia is usually present at the facility on those days. LPA Caballero reminded Licensee that it was a Tuesday on a day that Licensee doesn't go to school. LPAs then requested the Licensee to open her bedroom door and LPAs inspected Licensee's bedroom. LPAs observed an almost empty closet with a small number of disorganized belongings on the floor. There was a duffle bag on the floor with papers inside. There was approximately five pieces of clothing on the floor with hangers. There were other items like a cereal box, bed linen, torn cardboard boxes, and notebooks. LPAs looked inside the bathroom drawers and most of the drawers were empty. LPA observed a box of masks, a travel size Q-Tip container, and hair combs in one of the drawers. LPAs observed that the shower had two travel size hygiene items and a dish sponge on the shower floor. LPAs observed the hand soap in the bathroom sink that appeared to be brand new. LPAs observed face moisturizer, floss, and a travel size deodorant on top of the bathroom sink. LPAs observed a house plant on the bathroom counter that was extremely dried out due to poor water uptake. LPAs observed the clothing drawers empty with random items like a stapler and folders with licensing reports. LPAs observed little to no clothing in Licensee's clothing drawer. There was another dead house plant on top of Licensee's nightstand. LPAs did not see shoes, undergarments, and towels in Licensee's bedroom or bathroom. LPAs requested staff records from Licensee. Licensee stated that the printer did not have black ink and sent staff Israel to purchase ink. In the meantime, staff Brianna returned from the drug store and began to assist Licensee to make copies of records. During the inspection, Licensee was unable to answer questions posed by LPAs and repeatedly called someone seeking guidance. Licensee informed that she was on the phone with staff Alvarez. Another staff arrived at the SFH by the name of Dashawna Johnson and gave Licensee forms. LPA Caballero asked who the individual was, and Licensee stated that it was a new hire who had worked a couple of shifts at the SFH. LPA Caballero checked Guardian and noticed that staff Johnson, was not associated to the SFH, Licensee then request LPA to refresh the site and look again after speaking to staff Alvarez. During the inspection it was noted that staff Johnson was associated to the SFH after LPA Caballero informed Licensee that staff Johnson was not associated. Licensee confirmed that staff Johnson was associated during the time of the inspection. During the inspection, client #1 (C1) came out of C1's bedroom and said, "what is licensing doing here?" Licensee stated that LPAs were doing their job. Then, C1 began to ask LPA Caballero questions, and began to escalate telling LPAs that the LPAs needed to leave and that everything was fine there. C1 began to escalate and was telling LPAs that LPAs needed to leave. Licensee was unable to deescalate client. Licensee was unable to provide staff records. LPA Caballero requested the records to be brought to the Licensing office. LPAs decided to exit the SFH due to the escalating behavior of C1. C1 went to the State vehicle and began knocking on the car window telling LPAs to leave. LPA Vanegas observed staff Israel taking out trash and requested staff Israel to call Licensee to come outside so LPA Vanegas could give Licensee a copy of the Title Regulations Section 80066(c). LPA Vanegas observed C1 walking out of the SFH with Licensee behind C1. C1 was upset cursing at LPA Vanegas. LPA Vanegas redirected C1 and told C LPA was at the SFH to speak to the Licensee. Licensee was unable to deescalate C1 and C1 began to try to begin a fight with LPA Vanegas and continued cursing. Licensee came in between LPA Vanegas to prevent C1 from hitting LPA Vanegas. Staff Israel also attempted to redirect C1. Eventually, C1 complied and went inside with staff Israel. Due to the escalated and violent behavior of C1, the LPAs discontinued the inspection and LPA Vanegas informed Licensee of the licensing requirements to provide facility records to CCL. LPM Smith called the Licensee and informed her that LPAs would not be returning to the facility on 10/8/2024, due to C1 being escalated and threatening LPAs. Licensee was advised by LPM Smith that the records needed to be brought to the office by close of business day on October 8, 2024. LPM Smith advised Licensee if the records were not provided, she would be issued a deficiency. Licensee advised that her vehicle was not charged, client remained escalated, and she was overwhelmed, so she was not going to provide the records until the informal conference on 10/11/24 and was going to accept the deficiency. Regional Manager discussed accountability, trauma informed care, placement assessments, staff training, client ratios, clients' lack of school attendance, therapeutic needs, client activities, increased law enforcement contacts, severity of incident reports submitted to the Department, active programming, Department of Children and Family Services involvement, and Licensee was reminded that the client's needs must be met and operational needs of the facility must be addressed on a continuous basis. RM Cook advised that the Licensee must be active and functioning in her role in order to ensure accountability for the general supervision of the licensed facility and ensure established policies concerning its operational needs are implemented daily. LPM Smith requested the following be submitted to Riverside North Regional Office (RNRO) by close of business on 10/14/24: A plan of action detailing how the licensee will provide appropriate care and supervision to clients in placement, how the facility is meeting the high-level needs of clients in care (including staffing ratios), how clients are being assessed for placement needs, how Licensee is actively functioning in her role to ensure accountability for operational needs of the SFH. Facility, staff, and client records are delivered to the RNRO. Copies of LIC 500 licensing forms from May 2024 to October 2024. Copy of staff timesheets from May 2024 to October 2024. Copy of staff sign in sheets from May 2024 to October A signed declaration that Licensee is residing in the facility seven days a week. A copy of this report, LIC 811, and appeal rights were provided to Licensee Arianna Sattiwhite.

