facility_name: KAVERE SERVICES - CHERRYLAND HOME

raw_content:
Narrative:
Lastly, LPA Buchannan was unable to gather any further information from the reporting party due to them being anonymous and not having any contact information for them. Although the allegation may have happened or may be valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted, copy of this report and the Appeal Rights were discussed and provided to the licensee.

Investigation Findings:
13On September 12, 2024 at 12: P.M., Licensing Program Analyst (LPA) Sara Luman-Gonzalez made an unannounced visit to deliver findings to the above Group Home and met with Marissa Corral, Facility Administrator. Prior to the meeting LPA Buchannan conducted the 10-day inspection of the Group Home on 8/19/2024. No deficiencies were cited during that inspection. LPA Buchannan requested the following documents: staff rosters, staff schedule, staff training hours, and client face sheets. LPA Buchannan attempted 1 confidential interview and conducted 7 interviews between 8/19/2024-8/28/2024. Based on evidence obtained and confidential interviews conducted during the investigation process the above allegation cannot be substantiated. 6 out of 7 interviews confirmed that they have never seen, heard, or witnessed any facility staff vaping or smoking on the premises. LPA Buchannan also confirmed during the inspection that there was no designated smoking area at the facility UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Sara Luman-Gonzalez 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES - CHERRYLAND HOMEFACILITY NUMBER: VISIT DATE: 09/12/2024

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

met_with: Marissa Corral, Facility Administrator


state: CA

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
out of 8 interviews confirmed that the staff member accidentally touched the client's stomach while extending their hand to prevent the client from leaving without permission. LPA Buchannan also found that due to the client's trauma history, they can react strongly to any type of touch, perceiving it as harmful. This can lead the client to fabricate stories about the staff who triggered these feelings. Finally, the client stated that the touch was unintentional, explaining that they walked into the staff member's hand, but that they viewed it as a harmful touch. Although the allegation may have happened or may be valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted, copy of this report and the Appeal Rights were discussed and provided to the licensee

Investigation Findings:
13On November 7, 2024 at 10: AM Licensing Program Analyst (LPA) Sarina Buchannan made an unannounced visit to deliver findings to the above Group Home and met with Facility Administrator, Marissa Corral. Prior to the meeting LPA Sara Luman-Gonzalez conducted the 10-day inspection of the Group Home on 9/18/2024. No deficiencies were cited during that inspection. LPA Luman-Gonzalez requested the following documents: Client Roster, Needs and Service plans, Client Face Sheets, Staff Roster, and Staff File with any disciplinary actions. LPA Buchannan attempted 2 confidential interviews and conducted 8 interviews between 9/18/2024-10/14/2024. Based on evidence obtained and confidential interviews conducted during the investigation process, the above allegation cannot be substantiated. (Continued on LIC 9099C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Sarina Buchannan 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES - CHERRYLAND HOMEFACILITY NUMBER: VISIT DATE: 11/07/2024

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

report_type: Complaint Investigation

met_with: Facility Administrator, Marissa Corral

complaint_status: unsubstantiated


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Based on evidence gathered and confidential interviews conducted during the investigation, the allegations above cannot be substantiated because there were inconsistent statements throughout the investigation process. 7 out of 9 interviews stated that staff do have an appropriate relationship with clients. It was confirmed that in December 2022 an incident occurred in which a staff member took a client to their family gathering. However, it was also verified that this incident took place at a different facility, where the staff member was employed and the client resided at the time, not at the above facility. In addition, LPA was unable to confirm or deny instances of staff taking clients to their home to complete labor, or the client doing any labor while at the family gathering. Also, the investigation was unable to prove or disprove that the facility staff were being discouraged from and not reporting incidents in a timely manner. LPA could not confirm details regarding incidents, or dates of the incidents, which were not being reported. Also, the facility confirmed that there were no formal complaints from staff regarding them being discouraged from reporting and all staff interviewed stated they felt they could report incidents. Lastly, LPA could not determine whether staff mismanaged clients' money and then falsified minors' records. LPA could not establish a time frame in which clients' money was allegedly mismanaged causing staff to falsify the related documentation. Also, a record review did not show any errors in client funds or any missing receipts during the time frame of March 1, 2025, to May 7, 2025. Although the allegations may have happened or may be valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview conducted, copy of this report and the Appeal Rights were discussed and provided to the licensee.

Investigation Findings:
13On August 6, 2025 at 12:46PM Licensing Program Analyst (LPA) Tatyana Shulz made an unannounced visit to deliver findings to the above facility and met with Justin Ma'Ae, Adminisrator who granted LPA access to the facility. Prior to the meeting LPA Sarina Buchannan conducted the 10-day inspection of the facility on 05/08/2025. LPA Buchannan requested the following documents: Staff Roster (LIC 500), Client Roster (LIC9020), Staff Schedule (April), Staff Contact Information (April), related incident reports, client needs and services plans, and P&I Records (Last Months). LPA Buchannan conducted 9 and attempted 1 confidential interview between 05/08/2025-07/31/2025. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Tatyana Shulz 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES - CHERRYLAND HOMEFACILITY NUMBER: VISIT DATE: 08/06/2025

met_with: Justin Ma'Ae-Adminisrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Tana Kinder conducted an announced pre licensing inspection with the President, Regional Administrator and Senior Administrator on 2/24/2023 at 10:30 am at the facility. LPA conducted the walk through of the facility with the above named staff and observed 4 bedrooms, 1 garage, 2 common areas, 3 bathrooms, a kitchen, laundry room, staff office and a locked walk-in closet for medication, staff and client files and client funds. All spaces were clean, sanitary, free of insects, and had unobstructed pathways. LPA observed the refrigerator was 31 degrees and the freezer was 0 degrees. The hot water from the kitchen sink was 119.3 degrees. The facility does not utilize protective separation rooms. All the bedrooms are furnished with a bed, dresser, night stand, closet, beanbag chair and are well-lit. One bedroom is set up for 2 clients and the others are for one client. The front yard and back yard are fenced in with an accessible gate to the front of the property. The grounds have a recreation area with a basketball hoop, and a secured swing set that will be set up by April. There is a concrete patio area. There are 2 patio tables in the garage that will be assembled by April to be placed on the patio. There are 4 cameras on the outside of the facility. There are no inside cameras at the facility. The water source is well water that has been analyzed and is safe for consumption. There are 2 fully charged fire extinguishers, one on the first floor, one on the second floor. The smoke detectors and carbon monoxide monitor are linked and in working order. There are locked storage cabinets in the garage. There is a shed in the backyard that is empty. A lock will be put on it. The backyard is fenced off with extra yard on the other side that is not accessible to the clients at this time. On the other side of the locked side yard there are 2 locked workshops that are not in use or accessible to the clients. The facility is using a mini-van to transport clients. There are currently no clients at the facility. Continued... LPA has observed the following that need to be brought into compliance before issuance of the license: Expand facility sketch Post Grievance policy Lock on office closet LPA suggested the following: Move knives from hutch Remove glass from hutch and cabinet doors Remove lock from 3rd cabinet in laundry room LPA reviewed the following forms with the facility staff:

report_type: Facility Evaluation

visit_type: Prelicensing

met_with: President


summary: Facility Evaluation

raw_content:
Narrative:
On August 31, 2023, at 10: AM Licensing Program Analyst (LPA) Shalisa Stiger and Licensing Program Manager (LPM) Rosa Rodriguez conducted an announced Post Licensing visit to the above facility. LPA Stiger called the Administrator and was advised the facility is still waiting on vendor contracts, landscaping completion and currently does not have any clients. The facility hopes to be open in approximately two (2) weeks and will check in with LPA Stiger on any updates. The Administrator will contact LPA Stiger to schedule a follow up Post Licensing Inspection at a later date.

