summary: Facility Evaluation

raw_content:
Narrative:
On June 20, 2025, at 09: AM, Licensing Program Analyst (LPA) Raina Perez-Diaz conducted an unannounced Required Annual Inspection and met with Angie Custodio, Facility Manager. Five clients were present during the inspection. LPA began a physical plant inspection at 09: AM and included the following checks: Facility grounds are clean and free of debris and observable hazards. There is adequate indoor and outdoor activity space. Sports equipment, pool table, basketball court, swimming pool and games were observed for client's recreation time. All facility smoke detectors and carbon monoxide detectors are in appropriate working order; fire extinguisher is properly charged and serviced. Licensee maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. All required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster. Medications are locked and centrally stored in staff office. Chemicals/poisons and sharp objects are locked and stored in the staff office and staff restroom. First Aid Kits are also stored in the staff office and are complete. Licensee has provisions for contraceptives to be held individually by clients. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. The hot water in the client's bathroom was deemed safe and measured at 106.3 degrees Fahrenheit. During LPA's visit multiple outlets were observed being worked on by an electrical crew to restore electricity access to the back portion of the home; Therefore, a Technical Violation was given with the expectation the electricity will be restored within 14 days. Currently, the clients are being provided electricity via generator and each have a lantern to utilize at night. **Continued on LIC- 809-C** Facility has a pool which is appropriately fenced and secured with a wrought iron fence. The enclosure was measured to be over five feet tall, with a self-latching gate that swings outward. Additionally, there is one small shed holding holiday decorations and client's overflow items and one larger shed with maintenance equipment designated for the maintenance supervisor. Per Facility Manager, no firearms or weapons are allowed in the facility. Administrator, Patrick Williams is present at the facility a minimum of 20 hours a week, as verified by staff schedule. Review of the Administrative certificate revealed it had expired on January 18, 2025. Administrator reported he was missing the completion of one course. A copy of the completion certification for the course with the date of June 6, 2025, was received along with a copy of an email sending the course completion certification to the Policy, Training, and Quality Improvement Branch dated June 20, 2025. The facility does not currently have a certified administrator, therefore, the facility is being cited for violation of Short-Term Residential Treatment Program (STRTP) Interim Licensing Standards (ILS) ADMINISTRATOR QUALIFICATIONS AND DUTIES 87064(b) All STRTP's shall have a qualified and currently certified administrator. Appropriate staff/client ratios were verified during this inspection. The facility employs six facility managers, ten direct care staff, and a therapist. Licensee has obtained National Accreditation, the Accreditation is valid through July 2028. Annual Fees are current. Licensee has mental health approval from July 25, 2024, until July 25, 2025. Licensee keeps a manual restraint binder with the Pro-Act guidelines, along with a log of the date and summary of intervention usage; however, the log did not include client's name, date and time of the intervention, duration of the intervention, names of staff members, and results of licensee review. Licensee did have a binder and log; therefore, a technical violation was issued for licensee to update the log with all requirements which was updated and shown to LPA during the inspection. LPA Perez-Diaz reviewed files for five clients in care [Client #1 - Client #5 (C1-C5)]. All clients' files were found to have Cash/Property/Valuables records, Medical Consent forms and signed needs and services plans. LPA interviewed two staffs and two clients while at the facility. **Continued on LIC- 809-C** Based on the facility inspection and file reviews on this date, one Type B violation was issued to the facility. Due to time constraints LPA will return to the facility to complete the inspection at a later date. An exit interview was conducted, and a copy of this report, the LIC 811, LIC 809-D, and appeal rights was provided to Facility Administrator Patrick Willams.

met_with: Facility Manager- Angie Custodio & Administrator Patrick Williams


state: CA

facility_name: ETTIE LEE HOME-FONTANA HOME

summary: Facility Evaluation

raw_content:
Narrative:
On July 1, 2025, at 09: AM Licensing Program Analyst (LPA) Raina Perez-Diaz arrived to the facility to conduct an unannounced continuation annual inspection and met with Angie Custodio, Facility Manager and Patrick Williams Facility Administrator. A health and safety inspection of the facility was conducted and the use of extension cords were still being utilized to supply the back portion of the home with electricity; however, outlets were no longer exposed and an electrical metallic tube system was being installed. A Technical Violation was given on June 20, 2025, which gave a deadline to restore electricity within 14 days; therefore, a new Technical Violation was given with the expectation the electricity will be restore by Friday July 4, 2025; if not LPA will return to issue a citation. During time of inspection LPA reviewed five staff records (S1-S5) and a deficiency was observed. S3's emergency Intervention training certification was not current and had expired on May 10, 2025; therefore, the licensee is being cited for a violation of Interim Licensing Standards (ILS) EMERGENCY INTERVENTION STAFF TRAINING 87095.65(e) Staff must receive on-going training to maintain certification. Based on the facility inspection and file reviews on this date, one Type B violation was issued to the facility. An exit interview was conducted and a copy of this report was reviewed and given to Facility Administrator Patrick Williams, along with the confidential names list (LIC 811), LIC 9102, LIC 809-D and appeal rights.

report_type: Facility Evaluation

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On December 28, 2021, Licensing Program Analyst (LPA) LPA Sarah Smith arrived at the facility and met with Patrick Williams, Facility Administrator regarding an issue that arose when obtaining information regarding an incident involving client 7 (C7) and Facility Administrator (FA). LPA Smith was informed that on December 02, 2020, C7 became aggressive and upset with FA. It was disclosed that FA was forced to place C7 in a one-person floor restraint due to C7 becoming physically aggressive with FA. FA was informed that a one-person restraint is an improper restraint. FA stated that he had restraint training through Pro-Act. LPA reviewed the Ettie Lee Youth and Family Services approved Plan of Operation, which revealed the facility will maintain accordance with ProAct as its Emergency Intervention training curriculum. During this incident, FA did not follow PRO Act principles. Based on information obtained, Facility is cited for a violation of California Code of Regulations, Title 22, Division Six, regulation 80022(k): Plan of Operation. Based on interviews and record review the facility failed to follow the approved Plan of Operation when FA failed to follow the PRO ACT principles on 12/02/2020. A copy of this report, and the appeal rights were discussed, printed and given to facility representative.


summary: Facility Evaluation

raw_content:
Narrative:
On February 2, 2026, at 11:35 am, Licensing Program Analyst (LPA) Raina Perez-Diaz, arrived unannounced to Ettie Lee Home- Fontana Home Short Term Residential Treatment Program (STRTP) and met with Norma Valderrama, Facility Manager, for the purpose of conducting an interview related to a case management not at this facility.

met_with: Facility Manager- Norma Valderrama


summary: Facility Evaluation

raw_content:
Narrative:
On February 5, 2026, at 10: AM, Licensing Program Analyst (LPA) Raina Perez-Diaz, arrived unannounced to Ettie Lee Fontana Home, a Short-Term Residential Treatment Program (STRTP) and met with Administrator, Patrick Williams, to conduct a case management other inspection. Community Care Licensing (CCL) received information regarding an incident occurring on January 25, 2026, with concerns of client behavior and supervision level. LPA gathered additional information and obtained facility records to further review the case management. A copy of the LIC 809 and LIC 811 was provided to Administrator, Patrick Williams.

