summary: Facility Evaluation

raw_content:
Narrative:
On June 29, 2023, at 10: AM Licensing Program Analyst (LPA) Babatunde Aborchie began a Pre-Licensing inspection for a Small Family Home license. LPA met with applicants Akua Birago and Kwame Appiah led a tour of the home. The facility was toured both inside and out with the applicants. Applicants are applying for a capacity of 4 ambulatory clients. The home consists of: Downstairs: Bedroom #1, It was furnished with a full bed and a crib. It will sleep two residents - vacant. There were also a family room, a living room, formal dining area, a kitchen, a storage and one bathroom. Upstairs: Bedroom #2, The room consisted of a queen bed. It sleeps biological daughter, aged 19 years. Bedroom #3, The room was furnished with a queen bed. It sleeps biological son aged 20 years. Bedroom #4, The room was furnished with a twin bed and a toddler bed. It will sleep two residents. Bedroom #5, Master bedroom. The room consisted of one king sized bed. It sleeps the applicants/Licensees. There was also a big loft well furnished, where children can play and a den, furnished and used as office. 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 is adequate drawer and closet space for children's belongings. The smoke detectors were checked and were working properly. Inside the facility the fireplace was properly screened. Telephone service and appliances were in a working order. All hazardous items have been properly made inaccessible to areas where children will have access. The medication will be locked in the closet upstairs by the entrance of the bathroom area. Cleansers/chemicals were locked and stored in the laundry room cabinet. Sharp knives were inaccessible and stored in a locked upper kitchen cabinet. There were no guns or weapons as stated by applicants at this time. The hot water temperature was tested and noted to be 112 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit were accessible with all required items, and it was in the kitchen cabinet. A Fire extinguisher was observed and properly charged. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request to be licensed for small family home will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to applicants.

met_with: Akua Birago and Kwame Appiah


state: CA

facility_name: BIRAGO SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On August 7, 2024 ay 12: PM, Licensing Program Analyst (LPA) Karen Beal arrived at Birago Small Family Home to conduct a Pre-Licensing inspection for a location change. LPA met with license Akua & Kwame Appiah Birago who led a tour of the home. The home was toured both inside and out with the licensee. the home is currently licensed for 4 ambulatory children and 2 children in care currently. The home consists of: There is a family room, office, dining area, kitchen, laundry room and two bathrooms. Bedroom #1, Master bedroom, Queen Bed and a crib and it will sleep the licensees, the crib is currently vacant Bedroom #2, Twin bed - It will sleep the licensees adopted son. Bedroom #3, 1 full bed. It is currently vacant Bedroom #4, two twins beds. It will sleep two clients Bedrooms are arranged so that no more than two children share a room, and 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 were adequate drawer and closet space for the children's belongings. The smoke detectors were checked and were working properly. Telephone service and appliances were in a working order. Medications are locked in the hall way closet, cleansers/chemicals are located in the locked laundry room and under the locked under the kitchen sink, and sharp items will be locked in a kitchen cabinet. There will no weapons in the home as stated by licensees. The hot water temperature was tested and noted to be 116 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit was accessible with all required items in the hall closet. Two fire extinguishers was observed and properly charged. ***Continued on the LIC 809-C*** The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request to be licensed for small family home will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to Licensees

report_type: Facility Evaluation

visit_type: Prelicensing

met_with: Akua & Kwame Appiah Birago, Licensees


summary: Facility Evaluation

raw_content:
Narrative:
On June 23rd, 2025, at 9: AM Licensing Program Analyst (LPA) Claudia Aguilera arrived at Birago Small Family Home (SFH) to conduct an unannounced annual licensing inspection. The Facility was toured both inside and out with Licensee Akua Birago. The home is a single-story family home with four bedrooms and two bathrooms. Upon entry of the home, LPA observed an open floor plan with office/play area, living room, dining area, and kitchen. The office/play area consisted of toys, books, and games. The living room consisted of two couches, television, and toys. The dining room consisted of a table with chairs. In addition, two stools were observed to be available in the kitchen island. The kitchen was fully inspected. All sharps/knives were locked and stored in a kitchen cabinet. The fire extinguisher was observed to be operable and located in the kitchen. LPA also observed a trash can in the kitchen that contained a tight-fitting cover. Through the hallway the laundry room was located and fully inspected, all detergents and cleaners are locked and made inaccessible to clients. A hallway closet was also observed and stores supplies for the client as well as the first aid kit. In addition, two medications boxes with locks were observed to be available for future medications. Bathroom #1 was inspected and fully functioning. Bedroom #1 consisted of two twin beds, closet, and dresser this bedroom sleeps licensee's adoptive son. Bedroom #2 always remains locked and sleeps licensee's adult brother. Bedroom #3 consisted of a crib and a play pen, closet, and a dresser; this bedroom is occupied by 3-year-old client.Bedroom #4 sleeps licensee and spouse always remains locked. Licensee's bedroom also included bathroom #2. The garage was also inspected and observed to be utilized for storage and one vehicle. The water temperature was tested and measured at 117.7 degrees F. LPA observed a minimum of seven-day non-perishable and a three-day perishable supply of food. All windows and screens were in good repair. The smoke and carbon monoxide detectors were tested and operable. There were no guns or weapons in the home as stated by Licensee. The following required posted items were observed accessible: personal rights, visitation policy, and emergency numbers. The backyard was also fully inspected, no hazards or obstructions were observed. There were four cameras in the outdoor of the home, which meet the Title 22 camera policy. Based on today's inspection and observations, there are no deficiencies being cited at this time. An exit interview was conducted, and a copy of this report was provided to Licensee.

visit_type: Annual

met_with: Licensee Akua Birago


facility_name: BLESS KJC FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On January 28th, 2025, Licensing Program Analyst (LPA) Maryjane Perez met with applicant Nina Magee this date for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the LIC 184, Letter of Application Revision, and additional correspondence to assist with the revisions needed to the application. A copy of this report was provided to applicant Nina Magee.

met_with: Applicant- Nina Magee


summary: Facility Evaluation

raw_content:
Narrative:
On March 14th, Licensing Program Analyst (LPA) Maryjane Perez arrived at Bless KJC Small Family Home for a pre-licensing inspection for an initial license. LPA met with applicant Nina Magee who led a tour of the entire home inside and out. The applicant is applying to serve a capacity of two ambulatory children ages 0-17 years old. The home is a two- story building with 3 bedrooms and 3 bathrooms. The downstairs consists of a living room with couches, a den with couches, TV, and a fire place that was properly screened. There was a kitchen with a table, fully stocked pantry and refrigerator with perishable and non perishable foods. Fire extinguisher #1 was located on the kitchen counter along with first ad kit that had all required elements. There was also a dining room with a table and adequate seating. There was an office that would store clients files but was missing the a lock on the cabinet drawer. The downstairs bathroom was fully functioning with water temperature reaching 120 degrees Fahrenheit. Applicant was advised that water temperature was at its maximum heat level. The upstairs had bedroom #1 that would be utilized for clients and had two twin size beds with the proper bedding, storage space, lighting, books, and games. There was a door leading to a balcony but applicant was advised to keep it double locked at all times. There was bedroom #2 that was for applicants biological son and was fully furnished with a full size bed. The laundry room was accessible to clients and had laundry detergent and cleaning supplies stored in a cabinet that was not made inaccessible to clients. Fire extinguisher #2 was also located in the laundry room. There was bathroom #2 that had dual sinks, toilet, and shower/tub. The bathroom drawers stored towels but trash cans needed tight fitting lids. The hallway had extra blankets and linen. There was a movie room that had couches, television, and games. Bedroom #3 was the master bedroom for applicant and had a queen size bed and bathroom #3 that was fully functioning with a bathtub and walk in shower. The applicant was advised to keep master bedroom locked at all times and supervise clients when in master bedroom. The garage was a three car garage that stored parked cars, extra household items, and bikes. The backyard was fenced with a side gate having a latch and was free of hazards. There was no pool or other body of water. Bedrooms were arranged so that no more than two children share a room, and there was 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. The smoke detectors and carbon monoxide detectors were checked, and they were working properly. Appliances were in working order. There was no firearms in the home as stated by Ms. Magee at this time. The applicant understands that a telephone land line is needed in the home. The Facility Sketch, Emergency Disaster Plan, Personal Rights and Visitation Policy were posted at this time. Based on this inspection of the home, the facility will need the following corrections: - Obtain trash cans with tight fitting lids - Obtain a telephone land line service. - Obtain a lock for cabinet storing laundry detergent and cleaning supplies. - lock box for refrigerated medication. After corrections are completed, the applicant will notify LPA so another inspection can be completed. Component III orientation was also completed this day of March 14, 2025. An exit interview was conducted. A copy of this report was provided to applicant Nina Magee.