met_with: Licensee-Arianna Sattiewhite


summary: Facility Evaluation

raw_content:
Narrative:
On January 31, 2025 a non-compliance Conference was held with Amor Small Family Home at the Riverside North Children's Residential Programs Office. To discuss current Community Care Licensing (CCL) Concerns. Present at the meeting was LaCresha Cook, Regional Manager (RM), Jennifer Smith, Licensing Program Manager(LPM), Linda Haynes, Licensing Program Analyst (LPA) and Arianna Sattiewhite Licensee. RM advised that the purpose of the Non-Compliance Conference is to review problem areas, address important issues regarding facility operations, and impress upon the Licensee the seriousness of the situation. The need for the Non-Compliance Conference arises from a series of licensing violations, issuance of civil penalties, informal meeting, conversations with the Licensee, and a lack of timely responses from the Licensee when LPA or LPM has attempted to make contact with Licensee, regarding facility operational concerns, and the department not receiving plan of corrections for cited deficiencies in a timely manner. RM expressed concerns regarding: Licensee's ability to correct deficiencies in a timely manner by agreed upon due dates, as Licensee requested multiple extensions to correct deficiencies stating conflicts with attending school. RM explained that while there are allowances for the Licensee to hire staff to assist, it does not allow for this to be a substitute for the Licensee's responsibilities. Lack of submission of a plan of correction detailing how the Licensee will provide appropriate care and supervision to clients in placement. RM explained that hired staff can assist in providing care, but the Licensee is required to meet all the requirements, including training, participation, and supervision, contained in the Small Family Home (SFH) Chapter 4 regulations. Facility accessibility for Licensing when arriving to the facility. RM explained that a SFH, as defined in the Health and Safety Code (HSC) 1502(a)(6), states that the home must be the residence of the Licensee. The Licensee has not been available on multiple occasions and extended periods of time giving the explanation of attending school in lieu of meeting facility operational needs and meeting with Licensing representatives. () How the facility will meet the needs of clients in care (including staffing ratios). RM mentioned that per the California Code of Regulations Title 22 subsection (CCR) 83064(a), states the Licensee is responsible for providing care to the children in the home. On multiple occasions the Licensee has not been at the facility when Licensing has arrived to the SFH. The Department has received credible information that the Licensee does not reside in the SFH. CCR § 83064(b) states the Licensee shall be regularly present in the home when children are in the home full time. How clients will be assessed for placement needs and services. RM discussed that the Licensee accepted clients with intense behavioral issues that required mental health services, behavior modification intervention, and therapeutic services that were not being assessed or provided while in placement at the SFH. RM discussed the possibility for the Licensee to seek the assistance of a consultant in reviewing and updating therapeutic elements of the program statement to meet the needs of clients that require a higher level of care and that can assist staff in working with this type of client population. How Licensee is actively functioning in her role to ensure accountability for operational needs of the SFH. Clarification of Licensee's administrative duties as CCR § 83017 (a)(2) states that an applicant for a SFH license shall be educated, trained, or experienced in providing family home care and supervision appropriate to the type of children to be served. Licensee, Arianna Satterwhite will acknowledge responsibility for all the issues discussed in the meeting of January 31, 2025, and other areas of concern referenced above. Licensee has been asked and agreed to provide the following documentation to Community Care Licensing by February 07, 2025: () The Licensee agrees to do the following to bring facility into compliance no later than February 7, 2025. A plan of action detailing clarification of Licensee's administrative duties. How Licensee will actively function in her role to ensure accountability for operational needs of the SFH. A signed declaration that Licensee is residing in the facility seven days a week. How the licensee will provide appropriate care and supervision to clients in placement, how the facility will meet the high-level needs of clients in care (including staffing ratios). How the Licensee will provide additional training's to include Trauma Informed Care for staff. How clients will be assessed for placement needs. The Licensee agrees to do the following to bring facility into compliance no later than March 14, The Licensee will attend an additional 16 hours of training to include: General Licensing Requirements (Chapter 1), Health and Safety Code, role of the Administrator and personnel and understanding the tasks required to manage a SFH, and Trauma Informed Care. Licensee will submit an addendum to facility's program statement for updates mentioned above. Licensee has been advised that failure to complete the above agreed upon actions by the dates will result in this Department taking the following action(s): The Licensee is being informed that unless deficiencies are corrected and continued compliance is maintained, the case will be referred to the Legal Division for administrative action. The RM advised that the Non-Compliance Conference may be the last step prior to initiating administrative action following unsuccessful attempts by the Licensing Program Analyst and Licensing Program Manager to gain compliance. RM informed the Licensee that the conference does not in any manner excuse past problems or resolve the Department's concerns with the Licensee if the problems are not corrected. () CCL will enhance the monitoring of the SFH by increasing the frequency of unannounced inspections. These inspections may include nights and weekends. If the Department determines that the Licensee has not submitted the requested plan of action documentation to remedy the Licensee's noncompliance by February 07, 2025, the Department, in its discretion, may refer the facility for revocation of the license or other appropriate administrative action. LPA Haynes explained and provided Licensee Arianna Sattiwhite a copy of the LIC 809 and appeal rights.

visit_type: Case Management

met_with: Arianna Sattiewite


summary: Facility Evaluation

raw_content:
Narrative:
On December 6, 2024, Licensing Program Analyst (LPA) Linda Haynes contacted Licensee Arianna Sattiewhite via cellphone to meet at the facility. Licensee stated that no one was available to meet LPA at the facility and no one would be available for two weeks. The purpose of the inspection was to conduct a follow up plan of correction (POC) inspection for deficiencies cited on November 15, 2024. On November 14, 2024, the facility was cited for Title Regulations, Section 80063(a) Accountability due to the licensee failing to submit the items agreed upon at the Informal Conference held on October 11, 2024. As of December 19, 2024, the licensee has not submitted a plan of correction regarding the accountability of the licensee for meeting client's needs and facility operational requirements. The facility is out of compliance. On December 6, 2024, Community Care Licensing received an email with a letter from Arianna Sattiewhite's Attorney Robert Hahn. The letter stated the licensee intends to close her facility effective January 2, 2024. The facility is being assessed a civil penalty due to the correction not being completed by the due date of 11/21/24. A daily civil penalty assessment will accrue for each failure of correction, until the facility is brought into compliance regarding the plan of correction. This report, appeal rights and LIC 421 were submitted via email to Licensee Arianna Sattiewhite's Attorney Robert Hahn for review and signature.

met_with: Robert Hahn


summary: Facility Evaluation

raw_content:
Narrative:
On April 11, 2025 at 11: AM, Licensing Program Analyst (LPA) Linda Haynes met with Amor Small Family Home (SFH) Licensee Arianna Sattiewhite to complete an annual / Post-Licensing inspection. The facility was toured both inside and out with the Licensee. Currently there are no clients in placement. The home is a one story building with four bedrooms and three bathrooms. The Client's bedrooms were arranged so that no more than one client is in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There was a smoke detector / carbon monoxide detector in every bedroom. The five smoke detectors / carbon monoxide detectors were checked, and they were working properly. The backyard where clients will have access to play is fenced. All required documents were posted. A program statement was available for review. LPA interviewed Licensee as part of the inspection. There were no deficiencies found at this time. An exit interview was conducted and a copy of this report and appeal rights was given to Licensee Arianna Sattiewhite.