met_with: Administrator- Patrick William


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Community Care Licensing received information on January 20, 2026, alleging that lack of supervision resulted in minor in care being inappropriately touched. Information obtained in confidential interviews did not corroborate the allegation with a preponderance of evidence. Confidential interviews provided conflicting statements regarding the allegation. Confidential interviews denied allegation that S1, or any other group home staff had ever inappropriately touched or sexually abused C1 during the time that they had resided at this facility. Other confidential information received by Licensing Office stated that this allegation had occurred. There were no other known witnesses to this allegation. Based on interviews and confidential information obtained during the course of this investigation, the allegation that lack of supervision resulted in minor in care being inappropriately touched, may have occurred, however is not supported or proven by evidence. Therefore, the above allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Short Term Residential Therapeutic Program (STRTP) Administrator, Patrick Williams to discuss the investigative findings for the above stated allegation. LPA Mena conducted an inspection to the STRTP on January 28, 2026, and on March 12, 2026. No immediate hazards were observed. LPA Mena interviewed three of five foster children [Child # 2 (C2), Child # 3 (C3) & Child # 5(C5)], County Social Worker Supervisor (CSWS), Seven Staff Members [Staff # 1 (S1), Staff # 2 (S2), Staff # 3 (S3), Staff # 4 (S4), Staff # 5 (S5), Staff # 6 (S6) & Staff # 7 (S7)], as well as reviewed facility and client information. LPA Mena was unable to interview C4 due to their current whereabouts being unknown and C1 due to their refusal to speak to LPA Mena about the complaint allegation. Continues on next page UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Nicole Strickland LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: ETTIE LEE HOME-FONTANA HOMEFACILITY NUMBER: VISIT DATE: 04/09/2026

report_type: Complaint Investigation

met_with: Patrick Williams

complaint_status: unsubstantiated


facility_name: ETTIE LEE HOMES-DIAMOND L. RANCH

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
On August 22, 2022, Community Care Licensing received a complaint alleging that the facility does not meet minors' dietary needs. More specifically, staff lock the pantry and do not provide bread or fruit to C1 after 8: PM. LPA obtained conflicting statements throughout the investigation. Confidential interviews revealed that the staff prepares three meals per day and snacks between each meal. Confidential interviews revealed that the pantry closes at 8: PM and the bread is locked, however, the clients are provided a couple of options; they can have the left-over food from that day or they can make a sandwich and the staff will provide the clients with the ingredients. Other confidential interviews revealed that the left-over food cooked by staff was left out and exposed to flies therefore some clients refused to eat the food. Confidential interviews revealed that the clients have complained about only having sandwiches for a late-night snack and that C1 wants special food and if C1 did not get what C1 wanted C1 ended up breaking into the pantry at the facility. Based on confidential interviews, the allegation that the facility is not meeting minors' dietary needs, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report along with the appeal rights was provided to Facility Manager, Sydney Casillas On August 22, 2022, Community Care Licensing received a complaint alleging that staff speaks inappropriately to minors. Confidential interviews stated that no staff member at the STRTP has made any threats of killing a client. Confidential interviews did, however, admit that there was an incident that occurred involving S4 and Client 4 (C4). Confidential interviews further stated that S4 called "C White trash" and words were exchange between the staff member and C4. Confidential interviews also stated that the STRTP has a zero tolerance for such behaviors and have acted on those staff members behaviors. Other confidential interviews reported not witnessing staff members being inappropriate to clients. During record review LPA Urena found that the incident involving C4, and a S4 was documented by the STRTP. The documents that were collected are dated July 25, 2022, and July 26, 2022. All documents indicate that S4 did engage and exhibited inappropriate behaviors which resulted in S4 calling C4 "White trash". Based on confidential interviews and file reviews, the preponderance of evidence standard has been met, and the allegation that S4 speaks inappropriately to C4 is supported and proven by evidence. The facility is cited for violation of Short-Term Residential Treatment Facility (STRTP) Interim Licensing Standards Section 87072(c)(10) PERSONAL RIGHTS. Exit interview was conducted and a copy of this report along with the appeal rights was provided to Facility Manager, Sydney Casillas

Investigation Findings:
13On November 10, 2022, at 12: PM, Licensing Program Analyst (LPA) Cynthia Urena met with Ettie Lee Diamond L. Ranch Short Term Residential Therapeutic Program (STRTP) Facility Manager Sydney, Casillas to deliver the investigative finding for the above stated allegation. On August 29, 2022, at 8: A.M., Licensing Program Analyst (LPA) Cynthia Urena initiated the investigation at the STRTP. LPA Urena conducted a Health and Safety inspection, and no immediate deficiencies were observed. Additionally, LPA Urena interviewed three staff (S1 - S3) and 3 clients (C1-C3). At 11: A.M., LPA Urena conducted a collateral interview, and on November 9, 2022, LPA Urena interviewed a County Social Worker (CSW). LPA Urena attempted to conduct three additional interviews however Client 4 (C4) refused an interview, Client 6 (C6) could not be located for an interview, and Staff 4(S4) was terminated from employment, and could not be reached for an interview. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Cynthia Urena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE This is an official report of an unannounced visit/investigation of a complaint received in our office on 08/22/2022 and conducted by Evaluator Cynthia Urena COMPLAINT CONTROL NUMBER: 19-CR- FACILITY NAME:ETTIE LEE HOMES-DIAMOND L. RANCHFACILITY NUMBER: ADMINISTRATOR:DOWNEY, CLAYTONFACILITY TYPE: ADDRESS: SPRUCETELEPHONE: (909) 877- CITY:BLOOMINGTONSTATE: CAZIP CODE: CAPACITY:9CENSUS: 8DATE: 11/10/ UNANNOUNCEDTIME BEGAN: 12: PM MET WITH:Facility Manager, Sydney CasillasTIME COMPLETED:01: PM 9Facility does not meet minors' dietary needs INVESTIGATION FINDINGS: 13On November 10, 2022, at 12: PM, Licensing Program Analyst (LPA) Cynthia Urena met with Ettie Lee L. Diamond Ranch Short Term Residential Therapeutic Program (STRTP) Facility Manager, Sydney Casillas, to deliver the investigative finding for the above-stated allegation. On August 29, 2022, at 8: AM, Licensing Program Analyst (LPA) Cynthia Urena initiated the investigation at the STRTP. LPA Urena conducted a Health and Safety inspection, and no immediate deficiencies were observed. Additionally, LPA Urena interviewed three staff (S1 - S3) and 3 clients (C1-C3). LPA Urena attempted to conduct two additional interviews however C4 refused an interview, and C6 could not be located for an interview. At 11: AM, LPA Urena conducted a collateral interview, and on November 9, 2022, LPA Urena interviewed a County Social Worker (CSW). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Cynthia Urena 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: 3 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 PACIFIC INLAND CR, MAIN ST., Suite Riverside, CA Facility Name: Ettie Lee Homes-diamond L. RANCHFACILITY NUMBER: VISIT DATE: 11/10/2022

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: Facility Manager, Sydney Casillas


raw_content:
Narrative:
Based on inconsistent confidential interviews, the allegation that S4 threatened C1 while in care may have occurred, however, is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with appeal rights to given to Ettie Lee Homes Diamond L Ranch Short Term Residential Therapeutic Program (STRTP), Facility Manager, Sydney Vahle.

Investigation Findings:
13On 08/01/2024, at 12: PM, Licensing Program Analyst (LPA) Sarah Lo met with Facility Manager, Sydney Vahle, to deliver the finding for the above complaint allegation at Ettie Lee Homes Diamond L Ranch Short Term Residential Therapeutic Program (STRTP). On 03/07/24, LPA inspected the facility's physical plant, and no immediate health and safety hazards were observed. The investigation included interviews with five staff members (S1, S2, S3, S4, S5), eight County Social Workers and five clients (C1, C2, C7, C8, C9), clients (C3, C4, C5, C6) refused to be interviewed. Clients' Needs and Services Plans and case notes were reviewed. On March 5, 2024, Community Care Licensing received an allegation that staff (S4) threatened minor (C1) while in care. During the investigation, there was no corroborating evidence to support the above allegation. Although the Department received information that S4 had made threatening statement to FC1, confidential interviews could not provide consistent statements that could confirm that C1's personal rights were violated. (continued on LIC 9099c) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Sarah Lo LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., Suite Riverside, CA Facility Name: Ettie Lee Homes-diamond L. RANCHFACILITY NUMBER: VISIT DATE: 08/01/2024

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

met_with: Sydney Vahle, Facility Manager


raw_content:
Narrative:
Further review revealed an addendum for the missed dose was submitted on March 13, 2025, reporting medication and medication log were missing. Confidential interviews and record review provided conflicting information as to when the medication and log were initially found to be missing and when it was reported to CCL. Confidential interviews and record review could not confirm or dispute the allegation. Based on record review and confidential interviews the allegation alleging facility staff did not report the incident to CCL may have occurred, however it is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights to Facility Manager Sydney Vahle. record (MAR) log was discovered missing on or about March 9, 2025. Confidential interviews provided consistent statements that C1's medication and MAR log were unable to be located beginning March 9, through March 13, 2025. A records review conducted by LPA Perez-Diaz collaborated with the confidential interviews. All documents indicate that the medication and MAR log are missing. This is a violation of California Code of Regulations (CCR) regulation HEALTH RELATED SERVICES 80075(k)(1) Medication shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. The missing log violation of Short-Term Residential Treatment Facility (STRTP) Interim Licensing Standards (ILS) Standard 87070(b)(14) CHILDREN'S RECORDS A separate log for each psychotropic medication prescribed to a child documenting all of the following. Based on confidential interviews and record review the preponderance of evidence has been met the facility is cited for violation of CCR 80075(k)(1) and ILS 87070(b)(14). A copy of the report was discussed and provided along with appeal rights to Facility Manager Sydney Vahle.

