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Narrative:
information for C1, but might have delayed in doing so due to the high stress situation caused by the incident. According to confidential interview, S1 obtained permission from hospital and group home staff, prior to leaving C1 under the care of hospital medical staff. Confidential interviews also stated that once a staff leaves a client at the hospital there is always a staff designated to be on call for any questions, client discharge, or medical emergency. While other confidential information received by Licensing Office stated that these allegations had occurred, and that S1 left C1 at the hospital without approval after stating that they did not want to be around the "crazy people." Confidential information received also stated that staff was unable to provide some of C1's medical information for the Centralized Assessment Team (CAT) upon request. LPAs were unable to interview C1, due to legal guardian's refusal to allow LPA Mena to speak to C1 regarding these allegations. LPA Mena observed that C1 was the only child placed at the facility at the time of these allegations. There were no other witnesses to the allegations. Based on confidential interviews, the allegations that Facility Staff # 1 (S1) did not provide adequate care and supervision after leaving group home child # 1 (C1) alone in the hospital emergency room, and that facility staff # 1 (S1) did not have C1's medical information available for emergency personnel, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Lead Staff, Aime Rodriguez to issue the findings for the above stated allegations. An investigation was conducted by LPAs Michael Almaraz and Daniel Mena regarding allegations. LPAs conducted an investigation to the facility on July 14, 2021 at 11:00am, and on March 04, 2022 at 9:02am. No immediate hazards observed. LPAs interviewed seven staff (S1, S2, S3, S4, S5, S6 & S7), as well as reviewed client and facility records. Community Care Licensing received information on July 06, 2021 alleging that Facility Staff # 1 (S1) did not provide adequate care and supervision after leaving group home child # 1 (C1) alone in the hospital emergency room, and that facility staff # 1 (S1) did not have C1's medical information available for emergency personnel. Information obtained in confidential interviews did not corroborate the allegations with a preponderance of evidence. Confidential interviews denied allegations that staff was unable to provide medical information for C1, or that C1 was left alone in the hospital emergency room. According to confidential interviews, S1 did provide the medical UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: SAILS MARK VFACILITY NUMBER: VISIT DATE: 03/16/2022

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

met_with: Aime Rodriguez


state: CA

facility_name: SAILS OC CRISIS

summary: Complaint Investigation - Unsubstantiated - 1 allegation

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Narrative:
involved parties are aware of the behaviors. It was also reported that Client #2 wears too big, dirty, and clothing that has holes in it. It was also advised that Client #2 only has one pair of shoes and the sole is coming off. Information obtained stated that Client #2 has a lot of clothing and there are no clothes in disrepair. Staff members were unable to provide when the last time Client #2 had new clothing purchased for them. Staff was unable to provide the information, but reiterated that Client #2 had a lot of clothes. Client #2's County Social Worker stated there were no concerns regarding Client #2's clothing. It was also advised that Client #2 had an odor from his body and mouth. It was also advised that it appeared that Client #2 had not had a haircut in months. Staff stated Client #2 is bathed and brushes their teeth twice a day. Staff stated Client #2 was taken to the doctor and dentist on numerous occasions due to Client #2's body odor. Staff stated after being evaluated, medical personnel stated there were no concerns and it is normal due to the medication that Client #2 takes. Client #2's County Social Worker corroborated the information and stated there were no concerns regarding Client #2's health. LPA received inconsistent information regarding the allegation. According to facility records and interviews Client #2 needs are being met. Based on interviews and information obtained, Client #2 sustained unexplained injuries, Client #2 does not have appropriate sized clothes, shoes have holes, and staff are not managing Client #2's hygiene, may or may not have occurred; therefore, the allegations are unsubstantiated at this time. Exit interview conducted and a copy of the report will be provided to the facility.

Investigation Findings:
13On August 11, 2021, at 6: PM, Licensing Program Analyst (LPA) Jazmond Harris met with House Manager, Tajanaye Parker to deliver the findings for the investigation pertaining to the listed allegations. LPA Ann Valenzuela initiated the investigation on March 4, 2021 at 1: PM. During the investigation, LPA Valenzuela conducted interviews with Administrator, Client #2 (See Confidential Names List (LIC 811) dated August 11, 2021), County Social Worker, and an additional witness. LPA Harris interviewed three staff members. LPA Valenzuela and LPA Harris were unable to interview Client #1 due to being non verbal. On February 26, 2021, Community Care Licensing (CCL) received information which stated Client #1 sustained injuries while in care, did not have appropriate sized clothes, shoes have holes, and staff are not managing Client #2's hygiene. It was advised that Client #2 had numerous scratches and bruises on their arm. Information obtained from Administrator stated that Client #2 conducts self harm. Interviews advised that Client #2 scratches, bites, and hits self on the head and arms. It was advised that Client #2 wears a helmet, braces on their arm, and leg restraints in order to deter self harming. It was advised that all UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Jazmond D Harris 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 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: SAILS OC CRISISFACILITY NUMBER: VISIT DATE: 08/11/2021

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

report_type: Complaint Investigation

met_with: House Manager-Tajanaye Parker

complaint_status: unsubstantiated


summary: Complaint Investigation - Substantiated - 1 allegation

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Narrative:
minutes; causing C1 to become upset and urinate on themselves. Based on interviews and information gathered during the investigation, the preponderance of evidence standard has been met and the Department has determined the allegation that Facility Staff yelled at the resident, more specifically that Staff # 1 (S1) yelled at Child # 1 (C1) to the point where C1 urinated on themselves is substantiated. This posed a potential health and safety risk to the children placed in care. The facility is being issued a citation for violations of the Title Regulations 84072(d)(11) Personal Rights. See attached LIC 9099D for cited deficiency. An exit interview was conducted, and a copy of the report and appeal rights were provided.

Investigation Findings:
13LPA Mena met with Administrator, Nero Tinsley to discuss the investigative findings for the above stated allegation. An investigation was conducted by LPAs Kourtney Williams and Daniel Mena regarding allegation. LPAs Williams and Mena conducted an inspection to the facility on April 22, 2021 at 3:53pm and on November 12, 2021 at 8:28am. No immediate hazards observed. LPAs interviewed four staff, two of three foster children (C1, C2), as well as reviewed client and facility records. LPAs were unable to interview Child # 3 (C3) due to their limited verbal ability. Community Care Licensing received information on April 15, 2021 alleging that Facility Staff yelled at the resident, more specifically that Staff # 1 (S1) yelled at Child # 1 (C1) to the point where C1 urinated on themselves. Information received in confidential interviews corroborated allegation with a preponderance of evidence. According to confidential information received during interviews, S1 went into C1's bedroom after C1 had already been deescalated by another staff due to a negative behavior, and proceeded to yell at C1 after becoming aware of the incident for approximately to 20 to SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: SAILS OC CRISISFACILITY NUMBER: VISIT DATE: 11/17/2021

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

met_with: Nero Tinsley

complaint_status: SUBSTANTIATED


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Narrative:
In regards to facility not communicating with youth's authorized representative, Administrator stated that while getting physical appointment for C1, C1's biological father wanted to know what was going on, but it was in the hallway at the clinic, so staff advised father to wait until they get into the facility. Biological father became upset and yelled at staff. Administrator added that the biological father was impatient and angry at staff. A confidential witness did not provide any information pertaining to the allegation. It was reported that staff were not addressing C1's medical needs. Administrator indicated that C1's medical records were up to date. Administrator stated that the facility was following all the Doctor's orders and C1's was taken to medical appointments and follow up. A confidential interview corroborated the administrator's statement regarding C1's medical needs. SC stated that Father needed to give the facility the chance to provide service for C1 and she believed all medical appointments for C1 were completed during C1's placement at the facility. For the allegation regarding facility not having adequate food quantity, Administrator stated that the facility always had food for the residents, and they have additional storage in the garage. LPA observed that the facility had sufficient food supplies, however, a confidential interview disclosed that there were times where facility ran out of food or delayed grocery arrival and they had to go to the sister facility to get what they needed. Confidential interviews stated that the clients were always served three meals a day. SC stated she was not aware of the facility not having sufficient food, however, she indicated that C1 will sometimes refuse to eat because C1 was not happy with the school C1 was attending. Based on confidential interviews, the Department determined there was not sufficient information to determine GH staff are not communicating with C1's authorized representative, facility staff are not properly addressing C1's medical needs and facility does not have an adequate quantity of food. Although the allegations may have happened or may be valid, there was not a preponderance of evidence to support or deny the allegations. The Department's finding is that these allegations were unsubstantiated.

