raw_content:
Narrative:
not updated, were missing signatures, and were missing explanations. LPA confirmed this information upon review of client medication records for months of September and October 2022. Additionally, the reason for missed medication was not provided on some entries. Staff corroborate they were unaware of some of the required information needed on medication log records. The facility is being cited for violation of the Interim Licensing Standards section 87070(13)(G)(1), Children's Records. Based on confidential interviews, information gathered, and LPA's own observation and review of client medication logs, the allegation staff do not adequately maintain minor's medication records is SUBSTANTIATED because the preponderance of evidence standard has been met for the allegation. This poses a potential health, safety, or personal rights risk to clients in care. The facility is being cited the Interim Licensing Standards cited above. An exit interview was conducted and a copy of this report, LIC 811, and appeal rights, were emailed to Mr. Zachary for signature. Original signed reports will be placed in facility file. reported C1 has limited clean clothing in C1's closet and all the clothes were also on the floor of C1's room or in the dirty laundry hamper. Lastly, it was also reported that the space for therapy is in the garage where the temperature gets very high. While a witnesses maintains all the allegation details are correct, all other witnesses corroborate that the details of each allegation are untrue. Witnesses corroborate that while there may have been an old food menu on the fridge on at least one occasion, the menu is usually updated, however, clients request to eat out or would rather order food other than the food being cooked. LPA observed clients have scheduled laundry days and as long as clients are capable of doing their laundry the washer and dryer are available to clients for laundry needs. C1 has not wanted to do C1's laundry and keeps C1's room messy, regardless of being asked to pick up C1's clothes. Staff have also done C1's laundry on several occasions, as C1 does not complete C1's chores. Based on interviews conducted, the allegations that minors are not provided a food menu, C1's laundry needs are not being met, minors are not being provided a comfortable temperature, may have occurred, however, they are not supported or proven by evidence. The allegations are, therefore, UNSUBSTANTIATED. There are no deficiencies to be cited. An exit interview was conducted and a copy of this report, LIC 811, and appeal rights, were provided to FM, Zachary Williams, for original signature. Signed report will be placed in facility file.

Investigation Findings:
13On November 18, 2022, at 10: AM, Licensing Program Analyst (LPA) Carmen Escobar arrived at the Short-Term Residential Therapy Program (STRTP) facility and met with Facility Manager, Mr. William Zachary. LPA Escobar conducted a facility risk assessment interview with FM and proceeded to issue the investigative finding for the above allegations. During the investigation, LPA requested documents from client 1 (C1's) file including placement agreement, copy of C1's needs and service plan from time of allegation, special incident reports involving C1 and facility roster at time of allegation. LPA Escobar conducted interviews with staff 1 (S1), staff 2 (S2), staff 3 (S3), C1, client 2 (C2), client 3 (C3), C1's county social worker (CSW) and another involved party. The initial ten-day inspection to initiate the complaint investigation was completed by LPA Escobar at the facility on 09/14/21 at 12: PM, no health or safety concerns were observed. It was alleged that on or around 09/09/21, staff do not adequately maintain minor's medication records. Specifically, it was reported that the medication documentation logs are not in compliance. The logs were SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Carmen Escobar LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PENNACLE FOUNDATION INCFACILITY NUMBER: VISIT DATE: 11/18/2022

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

met_with: Facility manager-Wiliam Zachary


state: CA

facility_name: PENNACLE FOUNDATION INC

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
On October 27, 2022, Community Care Licensing (CCL) received a complaint alleging that staff mishandled a minor while in care. Regarding the allegation that LFM mishandled C1 while in care, a confidential interview stated that C1 was held by LFM to prevent C1 from hurting self and others. Confidential interview continued stating that during the incident LFM embraced C1 by placing both arms around C1. Confidential interview stated that law enforcement arrived to respond to C1's behaviors and spoke to C1 and LFM about the incident. LPA Urena obtained a 24-hour notice and a Law Enforcement Report dated 10/26/22 that states "C1 was moving so aggressively that LFM laid on C1 for approximately two minutes while trying to calm the client and de-escalate the situation". Another confidential interview stated that clients have expressed concerns about being mishandled by staff while in care but denied that staff were intentionally mistreating clients in care and added that staff are trained on how to respond to emergency situations. It was discovered that during the process of responding to C1's behaviors LFM did use a one-person restraint as a method of de-escalation. Based on confidential interviews, and record review the preponderance of evidence standard has been met, and the allegation that LFM mishandled C1 while in care, is supported and proven by evidence. The facility is cited for violation of Interim Licensing Standards (ILS) version four Section 87072(c)(11) PERSONAL RIGHTS. Exit interview was conducted. A copy of this report, along with LIC D, LIC 811, and appeal rights were explained and will be emailed to Pennacle Foundation Inc. STRTP Administrator Carolyn Ruffin. In regard to the allegation that LFM choked C1 while in care, A confidential interview denied that LFM choked C1 rather LFM was responding to C1 breaking windows at the facility resulting in no injury to C1's neck. Another confidential interview stated that staff only place hands-on clients as a last resort and for safety purposes only. Confidential interview denied that staff maltreat clients in care. Other confidential interviews denied witnessing LFM choking C1 while in care. Another confidential interview stated that C1 did not report concerns to CSW about staff maltreatment at the facility. Confidential interview further reported that CSW did not have concerns about the placement. C1 could not be reached for comment. LPA received inconsistent information about whether or not LFM choked C1 while in care. Based on confidential interviews, and record review the allegation that LFM choked C1 while in care, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report along with the appeal rights was provided to Administrator Carolyn Ruffin.

Investigation Findings:
13On April 27, 2023, at 12: PM, Licensing Program Analyst (LPA) Cynthia Urena conducted an unannounced visit at Pennacle Foundation Inc. Short Term Residential Therapeutic Program (STRTP) to deliver the finding of the above stated allegation. LPA was met by Adminsitrator Carolyn Ruffin. LPA Carmen Escobar conducted an inspection of the facility on November 3, 2022, at 10: AM and no immediate deficiencies were observed. On April 11, 2023, LPA Urena continued with the investigation at the STRTP and conducted interviews with a Lead Facility Manager (LFM), Administrator (ADM) and two staff members (S1, S2,). LPA attempted to interview two clients (C2, C3) however, both clients declined to be interviewed. Client #1 (C1) could not be reached for an interview due to an absence without leave (AWOL) status. Additionally, LPA interviewed a County Social Worker (CSW). SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Cynthia Urena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: PENNACLE FOUNDATION INCFACILITY NUMBER: VISIT DATE: 04/27/2023

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:

report_type: Complaint Investigation

met_with: Administrator Carolyn Ruffin

complaint_status: unsubstantiated


raw_content:
Narrative:
On November 17, 2022, Community Care Licensing (CCL) received a complaint alleging that staff choked a minor while in care, staff handled minor in an inappropriate manner, and that minor engaged in a physical altercation with another minor while in care. Regarding the allegations that staff choked C1 while in care and that staff mishandled C1 while in care, confidential interviews denied that staff choked and mishandled C1 while in care. Confidential interviews further stated that staff do intervene during client-on-client physical altercations but deny client mistreatment during the process. Other confidential interviews stated that C1 wanted to go back to county of origin and expressed to staff that C1 would inform school staff the C1 did not feel safe at current placement. Another confidential interview declined to provide any comments due to C1's short stay at the facility, and C1 could not be reached for an interview. LPA received inconsistent information regarding the allegations. Regarding the allegation that C1 engaged in a physical altercation with another client, a confidential interview stated that there was a fight that resulted in C1 being body slammed by another client in care. Confidential interview continued stating not being sure what occurred but maintained that C1 wanted to return to county of origin and was willing to make false allegations to get relocated. Other confidential interviews denied witnessing an altercation between C1 and another client. LPA received inconsistent information regarding the allegation. Based on confidential interviews, and record review the allegation that staff choked C1 while in care, staff handled C1 in an inappropriate manner, and that C1 engaged in a physical altercation with another minor while in care, may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the allegations are unsubstantiated at this time. Exit interview was conducted. A copy of this report, along with LIC D, LIC 811, and appeal rights were explained and will be emailed to Pennacle Foundation Inc. STRTP Lead Facility Manager, William Zachary

