raw_content:
Investigation Findings:
13On October 22, 2024 at 10:43 am, Licensing Program Analyst (LPA) Christine Wilson made an unannounced inspection to the above listed facility for the purpose of concluding the investigation on the above allegation: (1) Staff engaged in physical altercations with minors in care, The investigation included confidential interviews with, including but not limited to,clients, facility staff members and administrative staff, as well as client probation officer and records review. Staff (S1) engaged in physical and verbal aggression against clients, that resulted in a violation of personal rights. Based on information from record review and confidential interviews, the preponderance of the evidence standard has been met. The Department has determined substantiated finding for a violation of personal rights; thus, posing an immediate health, safety and personal rights risk of harm to children placed in care. The facility is issued a citation [See page LIC9099-D for cited deficiencies]. Report continues on LIC9099A. SubstantiatedEstimated 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION WOODLAND HILLS S.Ro, Ventura Blvd., STE. WOODLAND HILLS, CA This is an official report of an unannounced visit/investigation of a complaint received in our office on 08/19/2024 and conducted by Evaluator Christine Wilson COMPLAINT CONTROL NUMBER: 31-CR- FACILITY NAME:OLIVE CREST-HOPE REFUGEFACILITY NUMBER: ADMINISTRATOR:DAVID HARPERFACILITY TYPE: ADDRESS: REFUGIO ROADTELEPHONE: (805) 243- CITY:GOLETASTATE: CAZIP CODE: CAPACITY:16CENSUS: 6DATE: 10/22/ UNANNOUNCEDTIME BEGAN: 10: AM MET WITH:Facility AdministratorTIME COMPLETED:11: AM 9Staff do not ensure facility is kept free of pests INVESTIGATION FINDINGS: On October 22, 2024 at 10:43 am, Licensing Program Analyst (LPA) Christine Wilson made an unannounced inspection to the above listed facility for the purpose of concluding the investigation on the above allegation: (2) Staff do not ensure facility is kept free of pests The investigation included confidential interviews with, including but not limited to, facility staff members, and administrative staff, as well as review of pest service records for the facility. Based on the confidential interviews with all relevant persons, conducted during the investigation process, record review, and statements obtained, LPA Wilson concluded the allegation is unsubstantiated. Although the clients may have seen pests on the property, the licensee receives monthly pest control services for both indoor and outdoor pest control. Although the allegations may have happened, there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the finding is unsubstantiated. There are no deficiencies to be cited, at this time, regarding the above allegation. 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: 2 of Control Number 31-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: OLIVE CREST-HOPE REFUGEFACILITY NUMBER: 425802141

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


state: CA

facility_name: OLIVE CREST-HOPE REFUGE

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Investigation Findings:
13On 12/02/24, at 10:46am, 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 met with with Facility Administrator and together, discussed the investigative findings. During the investigative process by LPA Wilson, relevant parties have been accounted for. Supporting evidence includes: interviews with house residents reporting conflicting information related to allegatiosn. Further, key witnesses that could determine the validity of the allegations were either not available or declined to be interviewed. The above allegations are unsubstantiated meaning, although the allegations may have happened or is valid, there is not a preponderance of evidence to prove th ealleged violations did or did not occur. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION WOODLAND HILLS S.Ro, Ventura Blvd., STE. WOODLAND HILLS, CA This is an official report of an unannounced visit/investigation of a complaint received in our office on 08/16/2024 and conducted by Evaluator Christine Wilson COMPLAINT CONTROL NUMBER: 31-CR- FACILITY NAME:OLIVE CREST-HOPE REFUGEFACILITY NUMBER: ADMINISTRATOR:DAVID HARPERFACILITY TYPE: ADDRESS: REFUGIO ROADTELEPHONE: (805) 243- CITY:GOLETASTATE: CAZIP CODE: CAPACITY:16CENSUS: 6DATE: 12/02/ UNANNOUNCEDTIME BEGAN: 10: AM MET WITH:Program AdninistratorTIME COMPLETED:12: PM 9Staff served expired food to minors in care. INVESTIGATION FINDINGS: 13On 12/02/24, at 10:46am, 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 thefindings. LPA met with with Facility Administrator and together, discussed the investigative findings. During the investigative process by LPA Wilson, relevant parties have been accounted for. Supporting evidence includes: interviews with house residents and parole officers reporting corroborating information related to the allegation. During the course of the investigation it was discovered by LPA Wilson that expired food was made avaiable and being served to clients. Further, key witnesses that could determine the validity of the allegation were interviewed and provided supporting information. The above allegation is substantiated meaning,there is a preponderance of evidence to prove the alleged violation did occur, posing an immediate health, safety and personal rights risk of harm to children placed in care. A (1) Type A deficiency is being cited at this time (See LIC9099D). Exit Interview conducted, appeal rights and Plan of Correction were discussed and a copy of this report was left at the facility. SubstantiatedEstimated 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: 2 of Control Number 31-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: OLIVE CREST-HOPE REFUGEFACILITY NUMBER: 425802141

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

report_type: Complaint Investigation

met_with: Program Adninistrator

complaint_status: unsubstantiated


raw_content:
Narrative:
Page Further, key witnesses that could determine the validity of the allegation (1) were either not available or declined to be interviewed. The above allegations are unsubstantiated meaning, although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Although the allegations may have happened, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the finding is unsubstantiated. There are no deficiencies to be cited, at this time. Exit Interview conducted, and a copy of this report was left at the facility.

Investigation Findings:
13On December 10, 2024 at 10:50am, Licensing Program Analyst (LPA) Christine Wilson made an unannounced inspection to the above listed facility for the purpose of concluding the investigation on the above allegation. Based on the confidential interviews with all relevant persons, conducted during the investigation process, record review, and statements obtained, LPA Wilson concluded the allegations are unsubstantiated. During the investigative process by LPA Wilson, relevant parties have been accounted for. Supporting evidence includes: interviews with house residents reporting conflicting information related to allegations(2-8). Continued on LIC812C page 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 31-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: OLIVE CREST-HOPE REFUGEFACILITY NUMBER: VISIT DATE: 12/10/2024

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

met_with: Facility Administrator


raw_content:
Narrative:
Statements obtained did not uncover or sufficiently support the allegations, therefore, the allegation that Facility staff provided drugs, alcohol, monetary assistance, and a place to stay while facility clients ran away from the facility is unsubstantiated. The allegations may have happened or may be valid, however, 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 or Interim Licensing Standards (ILS) concerning the above allegations, at this time. A copy of this report, and LIC811 was discussed and left with Program Manager.

Investigation Findings:
13On 2/28/2025 at 2: PM, Licensing Program Analyst (LPA) Regina Martin made an subsequent complaint inspection at OLIVE CREST-HOPE REFUGE for the purpose of delivering findings on the above allegations. On July 29, 2024, Community Care Licensing Division (CCLD), received a complaint alleging conduct inimical by an unidentified staff member towards youth residents. It was reported that the staff member assisted youth making their unauthorized departure from the facility. It was further alleged that the staff member took the youth to the staff's home where they all reportedly smoked marijuana and drank alcohol together. The allegation was referred to CCLD Investigations Branch and investigated by Investigator, Douglas Real. On August 1, 2024, LPA Regina Martin met with Facility Administrator to inform and initiate the investigation and obtain facility records. The investigation further included confidential interviews with two former residents, their assigned Probation Officers, staff (S1), and review of facility file history. Information obtained revealed denial of said allegations and or revealed a lack of corroborating proof to substantiate the alleged. (Continued on pg LIC9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Regina Martin 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 31-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: OLIVE CREST-HOPE REFUGEFACILITY NUMBER: VISIT DATE: 02/28/2025

