summary: Facility Evaluation

raw_content:
Narrative:
On 6/24/2021, Licensing Program Analysts (LPA) Kendal Zirbes met with Administrator Kim Hayward Glover who granted access to the facility. The purpose of this inspection was to conduct an announced pre-licensing inspection for a Transitional Housing Placement Program (THPP) for Non-Minor Dependents (NMD) Sub Office. The administrative office was toured both inside and out with the Administrator at 12:05pm. Presently, the THPP NMD has requested a capacity of NMD's who will be placed in remote site apartments. Administrator was advised the apartments must be located within two hours of the administrative office. The THPP Administrative office is located in Riverside County. The office is located in a retail business establishment. The office consists of a reception area, two meeting/conference rooms, three case managers offices, three Administrative offices, locked storage area, two interview rooms, two bathrooms, and a kitchen area. In addition, there are five computer stations for the NMD's located in the reception area. The administration office was equipped with working office equipment, furniture, and supplies. According to Administrator, all participant files will be stored in locked cabinets within the case managers offices. The staff files will be located in a locked cabinet within the Administrators office. Currently the THPP is only staffed with the Administrator, all additional positions will be hired after obtaining the CCL license. During this inspection Component III for THPP NMD was conducted by LPA Zirbes. During this component, LPA discussed Post Licensing inspection that Community Care Licensing (CCL) may provide, solutions to problematic areas, overview of Title 22, THPP regulations; NMD regulations, personal fingerprint requirements, associations, abuse reporting requirements and licensing fees. LPA informed the Administrator, about the reporting requirements specifically, AB388 and LIC LE. Furthermore, Provider Information Notices (PIN), Resource Guides and the process for designating a new facility Administrator was reviewed. Licensee was advised that this pre-licensing report and application will be reviewed by the Department. The facility will be notified once they are licensed as a THPP NMD. An exit interview was conducted with Administrator Kim Hayward Glover and a copy of this report was emailed to the facility.

met_with: Administrator Kim Hayward Glover


state: CA

facility_name: DIVINITY PROPHET- RIVERSIDE

summary: Facility Evaluation

raw_content:
Narrative:
On August 8, 2022 at 9:10 am, Licensing Program Analysts (LPA) Darlene Almaraz-Oseguera met with Administrator Kim Glover who granted access to the facility. The purpose of this inspection was to conduct an announced post-licensing inspection for a Transitional Housing Placement Program (THPP) for Non-Minor Dependents (NMD) Sub Office. The administrative office was toured both inside and out with the Administrator. Currently the THPP has twenty-one NMD's placement's and fifteen remote site apartments. The remote apartments were all within two hours of the administrative office. The THPP Administrative office is located in Riverside County. The office is located in a retail business establishment. The office consists of a reception area, two meeting/conference rooms, three case managers offices, three Administrative offices, locked storage area, two interview rooms, two bathrooms, and a kitchen area. In addition there is a computer lab and there are motivational signs, along with an educational and employment resource area. The office is equipped with working office equipment, furniture, and supplies. LPA reviewed seven NMD files. The files were stored in locked cabinets within the case managers offices. LPA also reviewed all staff files which was a total of four. The staff files were in a locked cabinet in the Administrators office. Based on the annual inspection on this date, the THPP is in compliance. An exit interview was conducted with Administrator Kim Glover and a copy of this report was emailed to the facility.

report_type: Facility Evaluation

met_with: Kim Glover


summary: Facility Evaluation

raw_content:
Narrative:
On June 14th 2023, Licensing Program Analysts (LPA's), Darlene Almaraz-Oseguera and Emina Preciado arrived at Divinity Prophet, Riverside, Transitional Housing Placement Program (THPP). LPA's met with Program Administrator, Shari Wolvek, who granted access to the facility. The purpose of the visit was to conduct an unannounced required two year inspection for the THPP for Non-Minor Dependents (NMD's). The administrative office was toured both inside and out with the Administrator. Currently the THPP has twenty five NMD placement's and nineteen remote site apartments. The remote apartments were all within two hours of the administrative office. The THPP Administrative office is located in Riverside County. The office is located in a retail business establishment. The office consists of a reception area, one meeting/conference room, three case managers offices, three Administrative offices, locked storage area, two interview rooms, two bathrooms, and a kitchen area. In addition there is a computer lab and there are motivational signs, along with an educational and employment resource area. The office is equipped with working office equipment, furniture, and supplies. LPA's reviewed six non-minor dependent files. All files reviewed were complete and had the required documents. Facility provided a copy of the drill log of the emergency disaster and mass casualty plan. LPA's reviewed all staff files which was a total of three. All staff met the minimum qualifications and training requirements. A review of records shows that all staff have FBI, DOJ, and Child Abuse Index Check clearances. The staff files were in a locked cabinet in the Administrators office. Staff was informed that each Social Worker should maintain a 1 to 12 ratio, which should never be exceeded. Staff is aware of submitting unusual incident reports as needed to the Department and to include all Law Enforcement contacts. Based on observation and record review, the annual inspection on this date, the THPP is in compliance. An exit interview was conducted and a copy of this report was provided to Administrator, Shari Wolvek.

met_with: Shari Wolvek, Program Administrator


facility_name: DIVINITY PROPHET-GARDENA

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Investigation Findings:
13On June 25, 2021 at 2: PM, Licensing Program Analyst (LPA), Charmetha White made an unannounced visit to Divinity Prophet-Gardena THPP for the purpose of delivering findings on the on attached complaint investigation. LPA spoke to Office Manager, Dosalyn Smith and discussed the findings. During the course of this investigation LPA interviewed pertinent parties, reviewed relevant information, and conducted a walk through of the unit. Staff denied the allegations. Staff said the unit is safe, that Child #1 was provided a new bed when she moved into the unit, and that Child #1 has not voiced any concerns about her roommate nor the area to staff. Staff stated there is also a Sheriff's and Probation Department located a few blocks from the unit. Child #1 stated she is fine living in unit, that she does not have any issues with her roommate, but said she could use a bigger bed because she is tall. Child #2 said she does not have multiple people come in and out of the unit, but said she does have a friend over every now and then. Based on information obtained this investigation is being closed Unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the allegations occurred. No deficiencies cited. Exit interview completed. A copy of this report was left with facility Staff. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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

report_type: Complaint Investigation

met_with: Office Manager - Dosalyn Smith

complaint_status: unsubstantiated


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward completed the investgation of the above allegation. LPA spoke to the CEO of Divinity Prophet, the Probation Officer of Participant #1 and the orginal complainant. LPA also searched for SIR's regarding the departure of Participant #1 from the program. There were no SIRs found dor this matter. Per emailed statement provided by CEO Hope Ricks, an SIR was not submitted because Participantt #1 left the program on his own after notifying staff of his intent to do so. However, per Title Section 86261(d) the licensee shall notify the Department when a non-minor dependent is discharged in accordance with Title 22, Section 86268.4(c)(1)(B). Based on the information obtained during this investigation, the allegation that the licensee did not follow proper discharge procedure is resolved as substantiated. A finding that an allegations is substantiated means that the "preponderance of the evidence" standard has been met. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: DIVINITY PROPHET-GARDENAFACILITY NUMBER: 198209608

met_with: Meka Brown, Director of Programs, Licensed Care

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward met with Meka Brown, Shari Wolvek & Deborah Smith to discuss the allegation that the facility did not provide a full crib for the newborn infant of Participant #1. LPA Jones-Steward previously spoke to Particiapant #1 and verified that the crib in her apartment has no mattress. Per Ms. Smith there was a full crib offered but Participant #1 did not want that crib so a mini-crib was purchased. However the mini-crib does not have a mattress and Ms. Smith has been unable to find one that fits. Ms. Smith, Ms. Wolvek and Ms. Brown stated that there will be a full crib or bassinet in place within a matter of hours. Based on the information gathered during this investigation the above allegation is substantiated. Subtantiated means that the "preponderance of the evidence" standard has been met. Facility was cited under Title 22 86088(b)(1) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: DIVINITY PROPHET-GARDENAFACILITY NUMBER: 198209608

met_with: Meka Brown, Director of Programs. Licensed Care


summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward investigated the above allegations. LPA spoke with Meka Brown, Shari Wolvek, Diana Flaggs and Maurissa Mitchem. However no specific client was named as having had the above inappropriate fines levied against them. Without such information the allegations cannot be substantiated nor negated. Therfore they are resolved as unsubstantiated. Unsubstantiated means that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

met_with: Meka Brown, Shari Wolvek


raw_content:
Narrative:
The two toured units posed some physical plant concerns of a broken sliding door, cracked mirror, and front door panel damage. These concerns were cited and addressed during the initial visit. LPA was unable to justify rodents and expired food due to specific units not identified in the photos. Confidential interviews indicated that participants could leave their unit to go to work, school, and conduct personal business. Per staff interviews, the following was stated: Participants are required to notify case manager if they will be gone beyond a 24-hour period. Participants are required to work or be enrolled as a requirement of the program. The program was providing transportation prior to COVID but now encourages participants to take public transportation. Participants are responsible for purchasing their own hygiene products. The allegations stated minors are not provided allowance however, per client and staff interviews, an allowance is given every two weeks. There is no supporting evidence and it is unclear which clients did not receive an allowance. Per staff interviews, support was provided for budgeting and saving however, due to COVID it stopped and there isn't a set date for it to return. While touring one of the units, LPA/LPM observed a participant asking for parenting and anger management classes and staff stated they would accommodate. The initial photos provided, were not dated nor did they identify which unit they were taken in. The concerns do not reflect in the allegations and the alleged allegations occurred two years ago. Based on review and analyzing all of the evidence, the LPA has found this complaint to be Unsubstantiated, meaning the allegation may have happened or is valid, but there is not a preponderance of evidence to prove that the alleged violation occurred. There were no deficiencies cited at this time. A copy of this report and appeal rights will be emailed to the Case Mgr Supervisor and The Program Administrator Due to technical difficulties with the LPA's printer.

