raw_content:
Narrative:
S1 and school staff restrained C1 as the client's behavior continue to escalate. C1 was restrained to prevent them from hurting themselves and others. On December 4, 2023, C1 was sent home from school for repeatedly running out of the class when the teacher asked them to do their work. C1 became upset when staff told C1 that they would not be on electronics. C1 became aggressive and started to assault two staff. C1 was placed on restraint by two staff (S1 and S2) to prevent C1 from further assaulting staff. During both incidents, C1 was not slammed on the ground by neither staff. C1 did not provide any statements. The statements obtained from the confidential interviews did not provide sufficient information to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that alleged violation occurred, therefore the allegation is unsubstantiated. There were no deficiencies cited during this inspection. An exit interview was conducted. A copy of this report, Confidential Names Form, and Appeal Rights were provided to the facility representative via electronic mail.

Investigation Findings:
13On May 17, 2024, at 9: AM, Licensing Program Analyst (LPA) Karen Suh conducted a follow-up complaint inspection to deliver the finding of an investigation concerning to the allegation above. The LPA met with Corie Thomas, Administrator, and discussed the finding. The investigation included confidential interviews that consisted of but were not limited to: the Administrator, Head of Service, and one client on December 27, 2023, two staff on January 17, 2024 and May 14, 2024, County Social Worker (CSW) on December 27, 2023. The LPA was unable to interview the client as the client declined to be interviewed. The LPA obtained and reviewed client's (C1; see Confidential Names LIC 811, dated May 17, 2024) Needs and Services Plan, Child and Family Team (CFT) Meetings Report, restrained log, and Special Incident Reports It was alleged that staff slammed a minor to the ground. Staff denied the allegation. It was revealed that on November 29, 2023, staff (S1) went to C1's school because C1 was aggressive to school staff and causing property damage to the school. (Cont.) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Yan Yeung LICENSING EVALUATOR NAME: Karen Suh LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONES 5FACILITY NUMBER: VISIT DATE: 05/17/2024

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

met_with: Corie Thomas


state: CA

facility_name: BELOVED ONES 5

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
5. The staff is interfering with a minors telephone calls. The team (S1, S2, and S3) rebuffed the allegation and stated that C1 is allowed to have supervised phone conversations with his biological mother daily. Nevertheless, there are instances when C1 declines to engage with his parents, gets upset, and either abruptly terminates the call or goes as far as damaging the phone. S1 indicated that they have had to repeatedly caution C1's parents against scolding him for school-related matters, inquiring about the services he is receiving, or directing the therapist on what to do. Furthermore, S1 mentioned that they have sought advice from C1's CSW, who recommended that they advise the parents to contact the CSW for any questions regarding C1's NSP. 6. The staff yelled at a minor while in care and used inappropriate language towards a minor. The team (S1, S2, and S3) rebutted the accusation, underscoring that such actions from staff members are unacceptable and will be handled appropriately. They pointed out that staff members have needed to speak loudly to verbally guide clients in order to prevent verbal conflicts. The team refuted any assertions of clients or staff members reporting inappropriate language being used by any staff member towards them or in their presence. S1 also mentioned that clients often resort to swearing at each other or staff members when they are upset and do not receive their desired outcome. 7. The staff does not prevent a minor from accessing inappropriate material while in care. The team (S1, S2, and S3) disproved the alleged accusation and provided supplementary details. They stated that C1's father had gifted him a PlayStation virtual gaming system and had set up an account for him. The team clarified that the staff was unaware of C1 accessing inappropriate content, which his father discovered while checking the account from home. Additionally, the team mentioned that C1's parents expressed frustration during a supervised phone call, holding the staff responsible for not monitoring C1's activities on his virtual headset. The team explained to the parents that, as they had established the account, they were unable to search or monitor the content C1 was accessing due to it violating C1's personal rights and California privacy laws, as the account was created under C1's father's name. 8. The staff mishandled a minors personal belongings, and the staff does not safeguard a minors personal belongings. During a phone call, S1 acknowledged that C1's parents had expressed concerns about some Legos that were bought for C1. C1 claimed that the staff had caused damage to their Legos. S1 clarified that neither the staff nor any other client had ever reported taking or damaging personal belongings. S1 explained that C1, when angry with their parents or when the staff intervened to stop them from doing certain things, would intentionally break their own things. As a result of this behavior, C1 had broken their room window, kicked the wall and created holes in it, and thrown their toys against the wall. Eventually, C1 would throw away these toys as they were no longer usable. The team also emphasized that clients who have personal belongings they want to keep safe can ask a staff member to keep these items in the staff office to prevent any damage. Information obtained from C2 and C3 confirmed the aforementioned details and revealed that they feel secure residing at the facility and believe that the staff is assisting them in accomplishing their personalized plan. Additionally, the CSW mentioned that the facility staff were highly attentive and supportive, frequently engaging in communication with them regarding matters concerning C1 and their biological parents. The CSW disclosed that, due to the excessive involvement of the biological parents, the facility staff were required to report all incidents to the CSW, who would then relay the information to the biological parents. The CSW stated that during their visits with C1, no mention or discussion of the aforementioned allegations took place. Therefore, based on the information received, the above allegation(s) is determined to be unsubstantiated. Although the allegation(s) may have happened are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegations are found to be unsubstantiated. Appeal Rights were provided and discussed with the Foster Family Agency. There are no deficiencies to be cited at this time. An exit interview was conducted and a copy of the report along with the (LIC 811) was left with the STRTP Facility Manager.