met_with: Richard Herrera, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 04/15/24, Licensing Program Analyst (LPA) Lyta Vue arrived unannounced at the facility and met with Marissa Corral, Program Manager. The purpose of the visit was to conduct a Required Annual Inspection of the facility. This is the first Annual inspection for the facility and a Pre-Licensing was done on 08/31/23. LPA utilized the CARE Tool to complete the Annual inspection. The facility is licensed to provide treatment services for ambulatory children ages six (6) to Seventeen (17) years. The facility currently has (0) clients. Zero (0) client was present during the inspection. The facility is licensed for a maximum capacity of five (5). Staff to client ratio is depended on how many clients. For one (1) client, there will be staff working 168 hours per week and for two (2) clients, there will be staff working 224 hours per week, LPA conducted an inspection of the physical plant and checked for all necessary requirements. The facility had no noticeable odor and maintained an acceptable room temperature. There are a total of four (4) bedrooms available for clients, with one (1) bedroom being a shared bedroom of two (2) clients. The fifth bedroom is used for a locked staff office. LPA observed the client bedrooms, living room, kitchen, three (3) bathrooms, the backyard, the garage, and the staff office to be clean and organized. LPA observed each client bedrooms to have a closet, a dresser, and a clean mattress. Sheets, blankets, and pillows were in good condition. No bedrooms were decorated yet because the facility currently does not have any placement. LPA observed a locked staff office with a locked closet where files and medications will be stored. LPA observed the proper postings including facility license, complaint hotline, menu, and emergency disaster plan. Smoke alarms were in working order, fire extinguishers were current, and a first aid kit was fully stocked. The facility has no outstanding fees. LPA observed some snack items in cabinets but did not observe any food in the kitchen and in the additional refrigerator in the garage because the facility does not have any placement yet. Report continued on 809c Disinfectants and cleaning solutions will be made inaccessible and will be locked in locked cabinets in the garage. There will be extra non-perishable food stored in a pantry in the garage. LPA reviewed zero 0 client files due to the facility not having any placement yet. LPA reviewed zero (0) staff files due to no hired staff yet. LPA interviewed zero (0) staff on site. LPA interviewed zero (0) clients. The facility has no placement and no hired staff. No citations were given on this date. A signed copy of this LIC-809 and LIC 809c report was provided to Marissa Corral, Program Manager.

visit_type: Annual

met_with: Marissa Corral, Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On August 19, Licensing Program Analysts (LPAs) Sarina Buchannan and Sara Luman-Gonzalez arrive at the Kavere Services Cherryland Home. LPAs were greeted by Marissa Corral who granted LPAs access. LPA's conducted a tour of the inside and outside of the facility where LPA's observed the following deficiencies. Part of the chain link fence in the backyard is sticking out exposing metal. The rear fence gate to the remainder of acreage is unlocked exposing debris and unused building material. Pieces of metal are on the ground along the fence line exposing sharp metal. One bottle of cleaning product was left under the sink without a lock. (See LIC TV) This case management will remain open, until a follow up inspection is conducted to ensure the facility is in full compliance. An exit interview conducted and a copy of this report was left with Marissa Corral.

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On August 19, Licensing Program Analysts (LPAs) Sarina Buchannan and Sara Luman-Gonzalez arrived at the Kavere Services Cherryland Home. LPAs were greeted by Marissa Corral who granted LPAs access. LPA's conducted a tour of the inside and outside of the facility where LPA's observed the following deficiencies: · Part of the chain link fence in the backyard is sticking out exposing metal. LPA Buchannan received pictures from the facility on 8/27/24 showing that the part of the chain link that was exposing metal has now been removed and the remainder of the fence is in good repair. On September 12, LPA Luman-Gonzalez observed the broken portion of the chain link fence was removed and is in compliance. · The rear fence gate to the remainder of acreage is unlocked exposing debris and unused building material. LPA Buchannan received pictures from the facility on 8/27/24 showing the fence now has a lock on it and acreage is no longer accessible to clients in care. On September 12, LPA Luman-Gonzalez observed a lock to be on the gate blocking the rear acreage. · Pieces of metal are on the ground along the fence line exposing sharp metal. LPAs Buchannan and Luman-Gonzalez observed the metal be removed while at the facility on August 19, 2024. On September 12, LPA Luman Gonzalez confirmed the metal to be removed and the area is in compliance. · One bottle of cleaning product was left under the sink without a lock. LPA Buchannan received pictures from the facility on 8/27/24 showing the administrator informed staff of the mandatory training and screen shots of staff taking the training via Zoom. On September 12, LPA Luman-Gonzalez observed all cleaning products to be locked up and in compliance. (See LIC TV) This case management that was initially open on August 19, 2024 is now closed. The facility is in full compliance. An exit interview conducted and a copy of this report was left with Marissa Corral.


facility_name: KAVERE SERVICES-PINETOWN HOME

raw_content:
Narrative:
unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. No title 22 regulations were cited during today's inspection. Exit interview conducted and a copy of this report was left with Isaac Herrera, Administrator.