Investigation Findings:
13On June 29, 2022, at 10:45am Licensing Program Analyst (LPA), Enrique Hernandez, arrived at the facility for the purpose of concluding complaint findings of the investigation conducted by LPA Kuliema Callaway and LPM Lakescia Smith. LPA met with Deborah Smith Case Mgr Supervisor and Paisley Moore The Program Administrator at Divinity Prophet- Gardena. During the investigation, LPA Kuliema Calloway and LPM, Lakescia Smith reviewed documentary evidence, photos, toured two living units, and conducted confidential interviews. LPA and LPM attempted to tour three additional unit sites but were unsuccessful. One of the attempted sites in Carson had a lock box on the door. LPA contacted staff to inquire and they did not respond. Confidential interviews provided inconsistent statements and no witnesses to corroborate allegations. During the tour, there were no observations of drugs or dangerous objects however, LPA/LPM did observe empty liquor bottles in one of the units. Living units were observed to be clean, sanitary, and without odor. Continue on LIC9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Enrique M Hernandez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: DIVINITY PROPHET-GARDENAFACILITY NUMBER: VISIT DATE: 06/29/2022

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

met_with: Deborah Smith Case Mgr Supervisor


raw_content:
Narrative:
Although the allegations may have happened are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has determined that the allegations Personal Rights are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There are no deficiencies noted or cited. An exit interview was conducted, and a copy of this report was left at the Program Administrator.

Investigation Findings:
13On October 27, 2022 at 10: AM Licensing Program Analyst (LPA), Rosslyn Gray made an unannounced visit to DIVINITY PROPHET-GARDENA to conclude the investigation on the above allegations. LPA met with the Program Administrator to conclude the investigation and to deliver the findings. During the investigation LPA-Gray interviewed and accounted for all available relevant parties; and gathered pertinent information regarding the allegations. Based on the interviews and statements obtained during the investigation process, the allegation cannot be corroborated because supporting evidence includes the following: The Licensee denied the allegations.LPA accessed and found discrepancy in the alleged victims' statements. There is no evidence or witnesses to support that the facility "Staff did not afford a NMD privacy while in care and that staff mishandled a NMD while in care. Documented evidence and confidential interviews were congruent and confirmed that the youth obtain the proper allowances; that the staff followed provided proper protocol and directives when entering the participants unit and there were no witnesses present to confirm that the staff mishandled a NMD while in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: DIVINITY PROPHET-GARDENAFACILITY NUMBER: VISIT DATE: 10/27/2022

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

met_with: Program Administrator


raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward completed the complaint investigation that was began by LPA Charmetha White. LPA Jones-Steward spoke to three of the five current and former particiapants that were also enrolled in the Divinity Prophet program in 2020. The other two participants were unreachable. The participants all denied any major problems with receving their allowances. The majority stated that they felt safe in their apartments. They also stated that repairs were generally made in a timely manner, although one stated that they had to pay for repair of damages out of their allownance. LPA also reviewed allowance logs for the time period in question and allowances were always signed for according to procedure set forth by Divinity Prophet. Based on the vaguries of these allegations, the age of the complaint when received by this LPA and the small pool of clients available for interview, the above allegations are resolved as unsubstantiated. Unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that it did happened. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Shari Wolvek, Director of Quality Assurance & Compliance


raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward met with Ms. Meka Brown and Ms. Sheri Wolvek to resolve the above allegations. During the investigation, LPA interviewed staff, C1 and the original reporter. LPA reviewed PEX card statements and discussed them with Ms. Wolvek and C1. The situation of C1's alleged lack of a consistent case worker was discussed with staff, C1 and with the original reporter. Based on confilicting information gathered via interviews and record reviews LPA was not able to conclude that the allegations are true or false. Therefore they are resolved as unsubstantiated. Unsubstantiated means that an allegation lacks a preponderance of the evidence to prove that the violation occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

met_with: Meka Brown, Director of Programs


facility_name: DIVINITY PROPHET-PALMDALE

summary: Facility Evaluation

raw_content:
Narrative:
This Report Has Been Amended from the Previous Date 12/08/ Due to Confidential Information Listed. On December 8, 2021 at 10: AM Licensing Program Analyst, (LPA) Rosslyn Gray made an unannounced inspection at for the purpose of conducting Pre-Licensing Inspection for DIVINITY PROPHET- PALMDALE (THPP) Transitional Housing Placement Program LPA met with the Administrator, Elizabeth Richard who granted access into the Administrative Office and provided a tour. The Administrative Office is located at: 38345 30th St. East Suite B-1A Palmdale, CA 93550. The office is located on the 1st floor of the building. LPA observed the entire Administrative office. The restroom is located outside the administrative office to the left. The facility is licensed to provide Transitional Housing Placement for Non-Minor Dependents (NMD) for 27 participants ages eighteen (18) through twenty-one (21). There are currently seventeen (17) participants in placement residing in the program -Remote Sites. The Administrator stated that there are ten (10) Remote Sites are all located in the Palmdale and Lancaster. The administrator confirmed that no staff is residing in the Remote Sites. There are no bodies of water on the premises. LPA viewed the location of the Remote Sites and Residential Lease confirmed for Palmdale and Lancaster. LIC Page 1 of This Report Has Been Amended from the Previous Date 12/08/ Due to Confidential Information Listed. LPA's observed the entire Administrative office. The office is set up as follows: At the entrance. There is a front lobby there is a sliding glass Receptionist Window to greet clients and authorized representatives to sign in. There is locked door adjacent to the receptionist window that leads to the main administrative conference area. The Administrators office; is equipped with an office desk, desk top computer, office supplies, locked file cabinet, a book shelf utilized to store files. The shut valves are located inside the door. There is large conference table with ten (10) chairs; two (2) Case Management offices (desk, table top computers and chairs) an interview office utilized for residents, social workers and any other authorized representative. There are 2 seated desks with office supplies, a book shelf with additional office supplies; office equipment (printer fax machine) (1) computer, portable folding table and covered trash cans. There a small size kitchen equipped with cabinets, a sink, microwave, coffee maker, and supplies for the clients, food pantry, additional supplies for the units. LPA observed the THP+FC residence files and staff files were stored in the locked file cabinets. Currently the facility is staffed with two (2) Social Workers. The administrator is aware that the social worker meets the regulation requirements ratio 1 to 24 for supervision. The administrator is aware of submitting unusual incident reports as needed. The administrator ensures that the THPP residents are provided care and supervision by conducting visit at minimum of 1x weekly for one (1) hour session. The administrator stated that client independently cook their own food. The THPP provides a distributes allowances of $100 including gifts cards for incentives. The administrator conducts events to encourage the residents to build rapport; establish appropriate relations, discuss boundaries and limitations. Continued LIC Page 2 of LPA reviewed three (3) staff files and five (5) client files contain; (Admission agreement/ COVID-19/Intake/ Policy and Procedures, /Allowance Logs/Savings Log/Case Notes/Goals/ Incident Reports/Disciplinary notes/Vital documents/Mental Health/Disaster plan/Physical Health/Employment Education/Life Skills/County Benefits/Files and Transitional Resources LPA reviewed the LIC- Personnel Report; and the Register of Facility Client/Residents staff roster. LPA confirmed criminal record clearances with DOJ, FBI, and Child Abuse Index Check clearances for three (3) staff. LPA interview one (1) Staff/Administrator Per California Code of Regulations, Title Regulations, Division 6, Chapter 7, there are no deficiencies to be cited at this time. Exit interview was conducted with the Administrator and a copy of this report was left with the Administrator LIC Page 3 of 3

visit_type: Prelicensing


summary: Facility Evaluation

raw_content:
Narrative:
On May 23, 2022, at 12: PM., Licensing Program Analyst, Kuliema Calloway and Licensing Program Manager, Lakescia Smith conducted an unannounced Post-Licensing visit to 38345 30th Street Ste. B-1A, Palmdale, CA 93550. LPA and LPM met with Annlelise Galaviz, Case Manager Supervisor and conducted a tour of the administrative office. LPA was informed that Elizabeth Richard is no longer the Program Administrator and administrator qualifications were submitted one month ago for Annelise Galaviz to become the new Program Administrator. The Administrators office; is equipped with with four offices, a lobby, and a kitchen. A locked file cabinet is used to store client files and staff files are stored in one of the offices. The license is posted on the wall adjacent the conference table and LPA observed the Certificate of Compliance for the residential units. LPA will follow up with Annelise regarding on-call staff, Jaime Kirk who is not associated with the facility. LPA was informed it is currently one case manager and one case manager supervisor. One case manager is part-time and should reflect on the personnel report. Eight NMD's are assigned to Annelise and four NMD's are assigned to Carlos MIna. LPA advised staff to update personnel report to reflect staff current work schedule and submit to CCL. The following deficiency was cited (See 809D) Exit interview completed. A copy of this report was provided to the staff, Annelise Galaviz. Note: LPA will return at a later date to complete the inspection.

met_with: Annelise Galaviz, Case Manager Supervisor


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On May 27, 2022, at 11: AM., Licensing Program Analyst, Kuliema Calloway and Licensing Program Manager, Lakescia Smith made an unannounced Case Management Annual Continuation Visit at the Administrative Office. LPA and LPM met with staff, Annelise Galaviz and requested to review staff and client files. A file review was completed but LPA will return to complete the client record's review. LPA requested for Meka Brown, Director of Programs' file to be brought to the office for review since she is the acting Administrator for the this facility and filling in for Elizabeth Richard that is currently on a leave of absence. The following deficiencies were cited (See 809D). Exit interview completed, a copy of this report was given to Annelise Galaviz.