Investigation Findings:
13On June 25, 2024, at 1: PM, Licensing Program Analyst (LPA) Winston Moroney conducted a complaint inspection at the above Short-Term Residential Therapeutic Program (STRTP) and met with the Facility Manager Willy Ayala. The inspection aimed to deliver the finding(s) regarding the complaint allegation(s). On April 23, 2024, the Community Care Licensing Division of the California Department of Social Services received a complaint from the Centralized Complaint and Information Bureau (CCIB) with the following allegation(s): The staff does not ensure a minor is performing at school, the staff does not communicate effectively with the authorized representative, the staff does not properly report incidents involving a minor, the staff does not answer the facility telephone, the staff is interfering with a minors telephone calls, the staff yelled at a minor while in care, the staff used inappropriate language towards a minor, the staff does not prevent a minor from accessing inappropriate material while in care, the staff mishandled a minors personal belongings, and the staff does not safeguard a minors personal belongings. This LPA conducted the investigation of the above allegation(s) and it consisted of but was not limited to a review of records, including the client's needs and services plans, medical records, and interviews with the two staff members (S1) on 1/24/24, S2 on 1/24/24, (S3) on 1/24/24, 2 of 3 clients (C2, and C3) on 1/24/24, and the CSW on 1/31/24. C1 declined to be interviewed, so no statement was obtained from them.(Reference Confidential Names Form LIC 811, dated June 25, 2024). The Following Allegation(s) were reported: 1. The staff does not ensure a minor is performing at school. The team (S1, S2, and S3) denied the allegation by stating that they, along with other child support groups, held multiple Collaborative Family Team (CFT) meetings with school staff to monitor C1's academic advancement. Despite their efforts, there were times when C1 would refuse to adhere to his individualized plan and would sometimes show aggression towards the team members who were assisting him with his assignments. 2. The staff does not communicate effectively with the authorized representative. The accusation was firmly denied by the team (S1, S2, and S3), who also emphasized their exceptional communication with C1's CSW, school staff, and other supporting agencies. The team reassured that they would diligently report any incidents to C1's CSW on a daily basis. Furthermore, it was disclosed that the team often received phone calls from C1's biological mother, who would express frustration when informed that she should contact the CSW for information. This stemmed from the biological mother's attempt to impose her own beliefs regarding what was in C1's best interest. 3. The staff does not properly report incidents involving a minor. The team (S1, S2, and S3) refuted the allegation by confirming that they upheld continuous communication with C1's CSW and expeditiously informed all pertinent agencies of any occurrences via email. 4. The staff does not answer the facility telephone. The team (S1, S2, and S3) rebutted the allegation by clarifying that the phone is regularly monitored by staff members. If there are situations at the facility that prevent them from answering the phone, they are prepared to promptly return calls. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Winston Moroney LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200a Monterey Park, CA Facility Name: Beloved Ones 5facility Number: Visit Date: 06/25/ Narrative 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 325. The staff is interfering with a minors telephone calls. The team (S1, S2, and S3) rebuffed the allegation and stated that C1 is allowed to have supervised phone conversations with his biological mother daily. Nevertheless, there are instances when C1 declines to engage with his parents, gets upset, and either abruptly terminates the call or goes as far as damaging the phone. S1 indicated that they have had to repeatedly caution C1's parents against scolding him for school-related matters, inquiring about the services he is receiving, or directing the therapist on what to do. Furthermore, S1 mentioned that they have sought advice from C1's CSW, who recommended that they advise the parents to contact the CSW for any questions regarding C1's NSP. 6. The staff yelled at a minor while in care and used inappropriate language towards a minor. The team (S1, S2, and S3) rebutted the accusation, underscoring that such actions from staff members are unacceptable and will be handled appropriately. They pointed out that staff members have needed to speak loudly to verbally guide clients in order to prevent verbal conflicts. The team refuted any assertions of clients or staff members reporting inappropriate language being used by any staff member towards them or in their presence. S1 also mentioned that clients often resort to swearing at each other or staff members when they are upset and do not receive their desired outcome. 7. The staff does not prevent a minor from accessing inappropriate material while in care. The team (S1, S2, and S3) disproved the alleged accusation and provided supplementary details. They stated that C1's father had gifted him a PlayStation virtual gaming system and had set up an account for him. The team clarified that the staff was unaware of C1 accessing inappropriate content, which his father discovered while checking the account from home. Additionally, the team mentioned that C1's parents expressed frustration during a supervised phone call, holding the staff responsible for not monitoring C1's activities on his virtual headset. The team explained to the parents that, as they had established the account, they were unable to search or monitor the content C1 was accessing due to it violating C1's personal rights and California privacy laws, as the account was created under C1's father's name. 8. The staff mishandled a minors personal belongings, and the staff does not safeguard a minors personal belongings. During a phone call, S1 acknowledged that C1's parents had expressed concerns about some Legos that were bought for C1. C1 claimed that the staff had caused damage to their Legos. S1 clarified that neither the staff nor any other client had ever reported taking or damaging personal belongings. S1 explained that C1, when angry with their parents or when the staff intervened to stop them from doing certain things, would intentionally break their own things. As a result of this behavior, C1 had broken their room window, kicked the wall and created holes in it, and thrown their toys against the wall. Eventually, C1 would throw away these toys as they were no longer usable. The team also emphasized that clients who have personal belongings they want to keep safe can ask a staff member to keep these items in the staff office to prevent any damage. Information obtained from C2 and C3 confirmed the aforementioned details and revealed that they feel secure residing at the facility and believe that the staff is assisting them in accomplishing their personalized plan. Additionally, the CSW mentioned that the facility staff were highly attentive and supportive, frequently engaging in communication with them regarding matters concerning C1 and their biological parents. The CSW disclosed that, due to the excessive involvement of the biological parents, the facility staff were required to report all incidents to the CSW, who would then relay the information to the biological parents. The CSW stated that during their visits with C1, no mention or discussion of the aforementioned allegations took place. Therefore, based on the information received, the above allegation(s) is determined to be unsubstantiated. Although the allegation(s) may have happened are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegations are found to be unsubstantiated. Appeal Rights were provided and discussed with the Foster Family Agency. There are no deficiencies to be cited at this time. An exit interview was conducted and a copy of the report along with the (LIC 811) was left with the STRTP Facility Manager. SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Winston Moroney LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: LIC9099 (FAS) - (06/04)Page: 2 of 2

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

report_type: Complaint Investigation

met_with: Willy Ayala - Facility Manager

complaint_status: unsubstantiated


summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On October 1, 2024, Licensing Program Analyst (LPA) Johanna Aracena conducted an unannounced visit to Beloved Ones STRTP with purpose of delivering findings for the above complaint allegation. LPA Aracena met with Facility Manager, Willy Ayala and discussed the findings. During the investigation of the allegations, LPA Aracena conducted confidential interviews with facility staff, complainant, witnesses, and County Social Worker. LPA Aracena was not able to interview the client during the investigation (See Confidential Names List-LIC 811 dated 10/01/24).During the investigation, the allegation of abuse was denied by interviewed parties. Confidential interviews raised no concerns of abuse. Client #1 refused to be interview regarding the complaint investigation. Due to the information obtained during the investigation, it cannot be determined whether the above allegations occurred. Based on the compiled information the complaint allegation is unsubstantiated. Although the allegations may have happened or is valid, there not a preponderance of the evidence to prove that the allegations occurred. No deficiencies were cited. An exit interview was conducted, and a copy of this report provided to the above-named staff. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tira Logan LICENSING EVALUATOR NAME: Johanna Lofton 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: Willy Ayala- Facility Manager


facility_name: BELOVED ONES SIX

raw_content:
Narrative:
It was alleged that one staff member at the facility made inappropriate comments towards multiple clients in care. The alleged comments ranged from derogatory remarks to general disrespect. In interviews conducted, one child stated that the staff member did indeed use derogatory remarks towards clients in care and was verbally abusive in general. However, three other children stated that they had not seen or heard of the staff member ever making inappropriate comments, or verbally abusing any clients in care. Two children stated that the staff member was more strict than others but would remain professional in dealing with the clients. All children interviewed revealed that they felt safe in the home and could count on staff members to help them with anything that they needed. In interviews conducted, four staff members denied the allegation and stated that they have not seen or heard of any staff members in the facility making inappropriate statements to clients in care. Staff reiterated that even though clients may be challenging and frustrating at times, they are trained to be gentle and understanding towards clients in care. A review of records revealed no indications that staff have ever been verbally abusive towards clients in care. Based on interviews conducted and records reviewed, there is not a preponderance of evidence to prove that the above allegation occurred. Although the allegation may have happened or may be valid, there were no outside witnesses to confirm whether the incidents were improperly supervised and if they could have been prevented. Therefore, the allegation is deemed UNSUBSTANTIATED. An exit interview was conducted and a signed copy of this report, along with the Licensee's Appeal Rights (LIC 9058 01/16) was provided to the Licensee.

Investigation Findings:
13On April 27, 2022 at approximately 12: PM, Licensing Program Analyst (LPA) Raymond Wu conducted a follow-up complaint inspection with the facility to deliver the findings of a complaint investigation concerning the allegation above. LPA discussed the finding with the facility representative named above. During the course of the investigation, LPA interviewed clients and staff on 02/03/22 and 03/31/22. LPA also reviewed documents on 04/24/22 including, but not limited to, needs and services plan(s), and incident reports. One child at the center of this investigation was unable to be interviewed due to reunification with birth family. Attempts to contact the birth family were unsuccessful. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Yan Yeung LICENSING EVALUATOR NAME: Raymond Wu LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONES SIXFACILITY NUMBER: VISIT DATE: 04/27/2022

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

met_with: Supervising Facility Manager Tiffany Cotledge


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
Information obtained through confidential statements and a character witness (W1) statement it was revealed that S3 did in fact verbally abuse a client (C1) by calling C1 "a fat lazy bitch" which is a Personal Rights violation. This is a violation of the Short-Term Residential Therapeutic Program Interim Licensing Standards regulation 87072 (11) "To be free of physical, sexual, emotional, or other abuse, and from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature including, but not limited to, interference with the daily living functions of eating, sleeping, or toileting, or withholding of shelter, clothing, or aids to physical functioning." If not corrected, it will have a direct and immediate risk to the health and safety of the children in care. Therefore, the above allegation is substantiated. The agency was cited, and a plan of correction was initiated. Appeal rights were provided and discussed with the STRTP Administrator. A copy of the report and the Confidential Name List (LIC811) dated October 7, 2022, was provided to the STRTP Administrator, and an exit interview was conducted.