Investigation Findings:
13On December 9, 2021 at 12: PM, Licensing Program Analysts (LPA) Babatunde Aborchie arrived at the group home and met with Administrator Nero Tinsley to deliver the investigative findings of the above allegations. During the investigation, LPA Cervantes initiated the complaint allegations and conducted a health and safety tele-inspection at the GH on September 1, 2021 at 1: PM and no safety concerns were noted. LPA Cervantes also obtained facility schedules, activity schedules, daily logbooks, special incident reports, picture evidence and medication administration records. LPA Aborchie conducted interviews with Administrator, staff and Regional Center Worker. LPA Aborchie attempted to interview clients; however, they did not provide any response due to clients being non-verbal. On September 28, 2021, the department received allegations that facility staff are not communicating with C1's authorized representative, facility staff are not properly addressing youth's medical needs and facility does not have an adequate quantity of food. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie 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 22-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, THE CITY DR., SUITE FACILITY NAME: SAILS OC CRISISFACILITY NUMBER: VISIT DATE: 12/09/2021

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

met_with: Kate Adamu


raw_content:
Narrative:
In regards to the allegation that C1 sustaining unexplained injuries while in care , it was specified that C1 had black eye (red purplish) on C1's right eye; a greyish-black bruise next to his right ear, about one inch long; a 4-inch long light purplish-brown bruise on the bottom of C1's chin that is about 4 inches long; a purplish-reddish bruise on the knuckle of C1's right index finger; a half-inch long yellowish-brownish bruise on his chest between his nipples; a 3 inch scratch and bruise on his right ankle. During the investigation a confidential interview indicated that C1 had bruises days before the allegations, facility staff notified management on Friday prior the report, but school had not been notified, C1 had self-injurious behaviors of self-hitting on the head and face. Confidential interviews disclosed that C1's behaviors were increased due to 10-day quarantine during COVID-19 at the facility. It was reported that C1 had difficulty to adjust to the daily routine changes which resulted C1 being frustrated. The confidential interviews added that C1 self- expressed by hitting self during the quarantine period. Another confidential corroborated the information obtained and indicated that C1 was very agitated for not being able to go to school resulted to self-injurious behavior. For the allegation that staff inappropriately restrained C1 while in care; confidential interviews stated that C1 wears arm-splints to keep C1's arms straight, if not properly worn, it could make Velcro tangled together making the arms stuck together sometimes during transportation. Management was aware of the Velcro and got C1 a new splint to prevent future occurrence. A confidential interview stated facility staff do not restrain any of the client and bruising on C1 were from self-injurious behavioral episodes that occurred prior shift. Another confidential interview indicated that facility does not use any form of restraint other than protective equipment recommended by the physician. Based on confidential interviews, the Department determined there was not sufficient information to determine C1 sustained unexplained injuries while in care and staff inappropriately restrained C1. Although the allegations may have happened or may be valid, there was not a preponderance of evidence to support or deny the allegation. The Department's finding is that these allegations were unsubstantiated.

Investigation Findings:
13On December 9, 2021 at 1: Licensing Program Analysts (LPA) Babatunde Aborchie arrived at the group home (GH) met with Administrator Nero Tinsley to deliver investigative findings of the above allegations. On October 7, 2021 at 11:03 am LPA arrived at the GH to initiate the investigation regarding the above allegations and interviewed four staff including two Administrators, two of two clients. The two clients were non-verbal. LPA was unable to get any information from C1 and C2 regarding the allegations. Additionally, LPA obtained clients (C1 and C2) records, LPA reviewed documentation which showed that C1 uses protective equipment such as helmet that covers chick bones for protection from self-injury, protective pillows and uses arm splints On September 28, 2021, the department received allegations that child C1 sustained unexplained injuries while in care; staff inappropriately restrained child C1 while in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie 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 22-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, THE CITY DR., SUITE FACILITY NAME: SAILS OC CRISISFACILITY NUMBER: VISIT DATE: 12/09/2021

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


raw_content:
Narrative:
spoke negatively about other staff in the presence of clients. While other confidential information received by Licensing Office stated that these allegations had occurred, and that Staff # 1 (S1) talked negatively about S4 in the presence of C1 and C2; causing them to feel anxious and upset. LPAs were unable to interview Child # 1 (C1) and Child # 3 (C3) regarding this allegation, due to C1's current whereabouts being unknown and C3 being a non-verbal client. Based on confidential interviews, the allegations that Facility Staff speak inappropriately to youths in care, more specifically that children in care were being emotionally manipulated by staff, may have occurred, however is not supported or proven by evidence. Therefore, the above allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Lead Staff, Aime Rodriguez to issue the findings for the above stated allegation. An investigation was conducted by LPAs Kourtney Williams and Daniel Mena regarding allegation. LPAs conducted an investigation to the facility on May 04, 2021 at 4:15pm, and on November 12, 2022 at 9:30am. No immediate hazards observed. LPAs interviewed seven staff (S1, S2, S3, S5, S6, S7 & S8), one of three foster children (C2), as well as reviewed client and facility records. Community Care Licensing received information on April 26, 2021 alleging that Facility Staff speak inappropriately to youths in care, more specifically that children in care were being emotionally manipulated by staff. Information obtained in confidential interviews did not corroborate the allegations with a preponderance of evidence. Confidential interviews denied allegations that any staff were manipulating clients or causing them any stress by trying to get them to say things against Staff # 4 (S4). Confidential interviews also denied that any facility staff had conversations with any of the clients regarding other staff or UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: SAILS OC CRISISFACILITY NUMBER: VISIT DATE: 03/16/2022

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


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Regarding the allegation that C1 and C2 are not able to access outside, it was specifically stated that there were locks on the entry doors that were not able to unlock from the inside. A confidential interview stated that the entry door had locks that were accessible from the inside. A confidential witness stated that front door was easily accessible to C1 and C2 from the inside. LPA did not observe entry doors being locked during the inspection. Regarding the allegation that staff inappropriately restrained C2, it was specifically stated that staff were observed holding C2 to the floor. A confidential interview denied not holding C2 to the floor. Another confidential interview denied not holding C2 to the floor. A confidential witness did not see or receive any reports of restraint. Based on confidential interviews, the Department determined there was not sufficient information to determine staff sleeping in home, C1 and C2 are not able to access outside and staff inappropriately restrained C2. Although the allegations may have happened or may be valid, there was not a preponderance of evidence to support or deny the allegations. The Department's finding is that these allegations were unsubstantiated.

Investigation Findings:
13On June 17, Licensing Program Analysts (LPA) Babatunde Aborchie arrived at the group home (GH) met with Administrator Crystal Garcia to deliver investigative findings of the above allegations. On February 25, LPA arrived at the GH to initiate the investigation regarding the above allegations and interviewed two staff, Administrator, two of two clients. One client C1 was non-verbal and C2 did not have a clear speech. LPA was unable to get any information from C1 and C2 regarding the allegations. Additionally, LPA obtained clients (C1 and C2) records. On February 17, 2022, the Department received allegations that staff sleeping in home, Residents are not able to access outside and staff inappropriately restrained child. In regards to the allegation that staff were sleeping in the home, it was specified that staff is sleeping at the facility in the empty beds at the home at night. Confidential interview denied sleeping at the facility on an empty bed during night shift. Another confidential interview denied sleeping on an empty be during night shift. A confidential witness did not see or received reports of staff sleeping at the facility on an empty bed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie 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 22-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, THE CITY DR., SUITE FACILITY NAME: SAILS OC CRISISFACILITY NUMBER: VISIT DATE: 06/17/2022

met_with: Administrator


narrative: Regarding the allegation that C1 and C2 are not able to access outside, it was specifically stated that there were locks on the entry doors that were not able to unlock from the inside. A confidential interview stated that the entry door had locks that were accessible from the inside. A confidential witness stated that front door was easily accessible to C1 and C2 from the inside. LPA did not observe entry doors being locked during the inspection. Regarding the allegation that staff inappropriately restrained C2, it was specifically stated that staff were observed holding C2 to the floor. A confidential interview denied not holding C2 to the floor. Another confidential interview denied not holding C2 to the floor. A confidential witness did not see or receive any reports of restraint. Based on confidential interviews, the Department determined there was not sufficient information to determine staff sleeping in home, C1 and C2 are not able to access outside and staff inappropriately restrained C2. Although the allegations may have happened or may be valid, there was not a preponderance of evidence to support or deny the allegations. The Department's finding is that these allegations were unsubstantiated.

