summary: Facility Evaluation

raw_content:
Narrative:
On 08/23/2022 at 10: AM Licensing Program Analyst (LPA) Rosslyn Gray made an unannounced to WILBUR TEMPORARY SHELTER CARE FACILITY (TSCF) to conduct Post Licensing Inspection. A Health and safety risk assessment was conducted upon arriving at the facility. LPA met with the Administrator who granted access to the facility. The entire physical plant was inspected. The facility is to provide Temporary Shelter Care Services up to Days, to six (6) children ages 13-17 years; Ambulatory only. There are no bodies of water on the premises. The staff confirmed that there are no guns or weapons on the premises. LPA- Gray observed the follow during the inspection: TSCF Overview: This is a 1-story, 3 bedrooms; 2-bathroom home located in a residential neighborhood. There a living room, dining room, kitchen, staff office and a two (2) car garage. There is vehicle utilized to transport the children. The staff will provide information about the company vehicle later to be inspected to be operating in good condition. Outdoor Area: The passageways and porches are unobstructed. The activity space is free of hazard materials and debris. LPA observed the utility shut-off valves for gas and water located in back yard side of the of the facility. LPA observed all windows, screens and drapes from the inside and outside of the facility were observed to be in good condition. There is mounted basketball court, and several trees and a one (1) black metal picnic tables and a Barbecue Pit. LPA observed coverage trash cans in the kitchen, bathrooms and staff office. All posting requirements were met, (food menu posted on the refrigerator; regulations, emergency disaster plan is kept inside the office. In the dining area there is Grievance forms and a comment box mounted the wall. The Hot Water Heater is enclosed located the hallway in between bedrooms 1 and 2. The two (2) car garage The door entrance to the garage from the kitchen is key locked for precautionary measures. There is a space for laundry units washer and dryer. The detergent is distributed according the youths individual load of clothing. The Licensee will ensure that the children are always monitored when children are in the garage area. The garage is also utilized for extra storage, water, food supply and (PPE) Personal Protection Equipment. The facility keeps an inventory of the PPE supplies and to report when they are depleted. There are two (2) freezers, water bottles and Ping Pong table. LPA observed extra clothing donated by a church that is being organized separated by gender. Staff office: Is equipped with office furniture. There is a small refrigerator utilize to store medication that require to be refrigerated. All the clients prescribed medications; medication logs, files and medical devices are locked key entry. The cleaning supplies solutions, disinfectants are stored in the staff office. The sharp knives are also inaccessible in separate box in the key locked office.The First Aid kit met requirements, (age-appropriate, and scissors, tweezers, thermometer, and gauzes, antiseptic and First Aid Manual Guide). The facility has a working telephone and clients can use the telephone unless restricted by court order; in addition, for the authorized representatives to make contact. LPA observed a hard wired enter connected combined Smoke detector and Carbon Monoxide; tested to be operable. The Living Room is fully furnished with a sofa; two (2) large lounge chairs, one (1) television, red cabinet utilized to store electronic games; a long white computer desk and a monitor. Dining room/Kitchen: Observed to be clean and organized; The Kitchen stove is gas operated with 5 burners; the oven is separate from stove. There is a double door refrigerator with upper freezer.The dining table has six (6) chairs. All required posting are posted on the wall. LPA observed ample linen in the linen closet locate in the hallway. LPA observed two (2) Fully Charged Fire Extinguishers located in the kitchen and in the staff office fully charged. There are three (3) Bedrooms: Each bedroom is equipped with two (2) twin size beds, with a mattresses, clean linen, blankets, adequate drawer space and one (1) walk in closet, sliding windows and drapes; observed to be in good condition. The personal rights are posted on the back of each bedroom door. LIC Page 2 of Bedroom # 1: Is currently occupied by one (1) observed to be in good condition. Bedroom # 2: Is currently occupied by one (1), observed to be in good condition. Bedroom # 3: Is currently unoccupied, observed to be in good condition Bathrooms: There are two (2) Bathrooms were inspected and found to be clean. LPA ensured that all toilets flushed, and tested water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Bathroom #1 is a full-sized Bathroom (sink, toilet shower and tube)., located in hallway. Bathroom #2 is a Half bath with a sink toilet and a shower, located in the staff office. The staff will accompany clients to local recreational facilities based on the rules of the COVID-19. Clients are accorded dignity in personal relationships with staff and others. LPA observed that facility ensures that CDC Guidelines are implemented in effort to prevent other from contracting the COVID-19 virus (i.e wash hands with alcohol based hand sanitizer, display colorful preventative hygiene posters, temperature checks, maintain social distancing (six feet of space), disinfect commonly used areas and items (remote controls, mouse's, playing, cards cell phones, practice "cough etiquette". The Facility will operate within license conditions and limitations including capacity limitations. The Facility personnel are instructed to report violations of personal rights. Licensee will ensure report changes in the plan of operation affecting service to clients. Licensee will ensure to report client injuries requiring medical treatment. The administrator will provide the Personnel Report (LIC 500) and confirmed that the Ratio present for the six (6) clients in placement. The administrator ensured that all will have required criminal record clearance. DOJ, FBI and Child Abuse Response that will meet qualification. There were no deficiencies cited at this time. LPA's concluded the Post License Inspection. An exit interview was conducted, and a copy of this report was left at the facility with the Administrator on 08/23/2022


