summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced annual inspection on 4/12/2024 at 9: AM and met with Ramzy Shehadeh, Program Director. LPA did advise the agency that the inspection is being completed with the use of the CARE Tool. LPA Shelton conducted a walk-through of the office. LPA Shelton inspected and/or reviewed the following: · LPA reviewed client files. · LPA Interviewed (3) clients. · Client Records/Client Checklist using CARE Tool. · Clients with special health care needs using CARE Tool. · Emergency Intervention using CARE Tool. · Board Minutes were reviewed. · Disaster Preparedness was updated and available for review, quarterly drills are completed and logged in a binder and there are disaster preparedness supplies available and verified by LPA. · The following items were reviewed for compliance in the regional office prior to the facility inspection: Administrator Certificate for Jeffrey Beesley is current and verified. Fees have been paid and documentation was provided. No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.


state: CA

facility_name: GATEWAY RESIDENTIAL PROGRAMS-PALM HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced Case Management - Annual Continuation inspection on 4/17/2024 and met with Jeffrey Beesley, Deputy Director and Ramzy Shehadeh, Program Director, who assisted with the inspection. LPA Shelton conducted a walk-through of the home inside and out. LPA did advise that today inspection was done using the Care Tools. LPA Shelton inspected and/or reviewed the following: · Postings of facility license and Personal Rights Poster were appropriately posted. · Disinfectants/Cleaning solutions were inaccessible and locked as required. · Carbon monoxide detectors and Smoke Detectors were present and functioning. · First Aid Kit was present and fully stocked as required. · LPA observed the Grievance/Complaint Policy is posted as required. · Allowance binder was in compliance. · Common Room (living room) was available as was a separate room in the home for privacy. · Dining area with enough seating for clients in care was present and in good condition. · Clients bedrooms/bathroom. · LPA observed that the home's water was at required temperatures at all faucets within the home. · LPA inspected the Medication Log and the Controlled Medication Log for clients in care. · LPA observed that the facility was clean and maintained during the inspection and meal menu displayed. A staff file review was conducted at the office prior to the visit. No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Jeffrey Beesley, Deputy Director


summary: Facility Evaluation

raw_content:
Narrative:
On April 25, 2025 at 9:30AM, Licensing Program Analyst (LPA) Michelle Silvas made an unannounced visit to Gateway Residential Programs - Palm House to conduct a case management inspection. LPA met with Ramzy Shehadeh, Administrator who assisted with the inspection. 0clients and 1staff are present. On March 27, 2025 at approximately 4:05pm, LPA conducted a complaint investigation at the facility and spoke with S1. S1 stated that she previously worked at the Gateway-Ginger Blossom Residential Programs House and is now working at the Gateway Residential Programs - Palm House. After completing the inspection, LPA conducted a search of S1's criminal record clearance in the Guardian and determined that S1 does not have a clearance and is still "in process". LPA began to search all of the Gateway Residential Program homes to review each employee roster. The search resulted in identifying nine additional staff members do not have a criminal record clearance and one staff that is not associated. Continue LIC809-C LPA emailed Administrator Ramzy Shehadah on March 28, 2025, and requested and received a copy of the updated LIC500 for all the Gateway Residential Program homes. On April 2, 2025, LPA requested and received a copy of the work schedules for all of the Gateway Residential Program Homes. On April 9, 2025, LPA emailed Norma Leon Romero, Executive Director, to request the date of births and hire dates for the nine staff who do not have a criminal record clearance. The Ginger Blossom House - two staff, the Palm House - two staff, and Hickory House - three staff, and two mental health clinicians that work at all three locations - Palm House, Ginger Blossom and Hickory House. Each location will be cited and assessed a civil penalty. Palm House - A civil penalty of $100.00 per day for five days is being assessed for the five uncleared staff. An exit interview was conducted, and appeal rights were discussed with Ramzy Shehadeh, Administrator. A copy of this report was given to the facility.

met_with: Ramzy Shehadeh, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On May 21, 2025 at 10: AM, Licensing Program Analyst (LPA) Michelle Silvas initiated an unannounced case management inspection at the above listed facility. LPA met with Ramzey Shehadeh, Administrator, who assisted with the inspection. On April 25, 2025, LPA made an unannounced visit to Gateway - Palm House, to issue citations for the facility having un-fingerprinted staff working at multiple Gateway houses. On April 25, 2025, LPA emailed Ramzy Shehadeh, Administrator and Norma Leon Romero, Executive Director, the most current PIN for the Guardian. On April 28, 2025, LPA emailed Administrator and Executive Director to make sure they associate all staff who are working at their assigned Gateway houses. On April 29, 2025, LPA emailed Norma Leon Romero the Agency User Guide for the Guardian so she can get more familiar with the website. LPA also informed Executive Director that she has the ability to associate staff to the Gateway houses they are assigned to work at. Continue LIC809-C On May 5, 2025, LPA made an unannounced visit at Gateway - Palm House to deliver findings. Upon entering the home, LPA was met by Ariana Gomez, Residential Counselor, who was one of the previous uncleared staff working at the facility. LPA conducted a Guardian check of the staff roster prior to arriving at the facility and verified that Ariana Gomez is not cleared to work at the Palm House. An immediate Civil penalty is being assessed today in the amount of $250 for a repeat violation. The Department will assess a continuing civil penalty of $100 for each subsequent day that the repeat continues. An exit interview and appeal rights were discussed. A copy of this report along with the appeal rights were given to Ramzey Shehadeh, Administrator.

met_with: Ramzey Shehadeh, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Jean Stidman on 12/6/2022 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 Shawna Mason Residential Care Coordinator and inspected the facility inside and out. LPA reviewed four child's records and three staff personnel files on site at the facility. LPA reviewed four child's psychotropic medications and medication records. LPA interviewed three staff on site to discuss the facilities policies and procedures of operation. LPA interviewed four children currently prescribed psychotropic medication. Facility cited for violation of Interim Licensing Standards (ILS) version 4, 87068.2(a) Needs and Services Plan. LPA Stidman observed the Needs and Services Plan (NSP) for one client was not developed within 30 days of placement. Facility cited for ILS version 4, 87068.3(a) Modifications to The Needs and Services Plan for one client was not updated at least every 30 days in January 2022, March 2022, April 2022 and September 2022. These violations pose a potential Health, Safety or Personal Rights risk to children in care. During the inspection the LPA observed deficiencies (see attached 809D), plan of corrections were discussed and appeal rights were provided. LPA provided a copy of this licensing report to Shawna Mason Residential Care Coordinator.


summary: Facility Evaluation

raw_content:
Narrative:
On April 9, 2026, at 9: AM, Licensing Program Analyst (LPA) Michelle Silvas and IB investigator Meagan Hammond, made an unannounced visit to the facility for the purpose of an annual inspection. LPA met with Janine Coleman/Resident care coordinator/house director. LPA and IB investigator conducted a walk through of the facility inside and outside and observed a living room, game area, dining room, kitchen, office, laundry room, four bedrooms and two bathrooms. Outside is a large gated backyard. LPA and IB investigator observed the following: Postings of facility license and Personal Rights Poster were appropriately posted · Disinfectants/Cleaning solutions were inaccessible and locked as required · A working telephone on the premises · Carbon monoxide detectors and Smoke Detectors were present and functioning · First Aid Kit was present and fully stocked as required · Dining area with enough seating for clients in care was present and in good condition · Medication was centrally stored, locked/inaccessible. Continue LIC 809-C LPA observed Locked storage unit in the backyard with lawn equipment LPA conducted one staff interview. No citations were issued today. An exit interview was conducted and a copy of this report was provided.

visit_type: Annual


facility_name: GATEWAY RESIDENTIAL PROGRAMS-WINDING HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced annual inspection on 3/2/22 at 1: PM and met with, Catherine Matthews, Executive Director, Jeffrey Beesley, Deputy Director and Ramzy Shehadeh, Program Director. All Gateway properties were inspected by LPA on 3/1/22. LPA did advise the agency that the inspection is being completed with the use of the CARE Tool. LPA Shelton conducted a walk-through of the facility inside and out. There were no clients present during the inspection due to school. LPA observed four bedrooms with both single and double beds in each room. Two bathrooms with soap, paper towels hygiene products and towels. LPA Shelton inspected and/or reviewed the following: · Postings of facility license and Personal Rights Poster were appropriately posted · Disinfectants/Cleaning solutions were inaccessible and locked as required · Nonperishable Foods for one week and fresh perishable for foods two days minimum were present · Menu was present and posted · LPA observed a working telephone on the premises · Carbon monoxide detectors and Smoke Detectors were present and functioning · First Aid Kit was present and fully stocked as required · Common Room (living room) was available as was a separate room in each wing for privacy · Dining area with enough seating for clients in care was present and in good condition · Medication was centrally stored, locked/inaccessible. Centrally stored medication and log reviewed. · LPA's reviewed four (4) client files. No interviews were conducted · Motor Vehicle was not present during inspection due to school. · LPA observed that the facility appeared to be free of vermin · LPA observed Locked Facilities included a shed with lawn equipment · LPA reviewed complaint procedures for clients. · Board Minutes were reviewed · Disaster Preparedness was updated and available for review, quarterly drills are completed and logged in a binder and there are disaster preparedness supplies available and verified by LPA · Staff training was in compliance · Criminal record clearances were verified by LPA and in compliance · Certified Administrators certificate was valid and current · Staff job titles/qualifications were verified along with the required Hours of initial training. LPA verified that for staff that have been here longer than a year, the Hours of annual training was also present · Trauma informed practices are implemented as needed (including specialty mental health services and extracurricular activities and social supports) per discussion with the administrator. The following items were reviewed for compliance in the regional office prior to the facility inspection: Administrator Certificate for Catherine Matthews is current and verified Fees have been paid and documentation was provided No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.