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

met_with: Dominique Harrison, Program Manager


raw_content:
Investigation Findings:
13On 6/13/25, at 10:55 am, Licensing Program Analyst (LPA) Nestor Gomez and LPA Wendy Moodie-Naranjomade an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation and deliver the findings. LPA spoke with Facility Administrator (FA), David Harper and together, discussed the investigative findings. During the investigative process by Licensing program Analyst (LPA), Nestor Gomez, all relevant parties have been accounted for. During the confidential interviews, the validity of the allegations could not be determined. The parties interviewed either confirmed or denied the allegations. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) 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 emailed to FA. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nestor Gomez 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: Facility Administrator - David Harper


raw_content:
Investigation Findings:
13On June 18, 2025 at 9:17 am, Kenrick Ellis, Licensing Program Analyst (LPA), conducted an unannounced visit to Olive Crest-Hope Refuge for the purpose of concluding a complaint investigation of the above allegation. LPA met with David Harper, Administrator and discussed the complaint allegations. A health and safety assessment was conducted. During the investigation LPA conducted two client interviews and five staff interviews. During the investigation LPA also reviewed Personnel Report (LIC500), client roster, and incident reports. The interviews did not produce evidence to support the allegation. During the investigation there were no statements or evidence that indicated staff allowed minors in care to engage in inappropriate interactions. Statements indicated that staff conducted room checks every 15 minutes. Statements indicated that staff were briefed by S1 and S4 about inappropriate relationship between clients in care. Statements indicated that staff met with clients to discuss facility policies regarding relationships and inappropriate interactions. There are no deficiencies cited at this time. An exit interview was conducted, and a copy of this report was emailed to David Harper UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Kenrick Ellis 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: David Harper, Administor


raw_content:
Narrative:
The investigation, including confidential interviews with six youth, six staff members, Administrator, assigned Case Social Worker, assigned Probation Officer, review of Santa Barbara County Sheriffs Incident Report dated 6/2/2025, facility records, and review of facility file history, revealed a lack of corroborating evidence to prove inimical conduct of S1 showing inappropriate pictures, inappropriately exposing themselves to Y1, or that S1 engaged in illegal substances with Y1. Based on confidential statements and documentary evidence, the allegations are determined unsubstantiated. An unsubstantiated finding means that the allegations may have happened or may be valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. A copy of this report, and Confidential Names form LIC811 were provided to facility Administrator. Confidential interviews with youth, staff, and other related parties, as well as documentary evidence verified statements that S1 allowed the clients to use S1's personal nicotine vape pen. Based on the information gathered, the allegation claiming that Staff allowed youth to use their vape is substantiated. The facility is cited for violation of Health and Safety Code Section 1596.885(c): Staff (S1) allowed youth to use their vape while in care which poses potential health, safety and personal rights risk to youth in care. See page LIC9099-D for cited deficiency. Exit interview completed. A copy of this report, LIC811, and appeal rights were discussed and provided to the Administrator.

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

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

met_with: David Harper, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On January 27, 2022, at 8:30am Licensing Program Analyst (LPA) Enrique Hernandez conducted an announced pre-licensing inspection for Olive Crest/Hope Refuge Short Term Residential Therapeutic Program (STRTP) located at the above address, LPA met with the David Harper Facility Administrator (FA) and Tina Chang Program Director (PD) and together conducted a tour of the entire facility. Olive Crest/Hope Refuges is located in the Los Padres National Forest. The site was a previous recreational campground and currently Hope Refuge STRTP still open. There are three residential cottage, main house, dining hall, therapy building, Administration/Music building, school, bathrooms, central kitchen/staff lodging, laundry room, activity space. Currently Hope refuge Unit 1 (Olive cottage): It has four (4) bedrooms with a capacity for eight (8) clients with a sink in each bedroom. Two twin beds in each room, dresser, and adequate lighting and closet space. Four (4) bath units with a sink, shower and toilet all operable at time of inspection. There is a living room with a couch and chairs. LPA observed a fire extinguisher in the unit. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that must remain locked at all times and cannot be used as a pass through. There is an exit door to outside in both bedrooms with an alarm to alert staff if the door is opened. The alarms are audible and tested at time of inspection. The alarms must be activated at all times. Children's Personal Rights need to be posted. Due to the layout of the facility grounds, a small refrigerator, microwave and non-perishable food supplies must be available in each cottage. Continue on LIC809-C Unit 2 (Pine Cottage): It has four (4) bedrooms with a capacity for eight (8) clients with a sink on it. Two twin beds in each room, dresser, and adequate lighting and closet space. Four (4) bath units with a sink, shower and toilet all operable at time of inspection. There is a living room with a couch and chairs. LPA observed a fire extinguisher in the unit. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that must remain locked at all times and cannot be used as a pass through. There is an exit door to outside in both bedrooms with an alarm to alert staff if the door is opened. The alarms are audible and tested at time of inspection. The alarms must be activated at all times. Children's Personal Rights posted. Due to the layout of the facility grounds, a small refrigerator, microwave and non-perishable food supplies must be available in each cottage. Unit 3 (Oak Cottage): It has four (4) bedroom with a capacity for eight (8) clients with a sink on it. Two twin beds in each room, dresser, and adequate lighting and closet space. Four (4) bath units with a sink, shower and toilet all operable at time of inspection. There is a living room with a couch and chairs. LPA observed a fire extinguisher in the unit. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that must remain locked at all times and cannot be used as a pass through. There is an exit door to outside in both bedrooms with an alarm to alert staff if the door is opened. The alarms are audible and tested at time of inspection. The alarms must be activated at all times. Children's Personal Rights are posted. Ensure glass windows on exit doors are covered. Due to the layout of the facility grounds, a small refrigerator, microwave and non-perishable food supplies must be available in each cottage. Stone House/Central Kitchen: The Stone House will only be accessible to staff. The house will be off limits to the youth. This is a three (3) bedroom Two and a half (2 1/2) bathroom homes with a living room, dining area and kitchen. There is a Kitchen located adjacent to the dining room, equipped with one (1) refrigerator in the kitchen and one (1) commercial size walk-in refrigerator and freezer located outside the house. The refrigerator/freezer will need to be made inaccessible to the youth, one (1) toaster ovens, one (1) range, two (2) ovens, one (1) microwaves, trash can with lid, and fire extinguisher. LPA observed 1 fire extinguishers in the unit. The bedrooms are currently empty. Once the STRTP is licensed the bedrooms can be used by Direct Care Staff if they want to stay the night at the facility instead of driving back home. Continue on LIC809-C Dining Hall: The front of the hall is equipped with three (3) couches, and dining tables LPA observed a fire extinguisher in the unit. The Dining hall has two back rooms that are intended to be a nurse station and medication room. Applicant will need to provide a locked storage area for medications and a lock cabinet for youth and staff files. All fireplaces throughout campus need to have secured heat resist covers. Therapy Building: The unit has a group therapy area with four (4) chairs, couch, TV stand and bookshelf. The cottage also has two smaller therapy rooms with two (2) couches and a coffee table. No smoke detectors or carbon monoxide detectors available. Administration Building/Music Room: The front of the cottage is for administrator staff used only with six (6) cubicles and office materials. The back of the cottage they have a music room equipped with a piano, guitar and music stand reader. No smoke detectors or carbon monoxide detectors available. Outdoor Space: There is a gated pool on the premises with two outside accessible bathrooms, storage area and a locked room where pool pump is located. The pool is about 9 feet high with a self-closing key lock mechanism located halfway down from top of gate. School Building: Is to be used as on-site school and academic space. The front half consist of 6 desks with 5 chairs at each desk. The back half consist of 12 computer desks and chairs. No smoke detectors or carbon monoxide detectors available. Bath House: Equipped with three (3) toilets three (3) showers and two (2) sinks all operable at time of inspection. Applicant will ensure all doors are installed on bathroom stalls. Laundry Rooms: The laundry room is located in the screen room with one exterior entrance. There are three (3) washers and three (3) (dryers) sink and fire extinguisher. Additional laundry room located outside of the Stone House will not be used by the youth. Continue On LIC809-C LPA Hernandez went over the Component III agenda and discussed the forms required to be maintained at the Facility and available for inspections. LPA also went over the documents that should be available and posted in the Client's residences. LPA Hernandez went over the Child's Records documents that are required to be documented, retained and available for inspection. LPA Hernandez went over the forms: Preplacement appraisal information LIC603,Appraisal/Needs and Service Plan LIC625, Physician Report For Community Care Facilities LIC602, Identification and Emergency Information LIC601, Admission Agreement Guide for Residential Facilities LIC604, Personal Rights Children's Have the Rights LIC613B, Record Of Client's/Resident's Safeguarded Cash Resources LIC405, Client/ Residential Personal Property and Valuables LIC621, Consent For Emergency Medical Treatment Children's Residential Facilities LIC627B, Unusual Incident Report LIC624, Centrally Stored Medication and Destruction Record LIC LPA Hernandez discussed the Personnel records that are required to be documented, retained and available for inspection. LPA Hernandez went over the forms: Health Screening Report-Facility Personnel LIC503, Personnel Record LIC501, Criminal Record Statement LIC508, NOTICE Employee Rights LIC 9052, Statement Acknowledging Requirement To Report Child Abuse LIC9108, Child Abuse Central Index Check For State Licensed Facilities LIC198A, Designation Of Facility Responsibility LIC308, Personnel Report LIC500, Criminal Record Exemption Transfer Request LIC9188, Criminal Background Clearance Transfer Request LIC9182, Applicant/Licensee Rights LIC9058, Appeal Procedures For Applicants/Licensee LIC LPA Hernandez discussed the specific problems and issues of operating a STRTP. LPA Hernandez discussed sections A though N of the component III agenda including: Reporting Requirements, Personnel Requirements, Supervision, Intake Issues, Compatibility, Removal/Discharge, Complaint Procedures, Transportation, Health Services, Food and Hygiene, Visitation, Personal Property, Searches and Community Sensitivity. Licensure is pending final approval of Application, Plan of Operation and Program Statement. A copy of this report will be emailed to the facility administrator, due to technical difficulties with the LPA's printer