Investigation Findings:
13On October 7, 2022 at 11: AM, Licensing Program Analyst (LPA) Winston Moroney, conducted a follow-up complaint inspection to the above Short-Term Residential Therapeutic Program (STRTP) and met with STRTP Administrator Ashley MacLearn. The purpose of the inspection was to deliver a finding for the above complaint allegation. It was alleged that staff member S3 verbally abused minor C1 while in care. The investigation of the above allegation was conducted by LPA Moroney, which consisted of, but was not limited to, a review of records including the client's needs and services plans, interviews with two staff members (S1, S2) on 9/1/2022, TS on 9/12/22, five clients (C1, C2, C3, C4, C5) on 9/1/22, San Bernardino County Social Services Practitioner (SSP) on 9/1/22 and a witness (W1) on 9/9/22. (No statement was obtained from the alleged perpetrator due to not returning phone calls). (Reference Confidential Names Form LIC 811, dated October 7, 2022). SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Yan Yeung LICENSING EVALUATOR NAME: Winston Moroney LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION LA & TRI-COASTAL CR, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONES 6FACILITY NUMBER: VISIT DATE: 10/07/2022

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

met_with: Ashley MacLearn - Administrator

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Substantiated - 3 allegations

raw_content:
Narrative:
Page The Department received a referral regarding alleged conduct inimical by a facility staff. The referral reported staff (S1) allegedly raped a former client, who is now an adult (A1). S1 denied the allegation. However, S1 confirmed A1 spent the night at his home and slept on his bed on 9/12/23. The investigation revealed S1 did not follow the facility's polices and procedures by fraternizing with A1 while she was placed in the facility via text message using his personal cellular phone. Statements obtained from interviews conducted with facility staff consistently indicated staff are trained to not engage in behavior that may be deemed inappropriate, such as giving clients their personal cellular phone number. Per interviews conducted with staff, staff are reminded of the policy during bi-weekly meetings. Based on S1 admitting he was inappropriate by providing his contact information to A1 while she was a client at the facility and maintained contact with her by calling, texting, and seeing her outside of the facility, all of which was against the facility policy, which he confirmed he was aware of as evidenced by his signed acknowledgement, the allegation is Substantiated. The facility is cited for violation of Interim Licensing Standards, Short Term Residential Therapeutic Program Article 6, standard 87072(c)(15) Personal Rights. S1 violated A1's personal rights by failing to maintain a formal staff/client relationship by fraternizing with A1 while she was a youth placed at the facility. A copy of this report, LIC809D, LIC811 were given to the above mentioned facility representative. Appeals rights were provided. Per the new Civil Penalty laws, Health and Safety (H&S) Code section 1548(E), an Enhanced Civil Penalty (ECP) determination is pending due to the substantiated allegation. If an ECP is warranted, a Community Care Licensing (CCL) representative will return to the facility to deliver the penalty assessment.

Investigation Findings:
13An unannounced follow up complaint inspection was conducted by Licensing Program Analyst (LPA) Christopher Larios on 11/16/23 at 9: AM. During the inspection LPA Larios met with Supervisor Jerrell Jackson. The purpose of the inspection was to deliver findings for the above-mentioned complaint allegation. The investigation was conducted by Community Care Licensing Division (CCLD) Investigations Branch (IB) State Investigator (SI) Romelia Munoz. During the course of the investigation LPA Larios conducted a record review on 9/21/23 and obtained copies of, but not limited to, staff roster and contact information, staff training records, job description, staff evaluations and client roster, needs and services plans and special incident reports. SI Munoz then conducted interviews with one law enforcement officer, two facility managers, a client and an administrator between 9/20/23 and 10/25/23. SI Munoz conducted a record review and obtained copies of a social worker's delivered service log, Kern County Sheriff's report and a signed acknowledgement of the facility policies from a staff's file. Continued on page SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Christopher Larios LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONES 6FACILITY NUMBER: VISIT DATE: 11/16/2023

Allegations:
- SubstantiatedEstimated Days of Completion:
- Estimated Days of Completion:
- Estimated Days of Completion: 0

met_with: Jerrell Jackson


raw_content:
Narrative:
Allegation - Staff do not prevent a minor from threatening another minor. One client stated that the clients were just playing when they threatened to kill each other. Ref. #2 denied threatening anyone. Based upon the interview with the Administrator Fletcher, the clients engaged in regular children's behavior. The Administrator stated that the staff tried to keep Ref. #1 and #2 separated. The LPA received inconsistent information regarding the allegation. Allegation - Staff do not prevent a minor from having access to marijuana. Interviews with the Administrator Fletcher revealed that Ref. #2 smoked in the bedroom at the facility. The Administrator revealed that initially the facility did not have approval to search Ref. #2 when Ref. #2 returned from outside activities, but received approval from the County Social Worker. Once the approval was received Ref. #2 was searched for contraband. The Administrator stated that the situation was referred to mental health services. There was no preponderance of the evidence to substantiate the allegations. So, although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegations are unsubstantiated. There are no deficiencies to be cited regarding these allegations. A copy of this complaint was provided to the facility representative.

Investigation Findings:
13On December 7, 2023 at 2:45 p.m., Licensing Program Analyst (LPA), Karen McGee, delivered the findings of a complaint investigation. The LPA met with Administrator, Tiffany Cotledge. On August 2, 2023, the Monterey Park Children's Residential Program (MPCRP), received a complaint with the above mentioned allegations. Confidential interviews were conducted that included, but were not limited to: Administrator Jeanne Fletcher and two clients, Ref. #1 and #2, at the facility on August 3, 2023; one County Social Worker via telephone on December 5, 2023. After a few attempts the LPA did not receive a call back from the CSW for Ref. #1. The LPA reviewed the Needs & Services Plans and incident reports. Allegation - Staff did not prevent a minor from kicking another minor. The interviews did not reveal evidence that one client kicked the other. The staff did not witness one client kick the other. An interview with the Administrator Fletcher indicated that it was not reported to the staff, so there is no incident report regarding one client kicking the other. There were not witnesses to this allegation. This allegation was not corroborated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Karen McGee LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION LA & TRI-COASTAL CR, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONES 6FACILITY NUMBER: VISIT DATE: 12/07/2023

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

met_with: Tiffany Cotledge


raw_content:
Narrative:
Based upon the inspection and interviews, the complaint findings are unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the allegations occurred. A copy of this report was given to the above representative. No deficiencies were cited.

Investigation Findings:
13On July 1st, 2025, at 12: PM, Licensing Program Analyst (LPA) Ashley Ruacho completed the investigation on the above allegations. While investigating the allegations LPA conducted an inspection to the Short-Term Residential Therapeutic Program (STRTP). LPA toured the facility with the Administrator (AD) and observed that all smoke detectors were installed and in working order on 06/18/25. When speaking with AD the smoke detectors were not removed from the facility but taken down to change the battery and put back up by staff the same day. LPA also observed that one lock on a client bedroom door was reversed and on the outside of the bedroom. AD stated that a previous client had a history of AWOL and stated the door had the lock on the outside to ensure safety of the client and was not for the purpose of locking the client inside the bedroom. Client is no longer at the facility; LPA requested the facility to place the lock back on the proper side. During the visit the AD placed the lock to its original side, inside the bedroom. (See Confidential Names LIC 811 dated July 1st, 2025). Due to the inconsistency of information obtained during the investigation, it cannot be determined whether the above allegations occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tira Logan LICENSING EVALUATOR NAME: Ashley Ruacho LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION LA & TRI-COASTAL CR, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONES 6FACILITY NUMBER: VISIT DATE: 07/01/2025