met_with: Catherine Matthews, Executive Director


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced visit to the home and agency office on 4/7/2022 at 1: PM and met with Jeff Beesley and Ramzy Shehadeh. LPA made the visit to discuss an incident report for C1 (see LIC811 dated 3/28/2022) that occurred on 3/27/2022. In this incident C1 was trying to self-harm and attempt suicide. · What was staff's knowledge of C1's background and needs. · What type of calming techniques are used on clients and the training involved. · What issues were staff working on with C1 before and after the incident. · Who contacted and informed C1's Probation Officer/Bio Grandmother and when? While at the facility on 4/7/2022, LPA discussed the importance of ensuring the facility has knowledge and prepared to handle the behavior of new clients upon arrival. LPA requested C1's folder and reviewed all documents. LPA requested a timeline in which to address the time each incident occurred on 3/27/2022 with C1 and when Law Enforcement/Paramedics were contacted. LPA requested that this timeline be provided to Licensing by 4/22/2022. No citations were issued on this date and exit interview conducted. Documentation was provided.

met_with: Jeff Beesley, Deputy Director


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Jean Stidman on 12/6/2022 at 5pm. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Stidman met with Shawna Mason Residential Care Coordinator and inspected the facility inside and out. The facility does not currently have any clients or staff and has been vacant since June 2022. LPA did not review any child's records or staff personnel files on site at the facility. LPA did not interview any staff or children currently prescribed psychotropic medication. LPA observed the facility is a single story home with four bedrooms and two bathrooms with no clients in placement. No deficiencies are being cited at this time. LPA conducted exit interview with Shawna Mason Residential Care Coordinator. LPA will email a copy of this licensing report to Shawna Mason Residential Care Coordinator due to technical difficulties.


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
The Department has investigated the complaint that a child was restrained inappropriately. Gateway's Program Statement repeatedly establishes that they are a "hands off" program due to the residents needs to feel physically safe. Gateway does not train staff in the use of restraints nor allow staff to restrained clients. The staff involved in the incident was terminated. C1 stated that C1 keep pushing S1 to S1's limits, trash talking, and one thing led to another. C1 ran up to S1 and put his shoulder into S1. S1 then placed C1 in a headlock lock like you're getting a knuckle noogie. C1 picked up the staff and then release the staff and the incident ended at that point. As a result of the interviews conducted, documentation reviewed and investigation conducted, the allegation that a child was restrained inappropriately is SUBSTANTIATED at this time meaning that the allegation is valid because the preponderance of the evidence standard has been met. Facility cited for violations of California Code of Regulations, Title Division Six, regulation 87095.00(d) General Provisions: All children placed in a Short Term Residential Therapeutic Program have the right to be free from the use of restraints. An exit interview was conducted with Jeff Beesley and copy of the report and appeal right were provided. No title 22 regulations were cited during today's inspection.

Investigation Findings:
13Licensing Program Analyst (LPA) Mary Shelton conducted a visit on 8/18/2022, and LPA spoke with Jeff Beesley, Executive Director to deliver findings of the investigation on the complaint allegation that a child was restrained inappropriately. LPA Shelton informed the complaint investigation included a tour of the home on 5/25/2022. The initial 10-day complaint inspection was conducted by the LPA, at the home on 5/25/2022 and LPA, requested Needs and Service Individual Treatment Plan, facility sketch and training records. Interviews were conducted by LPA Mary Shelton, which included C1, C2, C3, C4, C5, S1, S2 and the agency social worker between 5/25/2022 and 8/5/2022. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene 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 CCLD Regional Office, NATOMAS PARK DR., STE FACILITY NAME: GATEWAY RESIDENTIAL PROGRAMS - HICKORY HOUSEFACILITY NUMBER: VISIT DATE: 08/18/2022

report_type: Complaint Investigation

met_with: Jeff Beesley, Executive Director

complaint_status: SUBSTANTIATED


facility_name: GATEWAY RESIDENTIAL PROGRAMS - HICKORY HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced annual inspection on 3/3/22 at 1: PM and met with, Catherine Matthews, Executive Director, and Ramzy Shehadeh, Program Director. All Gateway properties were inspected by LPA on 3/1/22. LPA did advise the agency that the inspection is being completed with the use of the CARE Tool. LPA Shelton conducted a walk-through of the facility inside and out. One staff was interviewed. There were no clients present during the inspection due to school. LPA observed four bedrooms with both single and double beds in each room. Two bathrooms with soap, paper towels hygiene products and towels. LPA Shelton inspected and/or reviewed the following: · Postings of facility license and Personal Rights Poster were appropriately posted · Disinfectants/Cleaning solutions were inaccessible and locked as required · Nonperishable Foods for one week and fresh perishable for foods two days minimum were present · Menu was present and posted · LPA observed a working telephone on the premises · Carbon monoxide detectors and Smoke Detectors were present and functioning · First Aid Kit was present and fully stocked as required · Common Room (living room) was available as was a separate room in each wing for privacy · Dining area with enough seating for clients in care was present and in good condition · Medication was centrally stored, locked/inaccessible. Centrally stored medication and log reviewed. · LPA's reviewed two (2) client files. No interviews were conducted. · Motor Vehicle was not present during inspection due to school. · LPA observed that the facility appeared to be free of vermin · LPA observed Locked Facilities included a shed with lawn equipment · LPA reviewed complaint procedures for clients. · Board Minutes were reviewed · Disaster Preparedness was updated and available for review, quarterly drills are completed and logged in a binder and there are disaster preparedness supplies available and verified by LPA · Staff training was in compliance · Criminal record clearances were verified by LPA and in compliance · Certified Administrators certificate was valid and current · Staff job titles/qualifications were verified along with the required Hours of initial training. LPA verified that for staff that have been here longer than a year, the Hours of annual training was also present · Trauma informed practices are implemented as needed (including specialty mental health services and extracurricular activities and social supports) per discussion with the administrator. The following items were reviewed for compliance in the regional office prior to the facility inspection: Administrator Certificate for Catherine Matthews is current and verified Fees have been paid and documentation was provided No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.

met_with: Catherine Matthews


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Misty Valencia on 03/03/2023 at 9: AM . This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Valencia met with Ramzy Shehadeh, Program Director and inspected the facility inside and out. LPA reviewed no child records and four (4) staff personnel files on site at the facility. LPA reviewed no child's psychotropic medications or medication records. LPA interviewed four (4) of staff on site to discuss the facilities policies and procedures of operation. LPA did not interview any children that were under eighteen (18) or a ward of the courts that are currently prescribed psychotropic medication. LPA provided a copy of this licensing report to Ramzy Shehadeh, Program Director. No deficiencies are being cited at this time. LPA conducted exit interview with Ramzy Shehadeh, Program Director.

met_with: Ramzy Shehadeh, Program Director


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced annual inspection on 4/12/2024 at 9: AM and met with Ramzy Shehadeh, Program Director. LPA did advise the agency that the inspection is being completed with the use of the CARE Tool. LPA Shelton conducted a walk-through of the office. LPA Shelton inspected and/or reviewed the following: · LPA reviewed client files. · LPA Interviewed (3) clients. · Client Records/Client Checklist using CARE Tool. · Clients with special health care needs using CARE Tool. · Emergency Intervention using CARE Tool. · Board Minutes were reviewed. · Disaster Preparedness was reviewed, quarterly drills are completed and logged in a binder and there are disaster preparedness supplies available and verified by LPA. The following items were reviewed for compliance in the regional office prior to the facility inspection: Administrator Certificate for Jeffrey Beesley is current and verified. Fees have been paid and documentation was provided. No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.