Investigation Findings:
13On April 27, 2023, at 1: PM, Licensing Program Analyst (LPA) Cynthia Urena conducted an unannounced visit at Pennacle Foundation Inc. Short Term Residential Therapeutic Program (STRTP) to deliver the finding of the above stated allegations. LPA was met by Lead Facility Manager, William Zachary. LPA Carmen Escobar conducted an inspection of the facility on November 3, 2022, at 9: AM and no immediate deficiencies were observed. On April 11, 2022, LPA Urena continued with the investigation at the STRTP and continued an interview with a Lead Facility Manager (LFM). In addition, LPA Urena conducted interviews Administrator (ADM) and four staff members (S1, S2, S3, S4). LPA attempted to interview two clients (C2, C3) however, both clients declined to be interviewed. Client #1 (C1) could not be reached for an interview due to an absence without leave (AWOL) status. Additionally, LPA interviewed a County Social Worker (CSW). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Cynthia Urena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: PENNACLE FOUNDATION INCFACILITY NUMBER: VISIT DATE: 04/27/2023

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

met_with: Lead Facility Manager, William Zachary


raw_content:
Narrative:
Regarding the allegation that staff do not prevent an inappropriate interaction between minors while in care, confidential interviews disclosed that staff did not prevent an inappropriate interaction between clients which resulted in an allegation of sexual abuse between clients (C1 and C2). Information gathered from confidential interviews stated that C1 indicated being inappropriately touched by another client in the home (C2). Other confidential interviews deny that there was any inappropriate interaction between clients. Information gathered from interviews stated that staff go over boundaries and respecting personal space with clients in care. Further information gathered revealed that when a client expressed that there was a possibility that they were inappropriately touched, staff sought medical attention for the client, reported the incident to law enforcement, and made proper room arrangements so that clients in care did not have to share a room with the alleged perpetrator. Based on interviews and confidential information obtained during this investigation, LPA received inconsistent information regarding the allegation. The allegation staff do not prevent an inappropriate interaction between minors while in care, may have occurred, however it is not supported, or proven by evidence. Confidential interviews could not confirm or dispute these allegations; Therefore, the allegations are unsubstantiated at this time. Exit interview conducted, appeal rights were discussed, and provided. A copy of this report was provided to Lead Facility Manager, William Zachary.

Investigation Findings:
13On May 17, 2023 at 11: AM, Licensing Program Analyst (LPA),Cynthia Urena, met with Pennacle Foundation Inc., Short Term Residential Therapeutic Program (STRTP), Lead Facility Manager, William Zachary, to deliver the findings for the above stated allegation. LPA Carmen Escobar conducted an inspection of the facility on October 26, 2022, at approximately 11:05 am and no immediate deficiencies were observed. The investigation included interviews with three staff (S1, S2, and S3) and two out of two foster youth (C1 and C2). Two County Social Workers (CSW's) did not respond to LPA's request for an interview, after multiple attempts, and therefore were not interviewed. In addition, county records and facility records were reviewed. On October 18, 2022, Community Care Licensing (CCL) received an allegation alleging that staff do not prevent an inappropriate interaction between minors while in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Cynthia Urena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: PENNACLE FOUNDATION INCFACILITY NUMBER: VISIT DATE: 05/17/2023

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


raw_content:
Narrative:
Specifically, it was reported that C1 did not have access to the home and would wander the neighborhood. Regarding the allegation that staff do not ensure C1 has access into the home while in care, information gathered stated that C1 was not given access to the facility and would go around neighboring homes stating that they were locked out of the facility. Additional information detailed that C1 would have to wait for staff to return from picking up other clients in the home and would not have access to the home while waiting. Other confidential interviews denied that staff does not ensure that minors have access into the home and that staff is present to let clients into the facility. There were limited details as to what staff members did not allow C1 access into the home or when clients in care were denied access to the home while in care. Regarding the allegation that staff do not prevent minor from wandering while in care, confidential interviews confirmed that clients in care wander off without any staff supervision, specifically C1. Further details gathered from interviews stated that staff would take away or hide shoes from clients in care to prevent clients from wandering or being absent from care. Other confidential interviews denied that staff do not prevent minors from wandering while in care. Additional details gathered that some clients in care were allowed to go on walks that did not require staff supervision and would not return on time or would be absent from care. Confidential interviews detailed that some clients were chronically absent from care and would leave the facility but then come back. Staff was unable to force clients to stay in the facility to prevent being absent from care but would use other methods such as redirecting and encouraging clients to stay in the facility. Furthermore, when unable to prevent clients from being absent from care staff would contact law enforcement to report clients being absent from care. Based on interviews and confidential information obtained during the course of this investigation, LPA received inconsistent information regarding the allegations that staff do not ensure that minor has access into the home while in care and staff do not prevent minor from wandering while in care, may have occurred, however is not supported, or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview conducted, appeal rights were discussed, and provided. A copy of this report along with, Confidential Names List, provided to Lead Facility Manager, William Zachary.

Investigation Findings:
13On May 17, 2023 at 11: AM, Licensing Program Analyst (LPA), Cynthia Urena, met with Pennacle Foundation Inc., Short Term Residential Therapeutic Program (STRTP), Lead Facility Manager, William Zachary, to deliver the findings for the above stated allegation. LPA Carmen Escobar conducted an inspection of the facility on October 26, 2022, at approximately 11:50 am and no immediate deficiencies were observed. The investigation included interviews with three staff (S1, S2, and S3), and three out of four clients (C1, C2, C3, C4). One of four clients declined to be interviewed. In addition, county records and facility records were reviewed. On October 19, 2022, Community Care Licensing (CCL) received an allegation alleging that staff do not ensure that minor has access into the home while in care and staff do not prevent minor from wandering while in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Cynthia Urena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: PENNACLE FOUNDATION INCFACILITY NUMBER: VISIT DATE: 05/17/2023

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


facility_name: PENNY LANE - SATELLITE I

summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
Title Regulation Standards Division 6 & Chapter 1 80078(a) Responsibility For Providing Care and Supervision Regulations on the attached LIC 9099D. A Type "A" citation for Immediate Health & Safety Hazard has been issued. Exit interview conducted. Copy of this Report and Appeal Rights emailed to Facility Representative.