Investigation Findings:
13Licensing Program Analyst (LPA) Jean Stidman, conducted an unannounced inspection to the facility on 6/2/23 at TIME to deliver complaint allegation findings. LPA met with Isaac Herrera, Administrator and discussed the above allegation. During the investigation of Staff pulled minor in care's hair, LPA toured the facility with Marissa Corral, Administrator on 1/24/23 and 2/2/23. On these inspections, LPA inspected the physical plant inside and out, reviewed four client files. On 2/6/23 and 2/23/ LPA obtained documentation for the complaint investigation of client's Admission Agreement, Individual Program Plan (IPP), identification and emergency information, notes, physical, behavior reports and incident reports. LPA conducted interviews on 1/24/23 and 2/2/23 with four clients and two staff. Confidential interviews and records reviewed revealed inconsistencies in statements provided. Based on LPA's observations, interviews which were conducted, and records reviewed, the preponderance of evidence standard has not been met, therefore the above allegation is found to be UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dara Campos LICENSING EVALUATOR NAME: Jean Stidman 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 23-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, NATOMAS PARK DR., STE FACILITY NAME: KAVERE SERVICES-PINETOWN HOMEFACILITY NUMBER: VISIT DATE: 06/02/2023

met_with: Isaac Herrera, Administrator


raw_content:
Narrative:
VRMC Admission Agreement, Facility Admission Agreement, and Incident Reports for two youths in care. For one youth, LPA requested the following for review: Needs and Services Plan, Photos of injuries, Weekly Case Notes, description of Injuries, and medical documentation. No serious concerns noted. Confidential interviews were conducted with seven individuals, two children, and five adults, and attempted with two adults during the period of 9/18/2024 to 10/21/2024. An investigation was conducted regarding the allegation: Minor sustained unexplained injuries while in care. Five out seven interviews conducted were consistent that minor did not sustain the injuries while in care. S1, S2, S3, S4, and C2 reported that C1 did not sustain bruising in care but would have normal bruising. C1 is non-verbal, has a history of self-injurious behavior and would go on home visits frequently. Additionally, documents reviewed, including Weekly Case Notes, description of Injuries and Needs and Services plan supports the allegation may not have happened. The facility noted all bruises that were visible on the minor and documented the bruising before and after the child was in care. Based on LPA interviews conducted, and records reviewed, the preponderance of evidence standard has not been met, therefore the above allegation is found to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted with and a copy of this report was provided to Marissa Corral, Administrator.

Investigation Findings:
13Licensing Program Analysts (LPAs) Maie Soliman and Jean Stidman conducted an unannounced complaint inspection with the above facility on 11/21/24 at 11:45am and met with Marissa Corral, Administrator. The purpose of the inspection was to deliver complaint findings for the allegation of: Minor sustained unexplained injuries. On 9/18/2024 at 10:40AM Licensing Program Analyst (LPA), Angelique Hill, arrived unannounced at the facility for the purpose of initiating a complaint investigation related to the above allegation. LPA met with Isaac Herrera, Administrator. During the course of the investigation, the following documents were gathered and reviewed: Client Roster, Staff Roster, Work Schedule for June to September 2024, Visitor Sign-In Log, Facility Sketch, UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dara Campos LICENSING EVALUATOR NAME: Jean Stidman 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES INC, PINETOWN CRISIS HOMEFACILITY NUMBER: VISIT DATE: 11/21/2024

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

met_with: Marissa Corral, Administrator


raw_content:
Narrative:
with four children and six staff, during the period of 5/8/25 to 6/4/25. Six out of six staff interviews reported the staff report incidents the next day and they are not discouraged from reporting incidents. Four out of four children and five out of six staff interviewed reported the client records are accurate and not falsified Based on LPA interviews conducted, and records reviewed, the preponderance of evidence standard has not been met, therefore the above allegations are found to be UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur. An exit interview was conducted, and a copy of this report was provided to Isaac Herrera, Administrator.

Investigation Findings:
13Licensing Program Analyst (LPA) Jean Stidman conducted an unannounced complaint inspection on 7/31/25 at 8:30am and met with Isaac Herrera, Administrator. The purpose of the inspection was to deliver complaint findings for the above allegations of facility failed to report incident, staff are discouraged from reporting incidents, and staff falsify client records. On 5/15/ LPA met with Isaac Herrera, Administrator to initiate this complaint investigation. LPA requested the following documents be given to LPA by 5/21/25 for two children in placement between June-October 2024 of Progress Notes, Needs and Services Plan, Medication Administration Records, medical assessment, Incident Reports, Personal and Incidental Funds logs and receipts. The client roster, staff roster or LIC500's, and staff work schedules for April 2024-October 2024. LPA Stidman review of these records reveal that all incidents were reported, and the client's records contain all the required information. Confidential interviews were conducted by LPA's Jean Stidman, Alyssa Burgess and Sarina Buchanan UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dara Campos LICENSING EVALUATOR NAME: Jean Stidman 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES INC, PINETOWN CRISIS HOMEFACILITY NUMBER: VISIT DATE: 07/31/2025

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


summary: Facility Evaluation

raw_content:
Narrative:
4/1/2021 beginning at 2:30pm. LPA spoke with the Administrator and explained the purpose of today's Licensing Program Analyst (LPA) Rob Sandles conducted an unannounced tele-inspection visit to the facility on contact was to conduct a Case Management regarding an incident report that the department received on 3/26/2021. The date of the incident was 3/24/2021 in which a youth had two fingers fractured by his roommate while playing games in their LPA requested following documents: Needs and Service Plan for two Clients, Staff Roster, Staff schedule for 3/22/2021-3/28/2021, and Facility Sketch. LPA inspected the facility and observed Staff and Client files in a locked room separated and filed in locked cabinets. All needed Covid-19 signage posted thru facility. LPA observed posted license and certifications in office. Smoke Detectors worked properly, and Fire Extinguishers were fully charged and up to date. Bedrooms were clear of clutter with client's personal effects. Extra linen and clean towels were observed. Seven days of perishables/14 days of nonperishables. Sharps utensils and Cleaning supplies locked up in separate cabinets. First Aid Kit checked. Bathrooms had proper handwashing signage and soap and paper towel. Temperature checked with clients three times a day. Staff temperature checked beginning of shift and end of shift. No citations were cited. Further investigation needed

met_with: Administrator Amanda Gulley


summary: Facility Evaluation

raw_content:
Narrative:
On 8/17/ Licensing Program Analyst (LPA) Rob Sandles and LPA Shoua Xiong conducted an unannounced visit to the facility beginning at 12: PM. LPAs met with Administrator Amanda Gulley and explained the purpose of today's visit was to conduct an ANNUAL/REQUIRE inspection. LPA Sandles inspected the facility and observed posted: Facility sketch, Evacuation plan, Covid hand washing signage and Facility License. LPA inspected the facility and observed Staff and Client files in a locked room separated and filed in locked cabinets. Smoke Detectors worked properly, and Fire Extinguishers were fully charged and up to date. Carbon Monoxide detectors were working properly. LPA observed that each client was provided their own beds with beddings, dressers, and closet space. Extra linen and clean towels were observed. Seven days of perishables/14 days of nonperishables food items was observed. Sharps utensils and Cleaning supplies were locked up in separate cabinets. The dining area contained a table that seated four. First Aid Kit checked and contained all required supplies. Bathrooms had proper handwashing signage and soap and paper towel. The garage contained play activities and games. Outside area was observed to be free of debris and safety hazards. Water temperature was checked and measured within the required range. LPAs began reviewing four client files but did not finish. LPAs will return on a different date and time to complete client file reviews and the inspection. No deficiencies were cited on today's date. Exit interview conducted and a copy of this report was given to Amanda Gulley, Administrator.