Deficiencies:
86066(a): Personnel Records

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On September 23,2022 at 10:45 a.m., Licensing Program Analyst (LPA) Kuliema Calloway made an unannounced Case Management Continuation Inspection visit to conduct an Annual inspection. LPA met with Annelise Galaviz, Program Administrator, who granted access and a tour of the administrative office located at 38345 30th Street East Ste. # B-1A, Palmdale, CA., 93550. The facility is a Transitional Housing Placement Program licensed to care for Non- Minor Dependent clients. (See confidential name list LIC 811 dated 09/237/2022). LPA conducted staff interviews with Staff (S1) and (PD). LPA continued the annual inspection by reviewing the Client Record's for Clients (C1), (C2), (C3), and (C4) and Staff Records for Staff (S1) and (PD). [See LIC 811 dated 9/23/22]. There was one deficiency cited at this time. See D. Exit interview was conducted. A copy of this report was left at the facility with Annelise Galaviz, Program Administrator.

met_with: Annelise Galaviz, Program Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 02/09/2023 at 9:30AM Licensing Program Analyst (LPA) Olivia made an unannounced to Divinity Prophet Transitional Housing Placement plus Foster Care (THP + FC) Administrative Office for the purpose to conduct the Annual/Required licensing Inspection. LPA Rosas met with Staff#1(S1) and Staff#2 (S2) who granted access to the Administrative Office and an inspection was conducted together. Individuals mention in this report are identify on the Confidential Names List (LIC811) dated 02/09/23. The annual fees are current. LPA Rosas inspected following during the inspection: The facility is licensed to provide Transitional Housing Placement plus Foster Care (THP + FC) and Non-Minor Dependents (NMD) to twenty-seven (27) participants ages eighteen (18) through twenty-one (21). There are currently six (6) participants in placement at different remote sites in the Antelope Valley (sites are located in Palmdale and Lancaster). The facility currently has Administrator serving as the Social Worker (1 per 12 participants) and the Director of Programs as the Social Worker Supervisor (1 per Social Workers). The facility is currently operating within staff ratio. If the capacity increased, then additional personnel would need to be added. The administrative office is set up as follows: The administrative office is located at E TH, EAST Suite B-1A., Palmdale, CA 93550. Administration office is equipped with (4) four offices with reception area, and a kitchen. Staff records and client records are maintained in inside locked cabinet. All posting requirements were met. Report continues on LIC 809-C Page 1 of LPA Rosas reviewed following during the inspection: LPA Rosas requested the following forms for review, copy of Register of participants, Current Census, Personnel Report (LIC 500), Emergency Disaster Plan Protocols, Emergency Disaster Plan for Children's Residential Facilities (LIC 610C). The certification/decertification list of participants living units. Staff Records Review: LPA Rosas reviewed (2) two staff files. LPA reviewed the Personnel Report (LIC 500) and confirmed that facility has currently has Administrator serving as the Social Worker (1 per 12 participants) and the Director of Programs as the Social Worker Supervisor (1 per Social Workers). The facility is currently operating within staff ratio. If the capacity increased, then additional personnel would need to be added. LPA review of Facility's Personnel Report Summary on 02/06/2023 that indicates that all personnel have criminal record clearance has obtain the necessary clearances with DOJ, FBI, and Child Abuse Response. The facility personnel available on a 24-hour basis to respond to any emergency. Clients Records Review: LPA reviewed three (3) clients records which meet requirement. LPA reviewed the Admission Agreements, date of placement in unit, Emergency Contact information, and Needs and Services Plan. Staff Interviews: LPA conducted a confidential interview using the inspection tool interview form with one (1) staff. LPA Rosas together with S1 conducted a collateral visit to three (3) remote sites located in Palmdale, CA. LPA Rosas during inspection the housing units did have telephone service but had no dial tone. S2 was able to provide LPA Rosas with a copy of Verizon monthly telephone. The monthly bill showed remote sites phone numbers listed as active line. S1 and S2 stated, the living units do have telephone service and checking with Verizon on why they are not working. LPA Rosas by email send the following PINS to S1 by email: PIN 21-26-CRP Transitional Housing Placement Provider (THPP) Nonsubstantive Changes to Regulations Update, PIN 22-06-CCLD Guardian Background Check Best Practices, PIN 22-07-CCLD Guardian Webinar For Licensees and Providers, PIN 21-20-CRP Statewide Launch Of New Inspection Tools For Children's Residential Licensees. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was left with S1.

visit_type: Annual

met_with: Staff#1 (S1)


facility_name: DOWNS & MARTIN THP+FC

summary: Facility Evaluation

raw_content:
Narrative:
A TEAMS Conference Meeting was conducted on Wednesday, March 30, 2022 at 10:00 am. The purpose of this meeting was a Program Statement Review to discuss the Application/ Program Statement submitted to the Community Care Licensing office. Meeting Attendees: Latricia Rogers- Licensing Program Analyst Christina Barns- Licensing Program Manager Cheraki Davis- Licensing Program Manager Emmett Downs- Program Director Anita Downs- Human Resource Director Rosa Hernandez- Housing Manager Jesse Vega- Program Manager The topics listed below were discussed during the meeting: Licensing Program Analyst (LPA) Rogers asked E. Downs for clarification regarding locations for physical sites/ housing for future participants as Application (LIC 200) only referenced an address for an office space. E. Downs informed LPA Rogers that they do not currently have placement sites and that they are in partnership with several apartment complexes for future placements. FORMS REVIEW · Supplemental Financial Information Form (LIC 401a) Needs Signature · Balance Sheet (LIC 403) Needs Signature · Surety Bond (LIC 402) Needs Signature · Personnel Report (LIC 500) Missing Support Staff · Transitional Housing Program Plus Foster Care (SOC 179) Change Section 12 to reflect Remote site ORGANIZATIONAL CHART Update Organizational Chart to match Job Descriptions submitted: · Organizational Chart Staff: o Director/ Administrator o Consultant/ Trainer o Program Manager o Housing Specialist o Case Worker Supervisor o Case Worker o Support Staff · Job Description: o Executive Director o Social Worker o Housing Specialist o Case Worker o Administrator LOCATION Address on lease agreement (Latham St. #140, Riverside) is a lease for office building. Where would the actual Staffed Site and Remote Site be located? STAFF · LIC500 does not show qualified Social Work personnel available on 24-hour basis for any emergency. (Title Section 86065 (5). · Social Worker qualification does not match Title Section 86065.3 regulations. · Executive Director/ Administrator qualification does not match Title Section 86064 regulations · Social Work Supervisor Job Description/ Duties/Qualifications missing. · Program Supervisor Job Description/ Duties/Qualifications missing. TRAINING · Qualifications for trainer Dr. D. Finklestein, PhD. · Training of New Employees · Ongoing Training · Initial Training Requirements (not listed) · Annual Training Requirements (not listed) EMERGENCY PROCEDURES Program Supervisor will rotate weekly responsibilities for managing 24 hour on-call phones. This is a duty for a Social Worker. PROGRAM STATEMENT · Does not address removal and/ or discharge procedures · Does not address telephone service for staffed site/ remote site (Administrative office is at different location) · Transportation for staffed sites? · Obtain valid Driver's License and Insurance for staff · Page #45- # Will NMD will learn how to locate a home or apartment in their price range. · All staff should be located in one section not throughout program statement. · Explain what is section 84470 as listed on page #48 · What are the disciplinary/ discharge policies for Remote Site · Where is the Program Policies & Shared Living agreement for Remote Site · Shared Living Agreement should be a part of the Program Statement and not only a sample of signed agreement for client and staff. · Medical Emergencies/ Personal Safety Plans · Unauthorized Purchases/ Grounds for Termination · Disciplinary measures (for each site) ITEMS NOT INCLUDED/ DETAILED · Procedures for Complaints · Emergency Plan/ 24-hour emergencies (how will handle) · Procedures for paying rent/ utilities/ consequences for not doing so · Furnishings (upon discharge from program? What can client keep/ take?) After TEAMS Meeting LPA Rogers contacted Emmett. Downs via telephone and discussed due to there being the need for additional clarification/ information of all three sites (staffed, remote, host) to incorporate into the submitted program statement; It was suggested to E. Downs to focus on updating and submitting application for remote site program and adding staffed site and host site at a later date. E. Downs agreed to only submit application for remote sites at this time. LPA Rogers informed E. Downs to submit an updated LIC 200 and Transitional Housing Program Plus Foster Care Form (SOC 179) (indicating for remote site only) along with updated Program Statement specifically addressing remote sites. E. Downs agreed to submit suggested updates/ changes to Community Care Licensing by Friday, April 22, 2022. LPA Rogers will email a copy of this Program Statement Review report to E. Downs for review and signature. E. Downs agreed to email signed copy back to LPA Rogers after review.

