raw_content:
Narrative:
Page Further, room checks for contraband and alcohol are completed on a daily basis and interviews reveal, that staff and house residents; deny any observance of staff having a lack of supervision minors. Lastly, there was not enough evidence of inappropriate sexual interaction between minors as a result of staff having a lack of supervision. Although the above listed allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility.

Investigation Findings:
13On July 24,2024 at 9:10am, Licensing Program Analyst (LPA) Christine Wilson made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegations and deliver the findings. LPA spoke with the Residential Counselot (R1), and together, discussed the investigative findings. During the investigative process by LPA Wilson, all relevant parties have been accounted for. LPA reviewed relevant documents, and conducted confidential interviews with Social Workers, house residents and staff. Supporting evidence includes evidence that a placement change for client (C2) took place after child's Needs and Services Plan was performed and with agreements between the licensee and County placement personnel. Continued on LIC9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Christine Wilson LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION WOODLAND HILLS S.Ro, Ventura Blvd., STE. Woodland Hills, CA Facility Name: for the Future, INC.FACILITY NUMBER: VISIT DATE: 07/24/2024

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

met_with: Residential Counselor (R1)


state: CA

facility_name: FOR THE FUTURE, INC.

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
9099C page 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. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was .signed by (RC3) whose signature confirms receipt of this report.

Investigation Findings:
13On October 9, 2024 at 10:30am, Licensing Program Analyst (LPA) Christine Wilson made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation and deliver the finding. LPA spoke with Residential Counselor (RC3) and together, discussed the investigative finding. During the investigative process, all relevant parties have been accounted for. Supporting evidence includes: interviews with, social workers, house residents and staff denying any observance of client requesting medical attenntion. Further, it has been reported that the resident ws not yet approved for PRN medications at the time of the incident and that staff acted to keep residents from engaging in further confrontation.There are no witnesses that can corroborate the observance of staff lack of supervision therefore the allegations are unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Christine Wilson LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION WOODLAND HILLS S.Ro, Ventura Blvd., STE. Woodland Hills, CA Facility Name: for the Future, INC.FACILITY NUMBER: VISIT DATE: 10/09/2024

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

report_type: Complaint Investigation

met_with: Residential Counselor

complaint_status: unsubstantiated


raw_content:
Narrative:
Evidence obtained from confidential interviews with pertinent witnesses including one resident, two staff members, Facility Administrator, assigned Social Worker and review of client records revealed that minor Y1 resided at the facility from 11/13/2023 through 03/20/2024. Youth returned to live at the facility on 05/17/2024 through 02/18/2025. From 07/03/2024, through 01/25/2025. Youth left from the facility without permission thirty-seven times to visit a friend. Youth was moved from Simi Valley High School in September 2024 to Options for Youth - Duarte, Inc. where Y1 was enrolled from 10/21/2024, through 02/11/2025. On 02/12/2025, facility staff conducted a search of Y1's room and recovered a marijuana pipe which staff seized. On 02/18/2025, Y1 was moved to another placement. Confidential interviews determined denial of knowledge Y1 was ever observed abusing narcotics in the facility or during outings. Y1 declined to speak with Investigator Spindola during the investigation. The investigation revealed a lack of evidence to prove that the facility allowed Y1 to abuse narcotics, allowed Y1 access to alcohol or did not ensure Y1 was enrolled in school, therefore the allegations are determined unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. There are no deficiencies cited per California Code of Regulations, Title 22 or Interim Licensing Standards (ILS) at this time. Exit Interview conducted. A copy of this report was provided with Facility Administrator.

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

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

met_with: Tessa Koziol, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 07/22/2021 at 9: AM Licensing Program Analyst (LPA's) Rosslyn Gray, Meghan McGee and LPM JoAunne Griffin made an unannounced to For the Future for Annual/Required licensing Inspection. LPA's met with Rubi Valerio (S1) who granted access to the facility. The entire physical plant was inspected. The facility is licensed to care for six (6) female clients, ages 13-17 years, ambulatory only. The facility acquired The National Accreditation through Commission on Accreditation of Rehabilitation Facilities (CARF) 04/20/2021 valid through 11/30/2023. LPA observed the following during the inspection: This is a one story home equipped with three bedrooms, two bathrooms, living room, dining area and kitchen. Dining area is also used as an arts and crafts activity space. Clients personal lockers were observed in living room. Attached garage is used as a storage space for washer, dryer, deep freezer, two additional refrigerators, dry goods, paper goods and clients in care personal belongings. Staff Office is equipped with one bathroom and access to additional office space. Bedroom #1: Is occupied by Client#1 (C1) it has two twin size beds, adequate closet and drawer space. Bedroom #2: Is occupied by Client#2 (C2) has two twin size beds, adequate closet and drawer space. Bedroom #3: Is occupied by Client# 3 (C3) it has two twin size beds, adequate closet and drawer space. There is no swimming pool or any other bodies of water on the premises. S1 states that there is no weapons or guns on the premises. The passageways and open porches are unobstructed. House rules, menu and alternative meals, grievance process, emergency disaster plan and personal rights were observed posted in kitchen area. The outdoor space is free of debris. LPA observed a broken wooden slate with an exposed nail. LPA observed chemicals such as cleaning solutions, disinfectants in the kitchen area under the kitchen sink. All medication and sharp knives are inaccessible to the clients and located in locked closet inside staff office. All prescribed medications are locked in the staff office; accessible only to employees supervising stored prescribed medications are locked in the staff office; accessible only to employees supervising stored medications. All smoke detectors and carbon monoxide detectors were tested and operable at the time of inspection. Facility is also equipped with pull alarm. LPA's observed two operable fire extinguisher located in the dining area and living room. Fire extinguishers were last serviced May 2021. LPA observed individual first aid kits fully stocked for each client in care. The bathrooms were inspected and found to be clean and good repair. The hot water was tested in the kitchen and bathrooms and was at a safe temperature. The facility was observed to have a working telephone. Clients can use the telephone unless restricted by a court order. Phone is operable and available to client in care throughout the day. Clients are accorded dignity in personal relationships with staff and others. Clients live in a safe, healthy, comfortable environment and are treated with respect. Clients currently attend school virtual via ZOOM, participate in extracurricular, cultural, and personal enrichment activities. Clients can contact Community Care Licensing or Foster Care Ombudsman office in confidence without threats or punishment. Facility operates within license conditions and limitations including capacity limitations. Facility has a current, written plan of operation. Facility personnel are instructed to report violations of personal rights. Licensee will report changes in the plan of operation affecting service to clients. Licensee will report client injuries requiring medical treatment. LPA will return to the facility at later date to complete the Annual Inspection (i.e Staff Records review, Staff and client interviews and include information regarding the Emergency Preparedness.) There were no deficiencies cited at this time. Exit Interview was conducted and a copy of this report was left at facility.

report_type: Facility Evaluation

visit_type: Annual

met_with: Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 07/28/2021 at 12:30PM Licensing Program Analyst (LPA's) Rosslyn Gray, made an announced visit to For the Future for Annual/Required licensing Inspection. LPA will return to the facility complete the Annual Inspection. LPA's met with Melissa Kagan (S1) who granted access to the facility. LPA reviewed the following during the inspection: Staff records review; the information regarding the Emergency Preparedness. LPA reviewed Criminal Records and confirmed that all current and former staff were also cleared. LPA reviewed The Administrator, Social Worker and Direct Care staff records. LPA reviewed the facility binder that included specific trainings, following a quiz for all staff: Specific Trainings include the following: Policies & Procedures; Health & Safety: Emergency Procedures: Medication;Trauma-Informed Care; Boundaries; Job Duties; and information about the Stakeholders. LPA also interviewed additional staff and clients that were not present during the initial inspection. LPA observed the Board of Directors Meeting Notes and confirmed that meetings are held quarterly. LPA Interviewed staff and clients that present during the initial inspection. There were no deficiencies cited at this time. Exit Interview was conducted and a copy of this report was left at facility.

visit_type: Case Management

met_with: Facility Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 4/4/23, at 1:00pm, Licensing Program Analyst (LPA) Nancy O'Connell, made an unannounced collateral visit to the above-listed facility, and met with the Facility Administrator (FA), who granted access to the facility. The purpose of this visit is to conduct a collateral interview with a resident that currently resides in the facility. During the collateral visit, LPA O'Connell conducted a confidential interview with C1 [See Confidential Names form (LIC811), dated 4/4/23, for names]. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 4, there are no deficiencies to be cited at this time. Exit interview was conducted a copy of this report will be emailed to FA.

met_with: Ruby Valerio, Administrator (FA)