report_type: Facility Evaluation

visit_type: Prelicensing


summary: Facility Evaluation

raw_content:
Narrative:
On June 20, 2022, at 1:45 pm Licensing Program Analyst (LPAs) Nancy O'Connell and Enrique Hernandez conducted an announced pre-licensing inspection for Olive Crest/Hope Refuge Short Term Residential Therapeutic Program (STRTP) located at the above address, LPAs met with the David Harper Facility Administrator (FA) and together conducted a tour of the entire facility. Olive Crest/Hope Refuges is located in the Los Padres National Forest. The site was a previous recreational campground. There are three residential cottage, main house, dining hall, therapy building, Administration/Music building, school, bathrooms, central kitchen/staff lodging, laundry room, activity space. Currently Hope refuge Unit 1 (Olive cottage): At the time of inspection, there were 4 clients in care. The cottage has four (4) bedrooms, one bedroom has been converted into a office. Each bedroom has a sink in each bedroom. Two twin beds in each room, dresser, and adequate lighting and closet space. Four (4) bath units with a sink, shower and toilet all operable at time of inspection. There is a living room with a couch and chairs. LPAs observed a fire extinguisher in the unit. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that must remain locked at all times and cannot be used as a pass through. There is an exit door to outside in both bedrooms with an alarm to alert staff if the door is opened. The alarms are audible and tested at time of inspection. The alarms must be activated at all times. Children's Personal Rights were posted. Due to the layout of the facility grounds, a small refrigerator, microwave and non-perishable food supplies are available in each cottage. Continue on LIC809-C Unit 2 (Pine Cottage): It has four (4) bedrooms with a sink installed in each bedroom. Two twin beds in each room, dresser, and adequate lighting and closet space. Four (4) bath units with a sink, shower and toilet all operable at time of inspection. There is a living room with a couch and chairs. LPA observed a fire extinguisher in the unit. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that must remain locked at all times and cannot be used as a pass through. There is an exit door to outside in both bedrooms with an alarm to alert staff if the door is opened. The alarms are audible and tested at time of inspection. The alarms must be activated at all times. Children's Personal Rights posted. Due to the layout of the facility grounds, a small refrigerator, microwave and non-perishable food supplies are available in each cottage. Unit 3 (Oak Cottage): It has four (4) bedroom with a sink on it. Two twin beds in each room, dresser, and adequate lighting and closet space. One bedroom has been converted into an office for staff. Four (4) bath units with a sink, shower and toilet all operable at time of inspection. There is a living room with a couch and chairs. LPA observed a fire extinguisher in the unit. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that must remain locked at all times and cannot be used as a pass through. There is an exit door to outside in both bedrooms with an alarm to alert staff if the door is opened. The alarms are audible and tested at time of inspection. The alarms must be activated at all times. Children's Personal Rights are posted. Ensure glass windows on exit doors are covered. Due to the layout of the facility grounds, a small refrigerator, microwave and non-perishable food supplies must be available in each cottage. Stone House/Central Kitchen: The Stone House will only be accessible to staff. The house will be off limits to the youth. This is a three (3) bedroom Two and a half (2 1/2) bathroom homes with a living room, dining area and kitchen. There is a Kitchen located adjacent to the Continue on LIC809-C dining room, equipped with one (1) refrigerator in the kitchen and one (1) commercial size walk-in refrigerator and freezer located outside the house. The refrigerator/freezer will need to be made inaccessible to the youth, one (1) toaster ovens, one (1) range, two (2) ovens, one (1) microwaves, trash can with lid, and fire extinguisher. LPA observed 1 fire extinguishers in the unit. The bedrooms are currently empty. Once the STRTP is licensed the bedrooms can be used by Direct Care Staff if they want to stay the night at the facility instead of driving back home. Dining Hall: The front of the hall is equipped with chairs, dining tables and solar panels. LPA observed a fire extinguisher in the unit. The Dining hall has two back rooms that are intended to be a nurse station and medication room but are no longer in use and are currently utilizing rooms as storage. Therapy Building: The unit has a group therapy area with couches, chairs, TV stand and bookshelf. The cottage also has a smaller therapy room with couches and a coffee table. No smoke detectors or carbon monoxide detectors available. Administration Building/Music Room: The front of the cottage is for administrator staff use only with six (6) cubicles, a conference table and office materials. The back of the cottage has a music room equipped with a piano, guitar and music stand reader. No smoke detectors or carbon monoxide detectors available. Outdoor Space: There is a gated pool on the premises with two outside accessible bathrooms, storage area and a locked room where pool pump is located. The pool is approximately 9 feet deep with a self-closing key lock mechanism located halfway down from top of gate. The pool area has two bathrooms, with one that is not in use and has a sign posted to indicate. The pool in inaccessible to clients without supervision. School Building: Is to be used as on-site school and academic space. The front half consist of 9 desks with 9 chairs at each desk. There is an adjacent classroom that is not in use and being used for storage. No smoke detectors or carbon monoxide detectors available. Continued on Lic 809c Bath House: Equipped with three (3) toilets three (3) showers and two (2) sinks all operable at time of inspection. Applicant will ensure all doors are installed on bathroom stalls. Laundry Rooms: The laundry room is located in the screen room with one exterior entrance. There are three (3) washers and three (3) (dryers) sink and fire extinguisher. Additional laundry room located outside of the Stone House will not be used by the youth. Per Title 22, there are no deficiencies to be cited at this time. Exit interview conducted and a copy of this this report was provided to the FA.

met_with: David Harper, Facility Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On January 13, 2023, at 10:30am, Licensing Program Analyst (LPA) Nancy O'Connell and Licensing Program Manager (LPM) Kevin Sauk, made an unannounced inspection to the above facility for the purpose of following up on two Case Management-Incident inspections. On 12/17/23, the Department received a Serious Incident Report (SIR) communicating that a resident, C6, was hospitalized after a period of demonstrated aggression toward self and others. The SIR reports that efforts were made to de-escalate C6 over a period of several hours before the resident was transported to the emergency room for evaluation. On 11/7/22, the Department received a Serious Incident Report (SIR) communicating that resident C5 engaged in aggressive behavior, resulting in her assaulting a resident, staff, and AWOLing from the facility. During the time of inspection, LPA and LPM interviewed three staff and 1 resident at the facility in order to gather additional details related to the incident. LPA interviewed FA, FM, and HOS and C3. [See Confidential Names form (LIC811), dated 01/19/23, for names]. More information is needed to conclude the investigations related to the above incidents. There are no deficiencies to be cited at this time. An exit interview was conducted and due to technical difficulties with the LPA's printer, a copy of this report was emailed to the facility administrator