met_with: Emmettt Downs- Program Director


summary: Facility Evaluation

raw_content:
Narrative:
On Monday, April 4, 2022 @ 11:30 am, Licensing Program Analyst (LPA) L. Rogers spoke with E. Downs- Program Director. LPA Rogers informed E. Downs that the LIC 809 dated 03/30/22 needed signatures on all pages. LPA Rogers asked E. Downs to sign all pages of the LIC809 dated 03/30/22 and email signed pages to LPA Rogers. LPA Rogers also reminded E. Downs that because of the agreed decision to only submit application for remote sites at this time, could the application corrections be submitted earlier on Friday, April 15, 2022. E. Downs agreed to submit an updated LIC 200 and Transitional Housing Program Plus Foster Care Form (SOC 179) (indicating for remote site only) along with updated Program Statement specifically addressing remote sites. E. Downs agreed to submit suggested updates/ changes to Community Care Licensing by Friday, April 15, 2022.


summary: Facility Evaluation

raw_content:
Narrative:
On Wednesday, April 27, 2022, Licensing Program Analyst (LPA) Rogers spoke with Emmett Downs regarding the submitted revisions to the THPP application and Program Statement. LPA Rogers informed Emmett Downs more information is needed in the following areas: 1. UTILITIES Give details as to who is responsible for acquiring and paying utilities for apartments (lights, gas, water, trash, cable). 2. FURNITURE Give details as to what furniture/ bedding/ towels/ kitchen utensils will be provided to clients upon entering THPP program. Give details as to what furniture/ bedding/ towels/ kitchen utensils clients can keep upon leaving the THPP program. 3. LOCATION Please verify if office location is open for business. 4. APPLICATION Please update LIC200 with a contact phone number where someone is available to answer the phone and able to leave a message. LPA Rogers informed E. Downs to submit the revisions to program statement to the Community Care Licensing office. E. Downs agreed to submit suggested revisions to Community Care Licensing by Friday, April 29, 2022. LPA Rogers will email a copy of this Program Statement Review report to E. Downs for review and signature. E. Downs agreed to email signed copy back to LPA Rogers after review.


summary: Facility Evaluation

raw_content:
Narrative:
On May 13, 2022, at 8:40am, Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an announced pre-licensing inspection at the facility agency's administrative office located at Latham St. suite #140, Riverside, Ca. 92502. LPA met with Administrator, Emmett Downs, housing specialist, Rosa Hernandez and program manager, Jesse Vega and was given a tour of the facility. Upon entrance into the facility, there is a spacious open area with a large table that will be used training's and equipped with a work station with a large printer/scanner. There are three separate offices with locked doors. Office # Identified as the Administrator's office. Offices #2 and #3 adjacent are the Supervising Social Worker Offices. All offices are fully equipped with work desk units, telephones computers and computer stations. Records: Client files will be locked in office #1. There is a staff break room equipped with refrigerator and microwave. The restroom are located inside the building. The conference room is equipped with a table, chairs, white board and file cabinets and television. The facility has Wi-Fi accessibility. The facility meets the Regulatory requirements and is ready for licensure at the conclusion of the visit. Exit interview conducted. A copy of this report was given to the Applicant

met_with: Emmett Downs


summary: Facility Evaluation

raw_content:
Narrative:
On April 11, 2023, at 8:30am, Licensing Program Analyst's (LPA's), Darlene Almaraz-Oseguera and Emina Preciado, conducted an unannounced post-licensing inspection at the facility agency's administrative office located at Latham St. Suite #140, Riverside, CA 92502. LPA's met with housing specialist, Rosa Hernandez, and Intake Coordinator, Rita Hill, and were given a tour of the facility. There are currently four participants residing in the program, which include two remote sites in the city of Riverside. Upon entrance into the facility, there is a spacious open area with a large table that is used for training's and is equipped with a workstation with a large printer/scanner. There are three separate offices with locked doors. The conference room is equipped with a table, chairs, white board, file cabinets, and television. The facility has Wi-Fi accessibility. The restroom are located inside the building. Office # Identified as the Administrator's office. Offices #2 and #3 adjacent are the Supervising Social Worker Offices. All offices are fully equipped with work desk units, telephones computers, and computer stations. LPA's observed that Participant files were stored in a locked cabinet in Office #1. Currently, the facility is staffed with two full-time Life Coaches (Social Workers), one Housing Specialist, one Supervising Social Worker, and one Program Director. Staff was informed that each Social Worker should maintain a 1 to 12 ratio, which should never be exceeded. Staff is aware of submitting unusual incident reports as needed to the Department and to include all Law Enforcement contacts. LPA's reviewed four staff records. All staff met the minimum qualifications and training requirements. A review of records shows that all staff have FBI, DOJ, and Child Abuse Index Check clearances. LPA's reviewed four non-minor dependent files. All files reviewed were complete and had the required documents. Facility provided a copy of the drill log of the emergency disaster and mass casualty plan. Based on observation and record review, the facility is in compliance, no deficiencies were noted at this time. Exit interview conducted with Housing Specialist, Rosa Hernandez, and a copy of this report was provided to the facility representative.

met_with: Rosa Hernandez


summary: Facility Evaluation

raw_content:
Narrative:
On April 11, 2024, at 11:10am, Licensing Program Analyst's (LPAs), Darlene Almaraz-Oseguera and Cynthia Robinson, conducted an unannounced annual/required inspection at the facility agency's administrative office located at Latham St. Suite #140, Riverside, CA 92502. LPAs met with Program Director Emmett Downs, housing specialist, Rosa Hernandez, and Intake Coordinator, Rita Hill, and were given a tour of the facility. There are currently 16 participants- Non Minor Dependents (NMD) residing in the program, which include 8 remote sites throughout Riverside County and 1 remote site in San Bernardino County. Upon entrance into the facility, there is a spacious open area with a large table that is used for training's and is equipped with a workstation with a large printer/scanner. There are three separate offices with locked doors. The conference room is equipped with a table, chairs, white board, file cabinets, and television. The facility has Wi-Fi accessibility. The restroom are located inside the building. Office # Identified as the Administrator's office. Offices #2 and #3 adjacent are the Supervising Social Worker Offices. All offices are fully equipped with work desk units, telephones computers, and computer stations. LPAs observed that Participant files were stored in a locked cabinet in Office #1. Currently, the facility is staffed with two full-time Life Coaches (Social Workers), one Housing Specialist, one Supervising Social Worker, and one Program Director. Staff was informed that each Social Worker should maintain a 1 to 12 ratio, which should never be exceeded. Staff is aware of submitting unusual incident reports as needed to the Department and to include all Law Enforcement contacts. LPAs reviewed four staff records. All staff met the minimum qualifications and training requirements. A review of records shows that all staff have FBI, DOJ, and Child Abuse Index Check clearances. LPAs reviewed four NMD dependent files. All files reviewed were complete and had the required documents with the exception of NMD (C1) missing the TB test. Facility provided a copy of the drill log of the emergency disaster and mass casualty plan. Continued Next Page Based on observation and record review, the facility is in compliance, no deficiencies were noted at this time. Exit interview conducted with Program Director Emmett Downs, and a copy of this report was provided to the facility representative.


raw_content:
Narrative:
Additional documents revealed that NMD was on a 30-day case plan to further enforce program rules and NMD violated program rules during the case plan which resulted in the final exit notice for NMD. On 07/01/2025, Community Care Licensing (CCL) received an allegation that staff did not prevent a non-minor dependent's (NMD) apartment from being unsanitary. It was alleged that NMD's apartment was unsanitary due to NMD's roommate. Confidential interviews revealed that NMD's roommate would make the apartment unsanitary due to their living habits. Confidential interviews revealed that the facility assisted with the apartment complex to be more sanitary and talked with NMD and NMD's roommate to create more collaborative effort. On 07/01/2025, Community Care Licensing (CCL) received an allegation that staff did not provide a safe environment for a non-minor dependent (NMD). It was alleged that NMD reported domestic violence occurring at the apartment they resided at due to NMD's roommate and their partner and there was no action taken from the staff. Confidential interviews revealed that NMD would have to physically intervene in the roommate and their partner causing NMD to feel unsafe. Additional confidential interviews reported that NMD never reported any domestic disputes, but that NMD was questioned about their safety with their (NDM) own partner due to video surveillance staff reviewed. Confidential interviews stated S1 questioned NMD about their (NMD) own safety and NMD denied needing any support. On 07/01/2025, Community Care Licensing (CCL) received an allegation that staff entered a non-minor dependent's (NMD) apartment without permission. It was alleged that NMD's personal belongings were being searched through when NMD was not present. Confidential interviews reported that NMD would notice items that were moved around after returning home leaving the assumption someone went through NMD's items. Additional confidential interviews reported that S1 would do unannounced visits to NMD's apartment per facility policies to either drop items off for NMD and or NMD's roommate or conduct health and wellness checks on the apartment. Confidential interviews stated S1 denied conducting any searches of NMD's personal items. Additional confidential interviews reported that S1 would confiscate items that were not permitted under policy rules if said items were on open display. (Continued on LIC 9099C...) Based on inconsistent confidential interviews and collected documentation, the allegations that staff illegally evicted a non-minor dependent (NMD), staff did not prevent a non-minor dependent's (NMD) apartment from being unsanitary, staff did not provide a safe environment for a non-minor dependent (NMD), staff entered a non-minor dependent's (NMD) apartment without permission are unsubstantiated. The allegations may have happened or are valid, but there is not a preponderance of evidence to prove that the alleged violations occurred. An exit interview was conducted. A copy of this report and appeal rights were explained and given to Rita Hill, Intake Coordinator.