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Dahl Larios conducted a case management inspection May 4, 2023, at 10:53 am 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 5 out of 5 youth files were reviewed. 2 out of Direct Care Staff and 2 out of 5 youth were interviewed. (See the Confidential Names List, LIC 811, dated May 4, 2023). 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, youth case plans, quarterly assessments, and crisis intervention plans, the licensee uses trauma-informed and evidence-based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. LPA Dahl Larios 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 Head of Service, Maral Sultanian.

met_with: Head of Service - Maral Sultanian


summary: Facility Evaluation

raw_content:
Narrative:
On May 17, 2023, at 8: AM, Licensing Program Analyst (LPA),Christine Wilson made an unannounced visit to For The Future Short Term Residential Therapeutic Program (STRTP) for the purpose of conducting an Annual inspection. LPA Wilson met with Staff #1 (S1) who granted access to the facility and an inspection of the facility was conducted together. (1) staff S1 was on site, and at 9:17AM Staff #2 (S2) arrived on site. (2) client residents (C1, C2), were at the facility and (2) client residents (C3, C4) were at school. Individuals mentioned in this report are identified on the Confidential Names List (LIC811) dated 05/17/2023. LPA Wilson and Staff#1 (S1), toured of the entire physical plant. This facility has a provisional Short Term Residential Therapeutic Program (STRTP) license to provide care and supervision for six (6) female children ages 13-17 years old, Ambulatory only. There is no pool or bodies of water on the premises. Licensee may provide care and supervision to six(6) female children, ages 13-17 years. Licensee serves ambulatory only. There are no bodies of water in the premises. The facility has obtained a Mental Health Program Approval contract with the Department of Health Care Services and Ventura County, which expired on March 3, 2023, and have submitted a Corrective Action Plan (CAP) to the Department of Health Care Services (DHCS). Staff confirmed that there are no firearms or dangerous weapons in the facility. There are no functional cameras in the facility. The facility is current with their annual fees. Accreditation is current. (Page 1 of 3) LPA Wilson inspected the following: This is a one (1) story (STRP) Short Term Residential Therapeutic Program, located in a residential neighborhood. This is a three (3) three-bedroom, two (1) bathroom, one (1) staff office in a family residence that includes a living"communal" room, dining area, kitchen, backyard, and an attached garage used for storage and laundry service. There are (2) unattached storage sheds. (continued on 809C page 2 of 3) (Page 2 of 3) During the facility was inspected, the following was observed: Vehicles: There are two (2) facility vehicles parked outside inspected to be in good operating condition, and with current insurance and registration. Vehicles are; a gray Toyota Sienna VIN 5TDKK3DC3FS613180, ODO 95, 887 and a white Ford Fiesta VIN 3FADP4EJ6GM143652, ODO 113,945. Ford Fiesta did not have a copy of license or registration in the vehicle. S1 made copies and immediately placed information in the vehicle. Both vehicles had a first aid kit. S1 stated "We have a mechanic that comes and maintains the cars. I dont think he gives us any paperwork on it." Last documented oil change was 7/17/2019. LPA observed a well kept front yard and front entry. All windows were in good condition. Windows had no screens. There were no security bars on the windows. There are two (2) fire extinguishers with last inspection date of 02/21/2021. (1) carbon monoxide detector is were working properly in the facility. Outdoor Area: There was no swimming pool or bodies of water on the premises. The activity space is free of hazard materials and debris. LPA observed a staff displayed the utility shut-off valves. The facility is surrounded by wood fence observed to be good condition. The passageways and porches are unobstructed. Garage/Laundry Area: This is a locked entry. S1 stated "The youth are not allowed to be in here doing laundry by themselves and are always with a staff person." The washer and dryer units are located in the attached garage. The laundry is equipped with a washer and dryer unit that was observed to be in good condition. The laundry detergent, bleach and other cleaning solutions are made accessible to the children and is located in a storage cabinet. Additional perishable and non-perishable food are stored here in a cabinet, refrigerator and freezer. Dining Area/Kitchen: LPA observed ample towels and linen closet. The dining/kitchen area has a large table with (6) chairs, where clients can participate in art and studying. There is adequate furniture which appears to be in good condition. There is a gas stove/oven with four (4) burners, all operating. There is a dishwasher, microwave, refrigerator with freezer and an air fryer. LPA Wilson observed (2) days of adequate perishable/ and (7) days of adequate nonperishable food supplies on the premises. Sharp knives, disinfectants/cleaning solutions are made inaccessible to the youth locked in the staff office closet with medications. Water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees fahrenheit. Most leftover perishable food is labeled with a made-by date. LPA Wilson asked how often food was checked for expiration dates. S1 responded "Every three days.". Two (2) items: hummus (exp: 05/07/2023), and milk (05/14/2023) were expired, and were removed by S1 and disposed of. (Report Continues on LIC809-C Page 3 of 3) (Page 3 of 3) Living "communal" Room: The living room has a small table, couch and television. The facility has one living "communal" room area used for recreating and activity room, which provide the necessary space and/or separation to promote and facilitate the program of planned activities and to prevent such activities from interfering with other functions. The living area has, books, DVDs, and magazines.. Bedrooms: There are (3) bedrooms in the facility with space for (2) clients in each. At the time of this report, (2) of the (4) clients placed have their own bedroom, and (2) clients share a bedroom. Windows were in working condition. Windows in each bedroom had no screens. There were no security bars on the windows. S3 stated they are currently on order. Clients had space for clothing and personal belongings. Bedroom 1: (2) beds and sleeps (1) client (C3), equipped with two twin-size beds, closet and dressers. Bedroom 2:(2) beds and sleeps (1) client (C2), equipped with two twin-size beds closet and dressers.Bedroom 3: (2) beds and sleeps (2) clients (C1, C4), equipped with two twin-size beds closet and dressers. Bathroom: There is (1) shared bathroom for all (4) clients. Bathroom has a functional sink, toilet, shower and lights observed to be in good working condition. Staff Interviews: Staff interviews were conducted with (S1, S3 and S4) LPA Wilson will need to return to facility to complete the staff file review. Client Interviews: Client interviews were conducted with (C2, C3 and C4) LPA Wilson will need to return to facility to complete the client file review. A review of Facility's Personnel Report Summary on 05/17/2023 indicates that all personnel have criminal record clearance has obtain the necessary clearances with DOJ, FBI, and Child Abuse Response.LPA Wilson will return to complete inspection at a later date. A (1) deficiency Type A has been determined at this time. Regulatory Reference 80076(a)(1): (2) items: hummus (exp: 05/07/2023), and milk (05/14/2023) accessible to clients are expired. A Technical Violation and a Technical Advisory have been determined at this time. Regulatory Reference 87009(a): TV: License posted in the staff office, which remains locked. Regulatory Reference 80088(b): TA There are no screens or bars on (2) bedroom windows. A copy of the report and the appeal rights were left at the facility.

met_with: Staff #1 (S1)


summary: Facility Evaluation

raw_content:
Narrative:
On 05/19/2023 at 8:48am, Licensing Program Analyst (LPA) Christine Wilson conducted an unannounced inspection, at the above-said facility,For The Future Short Term Residential Therapeutic Program (STRTP) for the purpose of conducting the continuation of an Annual inspection. LPA Wilson met with Staff #5 (S5) who granted access to the facility and an inspection of the facility files was conducted together. (3) staff (C2, S5, S6) were on site. (2) client residents (C1 and C2), were at the facility and (2) client residents (C3 and C4) were at school. Individuals mentioned in this report are identify on the Confidential Names List (LIC811 and LIC811C) dated 05/19/2023. S5 stated a new client will be arriving this afternoon. This will bring the census to five (5). LPA Wilson reviewed Emergency Response Services plan, Training plan and conducted the file review for two clients (C2, C4), reviewed the Needs and Services Plan (NSP) for each client (C1, C2, C3, C4) and conducted a file review of three (3) staff (S1, S2, S5).. [See Confidential Names form (LIC811 and LIC811C) dated 05/19/2023.), for names.] Emergency Response Services: LPA Wilson reviewed Emergency Procedures. Licensee provided plan "Emergency Response Services" and disaster drills, which are conducted u to (4) times per month. Training: LPA Wilson reviewed (2) Relias training logs date range 1/1/22 through 12/31/22 and 1/1/23 through 5/4/23. Licensee has a written record of all training, dates and hours, proof of on-going training which cover Trauma Informed Care, Emergency intervention techniques and handling aggressive behavior. LPA Wilson requested stat S3 provide (3) Pro-Act certificates of long-term staff. S3 stated that new employees have completed (8) hours of Pro-Act before working with clients, and additional hours are still in process. Client Files:LPA Wilson reviewed (2) client files. Medical information, NSP, client signed copies of relevant consent forms and licensee policies and procedures. NSP: Needs and Services Plan is current and signed by clients Staff Files: LPA Wilson reviewed (3) staff files. Copies of staff CPR Certification, criminal record clearance, driving records, health physical, TB clearance, legal identification, facility employee documents and diplomas were available. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 3, No deficiencies were cited at this time. Exit interview was conducted, and a copy of this report was left with the Facility Administrator (S5).