summary: Facility Evaluation

raw_content:
Narrative:
On April 15, 2025 at 10: AM, Licensing Program Analyst (LPA) Linda Haynes met with Amor Small Family Home (SFH) Licensee Arianna Sattiewhite for the purpose of conducting a case management inspection. During the review of an incident that occurred on October 5, 2024, information gathered revealed health and safety concerns. LPA interviewed Licensee, Clients 1, 2, and 3 (C1, C2, C3) Staff 1 (S1). A review of facility records, special incident reports, client files and county investigation reports were also conducted. Information was obtained that on October 5, 2024, at approximately 11: PM S1 found C1 handcuffed with pants and underwear down on the front porch. S1 was the only staff at the facility supervising clients; the licensee was not present. Confidential interviews revealed that S1 was in the facility when C1, C2, C3 stepped out onto the front porch. Confidential interviews and records further revealed that S1 found C1 outside on the front porch handcuffed with their pants and underwear pulled down. S1 brought C1 back into the home and called the police. Confidential interviews, special incident reports and county investigation reports confirmed that C3 had a history of inappropriate interactions with C1 including inappropriate touching, pulling down C1's pants and bullying C1, therefore the facility was aware that increased supervision was needed. Confidential interviews also confirmed that clients smoked outside the SFH on facility grounds on an ongoing basis. Based on confidential interviews and record review the preponderance of evidence standard has been met. () The facility is being cited for violation of Title 22, Division 6, Chapter Section 83072(d)(1) Personal Rights and Buildings and Grounds Section 83087(d). A copy of this report, LIC 811, and appeal rights were given to Licensee Arianna Sattiewhite.

met_with: Arrianna Sattiewhite


summary: Facility Evaluation

raw_content:
Narrative:
On October 2, 2024, at 2:00PM, Licensing Program Analyst (LPA) Adaleyci Caballero met with Amor Small Family Home (SFH) for the purpose of conducting a case management inspection regarding an incident that occurred on 10/2/24. During LPA's inspection at the Small Family Home (SFH), LPA discovered that there were three clients (C1-C3) in care supervised by a minor staff #1(S1). There were no other staff present. Clients were escalated and were not allowing LPA entry into the facility. S1 was unable to de-escalate clients (C1-C3). LPA asked S1 to contact Licensee Arianna Sattiewhite but S1 was unable to reach licensee. S1 contacted Law Enforcement due to clients escalated behaviors and property destruction. S1 requested S1 to call another staff to assist S1 and S1 was able to reach Facility Director Cynthia Alvarez. Cynthia Alvarez arrived at the (SFH) at 11:35AM. According to interviews, S1 was alone with (C1-C3) from 6AM to 11:35AM until LPA requested an adult to be present at the facility. Licensee Arianna Sattiewhite did not respond and was unreachable by S1, Facility Director Cynthia Alvarez, and (LPA) from the initial site inspection at 11:00AM to the time of the delivery of this report. Law Enforcement officer J. Garcia gave LPA the police report number. LPA took photographic evidence of the destroyed property. Additionally, LPA requested copies of SFH's Personnel Report (LIC 500) and document was not available to LPA at time of request. Based on confidential interviews and observations, the facility is being cited for General Licensing Requirements 80078 (a) Responsibility for Providing Care and Supervision which poses an immediate Health, Safety, and Personal Rights risk to clients in care and 80066(e) Personnel Records which poses a potential Health, Safety, and Personal Rights risk to clients in care. An exit interview was conducted and appeal rights were reviewed with Facility Director Cynthia Alvarez. A copy of this report, LIC 811, 809D, and appeal rights were provided to Cynthia Alvarez.