summary: Facility Evaluation

narrative: Licensing Program Analyst (LPA) Mary Shelton made an unannounced Case Management - Annual Continuation inspection on 4/17/2024 and met with Jeffrey Beesley, Deputy Director and Ramzy Shehadeh, Program Director, who assisted with the inspection. LPA Shelton conducted a walk-through of the home inside and out. LPA did advise that today inspection was done using the Care Tools. LPA Shelton inspected and/or reviewed the following: · Postings of facility license and Personal Rights Poster were appropriately posted. · Disinfectants/Cleaning solutions were inaccessible and locked as required. · Carbon monoxide detectors and Smoke Detectors were present and functioning. · First Aid Kit was present and fully stocked as required. · LPA observed the Grievance/Complaint Policy is posted as required. · Allowance binder was in compliance. · Common Room (living room) was available as was a separate room in the home for privacy. · Dining area with enough seating for clients in care was present and in good condition. · Clients bedrooms/bathroom. · LPA observed that the home's water was at required temperatures at all faucets within the home. · LPA inspected the Medication Log and the Controlled Medication Log for clients in care. · LPA observed that the facility was clean and maintained during the inspection and meal menu displayed. A staff file review was conducted at the office prior to the visit. No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 02/06/2025 at 2: PM, Licensing Program Analyst (LPA), Michelle Silvas arrived unannounced at Gateway - Hickory House for the purpose of initiating a case management- incident Inspection. LPA met with Mable Logo, Residential Care Counselor, who assisted with the inspection. About 40 minutes later, House Director, Simon Ballout and Program Director Ramzy Shehadeh arrived. During the inspection, LPA discussed the Incident Report received by the Department on 02/04/2025. LPA conducted a walk through of the facility inside and out. LPA Silvas Reviewed Psychotropic Medication Administration Records (paper PMAR) for C1 and conducted two staff and one client interview. An exit interview was conducted at time and a copy of this report was provided.

met_with: Mable Logo, Residential Care Couselor


summary: Facility Evaluation

raw_content:
Narrative:
On April 25, 2025 at 11:00AM, Licensing Program Analyst (LPA) Michelle Silvas made an unannounced visit to Gateway Residential Programs - Hickory House, to conduct a case management inspection. LPA met with Ramzy Shehadeh, Administrator who assisted with the inspection. 0 clients and 1 staff are present. LPA conducted an inspection of the facility inside and outside. The purpose for today's inspection is to issue a citation for 3 uncleared staff working at the facility. While conducting an inspection at one of the other Gateway homes, it was determined that multiple staff in every location did not have a criminal record clearance to work at the facility. A civil penalty of $100.00 per day for five days is being assessed for the three uncleared staff. An exit interview was conducted, and appeal rights were discussed. A copy of this report along with the appeal rights were given to Ramzy Shehadeh, Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced Case Management inspection at the facility and met with staff Brian Perrott and Program Director Ramsay Shehadeh, Executive Director Jeff Beesley who assisted with the inspection. CCL received an incident report dated 8/21/2023 concerning an allegation made by a client that a staff member (S1 - See Confidential Names List dated 8/29/2023) purchased one vape device for two clients, let them vape in the facility vehicle, and the staff vaped in the vehicle as well. The incident report stated a meeting with the staff would be held on 8/24/2023. LPA is conducting this Case Management inspection to learn what the outcome of this investigation is and to conduct additional investigation if necessary. LPA spoke with staff, Program Director, Executive Director and found that they conducted an internal investigation which consisted of them interviewing all clients. On 8/29/ S1 was terminated for this incident. Administration attempted to call S1 in on 8/23/2023, but S1 did not come in. S1 offered to do Zoom, and Administration accommodated this on 8/24/2023, however S1 did not attend. Administration asked S1 to come in again on 8/25/2023, S1 did not appear. Today, 8/29/2023, Administration sent out a Job Abandonment and Termination Letter. On this date, the facility is being cited for a violation of the Health and Safety Code Section 1558(a)(2), Conduct Inimical, which is detailed on the attached LIC809-D page. An exit interview was conducted with ED and PD and a copy of this report and appeal rights was left with them.

met_with: Brian Perrott & Ramsay Shehadeh


facility_name: GIRLS REPUBLIC

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
It was alleged that staff did not inform client of notice of removal, staff requested client's removal prior to updating the Needs and Services Plan and staff prevented authorized persons from communicating with client. Confidential interviews reveal that an emergency CFT Meeting was held on 10/3/22 to preserve client's placement. Client was in attendance and the emergency CFT meeting notes state in part that, "the identified client continues to meet criteria for placement in an STRTP and the level of care provided." However, a 14-day notice of request for removal was submitted by the facility on the same day, without client's knowledge. Staff explained that client was not informed of the removal request for client's own safety and that it's the policy of the facility not to inform clients of any planned removal for safety reasons. Staff explained that client was unable to commit to safety. There was no record found of any incident or safety issues involving the client during and after the CFT meeting to indicate the need for a removal request. There was no record found that the removal request was discussed with the client. The client's NSP was not updated prior to the removal request. There was no record found showing that the client was offered an opportunity in the development of any transfer plan. The client became aware of the removal request after being informed by the client's legal team during a scheduled court hearing. The client's legal team informed staff of the need to speak to the client prior to the scheduled court hearing. The client's legal team made several attempts to speak to the client, by phone calls and emails to staff, before and after the client's court date. All attempts to speak to the client, through staff and the facility, were unsuccessful. There was no record found that client refused to speak to the legal team. Based on information obtained from confidential interviews and records obtained, the allegations are substantiated, based on the preponderance of evidence. The following deficiency citations are issued under STRTP Interim Licensing Standards - 87068.4(e)(2)(E)(1) and 87068.4(e)(2)(D) Removal and/or Transfer Procedures and 87072(c)(4) Personal Rights. These violations pose an immediate and/or potential Health, Safety, or Personal Rights risk to clients in care. A Plan of Correction was discussed with the facility representative. Copies of the following were provided at the conclusion of the inspection: LIC 9099, LIC 9099-C, LIC 9099-D and LIC Confidential Names dated 5/4/23. Appeal rights forms were provided and explained. It was alleged that staff did not ensure sharp objects were inaccessible to client and staff did not provide client's record to authorized person. Confidential interviews reveal that client had access to a compact mirror, which was an age and developmentally appropriate personal item used for grooming and make up. Although client has a history of self injurious behavior, there was no record found that such item was prohibited. Client used the compact mirror to engage in self injurious behavior while inside the bathroom, resulting in hospitalization. The client's safety/crisis intervention plan was updated after the incident. Regarding the request for client's record, the document not immediately provided by staff who explained to the requestor that information was being added to the document. The document was provided after a week. There was no evidence found that the facility refused to provide or was withholding client's record. Based on information obtained, the allegations are unsubstantiated. Although the allegations may have happened or are valid, the preponderance of evidence to prove the allegations was not met. A copy of this report and the LIC Confidential Names Form dated 5/4/23, were provided to the facility representative. Appeal rights forms were provided and explained.

Investigation Findings:
13On May 4, 2023 at 9:30AM, Licensing Program Analyst (LPA) Irene Yamamoto conducted a complaint inspection at the facility. LPA met with the facility representative named above. The purpose of the inspection is to deliver the findings for the above allegations. The investigation was conducted by LPAs Heriberto Perez and the undersigned LPA. On 11/2/22, LPA Perez conducted the initial complaint inspection at the facility and obtained the staff and client rosters, Needs and Services Plan (NSP), Incident Reports (IR) and Request for Removal. LPA Yamamoto conducted interviews with former and current staff on 3/6/23, 3/30/23, 4/11/23, 4/12/23, 4/26/23 and 4/28/23. Placement agency staff was interviewed on 4/24/23. Current clients in placement were interviewed on 4/11/23. LPA attempted to obtain statements from other related parties on 3/2/23, 4/10/23, 4/24/23 and 5/1/23; those attempts were unsuccessful. Additional records were obtained and reviewed by LPA Yamamoto on 3/2/23, 3/6/23, 4/24/23 and 4/28/23 which include, but not limited to the Child and Family Team (CFT) Meeting notes, Discharge Summary, Safety/Crisis Intervention Plan, Student Chronological Record, Behavior Report, Intake Report and Admission Agreement. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Irene Yamamoto 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 32-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, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: GIRLS REPUBLICFACILITY NUMBER: VISIT DATE: 05/04/2023

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: Danielle Lopez, Assistant Residence Director

complaint_status: unsubstantiated


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Continue from page 1 . . . The staff stated that during a group meeting an altercation took place with clients in the facility. The staff stated that the meeting was to discuss an argument between two clients at school. The staff stated that one client became aggressive toward the other client and the staff was redirecting the client but the client was not receptive to the staff redirection. The staff stated that the client left the room where the meeting was taken place and went to the kitchen but was followed by one of the staff, the staff stated that the client got a fork and attempted to use it against other clients. The staff stated that they were redirecting the client to give up the fork and creating space between the clients. One staff stated that she attempted to take the fork from the client but the client got loose from the staff grasp. The staff stated that the fork was obtained from the client when another client grabbed and restraint the aggressor client. The staff stated that the Law Enforcement was called when the incident was getting out of control. The confidential interviews indicated that the clients were having a group meeting to discussed the altercation between two clients at school but one of the client became upset and began to hit others in the facility. The confidential interviews indicated that the staff was redirecting the aggressive client and was creating space between the clients. The confidential interviews revealed that the aggressive client went to the kitchen and got a fork while the other clients went outside the facility to create space. The confidential interviews revealed that the aggressive client was being follow by one of the staff and was being redirected to give up the fork but the aggressive client went outside. The aggressive client was used the fork against another client and resulted in injuries (scratches) on the client. The confidential interviews revealed that another client help to restraint the aggressive client and the staff was able to get the fork from the aggressive client before law enforcement got to the facility. The confidential interviews indicated that the staff was always with the clients and were redirecting the aggressive client and attempted to take away the fork from the client. Based on the interview and records reviewed the allegation is found unsubstantiated. Although the allegation have happened or is valid, there is not a preponderance of the evidence to prove the allegation was due to neglect or lack of supervision. Appeals rights were provided and discussed with the facility representative mention above. There were no deficiencies cited.