met_with: Staff #5 (S5)


summary: Facility Evaluation

raw_content:
Narrative:
On May 30, 2023 at 8:33am, Licensing Program Analyst (LPA) Christine Wilson arrived a the above mentioned facility for a Plan of Correction (POC) inspection, to verify the correction of deficiency(ies) cited in the licensing visit made on 05/17/23. LPA Wilson met with Staff (S5) regarding a Type A deficiency 80076(a)(18). Upon inspection, LPA Wilson observed food is not expired, and protected against contamination. Due to a technical difficulty, the licensee was given a copy of the signed deficiency page (809D) the licensing visit made on 05/17/23, and civil penalty was removed. There are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 05/21/25 at 9: AM Licensing Program Analyst (LPA) Nancy O'Connell made an unannounced visit to the above-listed facility for an Annual/Required licensing Inspection. LPA met with Tessa Koziol, facility Administrator (FA) and Kathleen Burrell, Program supervisor (PS), who granted access to the facility. The facility is licensed to care for six (6) female clients, ages 13-17 years, ambulatory only. LPA observed the following during the inspection: This is a one-story home equipped with three bedrooms, two bathrooms, living room, dining area and kitchen, and two staff offices. Attached garage is used as a storage space. Bedroom #1: Is occupied by C1 and C2- it has two twin size beds, adequate closet and drawer space. Bedroom #2: Is occupied by C3- has one twin size bed, adequate closet and drawer space. FA communicated that the second twin bed is missing due to C3 moving the bed out of the room repeatedly. FA confirmed that an additional bed is available and will be replaced immediately. Bedroom #3: Is occupied by C4 and C5- it has two twin size beds, adequate closet and drawer space. Bathroom#1: located in the main hallway and contains a toilet, sink, and standing shower. Bathroom had paper towels, and soap. LPA observed hygiene products in the shower and outside of the shower. FA agreed to remove items to ensure that hygiene products are not available for common use. LPA observed all items removed before concluding inspection. Bathroom#2: located in the staff office. This bathroom has a toilet, sink, and standing shower. Clients are allowed to use this bathroom if needed. Living room: contains enough seating for six (6) clients, a tv, and recreational games. This area is used for display of personal rights, the emergency disaster plan and the facility license. Dining room: contains enough seating for all clients in care. Area is used as an arts and crafts activity space. Kitchen: contains a refrigerator, stove, microwave, oven, and plenty of cabinet space. All appliances were observed to be in working condition. There were enough plates, cups, utensils for clients in care. LPA observed food within the refrigerator and freezer to be in the required amount and stored properly. Menu was posted with a date. A trash can was available and located within a contained storage area. Garage: contains washer, dryer, extra refrigerators, a deep freezer and additional recreation equipment/personal items for youth in care. LPA observed cleaning chemicals to be locked and inaccessible to youth in care. This area is kept locked and is inaccessible to youth without staff supervision. Outdoor-back yard: area is unobstructed and free from tripping hazards. The backyard had table seating for all youth, along with an umbrella for shade. The yard extends around the sides and back portion of the facility. The area in the back of the facility has two locked sheds that contain additional client/staff files along with extra client belongings. FA did not have keys to the two sheds and contacted additional off-site staff to unlock the sheds. LPA informed FA and PS that the facility must ensure access all areas within the facility property. Outdoor-front yard: area is unobstructed and free from tripping hazards. This area contains a driveway used to park two (2) facility vehicles. LPA inspected a Toyota Sienna and found it to be registered, insured and in working condition. LPA also inspected a Hyundai Accent and found it to be registered, insured and in working condition. Medication station: medications were observed to be locked and secure within the staff office. LPA observed medications to be properly stored, and kept with required documentation. This area is also designated as the storage area for sharps. This area is a locked closet in the staff office. Staff office#1: Located at end of bedroom hallway and secured with a metal security gate. This area contains an office computer, telephone line, and space for confidential meetings Staff office#2: this area is located adjacent to staff office #1 and has a door in staff office #1 that leads into staff office #2. During the time of inspection, LPA was informed that FA did not have access to the staff office as it is not in use. FA contacted off-site staff to gain access to staff office #2. S1 arrived and provided access. This office contains a large area with a desk, meeting table, printer, bookshelves, refrigerator, and telephone. There are a total of four doors that allow for exit (two doors lead outside and two lead back into the facility. Staff report that this office was previously used by the Head of Service until she moved her office to an alternate location. This office is currently unused and is kept locked at all times, preventing anyone from entering. LPA informed FA and PS that a plan will need to be developed to ensure access during investigations and required inspections. PS and FA understood and agreed. There is no swimming pool or any other bodies of water on the premises. There are no weapons or guns on the premises. All smoke detectors and carbon monoxide detectors were tested and operable at the time of inspection. There are two fire extinguishers located in the dining area and living room, observed to be in working condition and charged. LPA observed individual first aid kits fully stocked for each client in care. During this inspection, LPA completed the following sections of the Short Term Residential Treatment Program (STRTP) Care Tool: Physical Plant. Per California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulation, and Short Therapeutic Program (STRTP) Interim Licensing Standards (ILS) Version 5, there were no deficiencies cited during this inspection Due to time constraints, LPA will return on another day to complete the Annual Inspection. Exit Interview was conducted with the FA, and a copy of this report was provided to the facility.

met_with: Tessa Koziol, Facility Adminsitrator (FA), and Kathleen Burrell, Program Supervisor (PS).


summary: Facility Evaluation

raw_content:
Narrative:
On 6/20/25 9: AM Licensing Program Analyst (LPA) Nancy O'Connell, made an unannounced visit to the above-listed facility for the purpose of conducting a Case Management - Annual Continuation inspection. LPA was met by Tessa Koziol, Facility Administrator (FA),who provided access to the facility and facility records. LPA met with FA and informed her that the purpose of the visit is to conduct a continuation of the Annual inspection. LPA inquired about the current census, requested the Register of Clients, and a staff roster. LPA requested to interview selected staff and clients, and inspect client/ staff files. Client/Staff Interviews: LPA conducted interviews with four (4) staff (FA, S1, S2,S4, FS), and two (2) clients (C3, and C1). Additional client were unavailable for interview during time of inspection. Client/Staff File reviews: LPA conducted file review for (4) staff (FA,S1, S2, and S3), and five (5) clients (C1,C2,C3,C4, and C5) [See Confidential names list, LIC811, dated 6/20/25, for names.] During the time of inspection, LPA completed the following sections of the Care Tool for Short Term Residential Therapeutic Programs(STRTP): Emergency Preparedness, Operations, Emergency Intervention, Core Services, Staffing files, and Client Files. LPA inspected medication logbooks, allowance logs, inventory logs, reviewed Needs and Services Plans, records of core services, accountability meeting minutes, and disaster preparedness procedures and logs. LPA observed that the facility staff are currently being trained in Pro-Act training and has formalized a plan to have all staff fully trained by 8/30/25. Per California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulation, and STRTP Interim Licensing Standards (ILS) Version 5, there are no deficiencies cited during this inspection. An exit interview was conducted, and a copy of this report was sent to the administrator and head of services via email.

met_with: Tessa Koziol, Facility Adminsitrator (FA), and Melissa Kagen, Facility Supervisor (FS)


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Olivia Rosas conducted a case management inspection July 23, 2025, at 9:30am 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. In the inspection, 3 out of Direct Care Staff and 1 out of 4 youth were interviewed (See the Confidential Names List, LIC 811, dated July 23, 2025). 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 youth sase plans, Crisis Safety Plan,Child and Family Team summary, Needs and Service Plan (LIC625), 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 Rosas 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 with 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 Tessa Koziol, Administrator.