met_with: Facility Director-Cynthia Alvarez


summary: Facility Evaluation

raw_content:
Narrative:
On November 15, 2024, at 4:00PM, Licensing Program Analyst (LPA) Adaleyci Caballero and Licensing Program Manager (LPM) Jennifer Smith met with Amor Small Family Home (SFH) Licensee Arianna Sattiewhite via Microsoft Teams Meetings for the purpose of conducting a case management inspection regarding incidents that occurred between October 2, 2024, and October 15, 2024, during inspections at the SFH. On October 2, 2024, during LPA's inspection at the Small Family Home (SFH), LPA discovered that there were three clients (C1-C3) in care supervised by a minor staff #1(S1). There were no other staff present. Clients were escalated and were not allowing LPA entry into the facility. S1 was unable to de-escalate clients (C1-C3). Law enforcement arrived at the scene due to clients being involved in property damage and physical interactions between them. On October 11, 2024, Licensee confirmed that S1 was hired by the SFH. On October 8, 2024, Licensing Program Analysts (LPAs) Adaleyci Caballero and Rachel Vanegas arrived at the SFH to conduct a safety inspection regarding an incident that occurred on or around 10/03/24. LPAs disclosed the purpose of the visit and were granted entry into the SFH by staff Brianna Israel. During the inspection, LPA A. Caballero requested staff records from licensee. Licensee stated that the printer did not have black ink and sent staff Israel to purchase ink. In the meantime, staff Israel returned from the drug store and began to assist licensee to make copies of records. Licensee was cooperating with LPAs in getting copies of the records, but after licensee spoke with her attorney; licensee stated that she did not have to provide copies of records to CCL per her attorney. Lpa a. Caballero advised licensee that CCL has inspection authority per Title Regulations Personnel Records. Licensee was advised by Licensing Program Manager (LPM) Jennifer Smith that the records needed to be brought to the office by close of business day on October 8, 2024. LPM Smith advised Licensee if the records were not provided, she would be issued a deficiency. Staff records were not taken to CCL on October 8, 2024. On October 11, 2024, Licensee informed CCL that her vehicle was not charged, a client remained escalated at the SFH, and she was overwhelmed, so she was not going to provide the records until the scheduled informal conference on October 11, 2024. Licensee indicated that she was going to accept the deficiency. During LPAs October 8, 2024, inspection, LPAs observed a staff enter the facility and hand paperwork to licensee. Licensee confirmed that staff Dashawna Johnson had worked a couple of shifts at the SFH without being associated to the SFH. On October 11, 2024, an informal conference was held with Amor Small Family Home (SFH) at the Riverside North Children's Residential Program Office (RNCRPO) to discuss several health and safety concerns observed by LPAs Adaleyci Caballero and Rachel Vanegas during the various safety inspections. One of the concerns addressed in the informal conference was accountability to ensure that the operation of the SFH complies with applicable regulations and statutes. Licensee agreed to submit the following by close of business day on October 14, 2024: A plan of action detailing how the licensee will provide appropriate care and supervision to clients in placement; how the facility is meeting the high-level needs of clients in care (including staffing ratios); how clients are being assessed for placement needs; and how Licensee is actively functioning in her role to ensure accountability for operational needs of the SFH. In addition, the Licensee was instructed to deliver the facility, staff, and client records to the RNCRPO, copies of LIC 500 licensing forms and staff time sheets from May 2024 to October 2024 and a signed declaration that licensee is residing in the facility seven days a week. On October 14, 2024, LPA Caballero received a telephone call from licensee stating that she needed an extension for the items that were requested at the informal conference. Licensee indicated that she needed another day, in which an extension was granted for October 15, 2024, at 1:00PM. On October 15, 2024, at 1:18PM, LPA Caballero received a voicemail and text message from Licensee requesting another extension for the items that were requested at the informal conference on October 11, 2024. Licensee stated that she was unable to bring in the items to the RCRPO due to highway 215 road closures. Licensee stated she was able to bring the items on Wednesday, October 16, 2024. LPA received another text message from licensee on October 15, 2024, at 3:52PM stating that she was unable to bring the items to the office but could have them emailed to LPA. LPA responded to the text message on Wednesday, October 16, 2024, at 8:46AM asking licensee if licensee was saying that she could not bring the requested items on Wednesday, October 16, 2024. On October 15, 2024, Licensing Program Analyst (LPA) Rachel Vanegas arrived at the SFH to conduct a safety inspection regarding an incident that occurred on or around 10/09/24. LPA Vanegas requested needs and services plans, placement agreements, incident reports, and other pertinent documents but licensee stated she was not able to print out documentation because licensee had an appointment at 2:15PM and licensee was overwhelmed because "this was all too much." Licensee stated she would just take the citation for not providing facility records and send the documents to LPA Caballero in 48 hours. Based on observations, the facility is being cited for General Licensing Requirements Title Regulations 80063(a) Accountability, 80066(c) Personnel Records, 80070(d) Client Records, 80065(d)(1)(2) Personnel Requirements and 80019(e)(3) Criminal Record Clearance. Civil Penalties are also being assessed for criminal record clearance. An exit interview was conducted and a copy of this report, LIC 811, LIC809D, LIC421BG, and appeal rights were provided to Licensee Arianna Sattiewhite via email. Signed copies of reports will be placed in the facility file.

met_with: Licensee-Arianna Sattwhite


facility_name: ANGEL GABRIEL'S CARE HOME

summary: Facility Evaluation

raw_content:
Narrative:
On December 10, Licensing Program Analyst (LPA) Stephannie Verna arrived at the above facility for the purpose of conducing a required/annual inspection of the facility. LPA met with Marie Yadao, Administrator and Licensee and completed the required/annual inspection of the facility. The facility is a Small Family Home, consisting of five bedrooms and two bathrooms. There are a total of four clients, one non-ambulatory client. Two out of four clients share a bedroom, and are compatible to do so. There are a total of three live-in staff, including the two licensees, and one Direct Care Staff. During the course of the inspection, LPA reviewed four client files and nine staff files, and observed all required documentation was present and filed. Interviews were conducted with one client, three out of four clients in care are non-verbal and an interview was unable to be completed. Interviews were conducted with four staff. The facility was observed to be clean, organized, and free of debris and clutter. The home contained a living room, a kitchen, dining room, and multi-media/activity room. The dining room and multi-media room had a table for the clients to sit and eat, and complete activities and homework. The client bedrooms were observed to contain an individual bed, clean linens, and storage space for client property. The facility license, facility sketch, emergency plan, emergency telephone numbers, and fire clearance were observed to be posted in a prominent place. The fire extinguisher was observed to be in a prominent location and was charged, up-to-date and was last serviced in the last year. There was a hall closet with extra blankets and linens. There was a hall closet with client activities, games, and craft items. The refrigerator and freezer and pantry held enough perishable and nonperishable food in the home in a quantity to meet the needs of the next three meals and the between meal snacks. Client medication was observed to be locked, kept separate per each client, and medication administration documentation was in compliance with CCL regulations. A complete first aid kit was observed and inventoried. The garage also contained extra food storage in the freezer and refrigerator. The garage also stored storage items, and activities. The front and backyards were observed to be well-maintained and free of debris and hazards. The backyard contained a gazebo, a table and chairs, a garden, play area, and a basketball hoop. The facility smoke and carbon monoxide detectors are present and were tested and are in working condition. The water temperature of the facility was tested at multiple sources, including two client bathroom sinks, and the kitchen sink, and was observed to measure at 128 degrees F. The licensee stated they had a new water heater installed recently and LPA observed the setting on the water heater was set to Low. The licensee stated that they will ensure the temperature is lowered and until then will purchase a thermometer to test the water temperature prior to clients bathing or showering. The facility is out of compliance with 80088(e)(1). The facility is being cited for deficiencies of California Code of Regulations, Title 22, Chapter 1, section 80088(e)(1), which poses a potential. health, safety or personal rights risk to persons in care. See 809-D for citation and Plan of Correction information. An exit interview was conducted with Marie Yadao, Administrator. A copy of this report, and appeal rights, were reviewed and provided to Marie Yadao, Administrator.