Investigation Findings:
13On Tuesday October 19, 2021 @ 3:30PM Licensing Program Analyst (LPA) Kathy Landry conducted a Tele-Inspection regarding complaint allegation listed above. LPA Landry spoke with Facility Representative listed above. This investigation initially began 09/07/2021, since then more information has been received. On or around May 30, 2020, child #1 was outside of the facility while two other clients (child 2 and 3) were inside of facility with staff #2. While staff #3 prepared medication in the detached garage/office area staff #2 was designated to supervise these three clients. Staff #2 was inside the facility maintaining visual supervision of clients 2 and 3 while sitting near the front door looking/ listening for child #1, who was outside in the adjacent frontyard driveway playing basketball. It is unclear how much time passed when staff #2 conducted a routine head check and child #1 was not located. Runaway Procedures were executed. A Missing Persons Report was filed and pertinent parties notified. Child #1 never returned to the facility. Based on LPA Landry's observation and interviews which were conducted and record review, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be Substantiated per -----> SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Kathy Landry LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 31-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, VENTURA BLVD., STE. WOODLAND HILLS, CA FACILITY NAME: PENNY LANE - SATELLITE IFACILITY NUMBER: VISIT DATE: 10/19/2021

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

met_with: Kristn Malka

complaint_status: SUBSTANTIATED


facility_name: PERSISTENT YOUTH PATHWAYS

summary: Facility Evaluation

raw_content:
Narrative:
On 10/21/2025 at approximately 10: AM, Licensing Program Analyst (LPA) Joon Choi met with applicant Marquita Berry, for a Component II (Program Statement / Plan of Operations Review). LPA Choi and Marquita Berry reviewed revisions for the application prior to licensure. LPA provided additional information to assist with the revisions needed to complete the application process prior to the Pre-Licensing Visit. A copy of this report (LIC 809) was provided to applicant.

report_type: Facility Evaluation

met_with: Marquita Berry, Applicant


summary: Facility Evaluation

raw_content:
Narrative:
On April 20, 2026, Licensing Program Analyst (LPA) Joon Choi conducted a pre-licensing inspection for Persistent Youth Pathways Short Term Residential Therapeutic Program's (STRTP) license. LPA met with owner/applicant Marquita Berry. The facility was toured both inside and out with the applicant. Currently there are no clients placed in the facility. The facility is applying to serve six minor clients. The residence was originally a four bedroom, two-story house with two full bathrooms(upstairs) and a half-bathroom downstairs. The upstairs master bedroom was modified to now serve as a staff office and will also serve as an alternate room. The facility consists of a living room (common area), a kitchen, dining area, a downstairs staff office/den, the garage, and the backyard. The backyard has a sitting area with portable large umbrella and turf lawn. There is a trampoline in the side area of the backyard. The garage currently is inaccessible to clients. There are solar panels on the roof. The facility has 3 bedrooms and one full bathroom designated for clients. There is a half-bathroom downstairs for staff and client use. There is one bathroom designated for staff, that is in the upstairs master bedroom/alternate room. The bedrooms were arranged so that no more than two clients share a room, and there will be one child per bed. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate dresser drawer space and closet space for children's belongings. Towels, linens and extra hygiene were stored in a storage closet in the upstairs hallway. There are six smoke detectors / carbon monoxide detectors (1 downstairs and 5 upstairs) and all were checked and observed to be working properly. The home also has a fire sprinkler system: both floors. Continued on the Next Page There is no fireplace in the living room area. Telephone service (land line) and appliances were in a working order. All hazardous items and cleaning materials have been properly made inaccessible to areas where clients would have access by themselves ( located in the upstairs laundry room, locked with staff keys only). The client medications are located in the staff/den area and sharp objects/knives will be locked in a lockbox in of the lower kitchen cupboards. There is a first aid kit in the staff den office and facility vehicle. There were no guns or weapons as stated by applicant at this time. The hot water temperature was tested and noted to be holding at 117.1 degrees fahrenheit. Facility was advised that upon being notified of their provisional license being issued, then adequate food storage supply of two days of perishable foods and a week of non-perishable food will be required as soon as possible. Proper storage of all food was discussed. One trash can is located in the kitchen for storage of solid waste has a tight fitting lid. There is also a covered waist basket in the client's upstairs bathroom and downstairs bathroom. The Facility Sketch, Emergency Disaster Plan, visitation policy, client Personal Rights and the contact numbers for the Foster Care Ombudsperson and Community Care Licensing Hot-line were posted. (Foster Youth Bill of Rights Poster is needed) There was no pool or other body of water, and the backyard where clients will have access to play; was completely fenced and free of hazards. With the assistance of the owner/applicant. LPA inspected the facility's physical plant and reviewed the facility's operational requirements, disaster preparedness and emergency interventions. No interviews or file reviews were conducted during this visit. Currently, the facility is appropriate for a capacity of six ambulatory clients, ages nine to seventeen. This facility will not house Non-Minor Dependents. Technical advisories (TAs) were provided at this time regarding: client lock boxes and clearing of debris in the backyard. Licensing Program Manager will complete a final review prior to issuing a provisional license. Exit interview was conducted and a copy of this report and TAs were provided owner/applicant Marquita Berry.

visit_type: Prelicensing

met_with: Marquita Berry, Owner / Applicant


facility_name: PINTA HOME

summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
Based on witness interviews and records review, the preponderance of evidence standard has been met, and the allegation facility Staff #1 (S1) pushed Client #1 (C1) is substantiated. The facility is being cited for violation of STRTP Interim Licensing Standards (ILS) Version 3.1, Section 84072 (d)(11) Personal Rights. The facility did not ensure that C1 was free from physical, emotional, or other abuse, which poses a potential Personal Rights risk to clients in care. An exit interview was conducted. A copy of this report, LIC 811, LIC 9099-D, and Appeals Rights were provided to Sterling Kirk.

Investigation Findings:
13On April 19, 2022, Licensing Program Analyst (LPA) Lorena Valenzuela met with Pinta Short Term Residential Therapeutic Program (STRTP) Administrator Sterling Kirk to deliver the finding for the above-stated allegation. The investigation included an inspection of the STRTP, a review of records on 08/03/2021, and a San Bernardino Investigation Narrative review. In addition, LPA interviewed four clients (C1, C2, C3, & C4), three facility staff (S1, S2, & S3), and an Administrator. See the Confidential Names List, LIC 811, dated April 19, 2022. On July 30, 2021, Community Care Licensing (CCL) received information that alleged facility staff pushed a child while in care. Confidential interviews revealed, on 06/30/2021, Client #1 (C1) and Staff #1 (S1), where in the facility's kitchen area and C1 and S1 had a verbal confrontation. Confidential witnesses' statements indicated C1 made derogatory remarks toward S1, and C1 pushed C1's body against S1. Additional confidential interviews revealed that Staff #1 raised S1's arms toward C1 and placed S1's palms on C1 shoulders three times. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Lorena Valenzuela LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PINTA HOMEFACILITY NUMBER: VISIT DATE: 04/19/2022

met_with: Sterling Kirk, Administrator


raw_content:
Narrative:
On 6/8/2022, Community Care Licensing received an allegation that clients are not receiving their allowances. Confidential interviews reported that clients had stolen other clients' allowances. Confidential interviews reported that a client reported a staff member stealing their allowance. In addition, confidential interviews reported that an unknown client stole the allowance from C6. Other confidential interviews reported that staff had not stolen clients' allowances. Confidential interviews reported that staff always provide the clients with the allowances that they are required to have. Community Care Licensing also received an allegation that staff allows inappropriate touching between clients. Confidential interviews reported that staff does not allow hitting and inappropriate touching. Some confidential interviews reported that inappropriate touching was allowed by certain staff members and that this type of behavior was not corrected in a timely manner. Other confidential interviews reported that staff always redirected inappropriate physical behavior in a timely manner. Based on inconsistent confidential interviews during this investigation, the allegations that staff are allowing inappropriate touching between clients and clients are not receiving their allowances may have occurred, however, it is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time.