met_with: Maral Sultainian, Head of Service


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Investigation Findings:
13On 11/21/25 at 8:45AM, Licensing Program Analyst (LPA) Wendely Moodie-Naranjo made an unannounced inspection to the above-listed facility for the purpose of concluding a complaint investigation on the above allegation and deliver the findings. Licensing staff spoke with Tessa Koziol, Facility Administrator who gave access to the facility and together, discussed the investigative finding. During the investigative process by Licensing program Analyst (LPA), Moodie-Naranjo,interviewed all relevant parties and all have been accounted for. During the investigative process, LPA obtained information regarding all staff working within the facility and organization. Statements obtained did not support clear evidence. 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. No deficiencies are being cited at this time. Exit Interview conducted, and a printed copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Wendely Moodie-Naranjo LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Tessa Koziol-Facility Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On September 7, 2023 at 1:00 pm, Licensing Program Analyst (LPA) Christine Wilson made an unannounced visit to the above listed facility, in order to conduct a case management incident inspection, regarding SIR dated 08/26/23. LPA Wilson interviewed staff (S1) and obtained shift notes and shift schedule for week of 08/21/23. During the course of the incident investigation, it was revealed that on 08/26/23 the youth (C1, C2, C3 and C4[See LIC811 dated 09/07/23 for list of confidential names] were not supervised by enough staff to care for and meet the needs of clients, and licensee was out of ratio for client's behavioral needs, which included intoxication and resulted in property damage, due to a lack of supervision by staff A (1) deficiency Type A has been determined at this time. The following deficiency has been cited. (See LIC 809D) An exit interview was conducted and Plans of Correction was developed and reviewed with the licensee. A copy of this report and appeals rights were discussed and left with licensee. (S1) whose signature on this form confirm receipt of these documents.

met_with: Administrator (S1)


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Narrative:
Confidential interviews were conducted with clients placed in the facility, facility staff, and collateral contacts. During confidential interviews and review of documentation it was revealed that a physical altercation did occur on 12/08/2025 between C1 and two other clients (C2, C4). It was indicated that facility staff re-direct clients from fighting and separate clients when clients fight but do not put hands on clients or restrain clients. It was indicated that staff attempted to de-escalate the altercation on 12/08/2025 but were unsuccessful. It was indicated that staff called the police and that C1, C2 and C4 were cited for Battery. It was reported that C1 and C2 were offered transport to the Emergency Room and that C1 went to the Emergency Room and C2 declined. It was reported that C1 returned to the facility, with no further concerns noted by the hospital. During confidential interviews it was indicated that C1 has a history of methamphetamine use. It was reported that C1 used methamphetamine while on unauthorized leave in the past. During confidential interviews all parties denied knowledge of methamphetamine being present or being used in the facility. The allegations are determined to be unsubstantiated. A finding that is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. There are no deficiencies cited per California Code of Regulations, Title 22, at this time. A copy of this report was provided to the Facility Manager and Facility Administrator via email.

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

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

met_with: Naia Danko, Facility Manager


raw_content:
Investigation Findings:
13On December 12,2025 at 1: PM, Licensing Program Analyst (LPA) Wendely Moodie-Naranjo made an unannounced inspection to the above listed facility and met with the Tamana Sarajzada- Facility Manager for the purpose of concluding the investigation and delivering findings on the above allegation. Based on the confidential interviews conducted and records obtained during the investigation process, LPA Moodie-Naranjo concluded the allegations: The line of communication between the facility and the authorized representative was followed as per regulation. Per staff, transportation was offered and later denied by client. Per staff they maintain the ratio of 3:1 when clients in care. Although the allegation may have occurred, or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated. A copy of this report will be emailed to facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Wendely Moodie-Naranjo LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Tamana Sarajzada- Facility Manager


facility_name: FORECAST

raw_content:
Narrative:
according to their plan. In addition, confidential interviews reported that C1, C2, and C3 meets with their assigned therapist at least once a week for individual sessions and group sessions. Confidential interviews reported that if C1, C2, and C3 would like more sessions, the services are available. Confidential interviews revealed that the clinicians are available during afterhours for C1, C2, and C3. Other confidential interviews reported that the facility had not had any turnover for clinicians. Other confidential information received stated that clients in care missed therapeutic sessions due to the lack of therapist at the facility while other confidential interviews denied the allegation. Based on confidential interviews and information obtained, the allegation that facility is not meeting minors' (C1, C2, & C3) therapeutic needs, may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. Exit interviewed conducted. A copy of this report and appeal rights were given and explained to Ricardo Calzada.

Investigation Findings:
13On September 08, 2021 at 8: AM, Licensing Program Analyst (LPA), Cheraki Davis, met with Tyresha Calhoun and Ricardo Calzada, Short Term Residential Therapeutic Program (STRTP) Residential Managers to deliver the finding for the above complaint allegation. On 03/10/2021 at 11:30PM, LPA Ronnesha Fountain inspected the physical plant and no current safety hazards were observed. During the investigation, LPA obtained copies of records that included: Client Roster, Personnel Report, Needs and Services Plan, Mental Health and Counseling Services Clinical Review Forms. Interviews were conducted with clients (C1, C2, & C3) and six staff (S1, S2, S3, S4, S5, & S6). On 03/04/2021, Community Care Licensing received an allegation that facility is not meeting minors' (C1, C2, & C3) therapeutic needs. It was reported that a therapist (unknown) quit from this facility and a client (unknown) has not had any therapy sessions. Confidential interviews reported that the facility Mental Health Department staff covered the therapeutic sessions until clinicians were hired. Confidential interviews reported that C1, C2, and C3 haven't missed any therapy sessions with their assigned clinicians and received services UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Cheraki Davis LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FORECASTFACILITY NUMBER: VISIT DATE: 09/08/2021

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

met_with: Ricardo Calzada


raw_content:
Narrative:
dispute the allegations. Confidential interviews reported no knowledge of any inappropriate interactions between staff and residents occurring at the facility. Confidential interviews and record review revealed C1 does smoke however, were unable to confirm or dispute staff (unknown) ever smoked with C1. Based on record review and confidential interviews the allegations of staff (unknown) sexually abused youth (Child #1 [C1]), and staff (unknown) smoked with youth (C1), 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, and a copy of the report was provided along with appeal rights to Forecast Short Term Residential Therapeutic (STRTP) Program Administrator, Ricardo Calzada.

Investigation Findings:
13On May 19, 2022 at 11:02 am Licensing Program Analyst (LPA), Nicole Strickland, met with Forecast Short Term Residential Therapeutic (STRTP) Program Administrator, Ricardo Calzada, to deliver the finding for the above stated allegations. LPA conducted an inspection of the facility on September 28, 2021 at approximately 2:00pm and no immediate deficiencies were observed. The investigation was conducted by Special Investigator Georgina Tallagua and LPA Strickland which included interviews with Staff #3 (S3), Staff #4 (S4), four of four foster children (Child #1 [C1], Child #3 [C3], and Child #4 [C4], and Child #5 [C5]), and one Probation Officer (PO). Two confidential witnesses did not respond to LPA's request for an interview and therefore were not interviewed. In addition, county records and facility records were reviewed. On September 20, 2021, Community Care Licensing (CCL) received two allegations alleging that staff (unknown) sexually abused youth (Child #1 [C1]), and staff (unknown) smoked with youth (C1). Record review revealed a conversation insinuating C1 had sex and smoked with staff (unknown) had been made resulting in the above allegations. Confidential interviews and record review were unable to confirm or UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-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, MAIN ST., SUITE FACILITY NAME: FORECASTFACILITY NUMBER: VISIT DATE: 05/19/2022

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


raw_content:
Narrative:
permission and have since returned but were unable to confirm any knowledge of, or disclosures made alleging sexual abuse. Confidential interviews were unable to confirm or dispute the allegation. A second allegation alleging facility staff (Staff #1 [S1]) had an inappropriate relationship with youth (Child #1 [C1]) was received by CCL. Specifically it was reported that S1 would purchase underwear for C1 on a weekly basis and made comments to C1 about getting C1 showered. Confidential interviews reported conflicting accounts on how purchases of personal items (ie. underwear) were made. Confidential interviews reported youth were given their clothing allowance and allowed to purchase needed/wanted items including underwear. Additional confidential interviews reported that staff assisted youth in making the purchases to ensure appropriate sizes were selected. However, it was also reported that S1 often frequently picked up various items from thrift shops and would provide these items to youth. It was unknown if these items included underwear. Confidential interviews and record review could not confirm or dispute the allegation. A third allegation alleging facility staff (unnamed) did not accord youth (Child #1 [C1]) privacy. Specifically it was reported on an unknown date, while in the shower C1 felt as though C1 was being watched. Confidential interviews reported facility protocol is the bathroom door is the only door in the facility that is permitted to be closed and/or locked to allow for privacy. Confidential interviews reported if staff feel that foster youth are taking too long in the shower or bathroom they will continually knock the door and bother the youth. Confidential interviews could not confirm or dispute this allegation. Based on record review and confidential interviews the allegations of staff (Staff #1 [S1]) sexually abused youth (unknown), facility staff (Staff #1 [S1]) had an inappropriate relationship with youth (Child #1 [C1]), and facility staff (unnamed) did not accord youth (Child #1 [C1]) privacy, may or may not have occurred, however they are not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights was provided to Forecast Short Term Residential Therapeutic Program (STRTP) Residential Manager Ricardo Calzada.