visit_type: Case Management

met_with: David Harper, Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On March 7, 2023, at 11:50am Licensing Program Analyst (LPA) Nancy O'Connell conducted an unannounced annual inspection for Olive Crest/Hope Refuge Short Term Residential Therapeutic Program (STRTP) located at the above address, LPA met with the David Harper Facility Administrator (FA) and Roberta Strangfeld, Head of Service (HOS) and together conducted a tour of the entire facility. During the time of inspection, LPA O'Connell conducted an inspection of the following areas: Unit 1 (Olive cottage): The cottage has four (3) bedrooms, one bedroom has been converted into a office. Each bedroom has a sink in each bedroom. Two twin beds in each room, dresser, and adequate lighting and closet space. Four (4) bath units with a sink, shower and toilet all operable at time of inspection. There is a living room with a couch and chairs. LPAs observed a fire extinguisher in the unit. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that must remain locked at all times and cannot be used as a pass through. There is an exit door to outside in both bedrooms with an alarm to alert staff if the door is opened. The alarms are audible and tested at time of inspection. The alarms must be activated at all times. Children's Personal Rights were posted. Due to the layout of the facility grounds, a small refrigerator, microwave and non-perishable food supplies are available in each cottage. Continue on LIC809-C Unit 2 (Pine Cottage): It has four (3) bedrooms with a sink installed in each bedroom along with one bedroom converted into a staff office. This unit if intended to be utilized as a privilege room and will allow a resident to have their own bedroom. At time time, this cottage is not in use. LPA observed a fire extinguisher in the unit. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that was locked at all times and is not used as a pass through. There is an exit door to outside in both bedrooms with an alarm to alert staff if the door is opened. The alarms are audible and functional. Unit 3 (Oak Cottage): It has four (3) bedrooms with one bedroom converted into a staff office. Each bedroom has a sink and provides enough room for two residents to live in each. At time time, this cottage is not in use. LPA observed a fire extinguisher in the unit. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that was locked and is not used as a pass through. There is an exit door to the outside in both bedrooms with an alarm to alert staff if the door is opened. The alarms are audible and functional. Stone House/Central Kitchen: The Stone House is only be accessible to staff. The house is off limits to the youth. This is a three (3) bedroom Two and a half (2 1/2) bathroom homes with a living room, dining area and kitchen. There is a Kitchen located adjacent to the dining room, equipped with one (1) refrigerator in the kitchen and one (1) commercial size walk-in refrigerator and freezer located outside the house. LPA observed 1 fire extinguisher in the unit. The bedrooms are currently empty but may be used by staff as needed to stay the night at the facility instead of driving back home. Dining Hall: The front of the hall is equipped with chairs, dining tables and solar panels. LPA observed a fire extinguisher in the unit. The Dining hall has two back rooms that are used as a locked storage room for cleaning supplies. During the time of inspection, LPA and HOS inspected the small kitchen connect to the dining room and upon inspection of refrigerators, LPA found multiple items that were without dates, not packages in containers, and reflecting mold. LPA inquired about reason for items not being dates, stored properly or discarded due to mold, and HOS communicated that the staff cook is responsible for ensuring proper food storage. LPA retained pictures for records. Therapy Building: The unit has a group therapy area with couches, chairs, TV stand and bookshelf. The cottage also has a smaller therapy room with couches and a coffee table. Therapy is provided individually to clients and family sessions are conducted via telehealth. Continued on Lic 809c Outdoor Space: There is a gated pool on the premises with two outside accessible bathrooms, storage area and a locked room where pool pump is located. The pool is approximately 9 feet deep with a self-closing key lock mechanism located halfway down from top of gate. The pool area has two bathrooms, with one that is not in use and has a sign posted to indicate. The pool in inaccessible to clients without supervision. Due to the weather, the pool is not in use at this time. School Building: there is a classroom space available for residents to engage in curricular activities. However, it was reported that due to connectivity issues, residents have been completing school work within their cottages. Per Title 22, there is one deficiency to be cited at this time. Exit interview conducted and a copy of this this report will be emailed to the RPD.

visit_type: Annual

met_with: Roberta Stangfield (HOS) and David Harper (RPD)


summary: Facility Evaluation

raw_content:
Narrative:
On March 8, 2023, at 9:20am Licensing Program Analyst (LPA) Nancy O'Connell conducted a unannounced annual- continuation inspection for Olive Crest/Hope Refuge Short Term Residential Therapeutic Program (STRTP) located at the above address. LPA met with the David Harper Facility Administrator (RPD), who provided access to facility records for review. LPA completed the file reviews for four staff (S1, S2, S3, and S4) and three client files (C1, C2, and C3) [See confidential names (LIC811) dated 3/8/23, for names]. LPA also conducted three staff interviews with S2, S6, and S7, and 2 client interviews with with C2 and C3. LPA inspected three facility vehicles (two in use and one not in use). LPA observed that vehicle #2 did not have a valid registration and when LPA inquired with the RPD, it was communicated that the documentation is still in process and unavailable at this time.RPD confirmed that the vehicle has been in use for the last six weeks and use to facility business and transportation of residents. During the time of inspection, LPA completed the following inspection tool sections: Emergency Intervention Plan, Core Therapeutic Services, Disaster Preparedness, Operational Requirements, and continuation of Physical Plant. 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 is one deficiency to be cited today. See 809D for details. Exit Interview was conducted and a copy of this report was sent to the the RPD..

met_with: David Harper, Residential Program Director (RPD)


summary: Facility Evaluation

raw_content:
Narrative:
On 3/20/23, at 11:00am, Licensing Program Analyst (LPA) Nancy O'Connell and Licensing Program Manager (LPM) Kevin Sauk met with David Harper, Residential Program Director (RPD) for a teleconference office meeting. The purpose of this meeting was to discuss matters related to provision of services. During the meeting, LPM Sauk reviewed previously submitted Serious Incident Reports (SIRs), dated 12/2/22, 12/9/22, and 12/31/22. All incidents relate to missed medication and/or incorrect administration of medication. LPM Sauk clarified each instance for medication error and asked for additional information as to reason(s) for errors. RPD was able to review each incident and provide clarification for medication errors. RPD explained additional policies and efforts taken to ensure accurate medication administration, which includes new policy to only conduct medication exchanges among staff, within secured areas, and ordering a "gun safe" to be placed in the facility vehicles that can serve as a secure location for storing medications when on outings. There are no deficiencies to be cited at this time. A copy of this report was emailed to RPD and a signature is kept on file.


summary: Facility Evaluation

raw_content:
Narrative:
On July 17, 2023 at 10:00am, an Office Meeting was held at the Woodland Hills Regional Office. Present at the meeting were Licensing Program Manager (LPM), Kevin Sauk, Licensing Program Analyst (LPA), Christine Wilson, and the Facility Administrator, David Harper. The Office Meeting was called to discuss that the terms of settlement, involving a one-year probation of staff (S1), along with other terms and conditions of this settlement. S1's certification as an administrator is revoked upon the Department's adoption of the Stipulation as its Order. However, the revocation shall be stayed for a probationary period of one year subject to the following terms and conditions specified below: A. S1 meets all statutory and regulatory requirements related to the position of administrator, including but not limited to, Short-Term Residential Therapeutic Program (STRTP) Interim Licensing Standards, version 4, Section 87064 and 87064.1. B. S1 shall work for one facility currently located at Refugio Road, Goleta, CA 93117. If S1 changes location, he will first obtain approval from the Department and give notice to the CCL Regional Office located at Ventura Blvd, Suite Woodland Hills, CA 91364. C. S1 shall be on premises located in Refugio Road, Goleta, CA 93117 for a minimum of 40 hours per week, to manage and ensure compliance with applicable laws and regulations. In the absence of S1, a Program Supervisor shall receive authorization to take on S1's duties and responsibilities. D. S1 shall complete eight (8) hours of new training in STRTP administrator duties including medication management that was not previously completed and shall provide proof of said additional training to the Department. E. S1 shall obey all federal, state, and local laws; and F. S1 complies with all statutes and regulations related to S1's current employment. David Harper agreed to the above conditions as well as all of which is stated in the Stipulation and Order, which was dated and signed on 06/15/2023. S1's one-year probation shall expire on 06/15/2024. Exit interview completed, and a copy of this report was left with David Harper.