Investigation Findings:
13On 8/5/2022 at 9: AM, Licensing Program Analyst (LPA) Joon Choi met with Pinta Home Short Term Residential Therapeutic Program (STRTP) Program Administrator Denise Samano, to deliver the findings for the above allegations. The investigation included interviews with County Social Worker (CSW), clients (C1, C2, C3, and C6), staff (S1, S2, S3, S4, S5, and S6), and obtained documents pertinent to this investigation. Clients C4 and C5 declined a request for an interview. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Joon R Choi LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PINTA HOMEFACILITY NUMBER: VISIT DATE: 08/05/2022

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

met_with: Denise Samano, Program Administrator


raw_content:
Narrative:
consumed marijuana at school or on route to school. Confidential interviews stated that facility staff does not allow clients to possess or consume contraband, and that it is confiscated and disposed of by staff whenever found. While other confidential Information Received by Licensing Office stated that these allegations had occurred. There were no other known witnessed to these allegations. Based on interviews and confidential information obtained during the course of this investigation, the allegations that Child # 1 (C1) has access to marijuana, as well as attended school while under the influence of marijuana, as a result of a lack of care and supervision, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Direct Care Staff, Sandra Alonzo to issue the findings for the above stated allegation. An investigation was conducted by LPAs Lorena Valenzuela and Daniel Mena regarding allegations. LPAs Valenzuela and Mena conducted an investigation to the Short-Term Residential Therapeutic Program (STRTP) on January 13, 2022 at 2:45pm and on October 07, 2022 at 1:53pm. No immediate hazards observed. LPAs Valenzuela and Mena interviewed four foster children (C1, C2, C3 & C4), three staff (S1, S2 & S3), as well as reviewed client and facility records. Community Care Licensing received information alleging that Child # 1 (C1) has access to marijuana, as well as attended school while under the influence of marijuana, as a result of a lack of care and supervision. Information obtained in confidential interviews did not corroborate the allegations with a preponderance of evidence. LPA's obtained conflicting information in confidential interviews. Confidential interviews denied that C1 had ever consumed drugs at the facility prior to attending school or while under the care and supervision of staff. According to confidential interviews, C1 most likely obtained and UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PINTA HOMEFACILITY NUMBER: VISIT DATE: 10/14/2022

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

met_with: Sandra Alonzo


raw_content:
Narrative:
The Department received another allegation that a minor (FC1) is being bullied by other minors in care. It was reported that their roommate OC3 was bullying a minor (FC1) in care. Confidential interviews reported that a minor in care (OC3) tried to pressure another minor in care (FC1) for their allowance. Confidential interviews reported this incident was reported to staff, and staff intervened to protect the client and stopped OC3 from pressuring FC1 for their allowance. Confidential interviews reported that this "bully" minor (OC3) is no longer in the facility. Confidential interviews reported that when bullying behavior by minors occurred, staff would intervene and redirect this behavior. Other confidential interviews reported that some minors in the facility never experienced bullying. Based on inconsistent confidential interviews, the allegations that staff is verbally abusing a minor while in care and that a minor is being bullied by other minors in care may have occurred, however, is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted. A copy of this report, and appeal rights were explained and given to Direct Care Staff, Latonya Brown.

Investigation Findings:
13On 10/25/2022, at 11: AM Licensing Program Analyst (LPA) Joon Choi conducted an unannounced visit to Pinta Home Short Term Residential Treatment Program (STRTP) to deliver the investigative findings for the allegations listed above. LPA Choi conducted a health and safety inspection of the facility on 10/4/2022. No immediate health and safety issues were observed. The investigation included interviews with clients (FC1, FC2, FC3, and FC4), other clients (OC1, OC2, and OC3), and staff (TH, CW, S1, S2, S3, and S4). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Joon R Choi LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PINTA HOMEFACILITY NUMBER: VISIT DATE: 10/25/2022

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

met_with: Latonya Brown, Direct Care Staff


raw_content:
Narrative:
Confidential interviews reported that S1 told C1 to "shut the f up," but that S1 did not call C1 the "b" word. Other confidential interviews reported that S1 did admit to telling C1 to "shut the f up." Confidential interviews reported that S1 admitted to calling C1 the "b" word and telling C1 to "shut the f up." Confidential interviews reported that C1 admitted to verbally disrespecting S1. Confidential interviews reported that S1 admitted they did not respond in a professional manner. There are corroborated statements that S1 did not communicate in a dignified way toward C1. Based on confidential interviews and S1's own admission to the allegations, the preponderance of evidence standard has been met, and the allegations that staff (S1) spoke inappropriately to a foster child (C1) and staff (S1) do not accorded dignity in their personal relationship with a foster child (C1) in care are substantiated at this time. The facility is being cited for violation of Interim Licensing Standards Short-Term Residential Treatment Programs, Version 4, Personal Rights 87072(c)(10)(11). The facility did not ensure C1 was free from emotional abuse, humiliation, and intimidation. This poses an immediate health, safety, or personal rights risk to the children in care. An exit interview was conducted. A copy of this report and appeal rights were explained and given to Direct Care Staff LaTonya Brown. This report serves as an amendment to the LIC9099 report created on 03/21/2023.

Investigation Findings:
13On 03/21/2023 at 02: PM, Licensing Program Analyst (LPA) Joon Choi conducted an unannounced visit to Pinta Home Short Term Residential Treatment Facility (STRTP) and met with Direct Care Staff LaTonya Brown, to deliver the investigative findings for the allegations listed above with. On 02/27/2023, LPA Joon Choi visited the facility, obtained pertinent documents, and conducted an initial health and safety inspection. No immediate health and safety hazards were observed. LPA interviewed clients (C1-C4) and staff (S1-S4). On 02/22/2023, Community Care Licensing received allegations that staff (S1) spoke inappropriately to a foster child (C1) and staff (S1) did not accord dignity in their personal relationship with a foster child (C1) in care. Confidential interviews reported that after a minor in care (C1) called a staff member (S1) a derogatory name, S1 responded by calling, telling C1 to "shut the f up" and to stop acting like a "b" which means a female dog. Confidential interviews reported that S1 did not react professionally and calmly after being verbally disrespected by C1. CONTINUED ON THE NEXT PAGE SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Joon R Choi LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PINTA HOMEFACILITY NUMBER: VISIT DATE: 03/21/2023

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

met_with: LaTonya Brown, Direct Care Staff


raw_content:
Narrative:
Based on interviews and record reviews that C1 was hit and choked by other clients (names unknown) resulting in a bruise on C1's back, may have occurred, however is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Leonard Haynes.

Investigation Findings:
13On June 28, 2023 at 10:30am, Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an unannounced inspection to the facility to deliver the findings of the above allegations. LPA met with facility manager, Leonard Haynes. LPA Lisi Leon conducted an inspection of the facility on August 11, 2022, at 11:20 am and no immediate deficiencies were observed. Four of four clients (C1, C2, C3, C4), three staff and Facility Administrator were interviewed. It was reported to Community Care Licensing (CCL) that C1 was hit and choked by other clients (names unknown) resulting in a bruise on C1's back. Confidential staff interviews reported that C1 is the aggressor and attempts to start physical altercations with all of the clients in the facility. Confidential interviews reported that staff will verbally give C1 directives, in which C1 complies. Confidential interviews reported that C1 has hit C2, but staff immediately intervenes. Other confidential interviews stated that C1 had a bruise on the back, however the bruise was never observed by any staff or anyone else. The interviews that were provided to the LPA were not consistent regarding the allegations and did not provide any further specific details regarding staff supervision. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Darlene Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PINTA HOMEFACILITY NUMBER: VISIT DATE: 06/28/2023

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

met_with: Leonard Haynes


raw_content:
Narrative:
ever happened. Confidential interviews reported that C2 admitted to another client that C2 had oral copulation with C3. Confidential interviews reported that C2 denied pressuring any other client into touching their genitals and having oral copulation with any other client in the facility. Confidential interviews reported that facility staff supervised all the clients and denied ever witnessing any client touching another client's genital area or having oral copulation with each other. Confidential interviews reported that prior to receiving this complaint, the facility submitted a Special Incident Report (SIR) describing the same incidents detailed in the complaint. Confidential interviews reported that after the SIR was submitted, the facility developed and implemented a safety plan that reminded all facility staff to supervise all clients and watch out for peer pressure and inappropriate behaviors between clients. Based on inconsistent confidential interviews, the allegation that the facility did not provide adequate supervision resulting in inappropriate interactions between minors (C1, C2, and C3), may have occurred, however, is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted. A copy of this report and appeal rights were explained and given to Facility Manager Leonard Haynes.