met_with: Marie Yadao, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 12/01/22, at 10: AM, Licensing Program Analyst (LPA), Uchenna Ajaero, met with the License Marie Yadao to conduct an unannounced Annual/ Required inspection of a single story facility. This facility is a Small Family Home. It consists of five bedrooms and two bathrooms. There are a total of four clients, one non-ambulatory client who was home, two clients share a bedroom and one female client who has a room to herself. There are a total of three live-in staff. These are the two licensees, and one Direct Care Staff. At 10:50 am, we started a walk through of the facility for the inspection. The facility was observed to be clean, organized, and free of debris and clutter. The home contained a living room, a kitchen, dining room, and multi-media/activity room. The dining room and multi-media room had a table for the clients to sit and eat, and complete activities and homework. The clients bedrooms were observed to be bright, contain an individual bed, clean linens, clothes were organized in the closet and there were multiple storage space for client property. It was observed that several documents were posted on the board for easy access. The facility license, facility sketch, emergency plan, emergency telephone numbers, and fire clearance were observed to be posted in a prominent place. The fire extinguisher was observed to be charged and up-to-date and was last serviced in the last year. In the hallway were two closets. One contained extra blankets and linens. The other one contained client activities, games, books and craft items. The refrigerator and freezer had enough food to last more than 2 days. The pantry held enough nonperishable food that will last more than 5 days. There were varieties of snacks in the home. During the course of the inspection, LPA reviewed four client files, and observed all required documentation was present and filed. The facility did not have the current Personal Rights poster and LPA Ajaero provided them with the current copy. Interviews were not conducted with three clients because, these clients are non-verbal. There was one verbal client and he was interviewed. Interviews were conducted with three staff. Clients medications were observed to be locked. The garage contained extra food storage in the freezer and refrigerator. There were labeled boxes for office items and activities. The front and backyards were observed to be clean and well-maintained and free of debris and hazards. The backyard contained a large table with chairs, a small side garden, an open play area, and a basketball hoop. There was a locked shed at the back and it contained decorations for several seasons. The facility smoke and carbon monoxide detectors are present and were tested by the staff. LPA observed that they were in working condition. The water temperature of the facility was tested at multiple sources, including two client bathroom sinks, and the kitchen sink, and was observed to measure at 111 degrees F. An exit interview was conducted with Marie Yadao, Administrator. A copy of this report, and appeal rights, were reviewed and provided to Marie Yadao, Administrator.

met_with: Marie Yadao, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On December 2, 2022, Licensing Program Analyst (LPA) Uchenna Ajaero arrived at the above facility and met with Marie Yadao, the Licensee for the purpose of continuing the required unannounced annual inspection. LPA Ajaero completed the Personnel Review of all staff working at this facility both full time and part time staff. LPA compared them to the list of staff on Guardian who are associated with this facility and who are cleared and eligible to work in the facility and there were no discrepancies. LPA Ajaero completed the LIC 859 file review for 4 staff members ensuring their documents were up to date and in compliance. LPA Ajaero Reviewed the medications of all the youths at this facility. LPA completed the annual inspection on today's date. Licensing Program Analyst, (LPA) Uchenna Ajaero completed an exit interview. No Title 22 citations were issued during this 2 day inspection. A copy of this report, has been provided to Marie Yadao, Licensee.


summary: Facility Evaluation

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Narrative:
On 11/08/23, at 09: AM, Licensing Program Analysts, (LPA) Connie Goldie and LPA Monica Roberts made an unannounced visit to conduct an Annual/Required inspection. LPAs were greeted at the door by Assistant Administrator Ludy Valdez (S2) who contacted Administrator Marie Yadao who arrived shortly after. One youth was home at the time of arrival. Administrator (A) assisted LPAs with the inspection. S2 stated the 4 clients are due home between 2: PM and 4: PM. At 10: AM, LPAs conducted a physical plant tour. At the front door entry, LPAs observed a copy of license, personal rights poster and fire clearance permit. LPAs observed two fire extinguishers in the home that were in compliance with pins. LPAs proceeded through living room and formal dining area. LPAs had clear access, furniture was in excellent condition and LPAs observed adequate seating for all staff and clients. In the hallway, LPAs observed activity closet, spare linen closet, individual daily schedules including meal times for each youth. The home was a comfortable 70 degrees. The home has a functioning washer and dryer that was purchased this year. Secured cabinetry above washer and dryer included chemicals. There is one dual shared bedroom and two individual bedrooms for the youth. Bedrooms were observed to have organized closets and proper bedding, good lighting and an overall clean appearance. There are two bathrooms, which have trash cans with lids, and the water temperatures recorded at 106 degrees, within compliant range of 105-120 degrees. Soap and paper products were readily available. Kitchen had a fully stocked pantry labeled with expiration dates, refrigerator and freezer with at least 2 days of perishables and 5 days of non- perishables. Emergency disaster kit with flashlight, walkie talkies and emergency food was present. First aid kit is complete. Medications and sharps were locked. All cabinets and appliances were in good working condition. P&I is secured in kitchen cabinet. Additional room off of formal dining contained double locked staff/client files, emergency disaster plan, staff schedules, incident report requirement postings and a youth corner with toys and stuffed animals. The back yard contained a locked shed with holiday decor, a basketball hoop, a dining table and chairs and vegetable garden. (Continued on LIC809-C) LPAs observed a fence board with exposed nails, a bed frame against the fence and an unsecured base to the basketball hoop which may pose a safety risk. Administrator addressed these concerns immediately. Upon trying to enter the garage, the exit door was partially blocked by objects in storage. This is a potential safety risk. Administrator immediately cleared the door for full operation. A generator and extra storage cabinets holding food and briefs were present. Hot water heater was functioning. Smoke detectors and carbon monoxide detectors were tested and found to be in working order. LPA's observed one youth in his bedroom, and were granted permission by youth to enter. Facility van had no inside or outside damage, insurance and registration are both current, first aid kit, spare tire and fire extinguisher were present. The ramp to aid non-ambulatory youth is in working order. The van has working seat belts and is overall clean. Care tool domains completed during todays inspection include: Physical Plant, Operations, Staffing, and Client Records. LPA Goldie also interviewed three staff members. During inspection, two Type B Title 22 deficiencies were observed. See 809-D. Additionally, two technical violations and one technical assistance will be issued. These are not deficiencies. LPA will return to complete annual on a subsequent visit. Exit interview was conducted at 4: PM with Ms. Yadao. A copy of this report along with appeal rights were discussed and provided.