investigation_findings: 13On June 17, Licensing Program Analysts (LPA) Babatunde Aborchie arrived at the group home (GH) met with Administrator Crystal Garcia to deliver investigative findings of the above allegations. On February 25, LPA arrived at the GH to initiate the investigation regarding the above allegations and interviewed two staff, Administrator, two of two clients. One client C1 was non-verbal and C2 did not have a clear speech. LPA was unable to get any information from C1 and C2 regarding the allegations. Additionally, LPA obtained clients (C1 and C2) records. On February 17, 2022, the Department received allegations that staff sleeping in home, Residents are not able to access outside and staff inappropriately restrained child. In regards to the allegation that staff were sleeping in the home, it was specified that staff is sleeping at the facility in the empty beds at the home at night. Confidential interview denied sleeping at the facility on an empty bed during night shift. Another confidential interview denied sleeping on an empty be during night shift. A confidential witness did not see or received reports of staff sleeping at the facility on an empty bed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie 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 22-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, THE CITY DR., SUITE FACILITY NAME: SAILS OC CRISISFACILITY NUMBER: VISIT DATE: 06/17/2022


raw_content:
Narrative:
Based on confidential interviews and record review, the preponderance of evidence standard has been met and the allegation is substantiated. Facility is cited for violation of health-related services Title Group Home Chapter 5, Section 84675(c) Psychotropic medication. Confidential interviews and record reviews confirmed medication was not used in accordance with written directions of the physician prescribing the medication. A copy of this report was reviewed and provided to Administrator Crystal Garcia, along with the Appeal Rights Regarding the allegation that staff are not providing appropriate care and supervision to residents in care, a confidential interview stated that staff were providing appropriate care to C1 and C2 in care. Another confidential interview believed that facility was providing appropriate care for C1 and C2 in care. Based on confidential interviews, the Department determined there was not sufficient information to determine staff failed to seek medical attention for C1 in a timely manner and staff are not providing appropriate care and supervision to C1 and C2 in care. Although the allegations may have happened or may be valid, there was not a preponderance of evidence to support or deny the allegations. The Department's finding is that these allegations were unsubstantiated.

Investigation Findings:
13On June 16, 2022, Licensing Program Analyst (LPA), Babatunde Aborchie met with Sails OC Administrator Crystal Garcia to review the complaint investigative findings for the above stated allegations. During the investigation, LPA interviewed two staff, two of two clients (C1 and C2) residing in the facility, Administrator, and reviewed medication records. On February 28, 2022 the Department received allegations that staff failed to seek medical attention for minor in a timely manner and staff are not providing appropriate care and supervision to residents in care. Regarding the allegation that staff failed to seek medical attention for minor in a timely manner, a confidential interview stated that facility administrator (FA) was immediately notified. Another confidential interview stated that FA immediately made a telephone call to C1's primary doctor, FA was instructed to have staff observe C1 at the facility for any unusual changes. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, THE CITY DR., SUITE This is an official report of an unannounced visit/investigation of a complaint received in our office on 02/28/2022 and conducted by Evaluator Babatunde Aborchie PUBLICCOMPLAINT CONTROL NUMBER: 22-CR- FACILITY NAME:SAILS OC CRISISFACILITY NUMBER: ADMINISTRATOR:LORI CONTIFACILITY TYPE: ADDRESS: MARK LANETELEPHONE: (818) 357- CITY:COSTA MESASTATE: CAZIP CODE: CAPACITY:3CENSUS: 2DATE: 06/17/ UNANNOUNCEDTIME BEGAN: 12: PM MET WITH:AdministratorTIME COMPLETED:01: PM 9Resident was not administered medication(s) according to physician's instructions while in care. INVESTIGATION FINDINGS: 13On June 17, 2022, Licensing Program Analyst (LPA), Babatunde Aborchie met with Sails OC Administrator Crystal Garcia to review the complaint investigative findings for the above stated allegations. During the investigation, LPA interviewed two staff, two of two clients (C1 and C2) residing in the facility, Administrator, and reviewed C1 and C2's medication records. On February 28, 2022 the Department received allegations that resident was not administered medication(s) according to physician's instructions while in care. Confidential interview revealed that staff gave an additional dose of medication belonging to C2. Another confidential interview revealed that C1's medication was administered earlier but C2's medication was given to C1 in addition. Record review revealed that C2's medication was given to C1. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie 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: 2 of Control Number 22-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, THE CITY DR., SUITE FACILITY NAME: SAILS OC CRISISFACILITY NUMBER: 306003867


raw_content:
Narrative:
Regarding the allegation that staff are not providing appropriate care and supervision to residents in care, it was specified that staff did not feel comfortable caring for clients in the morning. Confidential interview denied not feeling comfortable caring for C1 and C2 in the morning. Another confidential interview denied not providing appropriate care and supervision for C1 and C2 in care. Other confidential interview stated that there was always a second staff in the morning and was comfortable providing care and supervision for C1 and C2. A confidential witness did not observe or receive reports of staff feeling uncomfortable providing appropriate care and supervision for C1 and C2 in care. Other confidential witness observed C1 and C2 were provided appropriate care and supervision in care during routine visits to the group home. Based on confidential interviews, the Department determined there was not sufficient information to determine staff are not providing appropriate care and supervision to C1 and C2 in care. Although the allegation may have happened or may be valid, there was not a preponderance of evidence to support or deny the allegation. The Department's finding is that these allegation is unsubstantiated. A copy of this report was reviewed and LIC 811 was provided to the group home facility manager.

Investigation Findings:
13On October 20, Licensing Program Analysts (LPA) Babatunde Aborchie arrived at the group home (GH) met with Facility Manager Kate Adamu to deliver investigative findings of the above allegation. On February 11, LPA arrived at the GH to initiate the investigation regarding the above allegation and interviewed two staff, Administrator, facility manager, two of two clients. One client C1 was non-verbal and C2 did not have a clear speech. LPA was unable to get any information from C1 and C2 regarding the allegations. Additionally, LPA obtained clients (C1 and C2) records. On March 4, 2022, the Department received allegation that Staff are not providing appropriate care and supervision to residents in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie 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 22-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, THE CITY DR., SUITE FACILITY NAME: SAILS OC CRISISFACILITY NUMBER: VISIT DATE: 10/20/2022

met_with: Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On June 3, 2021 at 10: AM, Licensing Program Analyst (LPA) Cindy Hamilton conducted an SB Psychotropic Medication tele-Inspection via Google Duo. The tele-inspection was held with the Administrator Manager Lakesha Buchanan. LPA conducted a virtual health and safety inspection with the Administrator Manager. During the inspection, LPA guided and observed a medication count and interviewed two staff including the Administrator Manager.. LPA conducted file reviews prior to inspection. LPA reviewed one client record and reviewed two staff records. At 10: AM, LPA began the two staff interviews via Google Duo. LPA was unable to interview the client (C1) due to clients limitation to communicate.. There were no deficiencies cited at this time. LPA conducted an exit interview with Assistant Manager Lakesha Buchanan. LPA scanned and emailed this LIC 809 to Lakesha Buchanan with a request for signature. Signed copies will be placed in the facility file.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Lakesha Buchanan, Administrator Manager


summary: Facility Evaluation

raw_content:
Narrative:
On January 20, 2022 at 10:15 am. LPA conducted an unannounced facility visit to Sails OC-Crisis and met with Facility Administrator Rukiyat Adams. The purpose of the visit was to conduct an annual required inspection. The home is licensed to provide care for three ambulatory clients. During this inspection, LPA toured the facility with the Administrator inside and out. Presently there are two clients in placement. The home is set up as follows: Bedroom #1 - It has a full-sized bed, No client at this time. Bedroom #2 - It has a full sized bed, sleeps one client; client #1. Bedroom #3 - It has a full sized bed, sleeps one client; client #2. Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. Rooms are free of smell and odor. There is adequate drawer and closet space for children's belongings. There are no guns or weapons as stated by Administrator at this time. Water temperature was tested and is safe and within regulatory requirements. Smoke detectors & carbon monoxide detector in hallways are all tested and operable. Proper storage of all food was noted. Trash cans for storage of solid waste have tight fitting lids. The Emergency Disaster Plan with exit map, Title Personal Rights, and visitation policies are posted at this time. All cleaning supplies and sharp objects (knives) were locked in the garage cabinets. There is adequate food supplies for available clients served. The emergency supplies contain all required items in case of emergency. The back yard is safe and free of hazards. There is a huge trampoline, barbecue area, lounging area in the backyard. Toys are safe, clean, and age appropriate for the age group of children being cared for. Two (02) children files and five (05) staff files were reviewed. Children and staff records are organized and up to date. Medications and log were reviewed. Administrative records included: A review of staff records on this date indicates that all facility staff have received criminal record and child abuse index check clearances. In accordance with Title 22, Division 6, Chapters 1 & 4 there are no deficiencies being cited at this time. Based on this annual inspection, the home was operating within the limitations of the license. An exit interview was conducted and copies of this report was provided to the Facility Administrator.