Investigation Findings:
13On April 22, 2025, at 08:57 am Licensing Program Analyst (LPA), Raina Perez-Diaz and Licensing Program Manager (LPM) Nicole Strickland met with Ettie Lee-Diamond Ranch, Facility Manager, Sydney Vahle, to deliver the finding(s) for the above stated allegations. A Health and safety inspection of the facility was conducted on March 14, 2025, and no immediate hazards were observed. The investigation included interviews with one foster Child #1 (C1) and seven Staff #1 - Staff #7 (S1-S7), and one county social workers (CSW). In addition, county records, and facility records were reviewed. On March 11, 2025, Community Care Licensing (CCL) received a complaint with two allegations alleging a minor's medication is missing and Medication log for minor in care is missing. Specifically, it was reported a client's (C1) prescribed medication and the corresponding medication administrative **Contintue on Next page** SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Nicole Strickland LICENSING EVALUATOR NAME: Raina Perez-Diaz 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 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., Suite Riverside, CA Facility Name: Ettie Lee Homes-diamond L. RANCHFACILITY NUMBER: 360900272

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:


summary: Facility Evaluation

raw_content:
Narrative:
On June 4, 2020 at 1: PM, Licensing Program Analysts (LPAs), Jazmond Harris and Val Wilson arrived at Ettie Lee Homes-Diamond L. Ranch to complete an annual required inspection. LPA was met at the facility by Facility Manager, Katey Garcia. There were two staff members and four clients present at the time of the inspection. Appropriate staff/client ratios were verified during the inspection. At 3: PM, a physical plant inspection was completed and included the following checks: The facility consists of five bedrooms, five bathrooms, a dining area, living room, kitchen, pantry, staff office, administrator office, game room, therapy room, maintenance office that is utilized for storage, storage room, conference room, recreation room and laundry room. Facility grounds are clean and free of debris and observable hazards. There is adequate indoor and outdoor activity space. Pool tables, games, and gym equipment were observed for client's recreation time. All facility smoke detectors and carbon monoxide detectors are in appropriate working order; fire extinguishers are properly charged and serviced. Licensee maintains more than two days' supply of perishable and seven days non-perishable foods and appears to be following the posted menu. All required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster. Medications are locked and centrally stored in staff office. Individual client beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. All bedrooms have individual beds, closet space, and drawer space for each client. The hot water in the client's bathroom was measured and deemed to be safe. Per facility staff, no firearms or weapons are allowed in the facility. Facility appears to be meeting the terms and conditions of their license. Administrator, April Hanley is present at the facility a minimum of 20 hours a week, as verified by staff schedule and interviews. Appropriate staff/client ratios were verified during this inspection. The facility employs one social worker, one therapist, five facility managers and six direct care staff. Licensee has obtained National Accreditation through Council on Accreditation (COA). The Accreditation is valid through 02/29/2024. Licensing fee payments have been paid and there is currently a balance of $0. LPAs reviewed five client files. All required documents were present in the files with required dates and signatures. Client #1 and Client #2's (See Confidential Names List (LIC 811) dated June 4, 2021, needs and service plans were not up to date. LPA Harris requested that the current needs and service plan be sent to LPA Harris at the earliest convenience. Currently there are no clients on medication. LPAs reviewed five staff files. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. LPAs reviewed the staff's first Aid/CPR certificates and proof of TB tests. LPAs conducted staff and client interviews. Clients indicated that their basic needs are being met at the facility and core services being provided as well. Staff interviews stated there were no issues or concerns. LPA discussed the following with Facility Manager: Incident reporting, including incidents related to Assembly Bill 388, law enforcement contacts as well as incidents involving emergency interventions. LPA discussed procedures for Child and Family Team (CFT) meetings, including an overview of required Core Services and Supports. Based upon the inspection of facility records and observation, the Licensee appears to be meeting CFT and Core Services/Supports requirements. An exit interview was conducted. A copy of the report will be provided to the facility.

visit_type: Annual

met_with: Facility Manager-Katey Garcia


summary: Facility Evaluation

raw_content:
Narrative:
On March 14, 2023 at 09: AM, Licensing Program Analyst (LPA), Sarah Lo arrived unannounced at Ettie Lee Homes-Diamond L. Ranch to complete an annual required inspection. LPA was met at the facility by Administrator, April Valdepena-Hanley. There were two staff members, and six clients present at the time of the inspection. Appropriate staff/client ratios were verified during the inspection. At 09: AM, a physical plant inspection was completed and included the following checks: The facility consists of five bedrooms, five bathrooms, a dining area, living room, kitchen, pantry, staff office, administrator office, game room, therapy room, maintenance office that is utilized for storage, storage room, conference room, recreation room and laundry room. Facility grounds are clean and free of debris and observable hazards. There is adequate indoor and outdoor activity space. Basketball court, games and gym equipment were observed for client's recreation time. All facility smoke detectors and carbon monoxide detectors are in appropriate working order; fire extinguishers are properly charged and serviced. Licensee maintains more than two days supply of perishable and seven days non-perishable foods and appears to be following the posted menu. All required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster. Medications are locked and centrally stored in staff office. Individual client beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. All bedrooms have individual beds, closet space, and drawer space for each client. The hot water in the client's bathrooms were measured (105.4, 112.4, 113.9 and 110.6) and deemed to be clean and safe. Per Administrator, no firearms or weapons are allowed in the facility. Facility appears to be meeting the terms and conditions of their license. (Continues on LIC 809-C) Administrator, April Valdepena-Hanley is present at the facility a minimum of 20 hours a week, as verified by staff schedule and interviews. Appropriate staff/client ratios were verified during this inspection. The facility employs one social worker, one therapist, five Facility Managers and five Residential Counselors. Licensee has obtained National Accreditation through Council on Accreditation (COA). The Accreditation is valid through 02/29/2024. Licensing fee payments have been paid and there is currently a balance of $0. LPA reviewed five client files. All required documents were present in the files with required dates and signatures. Client #2 (See Confidential Names List (LIC 811) dated March 14, 2023, is missing the signed copies of policy and procedure for the removal/transfer, discipline and complaints. Per ILS 87070 (c) If it is determined that the facility can provide the services necessary to meet the child's needs, the following additional information shall be maintained in the child's record: (2) Signed copies of the facility's policies and procedures regarding the child's removal and/or transfer; discipline; and complaints. Client #1-#5 (See Confidential Names List (LIC 811) dated March 14, 2023, is missing Tuberculosis (TB) test result, per Administrator, the client's refused getting the TB test at the initial health screening. Administrator was told will need to provide proof with client's signature to show client refused to get a TB test. Per CCR 80069 (c) The medical assessment shall include the following: (1) The results of an examination for communicable tuberculosis and other contagious/infectious diseases. LPA conducted three staff and three client interviews. The clients indicated that their basic needs are being met at the facility and core services being provided as well. The staff interviews stated there were no issues or concerns. An exit interview was conducted. A copy of the this report (LIC 809 and LIC 809-C) and appeals right is provided to the Administrator, April Valdepena-Hanley.