state: CA

facility_name: TSCF WILBUR

summary: Facility Evaluation

raw_content:
Narrative:
On 12/05/2022 at 11: AM Licensing Program Analyst (LPA) Rosslyn Gray made an unannounced to WILBUR TEMPORARY SHELTER CARE FACILITY (TSCF) to conduct a Annual/Required Inspection. A Health and safety risk assessment was conducted upon arriving at the facility. LPA met with the Administrator who granted access to the facility. The entire physical plant was inspected. The facility is to provide Temporary Shelter Care Services up to Days, to six (6) children ages 13-17 years; Ambulatory only. There are no bodies of water on the premises. The staff confirmed that there are no guns or weapons on the premises. LPA- Gray observed the follow during the inspection: TSCF Overview: This is a story, 3 bedrooms; 2 bathroom home located in a residential neighborhood. There is a living room, dining room, kitchen, staff office and a two (2) car garage. There is vehicle provide by the Los Angeles County Children's Residential Fleet Inspected to be operating in good condition. The vehicle is utilized to pick up supplies (i.e food, household cleaning supplies, etc; and the children are transported in the event of and emergency. Staff has authorized to transport children in their personal vehicles. Staff has valid drivers license and covered by by County of Los Angeles Risk Management Branch. Outdoor Area: The passageways and porches are unobstructed. The activity space is free of hazard materials and debris. LPA observed the utility shut-off valves for gas and water located in back yard side of the of the facility. LPA observed all windows, screens and drapes from the inside and outside of the facility were observed to be in good condition. There is mounted basketball court, and several trees and a one (1) black metal picnic tables and a Barbecue Pit. LPA observed coverage trash cans in the kitchen, bathrooms and staff office.All posting requirements were met,(food menu posted on the refrigerator; regulations, emergency disaster plan is kept inside the office. In the dining area there is Grievance forms and a comment box mounted the wall.The Hot Water Heater is enclosed located inside the garage adjacent to washer and dryer unit. The central air conditioning unit is located in the hallway in between bedrooms 1 and 2. The two (2) car garage The door entrance to the garage from the kitchen is key locked for precautionary measures. There is a space for laundry units washer and dryer. The detergent is distributed according the youths individual load of clothing. The Licensee will ensure that the children are always monitored when children are in the garage area. The garage is also utilized for extra storage, water, food supply and (PPE) Personal Protection Equipment. The facility keeps an inventory of the PPE supplies and to report when they are depleted. There are two (2) freezers, water bottles and Ping Pong table. LPA observed extra clothing donated by a church that is being organized separated by gender. Staff office: Is equipped with office furniture. There is a small refrigerator utilize to store medication that require to be refrigerated. All the clients prescribed medications; medication logs, files and medical devices are locked key entry. The cleaning supplies solutions, disinfectants are stored in the staff office. The sharp knives are also inaccessible in separate box in the key locked office. The First Aid kit met requirements, (age-appropriate, and scissors, tweezers, thermometer, and gauzes, antiseptic and First Aid Manual Guide). The facility has a working telephone and children can use the telephone unless restricted by court order; in addition, for the authorized representatives to make contact. LPA observed a hard wired enter connected combined Smoke detector and Carbon Monoxide; tested to be operable. The Living Room is fully furnished with a sofa; two (2) large lounge chairs, one (1) television, red cabinet utilized to store electronic games; a long white computer desk and a monitor. Dining room/Kitchen: Observed to be clean and organized; The gas stove is operated with 5 burners; the oven is separate from stove. There is a double door refrigerator with upper freezer.The dining table has six (6) chairs. All required posting are posted on the wall. LPA observed ample linen in the linen closet locate in the hallway. LPA observed two (2) Fully Charged Fire Extinguishers located in the kitchen and in the staff office fully charged. LIC Page 2 of There are three (3) Bedrooms: Each bedroom is equipped with two (2) twin size beds, with a mattresses, clean linen, blankets, adequate drawer space and one (1) walk in closet, sliding windows and drapes; observed to be in good condition. The personal rights are posted on the back of each bedroom door. Bedroom # 1, BR #2 and BR # Is currently occupied by one (1) child observed to be in good condition. Bathrooms: There are two (2) bathrooms inspected and found to be clean. LPA ensured that all toilets flushed, and tested water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Bathroom #1 is a full sized Bathroom (sink, toilet shower and a tube)., located in hallway. Bathroom #2 identified as staff bathroom; is a Half bath with a sink toilet and a shower, located in the staff office. This is e shower is not being utilized. The staff will accompany children local recreational facilities based on Monday's and Friday the rules of the COVID-19. LPA observed that facility ensures that CDC Guidelines are implemented in effort to prevent other from contracting the COVID-19 virus (i.e wash hands with alcohol based hand sanitizer, display colorful preventative hygiene posters, temperature checks, maintain social distancing (six feet of space), disinfect commonly used areas and items (remote controls, mouse's, playing, cards cell phones, practice "cough etiquette". The facility will operate within license conditions and limitations including capacity limitations. The facility personnel are instructed to report violations of personal rights. Licensee will ensure report changes in the plan of operation affecting service to children. Children are accorded dignity in personal relationships with staff and others; and the Licensee will ensure to report client injuries requiring medical treatment. The administrator will provide the Personnel Report (LIC 500) and confirmed that the ratio present for the six (6) clients in placement. The administrator ensured that all will have required criminal record clearance. DOJ, FBI and Child Abuse Response that will meet qualification. There were no deficiencies cited at this time. LPA's concluded the Annual/Required Inspection. An exit interview was conducted, and a copy of this report was left at the facility with the House Manager on 12/05/2022

report_type: Facility Evaluation

visit_type: Annual

met_with: House Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 6/23/2023 at 1:00pm Licensing Program Analyst conducted an collateral visit at TSCF Wilbur address Wilbur Northridge, CA 91234. LPA met with the Administrator who granted access to the facility. The purpose of the visit is to conduct an interview with C1. A copy of this report was left at the facility with Credell Jackson.

met_with: Credell Jackson, House Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 12/15/2023 at 2: PM Licensing Program Analyst (LPA) Rosslyn Gray made an unannounced visit to WILBUR TEMPORARY SHELTER CARE FACILITY (TSCF) to conduct an Annual/Required Inspection. A Health and safety risk assessment was conducted upon arriving at the facility. LPA met with the House Manager who granted access to the facility. The entire physical plant was inspected. The facility is to provide Temporary Shelter Care Services up to Days, to six (6) children ages 13-17 years; Ambulatory only. There are no bodies of water on the premises. The staff confirmed that there are no guns or weapons on the premises. LPA- Gray observed the follow during the inspection: TSCF Overview: This is a story, 3 bedrooms; 2 bathroom home located in a residential neighborhood. There is a living room, dining room, kitchen, staff office and a two (2) car garage. There is vehicle provide by the Los Angeles County Children's Residential Fleet Inspected to be operating in good condition. The vehicle is utilized to pick up supplies (i.e food, household cleaning supplies, etc; and the children are transported in the event of and emergency. Staff has valid drivers license and covered by by County of Los Angeles Risk Management Branch. Outdoor Area: The passageways and porches are unobstructed. The activity space is free of hazard materials and debris. LPA observed the utility shut-off valves for gas and water located in back yard side of the facility. LPA observed all windows, screens and drapes from the inside and outside of the facility were observed to be in good condition. There is mounted basketball court, and several trees and a black metal picnic table and a Barbecue Pit. LPA observed coverage trash cans in the kitchen, bathrooms and staff office. All posting requirements were met,(food menu posted on the refrigerator; regulations, emergency disaster plan is kept inside the office. In the dining area there is Grievance forms and a comment box mounted the wall. The Hot Water Heater is enclosed located inside the garage adjacent to washer and dryer unit. The central air conditioning unit is located in the hallway in between bedrooms 1 and 2. The two (2) car garage The door entrance to the garage from the kitchen is key locked for precautionary measures. There is a space for laundry units washer and dryer. The detergent is distributed according the youths individual load of clothing. The Licensee will ensure that the children are always monitored when they in the garage area. The garage is also utilized for extra storage, water, food supply and (PPE) Personal Protection Equipment. There are two (2) freezers and a water bottle. Staff office: Is equipped with office furniture. There is a small refrigerator utilize to store medication that require to be refrigerated. All the clients prescribed medications; medication logs, files and medical devices are locked key entry. The cleaning supplies solutions, disinfectants are stored in the staff office. The sharp knives are also inaccessible in separate box in the key locked office. The First Aid kit met requirements, (age-appropriate, and scissors, tweezers, thermometer, and gauzes, antiseptic and First Aid Manual Guide). The facility has a working telephone and children can use the telephone unless restricted by court order; in addition, for the authorized representatives to make contact. LPA observed a hard wired enter connected combined Smoke detector and Carbon Monoxide; tested to be operable. The Living Room is currently furnished with (4) large lounge chairs, one (1) television, red shelf. There is a sofa that has been removed due to damages and in the process of being replaced. Dining room/Kitchen: Observed to be clean and organized; The gas stove is operated with 5 burners; the oven is separate from stove. There is a double door refrigerator with upper freezer.The dining table has six (6) chairs. All required posting are posted on the wall. LPA observed ample linen in the linen closet locate in the hallway. LPA observed two (2) Fully Charged Fire Extinguishers located in the kitchen and in the staff office fully charged. LIC Page 2 of There are three (3) Bedrooms: Each bedroom is equipped with two (2) twin size beds, clean linen, blankets, adequate drawer space and one (1) walk in closet, sliding windows and drapes; observed to be in good condition. The personal rights are posted on the back of each bedroom door. Bedroom # 1, BR #2 and BR #3 currently the bedrooms are not occupied. There are three (3) mattress reportedly that have been damages and in process of being replaced. Bathrooms: There are two (2) bathrooms inspected and found to be clean. LPA ensured that all toilets flushed, and tested water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Bathroom #1 is a full sized Bathroom (sink, toilet shower and a tube)., located in hallway. Bathroom #2 identified as staff bathroom; is a Half bath with a sink toilet and a shower, located in the staff office. This is also a shower is not being utilized. The staff will accompany children local recreational activities. LPA observed that facility ensures that CDC Guidelines are implemented (i.e wash hands with alcohol based hand sanitizer, display colorful preventative hygiene posters, disinfect commonly used areas and items (remote controls, mouse's, playing, cards cell phones, practice "cough etiquette". The facility will operate within license conditions and limitations including capacity limitations. The facility personnel are instructed to report violations of personal rights. Licensee will ensure report changes in the plan of operation affecting service to children. Children are accorded dignity in personal relationships with staff and others; and the Licensee will ensure to report client injuries requiring medical treatment. The facility provided the Personnel Report (LIC 500) and confirmed that the ratio present for six (6) clients in placement. LPA observed required criminal record clearances that met qualification. There were no deficiencies cited at this time. LPA concluded the Annual/Required Inspection. An exit interview was conducted, and a copy of this report was left at the facility with the House Manager on 12/15/ LIC-809-C Page 3 of 3