visit_type: Annual

met_with: Admiministrator Rukiyat Adams


summary: Facility Evaluation

raw_content:
Narrative:
On March 8, 2023 at 10: AM LPA conducted an unannounced facility visit to Sails OC Crisis and met with Facility Manager Kate Adamu. The purpose of the visit was to conduct an annual required inspection. The home is licensed to provide care for three ambulatory clients. During this inspection, LPA toured the facility with the manager inside and out. Presently there are two clients in placement. The home is set up as follows: Bedroom #1 - It has a full-sized bed, No client at this time. Bedroom #2 - It has a full sized bed, sleeps one client; client #1. Bedroom #3 - It has a full sized bed, sleeps one client; client #2. Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. Rooms are free of smell and odor. There is adequate drawer and closet space for children's belongings. There are no guns or weapons as stated by facility manger at this time. Water temperature was tested and is safe and within regulatory requirements of 109.5 degree. Smoke detectors & carbon monoxide detector in hallways are all tested and operable. Proper storage of all food was noted. Trash cans for storage of solid waste have tight fitting lids. The Emergency Disaster Plan with exit map, Title Personal Rights, and visitation policies are posted at this time. All cleaning supplies and sharp objects (knives) were locked in the garage cabinets. There is adequate food supplies for available clients served. The emergency supplies contain all required items in case of emergency The back yard is safe and free of hazards. There is a huge trampoline, barbecue area, lounging area in the backyard. Toys are safe, clean, and age appropriate for the age group of children being cared for. Two (02) children files and five (05) staff files were reviewed. Children and staff records are organized and up to date. Medications and log were reviewed. Administrative records included: A review of staff records on this date indicates that all facility staff have received criminal record and child abuse index check clearances. In accordance with Title 22, Division 6, Chapters 1 & 4 there are no deficiencies being cited at this time. Based on this annual inspection, the home was operating within the limitations of the license. An exit interview was conducted and copies of this report was provided to the Facility Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Joon Choi on 08/15/2023 at 09: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the visit, LPA Choi met with, Giovanni Camponovo, District Manager and conducted a health and safety inspection of the facility. No immediate health or safety risks were observed. LPA reviewed 2 of child's records and 3 of staff personnel files on site at the facility. LPA reviewed 2 of child's psychotropic medications and medication records. LPA interviewed 2 of staff on site to discuss the facilities policies and procedures of operation. LPA interviewed 1 of children currently prescribed psychotropic medication. LPA provided a copy of this licensing report to Giovanni Camponovo, District Manager. No deficiencies are being cited at this time, however a Technical Assistance (TA) was provided. LPA conducted exit interview with Giovanni Camponovo, District Manager and provided a copy of this report and TA.

met_with: Giovanni Camponovo, District Manager


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On January 23, 2024 at 9:30am Licensing Program Analysts (LPA's) Jacqueline Garcia and Guadalupe Munoz arrived unannounced to conduct an annual inspection and met with Facility Administrator Kate Adamu. The home is licensed to provide care for three clients. During this inspection, LPA's toured the facility with the Administrator inside and out. Presently there are two clients in placement. The home is set up as follows: Bedroom #1 - It has a full-sized bed, No client at this time. Bedroom #2 - It has a full sized bed, sleeps one client; client #1. Bedroom #3 - It has a full sized bed, sleeps one client; client #2. Bedrooms are arranged so that no more than one child sleeps in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. Rooms are free of smell and odor. There is adequate drawer and closet space for children's belongings. There are no guns or weapons as stated by facility Administrator at this time. Water temperature was tested and is safe and within regulatory requirements of 106 degree. Smoke detectors & carbon monoxide detector in hallways are all tested and operable. Proper storage of all food was noted. Trash cans for storage of solid waste have tight fitting lids. The Emergency Disaster Plan with exit map, Title Personal Rights, and visitation policies are posted at this time. All cleaning supplies and sharp objects (knives) were locked in the garage cabinets. There is adequate food supplies for available clients served. The emergency supplies contain all required items in case of emergency The back yard is safe and free of hazards. There is a huge trampoline, barbecue area, lounging area in the backyard. Toys are safe, clean, and age appropriate for the age group of children being cared for. Two (02) children files and five (05) staff files were reviewed. Based on review of staff files LPA's observed missing clearances for one of the five staff files reviewed. This resulted in a Type A violation with a Civil Penalty (CCR-80019(e) "All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility"). Based on the review of the two children files, LPA's observed both children files did not have the required medication administration record form for each psychotropic medication. This resulted in a Type A violation (CCR-84070(b)(13) "(13) a separate log for each psychotropic medication prescribed to the child documenting all the following"). In accordance with Title 22, Division 6, Chapters 1 & 4 there are two Type A deficiencies being cited at this time. Based on this annual inspection, the home was operating within the limitations of the license. An exit interview was conducted and copies of this report and the appeal right will be provided to the Administrator.

Deficiencies:
80019(e): Deficient Practice Statement
1
2
3
4

met_with: Kate Adamu-Administrator

title:
Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility

description:
Deficient Practice Statement
1
2
3
4


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Guadalupe Munoz on July 24, 2024 at 10: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Munoz met with Administrator Giovanni Camponovo, District Manager and Aime Rodriguez, House Manager. LPA toured the facility with Aime Rodriguez and no deficiencies were observed during tour. LPA reviewed two of two child's records and two of two staff personnel files on site at the facility. LPA reviewed two of two child's psychotropic medications and medication records. LPA interviewed three staff on site to discuss the facilities policies and procedures of operation. LPA attempted to interview two of two youth currently prescribed psychotropic medication. Interview could not be completed due to clients level of functioning. . During the inspection the LPA, no deficiencies are being cited at this time. The facility was provided with a Technical Assistance (TA) note. LPAs conducted exit interview with Administrator and a copy of this report, LIC 811 dated 7/24/24 and the TA were provided to administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On March 03, 2025 at 09: AM, Licensing Program Analyst (LPA) Jacqueline Garcia arrived unannounced to conduct an annual inspection and met with Facility Administrator, John Tran. The home is licensed to provide care for three clients. During this inspection, LPA toured the facility with the Administrator inside and out. Presently there are three clients in placement. The home is set up as follows: Bedroom #1 - It has a full sized bed, sleeps one client; client #1. Bedroom #2 - It has a full sized bed, sleeps one client; client #2. Bedroom #3 - It has a full sized bed, sleeps one client; client #3. Bedrooms are arranged so that no more than one child sleeps in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. Rooms are free of smell and odor. There is adequate drawer and closet space for children's belongings. There are no guns or weapons as stated by facility Administrator at this time. Water temperature was tested and is safe and within regulatory requirements of 110 degree. Smoke detectors & carbon monoxide detector in hallways are all tested and operable. Proper storage of all food was noted. Trash cans for storage of solid waste have tight fitting lids. The Emergency Disaster Plan with exit map, Title Personal Rights, and visitation policies are posted at this time. All cleaning supplies and sharp objects (knives) were locked in the garage cabinets. The First Aid Kit is located in the hallway closet and contained all required supplies. There is adequate food supplies for available clients served. The emergency supplies contain all required items in case of emergency. LPA observed a minimum 7-day non-perishable and a 2-day perishable supply of food. There was a variety of snacks available for clients. ****. The back yard is safe and free of hazards. There is a huge trampoline, barbecue area, lounging area in the backyard. Toys are safe, clean, and age appropriate for the age group of children being cared for. Three (03) children files and five (05) staff files were reviewed. Children and staff records are organized and up to date. Medications and logs were reviewed. LPA conducted two staff interviews. There are no deficiencies being cited at this time. An exit interview was conducted and copies of this report along with LIC 811 was provided to the Facility Administrator, John Tran.

met_with: John G Tran-Administrator


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Jacqueline Garcia on April 30, 2025 at 08: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Garcia met with Administrator, John Tran. LPA toured the facility with John and no deficiencies were observed during tour. LPA reviewed two of two child's records and five of five staff personnel files on site at the facility. LPA reviewed two of two child's psychotropic medications and medication records. LPA interviewed two staff on site to discuss the facilities policies and procedures of operation. LPA attempted to interview two of two clients currently prescribed psychotropic medication however due to clients level of functioning, LPA was not able to conduct interviews. During this inspection there are no deficiencies being cited at this time. LPA conducted exit interview with Administrator, John and a copy of this report, along with LIC 811 dated 4/30/25 were provided to John.