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

met_with: TIFFANY COTLEDGE - ADMINISTRATOR


raw_content:
Narrative:
LPA conducted an investigation into the aforementioned allegations. This investigation included, but was not limited to, a thorough review of various records, such as the client's needs and service plans, medical records, SIR's and the police report. Additionally, interviews were conducted with three staff members: S1 on 3/6/25, S2 on 3/12/25, and S3 on 4/17/25. Furthermore, two out of four clients were interviewed: C3 on 4/17/25 and C4 on 3/12/25. An interview was also held with one San Bernardino County Social Worker (CSW3) on 4/23/25. It is important to note that no statements were obtained from C1 or C2, as they chose not to provide one. (Reference Confidential Names Form LIC 811, dated June 19, 2025). [The following allegations were reported.] 1. The staff did not provide adequate supervision, resulting in minor AWOLing and engaging in drug use. The staff members (S1, S2, S3) denied the allegations, asserting that the safety of their clients is their utmost priority and that they would never compromise their safety. The staff noted that the facility has between one to three staff members present, depending on the facility's requirements, while adhering to the Short-Term Residential Therapeutic Program (STRTP) Interim Licensing Standards, which stipulate a staff-to-client ratio of 1:4. Additionally, on the day of the alleged incident, February 24, 2025, staff received a call from the school requesting the pickup of clients C1 and C2 due to their cutting class and being caught using a wax pen behind the school. Upon their return from school, C1 and C2 expressed a desire to play basketball in the backyard under the supervision of S3. S3 reported that C1 and C2 hit the ball over the backyard fence and permitted C1 to retrieve it; however, both clients jumped the fence and began to walk away from the STRTP. S3 promptly followed them in the company vehicle and attempted to verbally redirect them to return to the vehicle and go back to the STRTP, but these efforts were unsuccessful. S3 stated that they pursued the clients until they lost sight of them as they ran through fields, neighboring backyards, and crossed a pedestrian bridge. S3 informed S1 that they had lost sight of the clients and quickly contacted local law enforcement to file a missing person's report for both clients. Continued.... S1 and S3 reported that the clients eventually returned to the STRTP on their own, declined any medical attention, and underwent a visual inspection for contraband, which yielded no findings on either C1 or C2. S1 then reached out to law enforcement to notify them of the clients' return to the STRTP. Later that day, a peace officer visited the STRTP to check on and speak with C1 and C2 before leaving shortly thereafter. 2. The staff did not report minors' elopement in a timely manner. The Staff (S1, S2, and S3) refuted the allegation, asserting that all incidents are reported without delay to all relevant agencies. S1 additionally noted that the incident that took place on February 24, 2025, involving C1 and C2 going AWOL was not reported immediately because S3 had visual contact with C1 and C2. Once S3 lost sight of C1 and C2, S1 instructed S3 to search the familiar areas where clients typically go AWOL; however, S3 was unable to find the clients, leading to a missing person's report being submitted to the local law enforcement. S1 emphasized that once a staff member loses sight of said client, staff will adhere to protocol and the Needs and Services of the respective client. S1 mentioned that staff will allow thirty minutes for the client to return before alerting local Law Enforcement. Furthermore, confidential statements acquired from clients C3 and C4 contradicted the allegations, affirming that the facility staff is consistently present and that clients are regularly monitored by the staff. C3 and C4 expressed that they felt secure living at the facility and appreciated the involvement of the facility staff with the clients. Information gathered from CSW3 indicated that they have no issues concerning the care and supervision provided to their clients and that staff would always promptly notify them of any incidents through email or text. Therefore, based on the information received, the above allegation(s) are determined to be unsubstantiated. Although the allegation(s) may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation(s) occurred, therefore, the allegation(s) are found to be unsubstantiated. Appeal Rights were provided and discussed with the STRTP Administrator. There are no deficiencies to be cited at this time. An exit interview was conducted, and a copy of the report along with the (LIC 811) was left with the STRTP Administrator.

Investigation Findings:
13On July 24, 2025, at 10: AM, Licensing Program Analyst (LPA) Winston Moroney carried out an unannounced inspection of the aforementioned Short-Term Residential Therapeutic Program (STRTP) to present the findings related to the stated complaint. LPA engaged with the Administrator of the STRTP and reviewed the results concerning the identified allegation(s). On February 27, 2025, the California Department of Social Services Community Care Licensing Division received a complaint from Centralized Complaint and Information Bureau (CCIB) with the following allegation(s): The staff did not provide adequate supervision, resulting in minor AWOLing and engaging in drug use; the staff did not report minors elopement in a timely manner. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Winston Moroney LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONES 6FACILITY NUMBER: VISIT DATE: 07/24/2025

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

met_with: Tiffany Cotledge - STRTP Administrator


raw_content:
Narrative:
cont.# The information revealed that the staff at this STRTP take most of their training in an online database, while other training is taken in person. The topics of training include, but are not limited to, crisis intervention, emergency procedures, trauma informed care, and regulatory compliance. At the time of the file review the Administrator did not have a current cardiopulmonary resuscitation and first aid certificate. LPA Flores, having considered the evidence provided during the investigation, deemed the allegation substantiated. A citation was issued on LIC809 dated 5/09/2025 for violation of Interim Licensing Standards (ILS), Version 5: Section 87065.1 (b)(8)(A): (A) Completion of cardiopulmonary resuscitation (CPR) and first aid training shall be demonstrated by current and valid CPR and first aid cards issued by the American Red Cross, the American Heart Association, a training program approved by the State Emergency Medical Services Authority pursuant to Health and Safety Code Section 1797.191, or from an accredited college or university. A finding that the complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. No further inspection is needed. A copy of this report, appeal rights and LIC811 was provided to the facility representative. Exit interview conducted.

Investigation Findings:
13On Thursday October 2, 2025, at 12:45PM, Licensing Program Analyst (LPA) Humberto Flores, conducted a follow-up complaint inspection at Beloved Ones Short Term Therapeutic Program (STRTP) and met with Administrator, Tiffany Cotledge. The purpose of the inspection was to deliver the findings for the above complaint allegation. The initial information that generated this complaint investigation stated that staff have not completed the training required at the facility. Reporting Party (RP) states the training is to ensure staff are equipped to handle resident care, crisis intervention, emergency procedures, trauma informed care, and regulatory compliance. RP states that despite multiple email notifications sent to staff, no action has been taken to complete the training from Relias. LPA Flores investigated the allegation and conducted interviews with RP, Administrator, and Executive Director (ED). A review of the Administrator and one Facility Manager Ref (FM) training records was reviewed, and copies were made available. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Humberto Flores LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION MONTEREY PARK CRP RO, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONES 6FACILITY NUMBER: VISIT DATE: 10/02/2025

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

met_with: Administrator, Tiffany Cotledge


summary: Facility Evaluation

raw_content:
Narrative:
On 5/27/21 at 5:30pm, Licensing Program Analyst (LPA) Johanna Lofton made an announced telephone call inspection at Fir Avenue, CA 93505. This facility is located in a residential area. The video call took place with the purpose of conducting a pre-licensing inspection for Beloved Ones 6. The telephone inspection was shown by the Jessica Hatley, Facility Administrator. This facility will be licensed for six (6) male clients. The inspection started at the facility's entrance. LPA Lofton saw and confirmed it was the correct address in a residential neighborhood. This facility is a one story home which consist of six (6) bedrooms, three (3) bathrooms, living room, dining room, kitchen, garage, front yard and backyard. The entrance of the facility will be equipped with thermometer, sanitizer, gloves and forms to check in client, staff and visitors for a Covid-19 symptoms triage. The facility had all utilities turned on and in working order. Smoke and Carbon Monoxide detectors were tested and found to be in working order. LPA observed a fire extinguisher located in the kitchen. Bedrooms #`1, #2, and #3 will be used for clients. Bedrooms #4, #5 and #6 will be use as therapy room, video/game room and office. Clients will have access to two bathrooms. The third bathroom will be for the staff use. Medicine and cleaning supplies will be locked in the hallway closet. There will be no sharp knives or utensils at the facility. All food will be pre-cut. There were no weapons or bodies of water on the premises. The facility is equipped with security sensor alarm for the security of the clients. Facility furniture and appliances were to be moved to the facility on 6/06/21. LPA Lofton will conduct a post- licensing visit for further inspection. Exit interview was conducted and a copy of this report was sent to Facility Director Thandi Smith for review and signature due to Covid-19 restrictions.

report_type: Facility Evaluation

visit_type: Prelicensing

met_with: Jessica Hatley- Facility Administrator


raw_content:
Narrative:
There was a statement that the FM1 told C1 to go outside so they could fight and the FM1 leaned against his chest and pushed him back causing him to fall and break the fence between the facility and the neighbors property. It revealed a statement that FM1 punched C1 causing a bruise on his right eye. An interview of C1 did not reveal a statement from C1 regarding C1's behavior and treatment of C2. The investigation revealed that C1 was upset because C1 was being moved to another facility within the program. It was revealed that C1 was moving for a better cultural experience, and due to C1's disrespect of female staff and previously bullying C2. As C1 was packing his belongings C1 was acting out and the FM1 decided to go outside to take a break from C1. The investigation revealed that C1 followed the FM1 outside, continued acting out and using curse words. C1 admitted to the LPA that he swung at the FM1. The investigation revealed that FM1 and FFM attempted to restrain C1 utilizing Pro-Act and C1 dropped down and the FM, FFM and C1 fell into the fence between the facility and the neighbors property and broke it. An interview with C2 indicated that C2 was not present during the incident. The LPA observed that conflicting statements were given regarding C1 receiving a red mark on his eye. The investigation revealed that California City Police Department was called to the facility, but C1 was uncooperative with the police officer. It revealed that the officer determined that there was no abuse against C1 and no crime was committed. The LPA was unable to obtain sufficient evidence to corroborate the allegations. There was no preponderance of the evidence to substantiate the allegations. So, although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegations are unsubstantiated. There are no deficiencies to be cited regarding these allegations. A copy of this complaint was provided to the facility representative.