met_with: Amanda Gulley, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Robert Sandles and LPA Shoua Xiong conducted an unannounced visit to to the facility on 8/18/21 beginning at 12: PM. LPAs met with Amanda Gulley, Administrator, and explained the purpose of the visit was to continue the Annual/Required inspection. On today's date upon arrival, there was one staff and no clients present. During the inspection visit, three clients arrived home and there was four staff present. On today's inspection, LPAs reviewed four client files and ten staff files. All client and staff files had all the required documents. LPAs also conducted interviews with three staff and two clients. No deficiencies was cited on today's date. Administrator Amanda Gulley had to leave due to prior engagements. Exit interview was conducted with Lead Staff Lashray Elliott and a copy of this report was given to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 11/15/ Licensing Program Analysts (LPAs) Jean Stidman and Kim Pawlowicz made an unannounced Annual Inspection. During the inspection LPAs met with Amanda Gulley Administrator who assisted with the inspection. LPAs conducted a walk-through of the facility inside and out. Facility staff-client ratio at time of inspection two staff and no kids were present. LPA observed the facility is a two story home with three bedrooms and three bathrooms. I. Physical Plant Posting of license_x__ Personal Rights_x__ Disinfectants/Cleaning solutions inaccessible_x__ Refrigerator Temperature at or below 45 degrees F _x Freezer Temperature at or below 0 degrees_x__ Nonperishable Foods one week and fresh perishable foods two days minimum_x_ Menu present and posted__x__ Working telephone _x__ Carbon monoxide detector x__ Smoke Detector x__ First Aid Kit fully stocked_x__ Common Room available__x_ Dining area (enough seating, furniture good condition, not broke or damaged) _x __Medication centrally stored, locked/inaccessible _x_ Office (locked and privacy) x__ Hot Water was 121 degree Fahrenheit and LPAs observed staff turned it down ___ Fire Extinguishers inspected May 2022. Toilets wash basin, bath and shower fixtures in good repair/no leaks___x__ Soap and Paper towels _x__ Laundry Facilities __x__ Bedrooms-required linen and furnishings _x_ Motor Vehicle properly maintained , lights, tires, registration/insurance and working seat belts__x_ Facility free of vermin __x_ Bedroom (required bedding/furniture, furniture in good repair) _x__ II. Operations Complaint Procedures For Youth Reviewed _x_ Board Minutes Reviewed__x___ III. Disaster Preparedness Quarterly Drills conducted and documented__X_ Disaster preparedness supplies verified _X_____ IV. Emergency Intervention Staff training __X___ V. Staffing Number of Staff files reviewed __4____Criminal record clearances verified _4__ First Aid Certificate__4__ Certified Administrators certificate valid and current_x_ Job title/qualification verified _X__ LPAs were unable to complete the inspection. An exit interview was conducted with Amanda Gulley Administrator and a copy of this report was left with Amanda Gulley Administrator.

met_with: Amanda Gulley Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPAs) Jean Stidman and Kim Pawlowicz made an unannounced annual inspection on 12/22/2022 at 1: PM. During the inspection LPA met with Amanda Gulley, Administrator who assisted with the inspection. LPAs conducted a walk-through of the facility inside and out. Facility staff-client ratio at time of inspection two staff and four clients present. Number of staff interviewed two Number of clients interviewed four. LPA observed # _3_bedrooms, # _2__bathrooms LPAs reviewed the following: VI. Client Records Number of Clients files reviewed ___5___Needs and Services Plan X Centrally Stored Medication and log reviewed _ X JV Reviewed X Psychotropic Medication and log reviewed X _Cash Resources_ X _ Compatible Assessment_ X VII. Core/Therapeutic Services Trauma Informed Practices are implemented as needed (including specialty mental health services and extracurricular activities and social supports) X Facility citation violation of California Code of Regulations, Title 22, Division 6, regulation 80088(e)(1) Fixtures, Furniture, Equipment and Supplies. During the inspection on 11/15/22 & 12/22/22 the water temperature was 121 degrees Farenheit which poses an immediate health, safety or personal rights risk to persons in care. The facility turned the hot water temperature down during the inspection. An exit interview was conducted with Amanda Gulley Administrator and a copy of this report was left with Amanda Gulley Administrator.


raw_content:
Narrative:
The Department has investigated the complaint that facility staff inappropriately restrained a minor. When discussing restraints with the clients, staff and other individuals, the youth are restrained only when they are a danger to themselves or other individuals in the home, it is a last resort and other de-escalation techniques have failed. A copy of Kavere Services Emergency Interventions Plan is located within the Program Statement which outline the use of restraints. The Reporting Party (RP) was following up on the use of restrains to confirm whether it was against regulations, which was determined that the home can use restraints. This was determined by Pro Act training records, Program Statement, Emergency Intervention Plan, and confidential interviews. On December 27, 2023, C1 was restrained using the prone method (restrained person is on their stomach) by staff and the restrain lasted for five minutes and C1 had no marks. The reporting party stated that a second incident occurred on December 29, 2023, where the prone method was used again by staff and C1 was restrained for five minutes, and no marks were observed. Later the same day, December 29th, C1 was restrained again using the prone method by staff C1 was restrained for two minutes, released and no marks were observed. When clients are restrained, the staff is watching their breathing and talking with them. The reason C1 was restrained was due to self-harming and staff aggression. This agency has investigated the complaint regarding the above allegation. We have found that the complaint was Unsubstantiated, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. No title 22 regulations were cited during today's inspection. A copy of this report and appeal rights were given to the agency.

Investigation Findings:
13Licensing Program Analyst (LPA) Mary Shelton conducted a visit to the home on 4/24/2024 at 11: PM, and LPA spoke with the Administrator, to deliver findings of the investigation on the complaint allegation as stated. LPA Shelton informed the complaint investigation included a Physical Plant Inspection of the home on 1/19/2024. The initial 10-day complaint inspection was conducted by LPA Connie Goldie, which included a walkthrough of the facility inside and outside on 1/19/2024. LPA Goldie opened the complaint and requested documentation related to the clients and staff at the facility to include client roster, face sheets, staff roster, including staff contact information and schedule for current month, facility sketch, Pro-Act certificates, restraint logs for December 2023, and Needs and Services Plan and case notes for C1. LPA Shelton interviewed Clients, staff, Pro Act Trainer, and the Program Administrator UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Mary Shelton 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES, INC/TRANSITIONAL SVC PRGM.FACILITY NUMBER: VISIT DATE: 04/24/2024

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

met_with: Marc Verzosa, Administrator


raw_content:
Narrative:
The Administrator stated that they did not take the client's laptop, and only asked the client if they could charge the laptop while the client slept at night. The client would stay up all night playing games on the laptop. The staff LPA interviewed stated the client would stay up late until 2: AM, and they would ask the client to turn in their laptop for the night so that they can go to sleep, however the client felt it was their right to use it. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted with FM and a copy of this report, confidential names list, and appeal rights were provided to him.