met_with: House Manager/Anna Jeong


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Olivia Rosas conducted a case management inspection April 16, 2024, at 10:30am based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. During this inspection, 5 out of Direct Care Staff and 1 out of 1 youth files were reviewed. In the inspection, 3 out of Direct Care Staff and 0 out of 1 youth were interviewed (See the Confidential Names List, LIC 811, dated April 16, 2024). The Plan of Operation including policies and procedures were reviewed. Minutes from a meeting related to the facility's incidents involving contact with law enforcement were reviewed. Based on the analysis of the confidential interviews and youth file review including the youth case plans, support plan, emergency access & placement referral form (DCFS6017), and foster child's needs and case plan summary (DCFS709), the licensee uses trauma-informed and evidence-based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. LPA Rosas observed documentation of completed training on policies and procedures on when and how to involve law enforcement in response to an incident. Training records show staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance with their Emergency Intervention Plan when there is an immediate risk of serious harm to a child or others. There are no deficiencies cited at this time. A copy of this report was discussed and provided to House Manager, Credell Jackson.

visit_type: Case Management

met_with: Regina Goree, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 12/16/2024 a 10:45AM PM Licensing Program Analyst (LPA) Rosslyn Gray made an unannounced visit to WILBUR TEMPORARY SHELTER CARE FACILITY (TSCF) to conduct an Annual/Required Inspection. A Health and safety risk assessment was conducted upon arriving at the facility. LPA met with the House Manager Credell Jackson who granted access to the facility. The entire physical plant was inspected. The facility is to provide Temporary Shelter Care Services up to Days, to six (6) children ages 13-17 years old; Ambulatory only. There are no bodies of water on the premises. S1 confirmed that there are no guns or weapons on the premises. LPA- Gray observed the follow during the inspection: TSCF Overview: This is a story, 3 bedrooms; 2 bathroom home located in a residential neighborhood. There is a living room, dining room, kitchen, staff office and a two (2) car garage. There is vehicle provide by the Los Angeles County Children's Residential Fleet Inspected, to be operating in good condition. The vehicle is utilized to pick up supplies (i.e food, household cleaning supplies, and to transport clients to community outings, to seek medical attention in the event of and emergency. Staff has valid drivers license and covered by County of Los Angeles Risk Management Branch. Outdoor Area: The passageways and porches are unobstructed. The activity space is free of hazard materials and debris. LPA observed the utility shut-off valves for gas and water located in back yard side of the facility. LPA observed all windows, screens and drapes from the inside and outside of the facility were observed to be in good condition. There is mounted basketball court, and several trees and a black metal picnic table, a Barbecue Pit and a two (2) seater swing chair. LPA observed coverage trash cans in the kitchen, bathrooms and staff office. All posting requirements were met,(food menu posted on the refrigerator; regulations, emergency disaster plan is kept inside the office. LIC- Page 1 of In the dining area there is Grievance forms and a comment box mounted the wall. The Hot Water Heater is enclosed located inside the garage adjacent to washer and dryer unit. The central air conditioning unit is located in the hallway in between bedrooms 1 and 2. The two (2) car garage The door entrance to the garage from the kitchen is key locked for precautionary measures. There is a space for laundry units washer and dryer. The detergent is distributed according the youths individual load of clothing. The Licensee will ensure that the children are always monitored when they in doing there laundry. The garage is also utilized for extra storage, clothing, art supplies, food and (PPE) Personal Protection Equipment. There are two (2) freezers and a water bottle. Staff office: Is equipped with office furniture. There is a small refrigerator utilize to store medication that require to be refrigerated. All the clients prescribed medications; medication logs, files and medical devices are locked key entry. The cleaning supplies solutions, disinfectants are stored in the staff office. The sharp knives are also inaccessible in separate box in safe inside the key locked office. The First Aid kit met requirements, (age-appropriate, and scissors, tweezers, thermometer, and gauzes, antiseptic and First Aid Manual Guide). The facility has a working telephone and children can use the telephone unless restricted by court order; in addition, for the authorized representatives to make contact. LPA observed a hard wired enter connected combined smoke detector and carbon monoxide; tested to be operable. The Living Room is currently furnished with (4) large lounge chairs, one (1) television and a long table. Dining room/Kitchen: Observed to be clean and organized; The gas stove is operated with 5 burners; the oven is separate from stove. There is a double door refrigerator with upper freezer.The dining table has six (6) chairs. LPA observed ample linen in the linen closet locate in the hallway. LPA observed two (2) Fully Charged Fire Extinguishers located in the kitchen and in the staff office fully charged. There are three (3) Bedrooms: Each bedroom is equipped with two (2) twin size beds, clean linen, blankets, adequate drawer space (six (6)) one (1) walk in closet, sliding windows and drapes; observed to be in good condition. The personal rights are posted on the back of each bedroom door. LIC Page 2 of Bedroom # 1, BR #2 and BR #3 currently the bedrooms are not occupied. Bathrooms: There are two (2) bathrooms inspected and found to be clean. LPA ensured that all toilets flushed, and tested water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Bathroom #1 is a full sized bathroom (sink, toilet shower and a tube) located in hallway. Bathroom #2 identified as staff bathroom; is a half bath with a sink toilet and a shower, located in the staff office. This is also a shower is not being utilized. The staff will accompany children local recreational activities. LPA observed that facility ensures that CDC Guidelines are implemented (i.e wash hands with alcohol based hand sanitizer, display colorful preventative hygiene posters, disinfect commonly used areas and items (remote controls, mouse's, playing, cards cell phones, practice "cough etiquette". The facility will operate within license conditions and limitations including capacity limitations. The facility personnel are instructed to report violations of personal rights. Licensee will ensure to report changes in the plan of operation affecting service to children. Children are accorded dignity in personal relationships with staff and others; and the Licensee will ensure to report client injuries requiring medical treatment. LPA reviewed the following during the inspection: Staff Records Review LPA reviewed four (4) staff records. Staff Interviews: LPA conducted a confidential interview with four (4) on duty staff. Clients Records Review: Currently there are no clients in placement. Client Interviews: Currently there were no clients in placement to interview. LPA reviewed the Personnel Report (LIC 500) and confirmed that staff ratio present for the six (6) clients in placement. LPA confirmed that all staff have required criminal record clearance. DOJ, FBI and Child Abuse Response; which meet qualification. LPA observed staff Annual Training that include the training transcripts for all staff and the First-Aid and CPR training were up to date. There were no deficiencies cited at this time. LPA concluded the Annual/Required Inspection on this day 12/17/2024. An exit interview was conducted, and a copy of this report will be provided via email to the facility House Manager Credell Jackson. LIC-809-C/ Page 3 of 3

met_with: House Manager Credell Jackson


facility_name: VALLEY OF THE MOON CHILDREN'S HOME

summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) David Hiett met with Administrator Sky Gray regarding a complaint investigation at the Temporary Shelter Care Facility. The purpose of the inspection was to deliver the findings for the above allegations. During the course of the investigation, LPA Hiett interviewed 5 youth and 5 staff, and reviewed documentation. Interviews with clients did not support any of the allegations. Interviews with staff revealed that staff were properly informed of mail protocol and proper procedures for determining discipline. This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the above allegations are true; therefore, the above allegations are unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: David Hiett LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

report_type: Complaint Investigation

met_with: Sky Gray

complaint_status: unsubstantiated


raw_content:
Narrative:
This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the Staff sexually assaulted a minor; therefore, the above allegation is Unsubstantiated. Appeal Rights were provided and discussed, and no deficiencies were cited. An exit interview was conducted and a copy of the report was given to the facility.

Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Brian Bertoli made an unannounced complaint investigation visit at the facility and met with Supervising Residential Care Counselor Chris Bozzetto. The purpose of the inspection was to deliver findings regarding the above allegation. The investigation was conducted by Investigator Melissa Burgoon. During the course of the investigation Inv. Burgoon interviewed the youth C1 (see LIC 811 dated 5/10/22), C1's therapist and psychologist, 5 other youth currently or formerly at the facility, 4 facility staff, and reviewed records and reports. All persons interviewed, other than C1, stated they had no knowledge or indication that the allegation occurred. The 5 youth interviewed, other than C1, indicated they felt safe at the facility and did not have concerns about the staff. Investigator Burgoon was unable to determine if staff sexually assaulted a client. There is a lack of clear evidence to make a determination as to whether a regulatory violation did occur. (continued on LIC 9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: Brian Bertoli LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 21-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, NEOTOMAS AVENUE, STE. FACILITY NAME: VALLEY OF THE MOON CHILDREN'S HOMEFACILITY NUMBER: VISIT DATE: 05/10/2022

met_with: Chris Bozzetto


raw_content:
Narrative:
This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that staff did not prevent client from engaging in CSEC activity; therefore, the above allegation is Unsubstantiated. Appeal Rights were provided and discussed, and no deficiencies were cited. An exit interview was conducted and a copy of the report was given to the facility.

Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) David Hiett made an unannounced complaint investigation visit at the facility and met with Program Manager.Sky Gray The purpose of the inspection was to deliver findings regarding the above allegation. Investigator Melissa Burgoon conducted the investigation. During the course of the investigation Inv. Burgoon conducted confidential interviews and reviewed relevant reports. Investigator Burgoon was unable to determine if staff did not prevent client from engaging in CSEC activity. There is a lack of clear evidence to make a determination as to whether a regulatory violation did occur. (continued on LIC 9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: David Hiett LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 21-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, NEOTOMAS AVENUE, STE. FACILITY NAME: VALLEY OF THE MOON CHILDREN'S HOMEFACILITY NUMBER: VISIT DATE: 06/24/2022


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Cheyenne McCambridge met with Administrator Sky Gray regarding a complaint investigation at the Temporary Shelter Care Facility. The purpose of the inspection was to deliver the findings for the above allegations. During the course of the investigation, LPA McCambridge interviewed youth and staff, and reviewed documentation. Interviews with clients did not support any of the allegations. Interviews with staff revealed that staff were propeerly following protocal and procedures. LPA also toured the kitchen and found adequate food supply at the facility. This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the above allegations are true; therefore, the above allegations are unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: Cheyenne McCambridge LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Cheyenne McCambridge met with Administrator Sky Gray regarding a complaint investigation at the Temporary Shelter Care Facility. The purpose of the inspection was to deliver the findings for the above allegations. During the course of the investigation, LPA McCambridge interviewed staff, and reviewed documentation. LPA was unable to interview clients involved due to refusal and unknown victim. There was also contradictory statements in the reporting party interview. Interviews with staff revealed that staff were not aware of any incident happening or being talked about. This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the above allegations are true; therefore, the above allegations are unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: Cheyenne McCambridge LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Brian Bertoli met with Section Manager Briana Downey regarding a complaint investigation at theTemporary Shelter Care Facility. The purpose of the inspection was to deliver the findings for the above allegation. During the course of the investigation, LPA Bertoli inspected the facility, interviewed youth, staff, and youth's representatives, and reviewed documentation. LPA confirmed through interviews with youth that there were incidents of one staff, who is no longer at the facility, who would touch the youth inappropriately. This was also supported by interviews with staff who indicated that the reports from the youth were consistent and they felt it was valid and that the youth involved were not prone to fabrication of events. Based on the information obtained, there is a preponderance of the evidence to prove that staff touched the minor inappropriately. Therefore, the above allegation is substantiated. Title 22 deficiencies were cited and Appeal Rights were provided and discussed with the facility. An exit interview was conducted and a copy of the report was left with the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Brian Bertoli LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 21-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SANTA ROSA RO, NEOTOMAS AVENUE, STE. FACILITY NAME: VALLEY OF THE MOON CHILDREN'S HOMEFACILITY NUMBER: 496890002

met_with: Briana Downey

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
LPA Hood reviewed the program statement for the facility. The program statement requires that staff have sight of the youth every thirty minutes while they are in their rooms for safety reasons. Based on confidential interviews, exceptions have been made when warranted. Based on five of the six interviews, youth had received medical attention consistently within the facility. Based on record review and interview, there is a medical professional on site. LPA was not able to interview the youth that was involved in this allegation. Based on IB investigation, record review, and confidential interviews, the following allegations are found unsubstantiated: minor in care used an illegal substance due to lack of staff supervision, staff are not adequately supervising minors in care, staff do not provide trauma informed services to minors in care, and staff did not seek medical attention for minor in a timely manner. LPA Hood conducted an exit interview with Sky Gray, Director, at 1:11PM whose signature confirms the receipt of this document.

Investigation Findings:
13On 6/1/2023 at 1:02PM, Licensing Program Analyst (LPA) Selena Hood conducted an unannounced visit to the licensed facility. The purpose of the visit was to deliver the findings for the listed allegations. LPA met with Sky Gray, Director. Investigation Branch (IB) Investigator Jorge Martinez completed the 10-Day visit to the facility on 3/24/2023. Based on thirteen confidential interviews and record review, IB found the allegation that "minor in care used an illegal substance due to lack of staff supervision" to be unsubstantiated. During the course of the investigation, Licensing Program Analyst (LPA) Selena Hood conducted six confidential interviews. LPA Hood reviewed pertinent incident reports, staff schedule, program statement, pertinent client files, and the IB report. LPA Hood reviewed the staff schedule, based on record review the staffing was consistently within ratio. Based on five of the six interviews there were not concerns with staffing supervision. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Selena Hood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 21-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: VALLEY OF THE MOON CHILDREN'S HOMEFACILITY NUMBER: VISIT DATE: 06/01/2023