Investigation Findings:
13On 06/30/2023 at 09: AM, Licensing Program Analyst (LPA) Joon Choi conducted an unannounced visit to Pinta Home Short Term Residential Treatment Facility (STRTP) and met with Facility Manager Leonard Haynes to deliver the investigative findings for the allegation listed above. On 05/16/2023, LPA Joon Choi visited the facility, obtained pertinent paperwork, and conducted an initial health and safety inspection. No immediate health and safety hazards were observed. LPA interviewed clients (C1, C2, C4, and C5), County Social Worker (CSW), and staff (S1-S6). LPA attempted to interview C3, but C3 refused to be interviewed. On 05/11/2023, Community Care Licensing received an allegation that the facility did not provide adequate supervision resulting in inappropriate interactions between minors (C1, C2, and C3). Confidential interviews reported that C1 disclosed that C2 made C1 touch C2's genital area. Other confidential interviews reported that C2 and C3 had oral copulatioith each other. Confidential interviews reported that C1 initially admitted to touching C2's genital area to a facility staff member but later recanted the statement and denied this ever CONTINUED ON THE NEXT PAGE UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Joon R Choi LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PINTA HOMEFACILITY NUMBER: VISIT DATE: 06/30/2023

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

met_with: Leonard Haynes, Facility Manager


raw_content:
Narrative:
**Continued from Previous Page*** (C1, C2, C4, C5 and C6). In addition, facility and county records were reviewed. LPAs attempts to interview S5 and C3 were unsuccessful. On April 16, 2024, Community Care Licensing (CCL) received an allegation alleging staff did not ensure that youth's (C1) medical needs were properly being met. Specifically, it was reported that on an unknown date in September or October of 2023, C1 was observed with a rash on C1's back and arms and when staff questioned about the follow-up visit to C1's primary care physician as instructed on the discharge papers C1 received from the Urgent Care visit on September 2, 2023, staff was informed that a second trip to urgent care would occur. Record review revealed C1 was taken to be seen for C1's rash a second time on September 4, 2023. Record review noted the follow-up comments from C1's second visit for C1's rash was to follow-up with C1's primary care physician. Record review could not confirm or dispute that the follow-up with C1's primary care physician occurred. A second allegation alleging staff (unknown) locked a youth (C6) outside of the facility, was also received by CCL. Specifically, it was alleged that an incident occurred on August 30, 2023, at the facility resulting in C6 being locked out of the facility by an unknown staff member. Confidential interviews reported inconsistent statements regarding C6's behavior and the events surrounding C6 coming and going from the facility. Confidential interviews and records review could not provide consistent accounts of the alleged incident occurring. Therefore, could not confirm or dispute the allegation staff locked a youth outside of the facility. Based on confidential interviews and record review the preponderance of evidence standard has not been met and the allegations that, staff did not ensure that youth's medical needs were properly being met and staff locked a youth outside of the facility, may have happened or are valid, but there is not a preponderance of evidence to prove that the alleged violations occurred. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, a copy of this report, confidential names report (LIC 811) along with appeal rights were given to Pinta Home Tina Collins, Executive Director.

Investigation Findings:
UnsubstantiatedEstimated Days of Completion: 90-Days Estimated Days of Completion: 90-Days Estimated Days of Completion: 90-Days

Allegations:
- UnsubstantiatedEstimated Days of Completion: 90-Days Unsubstantiated Estimated Days of Completion: 90-Days Unsubstantiated Estimated Days of Completion: 90-Days

met_with: Tina Collins, Executive Director


facility_name: PLAN-IT LIFE

raw_content:
Narrative:
The interviews that were provided to the LPA were not consistent regarding the allegation that staff are not properly supervising minors and did not provide any further specific details regarding staff supervision. Based on interviews and record reviews the allegation that staff did not properly supervise a minor while in care, may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Sharon Hancock.

Investigation Findings:
13On September 30, 2021 at 12:00pm, Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an unannounced inspection to the facility to deliver the findings of the above allegation. LPA met with Sharon Hancock. LPA Ronnesha Fountain conducted a tele-inspection of the facility on February 25, 2021 at 10:36 am and no immediate deficiencies were observed. Four of four children (C1, C2, C3, C4), four staff and facility administrator were interviewed. It was reported to Community Care Licensing (CCL) that staff did not properly supervise a minor while in care. Specifically, it was reported that C1 was observed by C2 doing inappropriate sexual behaviors. Confidential staff interviews reported that C2 reported to staff that C1 was acting out sexually in C1's bedroom. Confidential interviews reported that this was the first time that staff became aware and took appropriate action. Additional confidential interviews reported that this was the first time this type of incident occurred. Some confidential interviews disclosed having no issues with staff supervision at the facility while other confidential interviews stated that the allegation was true. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Darlene Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFEFACILITY NUMBER: VISIT DATE: 09/30/2021

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

met_with: Sharon Hancock


raw_content:
Narrative:
The interviews that were provided to the LPA were not consistent regarding the allegation that staff are not properly supervising minors and did not provide any further specific details regarding staff supervision. Based on interviews and record reviews the allegation that staff did not properly supervise minors, resulting in C1 and C2 engaging in inappropriate activities, may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Sharon Hancock.

Investigation Findings:
13On September 30, 2021 at 1:00pm, Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an unannounced inspection to the facility to deliver the findings of the above allegation. LPA met with Sharon Hancock. LPA Ronnesha Fountain conducted a tele-inspection of the facility on April 07, 2021 at 10:59 am and no immediate deficiencies were observed. Four of four children (C1, C2, C3, C4), four staff and facility administrator were interviewed. It was reported to Community Care Licensing (CCL) that staff did not properly supervise minors resulting in C1 and C2 engaging in inappropriate activities. Confidential staff interviews reported that staff became aware that C1 and C2 had engaged in sexual activity with one another, however staff was unaware of when or where this alleged incident had occurred. Confidential staff interviews reported that staff took appropriate action and increased the supervision with C1 and C2. Some confidential interviews disclosed that this incident did not occur at the facility and others reported that the incident never occurred. Other confidential interviews stated that the allegation was true. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Darlene Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFEFACILITY NUMBER: VISIT DATE: 09/30/2021

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


raw_content:
Narrative:
This poses an immediate Health, Safety or Personal Rights risk to the children in care. The STRTP is being issued a citation for violations of the Interim Licensing Standards, Chapter 7.5, Version 3, Sections 87072(d)(11) Personal Rights. See attached LIC 9099D for cited deficiency. An exit interview was conducted, appeal rights explained and a copy of this report was provided to Sharon Hancock, along with the LIC 811. Information obtained from confidential interviews revealed was inconsistent as to whether C1 injured self-due to acting out and assaulting S1 or being extremely upset during the incident. The interviews that were provided to the LPA were not consistent regarding the allegation that a minor sustained an injury while in care due to care and supervision issues or staff violating client personal rights. Based on interviews and record reviews the allegation that C1 sustained an injury while in care, may have occurred, however is not supported, or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Sharon Hancock.