met_with: April Valdepena-Hanley, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPA's) Jacqueline Garcia and Rachel Vanegas on March 12, 2025 at 09: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA's met with Program Manager, April Valdepena. LPA's inspected the facility inside and out with Facility Manager, Sydney Vahle and did not observe any deficiencies. LPA's reviewed 1 child records and 5 staff personnel files on site at the facility. LPA's reviewed 1 of 1 child's psychotropic medications and medication records. LPA's interviewed 2 of 5 staff on site to discuss the facilities policies and procedures of operation. LPA's interviewed 1 of 1 youth currently prescribed psychotropic medication. During the inspection LPA's did not observe any violations therefore no deficiencies are being cited at this time. LPA's conducted exit interview with Program Manager, April Valdepena and a copy of this report, LIC 811 dated 03/12/25 were provided to Program Manager, April Valdepena.

met_with: April Valdepena-Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On May 1, 2025 at 09: AM, Licensing Program Analyst (LPA), Jason Dalton and Licensing Program Manager (LPM) Nicole Strickland arrived unannounced at Ettie Lee Homes-Diamond L. Ranch to conduct an annual random inspection. LPA was met at the facility by Interim Administrator, Sydney Vahle. There were two staff members, and nine clients present at the time of the inspection. Appropriate staff/client ratios were verified during the inspection. At 02: PM, a physical plant inspection was completed and included the following checks: The facility consists of five bedrooms, five bathrooms, a dining area, living room, kitchen, pantry, staff office, administrator office, game room, therapy room, maintenance office that is utilized for storage, storage room, conference room, recreation room and laundry room. Facility grounds are clean and free of debris and observable hazards. There is adequate indoor and outdoor activity space. Basketball court, games and gym equipment were observed for client's recreation time. All facility smoke detectors and carbon monoxide detectors are in appropriate working order; fire extinguishers are properly charged and serviced. Licensee maintains more than two days supply of perishable and seven days non-perishable foods and appears to be following the posted menu. All required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster. Individual client beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. All bedrooms have individual beds, closet space, and drawer space for each client. The hot water in the client's bathrooms were measured (105.0, 105, 107.8 and 105.0) and deemed to be clean and safe. Per Administrator, no firearms or weapons are allowed in the facility. Facility appears to be meeting the terms and conditions of their license. (Continues on LIC 809-C) Interim Administrator, Sydney Vahle is present at the facility a minimum of 20 hours a week, as verified by staff schedule. Appropriate staff/client ratios were verified during this inspection. The facility employs one social worker, one therapist, five Facility Managers and five Residential Counselors. Licensing fee payments have not been paid and there is currently a balance of $2,040.00. LPA reviewed five client files. All required documents were present in the files with required dates and signatures. LPA reviewed five staff files (S1-S5). Review revealed S2 had an expired First Aide CPR Card therefore the facility will be cited for violation of Interim Licensing Standard (ILS) 87065.1 (d)(6)(A). Review further revealed documentation of 40 hours annual training for S4 is missing from file. This is a violation of ILS 87065.1(e)(1). Due to time constraints inspection was not able to be completed. LPA will return at a future date to complete inspection. An exit interview was conducted. A copy of the this report (LIC 809 and LIC 809-C and 809-D) and appeals rights were provided to the Interim Administrator, Sydney Vahle.

met_with: Sydney Vahle, Interim Administrator


summary: Facility Evaluation

raw_content:
Narrative:
**This is an Amended Report for the Report dated 5/1/25 to reflect the corrected end time of 2: PM** On May 1, 2025, at 09: AM, Licensing Program Analyst (LPA), Jason Dalton arrived unannounced at Ettie Lee Homes-Diamond L. Ranch to continue an annual random inspection that was conducted on 5/1/2025. LPA was met at the facility by Interim Administrator, Sydney Vahle and Alisha Yglesias-Guzman, Facility Manager. There were five staff members, and three clients present at the time of the inspection. Appropriate staff/client ratios were verified during the inspection. During the inspection, annual fees were not current. LPA reviewed and completed the remaining CARE Tools questions, one of two client interviews and two of two staff interviews at 1: PM on this date. Two Clients declined to interview. The facility has obtained accreditation through Council On Accreditation, The facility does not have the current certificate, however, the facility was able to provide proof of current accreditation. LPA also reviewed medication logs, and medication for Client #1 through Client #5. Please refer to Confidential names list LIC 811. LPA discussed the need for updating Transitional Independent Living Program information for Clients #1 and Client #2 with Interim Administrator. No deficiencies were cited. An exit interview was conducted. A copy of this report and appeal rights were discussed and provided to Facility Manager Alisha Yglesias-Guzman.

met_with: Alisha Yglesias-Guzman


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Michael Almaraz conducted a collateral visit at the facility and met with Program Manager, April Valdepena. The purpose of the inspection was to conduct a client interview regarding a prior placement (see Confidential Names form LIC 811) dated February 4, 2026. An exit interview was conducted. No deficiencies were cited. A copy of this report and LIC 811 was provided to April Valdepena.

met_with: April Valdepena


facility_name: FATHER'S HEART RANCH

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Narrative:
Confidential interviews also revealed in the first trimester of virtual schooling it was difficult to keep track of all the client's differing schedules however staff are in communication with clients' teachers when issues arise. Based on record review, confidential interviews and conflicting statements of what occurred, the allegation facility staff do not ensure that youths attend school may have occurred, however is not supported or proven by evidence. Therefore, the above allegation is unsubstantiated. A copy of this report, LIC 811 and appeal rights were explained and emailed to Administrator Christina Torres for signature. Signed reports will be placed in facility file. Interviews and record review revealed approximately 12-13 clients attend virtual schooling in the STRTP cafe through five different schools. Five clients attend the same school as C1 however do not have the same teacher. Confidential interviews and record review revealed clients have different schedules but a majority of the clients attend school Monday through Friday between 8:30 am and 8:45 am and work until approximately 2 to 3 pm. Interviews and record review revealed that day shift staff schedules are from 6 am to 3 pm and the same staff are in the cafe with clients for the whole school day. Record review revealed approximately 20 messages sent from ST between August 2020 through February 2021 indicating students (referring to C1 as well as other non-client students) were not logged in for small groups or ST was waiting for students (referring to C1 and other non-client students) to join. Record review revealed these messages were all sent between 1:20 pm and 1:30 pm. Confidential interviews revealed these messages were sent out if students were not yet logged back in after lunch and as a reminder. Additional confidential interviews revealed C1 would come back from lunch around 1:30 pm and would join small groups making it possible for the messages to go out before C1 joined. Confidential interviews revealed C1 had no attendance issues during small groups with RT from 1:30 pm to 2:00 pm, although noted the small groups did start at 1:15 pm. Interviews revealed C1 was returning late from lunch due to all clients being lined up to return to the cafe together. Review of C1's report card showed 59 days present and 2 days absent in the first trimester and showed 61 days present and 0 days absent in the second trimester. Confidential interviews revealed attendance is taken in the morning and not again in the afternoons but is monitored by ST in the afternoons. Confidential interviews revealed that there have been times C1 has missed afternoon class or logged off early and record review revealed that two messages were sent indicating C1 not being logged on after 2 pm. Interviews revealed after 2 pm to approximately 3:30 pm is independent work time for C1. Interviews revealed that due to clients' disruptive and dangerous behaviors in the afternoon AD asked SP that students from C1's school be able to log off of school at 2 pm. Confidential interviews revealed that all clients in virtual schooling were logged off at 2 pm to manage clients' disruptive behaviors for approximately 3-4 weeks from February to March 2021. Other interviews revealed only students that were completed with their school work were logged off at 2 pm while others stayed until 3 or 3:30 pm to complete work. Further confidential interviews revealed C1 had missed some afternoon class due to C1 saying C1 was finished with school and C1 also made it appear C1 had no further work by deleting it or rushing through it. (Continued)