Investigation Findings:
13On October 21, 2022 at 11:52_am Licensing Program Analyst (LPA), Nicole Strickland, met with Forecast Short Term Residential Therapeutic Program (STRTP) Residential Manager Ricardo Calzada, to deliver the findings for the above stated allegations. LPA conducted an inspection of the facility on November 2, 2021 at approximately 2:30 pm and no immediate deficiencies were observed. The investigation included interviews three staff (Staff #1 [S1], Staff #2 [S2], S2Staff #3 [S3]), four of five foster youth (Child #2 [C2], Child #3 [C3], Child #4 [C4], and Child #5 [C5]). One confidential witness did not respond to LPA's request for an interview and therefore was not interviewed. In addition, county records and facility records were reviewed. On October 27, 2021, Community Care Licensing (CCL) received an allegation alleging staff (Staff #1 [S1]) sexually abused youth (unknown). Specifically it was reported an unnamed resident had recently run away from the facility and claimed while residing at the facility on an unknown date, S1 sexually abused unnamed resident. Record review and confidential interviews confirmed residents have left the facility without UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-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, MAIN ST., SUITE FACILITY NAME: FORECASTFACILITY NUMBER: VISIT DATE: 10/21/2022

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

met_with: Residential Manager Ricardo Calzada


raw_content:
Narrative:
Other confidential interviews stated that C1 and C2 do not have a known history of inappropriate behaviors. The interviews that were provided to the LPA were not consistent regarding the allegations that staff are not properly supervising C1 and did not provide any further specific details regarding staff supervision. Based on interviews and record reviews the allegations that staff did not prevent C1 and C2 from engaging in inappropriate behavior and staff did not prevent C1 from awoling (absent without leave) from the, may have occurred, however is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Tyresha Calhoun.

Investigation Findings:
13On June 22, 2023 at 10:40 am, Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an unannounced inspection to the facility to deliver the findings of the above allegations. LPA met with Tyresha Calhoun. Lisi Leon conducted an inspection of the facility on August 18, 2022, at 12:10 pm and no immediate deficiencies were observed. Four of four clients (C1, C2, C3, C4), four staff and facility administrator were interviewed. It was reported to Community Care Licensing (CCL) that staff did not prevent C1 and C2 from engaging in inappropriate behavior and staff did not prevent C1 from awoling (absent without leave) from the facility. Confidential staff interviews reported that S1, C1 and C2 were in the living and S1 stepped away for several minutes. Confidential interviews reported that then C1 and C2 engaged in inappropriate behaviors. Confidential interviews reported that S1 observed C1 and C2 engaging in inappropriate behaviors, in the living room. Confidential interviews reported that C1 has left the facility without permission and staff will verbally give C1 directives but C1 refuses to follow verbal directives of staff. Confidential interviews reported that C1 and the other clients are always supervised while at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Darlene Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FORECASTFACILITY NUMBER: VISIT DATE: 06/22/2023

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

met_with: Tyresha Calhoun


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Confidential interviews reported S1 was observed to have been smoking with clients. Other confidential interviews reported that there were no witnesses that saw S1 smoking with any of the clients while at the hotels. Community Care Licensing also received an allegation that staff (S2) smoked marijuana with a minor while in care. Confidential interviews reported that S2 also worked the weekend that clients had to evacuate because of the power outages in the area, to a hotel and was seen smoking with clients. Other confidential interviews reported that S2 did work that weekend but denied witnessing S2 smoking with clients. Based on inconsistent confidential interviews, the allegations of staff (S1) smoking with the minors while in care and staff (S2) smoked marijuana with a minor while in care are unsubstantiated. The allegations may have happened or are valid, but there is not a preponderance of evidence to prove that the alleged violations occurred. An exit interview was conducted, and a copy of this report LIC 9099 and the appeal rights were discussed and provided to Shahana Zeigler, Youth Partner.

Investigation Findings:
13On March 10, 2025 at 1PM, Licensing Program Analyst (LPA) Cynthia Robinson conducted an unannounced visit to Olive Crest Forecast STRTP to deliver the investigative findings for the allegations listed above. On 01/17/2025, LPA Robinson conducted a health and safety inspection at the STRTP and obtained documents pertinent to the investigation. LPA interviewed clients (C1, C2, and C3), and staff (S1, S2, S3 and S4). LPA also interviewed Probation Officer (P.O). On 01/14/2025, Community Care Licensing received an allegation that staff (S1) smoked with the minors while in care. It was alleged that during a facility evacuation due to power outages, the clients were placed in a hotel for the weekend and S1 was smoking with the clients (C1, C2, and C3). Confidential interviews reported that S1 was seen on the outside patio with clients when they smelled a marijuana odor coming from the outside patio. (Continued on LIC 9099C...) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Cynthia Robinson LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: FORECASTFACILITY NUMBER: VISIT DATE: 03/10/2025

met_with: Shahana Zeigler, Youth Partner.


summary: Facility Evaluation

raw_content:
Narrative:
On October 13, 2021, at 10: AM Licensing Program Analyst (LPA) Ronnesha Fountain, Leslie Covarrubias and Licensing Program Manager (LPM) Jennifer Smith arrived at Forecast, Short Term Residential Program (STRTP). LPAs and LPM met with Residential Manager, Ricardo Calzada. The purpose of the visit is to conduct an annual inspection of the facility. At 10: AM, Residential Manager, Ricardo Calzada, led the physical inspection of the facility. The home is set up as follows: Bedroom #1- Was furnished with one twin bed. No client is placed in this room at this time. Bedroom #2- Was furnished with one twin bed. Sleeps one client. Bedroom #3- Was furnished with one twin bed. No client is placed in this room at this time. Bedroom #4- Was furnished with one twin bed. Sleeps one client. Bedroom #5- Was furnished with one twin bed. No client is placed in this room at this time. Bedroom #6- Was furnished with one twin bed. Sleeps one client. Bedrooms are arranged so that only one child is placed per room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate drawer and closet space for children's belongings. The dresser drawer in room #4 was observed to be broken approximately at top-left corner of bottom drawer. Bedroom #2 has a hole in the wall and the back of the door. Bedroom #3 door is cracked in the middle. A physical plant inspection was completed and included the facility's kitchen area, four refrigerators/freezers, food storage areas, client rooms, two bathroom/showers, and community gathering area and dining area. Facility grounds are clean and free of debris and observable hazards. Sports equipment/toys/books/games were observed for client's recreation time. There is adequate indoor and outdoor activity space. Facility smoke detectors and carbon monoxide detectors are in appropriate working order; fire extinguisher is properly charged and serviced. Licensee maintains an adequate supply of perishable and non-perishable foods and the menus were posted. At the time of inspection the facility license was observed to be posted by the staff office. All required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsperson poster. Medications are locked and centrally stored inside staff office. The Residential Manager stated they did not have individual contraceptive containers for clients. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. The hot water in the client's bathrooms was measured to be 120 for bathroom #2 and bathroom #1 was 121.2. Per the Residential Manager, no firearms or weapons are allowed in the facility. LPAs and LPM inspected the facility vehicle, and observed that there was a difficulty latching the third row seat into place. The facility was advised to have the third row seat serviced. LPAs and LPM observed the First Aid Kit to be complete. LPAs and LPM conducted a client record review of three of three client files. Client #1 did not have a current needs and service plan in the file. Licensee has Mental Health Program Approval that is valid through 12/13/2021. Licensee has obtained National Accreditation that is valid through 10/31/2021. Licensing fee payments have been paid and there is currently a balance of $0. Based on review of Physical Plant and Client Records, the facility is being cited for violation of the Interim Licensing Standards Version 4, Chapter 7.5, Sections: Client Records 87068.3(a) and Title Regulations Divsion 6, Chapter Fixture, Furniture, Equipment and Supplies 80088(e)(1). An exit interview was conducted and a copy of this report, LIC 809D, LIC9102, LIC 811 and appeal rights were provided to Residential Manager, Ricardo Calzada.