met_with: Administrator Marie Yadao


summary: Facility Evaluation

raw_content:
Narrative:
On 11/14/2023, at PM, Licensing Program Analyst, (LPA) Connie Goldie met with Program Administrator (PA) Marie Yadao to continue unannounced/required Annual inspection. PA stated that four staff and three clients are currently in the facility. One client is still at school. Care Tool domain Special Health Care Needs was completed during today's inspection. LPA Goldie conducted four youth interviews, C1, C2, NMD1 and NMD2. LPA observed no deficiencies during today's inspection. Annual inspection has been completed. LPA conducted exit interview with Ms.Yadao at 04: PM. A copy of this report along with appeal rights was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 12/16/2024, at 10: AM, Licensing Program Analyst, (LPA) Connie Goldie made an unannounced visit to conduct an Annual/Required inspection. LPA was greeted at the door by Direct Support Professional Editha Baybayan (S1) who contacted Administrator Marie Yadao who arrived shortly after. One youth was home at the time of arrival. Administrator (A) assisted LPA with the inspection. Administrator stated the 4 clients are due home early today as it is a early out day for school. At 10: AM, LPA conducted a physical plant tour. At the front door entry, LPA observed a copy of license, personal rights poster and fire clearance permit. LPA observed two fire extinguishers in the home that were in compliance. LPA proceeded through living room and formal dining area with adequate seating for all staff and clients. In the hallway, LPA observed an activity closet and a linen closet. The home was a comfortable 71 degrees. In the laundry room,.secured cabinetry is located above washer and dryer which stores chemicals. There is one dual shared bedroom and two individual bedrooms for the youth. Bedrooms were observed to have organized closets and proper bedding, good lighting and an overall clean appearance. There are two bathrooms, which have trash cans with lids, and the water temperatures recorded at 107.9 degrees, within compliant range of 105-120 degrees. Soap and paper products were readily available. Kitchen had at least 2 days of perishables and 5 days of non- perishables and a menu is posted. Emergency disaster kit with flashlight, walkie talkies and emergency food was present. First aid kit is complete. Medications and sharps were secured as required. P& I is secured in a kitchen cabinet. Additional room off of formal dining contained double locked staff/client files, emergency disaster plan, staff schedules, incident report requirement postings and a youth corner with toys and stuffed animals. The back yard contained a locked shed with holiday decor, a basketball hoop and a dining table and chairs. LPA observed van to have tires with appropriate tread, working headlights, turn indicators and seat belts. Continued on LIC809C Smoke/carbon-monoxide detector tested and compliant. Care tool domains completed during today's inspection include: Physical Plant, Operations, Staffing, and Special Health Care Needs. LPA Goldie interviewed five staff members and one client. No deficiencies were cited during today's inspection. LPA will return to complete Annual inspection on a later date. Exit interview conducted at 3: PM and reports were discussed and provided to facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 12/19/2024, at 11: AM, Licensing Program Analyst, (LPA) Connie Goldie met with Program Administrator (PA) Marie Yadao to continue unannounced/required Annual inspection. PA stated that two staff and one client are currently in the facility. Three clients are at school. Care Tool domain client records was completed during today's inspection. During inspection, one Type B Title 22 deficiency was observed. See LIC809-D. One technical violation was issued. This is not a deficiency. Annual inspection has been completed upon receiving plan of corrections. LPA conducted exit interview with Ms.Yadao at 2: PM. A copy of this report along with appeal rights was left at the facility.


summary: Facility Evaluation - 1 deficiency

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Narrative:
On 09/12/2024, at 10: AM, Licensing Program Analysts, (LPAs) Connie Goldie, Elena Gonzalez-Soto and Jean Stidman made an unannounced case management inspection. Three staff are present and one client. Marie Yadao, Administrator assisted with the inspection. LPA's conducted a walk through of the three bedroom, 2 bath home inside and outside. The tour began in the family room. LPA's observed confidential information, Client registrar and Staff Guardian information, on the bulletin board in a public viewing area. LPA Stidman requested these documents be relocated to the office to protect client and staff confidentiality. LPA's observed a live-in staff bedroom and administrator bedroom. We went to the backyard and observed a shed with holiday decor secured. Behind the shed is a gate. Both side yards were free of debris. LPA's observed kitchen to have adequate perishables and non-perishables. LPA's observed dining area and living room to have adequate seating and lighting. LPA's observed one dual bedroom with appropriate furniture. Bathroom number one was observed to have a hole created by door handle. LPA suggested placing a plate to cover the hole and safeguard the wall. LPA observed laundry area cabinets to be unsecured and to have bleach accessible. LPAs observed bedroom number two to have appropriate linens and furniture in place. LPA's observed hanging cords/extension cord next to dresser in bedroom three that poses a safety hazard. Ms. Yadao stated the lamp would be relocated to remedy this safety issue. Three staff interviews were conducted. A record review of LIC622 forms was conducted. LPAs observed 3 of 4 residents (C1, C2, C3 ) missing centrally stored forms for September 2024 and 1 resident (C4) was missing July, August and September 2024. The facility was cited for four Title 22, Division 6, Chapter 1, Article 6 regulations; Buildings and Grounds 80087(a) and 80087(g) and Client Records 80070(c) and 80075(b)(10). Please see LIC 809-D for the deficiencies. An exit interview was conducted with the above administrator and a plan of correction was completed. A copy of this report and Appeal Rights were given during the inspection.

Deficiencies:
80075: (10) Record of current medications..and instructions, if any, regarding control and custody of medications.

title: (b)Each record must contain information including, but not limited to, the following


