summary: Facility Evaluation

raw_content:
Narrative:
On Monday, April 13, 2026, 10:15AM, Licensing Program Analyst (LPA) Humberto Flores conducted an unannounced Annual Inspection at Unicorn Short Term Residential Therapeutic Program (STRTP) and met with Executive Director Kim Hudnall. LPA Flores stated the purpose of the inspection to the STRTP representative. LPA Flores conducted the inspection accompanied by Facility Manager (FM) Ranice Dodson. Physical Plant: It was observed that the facility was clean, safe, sanitary and in good repair. The passageways and ramps are unobstructed. The disinfectants and cleaning solutions are inaccessible to the children. There are no swimming pools or similar bodies of water at the facility. The clients in care are always supervised and protected. The STRTP representative stated that there are no firearms in the facility. The temperature in the rooms that clients occupy are maintained between 68 and 85 degrees (F). The STRTP has non-perishable foods for one week and perishable foods for two days and nutritious snacks are provided between meals. Medications are locked and accessible only to employees supervising stored medications. The fire alarms and carbon monoxide detectors were checked and are operating. The license was posted, Foster Youth Bill of Rights, grievance policy, grievance policy, Mental Health Program Approval, emergency disaster plan and facility sketch. cont.# There were extra linens, towels, and hygiene supplies in the cabinets. There was a working telephone in the facility. The first aid kit was complete and readily available. The smoke/carbon monoxide detectors were in working order. All medications were centrally stored. The hot water temperature in the kitchen sink faucet was 127. F. A citation type A was issued. Children Records: LPA reviewed 1 children's file. The files contain a record of client's admission agreement, medical assessment, consent forms, emergency information, appraisal and needs and services plan, immunization record, centrally stored medication record, safeguards for property/valuables, personal resources form and cash resource information. A medication count was conducted. LPA Flores observed that for C3 the following was observed: - For medication Ref #1 (BU) the PMAR shows that the dosage for 4/02/26 was taken, but the pill was found in the package. - On 4/13/26, C1 did not have the morning dosage available for BU. - For medication Ref #2 (OL) the PMAR shows that the dosage for 4/02/26 was taken, but the pill was found in the package. A citation Type A and 2 citations Type B were issued. Staff Records: A total of 2 employee files were reviewed. The files contain the following documentation: first aid certificate, Child Abuse Index Checks/Department of Justice (DOJ)/Federal Bureau of Investigation (FBI) criminal record clearances, education verification, personnel record, health screening, criminal record statement, employee rights and tuberculosis test. Personnel policies, job descriptions and training verification are included in the employees' file. cont.# LPA Flores conducted a criminal record review of all individuals listed in the LIC500 provided during the inspection. All individuals obtained, prior working, a criminal record clearance or exemption as specified in Health and Safety Code section 1522(a)(4). LPA Flores observed that the file for Staff Ref #1 (S1) did not contain a Physical Exam. A citation type B was issued. Four Advisory Notes/Technical Violations were issued. Administration/Accountability: The minutes of board of directors' meetings were available to the licensing agency to inspect, audit, and copy upon demand. The Emergency Evacuation plan and physical plant sketches are posted. The Emergency Disaster Plan, LIC 610C was posted. Personal Rights listing is posted. Facility License was posted in a prominent place. The STRTP submits monthly restraints reports and the biannual review of manual restraints to the Department. A copy of this report, citations pages, Advisory Notes/Technical Violations and LIC811s were provided to the facility representative. Exit interview conducted.


state: CA

facility_name: VALLEY OF THE MOON STRTP

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
During the investigation, LPA identified an area in which a Technical Assistance maybe beneficial. LPA is issuing an advisory for Short-Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS) Section 87095.61 (g) Documentation and Reporting Requirements. An exit interview was conducted, appeal rights provided, and a copy of this report left with Clinical Manager.

Investigation Findings:
13On 12/10/24, Licensing Program Analyst (LPA) Celeste Aparicio made an unannounced inspection to the facility for the purpose of delivering findings from a complaint investigation. At 2:40pm LPA met with met with Clinical Manager, Jaime Ott and informed Clinical manager the purpose of this visit. The Department received a complaint alleging staff inappropriately restrained minor in care and staff did not allow minor to use the restroom. LPA reviewed documentation and conducted confidential interviews. After the review of documentation and interviews with relevant parties, it was found that the allegations could not be corroborated due to inconsistent statements obtained. Although the allegations staff inappropriately restrained minor in care and staff did not allow minor to use the restroom may have happened or is valid, based on LPA's observations and interviews, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Celeste Aparicio 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 21-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO RO, TRAEGER AVE., SUITE FACILITY NAME: VALLEY OF THE MOON STRTPFACILITY NUMBER: VISIT DATE: 12/10/2024

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

report_type: Complaint Investigation

met_with: Clinical Manager, Jaime Ott

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli made an announced visit to the facility and met with Administrator Sky Gray and Program Manager Easter-Dawson. Also participating the inspection were Regional Manager (RM) Nelson Martinez and Licensing Program Manager (LPM) Isabel Mendoza. The purpose of the inspection was to review the planned addition of a Short-Term Residential Therapeutic Program facility to their existing operation. Prior to the visit, LPA Bertoli made a pre-screening COVID call, and Administrator Gray indicated they did not have any positive cases currently or known exposures or symptomatic persons. The facility was toured inside and out, including the administrative offices. The facility appears to be clean, safe, and sanitary. The current facility includes two wings for residential use and a common cafeteria between the residential wings. A large patio and playground surround the building. A review was done of which areas will be kept separate between the facilities, and which areas will be shared, and how the populations will be kept separate and supervised. The automated No Title 22 deficiencies were cited on this visit. An exit interview was conducted with Administrator Gray and a copy of this report was left with the facility.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Sky Gray and Meg Easter-Dawson


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli conducted an announced pre-licensing inspection of the facility. LPA met and toured the facility with Briana Downey, Sky Gray, and Sharene Kacyra. This Short-Term Residential Therapeutic Program is a one-story facility located in a building that is shared with their Temporary Shelter Care facility. The two facilities are kept in separate wings with their dining area in between. The facilities have separate dining times. Separation of youth is maintain by electronic system and key access by staff. The facility consists of 16 client bedrooms plus a bedroom for isolation due to illness and 8 client bathrooms, living areas, recreational room, shared kitchen, and office. The facility is clean, safe, sanitary, and in good repair. All passageways are unobstructed and all doors open freely. There is no pool on the premises. Firearms are not allowed on the facility premises. At the time of visit, the following was observed: Fire extinguishers and Smoke detectors/carbon monoxide detectors are throughout the facility and operational. Each bedroom has a bed, clean linens, and adequate drawer/cabinet space. Facility has a fire clearance. First aid kit was in compliance. Hot water temperature measured at 117 degrees Fahrenheit. Staff records are accessible and kept at a separate office. Client records are electronic. Medications will be centrally stored and locked in the medication room. Disinfectants and other toxic materials will be locked away from foods. Knives and sharps will be kept locked in the kitchen. The facility is found to be acceptable for a Short-Term Residential Therapeutic Program. This facility is licensed as of today, 6/5/23. LPA will mail Administrator a copy of the license. An exit interview was conducted and a copy of the Facility Evaluation Report was given to the facility.

visit_type: Prelicensing

met_with: Mary Gray, Sharene Kacyra, and Briana Downey


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli conducted an unannounced Annual/Required inspection of the facility. LPA met and toured the facility with Briana Downey and met with Sky Gray. This Short-Term Residential Therapeutic Program is a one-story facility located in a building that is shared with their Temporary Shelter Care facility. The two facilities are kept in separate wings with their dining area in between. The facilities have separate dining times. Separation of youth is maintain by electronic system and key access by staff. The facility consists of 16 client bedrooms plus a bedroom for isolation due to illness and 8 client bathrooms, living areas, recreational room, shared kitchen, and office. The facility is clean, safe, sanitary, and in good repair. All passageways are unobstructed and all doors open freely. There is no pool on the premises. Firearms are not allowed on the facility premises. Fire extinguishers and Smoke detectors/carbon monoxide detectors are throughout the facility and operational. Each bedroom has a bed, clean linens, and adequate drawer/cabinet space. First aid kit was in compliance. Hot water temperature measured at 110 degrees Fahrenheit. Staff records are accessible and kept at a separate office. Client records are electronic. Medications are centrally stored and locked in the medication room. Disinfectants and other toxic materials are locked away from foods. Knives and sharps will are kept locked in the kitchen. No deficiencies were cited. An exit interview was conducted and a copy of the Facility Evaluation Report was emailed to the facility per their request.