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


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Brian Bertoli met with Administrator Sky Gray regarding a complaint investigation at the Temporary Shelter Care Facility. The purpose of the inspection was to deliver the findings for the above allegation. The investigation was conducted by Investigations Bureau Investigator Blake Williams. During the course of the investigation Investigator Williams spoke with the victim, who indicated that he did not wish to pursue it at this time, and they did not provide any further information. Therefore Investigator Williams was not able to complete the investigation. This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the above allegations are true; therefore, the above allegations are Unsubstantiated. An exit interview was conducted and no deficiencies were cited. A copy of this report was given to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Brian Bertoli LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Brian Bertoli met with Administrator Sky Gray regarding a complaint investigation at the Temporary Shelter Care Facility. The purpose of the inspection was to deliver the findings for the above allegation. During the course of the investigation conducted confidential interviews and reviewed records. While the youth involved may have engaged in inappropriate activities, there is no indication that there is a lack of supervision or response by staff when such incidents occur. This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the Staff are not preventing inappropriate behaviors between minors; therefore, the above allegations are Unsubstantiated. An exit interview was conducted and no deficiencies were cited. A copy of this report was given to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Brian Bertoli LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Brian Bertoli met with Administrator Sky Gray regarding a complaint investigation at the Temporary Shelter Care Facility. The purpose of the inspection was to deliver the findings for the above allegation. During the course of the investigation LPA Bertoli conducted confidential interviews and reviewed records. While the youth involved may have engaged in inappropriate activities, there is no indication that there is a lack of supervision by staff. This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that there is a Lack of supervision resulting to inappropriate behaviors between minors; therefore, the above allegations are Unsubstantiated. An exit interview was conducted and no deficiencies were cited. A copy of this report was given to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Brian Bertoli LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Cheyenne McCambridge met with Section manager Briana Downey regarding a complaint investigation at the Temporary Shelter Care Facility. The purpose of the inspection was to deliver the findings for the above allegation. During the course of the investigation LPA conducted confidential interviews and reviewed records. LPA was unable to interview youh involved and other clients due to them declining. The youth is known to have self injurious behavors and documentation stated that there was no evidence of abuse. This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the Staff are not preventing inappropriate behaviors between minors; therefore, the above allegations are Unsubstantiated. An exit interview was conducted and no deficiencies were cited. A copy of this report was given to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Cheyenne McCambridge LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Cheyenne McCambridge met with Section manager Briana Downey regarding a complaint investigation at the Temporary Shelter Care Facility. The purpose of the inspection was to deliver the findings for the above allegation. During the course of the investigation LPA conducted confidential interviews and reviewed records. LPA was unable to interview youh involved and other clients due to them declining. During interviews it was stated that doors are locked on the outside for clients safety, but common areas and inside doors are unlocked. Some clients were eating in an outside area for a short time due to them causing disturbances and messes while in the cafeteria. This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the Staff are not preventing inappropriate behaviors between minors; therefore, the above allegations are Unsubstantiated. An exit interview was conducted and no deficiencies were cited. A copy of this report was given to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Cheyenne McCambridge LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


summary: Facility Evaluation

raw_content:
Narrative:
Commencing on the above date, Licensing Program Analyst (LPA) David Hiett conducted an Annual/Required inspection and met with Program Manager Sky Gray. The facility was toured, inside and out. The facility is clean, safe, sanitary, and in good repair. All passageways are unobstructed. There are no bodies of water on the property. There are no guns or weapons present. LPA Hiett reviewed 4 staff records and 8 client records all of which were compliant with relevant regulations. The facility has both an East and a West wing. Each wing has four Halls radiating from a central milieu area. Each hall contains four bedrooms, two bathrooms, and a utility or games room. All halls, and both buildings, are built to the same floor plan. The water temperature for all buildings is preset with a maximum of 110 degrees. There are outside play yards with climbing frames and play structures with wood chip flooring. There were no hazards. Administration and admissions offices are housed in a separate building on the same campus. Between the wings is a central area, containing a kitchen and dining area. The facility has a commercially licensed kitchen, which is staffed with a chef and residential service workers. Cleaning is done by residential services workers on a 7-day basis; disinfectants and cleaning solutions are stored in the back of the kitchen area and are transported by service workers by cart as needed. The facility stores all medications centrally at the nurse's office. Medications are distributed to residents from there. A first aid kit is in each hall and the medical office has first aid kits for use when youth are off facility. The lockers are padlocked, both staff and resident know the combination. All required postings are present. Smoke and carbon monoxide detectors were in all areas. LPA Hiett reviewed the facility's pre-intake procedures, intake procedures, discharge procedures, reporting requirements regarding the 10-day placement limit, daily reporting requirements and AB 388. No Title 22 deficiencies cited at this time. Exit interview conducted and a copy of the report was left with the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli visited the facility and met with Program Manager Sky Gray. The purpose of the visit was to interview two youth (see LIC811 dated 2/23/22). This was not related to an investigation at the facility. No deficiencies were cited on this visit. A copy of this report has been sent to Program Manager Sky Gray. This report has been reviewed and an exit interview has been conducted with Program Manager Sky Gray.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli made an announced visit to the facility and met with Administrator Sky Gray and Program Manager Easter-Dawson. Also participating the inspection were Regional Manager (RM) Nelson Martinez and Licensing Program Manager (LPM) Isabel Mendoza. The purpose of the inspection was to review the planned addition of a Short-Term Residential Therapeutic Program facility to their existing operation. Prior to the visit, LPA Bertoli made a pre-screening COVID call, and Administrator Gray indicated they did not have any positive cases currently or known exposures or symptomatic persons. The facility was toured inside and out, including the administrative offices. The facility appears to be clean, safe, and sanitary. The current facility includes two wings for residential use and a common cafeteria between the residential wings. A large patio and playground surround the building. A review was done of which areas will be kept separate between the facilities, and which areas will be shared, and how the populations will be kept separate and supervised. The automated door locks and alarms were demonstrated. No Title 22 deficiencies were cited on this visit. An exit interview was conducted with Administrator Gray and a copy of this report was left with the facility.

met_with: Sky Gray and Meg Easton-Dawson


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli conducted an Annual/Random inspection and met with Program Manager Sky Gray. The facility was toured inside and out. The facility is clean, safe, sanitary, and in good repair. All passageways are unobstructed. There are no bodies of water on the property. LPA Bertoli reviewed 3 client records, all of which were compliant with relevant regulations. Staff records were reviewed separately at the HR office. The complex has both an East and a West wing. The East wing houses their STRTP, which does not have any residents at this time (anticipated date 2024), and the TSCF facility is in the West wing. The TSCF wing has four halls radiating from a central milieu area. Each hall contains four bedrooms, two bathrooms, and a utility or game room. All halls are built to the same floor plan. The water temperature was tested at 115 degrees. There are outside play yards with climbing frames and play structures with wood chip surface. There were no hazards. Administration and admissions offices are housed in a separate building on the same campus. Between the wings is a central area containing a kitchen and dining area. The facility has a commercially licensed kitchen, which is staffed with a chef and residential service workers. Cleaning is done by residential services workers on a 7-day basis; disinfectants and cleaning solutions are stored separately in the back of the kitchen area and are transported by service workers by cart as needed. (cont on LIC 809-C) Since the kitchen/dining area connect to both wings/facilities, access is controlled electronically by computer and by card keys that staff have with them. Clients from each facility will have different meal times and clients will not be allowed to commingle with clients from the other facility. The facility stores all medications centrally at the nurse's office and the Medication Room, which is in an office connected to the dining hall. Medications are distributed to residents from there. A first aid kit is in each hall and the medical office has first aid kits for use when youth are off facility. The lockers are padlocked, both staff and resident know the combination. All required postings are present. Smoke and carbon monoxide detectors were in all areas. LPA Bertoli reviewed the facility's intake procedures, discharge procedures, reporting requirements regarding the 10-day placement limit, daily reporting requirements and AB 388. No Title 22 deficiencies cited at this time. An Advisory Note was issued as 4 staff had been previously been associated to the facility, but all 4 were separated as of 1/1/2019. This appears to be an error created by Guardian. An exit interview was conducted and a copy of the report was left with the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) made an unannounced visit to the facility and met with CRCC Joseph Regan. The purpose of the visit was to review incident reports that had been sent late to CCL. LPA reviewed the regulations on reporting with Joseph and gave him a list of Incident Reports that were apparently sent in late. LPA had discovered nine reports from two youth that occurred in February 2024 and weren't received until 2-4 weeks later. LPA gave Joseph the list and he will review and contact CCL by 3/22/24 to discuss the reason for the delay. LPA had also reviewed the regulations with Administrator Sky Gray. It was also noted that most of the incident reports have come to CCL in a timely fashion and have been in compliance. No deficiencies were cited and a copy of the report was given to the facility.