Investigation Findings:
13Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced complaint investigation inspection at the facility and met with Chiang Thompson Facility Manager (FM) who assisted with the inspection. LPA investigated this complaint by reviewing incident reports, and by conducting confidential interviews with the Reporting Party, the Administrator, one staff, three clients, one client's parent, and the client's Regional Center Service Coordinator (SC) between 1/24/2025 and 6/10/2025. During LPA's interview with the client, they stated that staff took their laptop on one or two ocassions overnight due to the client not going to sleep; staff have not kept the laptop, and staff have not prevented the client from doing anything they needed to do on it. The client's parent confirmed that the client had a hard time sleeping and their grades at school were suffering, so during an IEP meeting they arranged for the school to only allow the Wi-Fi to work while at school since the facility could not take the laptop from the client. Additionally, the parent stated that the facility staff were not supposed to take the laptop at night. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Alyssa M Burgess 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES, INC/TRANSITIONAL SVC PRGM.FACILITY NUMBER: VISIT DATE: 06/18/2025

met_with: Chiang Thompson


facility_name: KAVERE SERVICES, INC/TRANSITIONAL SVC PRGM.

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Shoua Xiong conducted an unannounced inspection visit to the facility on 10/20/21 beginning at 12: PM. LPA met with Najon Saina, Administrator, and explained the purpose of the visit was to conduct an Annual/Required inspection of the facility. At the time of this visit, present in the home was one client in care, two staff members, and the Administrator. On today's date, LPA completed a physical inspection of the home, inside and outside. This facility is a two story home with three client bedrooms, one office room with a bathroom, two client bathrooms, a living room, kitchen, garage, and a front and back yard area. The locked staff office was observed to contain staff and client files. There are current two clients placed in the facility. Each client was provided their own bedroom with beddings, dressers, closet space, and lamps. Smoke detectors were operational and observed in bedrooms, office, hallways, and the common area. There is a charged and serviced fire extinguisher, working carbon monoxide detector, and a complete first aid kit with a manual present in the facility. The facility's water temperature was tested and was within the required range of 105-120 degrees F. The facility was observed with the required two days' worth of perishable and seven days' worth of non-perishable food items. The facility was observed to have an extra refrigerator and pantry shelf in the garage for extra food supplies. The outside areas was observed to be well maintained and free of safety hazards. On today's date, LPA reviewed ten staff files. All staff files were found to be complete with the required documents present. LPA was unable to finish the Annual inspection and will return on another date and time to continue the inspection. No deficiencies were cited on today's date. Exit interview conducted and a copy of this report was given to Najon Saina, Administrator.

met_with: Najon Saina, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Shoua Xiong conducted an unannounced inspection visit to the facility on 10/22/21 beginning at 10: AM. LPA met with the facility's Shift Lead Supervisor, Roberto Rodriguez, and explained the purpose of the visit was to conduct an Annual Continuation of the inspection which had began on 10/20/22. At the time of this inspection, there was one staff present. During the process of this inspection, one client arrived on site along with a second staff. On today's date, LPA completed the rest of the inspection along with reviewing two client files. During client file review, LPA observed that each file was complete with the required documentation. LPA interviewed three staff members and one client in care. LPA was unable to interview the second client as they were currently still at school. The second client is also non-verbal. No deficiencies were cited on today's date. Exit interview conducted and a copy of this report was given to the Shift Lead Supervisor, Roberto Rodriguez.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/13/22, Licensing Program Analyst, (LPA) Uchenna Ajaero, paid an unannounced annual/required inspection visit and met with the facility administrator (AD), Kate Rush. LPA Ajaero introduced herseld to the AD and informed her of the purpose of the visit. Entrance checklist was provided to the administrator. The licensing fees are current. The facility is licensed for 2 youths and has 2 youths currently placed. The facility has a third bed in the case of an emergency. At 12:45 am we toured the bedrooms and they were neat. The beds were made, they had sheets, bed covers, comforter and top sheet with 2 pillows. The rooms were bright and lighted, the dressers were neat and closed appropriately, there were clothes hanging in the closet and more clothes folded away in the dressers. In the hall way there were clean folded linens, towels and personal toiletries. AD checked the alarm in the rooms and hall way and we observed that they all worked. At 1:05 am, we toured the kitchen. It was clean and organized. There were fresh fruits on the counter for the residents. The fridge was clean, there were no open foods. There was perishable food for about two days and nonperishable food for about 5 days in the kitchen area and more in the garage. There were client's rights poster on the wall, the youths activities and a menu on the refrigerator. AD stated she has clients who are traumatized by the wording of the Foster Kids on the current personal rights poster so she has a smaller sized current version from the Department of Social Services site posted alternatively. . At 1:25 am we inspected the garage. It was clean. There was hand washing sink in the garage, cleaning supplies were locked up in a cabinet, there was an extra fire extinguisher in the garage, there was a fridge with perishable food items and boxes of emergency foods and house items. At 4:00 pm LPA Ajaero interviewed AD, and S1, FY1 and FY2. LPA reviewed Community Care Licensing file, unusual incident reports, facility roster, facility profile and complaint history. LPA reviewed 2 client files. All documents were compliant per regulations. No deficiency is cited today. The annual required investigation is not complete. Staff will return tomorrow to complete the inspection. Exit interview was conducted, a copy of the report was provided, appeal rights were discussed and emailed.

met_with: Kare Rush, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
This is the second day of the annual required inspection. Licensing Program Analyst (LPA) Uchenna Ajaero conducted an unannounced inspection visit to the facility on 10/14/22 beginning at 10: AM. LPA met with Kate Rush, the facility administrator (AD) and explained the purpose of the visit was to conduct an Annual Continuation of the inspection which had began on 10/13/22. At the time of this inspection, there was one staff present. LPA completed the rest of the inspection along with reviewing three staff files. During the staff file review, LPA observed that each file was complete with the required documentation. LPA interviewed one staff member. LPA was unable to interview any client because they were currently still at school. No deficiencies were cited on today's date. Exit interview was conducted and a copy of this report was given to Kate Rush,the Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Katherine Rush, Administrator on 5/25/23 at 10:45am. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Stidman met with Katherine Rush, Administrator and inspected the facility inside and out. LPA reviewed zero child's records and four staff personnel files on site at the facility. LPA did not review any child's psychotropic medications and medication records due to one clients is not a dependent of the courts (aka foster child) and the other client has been in placement less than 30 days. LPA interviewed four staff on site to discuss the facilities policies and procedures of operation. LPA did not interviewed any children currently prescribed psychotropic medication due to one clients is not a dependent of the courts (aka foster child) and the other client has been in placement less than 30 days. LPA observed the sliding glass door screen was not on the door. The administrator provided documentation of a work order to have this repaired has been requested. LPA observed one metal chair in the backyard has a bent leg. LPA observed the administrator remove the chair. LPA provided a copy of this licensing report to Katherine Rush, Administrator. No deficiencies are being cited at this time. LPA conducted exit interview with Katherine Rush, Administrator..