summary: Facility Evaluation

raw_content:
Narrative:
On March 18, 2024, at 9:59am Licensing Program Analyst (LPA) Christine Wilson conducted an unannounced annual inspection for Olive Crest/Hope Refuge Short Term Residential Therapeutic Program (STRTP) located at the above address, LPA met with David Harper Program Director (PD) and together conducted a tour of the entire facility. At 10:27am LPA Wilson conducted the following: LPA Wilson conducted one (1) staff interview with (ES1) and (3) client interviews with (C1, C2 and C4). At 11:16am LPA Wilson inspected the following: During the time of inspection, LPA Wilson conducted an inspection of the following areas: Unit 1 (Olive Cottage): The cottage has three (3) bedrooms, one bedroom has been converted into a office. Each bedroom has a sink in each bedroom. Two twin beds in each room, dressers, and adequate lighting and closet space. Four (4) bath units with a sink, shower and toilet all operable at time of inspection. Water temperature was within range. There is a living room with a couch and chairs for (9) persons. LPA observed a fire extinguisher in the unit with recent inspection. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that must remain locked at all times and cannot be used as a pass through. There is an exit door to outside in both bedrooms with an alarm to alert staff if the door is opened. The alarms must be activated at all times. Children's Personal Rights were posted. Due to the layout of the facility grounds, a small refrigerator, microwave and non-perishable food supplies are available in each cottage for staff use. If medications are to be refrigerated, this can be used for that purpose. School Building: There is a classroom space available for residents to engage in education curricular activities. There are (6) desks and computers. There is a water dispenser and a heating system. Continued on 812C page 2 of At 12:00pm LPA Wilson inspected the following: Vehicles: LPA Wilson inspected (4) four facility vehicles in total 1. Honda CRV with current registration that expires in October 2024. HUB International Insurance 2. Toyota Sequoia (black) with current registration that expires in September 2024. HUB International Insurance. All vehicles are in good condition with no issues. Dining Hall: The front of the hall is equipped with chairs, dining tables and solar panels. LPA observed a fire extinguisher in the unit. The Dining hall has two back rooms that are used as a locked storage room for cleaning supplies. During the time of inspection, LPA and (PD) inspected the small kitchen connect to the dining room and upon inspection of the area for non-perishibles and snacks, LPA Wilson and PD were approached by clients, who complained about the snacks being too little. Clients were seen eating a 2oz applesauce packet. LPA inquired about reason for items Per the PD, snacks are provided to the clients, and staff choose which snacks are provided. Snacks are given to clients twice per day. PD communicated that the Facility Cook (FE) is responsible for ensuring enough snacks are purchased and that her budget has increased. LPA Wilson and (PD) reviewed CCR 80076(A) Food Services to review the regulations, Per (PD) they will meet with (FC) and review the menu and purchases to see if anything should be adjusted. At 1:40pm LPA Wilson conducted the following: Outdoor Space: There is a gated pool on the premises with two outside accessible bathrooms, storage area and a locked room where pool pump is located. The pool is approximately 9 feet deep with a self-closing key lock mechanism located halfway down from top of gate. The pool area has two bathrooms, with one that is not in use and has a sign posted to indicate. It is used for storage. The pool in inaccessible to clients without supervision. Per the (PD)Staff have water safety training each year prior to the pool availability. Due to the weather, the pool is not in use at this time. Vehicles: LPA Wilson inspected (2) additional facility vehicles - 3. Toyota Sequoia (white) with current registration that expires in October 2024. HUB International Insurance. 4. Kawasaki Mule 4x4 with current registration that expires in June 2024. Vehicle is used for on-site transportation only. Vehicles are in good condition with no issues. LPA Wilson will return to complete the inspection at a latter date with (PD) A copy of this report was reviewed and provided to David Harper Program Director (PD).

met_with: Program Director


summary: Facility Evaluation

raw_content:
Narrative:
On March 19, 2024, at 9:35am Licensing Program Analyst (LPA) Christine Wilson conducted an unannounced annual inspection for Olive Crest/Hope Refuge Short Term Residential Therapeutic Program (STRTP) located at the above address, LPA met with the David Harper Program Director and together conducted a tour of the entire facility. At 10:10am, LPA Wilson inspected the following : Therapy Building: The unit has a group therapy area with couches, chairs, TV stand and bookshelf. The cottage also has a smaller therapy room with couches and a coffee table. Therapy is provided individually to clients and family sessions are conducted via telehealth Unit 2 (Pine Cottage): There are no residents in this building. It has four (3) bedrooms with a sink installed in each bedroom along with one bedroom converted into a staff office. This unit if intended to be utilized as a privilege room and will allow a resident to have their own bedroom. At time time, this cottage is not in use. LPA observed a fire extinguisher in the unit. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that was locked at all times and is not used as a pass through. There is an exit door to outside in both bedrooms with an alarm to alert staff if the door is opened. The alarms are audible and functional. Unit 3 (Oak Cottage): There are two (2) residents in this building (C1 and C2) It has four (3) bedrooms with one bedroom converted into a staff office. Each bedroom has a sink and provides enough room for two residents to live in each. At time time, this cottage is not in use. LPA observed a fire extinguisher in the unit. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that was locked and is not used as a pass through. There is a hallway shelf unit with additional, cleaned and new bedding. Continued on 809C page 2 of Page 2 of There is an exit door to the outside in both bedrooms with an alarm to alert staff if the door is opened. Wilson inspected the medication room, medication logs and client's medications with (PD) At 12:11pm, LPA Wilson inspected the following: LPA Wilson conducted Two (2) staff interviews with ( ES2 and RS1 ) LPA Wilson inspected three (3) staff files (PM, HOS, RS1) Job description, drivers license, Physical/TB, Educational records, criminal record clearance, First Aid/CPR, , Pro-Act certification and Administration certification. LPA Wilson inspected the following: Emergency Intervention Plan: Staff received Pro-Act Training in February of Monthly Log for restraints is not available. Per the FM, restraints, if any are logged on a special incident report sent to the regional office. LPA reviewed Law Enforcement procedures utilized during awol, and use of restraints. LPA Wilson was unable to complete the inspection of client files of (C1, C2 and C3) Court records, emergency contact information, signed personal rights, Health.medical information, Educational information, personal property safeguards and allowance log. CFT Meeting Notes and Needs and Service Plans LPA Wilson will return to finish the annual inspection at a letter date. There are no deficiencies to be cited on this day. Exit interview was conducted and due to printer out of service, a copy will be emailed to the Program Director


summary: Facility Evaluation

raw_content:
Narrative:
On March 21, 2024, at 2:05pm Licensing Program Analyst (LPA) Christine Wilson conducted an unannounced annual inspection for Olive Crest/Hope Refuge Short Term Residential Therapeutic Program (STRTP) located at the above address, LPA met with the David Harper Program Director and together conducted a tour of the entire facility. At 2:15pm, LPA Wilson inspected the following: LPA Wilson was able to complete the inspection of client files of (C1, C2 and C3) Court records, emergency contact information, signed personal rights, Health.medical information, Educational information, personal property safeguards and allowance log. CFT Meeting Notes and Needs and Service Plans. Per the Program Director " We have a (1) Ring doorbell camera set-up which allows it to ring to my phone and the facility Manager's phone to see who is on the campus at the yellow house which will have cameras pointing up the driveway" LPA will observe the camera. LPA requested any further installment of cameras to be reported to the Regional Office, which includes; number of cameras, and direction of cameras. There are no deficiencies to be cited on this day. Exit interview was conducted and due to printer out of service, a copy will be emailed to the Program Director


summary: Facility Evaluation

raw_content:
Narrative:
On 12/02/24 at 10:46am, Licensing Program Analyst (LPA) Christine Wilson made an unannounced visit to the above listed facility in order to conduct a Plan of Correction (POC) visit, regarding complaint 31-CR-20240819115025, LPA Wilson met with the facility administrator and together discussed the POC Clearance. Licensee provided proof of two staff meetings addressing the incident and regulation and staff training regarding staff protocol to de-escalate staff/client interactions and conflict resolution. There are no deficiencies to be cited at this time. Plan of Correction Clearance Letter and copy of this report was left with the Facility Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 2/28/2025, at 2: PM, Licensing Program Analyst (LPA) Regina Martin conducted a follow-up Case Management - Incident inspection at OLIVE CREST-HOPE REFUGE. LPA Martin met with Dominique Harrison, Program Manager to deliver investigative findings concerning Incident Report submitted to Community Care Licensing (CCL) on 9/24/2024. The incident reported in part possible neglect/lack of supervision, as a youth in care sustained injuries to the head and elbow areas, resulting from a physical altercation with another youth in care. The incident was referred to CCL Investigations Branch for investigation. CCL Investigator, Douglas Real conducted the investigation including confidential interviews with four youth, two staff members and Facility Administrator. In addition, facility file history, incident reports and related medical reports were reviewed. Confidential interviews and documentary evidence revealed on 9/22/2024, two youth residents engaged in a physical altercation. Facility staff members were present during the altercation and verbally directed the youth to stop. At some point a third youth resident intervened pulling one youth away from the other. The two youth re-engaged with the physical altercation before stopping. Statements revealed complaints of youth having a hurt elbow and headache after falling during the altercation. A review of medical records indicated the youth's x-rays revealed no fractures or broken bones. Statements obtained from involved parties and witnesses, as well as record review, revealed a lack of evidence to prove neglect/lack of supervision resulting in a physical altercation between youth with injuries. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is determined Unsubstantiated. There are no deficiencies cited per California Code of Regulations or Interim Licensing Standards (ILS) at this time. A copy of this report is provided to Program Manager during this visit.