visit_type: Annual

met_with: Briana Downey and Sky Gray


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPAs) Nicole del Calvo and Brian Bertoli conducted an unannounced Post Licensing inspection of the facility. LPA met and toured the facility with Administrator Sky Gray. This Short-Term Residential Therapeutic Program is a one-story facility located in a building that is shared with their Temporary Shelter Care facility. The two facilities are kept in separate wings with their dining area in between. The facilities have separate dining times. Separation of youth is maintain by electronic system and key access by staff. The facility consists of 16 client bedrooms plus a bedroom for isolation due to illness and 8 client bathrooms, living areas, recreational room, shared kitchen, and office. The facility is clean, safe, sanitary, and in good repair. All passageways are unobstructed and all doors open freely. There is no pool on the premises. Firearms are not allowed on the facility premises. Fire extinguishers and Smoke detectors/carbon monoxide detectors are throughout the facility and operational. Each bedroom has a bed, clean linens, and adequate drawer/cabinet space. First aid kit was in compliance. Hot water temperature measured at 110 degrees Fahrenheit. Staff records are accessible and kept at a separate office. LPAs will continue the visit and review the staff files on another date. Client records are electronic and were found to be complete. Medications are centrally stored and locked in the medication room. Disinfectants and other toxic materials are locked away from foods. Knives and sharps will are kept locked in the kitchen. No deficiencies were cited. Technical Advisory was given under California Code Regulations 80019(e)(3) An exit interview was conducted and a copy of the Facility Evaluation Report was emailed to the facility per their request.

met_with: Sky Gray-Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On the above date Licensing Program Analyst (LPAs) Brian Bertoli and Nicole del Calvo conducted an unannounced inspection for the purposes of continuing an Annual/Required Inspection and met with Payroll Clerk Kendra Burgess. 5 staff files (including Administrator) were reviewed at the Human Resources office on Westwind Blvd. Per Title Regulations, no deficiencies were cited during this inspection. An exit interview was conducted and a copy of the report was left with the facility.

met_with: Kendra Burgess


summary: Facility Evaluation

raw_content:
Narrative:
On the above date Licensing Program Analyst (LPAs) Nicole del Calvo and Brian Bertoli conducted an unannounced inspection for the purposes of continuing an Annual/Required Inspection and met with Payroll Clerk Kendra Burgess 5 staff files (including Administrator Sky Gray) were reviewed at the Human Resources office on Westwind Blvd. Per Title Regulations, no deficiencies were cited during this inspection. An exit interview was conducted and a copy of the report was left with the facility.

met_with: Payroll Clerk-Kendra Burgess


summary: Facility Evaluation

raw_content:
Narrative:
On 07/02/25, Licensing Program Analyst (LPA) Celeste Aparicio made a visit to the facility to amend a report. LPA met with the Human Services Manager, Briana Downey and informed them on the purpose of the visit. The report was amended. An exit interview was conducted, and a copy of this report was left with the facility.

met_with: Human Services Section Manager,Briana Downey


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli conducted a Case Management visit to the Short-Term Residential Treatment Program. The purpose of the visit was to gather information regarding an investigation that was being conducted regarding another facility. LPA was not investigating the Valley of the Moon facility. A confidential interview was conducted. LPA did not conduct a facility inspection or record review. No deficiencies were cited for this visit. An exit interview was conducted and a copy of this report was given to the facility.

met_with: Sky Gray


summary: Facility Evaluation

raw_content:
Narrative:
On 9/9/25, Licensing Program Analysts (LPAs) Mariah Hawkins and Kimberly Hall conducted an unannounced random annual inspection. LPAs met with Administrator Jamie Ott and informed of the purpose of the visit. LPAs conducted a tour of the facility site and observed the facility site to be maintained in clean and safe condition. Sharps, chemicals, and medications are secured and inaccessible to clients. The food storage area is clean and well-organized. Client bedrooms offer individual beds, dressers, and table space. The first aid kit was observed to be complete. LPAs reviewed 5 client files, and observed all files to be complete. LPAs reviewed 5 personnel files, and observed all files to be complete. Using the CARE inspection tool, no deficiencies were found. A continuation visit will be conducted to complete this inspection. An exit interview was conducted, and a copy of this report was left with Administrator Jamie Ott.

met_with: Administrator Jamie Ott


summary: Facility Evaluation

raw_content:
Narrative:
On 09/24/2025 at 2: PM, Licensing Program Analyst (LPA) Jasmine Cardeno made a unannounced visit to the facility for the purpose to amend reports. LPA met with Program Planning and Evaluation Analyst, Julie Hillborn, who facilitated the inspection. LPA informed Program Planning and Evaluation Analyst the purpose of the visit was to deliver amended reports. The reports were amended. An exit interview was conducted, and a copy of this report along with the other amended reports were given to Program Planning and Evaluation Analyst, Julie Hillborn, whose signature on this form confirms receipt.

met_with: Julie Hillborn


summary: Facility Evaluation

raw_content:
Narrative:
On 9/25/25, Licensing Program Analysts (LPAs), Kimberly Hall and Mariah Hawkins visited the facility for an annual continuation inspection. LPAs met with Program Manager, Sky Gray and informed of the purpose of the visit. The inspection was initiated on 9/9/25. In order to complete the inspection, LPAs conducted two confidential staff interviews and one confidential client interview. Other clients declined an interview or were otherwise unavailable. No deficiencies were observed. An exit interview was conducted, and a copy of this report was given to the Program Manager.

met_with: Program Manager, Sky Gray


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli conducted an unannounced visit to the facility and met with Program Manager (PM) Stacie Kabour. The purpose of the visit was to conduct a Case Management Inspection regarding an Incident Report. The incident occurred on 10/27/2025 and was a report of a restraint of a youth in the facility. LPA Bertoli conducted confidential interviews and reviewed records, which indicated that the youth had stated the need to use the restroom and was not allowed to do so, but the youth was in a highly agitated and dangerous state, and the youth had on multiple previous occasions used the bathroom request as a method to get away from staff, so it was determined to continue the restraint. An Advisory Note was issued regarding Prone Restraints, which are shown as acceptable in the facility's Program Statement, but are prohibited under 87095.01(a)(4) Emergency Interventions Prohibition. No citations were issued at this visit. An exit interview was conducted with Stacie Kabour and a copy of this report was given to the facility.

met_with: Stacie Kabour


facility_name: VALLEY TEEN RANCH

summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13On 04/27/2021, Licensing Program Analyst (LPA) Tamara Melikian conducted a complaint investigation to inform the facility of the outcome of the above allegation. Met by CEO Andrea Evans. Due to restrictions of COVID-19, the inspection was conducted by telephone with this document scanned to Ms. Evans on this date with a request for signature and a scan back. Interviews were conducted of witnesses and staff (#1). Staff (#1) denies that anything inappropriate ever occurred. Witness provided documentation of minor (#2) admitting to contact with staff (#1). Minor (#2) was unable to be interviewed at this time as he has not returned to placement and his whereabouts are unknown. Based on the above, there is a preponderance of evidence to conclude that the allegation is substantiated. Deficiency on the attached page. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Melanie Krage LICENSING EVALUATOR NAME: Tamara Melikian LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 24-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, E SHAW AVE FACILITY NAME: VALLEY TEEN RANCHFACILITY NUMBER: 207200734

met_with: Andrea Evans

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On 04/27/2021, Licensing Program Analyst (LPA) Tamara Melikian conducted a complaint investigation to inform the facility of the outcome of the above allegation. Met by CEO Andrea Evans. Due to restrictions of COVID-19, the inspection was conducted by telephone with this document scanned to Ms. Evans on this date with a request for signature and a scan back. Interviews were conducted of witnesses and staff (#1). Staff (#1) denies that any type of relationship ever occurred. Minor (#2) was unable to be interviewed at this time as he has not returned to placement and his whereabouts are unknown. Based on the above, the complaint is unsubstantiated. There are no deficiencies to be cited on this date. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Melanie Krage LICENSING EVALUATOR NAME: Tamara Melikian LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2


summary: Facility Evaluation

raw_content:
Narrative:
On October 29, 2021, Licensing Program Analysts Rachel Bruce and Priscilla Zamudio (LPAs) arrived at Valley Teen Ranch for the purpose of conducting an unannounced annual inspection. Upon arrival, LPAs were met by David Carrera, Administrator who explained this particular facility currently has no residents and no staff assigned. The facility remains licensed at this time but there is nothing to inspect. The capacity on this home remains at 12. The home is on the property of the other Valley Teen home but it is not used for any purpose other than storage at this time. LPA will continue to monitor the status of the facility, when and if children are placed an annual inspection will be conducted at that time.

met_with: David Carrera, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On November 1, 2021, Licensing Program Analyst Rachel Bruce arrived at the Administrative Office of Valley Teen Ranch for the purpose of discussing the plans for the above STRTP. Currently the home is not accepting residents and would not be in the near future due to staffing issues/challenges. The staff currently is serving at the other home ( Rd 35) and serving the population at that residence. There are long term options to consider for the home at this time. The goal is not to surrender the license at this time to keep options open and to serve the clientele when necessary. The house is currently being renovated and Ms. Evans will notify CCL when clients can be accepted and an inspection will be completed at that time. The house will be physically ready within 14 days however staffing issues will not be resolved that quickly. Juanita Arroyo, Licensing Program Manager, was present on a phone conference during this visit. Ms. Arroyo will look into the options and will be conferring with the Regional office to determine the appropriateness for the tentative plan and the STRTP remaining in compliance. Other issues discussed included changing Administrators and decreasing capacity on the other home. Ms. Evans to follow up with LPA Bruce and submit correspondence accordingly.