Investigation Findings:
13On May 10, 2023, Licensing Program Analyst (LPA) Heriberto Perez conducted a follow-up complaint inspection to the above facility and met with Danielle Lopez, Assistant Supervisor. The purpose of the inspection was to deliver the finding for the above complaint allegation. During the course of the investigation, LPA interviewed two staff and three clients on 01/24/23, LPA interviewed one client via telephone on 04/14/23, LPA interviewed one staff via telephone on 04/18/23, LPA interviewed one staff and probation officer (PO) via telephone on 04/20/23 and LPA interviewed one probation officer (PO2) via telephone on 04/21/23 (see Confidential Names Form LIC 811 dated May 10, 2023). LPA also reviewed documents including but not limited to Client's Need and Service Plans, Special Incident Reports (SIR) and Law Enforcement investigation report. It was alleged Minors engaged in a physical altercation with each other at the facility resulting in injuries. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Heriberto Perez 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 32-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, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: GIRLS REPUBLICFACILITY NUMBER: VISIT DATE: 05/10/2023

met_with: Danielle Lopez, Assistant Supervisor


summary: Facility Evaluation

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Narrative:
On February 7, 2022, Licensing Program Analyst (LPA's) Nicolette David and Winston Moroney conducted an unannounced Annual inspection at the facility at 10: AM. LPA met with Lisa Denbo Facility Administrator. The purpose of the inspection was to conduct an Annual/Required inspection of the facility. The STRTP's Mental Health Program Application is approved. The STRTP has CARF accreditation that expires on 08/31/2024. This STRTP is licensed to serve up to six (8) ambulatory children ages 13-17 years of age. Currently, there are two (2) clients in placement. The facility is a 3- story house located in a residential neighborhood. It consists of 5 bedrooms (1 bedroom is located adjacent to staff office and is for Relief Staff). There are 4 1/2 bathrooms (2 bathrooms are located in the staff office), living room, dining room, kitchen, TV room, staff office and a clinician's office. The 3rd floor is an attic which is used for a computer Lab and arts craft. The living, dining, kitchen and TV room are located on the first floor, along with outside laundry area and downstairs basement which is used for storage. LPA observed the facility license, facility sketch, COVID signage posters, Grievance Procedures, Personal Rights, Ombudsman Poster, visitation policies, emergency disaster plan and activity calendar posted by the front entrance of the facility. The following sleeping arrangements were noted: Bedroom # 1, two twin beds, two dressers and closet Bedroom # 2 sleeps C-1, two twin beds, two dressers and closet Bedroom # 3, two twin beds, two dressers and closet. Bedroom # 4 sleeps C-2, two twin beds, two dressers and closet. All beds are clean and in good repair. Bedding and sheets were sufficient. There is adequate supply of perishable and non -perishable food. There is 2 refrigerator being used and one freezer in the laundry room. The kitchen utensils, glasses and dishes were found to be in good condition Medications, first aid kit, all cleaning supplies and laundry detergent, sharp knives and client files are kept in a locked storage room inside the locked staff office. Hot water was tested and found to be within regulatory guidelines at 120' degrees Fahrenheit. Fire/earthquake drills are conducted once a month and kept in a log. The carbon monoxide/smoke detectors were tested and found to be in good working condition. The facility is equipped with a fire alarm system which is tested annually by local fire department. In the backyard of the facility, (LPAs) observed a pool with a locked fence surrounding it, and patio furniture. There is a separate detached structure in the backyard area that is being temporary use by an employee that works at the Boys Republic site. Interviews: LPA's interviewed 3 staff that included the Administrator , Supervisor and HR . There are currently 17 staff working at the facility. LPA interviewed Clients. File Review: A review of 2 client flies and 6 staff files was conducted. Client files contained an original admission agreement. There are 2 clients currently taking medication. Files for clients currently taking prescribed medication contained all the required documentation such as the medical consent forms and authorizations. Overall, clients are provided adequate services in accordance with their needs and services plan and are being updated. Staff files contained criminal record clearances or exemptions and child abuse index check, job descriptions (except for the Administrator's file), required training and work evaluations. All documents were complete and signed by employee. All staff requiring training, including Mandated Reporter, Emergency Intervention, initial and annual training, was current. all adult individuals who require caregiver background checks have received criminal record and child abuse index check clearances or exemption. Operations Facility maintains a current, written plan of operation that meets licensing standards. Facility maintains a register of clients and the register is available upon request. The board of directors regularly conducts meeting to review and discuss the STRTP's operation. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill at least every month for each shift. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Needs and Services Plan for each client, medication records, and contact information for each client's responsible party and physician. Core/Therapeutic Services Facility provides core services and supports to children as appropriate or necessary that are trauma informed, culturally relevant, age and developmentally appropriate and include the following: Medi-Cal specialty mental health services; transition port services; educational and physical, behavioral, and mental health supports; activities to support children with services to achieve permanency. On today's inspection, there are no citations assessed during this inspection. LPA was provided with Board Minute Meetings and staffs schedule/personnel report An exit interview was completed, and a signed copy of this report was provided to the facility representative. .

met_with: Lisa Denbo


summary: Facility Evaluation

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Narrative:
On March 30, 2023 at 9: AM, Licensing Program Analysts (LPAs) Ashley Ruacho and Pamela Silva conducted an unannounced case management inspection to the facility and met with Tanya Miller, Administrator. The purpose of the case management was to follow-up on a Special Incident Report (SIR) received by the Department regarding medication error. Per the SIR, on 02/25/23 staff (S1) made an error distributing the wrong medication to client (C1) (see LIC Confidential Names List dated 03/30/23). The nurse advised the staff on shift to monitor C1's behavior and for any possible side effects but did not anticipate any major concerns. C1's authorized representative was informed of the incident. Medication training was provided to all staff on 03/08/23 but S1 was not present during the training. Since this was S1's second error regarding medication distribution a write up was given. S1 will be provided additional medication training and shadow staff for 4-5 months before she can distribute medication again. During the inspection, LPA's reviewed medication log vs medication packets, LPA's also checked JV 220's for all clients on psychotropic medication. No deficiency citation was issued during today's inspection. An exit interview was conducted, and a copy of this report was given to the Administrator.

met_with: Tanay Miller


summary: Facility Evaluation

raw_content:
Narrative:
On September 6th, 2023 at 1:45PM, Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced case management inspection at the above facility and met with the Administrator Tanya Miller. The purpose of the visit was to obtain a copy of the facilities mental health certificate. No citation was issued during today's inspection. An exit interview was conducted and a copy of this report was provided to the Administrator.

met_with: Tanya Miller- Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On December 6th, 2023 at 3: PM, Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced case management inspection at the facility and met with the above representative. The purpose of the case management was to follow-up on a Special Incident Report (SIR) received by the Department which stated a client (C1) had fell down the staircase. (See confidential name list LIC 811). During the visit LPA conducted in person interviews with the Administrator (AD) , Case Worker (CW), and client 2 (C2), and client (C3). LPA also took a tour and checked food supply with AD. LPA needs to conduct additional interviews and document review for this incident. No deficiency citation was issued during today's inspection. Further follow-up is required. An exit interview was conducted, and a copy of this report was given to the Administrator.