met_with: Katherine Rush, Administrato


summary: Facility Evaluation

raw_content:
Narrative:
On 6/6/23, Licensing Program Analyst, (LPA) Uchenna Ajaero arrived at Kavere Services in Stockton to conduct an annual required inspection. Due to the delay in conducting the inspection, FAS did not upload the CARE TOOLS and excel worksheet for the inspection. This is a record of all items checked and reviewed and the result. LPA observed all required postings on the board. License is posted for public view. LPA observed and tested smoke detectors and carbon monoxide detectors. There is a quiet room downstairs, one office with files, desks, and lockers upstairs. LPA observed 2 bedrooms with appropriate bedding and furniture. All bathrooms were checked and were clean. The water tested at the required temperature. The hallway cabinet contained extra linens, towels, blankets, cleaning supplies, and hygiene products. All cleaning chemicals were locked and inaccessible to clients and stored away daily in the garage. LPA observed medications and sharps to be locked. There were 3 fire extinguishers on site. They were last checked in May of 2023. LPA reviewed 2 youth and 5 staff files, LIC 858 and LIC 859. All required documents were observed in the files. First aid kits had all required items. LPA observed the kitchen refrigerator, freezer and pantry to be filled with perishable and non- perishable food items. LPA observed an adequate supply of utensils, dishes and a menu. A trash bin with a lid is located in the kitchen. The living room was observed to have adequate furniture and lamps LPA observed the outdoor area to be clear of clutter and debris. The garage contained holiday decorations, tools, can goods, emergency / disaster supply. No citations issued during this inspection. A copy of this report was left with Alfonso Jauregui, House Manager

met_with: Alfonso Jauregui, House Manager


facility_name: KAVERE SERVICES/STOCKTON CRISIS HOMES

raw_content:
Narrative:
The Department has investigated the complaint that the client sustained unexplained injuries and client was sexually assaulted. Client sustained unexplained injuries. It was reported during a restraint on 1/9/2024 that C1 had visible scratches on C1's neck, as well as a bloody noise, and was complaining about leg pain. During a confidential interview with the Department's Investigation Bureau Investigator, (IB) Jorge Jauregui C1 stated that C1 had been restrained by staff due to C1's behavior. C1 did not remember when the incident occurred. C1 did not mention any unexplained injuries. C1 stated that C1 felt safe at Kavere. The reporting party stated that there was not any evidence that supported the current allegation and believe the force that staff used to restrain C1 was appropriated to guarantee not only the staff's safety but also C1's safety. The reporting party stated the scratches that C1 sustained were minor and did not require medical treatment. The reporting party did not see any injuries to C1's legs or bruises. The social worker has no concern about the staff. Based on the investigation, observation, records reviewed, and interviews conducted, the complaint findings are UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Client was sexually assaulted. During confidential interviews C1 stated that C1 had not been touched inappropriately by Kavere staff. C1 also stated C1 felt safe at the home. The reporting party did not see any evidence that supported the allegation. C1 also stated to the reporting party that C1 made up the allegation. C1 was upset for not being allowed to play music videos. The social worker for C1 stated that he did not have any concerns regarding staff. Based on the investigation, observation, records reviewed, and interviews conducted, the complaint findings are UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. No title 22 regulations were cited during today's inspection. A copy of this report and appeal rights were given to the agency.

Investigation Findings:
13Licensing Program Analyst (LPA) Mary Shelton conducted a visit to the home on 2/14/2024 at 8: AM, and LPA spoke with the Administrator to deliver findings of the investigation on the complaint allegations as stated. LPA Shelton informed the complaint investigation included a tour of the facility on 1/19/2024. LPA Shelton informed the Administrator this case was investigated by the Department's Investigation Bureau Investigator, (IB) Jorge Jauregui. The initial 10-day complaint inspection was conducted by LPA Connie Goldie, at the home on 1/19/2024 which, included a Physical Plant Inspection of the home and obtaining of relevant documents: related to the clients and staff at the facility to include client roster, face sheets, staff roster, including staff contact information and schedule for current month, facility sketch, Pro-Act certificates, restraint logs for January 2024, and Needs and Services Plan and case notes for C1. Investigator, (IB) Jorge Jauregui, interviewed the reporting party, social worker, Intern and C1. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Mary Shelton 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES/STOCKTON CRISIS HOMESFACILITY NUMBER: VISIT DATE: 02/14/2024

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


raw_content:
Narrative:
The Department has investigated the complaint that Staff used prohibited restraints on a youth causing marks. C1 was not interviewed for the purpose of this complaint. The bio-parents thought it was best for C1 not to be interviewed. C2 is non-verbal and LPA was unable to establish a rapport. C3 did not want to talk about being restrained. When discussing restraints with the staff and other individuals, the youths are restrained only when they are a danger to themselves or other individuals in the home, it is a last resort and other de-escalation techniques have failed. A copy of Kavere Services Emergency Interventions Plan is located within the Program Statement which outline the use of restraints. Staff conducted a body check on C1 and found several marks on C1's lower back and a small mark on C1's chin. Staff stated the injuries could have occurred before the restraint. C1 grabbed staff's glasses, started swinging on staff, biting, and grabbing staff. The Pro Act trainer reviewed the Incident Report dated 2/11/2023 and stated that the injuries could have occurred when C1 wedged himself between the bed and door. Staff interviewed stated they never put pressure to the back when doing a restraint. Based on the investigation, observation, records reviewed, and interviews conducted, the complaint findings are UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. No title 22 regulations were cited during today's inspection. A copy of this report and appeal rights were given to the agency.