met_with: Andrea Evans, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On November 17, 2021, Licensing Program Analyst (LPA) Rachel Bruce was met by John Addington, Program Administrator. The purpose of this inspection is to conduct an unannounced required annual inspection. The facility is licensed for twelve residents. There are currently zero residents in placement. There is no staff on board at this time as there are no clients. No staff or client files were reviewed/inspected during this visit. The Administrator file and Facility file are complete. A tour of the facility was conducted and the following was observed: No Medications are stored at this time. Fire extinguisher charged. Smoke alarms in place and operational. Food supply does not apply as there are no residents Adequate Client furnishings. Yard is free of any hazards and there are no bodies of water. There are no weapons in the residence. Per Title Regulations, no deficiencies were cited during this inspection. A copy of the report was left with the facility representative

met_with: John Addington, Program Administrator


raw_content:
Investigation Findings:
13On 06/08/2021, Licensing Program Analyst (LPA) Tamara Melikian conducted a complaint investigation to inform the facility of the outcome of the above allegation. Met by CEO Andrea Evans. Due to restrictions of COVID-19, the inspection was conducted by telephone with this document scanned to Ms. Evans on this date with a request for signature and a scan back. Interviews were conducted of witnesses and staff (#1). Staff (#1) states that contact was made by the minor (#2) by a phone call and a handwritten letter that was received and given by the minor's (#2) probation officer. No further contact has occurred and the staff (#1) has blocked the minor (#2) from being able to contact her. Staff (#1) further states that no type of relationship ever occurred. Based on the above, the complaint is unsubstantiated. There are no deficiencies to be cited on this date. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Melanie Krage LICENSING EVALUATOR NAME: Tamara Melikian LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


raw_content:
Investigation Findings:
13Complaint Specialist C.K. Kinney(CS) traveled to Valley Teen Ranch offices and met with Andrea Evans to deliver findings. CS and Investigator Romelia Munoz conducted investigation that included review of documentation, and confidential interviews. Due to inconsistencies in the information obtained a preponderance of the evidence could not be found. Although the allegation may or may not be valid or may or may not have occurred, without a preponderance of the evidence the allegation is deemed Unsubstantiated. Copy of this report, LIC Confidential Names and LIC Appeal Rights left at the facility at conclusion of inspection UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Charles Kinney LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Daiquiri Boyd conducted an unannounced visit to the Short Term Residential Therapeutic Program (STRTP) to deliver the findings of the above allegations and met with Kim Gerhardt in Quality Assurance. The above allegations were referred to Community Care Licensing for investigation. The investigation included confidential interviews and a review of client files . Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegations occurred. Therefore, the allegations are UNSUBSTANTIATED at this time. A copy of this report was discussed and provided to STRTP. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Daiquiri Boyd LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Kim Gerhardt


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analysts (LPAs) Brinae Pointer and Miriam Flores conducted a complaint inspection and met with Administrator, John Addington and CEO, Andrea Evans. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the complaint alleging staff did not prevent minor from inappropriately touching another minor in care. LPA Pointer conducted interviews and obtained documentation. There were inconsistencies in the confidential interviews. Although the allegations may have happened or is valid, there is not a preponderance of evidence to provide the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tamara Melikian LICENSING EVALUATOR NAME: Brinae Pointer LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Administrator John Addington


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analysts (LPAs) Brinae Pointer and Miriam Flores conducted a complaint inspection and met with Administrator, John Addington and CEO, Andrea Evans. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the complaint alleging Staff innapropriately touched minor in care. LPA Pointer conducted interviews and obtained documentation. There were inconsistencies in the confidential interviews. Although the allegations may have happened or is valid, there is not a preponderance of evidence to provide the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tamara Melikian LICENSING EVALUATOR NAME: Brinae Pointer LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


raw_content:
Investigation Findings:
13On March 7, 2025, Licensing Program Analyst (LPA) Danny Macias conducted a complaint inspection at Valley Teen Ranch STRTP and met with David Carrera, Administrator (AD.) The purpose of the inspection was to deliver the findings for the above complaint allegation. During the investigation, LPA conducted interviews, a records review and reviewed supporting documents provided by the facility. Based on confidential interviews and other information obtained, the department has made the following determination. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted, and a copy of this report was left with David Carrera. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tamara Melikian LICENSING EVALUATOR NAME: Danny Macias LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: David Carrera


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Danny Macias arrived at the Short Term Residential Treatment Program (STRTP) to both open and close a complaint. LPA met with David Carrera, Administrator (S1). The purpose of the inspection was to inform the STRTP that an investigation is being conducted regarding the above allegation. LPA interviewed staff and clients and reviewed client files on this date. During the investigation, LPA conducted interviews and a records review provided by the facility. Based on confidential interviews and other information obtained, the department has made the following determination. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. There is a Technical Violation for Responsibility for Providing Care and Supervision 80078(a) being issued on today's visit. A copy of this report was left with David Carrera at the conclusion. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tamara Melikian LICENSING EVALUATOR NAME: Danny Macias LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


raw_content:
Investigation Findings:
13On September 2, Licensing Program Analyst (LPA) Danny Macias arrived at the STRTP to conduct confidential interviews. LPA met with Administrator (S1) David Carrera. LPA conducted 3 confidential interviews on this date. An exit interview was conducted and a copy of this report was left with David Carrera at the conclusion. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tamara Melikian LICENSING EVALUATOR NAME: Danny Macias LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


raw_content:
Investigation Findings:
13On October 6, 2025, Licensing Program Analyst (LPA) Danny Macias conducted a complaint inspection at the STRTP and met with Administrator (AD) David Carrera. The purpose of the inspection was to deliver the findings of the above complaint allegation. During the investigation, LPA conducted interviews and a records review provided by the facility. Based on confidential interviews and other information obtained, the department has made the following determination. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. A copy of this report was left with David Carrera at the conclusion. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tamara Melikian LICENSING EVALUATOR NAME: Danny Macias LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FRESNO RO, E SHAW AVE This is an official report of an unannounced visit/investigation of a complaint received in our office on 07/22/2025 and conducted by Evaluator Danny Macias PUBLICCOMPLAINT CONTROL NUMBER: 24-CR- FACILITY NAME:VALLEY TEEN RANCHFACILITY NUMBER: ADMINISTRATOR:J ADDINGTON/A EVANSFACILITY TYPE: ADDRESS: ROAD 35TELEPHONE: (559) 437- CITY:MADERASTATE: CAZIP CODE: CAPACITY:16CENSUS: 13DATE: 10/06/ UNANNOUNCEDTIME BEGAN: 01: PM MET WITH:David CarreraTIME COMPLETED:03: PM 9Staff member allowed minors to smoke marijuana while in care. INVESTIGATION FINDINGS: 13On October 6, 2025, Licensing Program Analyst (LPA) Danny Macias conducted a complaint inspection at the STRTP and met with Administrator (AD) David Carrera. The purpose of the inspection was to deliver the findings of the above complaint allegation. During the investigation, LPA conducted interviews and a records review provided by the facility. Based on confidential interviews and other information obtained, the department has made the following determination. Based on the information obtained, a preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED. This facility is being cited for violation of Interim Licensing Standards, Version 5, Section 87072(c)(1) Personal Rights. See LIC9099D. A copy of this report was left with David Carrera at the conclusion. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tamara Melikian LICENSING EVALUATOR NAME: Danny Macias LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 2 of Control Number 24-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FRESNO RO, E SHAW AVE FACILITY NAME: VALLEY TEEN RANCHFACILITY NUMBER: 200404880


summary: Facility Evaluation

raw_content:
Narrative:
On 06/24/2021, Licensing Program Analyst (LPA) Tamara Melikian conducted an annual inspection at the above facility. Met at the facility by Administrator John Addington and Social Workers David Carrera and Kim Gearhart. Currently there are 7 clients at the facility. Client files were inspected on this date. Staff files are at the corporate office and will be inspected at a later time. Clients are not home as they are attending school. A physical plant inspection was completed and included the following checks. Facility grounds are clean and free of debris and observable hazard. Adequate indoor and outdoor activity space and materials observed. All facility smoke detectors are in appropriate working order, fire extinguisher is properly charged and serviced. Facility maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. All required forms are posted. Medications are locked and centrally stored. Individual beds were observed with appropriate clean linens and are in good repair. Hot water measured 113 degrees. There are no firearms or pets at the facility. There is a pool at the other home on the facility grounds that is currently under renovation. The other home is under renovation and clients are not currently placed at that home. There are no deficiencies to be cited on this date. A copy of this report is left at the facility.

met_with: John Addington, David Carrera, Kim Gearhart


summary: Facility Evaluation

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Narrative:
On 06/24/21, Licensing Program Analyst (LPA) Tamara Melikian conducted an unannounced case management inspection to complete the annual inspection by reviewing staff files. Met at the corporate offices by Human Resource Manager Janet Grimson. Staff files and training inspected on this date. A review of staff records on 06/24/2021 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. There are no deficiencies to be cited on this date.