summary: Facility Evaluation

raw_content:
Narrative:
On September 26, Licensing Program Analyst (LPA) Maya Chavez arrived at Bless KJC Small Family Home (SFH) for a post-licensing inspection. LPA met with licensee Nina Magee who led a tour of the entire home inside and out. The SFH is approved to serve a capacity of two ambulatory children ages 0-17 years old. The home is a two- story building with 3 bedrooms and 3 bathrooms. The downstairs consists of a living room with couches, a den with couches, TV, and a fire place that was properly screened. There was a kitchen with a table, fully stocked pantry and refrigerator with perishable and non-perishable foods. Fire extinguisher #1 was located on the kitchen counter along with first aid kit that had all required elements. There was also a dining room with a table and adequate seating. There was an office that would store clients files in a lock box. The downstairs bathroom was fully functioning. The upstairs had bedroom #1 that would be utilized for clients and had two twin size beds with the proper bedding, storage space, lighting, books, and games. There was a door leading to a balcony which licensee stated would remain locked all times. There was bedroom #2 that was for licensees biological son and was fully furnished with a full size bed. The laundry room was accessible to clients and had laundry detergent and cleaning supplies stored in a cabinet that was not made inaccessible to clients. Fire extinguisher #2 was also located in the laundry room. There was bathroom #2 that had dual sinks, toilet, and shower/tub. The bathroom drawers stored towels but trash cans needed tight fitting lids. The hallway had extra blankets and linen. There was a movie room that had couches, television, and games. Bedroom #3 was the master bedroom for licensee and had a queen size bed and bathroom #3 that was fully functioning with a bathtub and walk in shower. ***Continued to LIC 809-C*** The garage was a three car garage that stored extra household items, and bikes. The backyard was fenced with a side gate having a latch and was free of hazards. There was no pool or other body of water. Bedrooms were arranged so that no more than two children share a room, and there was 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. The smoke detectors and carbon monoxide detectors were checked, and they were working properly. Appliances were in working order. There was no firearms in the home as stated by Ms. Magee at this time. The licensee has a telephone land line in the office downstairs. The Facility Sketch, Emergency Disaster Plan, Personal Rights and Visitation Policy were posted at this time. An exit interview was conducted. A copy of this report was provided to licensee Nina Magee.

met_with: Licensee- Nina Magee


facility_name: BLESSING SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On June 4, 2024 at 09:15AM, Licensing Program Analyst (LPA) Adaleyci Caballero met with licensee Latoya Hill via Microsoft Teams Meeting for a Component II of the application process. Lpa a. Caballero went over revisions needed for the application prior to license. Lpa a. Caballero gave a copy of the LIC 184, Notice of Incomplete Application, 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: Licensee-Latoya Hill


summary: Facility Evaluation

raw_content:
Narrative:
On July 10, 2024, at 11:13AM, Licensing Program Analyst (LPA) Adaleyci Caballero completed a pre-licensing inspection of Blessings Small Family Home (SFH). LPA met with Applicant Latoya Hill 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 home is a one story building with three bedrooms and two full bathrooms which are set up as follows: · Bedroom #1 (Applicant) It consisted of a king bed that sleeps applicant. · 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 bed had linen, comforters, and pillows. It will sleep two clients. · A living room, kitchen, dining area, office space, two car garage, and a backyard. The garage will be utilized for storage and laundry. 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 they were working properly. The Carbon Monoxide detector is in the living room and working properly. The home's central air conditioning module was in the backyard. The water heater was in the garage. The appliances were in working order. The client's files will be locked inside a filing cabinet in a storage closet in the hallway of the home. There was adequate food storage space and a supply of two days of perishable foods and a week of non-perishable foods. The home had a trash can for storage of solid waste with a tight-fitting lid. The sharp knives and medications are locked in a storage closet in the hallway of the home. The hot water was at a temperature of 108.3 degrees Fahrenheit. The First Aid kit was accessible and will be placed in a cabinet in the office space. There was one fire extinguisher present in the home located in the dining room. It was observed to be properly charged and inspected by the fire department. There are no firearms in the home. There is no pool or other bodies of water at the home. The backyard is fully fenced and free of debris. No corrections to be made. Component III was conducted. An exit interview was conducted, and a copy of this report was provided to applicant Latoya Hill. Application will be forwarded to Licensing Program Manager Jennifer Smith for licensure.


summary: Facility Evaluation

raw_content:
Narrative:
*******THIS FORM DOES NOT PERTAIN TO THIS FACILITY******* On June 4, 2024 at 09:15AM, Licensing Program Analysts (LPAs) Adaleyci Caballero and Rachel Vanegas met with applicant John Nwosu via Microsoft Teams Meeting for a Component II of the application process. Lpa a. Caballero went over revisions needed for the application prior to license. Lpa a. Caballero gave a copy of the this report, LIC 184- Notice of Incomplete Application, 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-John Nwosu


summary: Facility Evaluation

raw_content:
Narrative:
On October 30, 2024, at 9:45AM, Licensing Program Analyst (LPA) Adaleyci Caballero completed a post-licensing inspection of Blessing Small Family Home (SFH). LPA met with Licensee Latoya Hill who led a tour of the home. The facility was toured both inside and out with the licensee. There are two clients in placement. The home is a one story building with three bedrooms and two full bathrooms which are set up as follows: · Bedroom #1 (Licensee) It consisted of a king bed that sleeps licensee. · Bedroom #2- It consisted of two single beds. The beds had linen, comforters, and pillows. It sleeps Client #1. · Bedroom #3- It consisted of two single beds. The bed had linen, comforters, and pillows. It sleeps client #2. A living room, kitchen, dining area, office space, two car garage, and a backyard. The garage will be utilized for storage and laundry. 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 and Carbon Monoxide were checked and working properly. The home's central air conditioning module was in the backyard. The water heater was in the garage. The appliances were in working order. The client's files are locked inside a filing cabinet in a storage closet in the hallway of the home. There was adequate food storage space and a supply of three days of perishable foods and a week of non-perishable foods. The home had a trash can for storage of solid waste with a tight-fitting lid. The sharp knives and medications are locked in a storage closet in the hallway of the home. The hot water was at a temperature of 108.3 degrees Fahrenheit. The First Aid kit was accessible and placed in a cabinet in the office space. There was one fire extinguisher present in the home located in the dining room. It was observed to be properly charged and inspected by the fire department. There are no firearms in the home. There is no pool or other bodies of water at the home. The backyard is fully fenced and free of debris. There were no health or safety concerns observed. An exit interview was conducted, and a copy of this report and LIC 811 were provided to Licensee Latoya Hill.


facility_name: BLESSINGS ON BLESSINGS

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Based on confidential interviews and record reviews, the allegations that LI does not treat C1 with respect and LI does not have adequate training to meet the needs of C1, may have occurred, however, they are not supported or proven by evidence. Therefore, the above allegations are unsubstantiated. An exit interview was conducted and a copy of this report, LIC 811, and appeal rights were provided to Licensee, Shelia Pearson.

Investigation Findings:
13On 09/19/24, 09: AM, Licensing Program Analyst (LPA) Sarah Lo met with Blessings on Blessings Small Family Home (SFH) Licensee, Shelia Pearson, to issue the investigative findings for the above stated allegations. During the investigation, LPA interviewed the Licensee (LI), Client #1 (C1), and County Social Worker (CSW). On April 11, 2024, the department received a complaint alleging that Licensee (LI) does not treat minor (C1) with respect and Licensee (LI) does not have adequate training to meet the needs of the minor (C1). Specifically, it was reported that LI can't handle C1's aggressiveness and C1 requires a higher level of care or a more appropriate placement. It was also reported that LI is triggering C1's behaviors and causing C1 to be irritated. During the investigation, there was no corroborating evidence to support the above allegations. Confidential interviews could not confirm nor deny the alleged allegations. (continued on LIC 9099c) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Sarah Lo LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: BLESSINGS ON BLESSINGSFACILITY NUMBER: VISIT DATE: 09/19/2024

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

report_type: Complaint Investigation

met_with: Licensee, Shelia Pearson

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On August 10, 2023, Licensing Program Analyst (LPA) Linda Haynes met with Applicant Shelia Pearson for the Component III Presentation.

met_with: Shelia Pearson


summary: Facility Evaluation

raw_content:
Narrative:
On August 10, 2023 at 9: AM, Licensing Program Analyst (LPA) Linda Haynes began a pre-licensing inspection for Blessings on Blessings Small Family Home license. LPA met with applicant Shelia Pearson who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there are no clients in the home. The applicant is applying to serve 2 clients ages 3 to 17. The home is a one-story building with two bedrooms and 1.5 bathrooms which are set up as follows: · Bedroom #1 (Master) has one bed sleeps the applicant · Bedroom #2 (Client's) was vacant has two twin beds, it will sleep two client's. · A great room/living room, kitchen, dining area, 1.5 bathrooms, an attached one car garage, and the backyard. The Client's bedroom was arranged so that no more than two clients will be in the 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 two smoke detectors / Carbon Monoxide Detectors were checked, and they were working properly. There is no dedicated phone line. The home's central air conditioning module was located in the backyard. The home's hot water heater was located inside the garage. The appliances were in working order. The client's files will be locked in a file cabinet in the applicant's bedroom. There was adequate food storage space. There was a two day supply of perishable foods and a week of non-perishable foods. A proper storage of all food was discussed. A trash can for storage of solid waste had a tight fitting lid. The sharp knives are in a locked cabinet in the kitchen. The medications are located in a locked cabinet in the bathroom. The hot water in bathroom one measured to be 108.2 degrees Fahrenheit and in bathroom two 108.5 degrees Fahrenheit. The home's First Aid kit was accessible and is located in a cabinet in the bathroom. One fire extinguisher was present in the home and is located on the wall by the by the kitchen. It was observed to be properly charged and inspected by the fire department. There is no firearm in the home as stated by the applicant. There is no pool or other body of water. The backyard where clients will have access to play was fenced. The following items need to be corrected · Post the following documents, personnel rights, and complaint hot line · Dedicated phone line needed The request for a license will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to Shelia Pearson.