met_with: Tanya Miller - Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On January 5th, 2024, at 8: AM, Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced case management inspection at the facility and met with the above representative. The purpose of the case management was to follow up on a Special Incident Report (SIR) received by the Department which stated a client (C1) had fallen down the staircase. (See confidential name list LIC 811). Per the SIR, C1 fell down the stairs and sustained bruises on one of their legs, along with scrapes and swollenness on their cheeks. The injuries were stated to be a result of the extent of the fall. The medical report suggested youth to refrain from skipping any meals, stay hydrated, and to sit in a squat position when they feel like fainting. LPA Ashley Ruacho conducted in person interviews with the Administrator (AD), Case Worker (CW), and client 2 (C2), and client 3 (C3). C1 was on AWOL status and LPA was unable to obtain an interview with them. Proper actions were taken by the facility, and it was revealed that C1 has a medical history of fainting spells. LPA toured the facility and inspected the facilities food supply, there was a surplus of both perishables and non-perishable foods. Based on information provided in interviews LPA observed that the incident was not a result of lack of supervision or lack of food supply. No deficiency citation was issued during today's inspection. No further follow-up is required. An exit interview was conducted, and a copy of this report was given to the Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On February 22nd, 2024, at 9:30AM Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced inspection at the above facility for the purpose of conducting an annual/required inspection. LPA met with Assistant Supervisor, Danielle Lopez. LPA and the Assistant Supervisor toured the facility. LPA obtained and reviewed the following updated documentation: · LIC Personnel and Client Roster · LIC C Emergency Disaster Plan · Board of Directors report and Program Statement · Employee Grievance Policy/ Grievance Procedures · Emergency Preparedness: Disaster and Mass Casualties Drills · Emergency Evacuation Routes · Facility Monthly Activities Calendar · Emergency Intervention Plan · Complaint Procedures The facility was in full compliance with 7 applicable areas of the Compliance and Regulatory Enforcement (CARE) tools for Children's Residential Licenses. Annual compliance review consisted of the following domains: Physical plant, operations, disaster preparedness plan, emergency intervention, staffing, and client records. Community Care Licensing (CCL) focuses its efforts on three priority areas: prevention, compliance, and enforcement. There are two (2) fire extinguishers throughout the facility, all fully charged and all last serviced on November 3, 2023. The facility is a 3- story house located in a residential neighborhood. It consists of 5 bedrooms (1 bedroom is located adjacent to the staff office and is for extra storage space). There are 4 1/2 bathrooms (2 bathrooms are in the staff office), a living room, dining room, kitchen, TV room, staff office and a clinician's office. The 3rd floor is an attic which is used for storage and donations. The living, dining, kitchen, and TV room are located on the first floor, along with the outside laundry area and downstairs basement which is used for storage. LPA observed the facility license, facility sketch, Grievance Procedures, Personal Rights, Ombudsman Poster, visitation policies, emergency disaster plan and activity calendar posted by the front entrance of the facility. The facility has a working telephone that is accessible to clients and staff. All passageways and grounds were free of any obstructions. The medications and cleaning solutions were locked inside the cabinets in separate storage rooms. There was perishable foods enough for 3 days and non-perishable foods enough for client's consumption for more than a week. Each bedroom has two twin beds with clean sheets and linens. There were drawers and closet space in each bedroom for client use. The hot water temperature was tested and was in working order. At the time of this inspection the facility was observed to be clean, safe, and in good repair. The facility has a Honda Odyssey minivan used to transport clients. The vehicle has an active insurance policy. Facility provides core services and supports to children as appropriate or necessary that are trauma informed, culturally relevant, age and developmentally appropriate and include the following: Medi-Cal specialty mental health services; transition port services; educational and physical, behavioral, and mental health supports; activities to support children with services to achieve permanency. For this review, four (4) Los Angeles County placements, and one (1) Riverside County placement clients were selected for the sample to assess the level of care and services they receive. Additionally, LPA reviewed six (6) staff files for compliance with Title Regulations and Interim Licensing Requirements. LPA also conducted an interview with one staff member as they were the only staff at the facility during the time of this inspection. Clients in the facility were unable to be interviewed due to being at a culinary course off site. An exit interview was conducted. LPA provided the facility representative above a signed copy the LIC 809 and LIC 811 reports. There were no deficiencies cited at the time of this inspection.

met_with: Danielle Lopez- Assistant Supervisor


summary: Facility Evaluation

raw_content:
Narrative:
On January 29, 2025, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an un-announced annual/random inspection to the facility. LPA met Administrator, Tanya Miller. The facility is a three-story building with 4 bedrooms and 4 1/2 bathrooms located in a residential neighborhood. This STRTP is licensed to serve up to eight (8) ambulatory children ages 13-17 years of age and Non-Minor Dependents. Currently, there are two (2) clients in placement. Physical Plant LPA conducted the inspection accompanied by Administrator, Miller. The facility is a three-story building with 4 bedrooms and 4 1/2 bathrooms located in a residential neighborhood. LPA observed the following at the time of the inspection. The posted license, Emergency Disaster Plan, Foster Care Ombudsman's information and Youth's Personal Rights, Grievance Procedure, and Mental Health Program Approval. The facility has a staff office and therapist offices, a living room/dayroom, and a laundry room. A maximum of two (2) beds in each bedroom. All bedrooms have closet and drawer spaces for the clients clothing. The water temperature was tested (117 degrees Fahrenheit) and within the temperature allowed by regulation. All cleaning solutions were observed locked in cabinets. There was extra linens and hygiene supplies in the cabinets. All medications were stored locked inside a room in the staff office. The First Aid kit was complete. There were adequate perishable foods for at least 2 days and non-perishable foods for at least 7 days in the facility. The smoke/carbon monoxide detectors were working. The pool was locked and surrounded by a fence. All indoor and outdoor passageways were unobstructed. Client Records LPA reviewed two (2) client records. All client records are available to licensing to review. The current clients in the facility are less than 30 days in placement. The client records have some of the required forms. Staff Records LPA reviewed five (5) staff records. Staff records contain documentation of the required education and experience requirements and training. All staff subject to criminal records review have been fingerprinted and cleared. Emergency Intervention Plan The facility has written emergency intervention plan. The staff records have current proof of training. Disaster Preparedness Plan The facility has a disaster and mass casualty plan of action and conducts disaster drills at least quarterly. The facility maintains register of clients, medication records, and contact information for each client's responsible party and physician. Operations The facility maintains a register of clients available upon licensing staff request. The client records are centrally stored in a room inside the staff office. The board minutes meeting was available for review. The board of directors conducts meetings at least on a quarterly basis to review and discuss the STRTP's operation. The facility has written complaint procedures to file a complaint for the clients and/or their representatives. An exit interview was conducted, and a copy of LIC 809 and LIC 811s were provided to the administrator. No deficiency citations were issued at the time of the inspection.

met_with: Tanya Miller


summary: Facility Evaluation

raw_content:
Narrative:
On 09/09/2022 at 9: AM, Licensing Program Analyst (LPA) Pamela Silva conducted an unannounced follow up case management inspection at the above facility and met with Head of Service, Ellen Strickland. The purpose of the visit was to follow-up an incident reported to the Department on 08/18/2022 regarding a client (C1) who disclosed to facility staff that she snorted the medication administered to her on the night of 08/13/22. C1 also disclosed that she deliberately hid her medication between her lips and teeth, and then passed on the medication to another client C2 who admitted to snorting the medication on the night of 08/14/22 (see Confidential Names List LIC811 dated 09/09/22). During the inspection, LPA Silva conducted a tour of the facility, interviewed Head of Service regarding medication administration procedure, and reviewed clients' medication vs. medication records. LPA also interviewed four (4) staff members via telephone prior to today's inspection. All five (5) staff members confirmed that the facility's protocol on medication administration is that clients take their medications in staff's presence and that clients cough, blow and hold open their mouth and lift their tongue to ensure that medication was taken and swallowed. Based on interviews, staff S1 followed correct medication administration procedure. Staff is unsure of how C1 managed to hide and not swallow the medications she took on the nights of 08/13/22 and 08/14/22. Interviews with staff indicated that all staff who assist clients in medication administration received the proper medication training. Staff training on medication is given during initial training and is also part of their annual and in-service training. Interviews also indicated that additional training was given to staff members after the incident to ensure careful medication distribution and to prevent similar incidents from occurring. During medications vs. records review, LPA observed that C1 had missed doses of her medication but are not documented or explained on the Psychotropic Medication Administration Record (PMAR). A deficiency citation is issued , see LIC809D.. An exit interview was conducted. A copy of this report, LIC809D, LIC811 and appeal rights were provided to the facility representative.

met_with: Ellen Strickland


summary: Facility Evaluation

raw_content:
Narrative:
On March 1, 2023 at 12: PM, Licensing Program Analyst (LPA) Gilbert Gutierrez made a case management inspection to the facility and met Danielle Lopez, Assistant Supervisor . The purpose of the case management was to follow-up on a Special Incident Report (SIR) received by the Department regarding medication error Per the SIR, on 02/05/23 staff (S1) made an error distributing the wrong medication to client (C1) see LIC 811 (Confidential Names List). The nurse advised the staff on shift to monitor C1's behavior and for any possible side effects but did not anticipate any major concerns. C1's authorized representative was informed of the incident. S1 will be provided additional training by the nurse regarding medication distribution. Per Assistant Supervisor Lopez, S1 was given a verbal warning regarding the incident and had a virtual retraining on 02/07/23 regarding Medication Distribution and Administration. Section 80075(b)(5)(B) provides that once ordered by the physician the medication is given according to the physician's directions. An exit interview was conducted and a copy of this report, LIC 809D and LIC 811 were provided to the facility representative. A deficiency citation is issued to the facility per above section.