met_with: Janet Grimson


summary: Facility Evaluation

raw_content:
Narrative:
On December 9, Licensing Program Analyst (LPA) Rachel Bruce travelled to the facility listed above to conduct an initial pre licensing inspection. Facility Inspection conducted. Purpose of inspection is to issue a new license for decreased capacity, no program change or operational changes at this time. LPA was met at the facility by Administrator , David Carrera, 1. Facility Grounds inspected and observed to be free from hazard with appropriate activity space observed. 2. Chemicals, medications, and sharp objects are all stored in separate locked cabinets. 3. Observed locked cabinet inside locked closet for central storage of medications. Observed first aid kit and manual. 4. Individual beds and bedrooms are in good repair along with an appropriate amount of storage space. 5. Both House 1 and House 2 have 5 bedrooms each sufficient for double occupancy. Bedrooms are accommodating of all required furnishings. 6. Adequate food storage space observed. Perishable and non- perishable foods were observed at this time and found to meet regulatory requirements.. 7. Dining room observed with appropriate table and chairs. 8.. Licensee has a vehicle for use at the facility with appropriate insurance and registration. 9. Fire Clearance is pending. Facility has met requirements for initial licensure for decreased capacity. STRTP license to be issued reflecting capacity decrease from 20 to 16.


summary: Facility Evaluation

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Narrative:
February 16, 2023, Licensing Program Analyst (LPA) Rachel Bruce conducted a case management visit at the above STRTP and met with Administrator, John Addington. The purpose of the visit is to issue a citation regarding dispensing medication to the clients in care. On February 3, LPA Bruce received an incident report which indicated a child was found with a bag of crushed pills in the pocket of his jeans. The client disclosed that he had been 'cheeking' his morning and nighttime medication. The term 'cheeking' refers to hiding the medication in his cheek and not swallowing. Client further explained that the crushes the medication and puts the powder in water to get high. A review of the STRTP's medication dispensing procedures indicates the staff will check the client's mouth after providing medication to ensure that the pill had been swallowed and not hidden. In this particular case, the client was able to hid the medication in his throat despite drinking water and the staff checking. Increased monitoring will be put in place with this client and if necessary protocol will be changed. Administrator will check in with LPA to communicate the efficiency of the current procedures in place. Please see LIC811 for confidential names list. No citations issued at today's visit.

met_with: John Addington, Prior Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On June 20, Licensing Program Analyst (LPA) Rachel Bruce conducted an unannounced visit to the facility for the purpose of initiating a complaint investigation. The complaint form was not available on the computer so a form 9099 will be generated when the complaint is in the system. LPA Bruce explained to David Carrera the allegation being investigated and the complaint process. LPA will return and conduct interviews at a later date.

met_with: David Carrerea, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Daiquiri Boyd visited the Short Term Residential Therapeutic Program (STRTP) on February 26, 2024 for the purpose of clarifying recent incident reports. Client was seen with a white powder substance on 11/27/23, telling staff that he had gotten it from another client's medication. Staff Carrera told LPA that they check each client as they take their meds and verify that it is swallowed before the client leaves their sight. On this occasion, the client that had the white powder stated that he had gotten it from another client. Staff took extra precautions after this event, with that client, to ensure that his medications were swallowed appropriately. Client was questioned on 12/27/23 regarding the use of bleach while he was doing laundry. Staff had given the client bleach so he could add to his load of wash, but the client then took the bleach and added it to another client's clothes. Staff keeps the bleach locked in a cabinet, no client's have access to this cabinet.


summary: Facility Evaluation

raw_content:
Narrative:
On June 5, Licensing Program Analysts (LPAs) Briana Placencia and Angelica Borja conducted a Case Management inspection at Valley Teen Ranch and met with Michael Hidalgo. The purpose of this inspection was to discuss concerns with an incident report that was received by the Department on 05/01/2024, the incident in question happened on April 27, 2024. Case Manager stated that it was an isolated incident and nothing further came of it. Client #1 (see 811) has a his history of saying inappropriate comments to female staff. There are no findings or citations at this time, A copy of this report was left at the facility.

met_with: Michael Hidalgo


summary: Facility Evaluation

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Narrative:
On July 3, 2024, Licensing Program Analyst (LPA) Brinae Pointer and Licensing Program Manager (LPM) Tamara Melikian conducted an unannounced case management inspection at the above facility. Met at the facility by Administrator David Carrera. The purpose of the inspection is to discuss an incident that occurred on June 4, 2024 when client #1 (see LIC811 dated July 3, 2024) was not in view of the facility staff while on an outing. Client #1 was located shortly thereafter. There are no deficiencies to be cited on this date. A copy of this report is left with Administrator David Carrera.


summary: Facility Evaluation

raw_content:
Narrative:
On 07/18/2024, Licensing Program Analysts (LPAs) Brinae Pointer and Vanessa Galvan travelled to the above facility to conduct a 2-year required inspection. Met by David Carrera. At 12:30PM, LPAs met with Human Resource Director Janet Grimson and Administrator David Carrera conduct entrance interview. At 1:00PM, an inspection of Staff files was conducted. At 2:30PM, LPAs contacted Human Resource Director regarding staff files. At 3:00PM, LPAs started inspection of client files. LPAs will return at another date to continue the inspection. There are no deficiencies to be cited on this date. The exit interview was conducted at 4:15PM and a copy of this report given to the David Carrera.


summary: Facility Evaluation

raw_content:
Narrative:
On July 26, 2024, Licensing Program Analysts (LPA) Vanessa Galvan and Brinae Pointer traveled to Valley Teen Ranch located in Madera, CA, and met with David Carrera, Administrator. The purpose of today's inspection is to continue the 2-year Required inspection. A tour of House 1 and House 2 was conducted, a physical plant inspection was completed and included the following observation: Facility grounds are clean and free of debris. Adequate indoor and outdoor activity space and materials observed. Both houses are at comfortable temperature. Facilities smoke detectors are in appropriate working order and all fire extinguishers are properly charged and serviced. The kitchens have a full-size refrigerator & freezer and is operating at safe temperature. The facilities maintain an adequate supply of perishable and non-perishable foods and the food menu is available for clients to view. A supply of emergency food is stored at both facilities. Knives and sharps are key locked and inaccessible to clients. Chemical, disinfectants, and cleaning solutions are key locked and inaccessible to clients. The dining rooms are equipped with a large table and chairs accommodating of all clients. House 1 and House 2 have five bedrooms- for double occupancy, all bedrooms are located on one single level. Bedrooms are accommodating of all required furnishings and storage space. All rooms are equipped with a fire alarm. Beds were observed with appropriate clean linens and in good repair. House 1 has a staff bathroom (includes a shower/tub one toilet), One client bathroom (includes two client showers and two toilets). All bathrooms/restrooms are stored with hand soap, toilet paper, and paper towels. The facilities water temperatures are at a safe temperature range. The facilities medications are locked and inaccessible to clients. LPAs observed medications are centrally stored. Continued from page 1... Continued from page 1... The facilities have a First Aid kit is complete with all first aid items. Both facilities have a staff office and is inaccessible to clients. No firearms or weapons are allowed in the facility. The facility ground has (1) pool. The pool is surrounded by a gate, water is clean, and pool chemicals are inaccessible to clients in care. LPAs reviewed (5) Staff Files. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. LPA reviewed (5) clients files and the Disaster Mass Casualty Plan. LPAs interviewed five client and five staff. There are currently (1) Chief Executive Officer, (1) Program Director/Administrator, (1) Administrator, (1) Case Worker, (2) Clinician, (2) MHRS, (20) Direct Care Staff, and (1) Head of Service. A review of the Licensing Information System on July 17, 2024, indicates that all facility staff associated to the agency have DOJ, FBI, and child abuse index check clearances. The facility currently holds a Mental Health Program Approval valid through October 25, 2024. The licensee has obtained National Accreditation through The Joint Commission valid through October 31, 2024. The facility is being cite for CCR 886065(e)(2)- Type A violation, CCR 88087(e)(1)- Type A violation, and four Technical Violations. (See attached LIC 809-D for additional information) An exit interview was conducted to discuss this report and appeal rights. A copy of this report, appeal rights were provided to David Carrera at the conclusion of the inspection..


summary: Facility Evaluation

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Narrative:
On August 21, Licensing Program Analysts (LPAs) Brinae Pointer and Miriam Flores conducted a Case Management inspection at Valley Teen Ranch and met with Andrea Evans. The purpose of this inspection was to discuss concerns with an incident report that was received 07/26/2024, the incident in question happened on 7/25/24. LPA conducted interviews and collected documentation. Case Manager stated that it was an isolated incident, a safety plan was completed and a therapy session was conducted after this incident to follow-up with Client #1 (see 811). Client #1 has a history of seeking negative attention on self. There are no findings or citations at this time, A copy of this report was left at the facility.