facility_name: ANGELS HAVEN

summary: Facility Evaluation

raw_content:
Narrative:
On 06/03/2021 at 10:15 am, Licensing Program Analyst (LPA) M. Lopez conducted an unannounced annual required Inspection. LPA met with co-licensee/Administrator Arturo Lopez who led the tour of Angels Haven Small Family Home(SFH). LPA inspected the facility interior and exterior. There were two clients one female and one male residing at this facility three guardianship children reside in the home. The home is a six-bedroom and a four and half-bathroom home, and it is set up as follows: • Bedroom 1 had 2 twin-size bed and sleeps two guardianship children. • Bedroom 2 had 2 twin- size bed and sleeps one client and one vacancy. • Bedroom 3 had 1 twin-size bed and a modified crib. It sleeps one client and one guardianship child • Bedroom 4 was the licensee master bedroom and sleeps licensee and spouse (co-licensee). • Bedroom 5 was the licensee's biological son's room and sleeps one biological son. • Bedroom 6 was the staff room with 3 single beds. . Bedrooms are arranged so that no more than two children share a room and each bedroom includes adequate drawers and closet space for two children's belongings. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. All hazardous items have been properly made inaccessible and locked in laundry room where children will not have access. Medications were locked in the medication closet. Cleansers/chemicals were stored in a locked laundry room. Sharp knives were inaccessible and stored in a locked cabinet in the kitchen above the oven. The first aid kit was accessible and had all the required items. Facility has non-perishable foods for more than one week and perishable food for more than two days. There were no guns or weapons as stated by the administrator at this time. Water temperature was tested and was safe at 113. Smoke detectors in all rooms were tested and operable. Proper storage of all food was noted. Trash cans for storage of solid waste had tight fitting lids. The Emergency Disaster Plan, Facility Sketch and Title Personal Rights were posted at this time. The backyard was fenced with a wrought iron self-closing fence surrounding the pool. The access gate swings away from the body of water. The height of the wrought iron fence is 60", spacing horizontal bars is 56" apart, and it's 2" from the ground on hard surface. The pool was in compliance with the title Regulations. Two client files were reviewed including the Medication Administration Record (See Confidential Name List- LIC 811 dated on June 06, 2021). Two staff files were reviewed and facility personnel meet staff qualification and training requirements. Licensee's and staff's CPR and First Aid card were current and will expire in 2022 and 2023. Children and staff records are organized. All staff have received criminal record and child abuse index check clearances. There is no deficiency observed during today's visit. The home is in compliance with Title Regulation. An exit interview was conducted and this report was reviewed with co-licensee/Administrator Arturo Lopez and a copy of this report was provided.

met_with: Arturo Lopez


summary: Facility Evaluation

raw_content:
Narrative:
On July 25, 2022 at 11:30AM, Licensing Program Analyst (LPA) Carol Anderson made an unannounced visit to the facility for an annual/required visit. LPA met with Licensees Christine French and Arturo Lopez, who accompanied LPA on a tour of facility. LPA inspected the facility interior and exterior. There are three clients residing at this facility. Also, two guardianship children residing at the facility. One staff was interviewed. Clients are unavailable to be interviewed. LPA reviewed client records, staff files, clients' medication log, current disaster plan, client roster, first aid kit and smoke alarms were checked and operable. The water temperature reading at 106. There is a sufficient amount of perishable, nonperishable foods and snacks available. There is a sufficient amount of Jevity Enteral and Peptamen formula for clients. Menu was posted. Area evaluated were kitchen sharp items and knives are kept in a locked cabinet in the kitchen above the oven. The cleaning supplies and toxic were stored are locked in the laundry room. The bedroom had adequate storage for clothing. Medications are locked in a closet near the living room. Age appropriate games and activities are available for clients and Personal Rights are posted. Licensee Arturo Lopez stated there are no weapons or firearms in the facility. LPA observed in the pool area, a 5ft. 2 inches wrought iron fence that surrounds the entire pool area, the access gate swings away from the body of water, a self- closing and self- latching device closed on its own. Based on observations made during the inspection, no deficiencies observed during today's visit. An exit interview was conducted, a copy of this report was given to Licensee Arturo Lopez.

met_with: Christine French


summary: Facility Evaluation

raw_content:
Narrative:
On July 21, 2023, at 10:41AM, Licensing Program Analyst (LPA) Carol Anderson arrived at the facility to conduct an annual/required visit. LPA met with Licensees Christine French and Arturo Lopez. The facility is licensed for 4 clients. There are currently three regional center clients, and one guardianship client currently residing at the facility. LPA interviewed one client and two staff. LPA attempted to interview two clients, but clients were not able to verbally communicate with LPA. LPA reviewed three clients and three staff files and they had the necessary forms. LPA inspected the facility interior and exterior. The current disaster plan, client roster, first aid kit and smoke alarms were checked and operable. The water temperature reading at 115. There is a sufficient amount of perishable, nonperishable foods and snacks available. There is a sufficient amount of Jevity Enteral and Peptamen formula for clients. The kitchen sharp items and knives are kept in a locked cabinet in the kitchen above the oven. The cleaning supplies and toxic were stored are locked in the laundry room. The bedroom had adequate storage for clothing. Medications are locked in a closet near the living room. Age-appropriate games and activities are available for clients. The following documents are posted in the facility: facility license, facility sketch, menu and personal rights. A review of Guardian on June 21,2023 indicates that all facility staff associated to the facility had DOJ, FBI, and Child Abuse index check clearances. The following documents are posted in the facility: facility license, facility sketch, menu and personal rights. Licensee Arturo Lopez stated there are no weapons or firearms in the facility. LPA observed in the pool area, a 5ft. 2 inches wrought iron fence that surrounds the entire pool area, the access gate swings away from the body of water, a self- closing and self- latching device closed on its own. Based on observations made during the inspection, no deficiencies observed during today's visit. An exit interview was conducted, a copy of this report was given to Licensee Arturo Lopez.


summary: Facility Evaluation

raw_content:
Narrative:
On July 10, 2024, at 10:06AM, Licensing Program Analyst (LPA) Carol Anderson made an unannounced annual/required visit. LPA met with Licensees Christine French and Arturo Lopez. There are currently three clients, and one guardianship client currently residing at the facility. There is a room for staff to stay overnight if needed. Licensees French and Lopez's adult son live at the facility. LPA interviewed one staff. LPA attempted to interview two clients, but clients were not able to verbally communicate with LPA. LPA reviewed three clients and three staff files, and they had the necessary forms in the file. LPA inspected the facility interior and exterior. The current disaster plan, client roster, first aid kit, and smoke alarms were checked and operable. The hot water temperature reading at 105 degrees. The facility has perishable and non-perishable food supplies, and snacks available. There are adequate supplies of Katefarms Pediatric and Peptamen nutrition formulas for clients that are feed to G-Tube. The kitchen sharp items and knives are kept in a locked cabinet in the kitchen above the oven. LPA observed the cleaning supplies and toxic were stored are locked in the laundry room. LPA observed the clients' bedroom had adequate storage for clothing. LPA observed medications are locked in a closet near the living room. Age-appropriate games and activities are available for clients. The following documents are posted in the facility: facility license, facility sketch, menu, and personal rights. A review of Guardian on July 10, 2024, indicates that all facility staff associated to the facility had DOJ, FBI, and Child Abuse index check clearances. Licensee Arturo Lopez stated there are no weapons or firearms in the facility. LPA observed in the pool area, a 5ft. 2 inches wrought iron fence that surrounds the entire pool area, the access gate swings away from the body of water, a self- closing and self- latching device. Based on observations made during the inspection, no deficiencies observed during today's visit. An exit interview was conducted, a copy of this report was given to Licensee Arturo Lopez.