Investigation Findings:
13On October 14, 2021 at 11:00am, Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an unannounced inspection to the facility to deliver the findings of the above allegation. LPA met with Sharon Hancock. LPA Ronnesha Fountain conducted an inspection of the facility on April 02, 2021 at 1:32 pm and no immediate deficiencies were observed. Four of four children (C1, C2, C3, C4), four staff and facility administrator were interviewed. It was reported to Community Care Licensing (CCL) that staff #1 (S1) pushed C1. Confidential staff interviews reported that C1 became upset with S1 and C1 assaulted S1. Confidential interviews reported that S1 attempted to use de-escalation techniques on C1 but was unsuccessful. S1 then pushed C1 and became verbally aggressive with C1. Additional staff interviews report that another staff member then intervened, trading places with S1. All of the persons interviewed corroborated this information. Based on record review and interviews S1 did pushed C1. The preponderance of evidence standard has been met, therefore the allegation S1 pushed C1 is found to be Substantiated. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Darlene Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFEFACILITY NUMBER: 336408020

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


summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Erika Lopez 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


raw_content:
Narrative:
Several witnesses corroborate that even though marijuana is not allowed within the facility, clients will ignore the rules and risk consequences by sneaking in the marijuana and using it while at the facility. Staff corroborate that clients cannot be searched upon returning from absconding the facility and will often sneak drugs, such as marijuana, back into the facility. Several witnesses corroborate this is true. While C1 was able to sneak marijuana into the facility, S1 took immediate action and called law enforcement. The majority of witnesses corroborate this information. Based on interviews conducted and information obtained, the allegation that C1 had access to marijuana while in care at the STRTP, may have occurred, however, it is not supported or proven by evidence. The allegation is, therefore, UNSUBSTANTIATED. There are no deficiencies to be cited. An exit interview was conducted and a copy of this report, LIC 811, and appeal rights, were provided to Youth Care Counselor, for original signature. Signed report will be placed in facility file.

Investigation Findings:
13****This is an amended report of the original LIC 9099 dated 09/14/2022.**** On September 14, 2022, at 2: PM, Licensing Program Analyst (LPA) Erika Lopez arrived at the Short-Term Residential Therapy Program (STRTP) facility and met with Youth Care Counselor. LPA Lopez conducted a facility risk assessment interview with FM and proceeded to issue the investigative finding for the above allegations. During the investigation, LPA requested documents from client 1 (C1's) file including placement agreement, copy of C1's needs and service plan from time of allegation, special incident reports involving C1, incident reports involving law enforcement and C1, and facility roster at time of allegation. LPA Escobar conducted interviews with staff 1 (S1), client 2 (C2), and client 3 (C3), and C1's county social workers (CSW1 and CSW2). LPA Ronnesha Fountain interviewed staff 2 (S2) at the time of the initial ten-day inspection to initiate the complaint with the facility on 10/07/21 at 10: AM, no health or safety concerns were observed. It was alleged that on or around 09/28/21, C1 had access to marijuana while in care of the STRTP. Specifically, it was reported that after an altercation with S1, C1 went to the backyard and began to smoke marijuana. S1 then called law enforcement. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Erika Lopez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFEFACILITY NUMBER: VISIT DATE: 09/28/2022

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

met_with: Youth Care Counselor - Sharon Handcock


raw_content:
Narrative:
Confidential interviews reported that staff explained the consequences of negative behavior, such as losing privileges like video game time but no physical discipline or threats. The Department received another allegation that staff (unknown) inappropriately spoke to a minor (FC1). It was reported that staff told a client (FC1) they wanted to "punch FC1 in the face." Other confidential interviews reported that no staff ever said anything like this to any client of the facility. Confidential interviews reported that clients never heard any staff saying they wanted to punch FC1 in the face or any other remark that was threatening or inappropriate. LPA received inconsistent statements regarding these allegations. Based on inconsistent confidential interviews, the allegations that staff threatened the minor (FC1) while in care and staff spoke to minor (FC1) in an inappropriate manner, may have occurred, however, is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted. A copy of this report, and appeal rights were explained and given to Facility Manager, Darla Alexander.

Investigation Findings:
13On 10/25/2022, at 12: PM, Licensing Program Analyst (LPA) Joon Choi conducted an unannounced visit to Plan-It Life Short Term Residential Treatment Program (STRTP) to deliver the investigative findings for the allegations listed above. LPA Choi conducted a health and safety inspection of the facility on 10/4/2022. No immediate health and safety issues were observed. The investigation included interviews with clients (FC1, FC2, FC3, FC4, and FC5), other clients (OC1, OC2, OC3, and OC4), and staff (S1, S2, S3, S4, S5). On 03/11/2022, Community Care Licensing received an allegation that staff (unknown) threatened a minor (FC1) while in care. It was reported that a staff member threatened to harm a client if they didn't follow the rules. Confidential interviews reported that a staff member threatened a client by informing them they would harm them if they didn't follow the rules. Other confidential interviews reported that no staff member ever used any verbal threats against clients. Confidential interviews reported that staff has never used physical discipline on clients. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Joon R Choi LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFEFACILITY NUMBER: VISIT DATE: 10/25/2022

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

met_with: Darla Alexander, Facility Manager


raw_content:
Narrative:
Other confidential interviews revealed staff did not verbally abuse C1, however, it was reported staff was verbally abusive. Furthermore, confidential interviews revealed C1 was denied food and snacks and staff did not like C1. Based on confidential interviews and record review, the allegation that staff denied C1 food while in care may have occurred, however, it is not supported or proven by evidence. Therefore, this allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report and appeal rights were provided to Facility Manager, Jermaine Manassa.

Investigation Findings:
13On April 19, 2023 at 10: AM, Licensing Program Analyst (LPA), Lisi Leon, met with Plan-It Life, Inc Facility Manager, Jermaine Manassa, to deliver the finding for the above stated allegation regarding the Short Term Residential Therapeutic Program (STRTP). LPA Leon conducted a safety and health inspection on April 20, 2022 and there were no immediate health or safety deficiencies. LPA Leon conducted interviews with two staff [Staff #1 (S1 and Staff #2 (S2)], three residential clients [Client #1 (C1), Client #3 (C3), Client #5 (C5)] and one county social worker (CSW). LPA Leon obtained copies of the facility and client roster including schedules and reviewed client records. On April 14, 2022, Community Care Licensing (CCL) received an allegation that staff denied minor food while in care. Specifically, staff is verbally abusive to C1 and when C1 asks for a snack, C1 is denied snack. Confidential interviews revealed staff offered breakfast, lunch and dinner to all clients and there are no witnesses to staff denying any food to clients. Further confidential interviews reveal snacks were offered to clients at certain times, however, the sugary snacks were kept locked and were offered at designated times. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Lisi Leon LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFEFACILITY NUMBER: VISIT DATE: 04/19/2023

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

met_with: Facility Manager, Jermaine Manassa


raw_content:
Narrative:
Based on interviews and record reviews the allegations that C1 was threatened and physically abused by C2, and staff did not prevent C1 from being, may have occurred, however is not supported, or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Jermaine Manassa.