met_with: John G. Tran-Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 01/12/26, at 9: AM, Licensing Program Analyst (LPA) Gilbert Marquez met with Facility Manager Marta Garcia, for the purpose of conducting an annual inspection of the facility. The Facility is licensed to serve three non-ambulatory and/or ambulatory clients ages seven to 17 years. The facility is a single story dwelling. A physical plant inspection was completed with Facility Manager Aimee Rodriguez (S2 - See Confidential Names List LIC811) and included the following checks: three bedrooms, kitchen, medication closet, dining room, living room, and outdoor living space. Bedrooms contain full size beds, and bedroom #3 has one bathroom attached. The facility has one hallway bathroom. All beds were observed with appropriate bedding and mattress in good repair. Bedrooms contained adequate drawers and closet space. No bedroom occupied more than one client and not used for other purposes. The water temperature was tested in bathroom #2 (attached to bedroom #3) which measured 116.2 degrees Fahrenheit which is within the appropriate range of 105 degrees to 120 degrees Fahrenheit. The first aid kit was accessible and placed in the kitchen cabinet, and a second kit that had the scissors was locked in the medication closet. All required forms are posted including Grievance Procedures, Visitation Policies, Personal Rights, and the Emergency Disaster Plan. Clients' medications were observed to be inaccessible and stored in medication room. Facility grounds are clean and free of debris. There is adequate indoor and outdoor activity space. There are six smoke detectors; all facility smoke detectors and carbon monoxide detectors were tested and observed to be in working order. One fire extinguisher is properly charged and serviced. **Continued on LIC809C** **Continued from LIC809**Facility maintains an adequate supply of perishable and non-perishable foods to prepare the items on the posted menu. LPA observed a minimum seven-day non-perishable and two-day perishable supply of food. LPA reviewed two client medication records. LPA reviewed the fire drill logs. LPA conducted three staff interviews (S1, S2, and S3). Per facility staff, no firearms or weapons are allowed in the facility. No deficiencies were observed during today's inspection. Due to time constraints, LPA will return on another day to conduct client interviews, and review staff and client files. An exit interview was conducted, this report was discussed, and a copy of this report, the appeal rights, and LIC811 was provided to Facility Manager Marta Garcia. A copy of this report will be placed in the facility file.

met_with: Marta Garcia, Facility Manager


raw_content:
Narrative:
**Continued from LIC9099** Confidential interviews revealed that S1 and S2 were outside of the Facility moving cars in the driveway when C1 was able to leave the Facility without being noticed by staff. The preponderance of evidence standard has been met. Based on records reviewed and confidential interviews, the allegation that staff did not adequately supervise C1 in care is substantiated. The facility is being cited for the violation of Title 22, Division 6, Chapter 5, Section 84065.2(b)(1) Personnel Duties. An exit interview was conducted, a plan of correction discussed, appeal rights were explained, and a copy of this report, LIC811, and LIC9099D page was provided to SAILS OC Crisis Home Facility Manager Aimee Rodriguez..

Investigation Findings:
13On 03/12/2026, at 9: AM Licensing Program Analyst (LPA) Gilbert Marquez met with SAILS OC Crisis Group Home Facility Manager Aimee Rodriguez in person, and District Manager Giovanni Camponovo via phone to deliver the findings for the above-stated allegation. On 02/25/2026, LPA inspected the facility and no immediate health and safety hazards were observed. The investigation included confidential interviews with staff (S1-S4; see confidential names list LIC811), client (C1), C1's County Social Worker (CSW), and two Regional Center Service Coordinators (SC1, SC2). In addition, LPA reviewed pertinent client and facility files. On 02/17/2026, Community Care Licensing (CCL) received a complaint alleging that staff did not adequately supervise C1 in care. Specifically, it was alleged that C1 had left the Facility around 8: AM and was located at a nearby hospital. The hospital staff contacted Law Enforcement, and they were able to transport the child back to the Facility. **Continued on LIC9099C** SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Gilbert Marquez 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 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION ORANGE COUNTY RO, THE CITY DR., SUITE FACILITY NAME: SAILS OC CRISISFACILITY NUMBER: VISIT DATE: 03/12/2026

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

met_with: Facility Manager Aimee Rodriguez


facility_name: SAILS SAPPHIRE

raw_content:
Narrative:
An allegation has been made regarding the staff's failure to supervise clients adequately at the STRTP mentioned previously. These allegations claim that as a result, one of the clients suffered unexplained injuries. The staff members, S1 and S2, involved in the incident have denied the allegations, and they have stated that they adhere to the Interim Licensing standards, which maintain a staff-to-client ratio of 1:4. However, S2 reported an incident on the morning of January 19, 2024, around 2: AM. S2 heard a commotion coming from one of the client's (C2) bedrooms and found two clients (C1 and C2) lying in the same bed with an iPad next to them. S2 removed the iPad, and no further issues occurred. S2 reported that later that morning while getting C1 and C2 ready for school, S2 noticed some superficial scratches on C1's cheek, ear, and hand. S2 recorded what they observed in C1's behavior log and informed the facility administrator about it. Both clients have a history of scratching and picking at their skin when frustrated or worried. This could have made the scratches on C1 stand out more while at school, according to staff. The CSW and the Paternal Grandmother provided information that the siblings tend to kick, scratch, and bite each other over toys or when feeling frustrated since they are non-verbal. Additionally, it was revealed that C1 has a habit of picking at scabs or skin when nervous or in a new environment such as the case with the subject facility. Both the CWS and Paternal Grandmother confirmed that they have no issue with the care and supervision provided by the staff to the children. Therefore, based on the information received, the above allegation is determined to be unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the allegation is 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 Mr. Bell.

Investigation Findings:
13On February 14, 2024, at 6: PM, Licensing Program Analyst (LPA) Winston Moroney, conducted an unannounced complaint inspection at Sails Sapphire Short-Term Residential Therapeutic Program (STRTP) and met with STRTP Facility Administrator Tajon Bell. The inspection aimed to deliver the finding for the above complaint allegation(s). On January 1, 2024, the California Department of Social Services Community Care Licensing Division received a complaint from the Centralized Complaint and Information Bureau (CCIB) with the following allegation(s): Minor sustained unexplained injuries while in care. This LPA conducted the investigation of the above allegations, and it consisted of but was not limited to a review of records, including the client's need and services plans, medical records, and interviews with two staff members S1 on 2/1/24, S2 on 2/10/24, and CSW on 2/9/24. No statements were obtained from C1 and C2 due to being non-verbal. (Reference Confidential Names Form LIC 811, dated February 14, 2024). 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: SAILS SAPPHIREFACILITY NUMBER: VISIT DATE: 02/14/2024

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

met_with: Tajon Bell - Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On April 28, 2023, Licensing Program Analyst (LPA) Johanna Lofton, conducted an unannounced required annual inspection at the above facility and met with Facility Tajon Bell . This is a 24-hour facility which offers services and supervision to disabled, ambulatory and non-ambulatory clients. The facility is licensed for a capacity of four (4) male clients. There are currently four (4) clients in placement (See Client/Resident's Records Review - LIC811 dated 04/28/23). LPA requested a copy of the following: - LIC 500 (Personnel Report) -Client/resident roster -Board minutes - LIC C Emergency Disaster Plan & written disaster and mass casualty plan of action LPA conducted a walk through of the inside and outside of the facility. This facility has five (5) bedrooms, two (2) restrooms, a living room, a dinning area, a kitchen, a laundry room/area, a garage and outdoor space. There are no bodies of water on the premises. The facility is licensed to serve up to four (4) ambulatory and/or non-ambulatory minors ages 12-17 years of age. PHYSICAL PLANT LPA observed the following posted in the entrance of the home: group home license, personal rights, LIC 610, and grievance procedures. There is sufficient amount of perishable and non-perishable food. Disinfectant, cleaning solutions, sharps & knives and medication are kept locked and inaccessible to the clients. The client files and staff are kept locked in a locked closet near the entrance. The facility has a complete first aid kit and a fire extinguisher that was serviced on 4/10/2023. Carbon monoxide/smoke detectors were tested and observed to be operable. The facility's room temperatures was maintained at a safe and comfortable temperature. The hot water temperature was safe. There are no firearms on the premises. The facility phone system is operable. OPERATIONS Facility maintains a register of clients and the register is available upon request. The board of directors regularly conducts meeting to review and discuss the facility's operation. No citations were given. The inspection will be resume at a later date. An exit interview was completed and a signed copy of this report was provided to the facility representative.