Investigation Findings:
13On April 29, 2021 at 10:25 am, Licensing Program Analyst (LPA), Jessica Rubio made contact with Father's Heart Ranch, Administrator (AD) Christina Torres via Google Duo video due to COVID-19, to discuss the investigative finding of the allegation listed above. On March 22, 2021 at 1:34 pm, LPA Rubio conducted a safety tele-inspection of the facility. No safety hazards were observed and no deficiencies were cited. During the investigation, confidential interviews were conducted with three clients (C1, C2, C3) attending virtual schooling on the STRTP campus, Administrator (AD), staff 1 through 3 (S1, S2, S3), school teacher of C1 (ST), resource teacher of C1 (RT) and school principal for the school C1 attends. LPA Rubio obtained copies of the client and staff rosters as well as the needs and services plan, individual education plan and report card for C1. On March 18, 2021, Community Care Licensing (CCL) received a complaint alleging facility staff do not ensure that youths attend school; specifically, that C1 is missing a significant amount of virtual schooling in the afternoon due to clients being pulled away from schooling due to staff shift changes. (Continued) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Christina Barnes LICENSING EVALUATOR NAME: Jessica M Rubio LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 04/29/2021

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

met_with: Christina Torres


raw_content:
Narrative:
Confidential interviews and record review revealed that there was one incident where C1 and C2 were in the living area of their house playing the tickle game, which consisted of the two clients tickling each other in areas like the arms. Interviews revealed C1 moved and C2 accidentally touched C1 across C1's private area. Some interviews revealed there was no staff or other clients around to see the incident while other interviews and record review revealed S1 and S2 were present in the house, S1 in the same room as the clients and S2 in the hallway. Interviews with staff revealed that staff observed C2 tickling C1 and staff reminded C2 of boundaries and not to touch C1. These interviews further revealed neither staff actually saw C2 touch C1 in the private area however, S2 heard C1 say that C2 touched C1 in C1's private part. Interviews revealed S2 spoke with each client after the incident and C1 and C2 are not allowed to be near each other. Confidential interviews revealed C2 touching C1 in the private area was an isolated incident and an accident. CSW revealed there have been no prior disclosures of inappropriate touching between C1 and C2 or any other clients and no prior concerns of lack of supervision in the STRTP. Based on confidential interviews and conflicting statements of what occurred, the allegation C1 was inappropriately touched by C2 in care due to lack of supervision may have occurred, however is not supported or proven by evidence. Therefore, the above allegation is unsubstantiated. A copy of this report, LIC 811 and appeal rights were explained and provided to Administrator Christina Torres.

Investigation Findings:
13On February 3, 2022 at 10:35 am, Licensing Program Analyst (LPA), Jessica Rubio met with Father's Heart Ranch (STRTP), Administrator, Christina Torres to discuss the investigative finding of the allegation listed above. On December 28, 2021 at 2:50 pm, LPA Rubio conducted a safety inspection of the facility. No safety hazards were observed and no deficiencies were cited. During the investigation, confidential interviews were conducted with staff 1 and 2 (S1, S2) and two of two clients (C1, C2) involved in the complaint. LPA Rubio obtained copies of the facility staff and client roster and the needs and services plans for C1 and C2. On December 20, 2021, a complaint was received alleging minor was inappropriately touched by another minor in care due to lack of supervision; specifically, that C2 touched C1 on C1's private part. (Continued on LIC 9099C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Christina Barnes LICENSING EVALUATOR NAME: Jessica M Rubio LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 02/03/2022

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


raw_content:
Narrative:
allegation had occurred, and that C2 had also inappropriately touched C1 on at least one occasion. There were no other known witnesses to this allegation. Based on confidential information obtained during the course of this investigation, the allegation that Staff did not prevent inappropriate touching between minors in care, may have occurred, however is not supported or proven by evidence. Therefore, the above allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Administrative Director, Christina Torres to discuss the investigative findings for the above stated allegation. Licensing Program Analyst (LPA), Erika Lopez conducted an inspection to the Short Term Residential Therapeutic Program (STRTP) on December 12, 2022, at 10:45am. No immediate hazards observed. LPAs Erika Lopez and Cynthia Urena interviewed Facility Administrator (FA), two staff (S1 & S2), three foster children (C1, C2 and C3), as well as reviewed client and facility records. Community Care Licensing (CCL) received information on December 09, 2022, alleging that Staff did not prevent inappropriate touching between minors in care. Information obtained in confidential interviews did not corroborate the allegation with a preponderance of evidence. LPAs Lopez and Urena obtained conflicting information during confidential interviews. Confidential interviews denied a lack of supervision and stated that on one occasion when C1 attempted to touch C2 in their groin area during bedtime, Staff # 1 (S1) immediately intervened and redirected C1, as well as closely monitored C1 for the remainder of the night. Incident was said to have occurred after C1, C2 and C3 were allowed to sleep in hall/living room area by S1 after they refused to go to bed. According to confidential information, S1 reported this incident to administrative staff. While other confidential information received by CCL stated that this UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 11/13/2023

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


raw_content:
Narrative:
C1's ankle. Confidential interviews and records reviewed revealed a physical altercation between several residents occurred during a football game on October 14, 2023; during which time S1 attempted to de-escalate the situation. Confidential interviews provided varying accounts of how S1 ended up landing on C1's ankle causing the fracture and whether it was intentional. Confidential interviews and records review revealed that once C1's injury became known to staff, medical attention was provided to C1. Based on records review and confidential interviews the allegation alleging staff member (S1) caused an injury to minor (C1) while in care may have occurred, however is not supported, or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights to Father's Heart Ranch Short Term Residential Therapeutic Program (STRTP) Facility Manager, Gloria Thomas.

Investigation Findings:
13On November 17, 2023 at 10:36 am Licensing Program Analyst (LPA), Nicole Strickland met with Father's Heart Ranch Short Term Residential Therapeutic Program (STRTP) Facilitiy Manager Gloria Thomas to deliver the findings for the above stated allegation. A Health and safety inspection of house "C" was conducted on October 23, 2023, and no immediate hazards were observed. The investigation included interviews with five foster youth (Child #1 [C1], Child #2 [C2], Child #3 [C3], Child #4 [C4] and Child #5[C5]), ADM, two staff (Staff #1[S1] and Staff #2 [S2]), Riverside County Social Worker (CSW#1), Riverside Out of Homes Institutions (OHI) investigator. In addition, county records, facility records, and medical records were reviewed. On October 18, 2023, Community Care Licensing (CCL) received an allegation alleging staff member (S1) caused an injury to minor (Child #1 [C1]) while in care. Specifically, it was reported S1 fell on C1 fracturing UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 11/17/2023

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

met_with: Facility Manager, Gloria Thomas


raw_content:
Narrative:
knee into C1's back during a restraint. Confidential interviews provided conflicting statements regarding staff using excessive forms of restraints with some statements reporting staff are quick to restrain and residents occasionally are left with marks and/or bruises or soreness from the excessive forced used by staff during the restraint. Conflicting statements reported staff use a variety of de-escalation techniques prior to initiating a restraint on a resident and when restraints are used staff follow Pro-Act training. Confidential interviews could not confirm or dispute the allegations of excessive forms of restraint or C1 being handled in a rough manner. An additional allegation alleging Staff (unnamed) speaks inappropriate to minor (C1) in care was also received by CCL on July 24, 2023. Specifically, it was reported C1 was called slow, dumb, and stupid by unnamed staff. Confidential interviews and records reviewed revealed conflicting reports of staff speaking inappropriately to C1. Confidential interviews reported C1 claimed C1 was called slow on an unknown date by a staff member. Confidential interviews reported C1 interpreted this to mean C1 was stupid and dumb; however conflicting statements reported C1 was being told C1 was moving slow as the residents were transitioning from one activity to another. Confidential interviews could not confirm or dispute that the way the word slow was used was in an inappropriate manner. Based on record review and confidential interviews the allegations alleging Staff (unnamed) uses excessive forms of restraint on minor (C1) in care, staff (unnamed) handles minor (C1) in a rough manner and Staff (unnamed) speaks inappropriate to minor (C1) in care may have occurred, however is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights to Father's Heart Ranch Short Term Residential Therapeutic Program (STRTP) Facility Manager Gloria Thomas.