summary: Facility Evaluation

raw_content:
Narrative:
On September 10, 2024 at 01:05PM, Licensing Program Analysts (LPAs) Rachel Vanegas and Adaleyci Caballero arrived to the facility listed above for the purpose of conducting a post-licensing annual inspection. LPAs met with Licensee - Shelia Peason who led a tour of the home. The facility was toured inside and outside with the licensee. The home consists of two bedrooms, one and a half bathrooms, a living room, kitchen, a backyard, and a detached garage. Bedroom #1 - Currently has a queen bed and is set up to sleep one client. Licensee will take that single bed out and put two single beds in the bedroom to accommodate license capacity of sleeping two. The single beds are stored in the detached garage. The single beds will be set up within one week. Licensee will submit a photo of the beds in bedroom #1 to licensing. It contains ample closet space and drawers with adequate storage for personal belongings, etc. Bedroom #2 - Has one queen bed and sleeps the Licensee. Bedrooms were arranged so that no more than two children share a room and will have one child per bed. No room commonly used for other purposes is used as a bedroom. The full bathroom of the home is accessible through both bedrooms. There is a lock on each door that restricts access to others while it is in use. Inside the facility there were operable smoke detectors and carbon monoxide detectors located in each bedroom and common areas. The facility has an accessible fire extinguisher that is properly charged located in the kitchen. The hot water temperature was checked and measured in the kitchen and registered, 116.7 degrees F. Licensee has adequate food supply of non-perishable and perishable items. An exit interview was conducted and a copy of this report and appeal rights were reviewed and provided to the licensee - Sheila Pearson.

met_with: Shelia Pearson - Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On September 10, 2024, Licensing Program Analyst (LPA) Rachel Vanegas conducted a required annual inspection with the post licensing inspection. Due to technical difficulties, completion of the required annual inspection was not recorded. The purpose of this report is to record the annual inspection that was completed. A copy of this report and appeal rights were reviewed and provided to the Licensee, Shelia Pearson. This report was sent to licensee electronically for signatures and original signatures are in the facility file.

met_with: Licensee - Sheila Pearson


summary: Facility Evaluation

raw_content:
Narrative:
On October 23, 2024 at 10: AM, Licensing Program Analyst (LPA) Rachel Vanegas arrived at Blessings on Blessings Small Family Home (SFH) for a continuation of an unannounced post licensing annual inspection. LPA was met by the licensee, Sheila Pearson. The Physical Plant and Operation Requirements were inspected on September 10, 2024. LPA continued the inspection by conducting staff file reviews for Staff 1 (S1), Staff 2 (S2), Staff 3 (S3), and Staff 4 (S4). LPA observed documents in the files including: Drivers License, CPR/First Aid certificates, Background Clearance, etc. Staff files for S1, S2, S3, and S4 did not contain documentation regarding health screening, tuberculosis testing/results clearance, duties of the employee, and signed acknowledgement for child abuse and neglect reporting requirements. Based on observation and record review, the facility is issued three technical violations in accordance with California Code of Regulations (CCR) Title Section 80066(a)(8) for not having documentation regarding duties of the employees, CCR Title Section 80066(a)(11) for not having documented health screen, tuberculosis testing/results clearance, and Section 11165.7(c)(1) for not having signed acknowledgement for child abuse and neglect reporting requirements. An exit interview was conducted and a copy of this report, LIC 811, LIC 9120, and appeal rights were reviewed and provided to the licensee, Sheila Pearson.


facility_name: BLESSINGS ON BLESSINGS 2

summary: Facility Evaluation

raw_content:
Narrative:
On July 28, 2025, at 9: AM, Component II was conducted at the Monterey Park Children's Residential Program office with Blessings On Blessings Small Family Home applicants. Present at the Component II from Blessings On Blessings 2 was applicant Krishand Pearson and Licensing Program Analyst (LPA) Juliet Robles. The purpose of the meeting was to review and discuss the program statement and application. LPA called the meeting to order and introduce herself and asked questions regarding the applicant's Program Statement to assess their understanding of the regulations in place for a Small Family Home. LPA reviewed and discussed the following for the Plan of Operation: · LIC 500 · LIC 503 · LIC 501 · LIC 308 · LIC 610C · LIC LPA reviewed and discussed the following for the Program Statement: · Purpose/Source of Placement · Basic Care/Medications/Shifts/Personal Care · Service Plans · Visitation Policy · Monthly Activities Sample · Policy & Procedures for Medical Emergencies · Discipline · Discharge · Criteria for Assessment · Client Status · Psychotropic Medication · Immunization Requirements · Video Camera Policy- See PIN 24-09-CRP for guidance. · Qualifications for staff/position · Staff Training LPA advised the applicant that all revisions and documents need to be submitted on or before August 15, 2025. LPA advised the licensee that all documents and program statement revisions will be reviewed by her manager LPM Yan Yeung.

met_with: Krishand Pearson


summary: Facility Evaluation

raw_content:
Narrative:
On September 16, 2025 at 9: AM, Licensing Program Analyst (LPA) Juliet Robles made an announced visit to the Blessings On Blessings Small Family Home for the purpose of a Pre-Licensing inspection. LPA met with Krishand Pearson and Johnali Brown, applicants and together toured the external and internal areas of the home. LPA observed the following: Physical Plant This is a two story single home located in a residential community. This home is a five (5) bedroom, four (4) bathroom home with living room, kitchen, covered patio and three (3) car garages. There are three (3) cameras located on exterior of the home, sound is always disable and are monitored by applicant by Vivint Security. There are no cameras located inside and private restricted areas of the home. Knives, sharps, disinfectants and cleaning solutions are kept locked and secured in cabinets under the kitchen sink. Per applicant, there are no firearms on the premises. The facility has a centralized heat and air-conditioning unit. Temperatures throughout the home during the inspection were comfortable. Carbon monoxide and smoke alarms were tested and observed to be operational. The home has two fire extinguishers, one upstairs and one downstairs. The home has a working telephone that is available for client use. For regular medication boxes it is stored in a locked file cabinet in the office. For the medication that needed refrigeration, there is a container box inside the refrigerator intended for that use. The first aid kit and medication will be centrally stored. The kit contains all required supplies. The client and staff files will be stored in a locked file cabinet in the office. The Bedroom #1 is downstairs - grandson, with bathroom. Upstairs: Bedroom #2 -vacant for guests Bedroom #3- for potential client room - with 2 twin beds, 2 dressers and a closet- with bathroom for client's use Bedroom #4- daughter with own bathroom Bedroom #5 - Licensee's room with own bathroom All bathrooms maintained non-slip mats/rugs. The temperature of the water is within a ratio of 105. All passageways were clear and free from obstructions. A fire inspection was conducted by the Ontario Fire Department on 06/04/25 and a fire clearance was granted for ambulatory clients. Prior to today's visit, LPA submitted the final Program Statement/Plan of Operation to LPM Yeung. LPA and licensee agreed to do a Component III at the Regional Office on 09/18/25 at 10: AM. LPA will submit this report to LPM Yeung for final review and a new license will be mailed to the facility upon approval. No deficiencies were observed on this date. An exit interview was conducted, and a copy of this form was provided to the Applicant.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Juliet Robles conducted a Component III meeting with Applicant/Administrator Krishand Pearson. During the meeting the LPA covered a category specific to continuing requirement regulation review for Small Family Home program (SFH), with an emphasis on the facility operation and commonly found problem areas. This meeting provides the soon-to-be licensee with sufficient information to operate the facility within substantial compliance, as well as how to avoid common problem areas or pitfalls of a facility operation. It also provides a clear description of the LPA's role in the operation of the facility and provides a clear description of Civil Penalties. The following items were discussed and provided to the applicant: -Title 22 regulations on Small Family Homes - Continuing Requirements (General Licensing Requirements) - Buildings and Grounds requirements - Personnel Records (forms) - Client Records (forms) -Reporting Requirements -Health Related Services -Food Services -Deficiency Types -Civil penalties -PINs Notices - Other administrative forms An exit interview was conducted and a copy of this report LIC809 and a copy of the Small Family Home (SFH) Component III handout was provided.