met_with: CEO Andrea Evans


summary: Facility Evaluation

raw_content:
Narrative:
Complaint Specialist C.K. Kinney(CS) and Licensing Program Analyst Danny Macias(LPA) Traveled to Valley Teen Ranch and met with MHRS Carlos Vigil to conduct Case Management Inspections related to incident report dated 10/30/24. CS and LPA conducted confidential interviews, and reviewed documentation. No deficiencies observed or cited during this inspection. Copy of this report, LIC Confidential Names left at the facility at conclusion of inspection.

met_with: Carlos Vigil


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Danny Macias (LPA) and Complaint Specialist C.K. Kinney (CS) traveled to Valley Teen Ranch and met with Mental Health Rehabilitation Specialist (MHRS) Carlos Vigil to conduct Case Management Inspections related to incident report dated 10/20/24 (incident log 0001130-FN). LPA and CS conducted confidential interviews and reviewed documentation. Due to insufficient information available at this time, incident needs further investigation. A copy of this report and Confidential Names were left at facility at the end of investigation.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Danny Macias (LPA) and Complaint Specialist C.K. Kinney (CS) traveled to Valley Teen Ranch and met with Mental Health Rehabilitation Specialist (MHRS) Carlos Vigil to conduct Case Management Inspections related to incident report dated 10/26/24 (incident log 0001176-FN). LPA and CS conducted confidential interviews and reviewed documentation. Due to insufficient information available at this time, incident needs further investigation. A copy of this report and Confidential Names were left at facility at the end of investigation.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst Danny Macias(LPA) traveled to Valley Teen Ranch to conduct a Case Management inspection. LPA met with Quality Assurance Specialist Kim Gerhardt and Head of Service Jairo Delgado. The purpose of the inspection was to follow up on an incident that occurred December 4, 2024 in which C1 (see LIC811 dated 1/14/2025) was observed to have two cuts on his arm as a result of self-harm. LPA discussed C1's Needs and Services Plan and interventions used. The facility will continue to monitor C1 and provide resources as necessary. A copy of this report and LIC Confidential Names was left with Kim Gerhardt at conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst Danny Macias(LPA) traveled to Valley Teen Ranch to conduct a Case Management inspection. LPA met with Quality Assurance Specialist Kim Gerhardt. The purpose of the inspection was to follow up on an incident that occurred December 4, 2024 in which C1 (see LIC811 dated 1/14/2025) was given extra chores as a form of discipline. LPA discussed youth's personal rights and participation in the Discipline Policy Agreement. The facility will continue to work with youth and provide resources as necessary. A copy of this report and LIC Confidential Names was left with Kim Gerhardt at conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst Danny Macias(LPA) traveled to Valley Teen Ranch to conduct a Case Management inspection. LPA met with Quality Assurance Specialist Kim Gerhardt. The purpose of the inspection was to continue an inspection related to an incident that occurred October 20, 2024 in which staff did not administer medications to C1 (see LIC811 dated 1/14/2025) as prescribed. LPA discussed the facility's medications and staff discipline policies. A copy of this report and LIC Confidential Names was left with Kim Gerhardt at conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On 2-19-25, Licensing Program Analyst Danny Macias (LPA) traveled to Valley Teen Ranch STRTP and met with David Carrera, Administrator (AD) to conduct Case Management Inspections related to incident report dated 2-5-25. The purpose of the inspection is to follow up on an incident that occurred on February 1, 2025 in which foster youth #1 (see LIC811 dated 2-19-25) took a can of Red Bull from a staff/client shared refrigerator and was able to self harm with it. LPA gathered additional details on the incident. The STRTP will continue to monitor youth to limit access to potentially harmful objects. A copy of this report was left with David Carrera.


summary: Facility Evaluation

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Narrative:
On May 20, 2025, Licensing Program Analyst Danny Macias (LPA) traveled to Valley Teen Ranch STRTP and met with David Carrera, Administrator (AD) to conduct Case Management Inspections related to incident report dated 4-6-25. The purpose of the inspection is to follow up on an incident that occurred on 4-6-25 in which C1 (see LIC811 dated 5-20-25) was allegedly harming animals on the property. LPA gathered additional details on the incident. The STRTP will continue to monitor youth and provide appropriate supervision. A copy of this report was left with David Carrera at the conclusion.


summary: Facility Evaluation

raw_content:
Narrative:
On May 20, 2025, Licensing Program Analyst Danny Macias (LPA) traveled to Valley Teen Ranch STRTP and met with David Carrera, Administrator (AD) to conduct Case Management Inspections related to incident report dated 4-10-25. The purpose of the inspection is to follow up on an incident that occurred on 4-10-25 in which C1 (see LIC811 dated 5-20-25) disclosed an inappropriate relationship with a previous foster parent. LPA gathered additional details on the incident. The STRTP will continue to monitor youth and provide appropriate support. A copy of this report was left with David Carrera at the conclusion.


summary: Facility Evaluation

raw_content:
Narrative:
On June 17, 2025, Licensing Program Analyst Danny Macias (LPA) traveled to Valley Teen Ranch STRTP and met with Kim Gerhardt Quality Assurance Staff (QA), to conduct a Case Management Inspection. LPA discussed Needs & Services Plans and client searches with QA. An exit interview was conducted and a copy of this report was left with Kim Gerhardt at the conclusion.


summary: Facility Evaluation

raw_content:
Narrative:
On July 21, 2025, Licensing Program Analysts (LPAs) Danny Macias and Angelica Borja conducted an unannounced required two year inspection at Valley Teen Ranch STRTP located in Madera CA. LPAs met with Facility Administrator Carlos Vigil. LPAs reviewed 5 client files and 5 staff files, board minutes, and disaster plan. Due to time constraints, LPAs will complete the inspection at a later date. A copy of this report was left with Carlos Vigil at the conclusion of today's inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On July 28, 2025, Licensing Program Analysts (LPAs) Danny Macias and Angelica Borja continued a required two year inspection at Valley Teen Ranch STRTP located in Madera CA. LPAs met with House Supervisor Bayon Harris. LPAs completed a physical plant inspection, reviewed medication logs, interviewed 2 staff and 3 clients. Due to time constraints, LPAs will complete the inspection at a later date. A copy of this report was left with Bayon Harris at the conclusion of today's inspection.

met_with: Bayon Harris


summary: Facility Evaluation

raw_content:
Narrative:
On July 29, 2025, Licensing Program Analyst (LPA) Danny Macias continued a required two year inspection at Valley Teen Ranch STRTP located in Madera CA. LPA met with Administrator (AD) David Carrera. A physical plant inspection was completed and included the following checks. Adequate indoor and outdoor activity space and materials observed. The facility is maintained at 75°F. All facility smoke detectors are in appropriate working order, fire extinguisher is properly charged and serviced on May 13, 2025. All required forms are posted. Medications are locked and centrally stored. Individual beds were observed. STRTP was approved on 07/24/2018. The facility is accredited through CARF with accreditation through October 31, 2026, and they are approved through Alameda County Department of Behavioral Health through October 25, 2025. No firearms or weapons are in the facility per AD. LPAs reviewed 5 client files, and 5 staff files. LPAs interviewed 3 staff and 3 clients. There are Type A violations, Type B violations and a Technical Assistance being cited on today's visit. (Refer to attached 809-D pages for further information.) A copy of the reports was left with David Carrera at the conclusion of today's inspection.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Danny Macias (LPA) traveled to Valley Teen Ranch STRTP and met with Administrator (AD) David Carrera to conduct a Case Management Inspection related to incident report dated 7/14/25 (incident log 0001954-FN). LPA conducted confidential interviews and reviewed documentation. LPA discussed the incident in which a client alleged sexual harassment by another client. The STRTP addressed the situation and will continue to monitor clients to prevent any further incidents. (see 812) A copy of this report was left with David Carrera at the conclusion.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Danny Macias (LPA) traveled to Valley Teen Ranch STRTP and met with Administrator (AD) David Carrera to conduct a Case Management Inspection related to incident report dated 8/01/25 (incident log 0002031-FN). LPA conducted confidential interviews and reviewed documentation. LPA discussed the incident in which a client was observed by staff to be under the influence of an unknown substance for approximately 4 days. The STRTP addressed the situation and will continue to monitor clients to prevent any further incidents. (see 812) A copy of this report was left with David Carrera at the conclusion.


summary: Facility Evaluation

raw_content:
Narrative:
On Novermber 24, 2025, Licensing Program Analyst (LPA) Danny Macias arrived at the Short Term Residential Treatment Program (STRTP) and met with Administrator (S1) David Carrera. The purpose of the visit was to conduct a case management inspection related to an incident dated 11-18-25 in which a random search was conducted on a client's bedroom. LPA obtained relevant documents and discussed the STRTP's search policies and procedures, and terms of probation. (see 812) A copy of this report was left with David Carrera at the conclusion.