met_with: Tajon Bell- Facility Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On June 1, 2023, Licensing Program Analyst (LPA) Johanna Lofton conducted an unannounced Annual Inspection continuation at the above named facility and met with Facility Administrator, Tajon Bell. LPA stated the purpose of the inspection to the group home representative. During the annual inspection LPA reviewed the facility's physical plant, Operational Requirements, Disaster Preparedness, Emergency Intervention Plan, Client and Staff records. There were no citations issued during the inspection. An exit interview was conducted and a signed copy of this report (LIC809) was provided to the facility representative.


summary: Facility Evaluation

raw_content:
Narrative:
On July 25, 2024 at 4pm, Licensing Program Analyst (LPA) Carrie Palmer conducted an unannounced required annual inspection at the above facility and met with Administrator, Erinique Jones and House Lead Tyler Bell. This is a 24-hour facility which offers services and supervision to disabled, ambulatory and non-ambulatory clients. The facility is licensed for a capacity of four (4) male clients. There are currently four (3) clients in placement (See Client/Resident's Records Review - LIC811 dated 03/22/24). LPA Palmer requested a copy of the following: LIC 500 (Personnel Report), Client/resident roster, and Board Meeting Minutes. LPA Palmer conducted a walk through of the inside and outside of the facility. This facility has five (5) bedrooms, two (2) restrooms, a living room, a dinning area, a kitchen, a laundry room/area, a garage and outdoor space. There are no bodies of water on the premises. The facility is licensed to serve up to four (4) ambulatory and/or non-ambulatory minors ages 12-17 years of age. PHYSICAL PLANT LPA Palmer observed the following posted in the entrance of the home: group home license, personal rights, LIC 610, and grievance procedures. The Register of Facility Clients/Residents and the Personnel Report were also posted. Disinfectant, cleaning solutions, sharps & knives and medication are kept locked and inaccessible to the clients. The facility's room temperatures was maintained at a safe and comfortable temperature. The hot water temperature was safe. There are no firearms on the premises. The facility phone system is operable. The facility does not have a medical unit on staff. The first aid kit was present and well stocked. The client files and staff files are kept locked in a locked closet near the entrance. The facility has a complete first aid kit and a fire extinguisher that was serviced on 4/10/2023. OPERATIONS Facility maintains a register of clients and the register is available upon request. The board of directors regularly conducts meeting to review and discuss the facility's operation. No citations were given. The inspection will be resume at a later date. An exit interview was completed and a signed copy of this report was provided to the facility representative.

met_with: Erinque Jones and Tyler Bell (Administrator and HOS)


summary: Facility Evaluation

raw_content:
Narrative:
On July 30, 2024 at approximately 11: AM, Licensing Program Analyst (LPA) Carrie Palmer conducted an unannounced visit to the facility for the purposes of continuing a Required Annual Inspection. LPA Palmer met with the representative listed above and discussed the purpose of the visit. This is a 24-hour facility which offers services and supervision to disabled, ambulatory and non-ambulatory clients. The facility is licensed for a capacity of four (4) client. There are currently three (3) clients in placement (See Client/Resident's Records Review - LIC 811 dated 07/30/24). LPA Palmer requested a copy of the following: LIC 500 (Personnel Report), LIC 9020 (Client/resident roster), LIC C, Emergency Disaster Plan & written disaster and mass casualty plan of action, Proof of quarterly fire drills, Procedure on Emergency Power, Copies of Procedures on Medication Storage, Copies of Medication List, Employee Time Schedule, First Aid Cert from the staff files review, Adm certification, resumes of managers and lead staff, and the facility license. The facility has a company vehicle. The facility has 1 children under the age of 7 years old with an exception. Disaster Preparedness and Emergency Intervention The facility was able to provide their emergency drill binder to include drills for fire and earthquake drills, which include the review of the facility sketch and emergency exits. The staff training binder was also provided to LPA Palmer which referenced: Behavior Crisis Response, Medication Training Video, Child Sexual Abuse Prevention and Development Disability Awareness. The facility also offers training on Relias (electronic training system): De-escalation Techniques, Diabetes Basics for Direct Support Professionals, Disaster Preparedness Essentials, Emergency Preparedness for Home Caregivers, Emergency Preparedness Regulation and Emergency Preparedness for Home Based Care Providers , Employee Wellness: Managing Time, and Fire Safety. During the observation of the Relias data base, it was determined that not all staff were receiving the offered training. The facility administrator enrolled the staff in the appropriate training's during the annual review. There was no evidence of documentation regarding the updating of the Emergency Disaster Plan annually. The administrator corrected the non-compliance by creating a form to track the review and updating of the Emergency Disaster Plan. Client Records: Client files were reviewed. During the file review, LPA Palmer reviewed the file with the administrator and there was no evidence of a tuberculosis test for C1, but there was evidence of a risk assessment marked "no risk" for C2 and C3. During an interview with the administrator, it was stated the physician opted out of the testing and the doctors office was called to follow up on the missing test. Interviews: Interviews for children were not conducted; as they are nonverbal. Continued Page 2 of Staff Records: During the review of staff records, it was determined that staff received background checks prior to working at the facility. LPA Palmer was also able to observe staff exemptions. Staff also receives ongoing training that consists of, but not limited to the following: CPI Training and CPR, Sails and Initial Orientation Training, 4 hour and 16 hour Shadowing. Job Descriptions were also observed within the staffs files and the administrators certificate was up to date (expires 3/30/25). Health Screenings were present: Tuberculosis Testing and Physical Exam to include Doctors Office Notes. The administrators resume reflects supervisorial experience over 3 years supervising direct staff in a group home. The administrator oversees two facilities where the license capacity is 7 or more clients total. Staff states when children are seen by the doctor or mental health professional that the Record of Medical and Dental Care Form is completed to include the necessary information. There was no training on House Keeping and Sanitation. There was training on medication administration, food/nutrition services and change in conditions for health and mental health of the children in care. The Facility Manager has a written plan, which includes the daily, weekly and monthly responsibilities listed. Interviews: Staff may need training on what to do in the event of suspected child abuse or neglect and who to report to; as well as key features of the needs and services plan. Clients with Special Health Care Needs: There are no clients with special health care needs at this time. No deficiencies cited during today's visit for . An exit interview was conducted, and a copy of this report and the LIC 811 was provided to the licensee.

met_with: Erinque Jones, Adminstrator


summary: Facility Evaluation

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Narrative:
On June 30, 2025, 10:30AM, Licensing Program Analyst (LPA) Humberto Flores conducted an unannounced Annual Inspection at Sails Sapphire Group Home (GH) and met with Administrator Tajon Bell. LPA Flores stated the purpose of the inspection to the GH representative. LPA Flores conducted a tour of the facility along with Tajon Belt. It was observed that the facility was clean, safe, sanitary and in good repair. The passageways and ramps are unobstructed. The disinfectants and cleaning solutions are inaccessible to the children. There are not swimming pools or similar bodies of water in the facility. The children in care are always supervised and protected. The GH representative stated that there are not firearms in the facility. The temperature in the rooms that clients occupy are maintained between 68 and 85 degrees (F) and the hot water temperature was at 111F. The GH has non-perishable foods for one week and perishable foods for two days and nutritious snacks are provided between meals. Medications are locked and accessible only to employees supervising stored medications. A medication count was conducted, and it was correct. The fire alarms and carbon monoxide detectors were checked and are operating. Children Records: LPA reviewed 1 children's file. The files contain a record of client's admission agreement, medical assessment, consent forms, weight record, emergency information, appraisal and needs and services plan, immunization record, centrally stored medication record, safeguards for property/valuables, personal rights form and cash resource information. No child was interviewed because of they are non-verbal. cont.# Staff Records: A total of 1 employee file was reviewed. The files contain the following documentation: first aid certificate, Child Abuse Index Checks/Department of Justice (DOJ)/Federal Bureau of Investigation (FBI) criminal record clearances, education verification, personnel record, health screening, criminal record statement, employee rights and tuberculosis test. Personnel policies, job descriptions and training verification are included in the employees' file. LPA Flores conducted a criminal record review of all individuals listed in the LIC500 provided during the inspection. All individuals obtained, prior working, a criminal record clearance or exemption as specified in Health and Safety Code section 1522(a)(4). A staff was interviewede. Administration/Accountability: The minutes of board of directors' meetings were available to the licensing agency to inspect, audit, and copy upon demand. The Emergency Evacuation plan and physical plant sketches are posted. The Emergency Disaster Plan, LIC 610C was posted. Personal rights listing is posted. Facility License was posted in a prominent place. The GH has not sent to the Department the biannual review of manual restraints for the last period January-June 2025. The GH representative stated that there has been no restraint. No citation was issued. A copy of this report, LIC811s and LIC912 was provided to the facility representative. Exit interview conducted.