summary: Facility Evaluation

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Narrative:
On February 20, 2025 at 10:20 am, Licensing Program Analyst (LPA) Juliet Robles conducted an unannounced inspection at the Small Family Home facility and met with the licensee, Krishand Pearson. The purpose of the inspection was post licensing. Currently the facility has two (2) children in care. At 10:25 am, LPA and licensee toured the internal and external areas of the home. The following was observed at the time of inspection: This facility is a two story house located in a quiet residential community. The facility consists of five (5) bedrooms, four (4) bathrooms, kitchen, living room, dining area, covered patio and three (3) car garages. Overall, the facility is clean, sanitary and in excellent condition. Passageways are free from obstruction. There are three (3) cameras located on exterior of the home, sound is always disable and are monitored by applicant by Vivint Security. There are no cameras located inside and private restricted areas of the home. Knives, sharps, disinfectants, and cleaning solutions are kept locked and secured in cabinets under the kitchen sink. Per licensee, there are no firearms on the premises. Carbon monoxide and smoke alarms were tested and observed to be operational. The home has two fire extinguishers. Medications, the first aid kit, are centrally stored in a cabinet by the office. The first aid kit contains all required supplies. The following sleeping arrangements were noted: Bedroom #1 is downstairs - grandson, with bathroom. Bedroom #2 -Client 1 with queen bed, dresser and a closet Bedroom #3- Client 2 - with 2 twin beds, 2 dressers and a closet Bedroom #4- daughter with own bathroom Bedroom #5 - Licensee's and husband room with own bathroom The home has toilets, wash basins, and one shower/bath for clients' use. The water temperature was tested at the client's bathroom at 107 degrees, which is within regulatory guidelines. The licensee is the main caretaker of the home. Client and staff files are stored in a locked file cabinet in the office. LPA reviewed two (2) client records and three (3) staffs record. LPA checked required criminal records and child abuse index check clearance or exemption for all adults in the home. LPA reviewed staffs' current training courses, CPR and First Aid card certificates. The client's file contained: Admission Agreement, Medical Assessment, Consent Forms, Emergency Information, Appraisal Form, Immunization Record and Personal Rights. LPA interviewed two (2) staff at the facility. Two (2) Clients were not available for interview at the time of inspection. One client is in the hospital, and the other client is in a relative's house for the weekend. Based on the facility inspection and file reviews this date, a Technical Advisory (TA) is given, there are no deficiencies found at this time. An exit interview was conducted, and LPA provided a copy of the following reports: LIC 809, LIC 809C, LIC 811, LIC 9102, glossary to Ms. Krishand Pearson, Administrator/Licensee.


summary: Facility Evaluation

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Narrative:
On February 27, 2026 at 12:00 pm, Licensing Program Analyst (LPA) Juliet Robles conducted an unannounced follow up case management inspection to the Blessings on Blessings Small Family Home (SFH) and met with licensee/administrator, Krishand Pearson regarding a special incident report (SIR) that was submitted to Community Care Licensing Department (CCLD) on 02/16/26 about an incident that happened at the SFH with Law Enforcement (LE) presence and youth not allowed to get her belongings (reference Confidential Name Form LIC 811 dated 02/27/26). LPA contacted the licensee on 02/23/26 via a telephone call. According to the licensee, the client and her visitor were spending time together at home and when it's time for the visitor to leave, client does not want to give visitor's cell phone and belongings like backpack. Per licensee, the Uber was already downstairs waiting for the visitor, so as not to escalate the situation, licensee talked to visitor that she will return her belongings to her the following day. Visitor complied with the arrangement. However, when visitor was about to get in the Uber, the client opened her window upstairs and threw a glass vase in the visitor's direction that created more argument between the visitor and the client. According to licensee, she was able to direct the visitor to leave and the Uber. But for some reason, the Uber made a U-turn and came back to the house. According to licensee, that is when she decided to call LE for back up. Per licensee, Alameda County Social Worker on 02/24/26 came for a visit. Client has been refusing any Mental Health Services or therapy but is considering a wraparound. Based on the interview conducted and documentation provided during the inspection, the facility followed up by coordinating with the CSW to have client be assessed for mental health services. No deficiencies cited at this time and no further follow-up is needed. An exit interview was conducted and a copy of this report and LIC 811 were provided for Ms. Pearson.

visit_type: Case Management


summary: Facility Evaluation

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Narrative:
On March 20, 2025 at 10:50 am, Licensing Program Analyst (LPA) Juliet Robles conducted an unannounced case management inspection to the Small Family Home facility and met with Direct Care Service Provider, Sheila Pearson. The purpose of the inspection is to provide a Technical Assistance (TA) with resources for training websites. LPA contacted Administrator, Krishand Pearson via a telephone call and discussed with her the purpose of the visit. The following topics, training and websites were discussed with the Administrator. · Reporting Requirements · Foster Care healthy sexual Development · Reasonable & Prudent Parent Standard · Medication Guide · Personal Rights · Psychotropic Training An exit interview was conducted, and a copy of this report was provided to the facility representative.

met_with: Sheila Pearson


facility_name: BLUE SKY HOME

summary: Facility Evaluation

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Narrative:
On Wednesday March 16, 2023, Licesning Program Analyst (LPA) Linda Haynes met with Blue Sky Home Small Family Home Applicant Fiath Maina for a component II interview. LPA informed Applicant that a Pre-Licensing will be scheduled as soon as the fire clearance is completed. A signed copy of this report will be placed in the facility file.

met_with: Faith Maina


summary: Facility Evaluation

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Narrative:
On April 25, 2023 at 11: AM, Licensing Program Analyst (LPA) Linda Haynes began a pre-licensing inspection for Blue Sky Small Family Home license. LPA met with applicant Faith Maina who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there is no client in the home. The applicant is applying to serve 2 client's ages 0 to 17. The home is a two-story building with five bedrooms and four and one half bathrooms which are set up as follows: · Bedroom #1 (Master) has one bed sleeps the applicant and has a master bathroom · Bedroom #2 (Client's) was vacant has one king bed, it will sleep two clients. · Bedroom #3 (sons) has one king bed, it sleeps the son. · Bedroom #4 (daughters) has one queen bed and sleeps the daughter · Bedroom #5 (Master) has one Cal king bed and sleeps Applicants parents · A great room/living room, kitchen, dining area, four- and one-half bathrooms, an office, a sitting room, a loft an attached two car garage, laundry room, and the backyard. The Client's bedroom was arranged so that no more than one client will be in the 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. There is a dedicated phone line. The home's central air conditioning module was located on the side of the back yard. The home's hot water heater was located inside the garage. The appliances were in working order. The client's files will be locked inside a file cabinet in the office. There was adequate food storage space and a supply of two days of perishable foods and a week of non-perishable foods. A proper storage of all food was discussed. A trash can for storage of solid waste had a tight-fitting lid and was present. The sharp knives are in a locked kitchen drawer. The medications are located in a locked cabinet in the kitchen. The hot water in all bathroom's measured under 105 degrees Fahrenheit. The home's First Aid kit was accessible and is located in a cabinet upstairs in the loft. Three fire extinguishers were present in the home one is located on the wall by the stairs and two are located upstairs. They were observed to be properly charged and inspected by the fire department. There is no firearm in the home as stated by the applicant. There is a pool at the home the pool is properly fenced with mesh fencing and has a self closing gate.. The backyard where clients will have access to play is fenced. The following items need to be corrected · A home phone for the clients use · Hot water Temperature needs to be raised · Post client's rights · Post complaint hotline · Add a bed to client's bedroom so that it can sleep two client's The request for a license will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to Faith Maina

met_with: Faith Mwangi


summary: Facility Evaluation

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Narrative:
On July 31, 2024 at 10: AM, Licensing Program Analyst (LPA) Karen Beal began a post-licensing and capacity increase inspection for Blue Sky Small Family Home license. LPA met with applicant Faith Maina who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there is two clients in the home. The licensee is asking for a increase capacity from two ambulatory children to three ambulatory and one non-ambulatory. The home is a two-story building with seven bedrooms and four and one half bathrooms which are set up as follows: Upstairs: · Bedroom #1 (Master) has one bed sleeps the licensee and has a master bathroom · Bedroom #2 (Client's)two twin beds, it sleep two foster children. · Bedroom #3 (sons) has one king bed, it sleeps the son. · Bedroom #4 (daughters) has one queen bed and sleeps the daughter Bedroom #5 (grandmother) has one king bed and sleep the grandmother · Bedroom #6 (Vacant) has a queen bed and will sleep one ambulatory child Bedroom #7 (Vacant) has a twin bed and will sleep one non-ambulatory child Bedroom #6 and #7 was previously a master bedroom that had a seating area. The licensee enclosed the sitting area for an additional room and added a closet was added. The non-ambulatory bedroom has an exit door that lead outdoors. The home also includes a great room/living room, kitchen, dining area, four- and one-half bathrooms, a loft an attached two car garage, laundry room, and the backyard. The Client's bedroom was arranged so that no more than one client will be in the 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. There is a dedicated phone line. The home's central air conditioning module was located on the side of the back yard. ***Continued to LIC 809-C*** The home's hot water heater was located inside the garage. The appliances were in working order. The client's files are locked inside a file cabinet in the master bedroom. There was adequate food storage space and a supply of five 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 are in a locked kitchen drawer. The medications are located in a locked cabinet in the kitchen. Chemicals are locked under the kitchen sink. The hot water measured 108 degrees Fahrenheit. The home's First Aid kit was accessible and is located in a cabinet upstairs in the loft. Three fire extinguishers were present in the home one is located on the wall by the stairs and two are located upstairs. They were observed to be properly charged. There is no firearm in the home as stated by the licensee. the fire place is enclosed by glass. There is a pool at the home. The pool is properly fenced with mesh fencing and has a self closing gate that opens away from the pool. The backyard where clients will have access to play is fenced. The request for the capacity increase will be forwarded to a Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to Faith Maina