Investigation Findings:
13Licensing Program Analyst (LPA) Mary Shelton conducted a visit to the home on 4/24/2024 at 12: PM, and LPA spoke with the Administrator, to deliver findings of the investigation on the complaint allegation as stated. LPA Shelton informed the complaint investigation included a Physical Plant Inspection of the home on 1/10/2024. The initial 10-day complaint inspection was conducted by LPA Mary Shelton, at the agency on 1/10/2024 included a review of the facility and obtaining of relevant documents: documentation related to the clients and staff at the facility to include client roster, face sheets, staff roster, including staff contact information and schedule for current month, facility sketch, Pro-Act certificates, restraint logs, and Needs and Services Plan and case notes for C1. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Mary Shelton 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES/STOCKTON CRISIS HOMESFACILITY NUMBER: VISIT DATE: 04/24/2024

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


raw_content:
Narrative:
Allegation 1. Staff inappropriately restrained minor resulting in injuries. During the initial interview of FC1 at school, FC1 revealed that S1 pushed FC1 down and tried to choke FC1. During the second interview, FC1 stated there were two staff members who choked FC1. When LPA questioned FC1 about the inconsistency, FC1 declined any further response to the LPA's questions. Staff denied restraining FC1. Based on LPA's confidential interviews and documents reviewed, the allegation that Staff inappropriately restrained minor resulting in injuries is unsubstantiated, meaning that the allegation lacks a preponderance of evidence to prove that the violation occurred. Allegation 2. Staff inappropriately spoke to minor in care. It was alleged that S1 made inappropriate threats to FC1 during an altercation. FC1 did not recall the alleged statements when LPA interviewed FC1 on both occasions. Staff denied the alleged threats to FC1. Based on LPA's confidential interviews and documents reviewed, the allegation that Staff inappropriately spoke to minor in care is unsubstantiated, meaning that the allegation lacks a preponderance of evidence to prove that the violation occurred. Allegation 3. Staff refused to provide food to minor. During LPAs interview with FC1, FC1 stated that staff refused to provide a second helping of food to FC1. FC1 got angry and began to destroy things at the facility. S1 stated the FC1 never requested a second helping of food but began picking on FC2 while at the table and then directed his anger to staff once he got up from the table. S2 and S3 did not observe the incident but was later told of the incident by S1. Based on LPA's confidential interviews and documents reviewed, the allegation that Staff refused to provide food to minor is unsubstantiated, meaning that the allegation lacks a preponderance of evidence to prove that the violation occurred. Exit interview was conducted with Noel Maldonado, the DSP. A copy of the report and Appeal Rights were provided to the facility.

Investigation Findings:
13On 5/30/24 about 4: PM, Licensing Program Analyst, (LPA) Uchenna Ajaero conducted an unannounced complaint investigation visit to deliver finding for this allegation. LPA Ajaero met with Noel Maldonado, the DSP and informed him of the purpose of the visit. On 3/12/2024, LPA Ajaero visited the facility and met with the Administrator. LPA requested and received client file (C1) and obtained copies of Identification Sheet, Needs and Service Plans, IEP, and Progress Reports from January to March 2024. LPA interviewed the Administrator, (AD) and one staff member, (S1). LPA Ajaero interviewed FC1, FC1's teacher and three staff between 3/13/24 and 3/21/24. LPA reinterviewed FC1 on 4/1/2024. FC2 is nonverbal and could not be interviewed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Uchenna Ajaero 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES/STOCKTON CRISIS HOMESFACILITY NUMBER: VISIT DATE: 05/30/2024

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

met_with: Noel Maldonado, DSP


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Shoua Xiong conducted an unannounced inspection visit to the facility on 10/19/21 beginning at 10: AM. LPA met with Najon Saina, Administrator, and explained the purpose of the visit was to conduct an ANNUAL/REQUIRED inspection. At the time of arrival, there was one staff on shift and zero clients present, as they were currently in school. On today's date, LPA conducted a physical inspection of the home. LPA observed that each client was provided their own bedroom with beds, beddings, dressers, closet space, and adequate lighting. Extra linen and hygiene supplies was observed in hall closets. Smoke Detectors was present in each bedroom, in the hall, in the common area, and was in working condition. LPA observed an operating carbon monoxide detector and a charged fire extinguisher in the home. LPA observed that the facility had two refrigerators and stocked kitchen cabinets which contained more than two days' worth of perishable food items and seven days' worth of non-perishable food items. Knives, cleaning solutions, and medications were stored in locked closets. A complete First aid kit along with the manual was present in the facility. All sink faucets and toilets was observed to be in working order. The hot water was tested and was within the required range of 105 degrees F and 120 degrees F. The outside area was clean and free of safety hazards. LPA also conducted a review of two client files. LPA observed that the files were complete and had all the required documents. LPA conducted one staff interview. Two residents in care arrived from school around 3: PM. LPA attempted to conduct interviews with residents but was unable to complete the interviews due to one resident ending the interview early and the second resident refusing to speak with LPA. LPA was unable to begin reviewing staff files. LPA informed Administrator that they will return on another date and time to complete the Annual inspection process. No deficiencies were cited on today's date. Exit interview conducted and a copy of this report was given to Najon Saina, Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Shoua Xiong conducted an unannounced inspection visit to the facility on 10/20/21 beginning at 10: Am. LPA met with Najon Saina, Administrator, and explained the purpose of the visit was for an Annual Continuation of the inspection visit which began on 10/19/21. On today's date, LPA reviewed ten staff files. All staff files were found to be complete with the required documents present. However, LPA had technical difficulty and was unable to access and continue using the CARES inspection tool document. LPA will return on a different date and time to complete the inspection process. No deficiencies were cited on today's date. Exit interview conducted and a copy of this report was given to the Administrator, Najon Saina.


summary: Facility Evaluation

raw_content:
Narrative:
On 8/17/22, Licensing Program Analysts, (LPAs) Uchenna Ajaero and Connie Goldie, paid an unannounced annual/required inspection and met with the facility administrator (AD), Kate Rush. LPAs introduced themselves and informed the AD of the purpose of their visit. Entrance checklist was provided to the administrator. The licensing fees are current. The facility is licensed for 3 youths and has 2 youths currently placed. At 11:05 am, the LPAs and the AD toured the home. The kitchen was clean and organized, There were fresh fruits on the counter for the residents. The fridge was clean, there were no open foods. There was perishable food for about two days and nonperishable food for about 5 days. There were client's rights poster on the wall but it was outdated but the AD posted a current one. AD stated she has clients who are traumatized by the wording Foster Kids on the current personal rights poster so she printed a current version from the Department of Social Services site. At 11:30 am we inspected the garage. It was clean. There was hand washing sink in the garage, cleaning supplies were locked up in a cabinet, there was an extra fire extinguisher in the garage, there was a fridge with perishable food items and boxes of emergency foods. At 11:45 am we toured the bedrooms and they were neat. The beds were made, they had sheets, bed covers, comforter and top sheet with 2 pillows. The rooms were bright and lighted, the dressers were neat and closed appropriately, there were clothes hanging in the closet and more clothes folded away in the dressers. In the hall way there were clean folded linens, towels and personal toiletries. AD checked the alarm in the rooms and hall way and we observed that they all worked. . At 2:00 pm LPA Ajaero interviewed AD, S1 and S2. LPA's reviewed Community Care Licensing file, unusual incident reports, facility roster, facility profile and complaint history. LPAs reviewed 2 client files. All documents were compliant per regulations. One technical advisory was given and we explained to the AD that a technical advisory is not a deficiency. No deficiency is cited today. Exit interview was conducted, a copy of the report was provided, appeal rights were discussed and emailed.