met_with: Administrator, Tajon Bell


summary: Facility Evaluation

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Narrative:
On June 25, 2021 at 09: AM, Licensing Program Analysts (LPAs) Claudia Portillo and Jenny Mundo conducted an unannounced Annual/Required inspection at the above-named facility. LPA met with Ty Scherer, Administrator. The group home is licensed to serve five (4) male developmentally disabled clients, ages 12 - 17, ambulatory and non-ambulatory. Currently in placement are four (4) clients placed by Kern Regional Center. All clients currently attend summer school. The facility has a Covid-19 check in station where temperatures are checked every time an individual enters the facility. Staff are always required to wear masks and there were enough PPE supplies for clients/staff. LPA's Portillo and Mundo conducted a facility tour with Ty Scherer at 10: AM. LPAs started reviewing staff and client records at 11: AM. Physical Plant: 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. Disinfectants and other toxic materials are locked in the laundry room. Sharps and knives are locked in the hallway closet. Temperatures in rooms that clients occupy are maintained at 75 degrees (F). The hot water temperature was tested and measured at 107 degrees F. Each client bedroom has 1 bed, linens, and adequate drawer/cabinet space. LPAs also observed a complete First aid kit, and the smoke detectors and carbon monoxide alarm were tested and found to be operable. One fire extinguisher throughout the facility are fully charged. The facility has a working telephone that is accessible to clients. LPAs also reviewed the facility disaster drill and fire drill (fire drill was performed on 06/21/2021). Care and Supervision: The staff to client ratio in the day and overnight is 2:4. Facility has non-perishable foods for at least one week and perishable foods for at least two days. A review of weekly menu indicates that the facility provides nutritious meals and snacks. Medications are centrally stored/locked in the hallway closet and accessible only to employees supervising stored medications. (cont.) PERSONAL RIGHTS Facility posts child's personal rights, disability rights of California (office of client's right advocacy); Rights of individuals with developmental disabilities in the hallway. Clients live in a safe, healthy and comfortable home. Clients or their representatives can contact the licensing agency in confidence without threats or punishment for making complaints. CLIENT RECORDS LPA Portillo reviewed all four (4) client records. LPA reviewed all documents listed on LIC 858 (Client Records Review). STAFF RECORDS LPA Mundo reviewed four (4) randomly selected personnel records. LPA reviewed all documents listed on LIC 859 (Review of Staff Records). A review of Licensing Information System on today's date indicates that facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. All staffs are associated to SAILS Administrative File #157806006. ADMINISTRATION Facility's Emergency Disaster Mass Casualty Plan is current and available for review. Facility operates within license capacity and limitations. Deficiency cited and Advisory Notes given during today's inspection. Appeal rights given. An exit interview was conducted, and a signed copy of this report was left with the facility representative along with LIC 809D (Deficiency page), LIC 9102 (Advisory Notes), LIC 859 (Review of Staff Records) and LIC 858 (Client's Records Review).

met_with: Ty Scherer, Administrator


facility_name: SAILS V

raw_content:
Investigation Findings:
On August 5, 2021, Licensing Program Analyst (LPA), Karen McGee, delivered the findings of a complaint investigation to Administrator, Erinique Jones, at the facility. On April 7, 2021, the Monterey Park Children's Residential Program (MPCRP) received a complaint with the above mentioned allegations. The investigation included confidential interviews that consisted of, but were not limited to: Administrator and client (see Confidential Names, LIC Ref. #1 dated August 4, 2021) at the facility on July 22, 2021. Client Ref. #2 declined to be interviewed. The LPA was unable to interview Staff Ref. #3, because Ref. #3 resigned as of July 3, 2021 and moved out of state. The LPA reviewed Needs and Services Plans, and facility Status Change Form including a Resignation Letter. The investigation revealed that Ref. #1 admitted to attempting to discipline Ref. #3. Based upon statements Ref. #3 told Ref. #1 to stop and get off of Ref. #2. The LPA was unable to corroborate the statement. The investigation revealed that there is no documentation regarding a physical incident between Ref. #1 and #2. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that an alleged violation occurred, therefore the allegations are unsubstantiated. There are no deficiencies to be cited regarding these allegations. A copy of this complaint was provided to Ms. Jones. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Deborah A Santos 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 1

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

met_with: Anthony Carrillo


raw_content:
Narrative:
Continue from page 1 . . . . The information obtained from the staff interviews indicated that one staff was cooking dinner for the facility clients and served a client fish for dinner. The information indicated that the staff served a client fish by mistake but the client did not consumed the food when realized it was fish. Information indicated that the staff offered to cook a different plate but client refused and ate later in the evening. Statements obtained revealed that the staff has not denied the clients the telephone and that the clients are able to use the telephone when they want to. Statements obtained from confidential interviews did not revealed that a client was served fish to eat or that a client ate fish when he was not supposed to. There were conflicting statements indicating that a client was denied using the telephone but no details were given and other statements indicated that the clients have not been denied using the telephone. There were no witness to support the allegations and that the child's social worker was not available to make a statement. There was no corroborating information obtained through interviews to confirm the allegations. Based on the information obtained though interviews the allegations are found unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the allegations occurred, therefore, the above allegations are Unsubstantiated. Appeals rights were provided and discussed with the facility representative mention above. There were no deficiencies cited. An exit interview was conducted, and a signed copy of this report was left with above staff

Investigation Findings:
13On October 12, 2021, Licensing Program Analyst (LPA) Heriberto Perez conducted a follow-up complaint inspection to the above facility and and met with Erinique Jones, Administrator. The purpose of the inspection was to deliver the finding for the above complaint allegations. During the course of the investigation, LPA interviewed one three staff and two clients via telephone on 09/30/21 and LPA interviewed one client via telephone on 10/05/21 see Confidential Names Form LIC 811 dated October 12, 2021). LPA obtained and reviewed client's Patient Plan, Client's Food Menu/Restrictions and Identification and Emergency Information. It was alleged that the Staff denied minor use of telephone and Staff are not following minor's nutritional plan. Continue on page 2 . . . . UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Heriberto Perez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: SAILS VFACILITY NUMBER: VISIT DATE: 10/12/2021

met_with: Erinique Jones, Administrator


raw_content:
Narrative:
...page Complainant was unable to be interviewed. LPA was unable to locate social workers. C1 was unable to be interviewed. C2-C5 (See confidential names list 811 dated April 14, 2025) were interviewed. The investigation revealed the following: It was alleged that Staff did not have planned activities for a minor in care, staff mistreated a minor in care and staff withheld food from a minor while in care. LPA interviewed staff and during the interview, it was revealed that staff do not mistreat clients. Staff allow clients to make suggestions regarding activities as long as it is within STRTP guidelines. Staff allow clients to make suggestions on food choices and menu items. In confidential interviews with clients, it was revealed that there have been no reports of staff mistreating clients. Clients revealed planned activities they have participated in. Clients did not complain about food being withheld from them. Clients mentioned which food they liked and disliked. Based on the information gathered, although the allegations may have happened or is valid, the preponderance of evidence to prove the allegations was not met, therefore the allegation is unsubstantiated No deficiencies were cited at this time. A copy of this report and Appeal Rights were provided to Facility Administrator. Exit interview was conducted.

Investigation Findings:
13On April 14, 2025, at 5: P.M. Licensing Program Analyst (LPA) Demetris Teal conducted an unannounced visit to Sails V STRTP for the purpose of concluding the above identified complaint investigation. LPA met with Mike Gobea-Facility Administrator and discussed complaint findings. The investigation consisted of the following: On June 1, 2024, LPA met with Erinique Jones-Interim Administrator. LPA requested the current roster of clients. Current roster was received. LPA requested a roster of clients and staff from 2016. Interim Administrator advised LPA that the STRTP only keeps records for the past 5 years. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tira Logan LICENSING EVALUATOR NAME: Demetris Teal 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: Sails Vfacility Number: Visit Date: 04/14/ 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 32...page Complainant was unable to be interviewed. LPA was unable to locate social workers. C1 was unable to be interviewed. C2-C5 (See confidential names list 811 dated April 14, 2025) were interviewed. The investigation revealed the following: It was alleged that Staff did not have planned activities for a minor in care, staff mistreated a minor in care and staff withheld food from a minor while in care. LPA interviewed staff and during the interview, it was revealed that staff do not mistreat clients. Staff allow clients to make suggestions regarding activities as long as it is within STRTP guidelines. Staff allow clients to make suggestions on food choices and menu items. In confidential interviews with clients, it was revealed that there have been no reports of staff mistreating clients. Clients revealed planned activities they have participated in. Clients did not complain about food being withheld from them. Clients mentioned which food they liked and disliked. Based on the information gathered, although the allegations may have happened or is valid, the preponderance of evidence to prove the allegations was not met, therefore the allegation is unsubstantiated No deficiencies were cited at this time. A copy of this report and Appeal Rights were provided to Facility Administrator. Exit interview was conducted. SUPERVISORS NAME: Tira Logan LICENSING EVALUATOR NAME: Demetris Teal 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

met_with: Mike Gobea-Facility Administrator


summary: Facility Evaluation

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Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Jenny Mundo and Pamela Silva on 4/21/2022 at 9:15 am. During the inspection, LPAs met with Erinique Jones, Administrator and inspected the facility inside and out. LPAs did not review children records, children psychotropic medications or interview children due to the facility having no children in placement who meet the criteria. LPAs reviewed two (2) staff files on site at the facility at 9: AM. LPAs interviewed two (2) staff on site at 10: AM. LPAs conducted exit interview with Erinique Jones, Administrator at 11: AM. LPA provided the Summary Report to the Administrator upon completion. One (1) Technical Assistance (LIC9102TA) was also issued.