Investigation Findings:
13On November 17, 2023 at 9:51 amLicensing Program Analyst (LPA), Nicole Strickland met with Father's Heart Ranch Short Term Residential Therapeutic Program (STRTP) Facilitiy Manager Gloria Thomas to deliver the findings for the above stated allegations. A Health and safety inspection of the facility was conducted on July 31, 2023, and no immediate hazards were observed. The investigation included interviews with five of five foster youth (Child #1 [C1], Child #2 [C2], Child #3 [C3], Child #4 [C4] and Child #5 [C5]), four Facility Staff, San Bernardino County Social Worker (CSW#1). In addition, county records and facility records were reviewed. On July 24, 2023, Community Care Licensing (CCL) received two allegations alleging Staff (unnamed) uses excessive forms of restraint on minor (C1) in care and staff (unnamed) handles minor (C1) in a rough manner. Specifically, it was reported staff (unnamed) pulled both of C1's arms outward and placed a UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 11/17/2023

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

met_with: Gloria Thomas


raw_content:
Narrative:
Additionally, the confidential interviews stated that putting pressure on the neck and the back of a client during restraint is not the usual protocol and the staff would never do that to the client. Furthermore, a confidential interview stated that the staff are well trained on how to utilize restraints and have never seen or heard of a staff placing extra pressure on a client's neck during a restraint. The Department received another allegation that stated the staff (S1) handled youth (C1) in a rough manner while in care. Specifically, it was stated that S1 slammed C1's head on the floor. Confidential interviews revealed conflicting statements: Confidential interviews stated that S1 slammed C1's head on the floor in the cafeteria for no apparent reason, there were no witnesses, and no staff was notified of this incident. Additionally, the confidential interviews stated that they have never seen S1 slammed C1's head on the floor or any other clients at the facility. Based on inconsistent confidential interviews, the allegations that the S3 inappropriately restrained C1 while in care and S1 handled C1 in a rough manner while in care may have occurred, however, is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with appeal rights was provided to Father's Heart Ranch Short Term Residential Therapeutic Program (STRTP), Gloria Thomas, Facility Manager.

Investigation Findings:
13On 02/28/2024 at 10: AM, Licensing Program Analyst (LPA) Sarah Lo met with Gloria Thomas, Facility Manager, to deliver the finding for the above complaint allegations at Father's Heart Ranch Short Term Residential Therapeutic Program (STRTP). On 10/23/23, LPA inspected the facility's physical plant, and no immediate health and safety hazards were observed. The investigation included interviews with four staff members (S1-S4), five clients (C1-C5) and County Social Worker (CSW). Clients' Needs and Services Plans and case notes were reviewed. On October 16, 2023, Community Care Licensing received an allegation that stated the staff (S3) inappropriately restrained youth (C1) while in care. Specifically, it was stated that S3 had inappropriately restrained C1 by putting extra pressure on the neck. A confidential interview stated that S3 did not put extra pressure on C1's neck but did put extra pressure on C1's arm. (continued on LIC 812c) *this is an amended 9099 to the orginal signed on 02/28/24* UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Sarah Lo LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 02/28/2024

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

met_with: Gloria Thomas, Facility Manager


raw_content:
Narrative:
Other confidential interviews stated that staff do not grab clients in a rough manner and have never seen any staff grabbing clients in a rough manner. Based on inconsistent confidential interviews, the allegation that a staff grabbed resident (C1) in a rough manner may have occurred, however, is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with appeal rights was provided to Father's Heart Ranch Short Term Residential Therapeutic Program (STRTP), Gloria Thomas, Facility Manager.

Investigation Findings:
13On 02/28/2024 at 11: AM, Licensing Program Analyst (LPA) Sarah Lo met with Gloria Thomas, Facility Manager, to deliver the finding for the above complaint allegation at Father's Heart Ranch Short Term Residential Therapeutic Program (STRTP). On 09/26/23, LPA inspected the facility's physical plant, and no immediate health and safety hazards were observed. The investigation included interviews with four staff members (S1-S4) and eight clients (C1-C8). Clients' Needs and Services Plans and case notes were reviewed. On September 22, 2023, Community Care Licensing received an allegation that a staff grabbed resident (C1) in a rough manner. Specifically, it was stated that a staff went into C1's room and grabbed C1 by the arm and twisted it. A confidential interview stated that an unknown staff went into C1's room and grabbed C1 by the arm and twisted it. (continued LIC 812c) *this is an amended 9099 to the original signed on 02/28/24* UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Sarah Lo LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 02/28/2024

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

met_with: Gloria Thomas, Faciliity Manager


raw_content:
Narrative:
During the investigation there was no corroborating evidence to support the allegation. Although CCL received information stating that C1 was inappropriately restrained in care following an incident involving another client in care. The Investigator received inconsistent statements that supported a violation of neglect by staff during a restraint performed on C1 during a behavioral episode that posed a threat to C2 in care. Confidential interviews stated that staff members are trained in the usage of Professional Assault Crisis Training (Pro-ACT) and denied restraining C1 inappropriately during the incident in care. It was indicated that a restraint was used because C1 was choking C2 in care and after multiple verbal redirections by staff C1 refused to stop and staff intervened by using an appropriate Pro-ACT restraint on C1 during the incident. There were no other known witnesses to the allegation. Based on confidential interviews, and record review the allegation that staff inappropriately restrained C1 in care, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report along with the appeal rights was provided to Director, Christina Torres.

Investigation Findings:
13On March 21, 2024, at 12: PM, Licensing Program Analyst (LPA), Cynthia Urena met with Father's Heart Ranch Short Term Residential Therapeutic Program (STRTP) Director, Christina Torres to deliver the investigative finding for the above stated allegation. On December 8, 2023, Investigator Shawniece Poinsette with the Community Care Licensing Division (CCLD) Investigations Branch (IB) initiated the investigation at the STRTP. During the investigation process Investigator Poinsette conducted interviews with five staff members, two clients (C1, C2,) and a Sheriff Deputy. Additionally, medical and country reports were reviewed by Investigator Poinsette. On December 4, 2023, Community Care Licensing (CCL) received a complaint alleging staff inappropriately restrained youth in care. It was specifically reported to CCL that C1 was inappropriately restrained by staff following an incident involving another client in care. (**Continued on LIC C**) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Cynthia Urena 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 PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 03/21/2024

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

met_with: Director, Christina Torres


raw_content:
Narrative:
In regard to the allegation that due to lack of supervision, a minor was assaulted by other minors, it was specifically reported that four clients and one of the bigger clients jumped C1 at the STRTP resulting in C1 being hit on the face, the head, the left arm, and the leg. During investigation, it was disclosed that staff was present during the incident with the appropriate staff to client ratio. Another confidential interview stated staff tried to deflect the incident from progressing but the incident among clients escalated quickly. Additionally, a confidential interview mentioned that staff didn't say anything to prevent C1 from being assaulted. Other confidential interviews denied that the assault was due to a lack of supervision. LPA was unable to gather additional information. Regarding the allegation that staff did not report the incident to authorized representatives, confidential interview stated that the incident was reported. A confidential interview stated that the incident was not reported to C1's relative. However, the facility staff indicated that the incidents were not to be reported to the C1's relative; they were reported to all authorized representatives in a timely manner. Based on interview and record review, the allegation that C1 was assaulted by C2, C3, and C4 due to lack of supervision and staff did not report incident to the authorized representatives may have happened, however, there was not a preponderance of evidence to support the alleged violations, therefore, these allegations are unsubstantiated at this time. An exit interview was conducted. A copy of this report and appeal rights were explained and given to Office Manager, Sylvia Luna.