met_with: Joseph Regan


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli conducted an unannounced Case Management visit and met with Program Manager Sky Gray. The purpose of the visit was to review Overstay information and practices for pursuing placement for youth. LPA stated that there had been concerns expressed regarding the length of stays and if adequate efforts were being made for placement of the youth. LPA reviewed recent weekly report with Program Manager which detailed placement efforts and the difficulty of placing some of the youth. LPA gave Program Manager contact information for System of Care representatives for Technical Assistance and suggested calling them and that they would welcome participation in their meetings. No deficiencies were cited and a copy of this report was given to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 9/8/25, Licensing Program Analysts (LPAs) Mariah Hawkins and Kimberly Hall conducted a random annual inspection. LPAs met with Administrator Sky Gray and informed of the purpose of the visit. LPAs toured the facility site and inspected client files. LPAs observed the facility to be maintained in clean and safe condition. Chemicals, sharps, and medications are stored appropriately. No hazards were observed. Bedrooms had two beds. Clean linens were available and stored. LPAs inspected files for the four clients in care. LPAs observed records to be complete with required documentation. No deficiencies were observed during inspection. A continuation inspection will be conducted to complete this inspection. An exit interview was conducted, and a copy of this report was provided to Administrator Sky Gray.

met_with: Administrator Sky Gray


summary: Facility Evaluation

raw_content:
Narrative:
On 9/25/25, Licensing Program Analysts (LPAs), Kimberly Hall and Mariah Hawkins visited the facility for an annual continuation inspection. LPAs met with Administrator, Sky Gray and informed of the purpose of the visit. The inspection was initiated on 9/8/25. In order to complete the inspection, LPAs conducted two confidential staff interviews and one confidential client interview. One client declined an interview. No deficiencies were observed. An exit interview was conducted, and a copy of this report was given to the Administrator.

met_with: Administrator, Sky Gray


summary: Facility Evaluation

raw_content:
Narrative:
On 7/21/2021, Licensing Program Analyst (LPA) David Hiett received an email from Program Manager Sky Gray requesting a conference call regarding a personnel issue. At 12:30PM, LPA Hiett spoke via telephone with Program Manager Gray and HR Manager Tony walls. During this call, Ms. Gray described inappropriate staff behavior involving C1 (see LIC811). Per Ms. Gray, on 7/10/2021, staff member S1 directed C1 (see LIC811) to the bathroom to clean himself after he defecated and soiled himself. Upon leaving the bathroom, C1 was naked from the waist down. Ms. Gray stated that S1 then went over to S2 and S3 and made degrading remarks about the size of C1's penis. Staff did not make any report to CCL or other appropriate agencies about the incident. Per Ms. Gray, S4 (see LIC811) came forward and spoke with supervisor S5 (see LIC811) and reported the incident to her. S5then reported the incident to Ms. Gray on 7/19/2021. Facility cited for violation of California Code of Regulations, Title Division 6, regulation 87072(d)(10) "Personal Rights: To be accorded dignity in his/her personal relationships with staff and other persons." Based on records reviewed and interviews conducted on 7/21/2021, S1 was found to have made inappropriate comments that compromised the dignity of C1. In addition, the facility was cited for violation of California Code of Regulations, Title Division 6, regulation 80061: "Reporting Requirements: Upon the occurrence, during the operation of the facility, of any of the events specified in (1) below, a report shall be made to the licensing agency within the agency's next working day during its normal business hours. (E) Any unusual incident or client absence which threatens the physical or emotional health or safety of any client. In addition, a written report containing the information specified in (2) below shall be submitted to the licensing agency within seven days following the occurrence of such event. " {continued on LIC812-C} Based on record reviews conducted on 7/21/2021, LPA Hiett determined that no incident report had been submitted to CCL and that notification of the event was not made within the required 24 hour time frame. Interviews with staff indicated that none was familiar with California Code of Regulations, Title Division 6, regulation 87072 (Personal Rights) and that no training on this topic had occurred. Interviews further revealed that staff were not familiar with Incident Report guidelines and were unaware that an incident of this type needed to be reported as outlined in in regulations. An exit interview conducted and a copy of the report and appeal rights were provided to the facility.


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli conducted an unannounced Case Management visit and met with Administrator Sky Gray. The purpose of the visit was to issue citations regarding an incident that occurred at the facility on or around April 30, 2024, involving a male youth who entered a female youth's room and then got into her bed and removed his pants. Based on confidential interviews and records, staff were present and requested him to leave, but due to the prolonged nature of the event and the failure to act to remove the youth, the following deficiencies are being cited: 84065. Personnel Duties (b) Child care staff shall perform the following duties: (1) Supervision, protection and care of children individually and in groups at all times. Plan of Operation (k) The facility shall operate in accordance with the terms specified in the Plan of Operation and may be cited for not doing so. The VMCH Program Statement includes: "An assessment will be done of available community emergency services, including, but not limited to, the police/sheriff departments if the use of emergency interventions is not effective or appropriate". An exit interview was conducted and a copy of the report and appeal rights were provided to the facility.

Deficiencies:
84065.2: (1) Supervision, protection and care of children individually and in groups at all times.

80022 Plan of Operation
(k)


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, LIcensing Program Analyst (LPA) made an unannounced visit to the facility and met with Sky Gray and Julie Hillborn, who had emailed LPA regarding the new ILS regulations for the facility. LPA clarified that youth still need to be assessed for their needs to ensure the facility can meet those needs, but they do not need to complete a written Needs & Services Plan. LPA also reviewed public information regarding a facility being considered for placement of a youth and will review it further at a later date. An exit interview was conducted and no citations were issued.

met_with: Sky Gray and Julie Hillborn


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analysts (LPAs) Kimberly Hall and Brian Bertoli conducted an unannounced Case Management visit to the facility and met with Sky Gray, Administrator. The purpose of the visit was to cite for a deficiency that resulted from not receiving the monthly shelter report by 3/5/26. As of 3/6/25, LPAs have not received the required monthly report. Weekly reports are no longer needed with the exception of when a client stays over 10 days. LPAs are citing for Reporting Requirements 84661 (t). See attached LIC 809-D. An exit interview was conducted and Appeal Rights were discussed. A copy of this report was given to the facility.

met_with: Sky Gray, Administrator


facility_name: WAYFINDER FAMILY SERVICES - TSCF

raw_content:
Investigation Findings:
13On June 2, 2021, at 11: AM, Licensing Program Analyst (LPA) Charmetha White contacted the above location via telephone for the purpose of concluding the investigation and deliver findings on the above allegation. LPA spoke with the Program Director, Kristal Audoma and discussed the findings. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Interviews and records did not produce corroborating evidence to support the allegation. Staff denied there being a lack of supervision and stated staff are always present. Staff stated verbal redirect was used to discourage the behavior, however both clients continued the behavior and refused to stop. Additionally, Staff stated Client #1 met with the therapist continuously to address behaviors. LPA was unable to obtain statements from Client #1 and Client #2 as clients were no longer in placement. Although there was inappropriate contact between the clients in the facility. The Staff made attempts to intervene and deter the clients. Based on information obtained, the allegation is found to be unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. No deficiencies cited. Exit interview completed and a copy of this report was emailed to Program Director, Kristal Audoma. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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