Investigation Findings:
13On September 06, 2023, at 10:05am, Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an unannounced inspection to the facility to deliver the findings of the above allegations. LPA met with facility Jermaine Manassa. Lisi Leon conducted an inspection of the facility on September 29, 2022, at 12:10 pm and no immediate deficiencies were observed. Four of four clients (C1, C2, C3, C4), four staff and facility administrator were interviewed. It was reported to Community Care Licensing (CCL) that C1 was threatened and physically abused by C2, and staff did not prevent C1 from being. More specifically, C1 no longer felt safe at the facility due to the allegations. Confidential staff interviews reported that staff immediately intervened when they overheard C1 and C2 threatening each other. Confidential interviews reported that C1 was not in any physical altercations or physically hit by C2 while at the facility. The interviews that were provided to the LPA were not consistent regarding the allegations that are listed above and did not provide any further specific details regarding staff supervision and personal rights violation. Continued on page UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Darlene Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFEFACILITY NUMBER: VISIT DATE: 09/06/2023

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

met_with: Jermaine Manassa


facility_name: PLAN-IT LIFE TEMECULA HOUSE

raw_content:
Narrative:
LPA Fountain was provided with video surveillance and it was disclosed that minors smoking inside the group home has been an ongoing issue. Confidential interviews reported that minors are not allowed to smoke at the facility, and staff are trained on redirecting a client who is ever observed smoking. Lpa R. Fountain received a video in which it was alleged to be C1 sitting on a bed, smoking from an unknown vaping device. The video is not clear on the location as to where C1 was at the time. Confidential interviews who witnessed the video identified C1 as being in the video; however, there is no room (location) identifiers that indicate where C1 was at during the time. Based on confidential interviews and record review, the allegation that staff did not prohibit C1 from smoking inside the facility may have occurred; however, it is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. A copy of the report was discussed and provided along with appeal rights to Plan-It Life (Temecula House) STRTP , Administrator, Joe Jones.

Investigation Findings:
13On December 30, 2021 at 9:30 am Licensing Program Analyst (LPA) Ronnesha Fountain met with Plan-It Life (Temecula House) STRTP , Administrator Joe Jones to deliver the findings for the above stated allegation. LPA Fountain conducted an in-person inspection at the facility at 01:43 pm on Thursday, June 22, 2021; client files were reviewed, and pertinent documents were obtained. Lpa R. Fountain was unable to complete two of three client (C1, C2, C3) interviews. One client is no longer placed at the facility and whereabouts are unknown at this time and one client was unavailable to be interviewed. In addition, interviews with conducted with two of staff (S1 and S2) and contact made to the County Social Worker (CSW). The Department received a complaint on June 14, 2021, alleging that staff did not prohibit foster child (C1) from smoking inside the facility. More specifically, it was reported that C1 was smoking marijuana while at the STRTP. Due to technical issues, a hard copy was provided to the facility. Signature is on File. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Ronnesha Fountain LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFE TEMECULA HOUSEFACILITY NUMBER: VISIT DATE: 12/30/2021

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

met_with: Joe Jones


raw_content:
Narrative:
Continued from page Staff shared with LPA that minors will come back to the facility from AWOL under the influence of substances without determining how minors gained access. LPA interviewed minors (C1 and C2) and they denied doing drugs or acquiring drugs with assistance from facility staff and did not have any information regarding how drugs are purchased. CCL received another allegation, regarding facility staff not meeting minor's medical needs, it was specified in confidential interviews (FM, ADM, and CEO) that staff are supposed to take minors to their medical appointment and a medical appointment form is filled out even when appointments are refused. Confidential interviews indicated that appointments were made for C1, however, C1 refused to attend these appointments. C1 confirmed appointment refusals, however, the facility inconsistently documented C1's refusals. Based on confidential interviews and record review, the allegations that the facility staff are taking minors to buy drugs and staff not meeting minor's medical needs may have occurred, however, it is not supported or proven by evidence. Therefore, these allegations are unsubstantiated at this time. An exit interview is conducted and a copy of this report, LIC 811, and appeal rights were given and explained Plan-It Life Temecula Facility Manager, Katrina Vasquez.

Investigation Findings:
13On March 3, 2022 at 5: PM, Licensing Program Analyst (LPA), Val Wilson, met with Plan-It Life Temecula Facility Manager, Katrina Vasquez, to deliver the finding for the above stated allegations regarding the Short Term Residential Therapeutic Program (STRTP). LPA conducted a health and safety inspection of the STRTP on June 28, 2021 at approximately 12: PM and no immediate deficiencies were observed. Interviews were conducted with Facility Manager (FM), Administrator, Chief Executive Officer (CEO), one Youth Care Counselor (S1) and Child 1 and Child 2 (C1, C2). Additionally, Child 1 (C1) Client Record files and House Log entries were reviewed. On June 22, 2021, Community Care Licensing (CCL) received allegations that the facility staff are taking minors to buy drugs and facility staff are not meeting minor's medical needs. Regarding facility staff taking minors to buy drugs, confidential interviews denied that minors were able to purchase drugs with the assistance of staff. Confidential interviews shared that minors are within staff visual while visiting the park and staff (S1, S2, FM, and ADM) deny observing minors purchase drugs. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Valerie Wilson LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFE TEMECULA HOUSEFACILITY NUMBER: VISIT DATE: 03/03/2022

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

met_with: Katrina Vasquez


raw_content:
Narrative:
Further confidential interviews reveal C1 got upset when FM told C1, C1 could not go to the skate park because of a recent injury. Other confidential interviews revealed C1 got upset and started to break tables, chairs and removed the TV from the wall and threw it outside and punched holes in the wall. Furthermore, confidential record review reports C1 damaged the facility, however, other confidential interviews reveal S1 threw the bowl at C1. Based on confidential interviews and record review, the allegation that staff threw a bowl at C1 while in care may have occurred, however, it is not supported or proven by evidence. Therefore, this allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report and appeal rights were provided to Administrator, Joe Jones.

Investigation Findings:
13On March 7, 2023 at 4: PM, Licensing Program Analyst (LPA), Lisi Leon, met with Plan-It Life, Inc, Administrator, Joe Jones to deliver the finding for the above stated allegation regarding the Short Term Residential Therapeutic Program (STRTP). LPA Leon conducted safety and health inspection on March 25, 2022 and there were no immediate health or safety deficiencies. LPA Leon conducted interviews with one Facility Manager (FM), Client #2 and Client #4 (C2, C4) and one Facility Manager (FM), and one staff (S1) and attempted interviews with six County Social Workers. LPA Leon obtained copies of the facility roster including schedules and reviewed client records. On March 21, 2022, Community Care Licensing (CCL) received an allegation that staff threw a bowl at a minor while in care. Specifically, staff threw a fruit bowl at C1's chest. Confidential interviews revealed there were no witnesses to staff throwing a bowl at C1, however, did see a bowl on the floor. ***Continued on 9099-C*** UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Lisi Leon LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFE TEMECULA HOUSEFACILITY NUMBER: VISIT DATE: 03/07/2023

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

met_with: Facility Administrator, Joe Jones


raw_content:
Narrative:
which included not leaving the facility without permission and was provided a warning that the next occurrence of C1 leaving the facility without permission would result with C1 being removed from the program. Confidential interviews reported supervision included putting eyes on the residents to ensure residents were present and accounted for. Although some confidential interviews denied a lack of supervision, other confidential information received disclosed C1 constantly would leave the facility absent without permission. Based on record review and confidential interviews the allegation alleging staff do not provide adequate supervision to the minors, may or may not have occurred, however it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights to Plan it Life Administrator, Joe Jones.