met_with: Faith Maina, Licensee


summary: Facility Evaluation

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Narrative:
On December 17, 2025 licensing program analyst (LPA) Maryjane Perez arrived at Blue Sky Home Small Family Home (SFH) and met with licensee Faith Maina to conduct a Required-2 year inspection. Licensee Faith Maina led a tour of the home. The facility was toured both inside and outside. Currently there are three clients in the home (one non- ambulatory client and two ambulatory clients). The home was licensed for two ambulatory clients and two non-ambulatory clients. The home is a two story building with seven bedrooms and five bathrooms. The downstairs consisted of an entry way with a bulletin board that had the facility license, facility sketch, personal rights, and emergency disaster plan posted. There was a family room/ dining room with couches and dining table with adequate seating. There was a kitchen that had a fully stocked refrigerator and pantry with perishable and non-perishable foods. There was a locked cabinet for storing clients files, employee files, medications, cash resources, and a first aid kit with all required elements. There was also a locked kitchen sink cabinet that stored extra cleaning supplies. Fire extinguisher #1 was in the kitchen and there was a living room with couches, TV, and fake fireplace that was screened. Bathroom #1 was fully functioning and had hot water temperature measuring 115.8 degrees Fahrenheit and had a locked cabinet for storing laundry detergents and cleaning supplies. Bedroom #1 was vacant with a television and not used for clients. Bathroom #2 was fully functioning with a sink, toilet, and shower/bathtub. Bedroom #2 was utilized for two non-ambulatory clients and currently had one non-ambulatory client with one hospital bed, closet/dresser space, a TV and an exit door leading to the backyard. The laundry room was accessible to clients and was free of hazards. Upstairs consisted of a hallway with fire extinguisher #2 that was operable and cabinets that stored extra lines, towels, and blankets. there was a loft with couches, a table, and toys/books. Bedroom #3 was upstairs and was utilized for two clients and had two twin size beds, dresser/closet space, all required bedding, and lighting. Bathroom #3 was fully functioning with a sink, toilet, and shower/ bathtub. Bedroom #4 was for licensee's parents and had a queen size bed and was fully furnished. Bathroom #4 was fully functioning with a toilet, sink, shower/bathtub. Bedroom #5 was for licensee's biological daughter and had a fully furnished room with a queen size bed. Bedroom #6 was utilized for licensee's biological son and had a king size bed that was also fully furnished. Bedroom #7 was for licensee and had a kind size bed, office space and bathroom #5 that was fully functioning. The backyard had a garden, a trampoline, adequate seating arrangements and an underground pool. The pool was surrounded by a fence that was five feet and two inches tall. The pool gate swung away from the pool and there was a clear view of the pool. The backyard also had a locked shed that stored gardening tools and essentials. There was a side yard gate that had a latch and was free of obstruction. The garage was locked at all times and stored extra household items such as decor, shoes, and an extra freezer with frozen goods. There were no weapons/firearms as stated by licensee. There was a land- line telephone service, all appliances were in working order, and all trash cans for storage of solid waste had tight fitting lids. Bedrooms were 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. The smoke detectors and carbon monoxide detectors were checked and are working properly. All hazardous items have been properly made inaccessible to areas where children will have access. LPA interviewed two staff and two clients. LPA reviewed four staff files and three client files. No deficiencies were cited during this visit. An exit interview was conducted and a copy of this report was provided to licensee Faith Maina.

met_with: Licensee- Faith Maina


facility_name: BONIFACE KUREMA

summary: Facility Evaluation

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Narrative:
On August 26, Licensing Program Analyst (LPA) Maryjane Perez met with applicant Boniface Kuerma this date for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the LIC 184, Letter of Application Revision, and additional correspondence to assist with the revisions needed to the application. A copy of this report was provided to applicant Boniface Kurema.

met_with: Applicant- Boniface Kurema


summary: Facility Evaluation

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Narrative:
On October 8, 2025, Licensing Program Analyst (LPA) Maryjane Perez arrived at Boniface Kurema Small Family Home (SFH) for a pre-licensing inspection for an initial license. LPA met with applicant Boniface Kurema who led a tour of the entire home inside and outside. The applicant is applying to serve two ambulatory children ages 0 to 17 years old. Currently there are no clients placed in the home. The home is a two-story building with four bedrooms and three bathrooms. The downstairs consisted of an entry way with a living room that had couches and a television, there was a kitchen with a dining table with adequate seating, a fully stocked refrigerator and pantry, a locked cabinet storing knives and sharp objects and a locked sink cabinet storing cleaning supplies. There was a storage closet that stored extra household items such as pillows and blankets as well as a first aid kit that was missing a thermometer. Fire extinguisher #1 was in the hallway by the bulletin board that was missing required posting such as Emergency Disaster Plan, Facility Sketch, Visitation Policy and Personal Rights. Bathroom #1 was fully functioning with water temperature measuring exactly 120 degrees Fahrenheit. The upstairs had a hallway that stored a study area with a desk. Bedroom #1 was for applicants biological son and had a queen size bed and was fully furnished. Bedroom #2 was for applicants biological daughter and had a queen size, closet/ dresser space and was fully furnished. Bathroom #2 had dual sinks with a toilet, shower, and trash can with tight fitting lid. Bedroom #3 was utilized for two foster children but only had one queen size bed, closet/ dresser space and was currently vacant. Applicant understands that clients cannot share a bed therefore, two beds are required in the room to sleep two foster children. The laundry room was accessible to clients and had cleaning compounds and laundry detergents also accessible to clients. Applicant was advised to put a lock on laundry room door or to obtain a locked cabinet to store cleaning compounds/ laundry detergents. Fire extinguisher #2 was in the hallway and was operable. Bedroom #4 was the master bedroom for applicant that had a queen size bed, bathroom #3 with dual sinks, a toilet and shower. The backyard where children will have access to play was completely fenced, had a gate with a latch and was free of hazards. There were no pools or other bodies of water and no weapons/firearms as stated by applicant. The garage was free of hazards and stored extra household items such as holiday decorations and traveling bags. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. The smoke detectors and carbon monoxide detectors were checked and are working properly. All hazardous items have been properly made inaccessible to areas where children will have access. There was not a land- line telephone service but all appliances were in working order, and all trash cans for storage of solid waste had tight fitting lids. Based on this inspection of the home, the facility will need the following corrections: First aid kit to have a thermometer in place Required postings such as Emergency Disaster Plan, Facility Sketch, Visitation Policy and Personal Rights. Two twin size beds in the clients bedroom in order to sleep two clients Applicant to put a lock on laundry room door or to obtain a locked cabinet to store cleaning compounds/ laundry detergents Obtain two lock boxes for client medication and refrigerated medications Obtain a locked cabinet for storing client files/ employee files Obtain a telephone land- line service After corrections are completed, the applicant will notify LPA so that another inspection can be completed. Component III orientation was also completed this day of October 8th, 2025. An exit interview was conducted and a copy of this report was provided to applicant Boniface Kurema.