met_with: Program Director - Kristal Audoma


raw_content:
Investigation Findings:
13On November 19, at 11: AM, Licensing Program Analyst (LPA) Charmetha White arrived at Wayfinder TSCF for the purpose of concluding the investigation and deliver findings on the above allegations. LPA met with Director, Kaela Stambor. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Staff denied allegations and stated that none of the staff would ever say or do anything inappropriate to a child in care. Staff stated that sexual interactions between staff and clients is prohibited and is grounds for immediate termination. Additionally, Client interviews did not produce corroborating evidence to support the allegations and there were no witnesses to either allegation. Based on information obtained, the allegations are found to be Unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. No deficiencies cited. Exit interview completed and a copy of this report was left with the Director, Kaela Stambor. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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

met_with: Director - Kaela Stambor


raw_content:
Narrative:
The investigation consisting of confidential interviews, review of police report and related reports from the Department of Children and Family Services revealed a lack of evidence to support alleged neglect/lack of supervision. C1 declined to give Investigator a statement during the investigation process. Information obtained from witness statements did not produce information to corroborate neglect/lack of supervision leading to sexual and/or physical abuse towards C1 by another youth resident. The Department has investigated the complaint and found that the allegation is Unsubstantiated at this time; although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove neglect/lack of supervision contributed to the alleged. There were no deficiencies cited at this time. Appeal Rights issued and discussed.

Investigation Findings:
13On May 6, 2022 at 12: PM, Licensing Program Analyst Regina Martin conducted a subsequent complaint inspection to conclude and deliver findings concerning the allegation as mentioned above. LPA Martin met with Irene Manzanares, Assistant Director of Campus Safety and Program Support and advised the Complaint Investigation, investigated by Community Care Licensing Division (CCLD) Investigator Lorraine Patterson has been completed. Investigation details are discussed. On October 28, 2021, CCLD received a complaint referral alleging neglect/lack of supervision as Client #1 (C1) was reportedly sexually and physically assaulted by another resident while at the facility in June 2021 and in August 2021. C1 was reportedly observed at some point with a visible injury to the eye. It was reported that the sexual assault was not reported to staff and that the alleged perpetrator was transferred to a different facility. (Continued on page LIC9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Regina Martin LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: WAYFINDER FAMILY SERVICES - TSCFFACILITY NUMBER: VISIT DATE: 05/06/2022

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

visit_type: Complaint Investigation


raw_content:
Investigation Findings:
13On May 31, 2022 at 10am Licensing Program Analyst (LPA) Donald Martin conducted a follow up complaint inspection and spoke with Facility . The purpose of this inspection was to deliver findings for the above complaint allegation. During the course of investigation the allegation for facility staff is insufficiently staffed to meet the needs of the minors, interviews were conducted. The interview did not produce corroborating evidence to support said allegation. Interviews revealed inconsistent statements and no witnesses to suggest allegation occurred. There was no evidence of the facility being insufficiently staffed to meet the needs of the minors. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove or disprove that a violation occurred; therefore, the above allegation is Unsubstantiated. There are no deficiencies being cited at this time. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Donald C Martin 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

met_with: Kaela Stambor-Director


raw_content:
Investigation Findings:
13On 06/23/2022 at 9:30am, Licensing Program Analyst (LPA) Bernice Karnsrithong arrived at the facility for the purpose of delivering findings for the above complaint. Health and safety risk assessment were conducted upon arrival. LPA Karnsrithong met Kaela Stambor, Director who granted access to the facility.During the investigation of the allegations, minors are smoking marijuana while in care, staff do not provide adequate supervision to the minors while in care, and staff are not properly trained; LPA Karnsrithong conducted confidential interviews and reviewed documentary evidences. Statements were inconsistent and did not produce corroborating evidence that minors are smoking marijuana while in care, staff are not providing adequate supervision to the minors while in care and staff are not properly trained. There was no witness to corroborate the allegations and documentary evidences suggest that facility has an extensive policy on substance abuse and contraband searches and facility staff are receiving regular training. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. This complaint investigation is deemed unsubstantiated.There are no deficiencies cited at this time. Exit interview was conducted with Kaela Stambor and a copy of this report will be provided. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Bernice Karnsrithong LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Kaela Stambor, Director


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Narrative:
Due to lack of evidence obtained during the investigation, LPA determines that the allegations are unsubstantiated at this time meaning, although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. There were no deficiencies cited at this time. Exit interview conducted with Kaela Stambor, Director for TSC. A copy of this report will be provided to the facility.

Investigation Findings:
13On 07/13/2022 at 1:30pm Licensing Program Analyst (LPA) Bernice Karnsrithong arrived at the facility for the purpose of delivering findings for the above complaint investigation. Health and safety risk assessment were conducted upon arriving at the facility. During the visit, LPA Karnsrithong met with Kaela Stambor, Director of Temporary Shelter Care (TSC) who granted access to the facility. During the investigation of the following allegations: Residents are not adequately supervised, Young children have eloped from the facility, Staff are not trained to work with the residents, and Needs of the residents are not being met; LPA Karnsrithong conducted confidential interviews and reviewed documentary evidences. Statements were inconsistent and did not produce corroborating evidence to support that staff do not provide adequate supervision to clients, staff not being able to provide the needs of clients, and staff are not trained to work with residents. Although there were incidents of clients eloping or engaging in runaway activities, there were no corroborating evidence that suggest that staff are not complying with appropriate emergency intervention and appropriate runaway procedures. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Bernice Karnsrithong LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: WAYFINDER FAMILY SERVICES - TSCFFACILITY NUMBER: VISIT DATE: 07/13/2022

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

met_with: Kaela Stambor


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Investigation Findings:
13On 08/04/2022 at 9am, Licensing Program Analyst (LPA) Bernice Karnsrithong arrived at the facility for the purpose of delivering findings for a complaint investigation. Health and safety risk assessment were conducted upon arriving at the facility. LPA Karnsrithong met with Kaela Stambor, Director who granted access to the facility. During the investigation of the allegations, Staff member had sexual relations with minors in care and Staff member allowed group home children to drive the staff member's car; LPA Karnsrithong conducted confidential interviews and reviewed documentary evidences. Statements and documentary evidences did not produce corroborating evidence to support that the allegations; staff member had sexual relations with minors while in care or allowed group home children to drive a staff member's car. There were no witnesses to corroborate that such incidents have occurred. Internal investigation from the facility also determines that there was not enough evidence to substantiate these allegations. Therefore, LPA Karnsrithong determines that the allegations are unsubstantiated at this time meaning, although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. There are no deficiencies cited at this time and a copy of this report will be provided. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Bernice Karnsrithong LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Kaela Stambor, Director for TSC


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Investigation Findings:
13On 08/04/2022 at 9am, Licensing Program Analyst (LPA) Bernice Karnsrithong arrived at the facility for the purpose of delivering findings for a complaint investigation. Health and safety risk assessment were conducted upon arriving at the facility. LPA Karnsrithong met with Kaela Stambor, Director who granted access to the facility.During the investigation of the allegations, lack of supervision between minors while in care and staff did not properly report an incident regarding a minor while in care; LPA Karnsrithong conducted confidential interviews and reviewed documentary evidences. Statements and documentary evidences did not produce corroborating evidence that support lack of supervision between minors while in care and staff did not properly report incident regarding minors. Statements and documentary evidence suggest that the facility has extensive supervision and reporting procedures and policies that staff are trained on and is implemented to supervise while minors are in care. Due to lack of evidence obtained during the investigation, LPA determines that the allegations are unsubstantiated at this time meaning, although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. There are no deficiencies cited and a copy of this report will be provided to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Bernice Karnsrithong LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