Investigation Findings:
13On December 12, 2025, at 10: PM, Licensing Program Analyst (LPA) Cynthia Robinson conducted an unannounced visit to Downs & Martin THP + FC, Transitional Housing Placement Program (THPP) to deliver the investigative findings for the allegations listed above and met with Rita Hill, Intake Coordinator. On 07/08/2025, LPA initiated the complaint at THP and obtained documents pertinent to the investigation. LPA interviewed Non-Minor Dependent (NMD), staff (S1, S2, and S3). LPA attempted to interview County Social Worker (CSW) but was unsuccessful after multiple attempts made. On 07/01/2025, Community Care Licensing (CCL) received an allegation that staff illegally evicted a non-minor dependent (NMD). It was alleged that NMD was not given proper written notice for their (NMD) removal from the program. Collected documentation revealed that NMD was sent an e-mail notice two weeks prior to the removal date. Confidential interviews revealed that NMD was told they (NMD) were exited from the program after an incident and no prior notice. (Continued on LIC 9099C..) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Cynthia Robinson LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: DOWNS & MARTIN THP+FCFACILITY NUMBER: VISIT DATE: 12/12/2025

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

met_with: Rita Hill, Intake Coordinator


summary: Facility Evaluation

raw_content:
Narrative:
On January 30, 2026, at 09:45am, Licensing Program Analyst (LPA) Cynthia Robinson, conducted an unannounced annual random inspection at the facility agency's administrative office located at Latham St. Suite #140, Riverside, CA 92502. LPAs met with Program Director Emmett Downs, Program Director and Intake Coordinator, Rita Hill, and were given a tour of the facility. There are currently 33 participants- Non-Minor Dependents (NMD) residing in the program, which include 17 remote sites and 1 home site throughout Riverside County and in San Bernardino County. Upon entrance into the facility, there is a spacious open area with a large table that is used for training and is equipped with a workstation with a large printer/scanner. There are three separate offices with locked doors. The conference room is equipped with a table, chairs, whiteboard, filing cabinets, and television. The facility has Wi-Fi accessibility. The restrooms are located inside the building. Office # Identified as the Administrator's office. Offices #2 and #3 adjacent are the Supervising Social Worker Offices. All offices are fully equipped with work desk units, telephones computers, and computer stations. LPA observed that Participant files were stored in a locked cabinet in Office #1. Currently, the facility is staffed with three full-time Case Managers, two Housing Specialists, one Intake Specialist, and one Program Director. Staff were informed that each Case Manager should maintain a 1 to 12 ratio, which should never be exceeded. Staff is aware of submitting unusual incident reports as needed to the Department and to include all Law Enforcement contacts. LPA reviewed five staff records. (Continued on LIC 809C...) All staff met the minimum qualifications and training requirements. A review of records shows that all staff have FBI, DOJ, and Child Abuse Index Check clearances. LPA reviewed five NMD dependent files. All files reviewed were complete and had the required documents apart from NMD (C1) missing the Transitional Independent Living Plan (TILP) and Needs and Services (NSP). Based on observations made during the inspection, a deficiency is being cited (see LIC D). An exit interview was conducted and a copy of this report LIC 809 and LIC 809D along with appeal rights were provided to Jesse Vega, Program Director.

met_with: Jesse Vega, Program Director


facility_name: EA FAMILY SERVICES-ANTIOCH THPP

summary: Facility Evaluation

raw_content:
Narrative:
On Monday 03/14/2022 at 11AM, Licensing Program Analyst (LPA) Mariah Hawkins conducted a prelicensing inspection at the Transitional Housing Placement Program (THPP) administrative office. The THPP is currently licensed and is moving the local administrative office to the new location at which this visit was conducted. LPA met with Transitional Housing Program Director Jenna Bethancourt for the scheduled visit. Safety precautions were taken including mask-wearing and hand hygiene. The office is located in an office building. The THPP will continue to serve up to 15 participants. There are currently no units listed under this location. Director confirmed that Director and Executive Director Melody King are aware that all units must be within a 2-hour drive from this office. The program plans to utilize remote sites and host-family sites. During inspection, LPA toured the office with Office Manager and Director. LPA observed the office to be quiet, clean, and in good and safe condition. The office has storage space, meeting spaces, and a confidential meeting space. The office will be open Monday to Friday, 8AM to 5PM, and the program has a 24hr on-call worker. The fire extinguisher is located inside and is up to date, and the first aid kit was centrally stored and observed to be complete. Participant records will be stored in a locked cabinet in the main back room of the office, and personnel records will all be accessible through a digital filing software (currently, Kidnet). Three medium-large kitchen knives were accessible in the staff kitchen in an unlocked drawer. Director confirmed that knives will be stored in a locked drawer in the Office Manager's desk as a safety precaution for participants visiting the office. Per Director, there are no weapons or firearms on the premises. An exit interview was conducted, and a copy of this report was left with Director Jenna Bethancourt. Provisional licensure anticipated for Wednesday 03/16/2022.


summary: Facility Evaluation

raw_content:
Narrative:
On 7/15/22, Licensing Program Analyst (LPA) Mariah Hawkins conducted a post-licensing inspection. LPA met with Office Manager Lisa Florence and informed of the purpose of the visit. The CARE Inspection Tool was used to conduct this inspection. No deficiencies were found during the inspection. The facility site (administrative office) is tidy and well-organized. Participant and personnel files were observed to be complete. There are no participants currently in the program, and consequently no units currently held by the program, so no unit inspection was conducted. The facility was observed to be in compliance and operating according to the license. An exit interview was conducted, and a copy of this report was left with Office Manager Lisa Florence, whose signature on this form confirms receipt.

met_with: Office Manager Lisa Florence


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) George Karkazis made an unannounced required Annual inspection to EA Family Services. LPA met with Antonette Geiser, Office Manager. The Transitional Housing Placement Plus Foster Care program (THP-FC) services non-minors dependents. Only Office Manager Antonette Geiser was on site, no participants present. At 11:15AM, LPA did a walk through inspection with Antonette Geiser. The office has sufficient space for confidential meetings, all participant files and staff files are located in a locked cabinet in the file room. The agency has their license posted in their office. The office is in compliance with Community Care Licensing (CCL) regulations. LPA spoke with Antonette Geiser, about the residential units. Antonette Geiser stated that all residential units have at least one toilet, sink and tub in working order. Antonette Geiser stated that all disinfectants and cleaning supplies are locked up and inaccessible. Antonette Geiser notified LPA that the program provides all participants with household essentials and that there are no weapons or firearms stored in the housing units. At 10:21AM, LPA reviewed five staff files with Antonette Geiser. Staff files are complete, all documentation is up to date and all staff training were up to date/current. Antonette Geiser stated that they have received two new participants at the beginning of March 2023. Not all participant documents are on site. Participants have not been in placement for over 30 days, LPA did not review participant files. All documents are complete and up to date. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted and a copy of the report was left with Antonette Geiser, Office Manager.

met_with: Antonette Geiser, Office Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 3/5/24 at 11AM, Licensing Program Analyst (LPA) Mariah Hawkins met with Transitional Housing Placement Program (THPP) Executive Director Melody King and Program Director Jenna Bethancourt for an informal office meeting held virtually over Microsoft Teams. LPA informed of the purpose of the meeting, which was to discuss the Department's request for revisions to the program's plan of operation (POO). The Department was recently made aware that a revised participant agreement has been used by the provider. Upon review of the POO and the participant agreement document approved by the Department, the licensee is advised to make the following revisions to their POO. 1) Submit all revisions, including the participant agreement, to the Department for review. 2) Indicate in the POO the minimum stipend/allowance and the method(s) used to determine how much a participant receives in greater detail. 3) Remove fines as a consequence. LPA advised that the licensee revise this section to reframe consequences in a positive reinforcement manner and discussed ways to accomplish this during the meeting. 4) Remove the pet fine. LPA advises that having a pet is a rule violation, but applicable regulatory and/or licensing requirements provide that participants' cash resources must be free of any liability the licensee incurs. 5) Remove the move-in kit charge. LPA advises that the THPP is required to supply basic furnishing as a basic service in order to maintain licensure, and applicable regulatory and/or licensing requirements disallow a licensee from making expenditures from participants' cash resources for basic services. LPA discussed applicable regulatory sections, including Title 22, Sections 86126(d), 86126(f), 86088(a),86001(b)(2), and Nonminor Dependent Interim Licensing Standards for THPP, Section 86226. An exit interview was conducted, and a copy of this report was provided to Executive Director and Program Director, whose agreed to sign and send back to LPA an emailed copy to confirm receipt.