met_with: Danielle Lopez


facility_name: GREENACRE HOMES, INC. NO 1 (JOYCE DRIVE)

summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Brian Bertoli made an unannounced complaint investigation at the facility and met with Deputy Director Timothy Dimick, who assisted with the inspection. The purpose of the inspection was to deliver findings on the above allegation. During the course of the investigation LPA Bertoli interviewed 2 staff and the complainant, and reviewed records. The records and the interviews indicated that although the Needs and Services Plan was prepared for client C1 (see LIC 811 form dated 02/03/22), it was not sent for signature of the Authorized Representative until it was requested by them in August 2021. Based on the information obtained, there is a preponderance of the evidence to prove that the facility did not properly complete the Needs and Services Plan. Therefore, the above allegation is substantiated. Title 22 deficiencies were cited and Appeal Rights were provided and discussed with the facility. An exit interview was conducted and a copy of the report was left with Deputy Director Dimick. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: Brian Bertoli 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 21-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, NEOTOMAS AVENUE, STE. Santa Rosa, CA Facility Name: Greenacre Homes, INC. NO 1 (JOYCE DRIVE)FACILITY NUMBER: 490101336

met_with: Tim Dimick


summary: Facility Evaluation

raw_content:
Narrative:
On 6/24/2021 at 2:52PM, Licensing Program Analyst (LPA) David Hiett conducted an unannounced annual inspection for Greenacre Homes STRTP - . LPA met with Counselor Vicki MacNab and inspected the facility inside and out. The STRTP is licensed to serve 7 ambulatory male clients, ages 6-17. An inspection of the facility was conducted, and the following was observed: Hot water temperature measures 107F degrees Fahrenheit. Individual beds were observed with appropriate clean linens and are in good repair. Centrally stored medications are maintained in a lock cabinet. Toxic chemicals are locked in a cabinet located and secured in the kitchen. LPA observed all required documentation posted in the facility, to include: Facility license, Emergency Disaster Plan, LIC 610 and evacuation plan, Menu, Weekly Activity Schedule, Client's Rights, OSHA signs. A physical plant inspection was completed and included the following checks. Facility grounds are clean and free of debris and observable hazard. Adequate indoor and outdoor activity space and materials observed. All facility smoke detectors are in appropriate working order, fire extinguisher is properly charged and serviced. Facility has an active waiver to associate all personnel to the main file. There are no weapons at the facility. There are no pets at the facility. LPA conducted a review of 2 client files and 3 staff files. All files reviewed were complete and in compliance. As of June 25, 2021, all facility staff are associated to the facility and received fingerprint and child abuse index check clearances. Exit interview conducted and a copy of the report was left at the facility. There are no deficiencies to be cited at this time.

met_with: Vicki MacNab


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an annual/required inspection at the above facility. LPA McCambridge met with Administrator, Tim Dimick. The facility has not been operating since August of 2021, so the facility has been vacant. Therefore, LPA McCambridge did not use the Inspection Tool during today's inspection. Please note that the facility has been in communication with CCL regarding their current status, and the department is working closely with the facility. LPA McCambridge toured the facility inside and out and found the facility to be safe, clean, and in good repair. The refrigerator and freezer were empty due to the facility closure. LPA toured the upstairs, and there were a total of 5 bedrooms. All bedrooms were empty except for dressers, mattresses, and bed frames. The Administrator confirmed that their maintenance person visits the facility to ensure it remains in good standing. An exit interview was conducted and a copy of the report was left with the Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli met with Clinical Director Robin Hausserman at the facility for the purpose of completing an Annual/Required Inspection. Prior to the inspection a COVID pre-screening call was made, and there were no current cases, known exposures, or symptomatic persons at the facility. The facility is currently inactive and has no placements or staff. Greenacre Homes is in the process of hiring staff and will accept placements as soon as they meet the staffing requirements. Due to their inactive status, only the inspection of the facility and the Physical Plant section were completed (per LPM Isabel Mendoza). No Title 22 deficiencies were observed. An exit interview was completed and a copy of this report was left with the facility. Due to technical difficulties, the original signed copy of this report was deleted in error and a second copy was sent for signature.

met_with: Robin Hausserman


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli made an unannounced visit to the facility and met with Administrator Timothy Dimick. The purpose of the visit was to confirm closure of the Short-Term Residential Therapeutic Program (STRTP). The Request for Closure, written confirmation there being no STRTP youth remaining, and license were received by CCL. LPA Bertoli inspected the facility at 2:30pm and confirmed that no youth were present. The licensee is in the process of selling the property. Closure of the STRTP will be effective June 1, 2023. An exit interview was conducted with the Administrator to confirm the closure

met_with: Timothy Dimick


facility_name: GREENACRE HOMES, INC. NO 4 (EDDIE LANE)

raw_content:
Investigation Findings:
13On 05/20/ Licensing Program Analyst (LPA) Cheyenne McCambridge conducted a follow-up complaint investigation at the facility and met with Administrator Timothy Dimick. The purpose of the inspection was to deliver the findings for the above complaint allegation. During the investigation LPA McCambridge conducted staff and client interviews. During the interviews there were conflicting statements with the initial report. According to RP and staff, staff knew nothing about the incidents that occurred, but have ensured that staff will intervene and provide adequate supervision to ensure clients safety. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that there was inappropriate interactions between children in care; therefore, the above allegation is unsubstantiated. Appeal Rights were provided and discussed with staff and no deficiencies were cited. Exit interview was conducted and a copy of the report was left with the Administrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: Cheyenne McCambridge LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2


summary: Complaint Investigation - Unsubstantiated - 3 allegations

raw_content:
Investigation Findings:
13On 03/18/2025 at 10: AM, Licensing Program Analyst (LPA) Jasmine Cardeno and LPA Celeste Aparicio made an unannounced visit to the Facility listed above. LPAs met with Deputy Director, Timothy Dimick, who facilitated the inspection. LPA Cardeno informed Deputy Director that the purpose of the inspection is to deliver findings for the allegations listed above. Based on records review and confidential interviews, LPA Cardeno determined that the allegations: "Facility staff are not properly trained," and "Facility staff are not administering medication as prescribed," had inconsistent support. Although the allegations may have happened or is valid, the preponderance of evidence has not been met and there is no consistent evidence to support the allegations listed above. Therefore, the allegations are Unsubstantiated. An exit interview was conducted with Deputy Director and a copy of this report was left with Deputy Director, Timothy Dimick, whose signature on this form confirms receipt. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Carolyn Flynn LICENSING EVALUATOR NAME: Jasmine Cardeno LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Deputy Director, Timothy Dimick


summary: Facility Evaluation

raw_content:
Narrative:
On 6/24/2021 at 12:45PM, Licensing Program Analyst (LPA) David Hiett conducted an unannounced annual inspection for Greenacre Homes STRTP - Eddie Lane. LPA met with Deputy Director Tim Dimick and inspected the facility inside and out. The STRTP is licensed to serve 9 ambulatory male clients, ages 6-17. An inspection of the facility was conducted, and the following was observed: Hot water temperature measures 105F degrees Fahrenheit. Individual beds were observed with appropriate clean linens and are in good repair. Centrally stored medications are maintained in a locked cabinet. Toxic chemicals are locked in a cabinet located and secured in the laundry room. LPA observed all required documentation posted in the facility, to include: Facility license, Emergency Disaster Plan, LIC 610 and evacuation plan, Menu, Weekly Activity Schedule, Client's Rights, OSHA signs. A physical plant inspection was completed and included the following checks. Facility grounds are clean and free of debris and observable hazard. Adequate indoor and outdoor activity space and materials observed. All facility smoke detectors are in appropriate working order, fire extinguisher is properly charged and serviced. Facility has an active waiver to associate all personnel to the main file. There are no weapons at the facility. There are no pets at the facility. LPA conducted a review of 2 client files and 5 staff files. All files reviewed were complete and in compliance. As of June 25, 2021, all facility staff are associated to the facility and received fingerprint and child abuse index check clearances. Exit interview conducted and a copy of the report was left at the facility. There are no deficiencies to be cited at this time

met_with: Tim Dimmick


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Cheyenne McCambridge and Carolyn Flynn on 08/31/2021 at 10: AM. During the inspection, LPAs McCambridge and Flynn met with Tim Dimick, Deputy Director and Robin Hausserman, Clinical Director in the main office. LPAs reviewed zero of child's records on site at the facility at due to both clients being over the age of eighteen. LPAs reviewed zero of child's psychotropic medications and medication records. LPAs interviewed zero of children currently taking psychotropic medication. LPAs interviewed four of staff on site starting at 10: AM. LPAs reviewed four of staff personnel files on site at the facility starting at 12: PM. Brook Leone, Facility Manager escorted LPAs on a tour of the facility inside and out at 1: PM LPA provided the Summary Report to Robin Hausserman, Clinical Director upon completion. No deficiencies are being cited at this time. LPAs conducted exit interview with Robin Hausserman, Clinical Director at 1: PM