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Investigation Findings:
13On 08/04/2022 at 9am Licensing Program Analyst (LPA) Bernice Karnsrithong arrived at the facility for the purpose of delivering findings for a complaint investigation. Health and safety risk assessment was conducted upon arriving at the facility.LPA Karnsrithong met with Veta Talton, Assistant Director for TSC who granted access to the facility. During the investigation of the following allegations: Minor is attacking another minor while in care, minor's behavior poses as a risk to another minor while in care, Minor is not afforded privacy while in care, Staff pulled a minor's hair while in care, Minor sustained unexplained injuries while in care, and Minor threatened another client while in care; LPA Karnsrithong conducted confidential interviews and reviewed the client's observation log, personal care log and incident reports. Based on confidential interviews and documentary evidences, there were no evidence to prove that these allegations occurred. Due to lack of evidence obtained during the investigation, LPA determines that the allegations are unsubstantiated at this time meaning, although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a has violation occurred. There are no deficiencies cited at this time. A copy of this report will be provided to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Bernice Karnsrithong LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Veta Talton, Director for TSC


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Investigation Findings:
13On August 17, 2022, Licensing Program Analyst (LPA) C. White conducted an unannounced visit to Wayfinder TSCF for the purpose of delivering findings on the above allegations. LPA spoke with the Irene Manzanares, Assistant Director of Campus Safety and Program and discussed the findings. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Confidential interviews and records did not produce corroborating evidence to support the allegations. Staff stated they actively addressed the vermin issue by having maintenance seal holes found in the kitchen, and the facility was treated by an exterminator several times. Staff denied residents were not treated respectfully. LPA was unable to obtain a statement from Client #1 as the client was reunified with family. Based on information obtained, the allegations are found to be unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. No deficiencies cited. Exit interview completed and a copy of this report was left with or emailed to Assistant Director of Campus Safety and Program. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Irene Manzanares - Assistant Director of Campus Safety and Program


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Investigation Findings:
13On September 27, 2022, Licensing Program Analyst (LPA) C. White conducted an unannounced visit to Wayfinder TSCF for the purpose of delivering findings on the above allegations. LPA spoke with Administrator, Veta Talton and discussed the findings. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Confidential interviews and records did not produce corroborating evidence to support the allegations. Staff stated none of the staff carry weapons as it is against the policy. Staff denied having knowledge of any client being abused or encouraged to participate in illegal activity while in care. Staff stated minors are not left outside alone or denied entry into the facility. LPA was unable to obtain a statement from Client #1 as the client's whereabout are unknown. Based on information obtained, the allegations are found to be unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. No deficiencies cited. An exit interview was completed, and a copy of this report was left with facility staff. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

met_with: Administrator - Veta Talton


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Investigation Findings:
13On October 20, 2022, Licensing Program Analyst (LPA) C. White arrived at Wayfinder Temporary Shelter Care Facility (TSCF) for the purpose of delivering findings for the above complaint investigation. LPA met with Tony Weaver, VP, Clinical and Housing Services. During the course of this investigation, LPA conducted confidential interviews, gathered documentation, reviewed records and reports. Confidential interviews and records did not produce corroborating evidence to support the allegation. Confidential interviews produced inconsistent statements. LPA was unable to obtain statements from Client #1 and Client #2. Additionally, there were no witnesses to corroborate that the allegation occurred. Due to lack of evidence obtained, the allegations are found to be unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that a violation occurred. There were no deficiencies cited at this time. Exit interview conducted with VP, Clinical and Housing Services. A copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2


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Narrative:
Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove or disprove that a violation occurred; therefore, the above allegation is Unsubstantiated. There are no deficiencies being cited at this time.

Investigation Findings:
13On January 6, 2023 at 12pm, Licensing Program Analyst (LPA) Donald Martin conducted a follow up complaint inspection and spoke with Facility Director, Veta Talton. The purpose of this inspection was to deliver findings for the above complaint allegation. During the course of investigation the allegation for staff did not provide adequate supervision to a minor, interviews were conducted. The interviews did not produce corroborating evidence to support said allegations. Interviews revealed inconsistent statements and no witnesses to suggest allegations occurred. There was no evidence that staff did not provide adequate supervision to a minor. LPA was unable to interview the client specific to the complaint due to no name given. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Donald C Martin LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: WAYFINDER FAMILY SERVICES - TSCFFACILITY NUMBER: VISIT DATE: 01/06/2023

met_with: Veta Talton-Director


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Narrative:
Based on the information obtained from confidential statements and documentary evidence, the investigation did not provide evidence to substantiate sexual abuse against former Staff member #1 (S1). The investigation revealed the allegation that S1 sexually abused a former youth resident at Wayfinder Family Services were based on hearsay statements which was heard from another resident while at a former placement. The investigation did not reveal a sexually abused victim or a witness to attest that S1 sexually abused a youth resident at Wayfinder Family Services that was not hearsay; therefore, the allegation is unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. There are no deficiencies cited at this time. Exit interview completed. A copy of this report and LIC811 was provided to Facility Director.

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

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

met_with: Facility Representative, Veta Talton, Director


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Investigation Findings:
13On March 30, 2023, Licensing Program Analyst (LPA) C. White arrived at Wayfinder Temporary Shelter Care Facility (TSCF) for the purpose of delivering findings for the above allegations. LPA met with Administrator, Veta Talton. During the course of this investigation, LPA conducted confidential interviews, gathered documentation, reviewed records and reports. Staff denied the allegations and stated food was not kept away from the client, that all clients in care are provided three meals each day plus snacks, and that none of the staff verbally abuse any client as abuse of any kind is prohibited. LPA was unable to obtain a statement form Client #1. Additionally, there were no witnesses to corroborate that the allegations occurred. Based on information obtained, the allegations are found to be unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. There were no deficiencies cited. An exit interview was completed, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3


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Narrative:
Based on the information obtained from confidential statements and documentary evidence including review of related incident report, internal investigation, client and staff files, related Los Angeles County Sheriff's Department report and review of facility surveillance video footage, there is not enough evidence to substantiate sexual abuse by S1 towards C1. Information obtained indicates C1 was placed on November 13, 2022, at Wayfinder Family Services - TSCF as a temporary placement for 24-48 hours. An interview with C1 was not conducted as attempts to contact C1 was not successful. The investigation revealed inconsistencies in reported documentary statements. A review of facility video footage did not reveal any contact between C1 and S1. There were no witnesses or corroborating evidence to prove alleged sexual abuse. Therefore, the allegation is unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. There are no deficiencies cited at this time. Exit interview completed. A copy of this report and LIC811 was provided to Assistant Facility Director.

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

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

met_with: Facility Representative, Lakesha Buchanan, Assistant Director


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Investigation Findings:
13On September 14, 2023, Licensing Program Analyst (LPA) C. White arrived at the above location for the purpose of delivering findings on the above allegation. LPA met with Administrator, Veta Talton and discussed the findings. During the course of this investigation, LPA interviewed pertinent parties and reviewed documentary evidence. Interviews and records did not produce corroborating evidence to support the allegation: staff did not give medication to minor. Based on confidential interviews and documents reviewed, the allegation is found to be unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. There are no deficiencies cited at this time. Exit interview was conducted with the Facility Administrator, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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

met_with: Facility Administrator - Veta Talton


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Investigation Findings:
13On October 6, 2023, Licensing Program Analyst (LPA) C. White arrived at Wayfinder Temporary Shelter Care Facility (TSCF) for the purpose of delivering findings for the above allegation. LPA met with Program Support Manager, Chartrice Johnson. During the course of this investigation, LPA conducted confidential interviews and reviewed records. Staff denied the allegation. Staff stated staff do not give drugs to clients in care and that administering drugs to clients is prohibited. Client statements did not produce corroborating evidence to support the allegation. Based on information obtained, the allegation is found to be unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. There were no deficiencies cited. An exit interview was completed, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

met_with: Program Support Manager - Chartrice Johnson