met_with: Executive Director Melody King; Program Director Jenna Bethancourt


summary: Facility Evaluation

raw_content:
Narrative:
On 5/20/2024 at 9:50am, Licensing Program Analyst (LPA) Selena Hood and LPA Kristin Pierotti conducted an unannounced visit to the licensed facility. The purpose of this visit was to conduct the required annual inspection. LPAs met with Antonette Geiser, Office Manager. LPAs reviewed ten client files. During the file review, LPAs observed that the facility used one to two sentences to document what services the facility provided to clients. LPAs observed that the facility had documented services on the clients' bi-weekly case notes. LPAs advised that the facility should include more information on their Needs and Services Plans regarding services provided. LPAs delivered a Technical Assistance for Interim Licensing Standards 86268.3(c)(3) Needs and Services Plan. Based on record review and discussion, LPAs found that the facility had not done medical assessments for the clients within thirty days of admission. This poses a potential risk to the health, safety, and/or personal rights of clients in care. LPAs delivered a Type B citation for Title California Code of Regulations 86069(a) Participant Medical Assessments. LPAs reviewed three staff files. LPAs conducted one confidential interview. LPAs conducted a walk through of the facility. LPAs observed the posted license and observed that the office was clean, tidy, and in good repair. LPAs conducted an exit interview with Antonette Geiser, Office Manager at 1:10pm and delivered appeal rights.

met_with: Antonette Geiser


summary: Facility Evaluation

raw_content:
Narrative:
On 04/09/25 at 10:00am, Licensing Program Analyst (LPA) Kristin Pierotti and LPA Cole Oliver conducted an unannounced visit to the licensed facility. The purpose of this visit was to conduct the required annual inspection. LPAs met with Antonette Geiser, Office Administrator who assited with the inspection. LPAs reviewed ten client files. During the file review, all client files contained necessary documents and information. LPAs reviewed four staff files. During the file review, all staff had required documentation and training. LPAs conducted a walk through of the facility. LPAs observed the posted license and observed that the office was clean, tidy, and in good repair. LPAs conducted 1 confidential interview. An exit interview was conducted and a copy of this report was given to Antonette Geiser, Office Administrator.

met_with: Antonette Geiser, Office Admistrator


summary: Facility Evaluation

raw_content:
Narrative:
On 03/11/2026 at 9: AM, Licensing Program Analyst (LPA) Cole Oliver conducted an unannounced visit to the licensed facility. The purpose of the visit was to conduct the required annual inspection. LPA met with Antonette Geiser, Office Administrator, who assisted with the inspection. LPA reviewed sixteen (16) client files. During the file review, all client files contained the required documents and information. LPA reviewed five (5) staff online files with the assistance of the Office Administrator. During the file review, all staff files contained the required documentation and evidence of training. LPA conducted a walk through of the facility. LPA observed the posted license and noted that the office was clean, organized, and in good repair. LPA conducted one (1) confidential staff interview. An exit interview was conducted, and a copy of this report was provided to Antonette Geiser, Office Administrator, whose signature confirms receipt.

met_with: Antonette Geiser, Office Administrator


facility_name: EA FAMILY SERVICES-THPP

summary: Facility Evaluation

raw_content:
Narrative:
On 08/22/2024 at 09: AM, Licensing Program Analysts (LPAs) Misty Valencia and Tina Thorn met with Environmental Alternatives Family Services Social Worker Supervisor Jamie Cobabe to conduct a pre-licensing inspection. The facility is located in the same office complex as the EA Family Services Foster Family Agency (FFA) and Adoptions Program in Sacramento. There is a separate reception and entrance for the proposed adoption agency. The FFA, THP and Adoption agency will use the same entrances. The office is conveniently located for the public. The office has a reception area, 4 office spaces and a conference/training room, all of which can be used for confidential meetings. Agency has a communal staff bathroom and break room located outside the office in the hallway, which is available to staff and families. There are also multiple private room areas available for visiting LPA observed the rooms to have ample space for furniture and privacy for visitations with families. There is adequate parking available. Emergency Disaster Plan is posted in the reception area. License will be posted as soon as it is issued. All files and personnel records will be kept confidential and locked in the office and separated from visiting areas. As of right now all files are currently waiting in the old office to move into the new office space once license is provided and able to post in the building. The office space was observed to meet the requirements of Title Regulations at this time. The facility will be submitted for licensure. An exit interview was conducted with facility representative and a copy of the report was provided.

met_with: Jamie Cobabe, Social Work Supervisor


summary: Facility Evaluation

raw_content:
Narrative:
On Wednesday, November 13th, 2024, at 9AM, Licensing Program Analyst (LPA) Brittany Crass, made an unannounced visit to the facility with the purpose of conducting a follow up visit regarding an incident that was reported to the department on November 12th, 2024, involving the death of a client. LPA Crass met with the Assistant Executive Director/THP Director, Jenna Bethancourt. LPA Crass conducted four interviews. LPA Crass obtained copies of the client's complete file, including the most recent Needs and Services Plan, Medical Records, and Social Worker case notes. LPA Crass will obtain a copy of the coroners report and police report for the file at a later date; reports are not available at this time. An exit interview was conducted and a copy of this report was left with Jenna Bethancourt, THP Director.

met_with: Jenna Bethancourt


summary: Facility Evaluation

raw_content:
Narrative:
On Monday, November 18th, 2024, at 10AM, Licensing Program Analyst (LPA) Brittany Crass, made an unannounced visit to the facility with the purpose of conducting a subsequent, follow up visit regarding an incident that was reported to the department on November 12th, 2024, involving the death of a client. LPA Crass met with the Social Worker Supervisor, Jamie Cobabe. LPA Crass conducted one interview. A police report was not available at this time, but will be sent at a later date. An exit interview was conducted and a copy of this report was left with Jamie Cobabe.

met_with: Jamie Cobabe


summary: Facility Evaluation

raw_content:
Narrative:
On Thursday, November 21st, 2024 at 9: AM, Licensing Program Analyst (LPA) Brittany Crass, made an unannounced, subsequent visit for the purpose of closing out a Case Management, regarding an incident that was reported to the Department on November 12th, 2024, involving the death of a client. LPA Crass met with Brittany Johnson, Office Manager. LPA interviewed the THPP Director (S1), the client's prior Case Manager (S2), the prior Lead Care Manager for CalAim (S3), the client's current Case Manager (S4), the Facility Social Worker Supervisor (S5), the client's girlfriend (W1), and the client's County Social Worker's Supervisor (CSWS) between November 13th, 2024 to November 18th, 2024 and retrieved a copy of the client's complete file. LPA Crass will obtain a copy of the coroner's report and police report for the file at a later date, as reports are not available at this time. No deficiencies were cited. This case management is closed. No follow up is needed. An exit interview was conducted, and a copy of this report was left with Office Manager, Brittany Johnson

met_with: Brittany Johnson


summary: Facility Evaluation

raw_content:
Narrative:
On Thursday, July 31st, 2025, Licensing Program Analyst (LPA) Brittany Crass arrived Unannounced for the purpose of an Annual inspection. LPA met with Office Manager, Kelly Golla who assisted with the inspection. Office Manager Supervisor, Kitty Cannon arrived later to assist. LPA conducted a physical walk through of the facility. LPA observed that the office has a reception area, 3 office suites and a conference/training room, all of which can be used for confidential meetings. Agency has a communal staff bathroom and a break room located outside the office in the hallway, which is available to staff and families. There are also multiple private room areas available for visiting. LPA observed the rooms to have ample space for furniture and privacy for visitations with families. Emergency Disaster Plan and License are posted in the reception area. All areas of the building were clean, in good repair, and had no obstructions in the walkways. All files and personnel records are kept confidential and locked in the office and separated from visiting areas. LPA reviewed five staff files and five client files. LPA found that 6 staff who work at this THPP license are not associated to the license. However, all are DOJ/FBI/CACI cleared and associated to the agency's Sacramento FFA license. LPA found that all other staff requirements were met. For client files LPA found all requirements were met. The agency is being cited one Type A citation for a violation of the California Code of Regulations, Title 22, Section 86019(e)(2) CRIMINAL RECORD CLEARANCE on the attached LIC 809-D page. An exit interview was conducted with Kitty Cannon. A copy of this report, and appeal rights were given.

announced_status: Unannounced

met_with: Kitty


summary: Facility Evaluation

raw_content:
Narrative:
On March 11, 2026, at 10: AM, Licensing Program Analyst (LPA) Michelle Silvas arrived unannounced to the facility for the purpose of a Case Management (CM) incident Inspection and met with Jamie Cobab, Social Worker Supervisor. LPA conducted a file review and two staff interview. Records reviewed indicated the Agency case manager was making regular contact with the participant, provided supportive services and a current Needs and Services Plan was on file. LPA will continue to follow up with the facility as more information becomes available. no citations issued at this time. An exit interview was conducted and a copy of this report was provided to the facility.

met_with: Jamie Cobab, Social Worker Supervisor


facility_name: EA FAMILY SERVICES - EUREKA THPP/THP+FC

raw_content:
Narrative:
Interviews and records reviewed of the allegation, Staff misusing client(s) funds, were inconsistent that there were no discrepancies regarding any funds. Statements from interviews did not match the ledger of deposits and expenses from the clients' account. The ledger indicated that the client owes the agency $532.21 but the client reimbursed the agency back $332.78. However, the amount the client still owes is shown to be $330.56 which did not add up to what the client actually owed. A rental agreement of all lease terms was signed by the client and policies were verbally explained upon placement into the program. The client also signed acknowledgement of what funds would be removed when exiting the program. It was alleged that staff were retaliating against a client by discharging them from the program. Three agency staff and two County Social Workers reported that the client was discharged due to the client being out of compliance. However, during the investigation, the client was readmitted into the program. Based on LPA's interviews which were conducted, and records reviewed, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. A signed copy of this LIC-9099 report, the LIC-9099C, and appeal rights were provided to the facility. An exit interview was conducted.