Investigation Findings:
13On March 20, 2026 at 3:05 p.m., Licensing Program Analyst (LPA), Karen McGee, delivered the findings of a the complaint investigation to the facility. The LPA met with Administrator, Tiffany Cotledge. On October 17, 2025, Monterey Park Children's Residential Program (MPCRP), received a complaint with the above mentioned allegation. Confidential interviews were conducted that included, but were not limited to: Client (C2) at the facility on November 25, 2025; the Client (C1) on February 12, 2025 at the new placement; Facility Manager (FM1), Demetris Hall, via telephone o n March 10, 2026; Weekend Administrator, Carneisha Forney and the primary County Social Worker, on March 12, 2026 via telephone; the Administrator on March 13, 2026 via telephone. The LPA reviewed the following documents: Unusual Incident/Injury Report; Appraisal/Needs and Services Plan; Emergency Response Notice of Referral Disposition; Photographs; Investigation Narrative; California City Police Department Report. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Karen McGee LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION MONTEREY PARK CRP RO, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONES 6FACILITY NUMBER: VISIT DATE: 03/20/2026

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


facility_name: BELOVED ONES 7

raw_content:
Narrative:
Based upon the inspection and interviews, the complaint findings are unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the allegations occurred. A copy of this report was given to the above representative. No deficiencies were cited.

Investigation Findings:
13On July 1st, 2025, at 1: PM, Licensing Program Analyst (LPA) Ashley Ruacho completed the investigation on the above allegations. While investigating the allegations LPA conducted an inspection to the Short-Term Residential Therapeutic Program (STRTP). On 06/18/ LPA toured the facility with the Administrator (AD) and observed that one lock on a client bedroom door was reversed and on the outside of the bedroom. AD stated the door had the lock on the outside due to the clients' issues with self-harm and was not for the purpose of locking the client inside the bedroom. LPA requested the facility to place the lock back on the proper side. During the visit AD provided LPA Ruacho with a copy of a work order to change the doorknob. On 06/25/ AD emailed LPA a copy of the completed work order that showed the lock was placed back to the proper side on 06/22/25. On 07/01/ LPA verified the client's door and observed the lock to be on the proper side. (See Confidential Names LIC 811 dated July 1st, 2025). Due to the inconsistency of information obtained during the investigation, it cannot be determined whether the above allegations occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tira Logan LICENSING EVALUATOR NAME: Ashley Ruacho LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION LA & TRI-COASTAL CR, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONES 7FACILITY NUMBER: VISIT DATE: 07/01/2025

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

met_with: Willy Ayala - Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On November 10, 2022, Licensing Program Analysts (LPAs) Johanna Lofton and Demetris Teal made an announced visit to the above named facility with the purpose of conducting a pre-licensing inspection to relocate the facility from Sierra Road, California City, CA 93505 to Hemlock Avenue, California City, CA 93505. LPAs met with Administrator Ashley Mac Learn and toured the facility. This facility is located in a residential area. This facility will be licensed for six (6) female clients. This facility is a one-story home which consist of three (3) bedrooms, two (2) bathrooms, living room, dining room, kitchen, front yard and backyard. Medication will be placed in facility's entrance closet with which will be locked at all times and only staff will have access to it. During the inspection LPA's observed all utilities were on. Phone line was available at facility. Carbon monoxide and smoke detectors were in working condition. Backyard was clean and free of debris. Alley's were not obstructed. Fire extinguisher was available at the facility. The shed in the back was clean and free of debris. The facility is ready for move-in on Saturday, 11-12-22. Exit interview was conducted and a copy was left at the facility

met_with: Ashley Mac Learn-Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 05/10/23 at 9: AM, Licensing Program Analyst (LPA) Pamela Silva conducted an unannounced Post Licensing inspection at the facility. LPA met with Cindi Bertrand, Administrator. The facility currently has a provisional Short Term Residential Therapeutic Program (STRTP) license. The STRTP's Mental Health Program Application is pending approval. This STRTP is licensed to serve up to six (6) ambulatory children ages 7-17 years of age. The facility also provides services to non-minor dependents pursuant to W&I Code 16501.1 (C)(1). There are two (2) minors currently in placement. LPA requested the following: Personnel Report LIC500, Client Roster, Board of Meeting Minutes, Clients and Staff Files. This facility is a one-story 3-bedroom home with two (2) bathrooms. There are no bodies of water on the premises. There are no firearms or ammunition in the facility. At AM, LPA conducted a walk-through of the entire facility. Physical Plant The license, facility sketch, personal rights, emergency disaster form, complaints poster, emergency phone numbers and food menu are posted in a prominent, publicly accessible location in the facility. Disinfectants, cleaning solutions and sharps are kept inaccessible in a locked closet. Facility has non-perishable food for at least one week and perishable food for at least two days. Medications are centrally stored in a locked storage room. Smoke and carbon monoxide detectors were tested and in proper working order. Fire extinguishers were fully charged. A First Aid kit is available. Room temperatures are maintained at 76 degrees F. The hot water temperature was tested and measured at 112 degrees F. All sinks, showers and toilets were in working order. No more than 2 children share a bedroom. All beds are in good repair; equipped with good springs, clean mattresses and pillows. Adequate supply of beddings and linens were observed. Facility provides age-appropriate clothing items and hygiene products. Overall, facility is clean, safe, sanitary and in good repair. Operations Facility maintains a register of clients and the register is available upon request. The board of directors regularly conduct meetings to review and discuss the STRTP's operation. The facility administrator and manager are the responsible and capable staff for communicating with emergency personnel in the facility. The facility has developed, maintained and implemented written complaint procedures. Core/Therapeutic Services Facility provides core services and supports to children and non-minor dependents as appropriate or necessary that are trauma informed, culturally relevant, age and developmentally appropriate and include the following: Medi-Cal specialty mental health services; transition support services; educational and physical, behavioral, and mental health supports; activities to support children and non-minor dependents and services to achieve permanency. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill at least quarterly for each shift. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Needs and Services Plan for each client, medication records, and contact information for each client's responsible party and physician. Client Records LPA reviewed two (2) client records. All client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to, consent forms, court orders, needs and services plan, medical assessment; safeguards for cash resources, personal property and valuables; education records; personal rights forms; removal/discipline/complaints form and medication administration records. Staff Records LPA reviewed two (2) staff records. All staff have been subjected to criminal records review and have been fingerprinted and cleared with DOJ, FBI and CACI. Documentation of the required education and experience requirements are maintained in the personnel file. Documentation of staff training are on file. LPA interviewed two (2) staff members. The two (2) clients were not available for interview at the time of inspection. No deficiency citation is being issued during today's inspection. An exit interview was conducted, and a signed copy of this report was provided to the facility representative.

met_with: Cindi Bertrand


summary: Facility Evaluation

raw_content:
Narrative:
On 10/19/2023 at 9: AM, Licensing Program Analyst (LPA) Pamela Silva conducted an unannounced Annual Required inspection at the facility. LPA met with Phillip Cook, Supervising Facility Manager. The facility currently has a provisional Short Term Residential Therapeutic Program (STRTP) license. The STRTP has obtained Mental Health Program Approval and CARF Accreditation. This STRTP is licensed to serve up to six (6) ambulatory children ages 7-17 years of age. The facility also provides services to non-minor dependents pursuant to W&I Code 16501.1 (C)(1). There are two (2) minors currently in placement. LPA requested the following: Personnel Report LIC500, Client Roster, Board of Meeting Minutes, Clients and Staff Files. This facility is a one-story 3-bedroom home with two (2) bathrooms. There are no bodies of water on the premises. There are no firearms or ammunition in the facility. At 9: AM, LPA conducted a walk-through of the entire facility. Physical Plant The license, facility sketch, personal rights, emergency disaster form, complaints poster, emergency phone numbers and food menu are posted in a prominent, publicly accessible location in the facility. Disinfectants, cleaning solutions and sharps are kept inaccessible in a locked closet. Facility has non-perishable food for at least one week and perishable food for at least two days. Medications are centrally stored in a locked cabinet/safe inside the staff office. Smoke and carbon monoxide detectors were tested and in proper working order. The fire extinguishers were fully charged. A First Aid kit is available. Room temperatures are maintained at 76 degrees F. The hot water temperature was tested and measured at 115 degrees F. All sinks, showers and toilets were in working order. No more than 2 children share a bedroom. All beds are in good repair; equipped with good springs, clean mattresses, and pillows. There was an adequate supply of bed linens. Facility provides age-appropriate clothing items and hygiene products. Overall, the facility is clean, safe, sanitary and in good repair. Operations Facility maintains a register of clients and the register is available upon request. The board of directors regularly conducts meetings to review and discuss the STRTP's operation. The facility administrator and manager are the responsible and capable staff for communicating with emergency personnel in the facility. The facility has developed, maintained, and implemented written complaint procedures. Core/Therapeutic Services Facility provides core services and supports to children and non-minor dependents as appropriate or necessary that are trauma informed, culturally relevant, age and developmentally appropriate and include the following: Medi-Cal specialty mental health services; transition support services; educational and physical, behavioral, and mental health supports; activities to support children and non-minor dependents and services to achieve permanency. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill at least quarterly for each shift. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Needs and Services Plan for each client, medication records, and contact information for each client's responsible party and physician. Client Records LPA reviewed two (2) client records. All client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to, consent forms, court orders, needs and services plan, medical assessment; safeguards for cash resources, personal property and valuables; education records; personal rights forms; removal/discipline/complaints form and medication administration records. Staff Records LPA reviewed three (3) staff records. All staff have been subjected to criminal records review and have been fingerprinted and cleared with DOJ, FBI and CACI. Documentation of the required education and experience requirements is maintained in the personnel file. Documentation of staff training is on file. LPA interviewed two (2) staff members. The two (2) clients were not available for interview at the time of inspection. No deficiency citation is being issued during today's inspection. An exit interview was conducted, and a signed copy of this report was provided to the facility representative.