Investigation Findings:
13On 07/09/2024, at 12:45PM, Licensing Program Analyst (LPA) Maya Chavez arrived at Father's Heart Ranch Short-Term Residential Therapeutic Program (STRTP) and met with Office Manager, Sylvia Luna to deliver the investigative finding regarding the allegations involving Client #1 (C1) and the facility staff. On June 3, 2024, Community Care Licensing (CCL) received a complaint alleging that due to lack of supervision, minor was assaulted by other minors and staff did not report the incident to authorized representatives. On June 12, 2024, at 9:30AM, LPA Chavez arrived unannounced to Father's Heart Ranch STRTP to initiate the investigation with Administrator Director. LPA conducted a health and safety inspection with (S1). There were no immediate safety hazards observed at this time of inspection. In addition, LPA Chavez obtained client roster, copies of Special Incident Reports (SIR's), other documents and interviewed clients 1-7 (C1, C2, C3, C4, C5, C6 & C7) and staff 1-5 (S1, S2, S3, S4, & S5) as listed on the Confidential Names List (LIC811). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Maya Chavez 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: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 07/10/2024

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

met_with: Office Manager- Sylvia Luna


raw_content:
Narrative:
In regard to the allegation, it was specifically reported that the STRTP staff used an inappropriate restraint causing an injury to C1 while in care. During investigation, it was disclosed during a confidential interview that staff tried to prevent client from self-injuring during restraint by trying to prevent C1 from banging C1's head on the desk. Another confidential interview stated that C1 was not banging C1's head, staff were pushing C1's face onto the desk causing black eye during restraint. Other confidential interview stated that C1 came from school agitated and attempted to hurt a staff, therefore, staff had to place C1 in a standing restraint, however, C1 dropped down to the desk and staff continued to use the restraint on the desk attempting the de-escalate the aggression. LPA received conflicting information. Based on interview and record review, the allegation that staff used an inappropriate restraint causing an injury to C1 while in care may have occurred, however, there was not a preponderance of evidence to support the alleged violations, therefore, this allegation is unsubstantiated at this time. An exit interview was conducted. A copy of this report and appeal rights were explained and given to Office Manager, Sylvia Luna.

Investigation Findings:
13On 07/09/2024, at 12:45PM, Licensing Program Analyst (LPA) Maya Chavez arrived at Father's Heart Ranch Short-Term Residential Therapeutic Program (STRTP) and met with Office Manager, Sylvia Luna to deliver the investigative finding regarding the allegations involving Client #1 (C1) and the facility staff. On May 10, 2024, Community Care Licensing (CCL) received a complaint alleging that staff used an inappropriate restraint causing an injury to minor in care. On May 10, 2024, at 2:30PM, LPA Chavez arrived unannounced to Father's Heart Ranch STRTP to initiate the investigation with Administrator Director. LPA conducted a health and safety inspection with Administrative Director. There were no immediate safety hazards observed at this time of inspection. In addition, LPA Chavez obtained client roster, copies of Special Incident Reports (SIR's), other documents and interviewed clients 1-3 (C1, C2, & C3) and staff 1-3 (S1, S2, & S3) as listed on the Confidential Names List (LIC 811). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Maya Chavez 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: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 07/10/2024

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


raw_content:
Narrative:
In regard to the allegations, it was specifically reported that on two different occasions staff elbowed C1 in the face during a restraint and on another occasion, staff kicked a C4's leg during a restraint resulting in a broken leg. During investigation, it was disclosed that staff did not elbow C1. Another interview stated that C1 was elbowed but was not sure if the staff's action was on purpose or on accident. Medical record revealed that C4 had a fracture on the ankle not the leg. Confidential interview indicated that C4's ankle was fractured due to staff falling on C4 during restraint. Other confidential interviews or witnesses didn't disclose any additional information regarding the incidents. Based on interview and record review, the allegations staff elbowed C1 in the face and staff kicked C4's leg may have occurred, however, there was not a preponderance of evidence to support the alleged violations, therefore, these allegations are unsubstantiated at this time. An exit interview was conducted. A copy of this report and appeal rights were explained and given to Office Manager, Sylvia Luna.

Investigation Findings:
13On 07/09/2024, at 12:45PM, Licensing Program Analyst (LPA) Maya Chavez arrived at Father's Heart Ranch Short-Term Residential Therapeutic Program (STRTP) and met withOffice Manager, Sylvia Luna to deliver the investigative finding regarding the allegations involving Client #1 (C1) and Client #4 (C4) and the facility staff. On May 6, 2024, Community Care Licensing (CCL) received a complaint alleging that staff elbowed minor in the face during a restraint and staff kicked minors' leg during a restraint. On May 10, 2024, at 11: AM, LPA Chavez arrived unannounced to Father's Heart Ranch STRTP to initiate the investigation with Administrator Director. LPA conducted a health and safety inspection with Administraive Director. There were no immediate safety hazards observed at this time of inspection. In addition, LPA Chavez obtained client roster, copies of Special Incident Reports (SIR's), other documents and interviewed clients 1-5 (C1, C2, C3, & C5) and staff 1-5 (S1, S2, S3, S4, & S5) as listed on the Confidential Names List (LIC 811) LPA was unable to interview C4. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Maya Chavez 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: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 07/10/2024

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


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
Based on interview and record review, the preponderance of evidence standard has been met and the Department has determined that staff did not follow reporting requirements. Therefore, the allegation is substantiated. The facility is being cited for the violation of Title 22, Division 6, Article 06, Continuing Requirements 80061(b) Reporting Requirements (see LIC9099-D page). An exit interview was conducted. A copy of this report and appeal rights were explained and given to Office Manager, Sylvia Luna.

Investigation Findings:
13On 07/10/2024, at 12:45PM, Licensing Program Analyst (LPA) Maya Chavez arrived at Father's Heart Ranch Short-Term Residential Therapeutic Program (STRTP) and met with Office Manager, Sylvia Luna to deliver the investigative finding regarding the allegation involving Client #1 (C1) and the facility staff. On April 8, 2024, Community Care Licensing (CCL) received a complaint alleging that staff did not follow reporting requirements. On April 11, 2024, at 1:55PM, LPA Chavez arrived unannounced to Father's Heart Ranch STRTP to initiate the investigation. LPA conducted a health and safety inspection with Administraive Director. There were no immediate safety hazards observed at this time of inspection. In addition, LPA Chavez obtained client roster, copies of Special Incident Reports (SIR's) and interviewed clients 2-4 (C2, C3, & C4), staff 1-6 (S1, S2, S3, S4, S5, & S6), and County Social Workers (CSW) of C1 an C2 as listed on the Confidential Names List (LIC 811) LPA was unable to interview C1. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Maya Chavez 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: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 07/10/2024

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

met_with: Office Manager, Sylvia Luna

complaint_status: SUBSTANTIATED


raw_content:
Narrative:
In regard to the allegation, it was specifically reported that the STRTP staff did not prevent a physical altercation between minors in care. During investigation, a confidential interview disclosed that clients were playing, then argued and the argument escalated quickly to a physical altercation, and staff could not prevent the altercation resulting in C1 being injured. Confidential interviews stated that staff intervened immediately when the injury was observed on C1's head which was bleeding. Facility applied first aid and took C1 to a medical facility and the doctor applied staples on the injury. LPA did not receive additional information. Based on interview and record review, the allegation staff did not prevent a physical altercation between C1 and C2 while in care may have occurred, however, there was not a preponderance of evidence to support the alleged violation, therefore, the allegation is unsubstantiated at this time. An exit interview was conducted. A copy of this report and appeal rights were explained and given to Office Manager, Sylvia Luna.

Investigation Findings:
13On 07/010/2024, at 12:45PM, Licensing Program Analyst (LPA) Maya Chavez arrived at Father's Heart Ranch Short-Term Residential Therapeutic Program (STRTP) and met with Office Manager, Sylvia Luna to deliver the investigative finding regarding the allegation involving Client #1 (C1) and the facility staff. On April 8, 2024, Community Care Licensing (CCL) received a complaint alleging that staff did not prevent a physical altercation between minors in care. On April 11, 2024, at 1:55PM, LPA Chavez arrived unannounced to Father's Heart Ranch STRTP to initiate the investigation. LPA conducted a health and safety inspection with (S1). There were no immediate safety hazards observed at this time of inspection. In addition, LPA Chavez obtained client roster, copies of Special Incident Reports (SIR's) and interviewed clients 2-4 (C2, C3, & C4), staff 1-6 (S1, S2, S3, S4, S5, & S6), and County Social Workers (CSW) of C1 an C2 as listed on the Confidential Names List (LIC 811) LPA was unable to interview C1. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Maya Chavez 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: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 07/10/2024

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


raw_content:
Narrative:
Multiple confidential interviews denied that C2 was sexually inappropriate with C1 or other clients in care. Pertinent documentation collected as part of the investigation reported that C1 assumed C2 was "gay" and denied C2 sexually assaulted or made attempts to assault C1. In addition, a confidential interview denied C2 touching C1 inappropriately. Other confidential interviews reported hearing about the incident between C1 and C6 second-hand and could not provide an eyewitness account. An additional confidential interview denied a sexual interaction between C2 and C6 as alleged. Moreover, a confidential interview further reported staff provided adequate supervision of clients in care, and there were no concerns about C2's continued placement at the facility. Based on confidential interviews and documentation, the allegation that staff did not prevent minor (C2) from sexually abusing other minors (C1, C6) may have happened or be valid, but there is not preponderance of evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted. A copy of this report and appeal rights were explained and given to Office Manager, Sylvia Luna.