Investigation Findings:
13Licensing Program Analyst (LPA) Lyta Vue arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Giselle Olguin, Agency Social Worker (ASW). LPA Vue conducted the complaint investigation. LPA initiated the investigation with the facility on 08/20/25 and met with Giselle Olguin, Agency Social Worker (ASW) and conducted an interview and a Health and Safety Inspection. During the course of the investigation, LPA interviewed the Reporting Party, one former client, two (2) Agency Case Managers, one (1) Agency Social Worker Supervisor, and two (2) County Social Workers. LPA reviewed records including Staff Personnel Report (LIC500), Register of Clients and Discharge Records. LPA also reviewed Needs and Service Plans for four (4) clients, Agency Social Worker Case notes, Serious Incident Reports, prior complaint history, Participant Agreement, Rental Agreement, Behavioral Contract, Participant Balance, Placement Agreement and other client documents. Report continued on 9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Lyta Vue 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: EA FAMILY SERVICES - EUREKA THPP/THP+FCFACILITY NUMBER: VISIT DATE: 10/14/2025


summary: Facility Evaluation

raw_content:
Narrative:
On 8/28/2023 and 8/29/ Licensing Program Analyst (LPA) Kellie McKinley met with Social worker Leslie Naseath - social worker and Jeanne Harvey Senior social worker supervisor via Facetime. LPA McKinley toured the new facility and found it open and organized with the fire extinguisher recently inspected. LPA suggested EA obtain additional fire extinguishers as there is only one in the building currently. The LIC 610 was posted along with the emergency exit route floor plans in various locations in the building. The office First Aid kit was supplied with a thermometer, tweezers, scissors, gauze bandages and antiseptic wipes. The smoke and carbon monoxide detectors are in functioning order and all pathways were free and clear. All staff have required initial training's. The offices have sound machines just outside the SW offices for privacy. Each office had a adjustable sign to let others know if they are in a meeting or session with a client. The office building is a free standing among other office building surround it. There is a pathway most of the way around the building with clean landscaping and a ramp to enter the office for persons who are not ambulatory. Although the front office entry way is small the building offers much more space for social workers and client visit rooms. There is a copy room, large storage room with a code entrance, a kitchen, several offices, a conference room, and a large open space with couches. There are two glass slider exit route in case of emergency. The building has heating and air. The facility has two public restrooms for families and children and one employee only bathroom as well. Leslie and Jeanne were asked about cleaning the building prior to them moving in and what they have as a regular service. Jeanne stated they have a regular cleaning services and would have the building thoroughly cleaned prior to moving in the remainder of office furnishings and belonging from the G street location. No deficiencies were noted. No citations given.

met_with: Leslie Naseath- social worker


summary: Facility Evaluation

raw_content:
Narrative:
On 03/11/25, Licensing Program Analyst (LPA) Lyta Vue arrived unannounced at the facility and met with Agency Social Worker (ASW) Giselle Olguin. The purpose of the visit was to conduct a Required Bi-Annual Inspection of the facility. The last Annual inspection for the facility was on 04/11/23. LPA utilized the CARE Tool to complete the Annual Inspection. LPA conducted an inspection of the physical plant and checked for all necessary requirements. The facility was clean and organized and maintained an acceptable room temperature. The facility has seven (7) offices for Social Workers, Case Workers, and one (1) confidential interview/visitation room. LPA observed the proper postings including facility license, complaint hotline, and emergency disaster plan. The restrooms for clients and staff were clean. Smoke alarms were in working order, fire extinguishers were current and will expire 03/19/25, and a first aid kit was fully stocked. Evacuation drills for the facility were completed quarterly. LPA observed client files stored in the Office Manager's office in a locked filing cabinet and stored electronically with a password protection and username. The facility has no outstanding fees. The facility has sixteen (16) Non-Minor Dependent clients. Clients live in remote site apartments. No client resides more than two hours from the facility. The facility employs three (3) Case Managers. LPA reviewed three (3) Case Worker personnel files. Case work personnel had completed criminal record clearances and met minimum education and experience qualifications. All First Aid and CPR certifications were up to date for Case Worker personnel. Report continued on 809c LPA interviewed three (3) Case Worker personnel. Case work personnel indicated they did not have more than 12 clients on their caseload. LPA reviewed six (6) client files. All clients had signed Admission Agreements. Client files had current Needs and Service Plans, signed by the client, and placing agency. Needs and Services Plan detailed adequate supportive services the facility offers to the clients. Facility has no minor clients. A signed copy of this LIC-809 and LIC-809C report was provided to Agency Social Worker (ASW) Giselle Olguin. An exit interview was conducted. Appeal rights were provided


facility_name: EA FAMILY SERVICES - YUBA CITY THPP/THP+FC

raw_content:
Narrative:
Continuation from Based on the evidence gained, and statements in interviews the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations are being cited on the attached LIC9099D.

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

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

met_with: Administrator- Melody King


summary: Facility Evaluation

raw_content:
Narrative:
On 01/9/2024, Licensing Program Analyst (LPA) Wendy Brown arrived unannounced at the facility and met with Janelle Douglas, Social Worker. The purpose of the visit was to conduct a Required Biennial Inspection of the facility. The last inspection that occurred was the Pre-licensing Inspection of 12/10/2020. LPA utilized the CARE Tool to complete the inspection. LPA conducted an inspection of the physical plant and checked for all necessary requirements. The facility was clean and organized and maintained an acceptable room temperature. The facility has two offices for social workers and two interview/visitation rooms. LPA observed the proper postings including: facility license, complaint hotline, accreditation, and emergency disaster plan. The restroom for Clients and staff was clean. Smoke alarms were in working order, fire extinguishers were current, and a first aid kit was fully stocked. Evacuation drills for the facility were completed quarterly and exit maps posted. LPA observed client files were stored in a locked file cabinet. The facility has no outstanding fees. The facility has THP participants. Clients live in either approved homes or remote site apartments. No client resides more than two hours from the facility. The facility currently employs one Social Worker and two Case Managers in the program. LPA reviewed one Social Worker, two Case Manager, one Office Manager, and one Administrator personnel files. Personnel had completed criminal record clearances and met minimum education and experience qualifications. All First Aid and CPR certifications were up to date. LPA interviewed one Social Worker personnel and one Case Manager. The second Case Manager was not available. Social work personnel indicated they did not have more than 12 clients on their caseload. LPA addressed Case Manager response to child abuse and neglect reporting; see LIC812 on file. Continue on Lic-809c LPA reviewed five client files. All Clients had signed Admission Agreements. Four of five Client files did not have current Needs and Service Plans and a Plan of Correction was drafted and signed. No citations were given on this date. A signed copy of this LIC-809, LIC-809C, and LIC 809D, reports were provided to Janelle Douglas, Social Worker. An exit interview was conducted.

met_with: Janelle Douglas, Social Worker


summary: Facility Evaluation

raw_content:
Narrative:
Due to technical issues, Licensing Program Analyst (LPA) Wendy Brown was previously unable to complete and print appropriate documentation to conclude the biennial inspection of the facility. LPA returned on this date and spoke with Janelle Douglas, Social Worker to conduct the exit interview, obtain necessary signatures, and provide the LIC809 (2), LIC809-C, LIC809-D, Advisory Note (TV), and Advisory Note (TA) documents.


summary: Facility Evaluation

raw_content:
Narrative:
On 08/4/2025, Licensing Program Analysts (LPA) Yesenia Vallejo met with EA Family Services Breanna Cosgrove-Ramsaur Office Manager (OM) to conduct a pre-licensing inspection. The facility is located in the same office complex as the Adoptions and Foster Family Agency in Yuba City. The office is conveniently located for the public. Upon entering the building you find a lobby area, where you find the OM behind a glass partition. There is a locked door in the lobby to which OM will need to unlock to grant access to the office area. To the left of the office entry door there is one bathroom for staff and clients, a storage closet and tech room. To the right of the entry if OM desk, and a hallway that leads you to six staff offices, one Calaim office, two visitation rooms, one break room, and staff kitchen. LPA observed the rooms to have ample space for furniture and privacy for visitations with families. All client files will be kept confidential and locked in the office and separated from visiting areas. Personnel records are kept in the administrative office located a in Quincy Ca. As of right now all files are currently waiting in the old office to move into the new office space once license is provided and able to post in the building. The office space was observed to meet the requirements of Title Regulations at this time. The facility will be submitted for licensure. An exit interview was conducted with Oficce manager and a copy of the report was provided.


facility_name: EA FAMILY SSERVICES-EUREKA THPP/THP+FC

raw_content:
Narrative:
Continued from There was no verification that a client who correctly completed the process to get an Emotional Support pet authorized by a clinician or physician, was actually denied having the pet. Therefore, a Technical Violation was given to the facility to ensure future compliance with applicable state laws. Based on interviews, observation, and record review, there was not a preponderance of evidence to prove the allegation occurred, therefore the allegation is UNSUBSTANTIATED. A signed copy of this LIC-9099 and LIC-9099C report was provided to the Case Manager and emailed to Program Director. An Exit interview was complete.