summary: Facility Evaluation

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Narrative:
On November 5, 2025, Licensing Program Analyst (LPA) Maryjane Perez arrived at Boniface Kurema Small Family Home (SFH) and met with applicant Boniface Kurema who led a tour of the home. The purpose of this visit is to ensure corrections were made from the pre-licensing inspection on October 8, 2025. The applicant is applying to serve a capacity of two ambulatory children ages 0 to 17 years old. Currently there are no clients placed in the home. The home is a two-story building with four bedrooms and three bathrooms. The downstairs consisted of an entry way with a living room that had couches and a television, there was a kitchen with a dining table with adequate seating, a fully stocked refrigerator and pantry, a locked cabinet storing knives and sharp objects and a locked sink cabinet storing cleaning supplies. There was a locked storage closet that now stored client files and employee records, medications, and a first aid kit that had all required elements. Fire extinguisher #1 was in the hallway by the bulletin board that had postings such as Emergency Disaster Plan and Facility Sketch but was missing a visitation policy with sign in and out procedures. Bathroom #1 was fully functioning with water temperature measuring exactly 120 degrees Fahrenheit. The upstairs had a hallway that stored a study area with a desk. Bedroom #1 was for applicants biological son and had a queen size bed and was fully furnished. Bedroom #2 was for applicants biological daughter and had a queen size, closet/ dresser space and was fully furnished. Bathroom #2 had dual sinks with a toilet, shower, and trash can with tight fitting lid. Bedroom #3 was utilized for two foster children and now had two twin size beds with closet space but was missing a dresser for both clients the room was currently vacant. The laundry room now had a lock on the door and stored cleaning compounds and laundry detergents. Applicant understands that clients will need to be supervised when in the laundry room. Fire extinguisher #2 was in the hallway and was operable. Bedroom #4 was the master bedroom for applicant that had a queen size bed, bathroom #3 with dual sinks, a toilet and shower. The backyard where children will have access to play was completely fenced, had a gate with a latch and was free of hazards. There were no pools or other bodies of water and no weapons/firearms as stated by applicant. The garage was free of hazards and stored extra household items such as holiday decorations and traveling bags. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. The smoke detectors and carbon monoxide detectors were checked and are working properly. All hazardous items have been properly made inaccessible to areas where children will have access. There was now a telephone service and all appliances were in working order, and all trash cans for storage of solid waste had tight fitting lids. Based on this inspection of the home, the following corrections were made: First aid kit had all required elements including a thermometer Required postings such as Emergency Disaster Plan and Facility Sketch were posted Two twin size beds are now in the clients bedroom in order to sleep two clients Applicant put a lock on laundry room door since storing cleaning compounds/ laundry detergents Two boxes for clients medication were obtained and locked in storage closet Locked storage closet now stores client files/ employee files Applicant now has a telephone service The facility will still need the following corrections: One locked medication box for refrigeration A dresser for clients use in the clients bedroom Visitation policy with sign in and out procedures After corrections are completed, the applicant will notify LPA so that another inspection can be completed. An exit interview was conducted and a copy of this report and letter of additional application revisions was provided to applicant Boniface Kurema.


summary: Facility Evaluation

raw_content:
Narrative:
On March 18, 2026, Licensing Program Analyst (LPA) Maryjane Perez made an unannounced visit to Boniface Kurema Small Family Home (SFH) for a post licensing inspection and met with licensee Boniface Kuerma who led a tour of the entire facility inside and outside. Currently there is one client placed in the home. The home was approved for a capacity of two ambulatory clients ages 0 to 17 years old. The home is a two-story building with four bedrooms and three bathrooms. The downstairs consisted of a living room with couches, and a TV. There was a kitchen with a dining table that had adequate seating, a locked kitchen cabinet for storing sharp objects/ knives a fully stocked refrigerator and pantry, and a locked sink cabinet storing cleaning supplies. There was a locked storage closet that stored a locked file cabinet for client files, medications, a first aid kit with all require elements, and a lock box for clients cash resources. Fire extinguisher #1 was in the hallway by the bulletin board that had all required posting such as Emergency Disaster Plan, Facility Sketch, Visitation Policy and Personal Rights. Bathroom #1 was fully functioning with water temperature measuring 116.7 degrees Fahrenheit. The upstairs had a hallway that stored a study area with a desk. Bedroom #1 was for licensees biological son and had a queen size bed and was fully furnished. Bedroom #2 was for licensees biological daughter and had a queen size, closet/ dresser space and was fully furnished. Bathroom #2 had dual sinks with a toilet, shower, and trash can with tight fitting lid. Bedroom #3 was utilized for two clients and had two twin size beds one currently occupied, with a dresser/ closet space, lighting, and all required bedding. The laundry room was locked at all times as it stored laundry detergents and essentials. Fire extinguisher #2 was in the hallway and was operable. Bedroom #4 was the master bedroom for licensee that had a queen size bed, bathroom #3 with dual sinks, a toilet and shower. The backyard where children will have access to play was completely fenced, had a gate with a latch and was free of hazards. There were no pools or other bodies of water and no weapons/firearms as stated by licensee. The garage was free of hazards and stored extra household items such as holiday decorations and traveling bags. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. The smoke detectors and carbon monoxide detectors were checked and are working properly. All hazardous items have been properly made inaccessible to areas where children will have access. There was a land- line telephone service, all appliances were in working order, and all trash cans for storage of solid waste had tight fitting lids. During inspection, LPA interviewed licensee and traveled to interview one client. LPA reviewed licensees file and one client file. Facility cited for violation of California Code of Regulations, Title 22, Division Six, Chapter 4. regulation 83070(b)(12): Child's Records. See 809D. An exit interview conducted and a copy of this report, 10 technical violations and 1 deficiency were discussed and provided to licensee Boniface Kuerma.

met_with: Licensee- Boniface Kuerma


facility_name: BOUGAINVILLEA SFH

summary: Facility Evaluation

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Narrative:
On February 20, 2024 at 9: AM, Licensing Program Analyst (LPA) Linda Haynes began a pre-licensing inspection of Bougainvilla Small Family Home. LPA met with Applicant Ana Alcantar 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 The home is a one story building with four bedrooms and two bathrooms which are set up as follows: · Bedroom #1 (Master) has one bed will sleep the applicant. · Bedroom #2 (Client's) has one bed, it will sleep one client. · Bedroom #3 (Client's) has two beds, it sleeps two clients. · Bedroom #4 (Client's) has one bed, it will sleep one client. · A great room/living room, kitchen, dining area, two bathrooms, an attached two car garage, laundry room, and the backyard. The Client's bedrooms were arranged so that no more than two client's 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 in every bedroom. The four smoke detectors were checked, and they were working properly. The carbon monoxide detector is located in the hallway. The carbon monoxide detector was checked and it was working properly. The home's central air conditioning module was located in the back yard. The home's hot water heater was located inside a cabinet on the side of the house. The appliances were in working order. The client's flies will be locked inside a cabinet in the garage office space. 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 are 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 114.2 degrees Fahrenheit. The water temperature of bathroom 2 measured to be 113 degrees Fahrenheit. The home's First Aid kit was accessible and is located in the master bathroom and contained all required supplies. One fire extinguisher was present in the home it is located in the kitchen by the sliding glass door. It was 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. All required documents were Posted A Component III was conducted with applicant. There were no deficiencies at this time. An exit interview was conducted. Application will be forwarded to the Licensing Program Manager for Licensing.

met_with: Ana Alcantar


summary: Facility Evaluation

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Narrative:
On April 7, 2025 at 10:40AM, Licensing Program Analyst (LPA) Rachel Vanegas arrived unannounced at Bougainvillea Small Family Home (SFH) to conduct an annual/post-licensing inspection of the facility. LPA met with the Licensee, Ana Alcantar, who led a tour of the facility which was toured both inside and out. The facility is a one story home with four bedrooms and two bathrooms which are set up as follows: Bedroom #1 (Master) has one bed and sleeps the Licensee and spouse. Bedroom #2 (Client) has one queen size bed and is vacant. Bedroom #3 (Client) has two single beds and are vacant. Bedroom #4 (Client) has one queen size bed and sleeps one client. A great room/living room, kitchen, dining area, two bathrooms, an attached two car garage that remains locked and stores cleaning chemicals, laundry room, and the backyard. The client bedrooms are arranged so that no more than two clients are in one room and sleep one client 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 are combination smoke detector/carbon monoxide detectors in every bedroom and hallway. The smoke detector/carbon monoxide detectors were tested and are in properly functioning order. Home appliances were observed in proper functioning order. Sharp knives and medications are in a locked cabinet in the kitchen and are inaccessible to clients in care. There are two fire extinguishers in the home that were observed to be properly charged, one is located in the kitchen and one is located the laundry room. **Continued on LIC 809-C** The hot water temperature was checked in the kitchen and registered at 114.2 degrees Fahrenheit. Telephone services were in working order at the time of this inspection. LPA observed that there was an adequate two day supply of perishable food and seven day supply of non-perishable food in the kitchen refrigerator and pantry. There is an additional refrigerator in the garage that contained frozen foods and juice. A trash can for storage of solid waste had a tight-fitting lid and is located in the kitchen. The first aid kit is located near the kitchen and contained all of the required materials. LPA also observed other required postings upon entry to the home including the facility license, foster youth personal rights, grievance policy, etc. The backyard was observed to be clean and free of hazards. There were recreation games available for use throughout the home and backyard. There is no pool or other body of water at the facility at this time. The Licensee reported that there are no firearms or other weapons on the facility grounds at this time. LPA conducted one client file review for Client 1 (C1) and observed the needed documents in the file including, needs and services plans, consent to medical treatment authorization forms, placement agreements, signed personal rights form, etc. One out of one files did not contain documented results of tuberculosis (TB) screening for C1. LPA conducted three staff file reviews for Staff 1 (S1), Staff 2 (S2), and Staff 3 (S3) and observed that two out of three staff files contained needed documents including CPR/First Aid certificates, Drivers License, Job Duties, Health Screening, etc. One out of three staff files reviewed did not contain documentation of good physical health and tuberculosis (TB) screening. Based on observation and record review, the facility is being cited one Type B violation in accordance with California Code of Regulations (CCR) (Title 22) 80069(c)(1) for not having documentation of a medical/TB examination on file for C1 within 30 days of admission. The facility is also being cited one Type B violation in accordance with CCR Section 80065(g)(1) for not having documentation of a health screening and TB examination results on file for S3. The facility is issued one technical violation in accordance with CCR Section 80010(a) for operating the facility beyond the conditions and limitations specified on the license. An exit interview was conducted and a copy of this report, LIC 811, LIC 9102, and appeal rights were reviewed and provided to the licensee - Ana Alcantar.