raw_content:
Investigation Findings:
13On Novermber 24, 2025, Licensing Program Analyst (LPA) Danny Macias arrived at the Short Term Residential Treatment Program (STRTP) to deliver findings on the above allegation. LPA met with Administrator David Carrera. During the investigation, LPA conducted interviews and a records review provided by the facility. Based on confidential interviews and other information obtained, the department has made the following determination. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. A copy of this report was left with David Carrera at the conclusion. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tamara Melikian LICENSING EVALUATOR NAME: Danny Macias LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


summary: Facility Evaluation

raw_content:
Narrative:
On May 9, 2025, Licensing Program Analyst Danny Macias (LPA) traveled to Valley Teen Ranch STRTP and met with David Carrera, Administrator (AD) to conduct a Case Management Inspection. The purpose of the inspection is to follow up on two incidents that occurred on 4-19-25 and 4-22-25 in which clients C1, C2, C3 and C4 (see LIC 811 dated 5-9-25) were not given medications as prescribed. On 4-19-25, S1 states that he forgot to administer medications to clients C1, C2 and C3 as prescribed. On 4-22-25, S2 states that he forgot to administer medications to client C4 as prescribed. AD has provided training to all staff regarding medication protocols and has directed staff to notify him when medications have been administered. Based on document review, the STRTP is being cited for Title 22, Division 6, Chapter 1, Article 06, Continuing Requirements, Section Health Related Services. An exit interview was conducted, and a copy of this report, appeal rights, and LIC 811 were left with David Carrera at the conclusion.


summary: Facility Evaluation

raw_content:
Narrative:
On June 17, 2025, Licensing Program Analyst Danny Macias (LPA) traveled to Valley Teen Ranch STRTP and met with Kim Gerhardt Quality Assurance Staff (QA), to conduct a Case Management Inspection. The purpose of the inspection is to follow up on an incident that occurred on 5-15-25 in which a client was not given a medication as prescribed. On 5-15-25, S1 states that he forgot to administer a medication to client C1 as prescribed. AD has provided training to all staff regarding medication protocols and has directed staff to notify him when medications have been administered. (See 811 dated 6-17-25) Based on document review, the STRTP is being cited for Title 22, Division 6, Chapter 1, Article 06, Continuing Requirements, Section Health Related Services. In addition, the STRTP is being assessed a civil penalty as a result of a repeat violation. An exit interview was conducted, and a copy of this report, appeal rights, and LIC 811 were left with Kim Gerhardt at the conclusion.


summary: Facility Evaluation

raw_content:
Narrative:
On October 6, 2025, Licensing Program Analyst (LPA) Danny Macias traveled to Valley Teen Ranch STRTP and met with Administrator (AD) David Carrera to conduct a Case Management Inspection. The purpose of the inspection is to follow up on an incident that occurred on 9-9-25 in which a client was not given a medication as prescribed. On 9-9-25, client C1 was not administered medication as prescribed due to the medication not being prepped for passing. AD states that the medication protocol policy will be changed to prevent further errors. See 812. Based on document review, the STRTP is being cited for Title 22, Division 6, Chapter 1, Article 06, Continuing Requirements, Section Health Related Services. In addition, the STRTP is being assessed a civil penalty as a result of a repeat violation. An exit interview was conducted, and a copy of this report and appeal rights were left with David Carrera at the conclusion.


summary: Facility Evaluation

raw_content:
Narrative:
On Novermber 24, 2025, Licensing Program Analyst (LPA) Danny Macias arrived at the Short Term Residential Treatment Program (STRTP) and met with Administrator (S1) David Carrera. The purpose of the visit was to conduct a case management inspection related to incidents on 11-8-25 and 11-9-25 in which a staff member physically pushed a client. LPA obtained relevant documents and conducted interviews on this date(see 812s). Based on document review and interviews, the STRTP is being cited for Interim Licensing Standards Version Article Personal Rights 87072(c)(15) on the attached LIC809D. A copy of this report and appeal rights was left with David Carrera at the conclusion.


summary: Facility Evaluation

raw_content:
Narrative:
On March 17, 2022, Licensing Program Analyst (LPA) Rachel Bruce conducted an unannounced Case Management inspection and spoke with John Addington, Program Administrator. The purpose of the case management was to discuss an incident reported submitted to Community Care Licensing on April 7, 2022. Per the report, on March 30, 2022 a staff member transporting a client from Juvenile Hall failed to secure the client's medication in the lock box located in the back of the van. During a stop for gas, the client was left alone momentarily and confiscated the medication. The theft was noticed when logging the client's medication upon his arrival at the facility. The client returned the medication he had taken and no pills were missing. The staff member was subsequently retrained on the transportation of residents protocol. Additional training was highlighted during the staff's weekly training session. Based on the information obtained the agency is being cited for a personal rights violation. medication storage violation. See confidential names list attached. A copy of this report along with appeal rights was provided to the agency.


summary: Facility Evaluation

raw_content:
Narrative:
On August 16, 2022, Licensing Program Analyst (LPA) Rachel Bruce arrived at Valley Teen Ranch STRTP for an unannounced inspection for the purpose of delivering a case management report. On July 6, 2022 a minor in the facility was having an uneasy day and night. Ultimately this led to a verbal and physical altercation with another youth. Two staff intervened to separate the youths resulting in one staff member using excess force and placing the child in an inappropriate hold. The Sheriff department was called and at the conclusion of the incident, the staff member was placed on leave. On July 15, 2022 the staff member in question met with administration and accepted his termination without incident. A deficiency is bing issued today for the inappropriate restraint. On March 14, 2023, LPA Bruce arrived at Valley Teen Ranch STRTP for an unannounced inspection and met again with Jon Addington. The purpose of the visit today is to amend the citation code. The deficiency remains the same.

met_with: Jon Addington, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On February 16, 2023, Licensing Program Analyst (LPA) Rachel Bruce conducted a case management visit at the above STRTP and met with Administrator, John Addington. The purpose of the visit is to issue a citation regarding an inappropriate restraint used by a staff member on a client. On December 23, 2022 an incident report was submitted to the Community Care Licensing email in-box which indicated a child was placed in an inappropriate restraint by a staff member ultimately resulting in a physical altercation. Staff were able to diffuse the situation and separate the two involved. No medical treatment was needed for either party. A Personal Rights violation is being issued at today's visit and because it is a repeat violation within a 12 month period a civil penalty is being assessed. Please see LIC 809D for citation and LIC811 for confidential names list. A signed copy of this report was left with the agency along with LIC 809D, Appeal Rights, and LIC 811. On March 14, 2023, LPA Bruce arrived at Valley Teen Ranch STRTP for an unannounced inspection and met again with Jon Addington. The purpose of the visit today is to amend the citation code. The deficiency remains the same.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Danny Macias (LPA) and Complaint Specialist C.K. Kinney (CS) traveled to Valley Teen Ranch and met with Mental Health Rehabilitation Specialist (MHRS) Carlos Vigil to conduct Case Management Inspections related to incident reports dated 10/06/24 (incident log 0001101-FN) and 10/09/24. LPA and CS conducted confidential interviews and reviewed documentation. This facility is being cited for violation of Title 22, Division 6, Article Continuing Requirements 80078(a) Supervision and Title 22, Division 6, Article Continuing Requirements 80065(a) Personnel Requirements. A copy of this report, deficiency citations, LIC Confidential Names, LIC Appeal Rights were left at facility at conclusion.


summary: Facility Evaluation

raw_content:
Narrative:
On April 22, 2026, Licensing Program Analyst (LPA) Danny Macias traveled to Valley Teen Ranch Short Term Residential Treatment Program (STRTP) and met with Administrator (AD) John Addington. The purpose of the visit was to conduct a case management inspection related to an incident dated 4-12-26 in which an unapproved restraint was performed on a client in care. AD states that S1 performed an unapproved restraint on a client in care while attempting to take a phone out of the client's hands. Based on interview and video obtained from the facility, the STRTP is being cited for Interim Licensing Standards Version Article 10. Emergency Interventions Prohibition 87095.01(b) on the attached LIC809D. A copy of this report was left with John Addington at the conclusion.

met_with: John Addington


summary: Facility Evaluation

raw_content:
Narrative:
On April 22, 2026, Licensing Program Analyst (LPA) Danny Macias traveled to Valley Teen Ranch Short Term Residential Treatment Program (STRTP) and met with Administrator (AD) John Addington. The purpose of the visit was to conduct a case management inspection related to an incident dated 3-23-26 in which a staff member pushed a client in care. AD states that S1 pushed a client in care and was being aggressive with the same client while playing basketball. Based on interview, the STRTP is being cited for Interim Licensing Standards Version Article Personal Rights 87072(c)(16) on the attached LIC809D. A copy of this report was left with John Addington at the conclusion.