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analysts (LPA) David Hiett and George Karkazis made an unannounced visit to initiate a required annual inspection. LPA met with Deputy Director Time Dimick. 5 staff files and 3 client files were reviewed and found to be complete. All files were found to be complete and compliant with relevant regulations. Interviews and physical plant inspection will be completed on a subsequent visit. No deficiencies were cited and a copy of this report was with the facility. On June 23, 2022, Licensing Program Analyst (LPA) David Hiett continued an annual inspection for Greenacre Homes STRTP - Eddie Lane. LPA met with Facility Manager Brook Leone and inspected the facility inside and out. The STRTP is licensed to serve 9 ambulatory male clients, ages 6-17. An inspection of the facility was conducted, and the following was observed: Hot water temperature measures 109 degrees Fahrenheit. Individual beds were observed with appropriate clean linens and are in good repair. Centrally stored medications are maintained in a locked cabinet. Toxic chemicals are locked in a cabinet located and secured in the laundry room. LPA observed all required documentation posted in the facility, to include: Facility license, Emergency Disaster Plan, LIC 610 and evacuation plan, Menu, Weekly Activity Schedule, Client's Rights, OSHA signs. A physical plant inspection was completed and included the following checks. Facility grounds are clean and free of debris and observable hazard. Adequate indoor and outdoor activity space and materials observed. All facility smoke detectors are in appropriate working order, fire extinguisher is properly charged and serviced. Facility has an active waiver to associate all personnel to the main file. There are no weapons at the facility. There is a pet cat at the facility. LPA conducted interviews with 2 clients and 1 staff. As of June 23, 2022, all facility staff are associated to the facility and received fingerprint and child abuse index check clearances. Exit interview conducted and a copy of the report was left at the facility. There are no deficiencies to be cited at this time


summary: Facility Evaluation

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Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheyenne McCambridge on 03/07/2024 at 10: AM. During the inspection, LPA McCambridge met with human resources Shonna Kuhner in the main office. LPA reviewed zero of child's records on site at the facility at due to client not being on Psychotropic Medication. LPA reviewed zero of child's psychotropic medications and medication records. LPA interviewed zero of children currently taking psychotropic medication. LPA interviewed three of staff on site starting at 10: AM. LPA reviewed three of staff personnel files on site at the facility starting at 12: PM. Brook Leone, Facility Manager escorted LPA on a tour of the facility inside and out at 1: PM No deficiencies are being cited at this time. LPA conducted exit interview with Shonna Kuhner and a copy of the report was sent to the facility.

met_with: Shonna Kuhner


summary: Facility Evaluation

raw_content:
Narrative:
On 12-2-24 10:15PM, Licensing Program Analyst George Karkazis conducted an unannounced Annual/Random inspection at listed facility. LPA met with Timothy Dimick, Administrator and toured the facility inside and out. The Short Term Therapeutic Program is licensed to serve 9 clients. Present during the inspection were 3 staff and 2 clients. At 10:30AM LPA Karkazis reviewed client and staff files. All staff and client files are up to date and in good order. At 1:15PM, LPA Karkazis toured the facility. LPA Karkazis observed 9 bedrooms and 4 bathrooms. LPA observed facility license, personal rights, facility sketch, meal menu, and other forms posted on the walls throughout the facility. LPA Karkazis tested the water temperature and found it to be 112 degrees which is in range. The thermostat read 68 which is within range. Sharps were locked and chemicals were safely stored. There were two days of perishable foods and seven days non-perishable foods present. The medication was also stored and locked in the staff office in a locked cabinet. The facility is in good repair and clean. LPA Karkazis interviewed 3 staff and 2 clients. At 2:33PM, LPA Karkazis toured the backyard. There were no open bodies of water. The backyard was in good repair and clean. At this time there were no deficiencies. An exit interview was conducted, appeal rights discussed and a copy of this report was given to Timothy Dimick, Administrator

met_with: Timothy Dimick, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 03/18/25 at 10: AM, Licensing Program Analyst (LPA) Jasmine Cardeno and LPA Celeste Aparicio conducted an unannounced visit to the facility listed above. The purpose of the visit is to conduct the required SB Psychotropic Medications inspection. LPAs met with Deputy Director, Timothy Dimick, and Direct Care Staff, Isaiah Wisdom, who both facilitated the inspection. At the time of the inspection, two clients in care were present. The facility had one client that met the criteria for the SB Psychotropic Medication Inspection. LPAs reviewed 1 of child's records and 6 of staff personnel files on site at the facility. LPAs reviewed 1 of child's psychotropic medications and medication records. LPAs interviewed 3 of staff on site to discuss the facilities policies and procedures of operation. LPAs interviewed 1 of the children currently prescribed psychotropic medication. No deficiencies are being observed or cited at this time. The SB Psychotropic Medications inspection is complete. LPAs conducted an exit interview with Deputy Director and a copy of this report was left with Deputy Director, Timothy Dimick, whose signature on this form confirms receipt.


facility_name: GREENACRE HOMES, INC. (OCCIDENTAL)

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Brian Bertoli met with Director of Residential Services Tim Dimick regarding a complaint investigation. The purpose of the meeting was to deliver the findings for the above complaint allegation. During the course of the investigation, LPA Bertoli reviewed records and conducted confidential interviews, which did not indicate that the above allegation occurred. There is a lack of evidence to make a determination as to whether a regulatory violation did occur. This department has investigated the allegation, and although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that there was a Lack of supervision resulting in inappropriate activities by the youth; therefore, the above allegations are Unsubstantiated. Appeal Rights were provided and discussed, and no deficiencies were cited. An exit interview was conducted and a copy of the report was given to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lidia Tinoco LICENSING EVALUATOR NAME: Brian Bertoli LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3


summary: Facility Evaluation

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Narrative:
On 6/24/202 at 3:45PM, Licensing Program Analyst (LPA) David Hiett conducted an unannounced annual inspection for Greenacre Homes STRTP - Eddie Lane. LPA met with Facility Manager Charles Andrew and inspected the facility inside and out. The STRTP is licensed to serve 6 ambulatory male clients, ages 6-17. An inspection of the facility was conducted, and the following was observed: Hot water temperature measures 108F degrees Fahrenheit. Individual beds were observed with appropriate clean linens and are in good repair. Centrally stored medications are maintained in a lock cabinet. Toxic chemicals are locked in a cabinet located and secured in the kitchen. LPA observed all required documentation posted in the facility, to include: Facility license, Emergency Disaster Plan, LIC 610 and evacuation plan, Menu, Weekly Activity Schedule, Client's Rights, OSHA signs. A physical plant inspection was completed and included the following checks. Facility grounds are clean and free of debris and observable hazard. Adequate indoor and outdoor activity space and materials observed. All facility smoke detectors are in appropriate working order, fire extinguisher is properly charged and serviced. Facility has an active waiver to associate all personnel to the main file. There are no weapons at the facility. There are no pets at the facility. LPA conducted a review of 2 client files and 3 staff files. All files reviewed were complete and in compliance. As of June 25, 2021, all facility staff are associated to the facility and received fingerprint and child abuse index check clearances. Exit interview conducted and a copy of the report was left at the facility. There are no deficiencies to be cited at this time.

met_with: Charles Andrew


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Brian Bertoli on the above date. During the inspection, LPA Bertoli met with Tim Dimick, Deputy Director, at the administrative office on Eddie Lane, and was assisted by facility manager Charles Andrews at the facility. LPA reviewed two children's records and psychotropic medications and medication records at the administrative office at 9:30AM. LPA reviewed four staff personnel files on at the administrative office starting at 10: AM. LPA interviewed four staff on site starting at 1: PM. LPA interviewed two children at the facility at 3:00PM that are currently taking psychotropic medication. Facility Manager Charles Andrews escorted LPA on a tour of the facility inside and out at 1: PM and demonstrated medication practices and pill counts at 3:45PM LPA provided the Summary Report to Deputy Director Dimick upon completion. No deficiencies are being cited at this time. LPA conducted exit interview with Charles Andrews at 4: PM


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) David Hiett made an unannounced visit to initiate a required annual inspection. LPA met with Clinical Director Robin Hausserman at the main program office at the Eddie Lane facility. 5 staff files and 3 client files were reviewed and found to be complete. Interviews and physical plant inspection will be completed on a subsequent visit. No deficiencies were cited and a copy of this report was with the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On June 23, 2022, Licensing Program Analyst (LPA) David Hiett continued an annual inspection for Greenacre Homes STRTP - Hurlbut. LPA met with Facility Manager Charles Andrews and inspected the facility inside and out. The STRTP is licensed to serve 6 ambulatory male clients, ages 6-17. An inspection of the facility was conducted, and the following was observed: Hot water temperature measures 112 degrees Fahrenheit. Individual beds were observed with appropriate clean linens and are in good repair. Centrally stored medications are maintained in a locked cabinet. Toxic chemicals are locked in a cabinet located and secured in the laundry room. LPA observed all required documentation posted in the facility, to include: Facility license, Emergency Disaster Plan, LIC 610 and evacuation plan, Menu, Weekly Activity Schedule, Client's Rights, OSHA signs. A physical plant inspection was completed and included the following checks. Facility grounds are clean and free of debris and observable hazard. Adequate indoor and outdoor activity space and materials observed. All facility smoke detectors are in appropriate working order, fire extinguisher is properly charged and serviced. Facility has an active waiver to associate all personnel to the main file. There are no weapons at the facility. There are no pets at the facility. LPA conducted interviews with 2 staff and 3 clients As of June 23, 2022, all facility staff are associated to the facility and received fingerprint and child abuse index check clearances. Exit interview conducted and a copy of the report was left at the facility. There are no deficiencies to be cited at this time

met_with: Charles Andrews


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli made an unannounced visit to the facility and met with Deputy Director Timothy Dimick. The purpose of the visit was to confirm closure of the Short-Term Residential Therapeutic Program (STRTP). The Request for Closure, confirmation of no STRTP youth remaining, and license were received by CCL. LPA Bertoli inspected the facility at 3:35pm and confirmed that no youth were present. The licensee is in the process of selling the property. Closure of the STRTP is effective 03/11/2024. An exit interview was conducted with the Deputy Director to confirm the closure. A copy of this report was given to the Deputy Director.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli conducted an unannounced visit to the facility for the purpose of a Case Management Investigation. LPA met with Deputy Director Tim Dimick Based on Incident report dated 01/10/23, staff S1 (see LIC 811 dated 1/26/23) was wrestling with youth C1 and impeded the youth's ability to breathe and caused neck pain. LPA is issuing a citation from Title 22 (see LIC 809-D dated 1/26/23) for Personal Rights. Appeal Rights were discussed and a copy was provided to the facility. An exit interview was conducted with Tim Dimick and a copy of this report was given to the facility.