summary: Facility Evaluation

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Narrative:
On 11/22/2022 at 11:00am, Licensing Program Analysts (LPA) Johanna Lofton, Demetris Teal and Claudia Portillo conducted an unannounced required annual inspection at the above facility and met with the Erinique Jones, Administrator. This is a 24-hour facility which offers services and supervision to disabled, ambulatory and non-ambulatory clients. The facility is licensed for a capacity of five (5) clients, male ages 12 to 17 years old. There are currently three (5) clients in placement (See Client/Resident's Records Review - LIC811 dated 11/22/22). LPAs requested a copy of the following: -current LIC 500 (Personnel Report) -client/resident roster -Board minutes - LIC C Emergency Disaster Plan & written disaster and mass casualty plan of action LPAs conducted a walk through of the inside and outside of the facility. This facility has three (5) bedrooms, two (2) restrooms, a living room, a dinning area, a kitchen, a laundry room/area, a garage and outdoor space. There are no bodies of water on the premises. The facility is licensed to serve up to four (4) ambulatory minors ages 12-17 years of age. PHYSICAL PLANT LPAs observed the following signage posted in the entrance of the home: group home license, personal rights, LIC 610, and grievance procedures. There is sufficient amount of perishable and non-perishable food. Disinfectant, cleaning solutions, sharps & knives and medication are kept locked in the kitchen and inaccessible to the clients. The client files and staff are kept locked in the med closet near the entrance. The facility has a complete first aid kit and a fire extinguisher that was serviced on 4//2022. Carbon monoxide/smoke detectors were tested and observed to be operable. The following are kept inside the garage in locked cabinets which is inaccessible to clients: extra perishable food items in a refrigerator, emergency supplies, cleaning supplies and old files. The facility's room temperatures was maintained at a safe and comfortable temperature. The hot water temperature was tested and measured at degrees F. There are no firearms on the premises. The facility phone system is operable. OPERATIONS Facility maintains a register of clients and the register is available upon request. The board of directors regularly conducts meeting to review and discuss the facility's operation. The facility District Manager is responsible and capable staff for communicating with emergency personnel in the facility. CLIENT RECORDS LPAs reviewed four (5) client records. Client records are maintained locked onsite. STAFF RECORDS LPAs reviewed two (2) staff records. Two (2) staff members were interviewed. LPAs provided technical Advisory Note-Technical Violation (LIC9102TV) during this inspection. An exit interview was completed and a signed copy of this report was provided to the facility representative.

met_with: Erinique Jones- Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On November 30, 2022, Licensing Program Analyst (LPA) Johanna Lofton conducted a announced inspection visit with the purpose of obtaining signatures on reports. LPA Lofton met with the facility administrator to review the reports and obtain signatures. A copy of this report was left with the facility administrator. No citations were given and exit interview was conducted.


summary: Facility Evaluation

raw_content:
Narrative:
On December 13, 2022, Licensing Program Analyst (LPA) Johanna Lofton conducted an unannounced inspection at the above named facility with the purpose of interviewing clients for the continuance of the annual inspection. During the visit, LPA Lofton interviewed three (3) clients. Exit interview was conducted and a copy of this report was emailed to the above named staff.

met_with: Jonathan Flores- Interim Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On August 29, 2023, Licensing Program Analyst (LPA) Johanna Lofton, conducted an unannounced required annual inspection at the above facility and met with Facility Administrator, Jonathan Flores. This is a 24-hour facility which offers services and supervision to disabled, ambulatory and non-ambulatory clients. The facility is licensed for a capacity of five (5) male clients. There are currently 4 clients in placement (See Confidential Names List -LIC811 dated 8/29/23). LPA requested a copy of the following: - LIC 500 (Personnel Report) -Client/resident roster - LIC C Emergency Disaster Plan, written disaster & mass casualty plan of action LPA conducted a walk through of the inside and outside of the facility. This facility has five (5) bedrooms, two (2) restrooms, a living room, a dinning area, a kitchen, a laundry room, garage and outdoor space. There are no bodies of water on the premises. The facility is licensed to serve up to five (5) ambulatory and/or non-ambulatory minors ages 12-17 years of age. PHYSICAL PLANT LPA observed the following posted in the entrance of the home: group home license, personal rights, LIC 610, and grievance procedures. There is sufficient amount of perishable and non-perishable food. Disinfectant, cleaning solutions, sharps & knives and medication are kept locked and inaccessible to the clients. The facility has a complete first aid kit and a fire extinguisher that was serviced on 4/10/2023. Carbon monoxide/smoke detectors were tested and observed to be operable. The facility's room temperatures was maintained at a safe and comfortable temperature. The hot water temperature was safe. There are no firearms on the premises. The facility phone system is operable. OPERATIONS Facility maintains a register of clients and the register is available upon request. No citations were given. The inspection will be resume at a later date. An exit interview was completed and a signed copy of this report was emailed to the facility administrator.

met_with: Jonathan Flores-Interim Administrator


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPA) Juliet Robles on 05/02/24 at 10: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA met with Jonathan Flores, Administrator and inspected the facility inside and out. LPA reviewed (0) of children's records and three (3) of staff personnel files on site at the facility. LPA reviewed (0) of children's psychotropic medications and medication records. LPA interviewed two (2) of staff on site to discuss the facility's policies and procedures of operation. LPA interviewed 0 of children currently prescribed psychotropic medication due to children being a regional center client. No deficiencies are being cited at this time. LPA Robles conducted exit interview and provided a copy of this licensing report to Administrator, Jonathan Flores.

met_with: Jonathan Flores


summary: Facility Evaluation

raw_content:
Narrative:
On 8/29/2024 at 1:00pm, Licensing Program Analyst (LPA) Johanna Lofton conducted an unannounced required annual inspection at the above facility and met with Facility's Interim Administrator Michael Gobea. This is a 24-hour facility which offers services and supervision to disable, ambulatory and non-ambulatory clients. The facility is licensed for a capacity of five (5) clients, male ages 12 to 17 years old. There are currently five (5) clients in placement (See Client/Resident's Records Review - LIC811 dated 8/29/2024). LPA requested a copy of the following: -current LIC 500 (Personnel Report) -client/resident roster -Board minutes - LIC C Emergency Disaster Plan & written disaster and mass casualty plan of action LPA conducted a walk through of the inside and outside of the facility. This facility has three (5) bedrooms, two (2) restrooms, living room, dinning area, kitchen, laundry room/area, garage and outdoor space. There are no bodies of water on the premises. The facility is licensed to serve up to five (5) ambulatory and non-ambulatory minors ages 12-17 years of age. PHYSICAL PLANT During the facility inspection, LPA observed the following posters by the entrance of the home: group home license, personal rights, LIC 610, and grievance procedures. There is sufficient amount of perishable and non-perishable food. Disinfectants, cleaning solutions, sharps, & knives and medications are kept locked in the kitchen and inaccessible to the clients. The client files and staff are kept locked in the medication closet near the entrance. The facility has a complete first aid kit and a fire extinguisher that was serviced on 03/28/2024. Carbon monoxide/smoke detectors were tested and observed to be operable. The following are kept inside the garage in locked cabinets which is inaccessible to clients. Emergency supplies and cleaning supplies. The facility's room temperature was maintained at a safe and comfortable temperature. The hot water temperature was tested which met the requirements. There are no firearms on the premises. The facility phone system is operable. OPERATIONS Facility maintains a register of clients and the register is available upon request. LPA will resume the clients and staff file review at a later date. An exit interview was completed and a signed copy of this report was provided to the facility representative.

met_with: Michael Gobea- Interim Admininistrator