Investigation Findings:
13Licensing Program Analyst (LPA) Hillary Hall arrived unannounced at the facility for the purpose of opening the 10-day complaint investigation and delivering findings. LPA met with Zyla Oru, Case Manager, to discuss the allegation. LPA interviewed two case managers at the facility. During the course of the investigation, LPA interviewed two county social workers, one clinician, and one client. LPA reviewed relevant records on site and requested copies of records be sent to LPA including: Roster of clients with contact numbers, rental agreement, participant agreement, and agency social worker case notes for five clients for previous three months. The individuals interviewed indicated the facility does not allow clients to have emotional support pets. This was also documented in their participation agreement. This requirement by the facility violates California fair housing law for persons with disabilities. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Daniel Allmon LICENSING EVALUATOR NAME: Hillary Hall 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 25-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, COHASSET RD., STE. FACILITY NAME: EA FAMILY SSERVICES-EUREKA THPP/THP+FCFACILITY NUMBER: VISIT DATE: 10/04/2022

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

met_with: Zyla Oru, Case Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 4/11/2023 at 9: AM LPA Kellie McKinley met with Rayna Harkness for a annual inspections for the THP license for EA Family Services THP program.. Rayna is filling in for supervisor who is currently out. LPA McKinley toured the facility and found clean and organized with Fire extinguisher current for inspection which will be coming up in June 2023. The office First Aid kit was supplied with bandages, tweezers and small scissors. A separate scanning thermometer is in the office for use when needed. The smoke and carbon monoxide detectors are in functioning order and all pathways were free and clear. All staff have required initial training's, with the exception of a new employee who is in the process of completing all required training and documents for the staff file. THP Client files are stored in a locking file cabinet behind a locked office door. LPA reviewed 10 client files which were organized in order of the table of contents at the front of the folder. One client was missing a Needs and Services plan. On two additional client's Needs and Services plans, required signatures were missing A technical violation is noted for ILS regulation 8268.3 (d). (d) The Needs and Services Plan shall be signed by the nonminor dependent, the THPP administrator or social work personnel, and the person or agency responsible for placing the nonminor dependent, such as a social worker or probation officer, and maintained in the records for the nonminor dependent as specified in Section 86270, Nonminor Dependents' Records. No citation were given at the time of the annual inspection. A copy of this form was sent to the THP program at the time of the inspection completion. An exit interview was conducted.

met_with: Rayna Harkness- Substitute administrator


facility_name: ENVIRONMENTAL ALTERNATIVES DBA EA FAMILY SERVICES

summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst Lisa Slusher travelled to the Environmental Alternaves DBA EA Family Services office in Fresno CA. LPA was met by Administrators Rehmana Arif and Deally Curran. Also present were Jenna Bethancourt, Kathleen Hernandez, Lisa Florence and Kylie Martinez., for the purpose of a scheduled pre-licensing inspection for an THP+FC. Agency has an Assigned Administrator/Social Work Supervisor and two social workers, with more to be hired and assigned. A general overview of their program and a tour of the facility was provided. This facility has a reception area, waiting area, and office space for staff. Observed fixtures and furniture, equipment and supplies necessary for this operation. Also observed locked cabinets for client and staff files in order to ensure confidentiality. Discussed daily ongoing functions including incident reports. There is ample confidential space for meeting with clients on an as needed basis. Incident reports to be emailed to CCLFresnoIncidents@dss.ca.gov. This LPA's email address is Lisa.Slusher@dss.ca.gov. LPA received updated LIC 200 for facility name update during inspection. Agency will ensure that all appropriate personnel are associated to the facility license through Guardian. The above licensee meets the requirements to be licensed as in Fresno County serving participants within a two hour driving radius.


summary: Facility Evaluation

raw_content:
Narrative:
On this date 10/20/ Licensing Program Analyst (LPA) Lisa Slusher travelled to the facility to conduct a post-licensing inspection. Prior to this inspection a pre-inspection Covid screening was conducted. Met with Office Manager Kathleen Hernandez and Social Worker Supervisor/Administrator Deally Curan. The agency was licensed at this location on 10/12/21. A physical plant inspection was completed and included the following checks: client and staff files are kept in locked filing cabinets, and are printouts from an electronic filing system. Facility has adequate confidential meeting space and space for Social Workers to complete job duties. A review of their staff files on this date indicate that all facility staff have received child abuse index clearances and fingerprint clearances. Agency staff meet requirements of respective job descriptions. Agency Employs one Administrator, One Social Worker Supervisor, two Social Workers, two Case Managers and one office manager. Both the Administrator and Social Worker Supervisor as well as one of the case managers are shared with another licensed office. Employee and THPP Participant files reviewed. An exit interview was conducted with the Social Worker Supervisor as well as a copy of this report was given on this date. A Citation for CCR Title 22 section 86010(a) is issued on this date.

met_with: Deally Curan


summary: Facility Evaluation

raw_content:
Narrative:
On this date, a case management inspection is conducted by Licensing Program Analyst (LPA) Lisa Slusher. The agency has recently changed the Administrator for this facility. An advisory note is left on this date with the information required for a change of Administrator. The agency is to submit documents for a change of administrator by 4/28/23. In addition, LPA discussed Case Manager requirements as noted in PIN 18-02 on this date. No deficiencies are noted on this date.

met_with: Kylie Martinez


summary: Facility Evaluation

raw_content:
Narrative:
On this date, LPA (Licensing Program Analyst) Lisa Slusher conducted a case management inspection to follow up on an incident which occurred on 6/5/23 and involved a fire at a Participant's unit (See LIC 811 dated 6/22/23). LPA followed up with case manager and requested an email with digital photos of the damage as well as additional follow up conducted with the youth, including information on ensuring youth has moved into a new unit, has adequate belongings and any additional services provided or offered to the youth. File Review Conducted on this date. There are no deficiencies to be cited on this date.

met_with: Kylie Martinez, Yasmin Hernandez


summary: Facility Evaluation

raw_content:
Narrative:
On this date a case management inspection is conducted by LPA (Licensing Program Analyst). Met with Kayla Alvarez. Spoke with Office Manager Kathleen Hernandez regarding current operations including lease/rent issues. Also discussing incident reporting and timing. No deficiencies issued at this time.

met_with: Kayla Alvarez


summary: Facility Evaluation

raw_content:
Narrative:
On this date 10/20/ Licensing Program Analyst (LPA) Lisa Slusher travelled to the facility to conduct an unannounced annual inspection . Met with Office Manager Kathleen Hernandez. The agency was licensed at this location on 10/12/21. A physical plant inspection was completed and included the following checks: client and staff files are kept in locked filing cabinets, and are printouts from an electronic filing system. Facility has adequate confidential meeting space and space for Social Workers to complete job duties. A review of their staff files on this date indicate that all facility staff have received child abuse index clearances and fingerprint clearances. Agency staff meet requirements of respective job descriptions. Agency Employs one Administrator, One Social Worker Supervisor, two Social Workers, two Case Managers and one office manager. Administrator/Social Worker Kylie Martinez is on site two days per week and is responsible for both the THP+FC Programs and FFA program. Admin/SWS is also responsible for another office. This is addressed in a Technical Advisory on this date. Employee and THPP Participant files reviewed An exit interview was conducted with the office manager as well as a copy of this report was given to the agency on this date. Personnel Interviews are to be conducted. Only one staff member present on this date.

met_with: Kathleen Hernandez


summary: Facility Evaluation

raw_content:
Narrative:
On this date 2/23/22 at 9: Licensing Program Analyst (LPA) Lisa Slusher travelled to the facility to conduct a post-licensing inspection. Prior to this inspection a pre-inspection Covid screening was conducted. Met with Office Manager Kathleen HernandezThe agency was licensed at this location on 10/12/21. A physical plant inspection was completed and included the following checks: client and staff files are kept in locked filing cabinets, and are printouts from an electronic filing system. Facility has adequate confidential meeting space and space for Social Workers to complete job duties. A review of their staff files on this date indicate that all facility staff have received child abuse index clearances and fingerprint clearances. Agency staff meet requirements of respective job descriptions. Agency Employs one Administrator, One Social Worker Supervisor, one Social Worker and one Case Manager and one office manager. Both the Administrator and Social Worker Supervisor are shared with another licensed office. Employee and THPP Participant files reviewed. THPP Participant files were transferred from the Licensee's Tracy office. An exit interview was conducted with the Office Manager as well as a copy of this report was given on this date. A Citation for CCR Title 22 section 86068.3(a) is issued on this date. Additionally, Technical violations were discussed on this date.


facility_name: EA FRESNO THPP/THP+FC

raw_content:
Investigation Findings:
13Complaint Specialist C.K. Kinney(CS) traveled to EA Fresno THPP/THP+FC offices and met with Leticia Serrano to deliver findings of investigation. CS conducted investigation that included review of documentation and confidential interviews. Due to inconsistencies in the information obtained a preponderance of the evidence could not be obtained. Although the allegation may or may not have occurred or may or may not be valid without a preponderance of the evidence the allegation is deemed Unsubstantiated. No deficiencies observed or cited during this investigation. Copy of this report, LIC Confidential Names and LIC Appeal Rights left at the Facility at conclusion of inspection UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Charles Kinney LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Leticia Serrano