facility_name: GREENWAY ORCHARD

summary: Facility Evaluation

raw_content:
Narrative:
An unannounced annual inspection was conducted by LPA (Licensing Program Analyst) Lidia Tinoco on at Greenway Orchard STRTP. LPA met with Brandi Boehme and inspected the facility, inside and out. Currently the facility is inactive and has been inactive since August 2019. All facility smoke detectors were tested and appear to be in appropriate working order, fire extinguisher is properly charged. The facility currently keeps their food supply at an off site warehouse where they store non-perishables, fresh foods, and dairy that would be ready to be transported to the home would they choose to become active again. Individual beds were observed with appropriate clean linens and are in good repair. The facility is maintained at 72 degrees. No bodies of water were observed. No firearms or weapons are allowed in the facility. Licensee has obtained Mental Health Certification Including the following: Mental Health Program Approval valid through 9/24/21, Medi-Cal site certification issued on January 1, 2019 and a county contract through June 30, 2022. Licensee has obtained National Accreditation through CARF. The Accreditation is valid through September 30, 2023. Due to the facility being inactive no records of personnel/ staff members were reviewed and no records of clients were reviewed. There were no deficiencies to be cited on this date. A copy of this report was left with Brandi Boehme

met_with: Brandi Boehme


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Lidia Tinoco traveled to the Greenway Orchard House STRTP in Turlock, California for the purpose of conducting an unannounced Annual Inspection. LPA met with Program Director Brandi Boehme and inspected the facility, inside and out. A physical plant inspection was completed and included the following checks. Facility grounds are clean and free of debris. Adequate indoor and outdoor activity space and materials observed. The facility is maintained at 75 degrees. All facility smoke detectors and carbon monoxide detectors are in appropriate working order. Facility keeps some canned foods and non-perishables in the home, there is no perishable food in the house at this time but has access to a full pantry located at Merced Ranch where they can stock the facility should they chose to open the house again. All required forms are posted. Facility has the ability to keep medications locked and centrally stored. Individual beds were observed with appropriate clean linens and are in good repair. Licensee has obtained Mental Health Certification Including the following: The Facility has the Mental Health Certification valid through September 24, 2022. Licensee has obtained National Accreditation through CARF valid through September 30, 2023. The facility has a county contract valid through June 30, 2022. No firearms or weapons are allowed in the facility. Facility appears to be meeting the terms and conditions of their license. Currently the facility is inactive, therefore no children or staff are in placement therefore no files were reviewed. No Deficiencies were cited on today's visit. A copy of this report was left with Brandi Boehme.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Lidia Tinoco traveled to the Greenway Orchard House STRTP in Turlock, California for the purpose of conducting an unannounced Annual Inspection. LPA met with Assistant Executive Director Lisa Jacobs and inspected the facility, inside and out. A physical plant inspection was completed and included the following checks. Facility grounds are clean and free of debris. Adequate indoor and outdoor activity space and materials observed. The facility is maintained at 75 degrees. All facility smoke detectors and carbon monoxide detectors are in appropriate working order. Facility keeps some canned foods and non-perishables in the home, there is no perishable food in the house at this time but has access to a full pantry located at Berkeley Lodge where they can stock the facility should they chose to open the house again. All required forms are posted. Facility has the ability to keep medications locked and centrally stored. Individual beds were observed with appropriate clean linens and are in good repair. Licensee has obtained Mental Health Certification Including the following: The Facility has the Mental Health Certification valid through September 24, 2023. Licensee has obtained National Accreditation through CARF valid through September 30, 2023. The facility has a county contract valid through June 30, 2023. No firearms or weapons are allowed in the facility. Facility appears to be meeting the terms and conditions of their license. Currently the facility is inactive, therefore no children or staff are in placement therefore no files were reviewed. No Deficiencies were cited on today's visit. A Technical Assistance was discussed. A copy of this report was left with Lisa Jacobs.

met_with: Lisa Jacobs


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco arrived at the Greenway Orchard for the purpose of conducting a Case Management inspection. LPA met with Aaron Holloway. On May 28, 2024, LPA Tinoco was notified by Administrator Brandi Boehme that an Agency decision was made to relinquish the license for the Greenway Orchard Home. On June 4, 2024, LPA Tinoco received the electronic documents including the reason for closure, board of director letter, and the facility license. On June 6, 2024, the original documents were received at the Fresno Office. On June 7, 2024, LPA Tinoco arrived at the Greenway Orchard house in order to conduct a final walk through of the facility. There have not been clients in placement at this home since August 2019. LPA Tinoco confirmed that there are no clients in placement on this date. No deficiencies were observed on this date. A copy of this report was provided to Aaron Holloway.

met_with: Aaron Holloway


facility_name: GUIDING LIGHT HOME FOR BOYS INC.

summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
interviews confirmed C1 slept in the loft of the facility on 10/11/2021 due to fear of sharing a room with C2. Confidential interviews reported when C1 woke up a gun was being held to C1's head. Confidential interviews and record review confirmed C1 sleeping in the loft. Confidential interviews and record review revealed C2 was removed from the facility on 10/11/2021 after which C2 contacted residents looking for a backpack which was found a few days later with a handgun in it. Record review and confidential interviews reported the handgun was turned into the local police department. CCL received and additional allegation that Minor (Child #1 [C1]) was being bullied by another minor (Child #2 [C2]) in care. Confidential interviews provided consistent statements of C2 intimidating residents and bullying residents. Confidential interviews confirmed C1 sleeping in the loft on the morning of 10/11/2021 due to C1's fear of sharing a room with C2. Confidential interviews provided consistent statements of the facility environment being hostile while C2 resided in the facility due to C2's bullying and intimidating the residents and staff. Based on confidential interviews the allegations Minor (Child #2 [C2]) threatened another minor (Child #1 [C1]) with a firearm and Minor (Child #1 [C1]) was being bullied by another minor (Child #2 [C2]) in care are substantiated. The preponderance of evidence standard has been met. Facility is cited for violation of Interim Licensing Standards (ILS) standard 87072 (d) The licensee shall ensure that each child, regardless of whether the child is in foster care is accorded the personal rights specified in Welfare and Institutions Code Section 16001.9 as applicable, and ILS standard 87072 (d)(11) To be free of physical, sexual, emotional, or other abuse, and form corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature including , but not limited to, interference with the daily living functions of eating, sleeping, or toileting, or withholding of shelter, clothing, or aids to physical functioning. A copy of the report was discussed and provided along with appeal rights to Guiding Light Home for Boys Administrator (ADM) Cathy Gooden.

Investigation Findings:
13On January 26, 2022 at 10:20am Licensing Program Analyst (LPA), Nicole Strickland, met with Guiding Light Home for Boys Administrator (ADM) Cathy Gooden, to deliver the findings for the above stated allegations. LPA conducted an inspection of the facility on October 20, 2021 at approximately 12:30 pm and no immediate deficiencies were observed. The investigation was conducted by LPA Strickland and included interviews with five of six foster youth (Child #1 [C1], Child #3 [C3], Child #5 [C5], and Child #7 [C7]), two Staff (Staff #1 [S1] and Staff #2 [S2]), Riverside Out of Home Institutions (OHI) investigator, and County Social Worker (CSW). One confidential witness did not respond to LPA's multiple requests for an interview and therefore was not interviewed. In addition, county records and facility records were reviewed. On October 12, 2021, Community Care Licensing (CCL) received an allegation alleging Minor (Child #2 [C2]) threatened another minor (Child #1 [C1]) with a firearm. Confidential interviews provided consistent statements of C2 making threats to residents in care and C2's statements of having a gun. Confidential SubstantiatedEstimated 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 Riverside, CA Facility Name: Guiding Light Home for Boys INC.FACILITY NUMBER: VISIT DATE: 01/27/2022

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

met_with: Cathy Gooden