met_with: Christine French,Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On June 27, 2025 at 12: PM, Licensing Program Analyst (LPA) Lucero Jauregui conducted an unannounced annual required Inspection. LPA met with Christine French, Administrator who provided LPA with an indoor and outdoor tour of the facility. The home is a six-bedroom and a four and half-bathroom, with living room, dinning room, kitchen, and medication closet. Two bedrooms are for client use. Bedrooms are arranged so that no more than two children share a room and each bedroom includes adequate drawers and closet space for children's belongings. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. Water temperature was tested in the client bathroom to be at 105. All hazardous items have been properly made inaccessible and locked in laundry room where children will not have access. Medications were locked in the medication closet. The first aid kit was accessible and had all the required items. Cleansers/chemicals were stored in a locked laundry room. Sharp knives were inaccessible and stored in a locked cabinet in the kitchen. There are adequate supplies of Katefarms Pediatric and Peptamen nutrition formulas for clients that are feed to G-Tube. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris and observable hazards. All facility smoke detectors and carbon monoxide detectors are in appropriate working order; fire extinguisher are properly charged and serviced. Continued.... Facility has a pool which is appropriately fenced and secured with a wrought iron fence. The enclosure was measured to be 5 feet with a self-latching gate that swings outward. Per facility administrator there are no firearms in the home. LPA observed the following items posted: Grievance Procedures, Emergency Disaster, Facility Sketch, Personal Rights, Rights of Individual with Developmental Disabilities, COVID guidelines and Facility License. LPA reviewed five out of five staff files and three out of three client files. LPA conducted one staff interview. LPA was unable to interview three clients due to their limited verbal abilities. Based on today's inspection there are no deficiencies cited at this time. An exit interview was conducted and a copy of this signed report was provided to Christine French, Administrator.

met_with: Christine French, Administrator


facility_name: ANGIE'S SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On August 20, 2025, at 09:20 a.m., a Component II orientation was conducted at the Monterey Park Children's Residential Program Regional Office with Angie's Small Family Home's (SFH's) applicant Angela Silva. Present for the Department were Licensing Program Analysts (LPAs) Brent Lockhart, Amber Hunter, John Bonilla, and Licensing Program Manager (LPM) Jean Herring. The purpose of the meeting was to review and discuss the facility's Application Instructions for a Facility License (LIC281) submission. LPAs and LPM went over Section A Licensing Forms and Section B Supportive Documents of the Licensee's application that were missing forms, needed corrections and /or revisions. LPA Bonilla instructed Licensee to make corrections and/or revisions to the appropriate sections of the application (Sections A and B) and then resubmit to LPA via email on or before September 5, 2025. LPA Bonilla advised the applicant that all documents including Section B revisions will be reviewed by LPM Jean Herring. Exit interview conducted. Meeting adjourned.

met_with: Angela Silva, Applicant


summary: Facility Evaluation

raw_content:
Narrative:
On December 11, 2025, at 11:00 a.m., Licensing Program Analysts (LPAs) John Bonilla and Ashley Ruacho conducted a pre-licensing inspection at Angie's Small Family Home (SFH). LPAs met with Licensee Angie Silva and Damon Farmar, who provided a tour of the facility. Physical Plant This facility is located in a quiet residential community. The facility consists of four (4) bedrooms, 3 restrooms (two for client use and an additional in master bedroom for licensee), an office, living room, kitchen with dining area and den attached, a locked laundry room which has a doorway to the garage, and a backyard. The facility's backyard is a grassy area with high fencing in good repair. Overall, the facility is clean, sanitary and in good condition. Passageways are free from obstruction. Fixtures, Furniture, Equipment, and Supplies The home has toilets and wash basins for clients' use. Client bedrooms were observed to be clean, orderly, and contained twin beds. LPAs observed clean pillows, bed sheets and blankets. The clients' bedroom has adequate closet and drawer space to accommodate the clients' clothing and personal belongings. Continued next page... Heath Related Services and Record Keeping The first aid kit will be centrally stored in the den area in a locked cabinet. The kit contains all required supplies. The client and staff files will be in a locked file cabinet located in the Licensee's Office. The medication will also be stored in a locked individual container located in the Office. Prior to being licensed the following are still pending: -Facility shall post LIC610C in an accessible location. -Facility shall post a weekly menu for clients. -Facility shall have a grievance box available for clients. A Component III orientation will be scheduled for December 23, 2025. LPAs will conduct a final review once the requested documents are submitted. Once manager approval and all requirements are met, a new license will be mailed to SFH upon approval. An exit interview was conducted. Signed copies of LIC809 and LIC809-C were provided to applicants.

met_with: Angie Silva, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On December 23, 2025 at 2:00 p.m., Licensing Program Analyst (LPA) John Bonilla conducted a virtual Component III meeting via Teams. Present at the meeting was Angela Silva, applicant/licensee. The purpose of the Component III meeting is to familiarize the applicant with general Small Family Homes Rules and Regulations, prepare the applicant to maintain and operate the facility, provide information to avoid potential problem areas during operation, provide clear description of LPA's role in operation of facility, and provide clear description of Civil Penalties. During the meeting, continuing requirements for Small Family Homes were also discussed. LPA Bonilla conducted the Component III PowerPoint presentation. A copy of the Small Family Home Component III Presentation Materials was provided to the applicant. Applicant was informed that the home would be licensed, pending final review, supervisor approval and all requirements being met. An exit interview was conducted, and a copy of this report was emailed to the applicant for signature.

met_with: Angela Silva, Apllicant/Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On February 2, 2026, at 4:00 p.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management- Other inspection at Angie's Small Family Home. The purpose of the inspection was to deliver the Licensee their new LIC203A State License. LPA met with Angie Silva, Licensee. Exit interview conducted. No deficiencies cited. A signed copy of this report was provided to Ms. Silva.