facility_name: VARSITY TEAM INC #4

raw_content:
Narrative:
towards the minors while in care, and staff did not seek timely medical attention for a minor. Confidential interviews and documents reviewed indicated conflicting statements. Furthermore, two clients were unable to be interviewed. Thus, the investigation did not corroborate the allegations with a preponderance of evidence. Based on confidential interviews and records reviewed that the staff mishandled C1 while in care, staff intimidate the minors to disclose confidential information, staff make inappropriate comments towards the minors while in care, and staff did not seek timely medical attention for C5, which may or may not have occurred, however, it is not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Gabriel Sanchez. Due to printer malfunction, a copy of this report, LIC 811, and appeal rights will be emailed to the Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On 07/30/2023, at 3:30 pm, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Gabriel Sanchez, Facility Manager, to discuss the investigative findings for the allegations noted above. LPA Meza-Gonzalez conducted an inspection of the facility on 02/14/2023 at 9:45 am and no deficiencies were observed. LPA Meza-Gonzalez interviewed one client (C1) and two staff (S1-2). LPA Linley interviewed two clients (C3-4) and was unable to interview two clients (C2, C5), despite multiple attempts to contact them, and interviewed seven staff (S3-9). LPA reviewed the following documents during the investigation: Client Roster, C Identification and Emergency Information form, C Needs and Services Plan, Staff Schedule, and Staff Contact List. On 02/09/2023, Community Care Licensing (CCL) received allegations that staff mishandled a minor while in care, staff intimidate the minors to disclose confidential information, staff make inappropriate comments UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: VARSITY TEAM INC #4FACILITY NUMBER: VISIT DATE: 07/30/2023

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

met_with: Gabriel Sanchez


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
This is an amended version of the original report dated August 19, 2025. Confidential interview revealed that S1 admitted to hugging minor in care as a return hug, when they saw them crying. When hug was exchanged, confidential interview also revealed that it was thought that C1 tried to kiss S1. Confidential interview revealed that C1 was uncomfortable with what had occurred and informed staff. Confidential interview indicated that overnight staff was overly nice and wanted to do laundry for minor in care. Confidential interview revealed that C1 was diagnosed with special needs and may have been targeted as a result of their diagnosis. Additional confidential interviews disclosed that overnight staff (S1) did not attempt any other inappropriate interaction while at the facility. S1 was employed for approximately three months. Confidential interview indicated that once the administrator became aware of the inappropriate interaction, S1 was placed on administrative leave, and S1 subsequently resigned. Based on interviews and information gathered during the investigation, the preponderance of evidence standard has been met, and the department has determined the allegation that staff had an inappropriate interaction with minor in care is substantiated. This posed an immediate health and safety risk to the children placed in care. These actions are in violation of the Interim Licensing Standards (ILS) Version 5, Article 6, 87072 (c)(1) Personal Rights. Administrator gave Manuel Hernandez, Direct Care Counselor, to sign in their absence. An exit interview was conducted, and a copy of the report and appeal rights were provided to Manuel Hernandez, Direct Care Counselor.

Investigation Findings:
13This is an amended version of the original report dated August 19, 2025. On August 19, 2025, Licensing Program Analyst (LPA) Cynthia Velasquez met with Manuel Hernandez, Direct Care Counselor, to deliver findings on above allegation. On May 1, 2025, at 12: PM LPA Abby Saeteurn conducted an unannounced investigative inspection at the facility and no immediate deficiencies were noted. Pertinent documents were obtained, and interviews with staff (S1-S4) and clients (C1-C5) were conducted. On April 30, 2025, the department received an allegation that staff had inappropriate interactions with minor in care. It was reported that an overnight staff worker asked a minor in care for a hug while crying, and the minor complied. It was also reported that on another occasion, overnight staff invited minor in care into a room, which was prohibited, and asked questions about their sexuality and gender preference. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: Cynthia Ann Velasquez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # FACILITY NAME: VARSITY TEAM INC #4FACILITY NUMBER: VISIT DATE: 08/19/2025

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

met_with: Manuel Hernandez, Direct Care Counselor


summary: Facility Evaluation

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Narrative:
On 12/02/2021 at 9: AM, Licensing Program Analyst (LPA) Gloria Meza-Gonzalez conducted an announced inspection at the above facility. LPA Meza-Gonzalez met with Chief Executive Officer (CEO) Lance Hickman and Chief Operating Officer (COO) Drew Dahlstedt. The purpose of the inspection is to conduct a pre-licensing for change of location. The facility services six ambulatory males from 12 years old to 17 years old and non-minor dependents. The facility sits on a 4-acre lot. The facility is a single-story home. The home has three bedrooms, two bathrooms, living room, lounge room, dining room, laundry room, and kitchen. Across from the walkway staff and clinical office, game and fitness room and bedroom with a bathroom. There is a water pump house in front of the main house. In the back of the house there are animal pens, a covered open barn and a house corral. On the side of the house there is a carport. The facility is set up a follows: Bedroom #1 is arranged for one client. Bedroom #2 is arranged for one client. Bedroom #3 is arranged for two clients. Bedroom #4 is across the walkway and is arranged for two clients. LPA Meza-Gonzalez observed all the bedrooms to have adequate shelf and closet space for client's belongings. Bedroom #1 and #2 share a bathroom. Bedroom # 3 and # 4 has its own bathroom. LPA Meza-Gonzalez observed all the bathrooms were clean and in good repair. The hot water in the client bathroom was measured to be 111 degrees, which is in range (105 degrees and 120 degrees). The laundry room has a washer and dryer for clients' use. The facility's smoke detectors in the hallways and bedrooms were checked and were operable. The carbon monoxide detector located in hallways were operable. There is a covered patio behind the house. See LIC809C page 2 for continuation The staff and clinical office is located across the walkway from the main house. The medication will be locked in cabinet in the locked staff office. All clients' files and staff files will be in locked file cabinets in the staff/clinical office. The office a kitchenette, three desks, three tables and three locked cabinets. Next to the office is the garage will be used as an indoor game and fitness room. The open barn behind the garage. The barn will be used sports court. Next to the barn are animals pens. The animals pens are not currently in use. Behind the barn is a horse corral that is not currently in use. Water Pump house is locked. Outside grounds was also inspected and it was observed to be clean and well maintained. No bodies of water were observed at this time. Emergency exits were free from obstruction. There are no guns or weapons in the facility as stated by CEO Hickman and COO Dahlstedt. The facility outside grounds was also inspected and it was observed to be clean and well maintained. No bodies of water were observed at this time. Emergency exits were free from obstruction. LPA Meza-Gonzalez reminded that following items need to be posted and accessible to clients prior to accepting clients: Grievance Procedures, Personal Rights, Ombudsman Poster, Visitation policies, and current menu. Based on LPA Meza-Gonzalez observations of the physical plant and all the documents that have been received the faciltiy meets the minimum requirements of Title 22 regulations. An exit interview was conducted, a copy of this report was discussed and left with the COO Dahlstedt.

met_with: Lance Hickman and Drew Dahlstedt.


summary: Facility Evaluation

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Narrative:
On 03/02/2022 at 10: AM, Licensing Program Analyst (LPA) Gloria Meza-Gonzalez conducted an announced inspection at the above facility. LPA Meza-Gonzalez met with AM Supervisor (AMS) Brandy Bianco and Program Administrator (PA) David Salazar. The purpose of the inspection is to conduct a post licensing inspection. The facility services six ambulatory males from 12 years old to 17 years old and non-minor dependents. There are four clients in care. One client was present. LPA Meza-Gonzalez reviewed four client files (see confidential name list, LIC811, dated 3/2/2022). LPA Meza-Gonzalez observed the client files to complete and in order. LPA Meza-Gonzalez conducted one confidential interview. Due to time constraints, the post licensing inspection will be extended to review physical plant, disaster preparedness, emergency intervention, core/therapeutic services, staff files, and staff interviews. Based on LPA Meza-Gonzalez observations of client files, the facility meets the minimum requirements of Title 22 regulations and interim licensing standards (ILS). An exit interview was conducted, a copy of this report was discussed and left with the PA Salazar.

met_with: Brandy Bianco and David Salazar


summary: Facility Evaluation

raw_content:
Narrative:
On April 14, 2022, at 10: AM, Licensing Program Analyst (LPA) Gloria Meza-Gonzalez conducted an unannounced inspection at the above facility. LPA Meza-Gonzalez met with AM Supervisor (AMS) Brandy Bianco and Program Administrator (PA) David Salazar. The purpose of the inspection is to conduct case management for the continuation of the post-licensing inspection. The facility services six ambulatory males from 12 years old to 17 years old and non-minor dependents. Four clients were present at the time of inspection. The facility is a single-story home. The home has three bedrooms, two bathrooms, a living room, lounge room, dining room, laundry room, and kitchen. Across from the walkway staff and clinical office, a game and fitness room, and a bedroom with a bathroom. There is a water pump house in front of the main house. In the back of the house are animal pens, a covered open barn, and a horse corral. On the side of the house, there is a carport. The facility is set up as follows: Bedroom #1 is arranged for one client. Bedroom #2 is arranged for one client. Bedroom #3 is arranged for two clients. Bedroom #4 is across the walkway and is arranged for two clients. LPA Meza-Gonzalez observed all the bedrooms to have adequate shelf and closet space for the client's belongings. Bedrooms #1 and #2 share a bathroom. Bedrooms # 3 and # 4 have their own bathroom. LPA Meza-Gonzalez observed all the bathrooms were clean and in good repair. The hot water in the client's bathroom was measured to be 116 degrees, which is in the range (105 degrees and 120 degrees). The laundry room has a washer and dryer for clients' use. The facility's smoke detectors in the hallways and bedrooms were checked and were operable. The carbon monoxide detector located in hallways was operable. There is a covered patio behind the house. LIC C Page The staff and clinical office are located across the walkway from the main house. The medication will be locked in a cabinet in the locked staff office. All clients' files and staff files will be in locked file cabinets in the staff/clinical office. The office has a kitchenette, three desks, three tables, and three locked cabinets. Next to the office is the garage will be used as an indoor game and fitness room. The open barn behind the garage. The barn will be used sports court. Next to the barn are animals pens. The animal pens are not currently in use. Behind the barn is a horse corral that is not currently in use. The water pumphouse is locked. Outside grounds were also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. There are no guns or weapons in the facility as stated by PA Salazar and AMS Bianco. The cleaning supplies is locked in a cabinet in the laundry room. The facility's outside grounds were also inspected and it was observed to be clean and well maintained. There is nobody of water were observed at this time. Emergency exits were free from obstruction. LPA Meza-Gonzalez observed the following items posted and accessible to clients: Grievance Procedures, Personal Rights, Ombudsman Poster, Visitation policies, and current menu. LPA Meza-Gonzalez reviewed ten staff files (see confidential name list, LIC811, dated April 14, 2022). LPA Meza-Gonzalez observed the client files to complete and in order. LPA Meza-Gonzalez conducted four staff confidential interviews and one client interview. LPA Meza-Gonzalez inspected and reviewed disaster preparedness, operations, emergency interventions, and core therapeutic services. Based on LPA Meza-Gonzalez's observations of staff files, staff interviews, physical plant, disaster preparedness, operations, emergency interventions, and core therapeutic services. the facility meets the minimum requirements of Title 22 regulations and interim licensing standards (ILS). An exit interview was conducted, and a copy of this report was discussed and left with PA Salazar.