summary: Facility Evaluation

raw_content:
Narrative:
On 03/20/2025, at 11:15 am, Licensing Program Analyst (LPA) Nestor Gomez arrived at the above facility, for the purpose of conducting an Annual Required Inspection on the Olive Crest-Hope Refuge (STRTP) facility. LPA Gomez met with Facility Administrator, David Harper who granted access to the facility. The annual fees are current. During the time of inspection, LPA Nestor conducted an inspection of the following areas:Unit 1 (Olive Cottage): There are currently four (4) residents residing in Olive Cottage. The cottage has three (3) bedrooms, one bedroom has been converted into an office. Each bedroom has a sink in each bedroom. Two twin beds in each room, dressers, and adequate lighting and closet space. Four (4) bath units with a sink, shower and toilet all operable at time of inspection. Water temperature was within range. There is a living room with a couch and chairs for (9) persons. LPA observed a fire extinguisher in the unit with recent inspection on 2/19/2025. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that must remain locked at all times and cannot be used as a pass through. There is an exit door to outside in both bedrooms with an alarm to alert staff if the door is opened. The alarms must be activated at all times. Children's Personal Rights and Emergency Evacuation plan were posted. Due to the layout of the facility grounds, a small refrigerator, microwave and non-perishable food supplies are available in each cottage for staff use. If medications are to be refrigerated, this can be used for that purpose. Medication is located in the restroom of the staff office and is locked. Continue on 809-C (Page 1) Unit 2 (Pine Cottage): There are no residents in this building. It has four (3) bedrooms with a sink installed in each bedroom along with one bedroom converted into a staff office. This unit if intended to be utilized as a privilege room and will allow a resident to have their own bedroom. At time, this cottage is not in use. LPA observed a fire extinguisher in the unit with a date of 2/28/2025. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that was locked at all times and is not used as a pass through. There is an exit door to outside in both bedrooms with an alarm to alert staff if the door is opened. The alarms are audible and functional. Unit 3 (Oak Cottage): There are four (4) residents in this building. It has four (3) bedrooms with one bedroom converted into a staff office. Each bedroom has a sink and provides enough room for two residents to live in each. LPA observed a fire extinguisher in the unit . All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that was locked and is not used as a pass through. There is a hallway shelf unit with additional, cleaned and new bedding. Medication is locked and stored by the staff office. Therapy Building: The unit has a group therapy area with couches, chairs, TV stand and bookshelf. The cottage also has a smaller therapy room with couches and a coffee table. Therapy is provided individually to clients and family sessions are conducted via telehealth. LPA observed a fire extinguisher that was dated for 2/29/2025. Staff Office/Music Room Building: The music room contained several musical instruments, 2 couches, 11 chairs, and a fire extinguisher that was dated for 2/28/2025. Continue on 809-C (Page 2) School House Building: There is a classroom space available for residents to engage in education curricular activities. There are (9) desks and computers. There is a water dispenser and a heating system. Fire extinguisher was observed and dated for 2/28/2025. Personal rights were posted within the classroom. Dining Hall: The front of the hall is equipped with chairs, dining tables and solar panels. LPA observed a fire extinguisher in the unit that was dated for 2/28/2025. The Dining hall has two back rooms that are used as a locked storage room for cleaning supplies. During the time of inspection, LPA and (PD) inspected the small kitchen connect to the dining room. The kitchen area, nurse office, infirmary located on the other side of the building is not in use. Pool House/Outdoor Space: There is a gated pool on the premises with two outside accessible bathrooms, storage area and a locked room where pool pump is located. The pool is approximately 9 feet deep with a self-closing key lock mechanism located halfway down from top of gate. The pool area has two bathrooms, with one that is not in use and has a sign posted to indicate. It is used for storage. The pool in inaccessible to clients without supervision. Per the (FA) Staff have water safety training each year at the beginning of summer prior to the pool availability. Due to the time of the year, the pool is not in use at this time. Per FA the pool will open in May or June 2025. Vehicles: LPA Nestor inspected (4) four facility vehicles in total. 1. Toyota Sequoia (white) with current registration that expires in October 2024. Alliance of Nonprofits for Insurance, Risk Retention Group that expires 10/08/2025. 2. Kawasaki Mule 4x4 with current registration that expires in June 2025. Vehicle is used for on-site transportation only. Continue on 809-C (Page 3) Honda CRV with current registration is expired. The vehicle is currently not in use at the time of the inspection per FA. Alliance of Nonprofits for Insurance, Risk Retention Group that expires 10/08/2025. Toyota Sequoia (black) with current registration that expires in September 2025. Alliance of Nonprofits for Insurance, Risk Retention Group that expires 10/08/2025. All vehicles are in good condition with no issues. Vehicles are in good condition with no issues. Kitchen: Food was stocked with enough food for the current client census of 8. Food was stored and dated. LPA observed the area to be clean and sanitary. Staff Interview: LPA Nestor conducted four (4) interview with FA, Staff (S#) S1, S2, and S3. Client Interview: LPA Nestor conducted four (4) client interviews with Client (C#) C1, C2, C3, and C4. LPA Nestor will return to complete the inspection. There were no deficiencies observed or cited at this time. A copy of this report was reviewed and provided to David Harper Program Director (PD). End of Report (Page 4)


summary: Facility Evaluation

raw_content:
Narrative:
On 03/21/2025, at 9:00 am, Licensing Program Analyst (LPA) Nestor Gomez returned to the above-mentioned facility to continue the annual inspection that was started on 3/20/2025. LPA Gomez met with Facility Administrator(FA), David Harper who granted access to the facility. The following was observed during the Inspection: Staff Interview: LPA Nestor conducted two (2) staff interviews with (Staff#) S6 and S7. Staff Records Review: LPA reviewed six (6) staff records for the FA, (Staff#) S1, S2, S3, S4, and S5. Clients Records Review: LPA reviewed four (4) client records for (Client#) C1, C2, C3 and C4 which meet qualification. There were no deficiencies observed or cited at this time. Exit interview was conducted with the Facility Administrator and a copy of this report was emailed to the Facility Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 8/25/25, at 11:45 am, Licensing Program Analyst (LPA) Nestor Gomez, made an unannounced visit to the above-mentioned facility, in order to conduct a case management incident inspection, regarding two (2) SIRs dated 7/20/2025. LPA Gomez was met by Scott Rothdetush (S1) who granted access to the facility. Per the incident report dated 7/20/25, Staff (S1) failed to provide C1's noon medication. S1 also failed to provide C2's morning medication. PER California Code Regulation, (1) deficiency Type A has been determined at this time. The following deficiency has been cited. (See 809-D) An exit interview was conducted, and a copy of this report was discussed and emailed to the licensee.

met_with: Scott Rothdetusch - Maintenance Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 7/28/2022 at 10:00am, Licensing Program Analyst (LPA) Nancy O'Connell, made an unannounced inspection to the above-listed facility, and met with the Trina Garcia (S1), who granted access to the facility and provided a tour of the facility, inside and out. The purpose of this inspection is to follow-up on recent Medication Incident Reports submitted to the Department. LPA O'Connell conducted a walk-through of the facility cottage (Olive) with S1. During the time of the inspection, LPA interviewed one client (C1) and all other clients (C2, C3,and C4) refused to be interviewed [See Confidential Names form (LIC811), dated 07/28//2022, for names]. LPA observed locked medication closet, fire extinguisher, available snacks, and the cottage to be clean and orderly. LPA O'Connell reviewed the medication log for all four (4) residents. LPA also toured the facility pool and noted that the gate was locked and the body of water was inaccessible to residents. At 11:00am, LPA O'Connell met with the FM and reviewed recent medication incident reports submitted to the Department (dated 6/26/22, 6/26/22, and 7/24/22) and asked about reason for instances of missed medication. FM reported that staff S2, responsible for passing morning medication to residents (C4 and C5), was supposed to provide medication at 7:00am, and "forgot" to pass the morning medications to residents due to focusing on getting residents ready to go on a activity outing, which was scheduled for deaprture at 8:15am. FM explained that S2 believed that another staff provided the medication. Continued on LIC809D 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, a deficiency will be cited on this day. Exit Interview conducted, and due to technical difficulties with LPA's printer, a copy of this report will be emailed to the FM along with appeal rights. .