summary: Facility Evaluation

raw_content:
Narrative:
On October 29, 2021, at 8: AM, Licensing Program Analyst's (LPAs) Ronnesha Fountain, Carmen Escobar, and Leslie Corruvabias arrived at Olive Crest - Forecast Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to complete the continuation inspection for STRTP annual inspection that was initiated on October 13, 2021. LPAs already completed the physical inspection of the facility and reviewed facility client files on the first day of the annual inspection. During this annual inspection continuation, the LPAs reviewed 10 of the 11 personnel files to ensure they contained all required documentation per Title Regulations and Interim Licensing Standards (ILS). Personnel Files are usually maintained at the corporate office in Riverside. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. Seven of the ten files that were reviewed were for employees who converted from group home personnel to STRTP personnel. LPAs observed the converted staff members were trained according to the STRTP training requirements for employees. Per interview conducted, there are some potential concern's regarding the hands-off policy. Currently there are no deficiencies being cited under the Interim Licensing Standards section Personnel Requirements.


summary: Facility Evaluation

raw_content:
Narrative:
On Friday, November 19, 2021, at 2:45 pm, Licensing Program Analyst (LPA) Ronnesha Fountain conducted an announced inspection. The purpose of the inspection was to complete the continuation inspection for the Forecast STRTP annual inspection initiated on October 27, 2021. LPA Fountain has already completed the physical plant inspection, client records, and client interviews. During the time of the inspection, there were no clients on site. LPA Fountain reviewed staff records, Operational Requirements, Disaster Preparedness, Emergency Intervention Plan, and Core/Therapeutic Services during this annual inspection to ensure the STRTP meets the Title Regulations and Interim Licensing Standards (ILS), see LIC 811 dated 11/10/21. The client interviews are located under the LIC 809 dated 10/27/21, 10/29/21, 11/04/21, and 11/19/21. Based on the review of staff records, the STRTP appears to be meeting Core Services/Supports requirements. Due to the need to interview staff and time restrictions, this annual inspection for the Forecast STRTP will be continued later. No deficiencies were found during this inspection. An exit interview was conducted, and a copy of this report was provided to the residential manager Anne Lacy.

met_with: Anne Lacy


summary: Facility Evaluation

raw_content:
Narrative:
On Tuesday, December 7, 2021, at 1:54 pm, Licensing Program Analyst (LPA) Ronnesha Fountain conducted an announced inspection. The purpose of the inspection was to complete the continuation inspection for Forecast STRTP annual inspection initiated on October 29, 2021. LPA Fountain has already completed the physical plant inspection, client records, and some client interviews. During the time of the inspection, there were three clients on site. LPA Fountain reviewed staff records, Operational Requirements, Disaster Preparedness, Emergency Intervention Plan, and Core/Therapeutic Services during this annual inspection to ensure the STRTP meets the Title Regulations and Interim Licensing Standards (ILS), see LIC 811 dated 12/07/21. Based on the client interviews, the STRTP appears to be meeting Core Services/Supports requirements. With the facility's inspection, interviews with clients and staff, and a review of their records, CCL does not recognize any violation of regulations and/or ILS. This will conclude the annual inspection for Forecast STRTP's last visit. No deficiencies were found during this inspection. An exit interview was conducted, and a copy of this report was provided to the residential manager Ricardo Calzada .

met_with: Residential Manager


summary: Facility Evaluation

raw_content:
Narrative:
On November 29, 2023 at 9:19 am, Licensing Program Analyst (LPA), Emina Preciado, conducted an unannounced visit at Olive Crest - Forecast, Short Term Residential Therapeutic Program (STRTP). The purpose of the visit was to conduct a required annual inspection of the facility. LPA met with Residential Manager, Tyresha Calhoun. While at the facility, LPA reviewed client and facility records, conducted three staff interviews, and two client interviews. At, approximately, 11 am LPA conducted a walk through and physical inspection of the facility. Youth Partner, Shahana Zeigler, led the walk through of the facility. While conducting the physical inspection, LPA made the following observations: the facility's kitchen area was in good repair and free of hazards, there are four refrigerators/freezers, a dining area, and a community gathering area. There are six client bedrooms, two bathroom/showers, one staff restroom, one staff office, one clinician office, and one administrator office. Facility grounds are clean and free of debris and observable hazards. Washers and dryers are in working order. Sports equipment/toys/books/games were observed for client's recreational time. There is adequate indoor and outdoor activity space. Facility smoke detectors, carbon monoxide detectors, and fire extinguishers are in good repair and appropriate working order; The facility maintains a designated food storage area (pantry), an adequate supply of perishable and non-perishable foods, and the menu was accessible. Licensee has Mental Health Program Approval that is valid through 12/13/2023. All required forms are posted near the facility entrance or staff office and included: the Facility License, Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsperson poster. Medications, knives, and laundry supplies are locked and centrally stored inside staff office. Cleaning supplies are locked and centrally stored in a cabinet near the laundry room/pantry storage. Per the Residential Manager, no firearms or weapons are allowed in the facility. *...* The facility currently has three occupied beds and three open (vacant) beds. The bedroom living arrangements are as follows: Bedroom #1- Furnished with one twin bed, sleeps one client, and is occupied. Bedroom #4- Furnished with one twin bed, sleeps one client, and is occupied. Bedroom #5- Was Furnished with one twin bed, sleeps one client, and will be occupied by an incoming client. Bedrooms #2, 3, and 6- Are furnished with one twin bed and sleeps one client. No clients are placed in those rooms at this time. The bedrooms are arranged so that only one child is placed per room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. Individual beds were observed with appropriate clean linens, pillows, comforters, storage space, and mattresses in good repair. During the inspection, LPA reviewed three of three client records. Three of three client records reviewed were in compliance and contained required documentation per Title Regulations and Interim Licensing Standards (ILS). The facility has an Administrator that is qualified and has a current STRTP Administrator certificate. Based on staff/client interviews (please refer to LIC 811, Confidential Names List), the facility appears to be meeting Core Therapeutic Services, and Supports, and Emergency Intervention Plan requirements. Staff records are not kept on facility grounds; On November 13, 2023, LPA met with Human Resources Administrative Manager to conduct the Staff Records review portion of the inspection at Olive Crest (336425183) located at: Technology Court Suite Riverside, CA 92507. LPA reviewed five personnel records, to ensure they contained required documentation per Title Regulations and Interim Licensing Standards (ILS). Five out of five personnel records reviewed were associated to the facility and the following background clearances were completed and on file: Department of Justice (DOJ), Federal Bureau of Investigation (FBI), and Child Abuse Central Index (CACI). Five out of five personnel records reviewed had a health screening and tuberculosis (TB) test on file. Five out of five personnel records reviewed had annual training's, current cardiopulmonary resuscitation (CPR), and first aid certification on file. Based on observation and record review, there are no deficiencies noted at this time during the inspection. Exit interview conducted and a copy of this report along with LIC 9102 and LIC 811, Confidential Names List, was provided to Residential Manager, Tyresha Calhoun.

met_with: Tyresha Calhoun, Residential Manager


summary: Facility Evaluation

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Narrative:
On August 13, 2025, at 10:25 am, Licensing Program Analyst (LPA), Julian Lucas, arrived unannounced at Forecast Short Term Residential Therapeutic Program (STRTP) located at 20051A Vista Del Lago, Perris, CA 92570. The purpose of the visit was to conduct a required annual inspection of the facility. LPA met with Administrator, Stacy Rougely. LPA began a facility tour at 10:35 am with Shahana Zeigler, Youth Partner. During the inspection, LPA observed the Facility License, Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster posted near the entrance of the facility. The living room area consisted of two sofas and two chairs, a coffee table, two end tables, television, books, and board games placed on shelves. There is a dining area with a table with four chairs and two benches. The kitchen has one refrigerator with freezer. There are six client bedrooms, two bathrooms, with one shower in each bathroom, one staff office, one staff restroom, one clinician office, and one administrator office. There are two washers, and one dryer all are in working order in a separate locked room from the kitchen. There is sports equipment which includes bikes, and exercise equipment located in the garage are, which is locked. There is adequate indoor and outdoor activity space. All smoke detectors, carbon monoxide detectors are in working order. There are two fire extinguishers that are up to date. The facility maintains a designated food storage area (pantry), an adequate supply of perishable and non-perishable foods, and the menu was accessible. Facility grounds are clean and free of debris. During the inspection, LPA reviewed 3 client files, facility records, 3 staff files. LPA conducted one staff interview Continued on 809C Medications are locked and centrally stored in the facility staff's office inside a locked file cabinet. Medication records were reviewed and observed to be completed with dates and staff initials on dispensing records. Chemicals/poisons are locked inside the facility staff's office and sharp objects stored in the staff office inside a locked file cabinet. The facility staff's office always remains locked. First Aid Kits are complete and stored in the staff office. Based on the annual required inspection on this date, there were no deficiencies found. An exit interview was conducted with the Administrator, Stacy Roughley and a copy of this report was given to the administrator. An exit interview was conducted, and a copy of this report was provided to the Administrator, Stacy Roughely.