met_with: Licensee - Ana Alcantar


facility_name: BRIGHT FUTURE HOME

summary: Facility Evaluation

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Narrative:
On 12/26/2024 at 10: AM Licensing Program Analyst (LPA) Olena Maico and Licensing Program Manager (LPM) Tira Logan-Shanks conducted a Component II - Face to Face Meeting at the Monterey Park Regional Office via Teams. The following were present Beatrice Mausah and Wilson Wamagatta, applicants. LPA and LPM discussed their application and program description and advised them of the following corrections. The following information must be completed and submitted to Licensing: Fingerprints are done and pending in Guardian. Section A LIC Hours of operations need to be completed, mark source of water on the application. LIC Applicants groceries are only $200 shown, applicant will revise. LIC 610C Emergency Disaster Plan for Children's Residential Correct spelling for the water hose (not horse), list available staff phone numbers and emails, add positions responsible and put TBD. LIC Facility Sketch. Needs to identify ambulatory vs non-ambulatory rooms, how many clients in each room, show all the emergency exits on the sketch including the balcony one, show utility shut of outside. Pool is located on the premises of gated community and the applicant will need to get a water safety certificate. Fire clearance - pending. Section B Adjust the capacity to 3 from 6. Elaborate more on the reporting requirements, licensee's duties and responsibilities and application of the Reasonable and Prudent Parent standard. Continue Page Page How the results of the services will be measured (developmental milestones, educational progress etc.) Discipline policies Please elaborate how the children and their representatives will be informed of the discipline policies in writing. Physical restraints are mentioned in your statements, but they are not allowed in the SFH. Please amend. Provide provisions for contacting the Law Enforcement in the case verbal de-escalation techniques are not working. Admission/Intake How will the clients and representatives will be notified if the home cannot meet their needs? Attach admission agreement or will you be using the Regional Center Admission agreement? Who will be signing the agreement? Emergency removal or dismissal How will the representative be notified; the timeline and that emergency removal will not occur without the representative being notified. Continue on page Page Allowance and safeguard for cash resources. Please provide the information on the children's allowance and how and when it will be distributed. And what the allowance will be spend for and how will the licensee ensure the proper records of the money received and money spend by the child. Clothing and hygiene provided and age and culturally appropriate. Needs and Services Plan (NSP) Who will participate in creating NSP, will it be based of Regional Center IPP? How often it will be updated? Provide what NSP will contain and if it is Regional Center will it be based on their IPP? Steps if NSP not provided to the licensee. Who will sign the NSP once it is created. Medical/Dental Insurance utilized and who is responsible for emergency medical treatment? Consent for the emergency medical treatment and who is notified in the case of emergency. Who is responsible if the medical expense is not covered by the insurance? Consent for emergency treatment. Medication administration procedures. Psychotropic medications procedures and regular medication procedures, how the record will be maintained and what forms will be used (LIC A (MAR) and LIC622B (PMAR)). Self-administration medication/injections procedures and what staff will be responsible, refusal procedures documentation. Continue on page Page Children's records What will be in the records, who will be responsible for updating and maintaining children's records. Personal Rights/ Personal Rights of Children with Special health care needs. How will the children and their representatives will be informed of the personal rights (forms)? What form will be used (LIC613B), elaborate more on the personal rights of the children with special health care needs (83072.2). Corporal punishment will not be allowed. Bedroom sharing Please include bedroom sharing policies. Transportation Who will provide the transportation? How vehicle will be maintained to ensure safe operation? How will ensure the vehicle is utilizing proper and age applicable restraint systems, no smoking in the vehicle either children present or not. Visitation rules and policies Who will be visiting, visiting hours and when visits not permitted. Visitation rules and times. Continue on page Page House rules Curfew times and quiet times. Chores and other assignments age appropriate and applying prudent parent standards. Cameras Will facility be utilizing cameras? Licensee will go over the PIN 24-09-CRP to review the guidelines. A signed copy of this report was provided to the applicant. Exit interview conducted.

met_with: Beatrice Mausah ,Applicant Wilson Wamagatta, Applicant


summary: Facility Evaluation

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Narrative:
On 01/31/2025 at 10: AM, Licensing Program Analyst (LPA) Olena Maico conducted an announced pre-licensing inspection at the above address. LPAs met with Beatrice Mausah and Wilson Wamagata, Licensees. LPA Maico conducted a physical plant inspection inside and outside the home alongside with the applicants. The following were observed at the time of inspection: This facility is a tri-level home located in a gated community residential neighborhood. The facility consists of 4 bedrooms, 3 full bathrooms,one half bathroom, a living room, kitchen, dining room, 2-car garage, laundry closet. Overall, the facility is clean, sanitary and in good condition. The facility has a community pool located approximately 1000 feet from the home. The pool has a gate opening away from the pool and is over 5 feet tall fence. The fence is not obstructing the pool view, it has live plants on one side of the fence. LPA advised for the licensee to put the facility sketch next to the emergency plan and mark the emergency exits. The facility has a centralized heat and air-conditioning unit. Temperatures in all rooms are maintained at 69 degrees (F). The hot water temperature was measured at 107.5 degrees (F). Carbon monoxide and smoke alarms were tested and observed to be operational. The fire extinguisher located on each floor of the home. The utility shut offs and emergency exits match the emergency disaster plan. Knives and sharps were observed on the kitchen table, licensee will get a lockbox for the sharps. Disinfectants and cleaning solutions are kept in the cabinet located under the sink in the kitchen, as well as in the bathrooms, and are locked. The facility has a working cell phone. The applicant reports no firearms on the premises as well as no poisons and pesticides. The grounds are free from obstructions and hazards. Facility will be licensed for 3 clients, 2 ambulatory and 1 non-ambulatory. Bedroom #1 downstairs has a full size bed with comfortable mattress, bedding, pillows. It also has closet space and drawers attached to the bed. Bedroom #1 has bathroom with sink, toilet and shower, toiletries. Bedroom #2 has bassinet and a queen size bed with adequate bedding and a table. It has a closet and laundry hamper. Bedroom # 3 has a full bed and and drawers for storage, as well as laundry basket in the closet. Bedroom is a master bedroom and has king size bed, walking closet, ottoman full of extra linens and bedding. Bedroom downstairs will be used by the non-ambulatory clients,, upstairs bedrooms will be used by ambulatory clients. LPA observed bathrooms to be in good repair and working order. Bathroom in the bedroom # 1 has 1 sink, shower with the shower curtain and a toilet. Bathroom # 2 located on the second floor has has a sink and a toilet. The third bathroom is on the 3rd floor and has shower and a bathtub, toilet and sink. Master bedroom (#4) has 2 sinks, shower. Individual beds are observed to be in good repair, equipped with good springs, clean mattresses and pillows, as well as appropriate clean linens in good repair. LPA also observed extra towels stored in the hallway closet. Medications will be centrally stored in the lockboxes in the kitchen cabinets. Snack cabinets had locks, licensee will remove it. Licensee will acquire first aid kit with the necessary items. Kitchen has a refrigerator, dishwasher, stove and adequate utensils and tableware to accommodate the number of clients. LPA observed the kitchen area to be clean and the refrigerator is clean. LPA observed snack fridge and cabinets in the kitchen. Licensee will post food menu in the kitchen. Dining room has a table with 6 chairs to accommodate clients and the living room has a couch with enough room for 3 clients. There are no cameras inside the home. The fire department clearance is pending. Before today's visit, the applicant submitted the final Program Statement/Plan of Operation to LPA Maico with requested amendments and corrections. LPA Maico will submit it for final review, and a new license will be mailed to the licensee upon approval. Physical Plant - No Deficiency: 80075(k)(1) - Licensee will get a lockbox for medication and will store in the kitchen above the fridge Physical Plant - No Deficiency: 80075(g) - First aid kit will be purchased by the licensee Physical Plant - No Deficiency: 80075(j)(1) - Licensee will get another lockbox and the fridge for the refrigerated medications in case medication needs to be refrigerated. Physical Plant - No Deficiency: 80088(e)(3) - Licensee will get non-slip rags for the bathtub and shower Physical Plant - No Deficiency: 83088(g)(1) - Bedrooms had plenty of closet space, drawers are in the bed frames Physical Plant - No Deficiency: 83088(f) - Toy room upstairs full of books, toys, puzzles Physical Plant - No Deficiency: 80087(b)(1) - Licensee will buy non-slip rags for the bathtub and showers Physical Plant - No Deficiency: 80087(c) - The non-ambulatory clients are able to enter through the garage and the front through the use of detachable railings Operational Requirements - No Deficiency: 80026(j) - Licensee will lock the cash resources in the office that will be moved upstairs Operational Requirements - No Deficiency: 80023(a) - The license and the casualty plan will be posted in the kitchen/living room area. During the pre-licensing a Component III was conducted on what to expect after licensing. An exit interview was conducted a signed copy of this report was provided to the applicant.