visit_type: Annual

met_with: Phillip Cook


summary: Facility Evaluation

raw_content:
Narrative:
On Monday 19, 2025, at 4:00PM, Licensing Program Analyst (LPA) Humberto Flores, conducted a Case Management inspection at Beloved Ones Short Term Residential Therapeutic Program (STRTP) and met with Administrator Kenny Herrera. The purpose of the inspection was to conduct a criminal record review of all staff working at the facility. LPA Flores obtained a copy of the LIC Personnel Report and conducted a search and review in Guardian. The information revealed that all twenty-one (21) employees listed in the LIC500 dated 05/01/2025, have a criminal record clearance from the Department of Justice (DOJ), Federal Bureau of Investigation (FBI) and Child Abuse Central Index (CACI), prior to the staff's employment. No further inspection is needed. No citation was issued. A copy of this report was provided, via email, to the STRTP representative. Exit interview conducted.

visit_type: Case Management

met_with: Administrator, Kenny Herrera


summary: Facility Evaluation

raw_content:
Narrative:
On 10/02/24 at 9: AM, Licensing Program Analyst (LPA) Pamela Silva conducted an unannounced case management inspection at the above facility and met with Interim Administrator, Phillip Cook. The purpose of the inspection is to follow up on a Special Incident Report (SIR) received by the Department on 09/11/24. The incident indicated that staff S1 grabbed client C1's arms from behind in an attempt to remove a pencil that may be used as a weapon, which resulted to C1 falling and sustaining a nosebleed (refer to Confidential Names List LIC811 dated 10/02/24). LPA Silva reviewed the SIR and a video recording, and conducted telephone interviews with two (2) staff members on 09/12/24 and 09/13/24. The incident started when C1 got upset when the wi-fi was turned off at 12PM, in accordance with facility house rules. C1 became agitated and started to throw things and was threatening to stab staff with a colored pencil. As C1 turned her back from S1 and was walking away, S1 grabbed both arms behind C1's back in an attempt, to take the colored pencil from C1. S1 then tried to take C1 down on the couch while still holding C1's arms behind him/her. C1 fell on the couch face first, which resulted to C1 sustaining a nosebleed. S1 was able to remove the pencil from C1 after she fell. According to S1, he removed the pencil from C1 to prevent C1 from harming or stabbing herself and another staff S2. S2 stated that she did not witness the incident from when S1 took C1 to the couch to C1 falling on the couch. C1 was given an ice pack for the nosebleed. C1 was offered further medical attention but C1 refused. Staff monitored C1's nosebleed. Based on the information gathered from confidential interviews and records reviewed, a deficiency citation on STRTP Interim Licensing Standards, Personal Rights Section 87072(c )(32) is being issued (see LIC809D). A Technical Violation on Title Division 6, Chapter 1, Article Section Inspection Authority of the Licensing Agency, is also being issued (see LIC9102TV). An exit interview was conducted and a copy of this report and appeal rights were provided to Mr. Cook.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Pamela Silva and Juliet Robles on 10/11/24 at 9: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPAs met with Interim Administrator, Phillip Cook, and inspected the facility inside and out. LPAs reviewed two (2) of children's records and three (3) of staff personnel files on site at the facility. LPAs reviewed two (2) of child's psychotropic medications and medication records. LPAs interviewed two (2) of staff on site to discuss the facility's policies and procedures of operation. LPAs interviewed one (1) of child currently prescribed psychotropic medications. During the inspection, LPAs observed deficiency (see attached 809-D). Plan of correction was discussed, and appeal rights were provided. LPAs provided a copy of this licensing report to the Interim Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On February 25, 2026 at 8: AM, Licensing Program Analyst (LPA) Pamela Silva conducted an unannounced Annual Random inspection at the above facility and met with Willy Ayala, Administrator. This STRTP is licensed to serve up to two (2) children ages 7-17 years of age. The facility also provides services to non-minor dependents pursuant to W&I Code 16501.1 (C)(1). There are two (2) minors currently in placement LPA obtained and reviewed the following updated documentation: · LIC Personnel, Client Roster · LIC C Emergency Disaster Plan/Mass Casualty Plan · Current Board Meeting Minutes · Continuous Quality Improvement Report The Compliance and Regulatory Enforcement (CARE) Tool was used by the LPA during today's inspection which consisted of a review of the following domains: Physical Plant, Operations, Disaster Preparedness Plan, Staff Files, Client Files, Core Therapeutic Services and Emergency Intervention Plan. LPA conducted a physical plant inspection. This facility is a one-story 2-bedroom home with two (2) bathrooms. There are no bodies of water on the premises. There are no firearms or ammunition in the facility. Overall, the facility is clean, sanitary and in good condition. However, during the inspection, LPA observed that the hot water temperature measured at 135 degrees F, see LIC809D. LPA reviewed two (2) client records and three (3) staff records. All staff have been subjected to criminal records review and have been fingerprinted and cleared with DOJ, FBI and CACI. Documentation of initial and annual staff training, including training on emergency intervention, is on file. Two (2) staff members were interviewed. LPA interviewed one (1) client. One client was unavailable for interview due to being taken to the hospital at the time of inspection. An exit interview was conducted and a plan of correction was discussed with the Administrator. A signed copy of this report was provided to the Administrator along with the LIC809, LIC809D, LIC9102TVs and appeal rights were provided.

met_with: Willy Ayala


summary: Facility Evaluation

raw_content:
Narrative:
On March 1, 2022 at approximately 2: PM, Licensing Program Analyst (LPA) Jean Herring conducted an announced pre-licensing inspection of the facility. LPA met and toured the facility with Thandi Smith, Administrator. This Short-Term Residential Therapeutic Program is a one-story facility located in a residential area. The facility consists of 3 bedrooms and 2 full bathrooms, living and dining areas, kitchen, laundry room and garage. The home also has an empty barn in the backyard. Overall, the facility is clean, safe, sanitary, and in good repair. All passageways are unobstructed and all doors open freely. There are no bodies of water in the facility. At the time of inspection, the following was observed: The fire extinguisher located in the kitchen is fully charged. The facility has central AC and heating units. The water temperature is within the mandated range. Fire alarms, thermostats and carbon monoxide units are observed to be operational. Each bedroom is furnished with 2 beds and adequate closet/drawer space. Staff records, client files and medications will be centrally stored and locked in the cabinet located in the laundry room. There's also a locked file cabinet in the living room. Disinfectants and other toxic materials will be locked in the laundry area. The home is furnished with sofa, chairs, tables, kitchen appliances, TVs, washer and dryer, beds and dressers. The facility has surveillance cameras installed in the front and back patios, garage, kitchen, living area, laundry and hallways. The facility received its fire clearance on 2/28/22. (page 1 of 3) The following buildings and grounds issues need to be corrected: Applicant submitted an application to be licensed for a capacity of eight (8) but the home only has 3 bedrooms. Applicant stated that the living area next to the laundry will be converted into a bedroom. LPA observed 2 beds in the living area mentioned. Applicant also stated that the garage will be converted into an activity room. LPA observed exposed nails/screws in the drywall and exposed electrical outlets in the garage. Applicant stated he will purchase a safe box for medications. Door knobs in both bathrooms won't lock. Propane tank in the backyard needs to be locked. The following documents were received prior to the pre-licensing inspection: LIC 200 - Application for CCF (needs revision) LIC 308 - Designation of Facility Responsibility LIC 309 - Administrative Organization LIC 401 - Monthly Operating Expenses LIC 508 - Criminal Record Clearance LIC 610C - Emergency Disaster Plan LIC 999 - Facility Sketch (needs revision) Control of Property (Lease Agreement) Prior to this inspection, the applicant was advised to submit the following missing documents: Copy of Orientation Certificate Copy of STRTP Administrator Certificate County Letter of Recommendation LIC 215 - Applicant Information LIC 400 - Affidavit Regarding Client Cash Resources LIC 402 - Surety Bond LIC 401A - Supplemental Financial Information LIC 403 - Balance Sheet LIC 403A - Balance Sheet Supplemental Schedule LIC 500 - Personnel Report (page 2 of 3) LIC 501 - Personnel Record LIC 503 - Health Screening LIC 9165 - Board of Directors Statement The Department has not received the missing documents mentioned above. The applicant will submit the documents in the next 7 days. A follow up pre-licensing inspection is required to verify corrections on the physical plant issues noted. A signed copy of this report was provided to the applicant. (page 3 of 3)