summary: Facility Evaluation

raw_content:
Narrative:
On December 7, 2023 at 10: AM, Licensing Program Analyst (LPA) Lucero Jauregui conducted an unannounced inspection at the above facility and met with David Salazar, Administrator. The purpose of the inspection is to conduct an inspection. The facility services six ambulatory males from 12 years old to 17 years old and non-minor dependents. The facility sits on a 4-acre lot. The facility is a single-story home. The home has three bedrooms, two bathrooms, living room, lounge room, dining room, laundry room, and kitchen. Across from the walkway there is staff and clinical office, game and fitness room and bedroom with a bathroom. There is a water pump house in front of the main house. In the back of the house there are animal pens, a covered open barn and a house corral. On the side of the house there is a carport. The facility is set up as follows: Bedroom #1 is arranged for one client. Bedroom #2 is arranged for one client. Bedroom #3 is arranged for two clients. Bedroom #4 is across the walkway and is arranged for two clients. LPA Jauregui observed all the bedrooms to have adequate shelf and closet space for client's belongings. Bedroom #1 and #2 share a bathroom. Bedroom # 3 and # 4 has its own bathroom. The hot water in the client bathroom was measured to be 120 degrees, which is in range (105 degrees and 120 degrees). The laundry room has a washer and dryer for clients' use. Disinfectants, detergents and cleaning solutions are maintained in locked cabinets in the laundry room. The facility's smoke detectors in the hallways and bedrooms were checked and were operable. Continued.... The carbon monoxide detector located in hallways were operable. Fire extinguisher are properly charged and serviced. The last emergency disaster drill was held on November 14, 2023. The staff and clinical office is located across the walkway from the main house. The medication will be locked in a locked closet in the staff office. All clients' files are locked in a cabinet in the locked closet in the staff office. Sharps were observed locked in a cabinet in the locked closet in the staff office. The staff office is remained locked at all time. The office a kitchenette, two desks, one table, one couch and one locked cabinets. Next to the office is the garage used as an indoor game and fitness room. There is an open barn behind the garage. The barn is used as a basketball court. Next to the barn are animals pens. There are three goats, twelve chickens, and two pigs. Animals are therapeutic for clients. Outside grounds were also inspected and it were observed to be clean and well maintained. No bodies of water were observed at this time. Emergency exits were free from obstruction. There are no guns or weapons in the facility as stated by Administrator. LPA Jauregui observed the following items posted and accessible to clients: Grievance Procedures, Facility Sketch, Emergency Disaster Plan, Personal Rights, Ombudsman Poster, Visitation policies, and activity schedule. LPA Jauregui reviewed five out five client files (see LIC 811 dated 12/7/2023), and conducted two staff interviews. LPA was unable to conduct client interviews at the facility due to clients being at school. This annual will be continued due to staff files located at the Corporate Office. Based on today's observations there are no deficiencies at this time. An exit interview was conducted, a copy of this report was discussed and left with David Salazar, Administrator.

met_with: David Salazar, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On December 14, 2023 at 9: AM, Licensing Program Analyst (LPA) Lucero Jauregui arrived to the facility's corporate office and met with Lance Hickman, Chief Executive Officer (CEO). The purpose of this Case Management inspection is to conduct an annual continuation from 12/07/2023. LPA Jauregui reviewed five staff files (S1-S5). The staff files have the acknowledgement of child abuse reporting requirements, criminal record clearances, staff qualifications, job duties, and training requirements. Based on observations made during the inspection and file reviews no deficiencies were observed during today's inspection. An exit interview was conducted, and a copy of this report was given to Lance Hickman, CEO.

met_with: Lance Hickman, Chief Executive Officer


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Jose Gonzalez and Joon Choi 08/06/2025 at 09: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the visit, LPAs Gonzalez and Choi met with Residential Director of Operations Adriana Carbal and conducted a health and safety inspection of the facility. No immediate health or safety risks were observed. LPA reviewed 2 staff personnel files on site at the facility. LPA interviewed 2 of staff on site to discuss the facilities policies and procedures of operation. LPA provided a copy of this licensing report to Residential Director of Operations Adriana Carbal.


summary: Facility Evaluation

raw_content:
Narrative:
On September 25, 2025, Licensing Program Analyst (LPA) Cynthia Velasquez arrived unannounced at facility for the purpose of obtaining signatures and delivering an amended report. Due to unforeseen circumstances, facility representative's signature was not obtained during the visit. A copy of the report was emailed to the facility representative for signature, and a signed copy will be maintained in the facility file.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Sethany Yem conducted a case management inspection on 10/15/25 at 12:45pm based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. During this inspection, 5 out of Direct Care Staff and 4 out of 4 youth files were reviewed. 2 out of Direct Care Staff and 2 out of 4 youth were interviewed. (See the Confidential Names List, LIC 811, 10/15/25). The Plan of Operation including policies and procedures were reviewed. Minutes from the board of directors' meetings related to the facility's incidents involving contact with law enforcement were reviewed. Based on the analysis of the confidential interviews and youth file review including the needs and service assessments, and progress notes, the licensee uses trauma-informed and evidence-based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. LPA Yem observed documentation of completed training on policies and procedures on when and how to involve law enforcement in response to an incident. Training records show staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance to their Emergency Intervention Plan when there is an immediate risk of serious harm to a child or others. There are no deficiencies cited at this time. A copy of this report was discussed and provided to Director David Salazar, Staff Supervisor Brandy Bianco, COO Drew Dahlstedt, CEO Lance Hickman and Head of Services Tara Ramirez.

met_with: Drew Dahlstedt


raw_content:
Narrative:
Continuation of LIC9099. It was reported that C3 was upset due to an incident that happened with another resident, who went into C3's room without permission while C3 was sleeping and proceeded to put their hands inside their pants and began to touch themselves. It was reported that C3 woke up and saw the client in C3's room with their hand in their pants. During the investigation, confidential interviews indicated that C2 often walk around the house with their hands inside the waistband of their shorts. Conflicting confidential interview indicated that C2 did go into C3's bedroom but no inappropriate interactions took place. Confidential interviews and records reviews indicated that staff were actively addressing C2's poor boundaries after the alleged interaction. A confidential interview indicated that staff were supervising the residents during the time the alleged incident took place but were not aware of it happening. Confidential interviews revealed that C3 later stated that nothing happened and C3 didn't know what was seen since the room was dark, it could've been that C2 had their hands in their waistband. Based on confidential interviews and a lack of evidence to confirm the allegation, the allegation that staff did not prevent minor in care from engaging in inappropriate interaction is unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this report and appeal rights were given to David Salazar, Facility Administrator.

Investigation Findings:
13On November 13, 2025, at 12: PM, Licensing Program Analyst (LPA) Lisa Bernabe met with David Salazar, Facility Manager, to deliver the finding for the above stated allegation. On August 5, 2025, Community Care Licensing received a complaint allegation that facility staff did not prevent minor in care from engaging in inappropriate interaction. On August 12, 2025, LPA Bernabe conducted a health and safety inspection at the facility, and no immediate health or safety hazards were observed. LPA Bernabe interviewed clients (C1, C2, and C3), staff (S1, S2, and S3), and reviewed pertinent facility records. On August 5, 2025, it was reported to Community Care Licensing (CCL) that staff did not prevent minor in care from engaging in inappropriate interaction. Continuation on LIC9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: Lisa Bernabe LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # FACILITY NAME: VARSITY TEAM INC #4FACILITY NUMBER: VISIT DATE: 11/13/2025

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

met_with: David Salazar, Facility Manager,