met_with: Kate Rush, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 8/18/22, Licensing Program Analysts, Uchenna Ajaero and Connie Goldie returned to the facility to complete the Annual Continuation Inspection visit that began on 8/17/22. LPAs met with the Administrator Kate Rush, AD. to assist with completion of inspection. No deficiencies were cited. At 1:10 pm LPAs interviewed C1 as he had a minimum day at school. LPA reviewed 2-staff records, and Administrator's training records and documents, and the LIC 500. LPAs interviewed C2 at 3:40 pm. Exit interview was conducted, appeal rights were discussed and document emailed to Administrator and return receipt requested.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Katherine Rush, Administrator on 5/25/23 at 9:30am. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Stidman met with Katherine Rush, Administrator and inspected the facility inside and out. LPA reviewed zero child's records and two staff personnel files on site at the facility. LPA did not review any child's psychotropic medications and medication records due to the clients are not dependents of the courts (aka foster children). LPA interviewed two staff on site to discuss the facilities policies and procedures of operation. LPA did not interviewed any children currently prescribed psychotropic medication due to the clients are not dependents of the courts (aka foster children). LPA observed the backyard fence on the left side of the yard (as you're facing the house from the street) has a board missing. The administrator provided documentation of a work order to have this repaired has been requested. LPA provided a copy of this licensing report to Katherine Rush, Administrator. No deficiencies are being cited at this time. LPA conducted exit interview with Katherine Rush, Administrator..

met_with: Katherine Rush, Administrator


facility_name: KB HOMES LLC

summary: Facility Evaluation

raw_content:
Narrative:
On January 20, 2026, an informal conference was held with Applicant Markiesha Brown of KB Homes, LLC to discuss current Community Care Licensing (CCL) areas of clarification. Present at the meeting were Licensing Program Manager (LPM) Ann Valenzuela, Licensing Program Analysts (LPAs) Charmaine Linley and Stefanie Mutialu and Applicant, Markiesha Brown. The following areas of clarification were addressed: LPM Valenzuela asked Ms. Brown to provide the facility number, address, and telephone number for Stella Morris. Ms. Brown provided the address of Sylmar Drive, Moreno Valley, 92553 and phone number (909) 496-4465. Ms. Brown stated they did not have the facility number and stated the facility is currently not operating right now. LPM Valenzuela asked Ms. Brown to clarify the dates of employment and Ms. Brown stated they worked at the facility from 2021-May 2025. Ms. Brown stated the facility closed in August. LPM asked Ms. Brown if Stella Morris is a Group Home or Short-Term Residential Treatment Program (STRTP) and Ms. Brown stated the facility is a STRTP. LPM Valenzuela asked Ms. Brown to clarify if Lakechia is the same on all the forms submitted to Community Care Licensing (CCL) and Ms. Brown stated Lakechia is the same person and is going to work with Ms. Brown. LPM asked Ms. Brown to clarify if Lakechia is the individual who wrote the letter of employment experience and Ms. Brown said yes. LPM Valenzuela asked Ms. Brown to clarify their role at IHeart Lives and Ms. Brown stated they are a DSP, Direct Support Professional. LPM Valenzuela asked what their responsibilities were and Ms. Brown stated daily activities with the kids. Ms. Brown stated the facility just opened up and Ms. Brown went through the *** LPM Valenzuela asked Ms. Brown to confirm that their resume stated that they were a Direct Support Professional at Stella Morris in Moreno Valley and assisted with independent living skills, medication administration, and behavioral supports for 6 or more children and Ms. Brown confirmed that was correct. LPM Valenzuela asked Ms. Brown for the capacity of the facility and Ms. Brown stated the facility was a capacity of six. LPA Linley asked if the clients were male or female and Ms. Brown stated the clients were female. LPM Valenzuela asked Ms. Brown if Stella Morris is the same as Stella Marris and Ms. Brown stated yes that Stella Moris Growth Center is the same as Stella Moris. LPA Linley asked if Ms. Brown worked with any other supervisors if Lakechia was not available and Ms. Brown stated they mainly worked with Lakechia and stated there was an owner, but could not think of his name. Ms. Brown stated that the Owner's name is Charles Ohaeri and the facility number is 336402176. LPM Valenzuela asked Ms. Brown if they had any questions and Ms. Brown asked if the revisions had been reviewed and LPA Linley said yes. LPA Linley asked Ms. Brown if they could provide proof of employment experience to Community Care Licensing and Ms. Brown said they had paycheck stubs and would email copies of the stubs to LPA by end of business day tomorrow. LPA Linley asked Ms. Brown if the information in this document is accurate, true and correct and Ms. Brown stated yes. An exit interview was conducted and a copy of this report and appeal rights were reviewed and provided to Ms. Brown. whole process to set it up. LPA Linley asked Ms. Brown to clarify what they meant by helping set it up and Ms. Brown stated they were the Administrative Support role and they were doing applications, setting up the Group Home, and completing paperwork. Ms. Brown said they did not do hands on at the facility and the facility received their first two clients this month. LPM Valenzuela stated that Ms. Brown cannot use their experience as an Administrator at KB Homes, LLC or IHeart Lives because the facilities do not have any clients to provide direct services. LPM Valenzuela asked Ms. Brown why they left Stella Morris and Ms. Brown stated the facility closed. LPM Valenzuela asked if they knew the reason why the facility closed and Ms. Brown stated they were not sure and the facility was switching counties. LPM Valenzuela discussed and reviewed documents that were submitted to the Department by Applicant Markiesha Brown on December 14, 2025: On the LIC 215, Ms. Brown listed Lakeisha Brooks as a personal reference and LPM Valenzuela asked Ms. Brown if Lakeisha Brooks is the same person listed on all the documents and Ms. Brown said yes, they are the same person, and it might have been a typo or spelling error. Ms. Brown stated Lakeisha's correct last name is Donald. On the LIC 215, Ms. Brown listed she worked at the Stella Morris Group Home located at Steeplechase Drive Moreno Valley, CA 92555 and Ms. Brown stated the termination reason as "on call," and Ms. Brown stated that must have been a mistake. On the LIC 501, Ms. Brown listed that she worked at Stella Morris as a STRTP and stated the facility was closed and worked there from 06/2021-08/2025 and LPM Valenzuela wanted to confirm the dates of employment. Ms. Brown stated that the facility slowed down in May, they moved to "on-call," and the facility closed in August. On the LIC 501, Ms. Brown stated that Lakeisha Brooks is their reference for past employer and Ms. Brown confirmed that Ms. Donald is their reference for past employment at Stella Morris. ***

met_with: Markiesha Brown