Investigation Findings:
13On June 20, 2023 at 3:07pm, Licensing Program Analyst (LPA), Nicole Strickland, met with Plan it Life Administrator, Joe Jones, to deliver the finding for the above stated allegation. A Health and safety inspection of the facility was conducted on July 7, 2022, and no immediate hazards were observed. The investigation included interviews with County Social Worker (CSW), Administrator (ADM), two staff (Staff #4 [S4] and ADM), and two foster youth (Child #2 (C2) and Child #4 (C4). Multiple attempts were made and unsuccessful in obtaining interviews with additional confidential witnesses. In addition, facility records, county records, and Riverside County Sheriff's Department record was reviewed. On June 29, 2022, Community Care Licensing (CCL) received an allegation alleging staff do not provide adequate supervision to the minors. Specifically, it was reported the residents "come and go as they please." Confidential interviews reported Child #1 (C1) had a history of leaving the facility without permission. Confidential interviews and record review revealed C1 was encouraged to run C1's program UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFE TEMECULA HOUSEFACILITY NUMBER: VISIT DATE: 06/20/2023

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


raw_content:
Narrative:
The interviews that were provided to the LPA were not consistent regarding the allegations that are listed above and did not provide any further specific details regarding staff supervision and personal rights violation. Based on interviews and record reviews the allegations that staff caused injury C1, C1 was threatened by C2, C1 and C2 got into a physical altercation, staff restrained minors and C2 threw trash inside of C2's bedroom, may have occurred, however is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Joe Jones.

Investigation Findings:
13On August 4, 2023, at 8:40 am, Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an unannounced inspection to the facility to deliver the findings of the above allegations. LPA met with facility Joe Jones. Lisi Leon conducted an inspection of the facility on August 24, 2022, at 2:40 pm and no immediate deficiencies were observed. Three of four children (C1, C2, C3, C4), three staff and facility administrator were interviewed. It was reported to Community Care Licensing (CCL) that staff caused injury C1, C1 was threatened by C2, C1 and C2 got into a physical altercation, staff restrained minors and C2 threw trash inside of C2's bedroom. More specifically, on August 19, 2022, C1 had thrown trash into C2's bedroom. Staff overheard C1 and C2 arguing about the trash being thrown and threatening one another. Confidential interviews reported that staff immediately intervened and C1 went outside. Confidential staff interviews reported that C1 and C2 were not in a physical altercation, however they were in a verbal altercation. Confidential interviews reported that staff did not use any restraints and did not cause any injuries to either of the minors. LPA attempted to interview C1, but C1 refused after several attempts. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Darlene Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFE TEMECULA HOUSEFACILITY NUMBER: VISIT DATE: 08/04/2023

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


raw_content:
Narrative:
facility with hickeys. During the investigation, there was no corroborating evidence to support the above allegation. Confidential interviews revealed conflicting statements. Thus, confidential interviews did not corroborate the allegation with a preponderance of evidence. Based on confidential interviews and records reviewed the allegation that staff are not providing adequate supervision to youths in care, which may have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with and provided to Katrina Vasquez. A copy of this report will be placed in the facility file.

Investigation Findings:
13On May 29, 2024, at 12:40 pm, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Katrina Vasquez, Facility Manager, to discuss the investigative finding for the allegation noted above. LPA Jason Dalton conducted an inspection of the facility on February 1, 2024, at 2:45 pm and no deficiencies were observed. LPAs Dalton and Linley interviewed two clients (C1, C2), four staff (S1-4), and one client declined to be interviewed (C3). The following documents were reviewed during the investigation: Personnel Roster, Client Roster, copies of shift log, Child-Family-Team Meeting Notes, Treatment Plan, Needs and Services Plans, and Special Incident Reports. On January 22, 2024, Community Care Licensing (CCL) received an allegation that staff are not providing adequate supervision to youths in care. It was reported that staff drive the clients to the park and leave them and drive away. It was also reported that clients go to the park at night and use marijuana and return to the UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFE TEMECULA HOUSEFACILITY NUMBER: VISIT DATE: 05/29/2024

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


raw_content:
Narrative:
interviews did not corroborate the allegation with a preponderance of evidence. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with and provided to Katrina Vasquez. A copy of this report will be placed in the facility file.

Investigation Findings:
13On May 29, 2024, at 1:00 pm, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Katrina Vasquez, Facility Manager, to discuss the investigative finding for the allegation noted above. LPA Jason Dalton conducted an inspection of the facility on January 19, 2024, at 1:00 pm and no deficiencies were observed. LPAs Dalton and Linley interviewed one client (C2) and six staff (S1-6). The following documents were reviewed during the investigation: Personnel Roster, Client Roster, Special Incident Reports, S2's Resignation Email, Shift Log note, C2 progress notes, C2's placement forms, and C Health and Education Passport. On January 12, 2024, Community Care Licensing (CCL) received an allegation that staff engaged in an altercation with a youth at the facility. It was reported that S1 and S2 escorted C2 from the staff office and S2 engaged in a physical altercation with C2. During the investigation, there was no corroborating evidence to support the above allegation. Confidential interviews revealed conflicting statements. Thus, confidential UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFE TEMECULA HOUSEFACILITY NUMBER: VISIT DATE: 05/29/2024

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


raw_content:
Narrative:
not arrive to pick up C1 until 12:53 pm. Confidential interviews revealed conflicting statements on why C1 was not picked up from the school until 12:53 pm. Confidential interviews did not corroborate the allegation with a preponderance of evidence. Based on confidential interviews and records reviewed the allegation that staff did not meet C1's needs, which may have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with and provided to Katrina Vasquez. A copy of this report will be placed in the facility file.

Investigation Findings:
13On May 29, 2024, at 1:15 pm, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Katrina Vasquez, Facility Manager, to discuss the investigative finding for the allegation noted above. LPA Jason Dalton conducted an inspection of the facility on December 13, 2023, at 3:00 pm and no deficiencies were observed. Lpa J. Dalton interviewed four staff (S1-4) and one client declined to interview (C1). LPA reviewed the following documents during the investigation: Client Roster, Personnel Roster, C1's Medication Administration Records, C1's Placement Agreement, C1's Behavior Notes, and C1's Health and Education Passport. On December 7, 2023, Community Care Licensing (CCL) received an allegation that staff did not meet C1's needs. It was reported that C1 was at school, did not feel well and needed to be picked up and the facility was notified at 10:30 am. It was reported the facility was called multiple times to pick up C1 and staff did UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFE TEMECULA HOUSEFACILITY NUMBER: VISIT DATE: 05/29/2024

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


facility_name: PLAN-IT LIFE, INC

raw_content:
Narrative:
Based on confidential interviews, the allegation facility staff use derogatory language towards FC1 may have occurred, however is not supported, or proven by evidence. Therefore, the above allegation is unsubstantiated at this time. An exit interview was conducted and a copy of this report LIC 9099 along with the appeal rights were discussed and provided to Youth Care Counselor, Helen Cotton.

Investigation Findings:
13On March 16, Licensing Program Analyst (LPA) Leslie Covarrubias met with Youth Care Counselor, Helen Cotton for the purpose of delivering the compliant finding to the allegation listed above. LPA Belinda Torres inspected the STRTP on 08/12/2021 at 11: AM and no safety concerns were observed. During the course of the investigation, the LPA conducted confidential interviews with Facility Manager (S1), Youth Care Counselor (S2), Foster Child 1 (FC1), Foster Child 2 (FC2), Foster Child 3 (FC3), Foster Child 4 (FC4), Foster Child 5 (FC5), Foster Child 6 (FC6) and obtained copies of Mental Health Service Logs, Placement Agreement for FC1, SIRS, and ProAct Training Logs. On 08/03/2021, Community Care Licensing (CCL) received a complaint that facility staff used inappropriate language towards client. Specifically, it was alleged staff use derogatory language towards FC1. Confidential interviews revealed 2 of 6 clients reported staff uses derogatory language at times. Other interviews denied the allegation occurred. (Continue on next page...) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Leslie Y Covarrubias LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: PLAN-IT LIFE, INCFACILITY NUMBER: VISIT DATE: 03/16/2022

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

met_with: Youth Care Counsler, Helen Cotton