met_with: Stacy Rougely, Administrator


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On November 19, 2025, at 11: AM, Licensing Program Analysts (LPA's) Cynthia Robinson and Jessica Peete conducted an unannounced case management visit at Olive Crest - Forecast Short Term Residential Therapeutic Program (STRTP). LPA Robinson met with Rhonna Tan, Mental Health Director, to discuss the incident report submitted to Community Care Licensing on October 21, 2025, alleging staff hit a client, identified on the Confidential Names List LIC 811. LPA Robinson reviewed the incident report, supporting documentation, and interviewed facility staff (S1, S2, S3, S4 and S5) and client 1 (C1). Documentation indicated that S1 had slapped C1 on the back with an open palm and S1 attempted a second strike when C1 evaded or moved from the strike. During the time of the incident, law enforcement was contacted, however no law enforcement actions were taken. Statements about the incident stated that S1 and C1 were outside hanging up holiday decorations on the front door/ patio area when two eyewitnesses seen S1 slap C1 with an open palm on the upper back area between shoulders. Statements collected from interviews revealed that the slap made a loud noise due to the force of contact. It was also revealed from documentation and statements that S1 attempted to hit C1 a second time but was unsuccessful as C1 was running away and moved out of the way missing C1's attempt. Based on confidential interviews and facility information obtained, the licensee is cited for violation of Interim Licensing Standards (ILS) Article 06. Continuing Requirements, Personal Rights (c)(16), which states (c) the Licensee shall ensure that each child... (16) to be free of physical... abuse... An exit interview was completed, and LPA provided this report, the Confidential Names List LIC 811, and appeal rights to Rhonna Tan, Mental Health Director.

Deficiencies:
87072: Based on confidential interviews and supporting documentation, the facility did not ensure C1 was free from physical abuse from S1 due to S1 hitting C1 on the back. 1
2
3
4
5
6
7

met_with: Rhonna Tan, Mental Health Director

title:
Personal Rights (c)(16) The Licensee shall ensure that child... be free from physical... abuse...
This requirement was not met as evidenced by


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Narrative:
Confidential interviews reported that S1 was transporting C1 and C2, and during the transport, C1 became upset because S1 directed C1 not to touch the car radio per facility policy. Confidential interviews reported that S1 was using their (S1) hand to prevent C1 from changing the radio. Confidential interviews denied that S1 smacked C1 on the hand. LPA was unable to determine if S1 smacked C1's hand. LPA was unable to determine any other incidents of C1 being hit by staff. On 11/05/2025, Community Care Licensing (CCL) received an allegation that staff (unknown) inappropriately threw down a minor (C1). It was alleged that C1 was thrown down on the floor by an unknown staff member. Confidential interviews denied any physical altercation or restraint involving C1 while in care. Due to limited information, LPA was unable to determine if staff inappropriately threw down a minor (C1). Based on inconsistent confidential interviews, the allegations that staff (S2, S3, S4, and S5) hit a minor (C1) and staff (unknown) inappropriately threw down a minor (C1) are unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of evidence to prove that the alleged violations occurred. A copy of this report and appeal rights were provided to Administrator, Caitlyn Farris.

Investigation Findings:
13On March 27, 2026, at 01: PM, Licensing Program Analyst (LPA) Cynthia Robinson conducted an unannounced visit to Forecast to deliver the investigative findings for the allegations listed above. On 11/12/2025, LPA Robinson conducted a health and safety inspection at the STRTP and observed no immediate health and safety hazards. LPA obtained documents pertinent to the investigation. LPA interviewed Clients (C3, C4, C5, C6, C7, C8), and Staff (S1 and S2). LPA attempted to interview Clients (C1 and C2) but was unsuccessful due to the clients being detained. LPA made several attempts to interview Staff (S3, S4, and S5) but was unsuccessful. LPA made several attempts to interview the County Social Worker (CSW) but was unsuccessful. On 11/05/2025, Community Care Licensing (CCL) received an allegation that staff (S2, S3, S4, and S5) hit a minor (C1). Documentation revealed that C1 reported that S1 had repeatedly smacked their (C1) hand to prevent C1 from changing the car radio. (Continued on LIC 9099C...) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Cynthia Robinson LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: FORECASTFACILITY NUMBER: VISIT DATE: 03/27/2026

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

met_with: Administrator, Caitlyn Farris


facility_name: FRED FINCH YOUTH CENTER

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Narrative:
Based on the information obtained; there is a preponderance of evidence to prove that facility staff shared a video of a client in care without guardian consent. Therefore, the above allegation is substantiated. Appeal Rights were provided and deficiencies were cited. Exit interview conducted and a copy of the report was sent to the Adminstrator for signature. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that facility staff increased client in care medication without medical approval, facility staff did not observe changes in client in care physical condition, facility staff are not transporting client in care to medical appointments, facility staff did not develop client in care needs and service plan and facility staff did not meet client in care hygiene needs,therefore the above allegation is unsubstantiated. Exit interview conducted with SD and LPA left report at the facility.

Investigation Findings:
13Licensing Program Analyst (LPA) Christopher Rollins conducted a complaint inspection with Fred Finch and met with Mar Smith Senior Director. The purpose of the inspection was to deliver the finding for the above complaint allegation. During the course of investigating this allegation, LPA conducted confidential interviews with staff, clients, social workers, conducted a client file review and reviewed documentation. Confidential interviews and documentation reveal that facility staff shared a video of a client in care without guardian consent. Based on confidential interviews and documentation there was enough evidence to prove that facility staff shared a video of a client in care without guardian consent. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: Christopher Rollins 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 14-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, TRAEGER AVE., SUITE FACILITY NAME: FRED FINCH YOUTH CENTERFACILITY NUMBER: VISIT DATE: 09/02/2021

met_with: Mar Smith-Senior Director


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Narrative:
continued from LIC Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that staff engages in inappropriate behavior with minors. Therefore, the above allegation is UNSUBSTANTIATED. Regarding the allegation that staff speaks to minor in an inappropriate manner: Licensing Program Analyst Karkazis (LPA) conducted confidential interviews with staff, clients, and conducted document research. During confidential interviews with staff and clients, inconsistent information provided. One interviewee stated that staff asked clients inappropriate questions. Another interviewee stated that staff told a participant to stop inappropriate behavior, while other interviewees stated that no staff ever spoke to a minor inappropriately. LPA conducted document research and found no evidence to support staff speaking to minor inappropriately. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that staff speaks to minor in an inappropriate manner. Therefore, the above allegation is UNSUBSTANTIATED. Regarding the allegation that facility is operating outside the scope of the license: Licensing Program Analyst Karkazis (LPA) conducted confidential interviews with staff, clients, and conducted document research. During confidential interviews with staff and clients, inconsistent information provided. One interviewee stated the facility cannot place certain restrictions while all other interviewees stated that restrictions can be placed if certain criteria are met. LPA conducted document research and found that criteria had been met for restrictions to be implemented, for safety reasons. . Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that facility is operating outside the scope of the license. Therefore, the above allegation is UNSUBSTANTIATED. An exit interview was conducted and a copy of this report was given to Mar Smith, Senior Director.

Investigation Findings:
13On 10-6-23 2:15PM, Licensing Program Analyst (LPA) George Karkazis conducted an unannounced inspection at Fred Finch Youth Center and met with Mar Smith, Senior Director, who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. Regarding the allegation that staff engages in inappropriate behavior with minors: Licensing Program Analyst Karkazis(LPA) conducted confidential interviews with staff, clients, and conducted document research. During confidential interviews with staff and clients, inconsistent information provided. One interviewee stated that staff engaged in inappropriate behavior with a minor but could not state when it happened. All other interviewees stated that staff never engaged in inappropriate behavior with minors. LPA conducted document research and found no evidence of staff engaging in inappropriate behavior. continued on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: George Karkazis 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 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO ASC, TRAEGER AVE., SUITE FACILITY NAME: FRED FINCH YOUTH CENTERFACILITY NUMBER: VISIT DATE: 10/06/2023

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

met_with: Mar Smith, Program Director


raw_content:
Investigation Findings:
13On 12-1-23 10:58AM, Licensing Program Analyst (LPA) George Karkazis conducted an unannounced inspection at Fred Finch Youth Center, and met with Mar Smith Senior Director, who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. The complaint alleged that staff do not ensure that the roof is inaccessible to youths in care, staff do not ensure that hazardous items are inaccessible to youths in care, and staff do not adequately supervise youths in care. LPA Karkazis conducted confidential interviews, and conducted document research, in which inconsistent information was provided. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the allegations occurred. Therefore, the allegations are UNSUBSTANTIATED. A copy of this report was given to Mar Smith Senior Director. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lidia Tinoco LICENSING EVALUATOR NAME: George Karkazis LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

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

met_with: Mar Smith, Senior Director


summary: Complaint Investigation - Unsubstantiated - 3 allegations

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

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

met_with: Director, Mar Smith


summary: Complaint Investigation - Substantiated - 3 allegations

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Narrative:
No citation will be issued for Reporting Requirements 80061(A)(f)The items specified in (b)(1)(A) through (H) above shall also be reported to the client's authorized representative, if any;due to this deficiency being addressed and corrected. Refer to LIC809 dated 08/11/2025. An exit interview was conducted, appeal rights discussed, and a copy of this report was left with Director, Mar Smith. Whose signature on this form confirms receipt.