met_with: Thandi Smith, Applicant


summary: Facility Evaluation

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Narrative:
On March 22, 2022 at 10: AM, Licensing Program Analyst (LPA) Jean Herring conducted an announced Pre-licensing- Continuation inspection of the facility. LPA met and toured the facility with Thandi Smith, Administrator. The purpose of this inspection was to follow up on Buildings and Grounds issues observed during the initial Pre-licensing inspection conducted on 03/01/22. The following corrections to the buildings and grounds were observed: The living area next to the laundry has been converted into a bedroom adding a 4th bedroom to a 3-bedroom house. It must be noted that the applicant submitted an application to be licensed for a capacity of eight (8). This added bedroom is furnished with 2 beds, 2 drawer dressers, and TVs. The applicant was advised to add a closet/wardrobe to the bedroom. A picture of the closet will be emailed to LPA. The garage has been converted into a recreation/activity room. There were no exposed nails or electrical outlets observed. LPA observed a few sport/exercise equipment in the garage. LPA observed a safe box for medications in the laundry closet. Door knobs in both bathrooms have been repaired. The facility has a propane tank in the backyard that's secured with a combination lock. The following additional required documents were submitted by the applicant: Copy of Orientation Certificate County Letter of Recommendation LIC 200 - Application for a CCF (Revised) LIC 215 - Applicant Information (See Continuation page) LIC 400 - Affidavit Regarding Client Cash Resources LIC 401 - Monthly Operating Expenses LIC 401A - Supplemental Financial Information LIC 403 - Balance Sheet LIC 403A - Balance Sheet Supplemental Schedule LIC 500 - Personnel Report LIC 501 - Personnel Record The applicant will submit the following required documents by 3/25/22: Copy of current STRTP Administrator Certificate LIC 402 - Surety Bond LIC 9165 - Board of Directors Statement Procedures for use of surveillance cameras Facility will provide the following information regarding use of your surveillance cameras: - reason for installing surveillance cameras - identify the areas where cameras are installed - procedures for operation of the cameras (e.g. who has access to recordings/footage; recording mode; how information obtained through video monitoring will be used; procedures for storing recorded information) - procedures to ensure that children's personal rights are not violated (e.g. no audio capability) - appropriate signage to provide notice of the security cameras in the facility The applicant will also submit pictures showing A signed copy of this report was provided to the applicant.


facility_name: BELOVED ONES 8

raw_content:
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: Desiree Terry


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Narrative:
continued from LIC Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that staff spoke to minor in an inappropriate manner. Therefore, the above allegation is UNSUBSTANTIATED. Regarding the allegation that staff handled minor in a rough manner: During the course of the investigation, LPA Karkazis conducted confidential interviews, document research, and facility video surveillance review. During confidential interviews with staff and clients, a youth stated staff have never handled her in a rough manner. All staff interviewed stated they use de-escalation techniques, redirection, and restraints as last resort. Staff stated that the youth pulled staff's hair, and pulled staff on top of the youth, and could not get off of her until the youth let go of staff's hair. Once the youth let go, staff immediately got off of the youth. LPA viewed video surveillance and witnessed staff using de-escalation, redirection, and proper restraint holds, ensuring client and staff safety. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that staff handled minor in a rough manner. Therefore, the above allegation is UNSUBSTANTIATED. Regarding the allegation that medical attention was refused to a minor in care: LPA Karkazis conducted confidential interviews and document research. During confidential interviews with staff and clients, the youth stated that she has never been denied medical attention during the incident or any other time while residing at this facility. Staff stated that during the incident, the youth was combative and destructive in the presence of law enforcement. Law enforcement tried to determine if the youth needed a psychiatric evaluation. Staff stated to law enforcement that the youth's behavior is normal, and will return to baseline behavior, in which she did. Staff told law enforcement that a psychiatric evaluation was not necessary. During document research, LPA found that there was no evidence of injury, no need for medical attention, and no medical attention refused. However, the youth did not speak directly to law enforcement to refuse psychiatric attention, meaning the staff statements to law enforcement could be perceived as speaking on behalf of the youth. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that medical attention was refused to a minor in care. Therefore, the above allegation is UNSUBSTANTIATED. An exit interview was conducted and a copy of this report was given to Desiree Terry, Facility Administrator whose signature confirms its receipt.

Investigation Findings:
13On 3-22-23 11:24AM, Licensing Program Analyst (LPA) George Karkazis conducted an unannounced follow up inspection at the Beloved One's 8, and met with Desiree Terry, Facility Administrator. The purpose of the inspection was to deliver the findings for the above complaint allegation. Regarding the allegation staff spoke to minor in an inappropriate manner: During the course of the investigation, LPA Karkazis conducted confidential interviews, document research, and facility video surveillance review. During confidential interviews with staff and clients, a youth stated that staff do cuss when participants are out of task. Interviews cannot confirm when staff cussed at her, what they said, who said, and how many times. All staff interviewed stated that they never yell or speak inappropriately to clients. During document research, LPA found no evidence of staff speaking to minor inappropriately. Video surveillance footage does not provide audio. continued on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: George Karkazis 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 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CENTRAL COAST SC/RES, TRAEGER AVE., SUITE FACILITY NAME: BELOVED ONES 8FACILITY NUMBER: VISIT DATE: 03/22/2023

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

met_with: Desiree Terry, Facility Administrator


raw_content:
Narrative:
continued from LIC Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove that staff handled minor in a rough manner. Therefore, the allegation is UNSUBSTANTIATED. Regarding the allegation that staff do not give minor privacy while taking a shower: During the course of the investigation, LPA Karkazis conducted confidential interviews, document research, and facility video surveillance review. During confidential interviews with staff and youths, a youth stated that she does not know when staff watch her shower, how many times it happened, and cannot provide a description of the staff member. All staff interviewed stated that they are not allowed in the bathroom while a client is inside. All staff stated that they have never entered while a client showers, or while a youth is in the bathroom. During document research , LPA found no evidence of staff entering the bathroom while a youth was inside. During video surveillance review, LPA found no evidence of staff entering the bathroom while a youth was in the bathroom. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove that staff do not give minor privacy while taking a shower. Therefore, the allegation is UNSUBSTANTIATED. An exit interview was conducted and a copy of this report was given to Desiree Terry, Facility Administrator whose signature confirms its receipt.