met_with: Beatrice Mausah, Licensee Wilson Wamagatta, Licensee


summary: Facility Evaluation

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Narrative:
On 03/06/25 at 9: AM Licensing Program Analyst (LPA) Olena Maico conducted an announced pre licensing visit to the facility for the purpose of following up on the adjustments the facility had to make. LPA met with the licensees Beatrice Mausah and Wilson Wamagatta. LPA conducted the inspection of the rooms. All the extra stuff was removed, the closets have space for the children to store their clothes and personal items, there is a night stand with the drawer space for personal belongings in each room. Each room has a hamper and bed with clean linens (see detailed description in the prior pre licensing inspection). Bathrooms have empty drawers and nothing under the sink and medicine cabinet is cleared on the first floor bathroom. Licensee obtained a lock mechanism for the balcony door (LPA will attach the photo) that locks the handle and the children unable to open the door. Licensee also obtained a signal system for the front door and the garage door due to the community pool being in the area of approximately 700 feet from the home and having a live fence that partially obstructs the view. The signal system can be heard throughout the home. The pool has a tap key and opens away from the pool. The fence is on the concrete base (about 1,5 ft) and is about 5 ft tall ( about 6,5 ft in total height). Licensee obtained mini fridge for the medications that will need to be refrigerated and the lock boxes for the medications and knives. Lockboxes have keys or combination lock. Licensee has a first aid kit with all the necessary supplies and within the guidelines of the licensing requirements. The lock has been removed from the snack fridge. All bathrooms have non-slip rugs and the chemicals are all centrally locked on the third floor in the cabinet. The children and staff files will be kept locked in the licensee's master bedroom and inaccessible. Guardian clearance still pending, Licensee will reach out to Guardian. LPA will also send an e-mail to check on the status. Fire clearance has been received and granted by the Fire Marshall. Licensee was provided with this report. LPA will submit all the paperwork for the approval once Guardian clearance is received.


summary: Facility Evaluation

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Narrative:
On 06/19/25 at 8: AM, Licensing Program Analyst (LPA) Olena Maico conducted an announced post licensing inspection at the above address. LPAs met Wilson Wamagatta, Licensee. LPA Maico conducted a physical plant inspection inside and outside the home alongside with the applicants. The following were observed at the time of inspection: This facility is a tri-level home located in a gated community residential neighborhood. The facility consists of 4 bedrooms, 3 full bathrooms, one half bathroom, a living room, kitchen, dining room, 2-car garage, laundry closet. Overall, the facility is clean, sanitary and in good condition. The facility has a community pool located approximately 1000 feet from the home. The pool has a gate opening away from the pool and is over 5 feet tall fence. The fence is not obstructing the pool view, it has live plants on one side of the fence. Licensee has a door alarm that alerts them when the door opens outside or into the garage due to the pool having live fence and obstructing view from one side. LPA advised for the licensee to put the facility sketch next to the emergency plan and mark the emergency exits. The facility has a centralized heat and air-conditioning unit. Temperatures in all rooms are maintained at 69 degrees (F). The hot water temperature was measured at 107.5 degrees (F). Carbon monoxide and smoke observed in the home. The fire extinguisher located on each floor of the home. The utility shut offs and emergency exits match the emergency disaster plan. Knives are locked in the office cabinet and inaccessible. Continue pg Disinfectants and cleaning solutions are kept in the cabinet located under the sink in the kitchen and are locked. LPA observed chemicals in the garage, garage door locks. LPA advised the Licensee to obtain the locked cabinet for the chemicals in the garage. The facility has a working cell phone. The applicant reports no firearms on the premises as well as no poisons and pesticides. The grounds are free from obstructions and hazards. All bedrooms have comfortable beds equipped with the good mattress and bedding and pillows, as well as blankets. Individual beds are observed to be in good repair, equipped with good springs, clean mattresses and pillows, as well as appropriate clean linens. The rooms have an ample amount of space for the clients and the closets have a lot of room for the clients' belongings. Bedrooms also have dressers. LPA observed bathrooms to be in good repair and working order. LPA also observed extra towels stored in the hallway closet. Medications will be centrally stored in the lockboxes in the office. Kitchen has a refrigerator, dishwasher, stove and adequate utensils and tableware to accommodate the number of clients. LPA observed the kitchen area to be clean and the refrigerator is clean. LPA observed snack fridge and cabinets in the kitchen. Licensee has post food menu in the kitchen. Licensee has an adequate amount of perishable and non-perishable foods. Dining room has a table with 6 chairs to accommodate clients and the living room has a couch with enough room for 3 clients. LPA reviewed one (1) client record and two (2) staff record. LPA checked required criminal record and child abuse index check clearance or exemption for all adults in the home. The client's files contained: Admission Agreement, Medical Assessment, Consent Forms, Emergency Information, Appraisal Form, NSP still pending. LPA verified medical assessment of the licensee RP2 on the phone, LPA instructed Licensee to print and file the medical assessment in the files. LPA did not observe Health Screening for RP1. Type B citation is issued. LPA did not observe water safety certificate for either licensee. Type B citation is issued. LPA interviewed the Licensee. Based on the facility inspection and file reviews this date, there are two deficiencies found at this time. An exit interview was conducted and LPA provided a copy of the following reports: LIC 809, LIC 809C, 809D, TA and TV and LIC 811 and copy of appeal right to the Licensee.

met_with: Wilson Wamagatta, Licensee


summary: Facility Evaluation

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Narrative:
On March 12th, T 9:05 am Licensing Program Analyst (LPA) Olena Maico conducted an announced annual inspection at the above address. LPA met with Beatrice Mausah, Licensee. LPA Maico conducted a physical plant inspection inside and outside the home alongside with the applicants. The following were observed at the time of inspection: This facility is a tri-level home located in a gated community residential neighborhood. The facility consists of 4 bedrooms, 3 full bathrooms, one half bathroom, a living room, kitchen, dining room, 2-car garage, and a laundry closet. Overall, the facility is clean, sanitary and in good condition. The facility has a community pool located approximately 1000 feet from the home. The pool has a gate opening away from the pool and is over 5 feet tall fence. The fence does not obstruct the pool view, it has live plants on one side of the fence. Licensee has a door alarm that alerts them when the door opens outside or into the garage due to the pool having live fence and obstructing view from one side. Licensee has a door alarm that alert them if the clients will leave the home. The facility has a centralized heat and air-conditioning unit. Temperatures in all rooms are maintained at 70 degrees (F). The hot water temperature was measured at 120 degrees (F). Carbon monoxide and smoke are observed in the home and tested. The fire extinguisher was located on each floor of the home. The utility shut offs and emergency exits match the emergency disaster plan. Knives are locked in the office cabinet and inaccessible. Disinfectants and cleaning solutions are kept in the cabinet located under the sink in the kitchen and are locked. Licensee will get lock that is more secure. Continue pg LPA observed chemicals in the upstairs cabinet and it had a lock, but the lock is easy to open, Licensee will get a more secured lock for the cabinet. The facility has a working cell phone. The applicant reports no firearms on the premises as well as no poisons and pesticides. All bedrooms have comfortable beds equipped with the good mattress, bedding and pillows, as well as blankets. Individual beds are observed to be in good repair, equipped with good springs, clean mattresses and pillows, as well as appropriate clean linens. The rooms have an ample amount of space for the clients, and the closets have a lot of room for the clients' belongings. Bedrooms also have dressers. LPA observed bathrooms to be in good repair and working order. LPA also observed extra towels stored in the hallway closet. Medications centrally stored in the lockboxes in the office. Kitchen has a refrigerator, dishwasher, stove and adequate utensils and tableware to accommodate the number of clients. LPA observed the kitchen area to be clean, and the refrigerator is clean. LPA observed snack fridge and cabinets in the kitchen. Licensee has food menu in the kitchen. Licensee has an adequate amount of perishable and non-perishable foods. Dining room has a table with 6 chairs to accommodate clients, and the living room has a couch with enough room for 3 clients. LPA reviewed two(2) clients record and two (2) staff record. LPA checked required criminal record and child abuse index check clearance. The client's files contained: Admission Agreement, Medical Assessment, Consent Forms, Emergency Information, Appraisal Form. NSP was not in the client's files, personal rights were not in the files. LPA issues three (3) type B citations and two (2) Technical Violations. Continue pg Based on the facility inspection and file reviews this date, there are three deficiencies found at this time. An exit interview was conducted and LPA provided a copy of the following reports: LIC 809, LIC 809C, 809D, TV and LIC 811 and copy of appeal right to the Licensee.

met_with: Beatrice Mausah, Licensee