met_with: Trina Garcia, Staff (S1), Tayler Abernathy (FM)


summary: Facility Evaluation

raw_content:
Narrative:
On August 17, 2023 at 10:41 am, Licensing Program Analyst (LPA) Christine Wilson made an unannounced visit to the above listed facility, in order to conduct a case management deficiency. A medication incident report, dated 08/8/23 was reported to Community Care Licensing (CCL). During the course of the deficiency investigation it was discovered that licensee did not ensure medication for youth (C1) (Sucralfate) was taken or administered as prescribed during an outing. LPA Wilson and Licensee discussed the possible mitigating factors which led to the MIR. Licensee stated a discussion with the physician regarding switching to non-refrigerated medication will take place as well as continued training on medication procedures during outings with clients. 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: Licensee David Harper


summary: Facility Evaluation

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Narrative:
On November 9, 2023 at 10:21 am, Licensing Program Analyst (LPA) Christine Wilson made an unannounced visit to the above listed facility, in order to conduct a case management deficiency. It was discovered that an incident report for the youth (C1), SIR dated 9/22/2023; was not received by the regional office, and the licensee (PD) did not ensure proper Incident Reporting to CCL (Reporting Requirements). During a visit on 09/27/23, LPA Wilson spoke to staff (PM), and requested that the Incident Report be sent to CCL. The SIR was not received by CCL until 10/05/2023 , which poses a potential health and safety risk to persons in care A (1) deficiency Type B 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 Program Manager. (PM) whose signature on this form confirm receipt of these documents.

met_with: Program Manager


summary: Facility Evaluation

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Narrative:
On August 2, 2024 at 10:17 am, 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 three (3) SIRs; (2) dated 07/24/24 and (1) dated 07/23/24. LPA Wilson was met by Program Director/Administrator (PD). During the course of the incident investigation, it was revealed that on dates 07/23/24 and 07/24/24 the youth (C1) was not provided proper dosage of medications as prescribed by their physician by staff (S1,S2 and S3). Per the (PD) New staff did not understand the instructions for the prescription and needed to wake up the child at 1:00am for a dosage. Staff did not pass medication at 1:00am due to medication log not documenting 1:00am dosages . (PD) spoke to the dentist who prescribed the medication and gave orders to continue to provide the client with the antibiotic. (PD) and (PM) spoke with staff who missed the medication and provided a medication training on 07/31/24 (LPA obtained copies of training sign in sheets and the post-test results). Staff (S1) did not take the training, due to preparation for her last day of employment, which was on 08/01/24. (PD) provided an update on the fire suppression line, which is on hold until an engineer assesses the landscape. NO other projects may start until fire suppression begins. Kitchen upgrade is a year-long project which will not affect services to the clients and will take place after fire suppression project ends. 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, whose signature on this form confirm receipt of these documents.

met_with: Program Director/Administrator


summary: Facility Evaluation

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Narrative:
On December 26, 2024 at 10:49 am, Licensing Program Analyst (LPA) Christine Wilson and Licensing Program Analyst (LPA) Nestor Gomez, made an unannounced visit to the above listed facility, in order to conduct a case management incident inspection, regarding an SIR dated 12/08/24. LPA Wilson was met by the Youth Education Specialist (S1) who was placed in charge of all facility operations on site. There was no Administrator on site or within 30-minutes of the facility on this day. Per (S1) "The Program manager will be back onsite January 31st and the Program Administrator and Head of Service will return on January 2nd but are available by phone." Per the incident report, at the beginning of (S2) shift she was notified from her relief staff that (C1) was out of her medication, therefore (C1) did not get her medication. (S1) provided an update on the fire suppression line, pipes for water, electrical, fiber optics and kitchen renovation. A repeat violation,(1) deficiency Type A has been determined at this time. The following deficiency has been cited. (See LIC421M). 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, whose signature on this form confirm receipt of these documents.

met_with: Youth Education Specialist (S1)


raw_content:
Narrative:
Due to a lack of evidence obtained during the investigation, it is determined that the allegation is unsubstantiated. Although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that a violation occurred. There are no deficiencies cited at this time. An exit interview was conducted, and a copy of this report was emailed to Administer David Harper.

Investigation Findings:
13On November 7th, 2025, at 11: AM Licensing Program Analyst (LPA) Andrew Upshaw made an unannounced visit to conclude the investigation. Prior to entering the facility LPA Upshaw conducted a health and safety risk assessment. During the investigation, LPA Rosslyn Gray interviewed all relevant parties available and gathered pertinent information in reference to the allegation. Based on confidential interviews and review of documentary evidence, there is no evidence or witnesses to support the allegation that staff did not ensure a minor is performing academically. Records include various school records as evidence by Education Course Titles; Progress notes; Transcripts of Student Progress; Child Family Team Meeting (CFT); Needs and Service Plan (NSP); and Interventions implemented to support Client 1's (C1) academic goals. Statements determined that C1's absence was reported, there were no medical records of serious injury sustained, medical treatment was provided via in-house First-Aid. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Andrew Upshaw 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 31-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: OLIVE CREST-HOPE REFUGEFACILITY NUMBER: VISIT DATE: 11/07/2025

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

met_with: Scott Rothdeutsch, Manager


facility_name: OLIVE CREST TREATMENT CENTERS - MALENA

summary: Complaint Investigation - Substantiated - 1 allegation

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Narrative:
Confidential interviews and record review revealed that on 11/14/2020, C1 and C2 were outside of the STRTP smoking and S2 asked the clients to give up what they were smoking. The clients refused and began walking away from the facility. At that time, S2 and S1 followed the two clients and there was a verbal altercation as staff were trying to get clients to go back to the facility. One confidential interview revealed C1 pushed S1 after S1 grabbed C1's hand, while another interview and record review revealed C1 pushed S1 when S1 stood in front of C1. Confidential interviews revealed that after C1 pushed S1, S2 told C1 if C1 put hands on staff again, S2 would push C1. S2 admitted to saying to both clients, not either one specifically, that S2 would push them if they pushed staff. S2 revealed at that time, S1 told S2, S2 could not say those things to the clients. S2 stated it was S2's first month on the job and admitted S2 made a mistake in saying that. Based on confidential interviews and record review, the preponderance of evidence standard has been met. The department has determined the allegation that S2 threatened C1 while in care is substantiated. The facility is being cited for violation of the Short-Term Residential Therapeutic Program Interim Licensing Standards (ILS) Chapter 7. Version 3.1, Regulation Section 87072 (d)(11) Personal Rights, which poses a potential health, safety and personal rights risk to children in care. An exit interview was conducted and a copy of this report, LIC 811 and appeal rights were provided to Facility Manager Michael Cabrera.

Investigation Findings:
13On August 19, 2021 at 12:45 pm, Licensing Program Analyst (LPA), Jessica Rubio met with Olive Crest Treatment Center (STRTP), Facility Manager (FM) Michael Cabrera to deliver the investigative finding for the above stated allegation. LPA received verbal authorization from Administrator Amy Ahern to have FM sign the report. On 11/30/2020 at 3:40 pm, LPA Ann Valenzuela conducted a safety tele-inspection of the STRTP and no safety concerns or deficiencies were observed. During the investigation, LPA Rubio interviewed one client (C1), one staff (S1) and county social worker of C1 (CSW). LPA Rubio also reviewed the staff roster, the needs and services plan for C1 and a special incident report. On 11/20/2020, Community Care Licensing (CCL) received an allegation staff threatened minor while in care; specifically, that S2 told C1 that S2 would push C1 into the street. (Continued on LIC 9099-C) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Jessica M Rubio LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, THE CITY DR., SUITE FACILITY NAME: OLIVE CREST TREATMENT CENTERS - MALENAFACILITY NUMBER: VISIT DATE: 08/19/2021

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

met_with: Residential Manager Michael Cabrera

complaint_status: SUBSTANTIATED


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Narrative:
Confidential interviews reported that C1 did not admit to what substances if any, they were under the influence of. Confidential interviews reported that a vape pen was found in C1's room. Confidential interviews reported that C2 sometimes did and didn't comply with searches upon returning from being absent without permission. Confidential interviews reported that C2 never brought back marijuana upon returning from being absent without authorization and consistently adhered to search requests from staff. Confidential interviews reported that C1 never received any marijuana from C2. Confidential interviews reported that C2 denied the allegation of ever supplying C1 with marijuana or other drugs. Confidential interviews reported that it was suspected C2 was bringing drugs into the facility, but the facility never found contraband on C2 during room searches or upon C2's return from being absent without permission. Community Care Licensing also received an allegation that facility staff is not adequately supervising a minor and another resident in the home. Confidential interviews reported that on 05/24/2022, C2 was discovered in the same bed as C1. Confidential interviews reported that C1 and C2 were instructed to get out of bed, but both refused. Confidential interviews reported this was a concern as C2 was an adult and C1 was still a minor. Confidential interviews reported that C2 was placed in this facility as a minor and transitioned into adulthood during their placement. Confidential interviews reported that when C2 was a minor, they received permission from staff to visit C1's room. Confidential interviews reported that C1 and C2 never admitted to being in each other's beds. Confidential interviews reported that if C1 and C2 were discovered in each other's room, staff would redirect them to exit the bedroom. Confidential interviews reported that if C1 or C2 didn't comply, staff would directly supervise them outside the room, with the door open, until they complied. Confidential interviews reported that C1 and C2 were never permitted to be in each other's room, which was against facility rules. Based on inconsistent confidential interviews, the allegations that a resident (C2) in the home supplied another minor (C1) with marijuana and that facility staff are not adequately supervising a minor (C1) and other resident (C2) in the home may have occurred, however, is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted. A copy of this report and appeal rights were explained and provided to Residential Coordinator Mayra Medina.