Investigation Findings:
13On 3-22-23 12:30PM, Licensing Program Analyst (LPA) George Karkazis conducted an unannounced follow up inspection at the Beloved Ones's 8, and met with Desiree Terry, Facility Administrator. The purpose of the inspection was to deliver the findings for the above complaint allegations. Regarding the allegation of staff handled minor in a rough manner: During the course of the investigation, LPA Karkazis conducted confidential interviews, document research, and facility video surveillance review. Based on confidential interviews with staff and youths, it was disclosed that a staff pushed and touched a client inappropriately. The youth could not recall exactly where she was touched, when it happened, and gave a vague description of the person. This only happened one time. During confidential interviews staff stated that there are occasional pillow fights with youths. Staff stated that they never touched clients, only tap the pillow below the waist, aiming for legs, avoiding all inappropriate areas. During video surveillance review, LPA found no evidence of staff inappropriately handling minor in a rough manner. continued on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: George Karkazis 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 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CENTRAL COAST SC/RES, TRAEGER AVE., SUITE FACILITY NAME: BELOVED ONES 8FACILITY NUMBER: VISIT DATE: 03/22/2023

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


raw_content:
Investigation Findings:
13On 4/27/23 at 10: AM, Licensing Program Analyst (LPA) Alyssa Ng conducted a complaint inspection at Beloved Ones 8 and spoke with Desiree Terry, Administrator. The purpose of the inspection was to deliver the findings for the above complaint allegation. This complaint was taken as an assignment by Community Care Licensing's (CCL's) Investigations Branch (IB) on 02/28/2023. Complaint was upgraded to a full investigation on 03/08/2023 and assigned to Inv. Sergio Guerra. During investigation, interviews were conducted, photos obtained, and incident reports were reviewed, and it was determined that staff caused injuries to a minor while in care. The preponderance of evidence standard has been met, therefore the above allegation, staff caused injuries to a minor while in care is found to be SUBSTANTIATED. Facility is being cited for violation of California Code of Regulations (CCR), Title 22, Division 6 & Chapter 1: 80072(a)(3) Personal Rights. Please refer to attached 9099D. An exit interview was conducted, and a copy of this report was given to Desiree Terry, Administrator. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Alyssa Ng 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 14-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, TRAEGER AVE., SUITE FACILITY NAME: BELOVED ONES 8FACILITY NUMBER: 075650164

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


raw_content:
Investigation Findings:
13On 7/3/23 at 11: AM, Licensing Program Analyst (LPA) Alyssa Ng conducted a complaint inspection at Beloved Ones-8 and spoke with Desiree Terry, Administrator. The purpose of the inspection was to deliver the findings for the above complaint allegations. During investigation, confidential interviews were conducted, incident reports were reviewed, and it was determined that staff did not physically abuse minor while in care, staff did not handle minor in a rough manner, and staff did not confiscate minor's personal belongings. Although, the allegation may have happened or is valid, there is not a preponderance of the evidence to prove Staff physically abused minor while in care, Staff handled minor in a rough manner, and Staff confiscated minor's personal belongings. Therefore, the above allegations are unsubstantiated. An exit interview was conducted, and a copy of this report was given to Desiree Terry, Administrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Alyssa Ng 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

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


raw_content:
Investigation Findings:
13On 11/29/23 at 12: PM Licensing Program Analysts (LPA's) Celeste Aparicio and Mariah Hawkins made an unannounced inspection to the facility for the purpose of delivering findings from a complaint investigation. LPA's met with Administrator Desiree Terry, and informed her on the purpose of this visit. Based on LPA's observations, record review, and interviews, a resident in care sustained bruising on their arm following an improper restraint performed by staff. Witness statements reflect that the bruising was not observed prior to the restraint incident and was observed after the incident. The preponderance of evidence standard has been met, and therefore the above allegation is found to be substantiated. LPA is issuing a citation of 87095.01(b). An exit interview was conducted, appeal rights were provided, and a copy of this report was left with Administrator Desiree Terry, whose signature on this form confirms receipt. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lidia Tinoco LICENSING EVALUATOR NAME: Celeste Aparicio 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 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO RO, TRAEGER AVE., SUITE FACILITY NAME: BELOVED ONES 8FACILITY NUMBER: 075650164

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

met_with: Administrator Desiree Terry


raw_content:
Investigation Findings:
13On 2-21-24 11:21AM, Licensing Program Analysts (LPA's) George Karkazis and Jasmine Cardeno conducted an unannounced inspection at Beloved Ones 8, and met with Desiree Terry, Administrator, who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. The complaint alleged staff physically assaulted a minor which resulted in an injury. LPA's Karkazis and Cardeno conducted confidential interviews, viewed video surveillance, and conducted document research, in which inconsistent information was provided. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegation occurred. Therefore, the allegation is UNSUBSTANTIATED. A copy of this report was given to Desiree Terry, Administrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: George Karkazis 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: Desiree Terry, Administrator


raw_content:
Narrative:
An exit interview was conducted, appeal rights discussed and a copy of this report was left with Facility Administrator whose signature on this form confirms receipt.

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:


summary: Facility Evaluation

raw_content:
Narrative:
*Amended to document signatures 5/22/2026* On 5/15/26 at 11:40AM, Licensing Program Analyst (LPA) Kaitlyn Wong made an unannounced inspection at the facility to conduct a required annual inspection. LPA met with Monique Garrett and informed of the purpose of the visit. Desiree Terry, Administrator, assisted in the conclusion of the inspection. The Short Term Residential Therapeutic Program (STRTP) is licensed to provide care for 6 ambulatory clients ages 7- At the time of the inspection there was 1 staff and 0 clients present. During inspection 1 staff and 1 client arrived at the facility. LPA used the CARE inspection tool and conducted file review. reviewed the plan of operations to meet all standards and fire clearance to be maintained, and the facility has recently received their mental health program approval. The board of directors conduct quarterly meetings. A set of keys for facility vehicles and exits are available in the facility. The facility had a metal complaint box removed from the wall due to a previous client escalation. The facility reviews complaint procedures with clients but does not have complaint procedures posted. The facility posted the complaint procedures during the inspection. One Technical Violation was issued for Interim Licensing Standards (ILS) Section 87072.2(a)(3) Complaint Procedures. Disaster preparedness drills are conducted on a monthly basis. The log of the most recent drill was conducted on 4/21/2026. Previous logs were maintained posted on the wall but were destroyed during a previous client escalation. The facility plans to maintain future disaster drills in a binder. LPA is issuing one Technical Violation for California Code of Regulations (CCR) Section 80023(d)(2) Disaster and Mass Casualty Plan. [Continued on LIC 809-C] LPA inspected the emergency intervention plans of the facility. Manual restraints have not been used by the facility within the past year. However, the facility maintains record of past manual restraints in a monthly log and staff are currently provided training on emergency intervention techniques. The facility has an on-call nurse available 24 hours, 7 days a week for medical emergencies. LPA concluded the inspection using the CARE tools. At this time, the facility is issued two Technical Violations (See attached LIC9012 for details). The annual inspection is complete. An exit interview was conducted, appeal rights provided, and a copy of this report was left with Monique Garrett, Administrator, whose signature on this form confirms receipt.

met_with: Monique Garrett, Administrator and Desiree Terry, Adminstrator


summary: Facility Evaluation

raw_content:
Narrative:
On May 22, 2026 at 10:50AM, Licensing Program Analyst (LPA) Kaitlyn Wong made an unannounced inspection at the above facility for a case management. LPA met with Desiree Terry, Administrator, and informed them of the purpose of the visit. At the time of the inspection there were 3 staff and 2 clients present. The facility informed LPA that the clients did not have school due to holiday. The purpose of the the inspection was to collect signatures on an amended document. Signatures were obtained, and missing signatures thereafter were signed on the physical report left with the facility. No deficiencies were found at this time. An exit interview was conducted, and a copy of this report was emailed with Desiree Terry, Administrator, whose signature on this form confirms receipt.


facility_name: BELOVED ONES 9

raw_content:
Investigation Findings:
13On 12/14/22 at TIME, Licensing Program Analyst (LPA) Alyssa Ng conducted a complaint inspection at Beloved Ones 9 and spoke with Desiree Terry, Facility Manager. The purpose of the inspection was to deliver the findings for the above complaint allegations. During investigation, interviews were conducted, and documents were reviewed, and it was determined that staff did not prevent minor from operating a vehicle, staff threatened minor, and staff made inappropriate comment towards minor. Based on LPA's interview with staff, client, and record review(s), the preponderance of evidence standard has been met, therefore the above allegations, staff did not prevent minor from operating a vehicle, staff threatened minor, and staff made inappropriate comment towards minor is found to be SUBSTANTIATED. Facility is being cited for violation of California Code of Regulations (CCR), Title 22, Division 6 & Chapter 1: 80078(a) - Responsibility for Providing Care and Supervision and 80072(1) - Personal Rights. See the attached LIC9099-D for details. At this time, two deficiencies were given. An exit interview was conducted, appeal rights provided and discussed, and a copy of this report was sent to Desiree Terry, Facility Manager. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Alyssa Ng 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 14-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, TRAEGER AVE., SUITE FACILITY NAME: BELOVED ONES 9FACILITY NUMBER: 075650165

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


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

met_with: Supervising Facility Manager (SFM) Quaneda Morris