Investigation Findings:
13On July 18, 2024, at 10: AM, Licensing Program Analyst (LPA) Jessica Peete made an unannounced visit to Father's Heart Ranch Short Term Residential Therapeutic Program (STRTP) and met with Office Manager, Sylvia Luna to deliver the investigative finding for the allegation mentioned above. On 05/03/2024, LPA Peete initiated the investigation at the STRTP and collected pertinent documents to assist with the investigation process. The investigation assignment was conducted by Special Investigator (SI) Laarni Santiago of the Community Care Licensing (CCL) Investigations Bureau. SI Santiago interviewed two clients (C1 and C6). LPA Peete interviewed three clients (C2, C4, and C5) and four STRTP staff members (S1-S4). LPA attempted to interview C3 but was unsuccessful due to C3's inability to communicate verbally. On April 26, 2024, Community Care Licensing (CCL) received a complaint alleging staff did not prevent minor (C2) from sexually abusing other minors. Specifically, there were concerns that C2 had sexually touched C1 and had engaged in inappropriate sexual behavior with another client (C6) at school. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Jessica M Peete 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 PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 07/18/2024

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

met_with: Sylvia Luna, Office Manager


raw_content:
Narrative:
Regarding the allegation that staff did not prevent a minor from causing injury to another minor in care, it was specifically reported that C2 gave C1 a black eye. During investigation, multiple confidential interviews disclosed that staff used verbal de-escalation during the altercation between C1 and C2 resulting in C1 receiving a black eye. In addition, multiple confidential interviews disclosed that during altercations between clients, staff will use verbal de-escalation and prevent clients from hurting one another by separating them or staff will physically get in between clients to prevent clients from hitting one another. Another confidential interview disclosed that staff can't control C2 because of C2's size resulting in other clients to feel unsafe. LPA received conflicting information. Based on interviews, the allegation that staff did not prevent C2 from causing injury to C1 in care may have occurred, however, there was not a preponderance of evidence to support the alleged violation, therefore, this allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Facility Manager, Gloria Thomas.

Investigation Findings:
13On 10/31/2024, at 1:30PM, Licensing Program Analyst (LPA) Maya Chavez conducted an unannounced visit to Father's Heart Ranch short term therapeutic residential program (STRTP) and met with Facility Manager, Gloria Thomas to deliver the investigative finding for the allegation listed above involving the STRTP staff and clients 1 and 2 (C1 & C2). On 09/23/2024, Community Care Licensing (CCL) received a complaint that staff did not prevent a minor from causing injury to another minor in care. On 09/26/2024, LPA Maya Chavez conducted a health and safety inspection at the STRTP, and no immediate health and safety hazards were observed. In addition, LPA Chavez interviewed staff 1-4 (S1-S4), clients 1 and 2 (C1 & C2), and county social worker (CSW). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Maya Chavez 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: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 10/31/2024

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

met_with: Facility Manager- Gloria Thomas


raw_content:
Narrative:
Regarding the allegation staff did not ensure care and adequate supervision was provided resulting in child elopement, it was specifically reported that a ten-year-old non-verbal client who is medically fragile entered a house and ransacked it at 4:00AM in the morning. During investigation, a confidential interview disclosed that overnight staff do bedroom checks every fifteen minutes, but on the morning the client left the facility, bedroom checks were not conducted from 2:30AM-5:30AM according to documentation. In addition, confidential interviews disclosed that staff left the client's house for unclear reasons and clients were left unsupervised. A confidential interview stated that staff went to use the restroom while documents gathered indicated that staff went to do laundry. Multiple confidential interviews disclosed that when a client leaves the facility, staff would notice it right away and will follow AWOL protocol, however, a confidential interview and incident report corroborated that facility staff was not aware that the client AWOLed until law enforcement brought back C1 to the facility. Based on confidential interviews and record review, the preponderance of evidence standard has been met and the Department has determined staff did not ensure care and adequate supervision was provided resulting in C1's elopement. Therefore, this allegation is substantiated. The facility is being cited for violation of the Interim Licensing Standards, 80078(a). An exit interview was conducted, appeal rights explained, and a copy of this report was provided to facility manger, Gloria Thomas.

Investigation Findings:
13On 10/31/2024, at 1:30PM, Licensing Program Analyst (LPA) Maya Chavez conducted an unannounced visit to Father's Heart Ranch short term therapeutic residential program (STRTP) and met with facility manager, Gloria Thomas to deliver the investigative finding for the allegation listed above involving the STRTP staff and client 1 (C1). On 09/19/2024, Community Care Licensing (CCL) received a complaint that staff did not ensure care and adequate supervision was provided resulting in child elopement. On 09/26/2024, LPA Maya Chavez conducted a health and safety inspection at the STRTP, and no immediate health and safety hazards were observed. In addition, LPA Chavez obtained documents pertinent to the investigation and interviewed staff 1-4 (S1, S2, S3, & S4), client 2 (C2) and county social worker (CSW). LPA was unable to interview C1 due to C1 being non-verbal. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Maya Chavez 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: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 10/31/2024

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


raw_content:
Narrative:
**This is an amended report of the original dated November 15, 2024** Regarding the allegation that staff falsify minors' documentation, it was specifically reported that the facility manager engages in fraudulent practices when it comes to clients' documents specifically needs and service plans (NSP's) and a client's physician's note was recreated by staff and physician's signature was photocopied. Multiple confidential interviews disclosed that staff have been instructed to create NSP's after the due date and put incorrect dates. Another confidential interview disclosed that staff was instructed to recreate a physician's handwritten document into a typed document. In addition, confidential interview disclosed that on the recreated physician's document S6 forged physician's signature onto the typed document to expedite process rather than obtain typed/signed document from the physician. Other confidential interviews disclosed that management has not asked staff to falsify a document. LPA reviewed the documents gathered and noticed discrepancies. Additional interviews corroborated that facility staff modified the Children and Family Services C1's medical procedure authorization's document. However, another interview denied that staff has forged physician's signature onto the typed medical document. Staff transcribed the Physician's notes and took back the notes to the Doctor for signature. Based on confidential interviews and record review, the preponderance of evidence standard has been met and the Department has determined staff falsity C1's documentation. Therefore, this allegation is substantiated. The facility is being cited for the violation of the title 22, Division 6, Chapter False Claim 80012(a). See LIC9099D. An exit interview was conducted, appeal rights explained, and a copy of this report were provided to Office manager, Sylvia Luna.

Investigation Findings:
13**This is an amended report of the original dated November 15, 2024** On 11/15/2024, at 1: PM, Licensing Program Analyst (LPA) Maya Chavez conducted an unannounced visit to Father's Heart Ranch short term therapeutic residential program (STRTP) and met with Office manager, Sylvia Luna to deliver the investigative finding for the allegation listed above involving the STRTP staff and clients specifically clients 1 and 2 (C1 and C2) as listed on the Confidential Names (LIC 811). On 10/23/2024, Community Care Licensing (CCL) received a complaint that staff falsify minors' documentation. On 10/24/2024, LPA Maya Chavez conducted a health and safety inspection at the STRTP, and no immediate health and safety hazards were observed. In addition, LPA Chavez obtained clients needs and services, medical documents, and additional documents pertinent to the investigation. Also, LPA interviewed staff 1-5 (S1, S2, S3, S4 & S5), and attempted to conduct interviews with county social worker (CSW). LPA conducted an additional interview and gathered additional documents. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Maya Chavez 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: FATHER'S HEART RANCHFACILITY NUMBER: VISIT DATE: 11/15/2024

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

met_with: Office manager- Sylvia Luna