Investigation Findings:
SubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion: 0

Allegations:
- SubstantiatedEstimated Days of Completion:
- Estimated Days of Completion:
- Estimated Days of Completion: 0

complaint_status: SUBSTANTIATED


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) Christopher Rollins conducted an unannounced case management tele inspection with Fred Finch Youth Center and spoke with Mar Smith Senior Director (SD). The purpose of inspection was to follow up on an incident report that was reported to the licensing agency in the form of an Law Enforcement Incident Report (LIC LE) dated 03/23/21. Incident report stated a client was in a restraint hold for 25 minutes. The report identified a 14 year old client who was in a restraint for 25 minutes because client was a danger to himself and staff. LPA interviewed SD and Administrator about the incident. SD and Administrator both stated that this was a common practice and pattern to de-escalate client. SD e-mail over past incident reports that staff had to restraint client. LPA review incident report and saw a pattern that staff had to de-escalate. LPA ask both Adminstrator and SD if client was hurt in the restraint? SD and Administrator stated that client was not hurt. At this time, further investigation is not needed. Exit interview conducted and a copy of the report was e-mailed to SD for signature.


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) Christopher Rollins conducted an unannounced annual inspection at Fred Finch Youth Center. The facility converted from a Group Home to STRTP (Short Term Therapeutic Program) on October 15, 2018 . During the inspection, LPA met with Mar Smith Senior Director (SD) and Grace Helton Administrator as well as additional facility personnel. The STRTP is licensed to serve 14 clients ages 12-18. The facility consists of 10 bedrooms (6 double occupancy and 4 single occupancy) and 11 bathrooms (10 client and 1 staff). At 12: PM, LPA Rollins toured the facility with SD and Administrator inside and out. LPA observed the kitchen is clean. Water measured 113.4 degrees F. The facility has plenty of non perishable and perishable food supply. Medication and knives are locked away. There are enough folks, spoons, plates and cups. All passageways are unobstructed. All smoke detectors are up to date and working. The facility is clean, safe and sanitary. There are no firearms on the property. There are no bodies of water on the property. The facility is maintained at a comfortable temperature. Personal rights, floor plan, food menu and Emergency disaster forms were posted in clear view. Fire Extinguisher was up to date and carbon monoxide was in good working shape. There were no Title 22 violations regarding physical plant observed at this time. Ten client files were reviewed. LPA observed all ten client files and found no deficiencies. Needs and services plan are updated. The documentation is in the clients files are complete. LPA observed medication logs to be updated and current. Facility already received their mental health approval as of August 2, 2019. LPA observed five staff files and found no deficiencies. Staff have completed there 40 hours annual training. All staff documentation is current. LPA discussed with Senior Director and Administrator overview of required Core Services and Supports and based upon inspection of facility records. Licensee appears to be meeting requirements. Per Title Regulations, no deficiencies were cited during the inspection. Exit interview was conducted and a copy of the report was left at the facility.

met_with: Mar Smith Senior Director and Grace Helton Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Christopher Rollins conducted an annual inspection at Fred Finch Youth Center. LPA met with Mar Smith Senior Director (SD) and Grace Helton Administrator as well as additional facility personnel. The STRTP is licensed to serve 14 clients ages 12-18. The facility consists of 10 bedrooms (6 double occupancy and 4 single occupancy) and 11 bathrooms (10 client and 1 staff). At 01: PM, LPA Rollins toured the facility with SD and Administrator inside and out. LPA observed the kitchen is clean. LPA measured hot water in the bathroom, kitchen sink and shower at 113.4 degrees F. The facility has plenty of non perishable and perishable food supply. Medication and knives are locked away. There are enough folks, spoons, plates and cups. All passageways are unobstructed. All smoke detectors are up to date and working. The facility is clean, safe and sanitary. There are no firearms on the property. There are no bodies of water on the property. The facility is maintained at a comfortable temperature. Personal rights, floor plan, food menu and Emergency disaster forms were posted in clear view. Fire Extinguisher was up to date and carbon monoxide was in good working shape. At 2: PM, LPA reviewed seven client files with SD and Administrator. LPA observed all seven client files to be complete and found no deficiencies. LPA observed all documentation to be up to date. LPA observed medication logs to be updated and current. At 2: PM, LPA observed 5 staff files with SD and Administrator. LPA observed staff files to be complete and documentation was update. LPA found no deficiencies. LPA observed all facility staff have completed there 40 hours annual training. LPA observed all training to be up to date and all certificates to be complete. At 3: PM, LPA conducted staff and client interviews. During inspection, LPA receive an updated copy of the LIC Personnel Report to maintain their file current. A review of Licensing Information System on October 11, 2021 indicates that all facility staff associated to the facility had DOJ, FBI and child abuse index check clearances. Per Title Regulations, no deficiencies were cited during the inspection. Exit interview was conducted and a copy of the report was left at the facility.

met_with: Mar Smith-Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 10-6-23 10:10AM, Licensing Program Analysts George Karkazis conducted an unannounced Annual/Random inspection at listed facility. LPA met with Mar Smith,Senior Director and toured the facility inside and out. Safety precautions were taken including screening call and mask wearing. The Short Term Therapeutic Program is licensed to serve 14 clients. Present during the inspection were 2 staff and 2 clients. Staff and clients interacted peacefully. At 11:26AM LPA Karkazis reviewed client and staff files. All staff and client files reviewed were complete and in good order. At 10:30AM, LPA Karkazis toured the facility. LPA Karkazis observed 10 bedrooms and 10 bathrooms. LPA observed facility license, personal rights, facility sketch, meal menu, and other forms posted on the walls throughout the facility. LPA Karkazis tested the water temperature and found it to be 118 degrees which is in range. The thermostat read 70 degrees which is within range. Sharps were locked and chemicals were safely stored. There were two days of perishable foods and seven days non-perishable foods present. The medication was also stored and locked in the nursing office in a locked safe. The facility is in good repair and clean. LPA Karkazis interviewed 2 staff and 2 clients. At 11:15AM LPA Karkazis toured the backyard. There were no open bodies of water. The backyard was in good repair and clean. At this time there were no deficiencies. An exit interview was conducted, appeal rights discussed and a copy of this report was given to Mar Smith, Senior Director.


summary: Facility Evaluation

raw_content:
Narrative:
On 4/16/2024 at 10:45am, Licensing Program Analyst (LPA) Selena Hood and LPA Brenda Rodriguez conducted an unannounced visit to the licensed facility. The purpose of this visit was to conduct the SB Psychotropic Medications Inspection. LPAs met with Carlton White, Medical Coordinator. The facility currently had a census of ten clients, two of the clients in care met SB484 inspection criteria. LPAs reviewed the client files and medication records for two clients in care. Based on record review, LPAs observed that both of the client's Treatment Plans (Needs and Services Plans) were missing signature from the client and their authorized representatives. LPAs delivered a Technical Violation for Interim Licensing Standards 87068.2(g). At 12:05pm, LPAs observed Carlton White, Medical Coordinator, conduct a pill count of the psychotropic medications. LPAs did not observe deficiencies with the pill counts. LPAs met with Grace Helton, Administrator, and received five staff files. LPAs reviewed five staff files. LPAs found no deficiencies. LPAs conducted four confidential interviews. LPAs conducted a walk through of the facility. LPAs observed that the medications were kept in a locked cabinet inside of a locked room. This inspection is not yet finished, LPAs will attempt to interview one more youth that was not present at the facility. LPAs conducted an exit interview with Grace Helton, Administrator and Carlton White, Medical Coordinator at 1:50pm. Administrator's signature confirms the receipt of this document.

met_with: Carlton White