Investigation Findings:
13On 01/24/2023, at 11: AM, Licensing Program Analyst (LPA) Joon Choi conducted an unannounced visit to Olive Crest - Malena Short Term Residential Treatment Facility (STRTP) to deliver the investigative findings for the allegations listed above. On 05/25/2022, LPA Leslie Covarrubias conducted an initial health and safety Inspection at the facility, and no immediate health and safety hazards were observed. On 12/29/2022, LPA Choi conducted a follow-up health and safety inspection of the facility, and no immediate health and safety hazards were observed. The investigation included interviews with clients (C1, C2, and C3) and staff (S1, S2, and S3). LPA obtained pertinent documentation during this investigation, such as the Special Incident Reports relating to this complaint and the Orange County Child Protective Services Cross Report Documents. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Joon R Choi LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: OLIVE CREST TREATMENT CENTERS - MALENAFACILITY NUMBER: VISIT DATE: 01/24/2023

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

met_with: Mayra Medina, Residential Coordinator


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
allegations that C1 was physically assaulted by other clients and stated that it was C1 who instigated the fight with Child # 2 (C2) by calling C2 a racial slur and by getting in C2's face as well as throwing a rolling pin at C2. According to confidential interviews, staff immediately intervened in altercation by attempting to separate clients by getting in between C1 and C2, and by giving verbal prompts to both C1 and C2. According to confidential interviews, C1 was assessed by paramedics after the altercation and refused any type of medical treatment. Confidential information obtained by LPA Mena showed that C1 was seen the following day by a medical doctor. While other confidential information received by Licensing stated that the allegations had occurred and that staff did not offer to take C1 to seek medical care the day of the incident, and the staff also did not intervene in physical altercation. There were no other known witnesses to this incident. Based on confidential information obtained during the course of this investigation, the allegations that Foster Child # 1 (C1) was physically assaulted by other minors in care and that staff did not seek medical attention for Child # 1 (C1), may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Residential Manager, Michael Cabrera to discuss the investigative findings for the above stated allegations. LPAs Leslie Covarrubias, Joon Choi and Daniel Mena conducted an inspection to the Short Term Residential Therapeutic Program (STRTP) on August 10, 2022, December 29, 2022, and on May 5, 2023. No immediate hazards observed. LPAs Covarrubias and Mena interviewed five staff (S1, S2, S3, S4 & S5), five of five foster children (C1, C2, C3, C4 & C5), as well as reviewed client medical and facility records. Community Care Licensing received information on August 03, 2022, alleging that Foster Child # 1 (C1) was physically assaulted by other minors in care and that staff did not seek medical attention for Child # 1 (C1). Information obtained in confidential interviews did not corroborate the allegations with a preponderance of evidence. LPAs Covarrubias and Mena obtained conflicting information during interviews. Confidential interviews denied UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: OLIVE CREST TREATMENT CENTERS - MALENAFACILITY NUMBER: VISIT DATE: 05/09/2023

met_with: Michael Cabrera


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Narrative:
S5 discussed C1's inappropriate drawings when S5 started their work shift. Confidential interviews stated that S1 discussed the drawings with C1. Confidential interviews stated that C1 denied the allegation of staff requesting C1 to draw inappropriate pictures. Confidential interviews indicated that no clients had been coerced by S1 or any staff to draw, talk about or do wrong things. Based on record review and confidential interviews, the allegation that a staff (S1) requested a minor (C1) to draw an inappropriate picture may have occurred, however, it is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted. A copy of this report, LIC 811, and appeal rights were explained and given to Administrator, Amy Ahern.

Investigation Findings:
13On August 10, 2023, at 10: AM, Licensing Program Analyst (LPA) Leslie Covarrubias met with Administrator, Amy Ahern to deliver the findings for the above-stated allegation. On 06/08/2022 at 10:30AM, LPA Covarrubias inspected the physical plant and observed no immediate health and safety hazards. The investigation included an interview with Clients (C1- C4), Facility Staff (S1-S6), Probation Officer, and County Social Worker. The Department received an allegation on May 31, 2023, that a staff (S1) requested a minor (C1) to draw an inappropriate picture. A confidential interview stated that C1 drew inappropriate pictures of body parts. Other confidential interviews revealed that S1 did not request C1 to draw the inappropriate pictures, C1 willingly drew the pictures of body parts, and when S1 noticed, S1 stated to C1 that it was inappropriate. The record review revealed that the incident was not logged into the communication logbook by the staff (S1) that witnessed the drawing. (Continue on next page...) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Leslie Y Covarrubias LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: OLIVE CREST - MALENAFACILITY NUMBER: VISIT DATE: 08/10/2023

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

met_with: Administrator, Amy Ahern


raw_content:
Narrative:
Specifically, it was reported that the Staff allowed minor (C1) to visit their boyfriend's grandmother's home on April 5, 2025, and C1 missed the bus and had no means of returning to the facility due to the facility refusing to pick up C1. The facility reported C1 as an unauthorized absence on April 5, 2025, and did not report unauthorize absence to CSW and PO until April 7, 2025. In addition, facility did not report or submit report to the Department until April 17, 2025, when 10-day notice of complaint was delivered. Confidential interviews revealed consistent information. Confidential interviews entailed that C1 was denied transportation home, marked as an unauthorized absence, and was not reported to CSW, PO, and the Department per requirements. Confidential interviews entailed that C1 was denied transportation home until two days after the facility dropped off C1 at C1's boyfriend's grandmother's home. Based on confidential interviews and documents reviewed, the preponderance of evidence standard has been met and the allegations that facility staff did not ensure reporting requirements were followed, and facility staff did not ensure transportation was provided to youth in a timely manner are substantiated. The Short Term Residential Treatment Agency is being cited for violations of Interim Licensing Standards (ILS), version 6, subchapter 1, section 87061 (b)(4) - Reporting Requirements: (b)The licensee shall ensure that the child's authorized representative is notified no later than the next business day if the following circumstances have occurred without the authorized representative's participation: (4) Any unusual absence or failure of a child to return or inform the facility that they are not returning for a specified period of time, and 87074 (3) - Transportation -Unless other arrangements are specified in the needs and services plan or the Transitional Independent Living Plan for a child or nonminor dependent, a licensee shall ensure transportation is provided to the following: (3)Extracurricular, personal enrichment, cultural, racial, ethnic, and social activities, in accordance with the reasonable and prudent parent standard specified in Section 87067. An exit interview was conducted with Residential Coordinator, Leticia Rodriguez. A copy of this report and LIC811 dated 06/04/2025 was provided to Residential Coordinator, Leticia Rodriguez.

Investigation Findings:
13On June 4, 2025, at 12: PM, Licensing Program Analyst (LPA) Stefanie Mutialu conducted an unannounced inspection and met with Residential Coordinator, Leticia Rodriguez to deliver and discuss the investigative findings for the allegations noted above. During the investigation, LPA interviewed one of six Children (C1), one County Social Worker (CSW), one Probation Officer (PO), and two Staff (S1-S2), please see LIC811 for confidential names. During the investigation, the following documents were reviewed: facility documentation, C1 file, and county documentation for C1. On April 11, 2025, Community Care Licensing (CCL) received allegations that facility staff did not ensure reporting requirements were followed, and facility staff did not ensure transportation was provided to youth in a timely manner. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Stefanie Mutialu LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION ORANGE COUNTY RO, THE CITY DR., SUITE FACILITY NAME: OLIVE CREST - MALENAFACILITY NUMBER: VISIT DATE: 06/04/2025

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