raw_content:
Narrative:
Confidential interviews and record review revealed C1 was placed in the STRTP from 6/10/2021-7/21/2021. Confidential interviews revealed C1 ran out of C1's medication and was not given C1's medication for approximately one month; while other interviews revealed C1 was out of medication for a few days. Record review revealed C1 ran out of psychotropic medication and took C1's last dose on 7/9/2021 and did not receive his prescribed medication from 7/10/2021 through 7/21/2021. Interviews with staff revealed they were aware that C1 was low on medication however believed it would still be the Wellness Recovery Action Plan (WRAP) team's responsibility to obtain C1's refill. Other confidential interviews revealed that the STRTP staff was told C1 could be seen by an outside psychiatrist to obtain a refill however the STRTP did not schedule an appointment for C1 to be seen. Interviews and record review revealed that in a meeting held on 7/14/2021 it was determined C1's WRAP services would be terminated, however, the WRAP team was able to schedule an emergency appointment on 7/15/2021 for C1 to be seen by a psychiatrist and obtain a prescription refill on C1's medication. Interviews revealed the STRTP obtained the medication refill on 7/19/2021 however record review revealed C1 was not given C1's medication for the remainder of C1's placement in the STRTP. Based on confidential interviews and record review, the preponderance of evidence standard has been met. The department has determined the allegation that staff did not ensure C1 received medication is substantiated. The facility is being cited for violation of the Title General Regulations Division Chapter 1, Section 80075 (a) Health Related Services. Per confidential interviews and record review facility staff did not ensure C1 was provided medical services to obtain a refill on medications which resulted in C1 not receiving their psychotropic medications which poses an immediate health, safety or personal rights risk to clients in care. An exit interview was conducted and a copy of this report, LIC 811 and appeal rights was provided to Senior Facility Manager Cedric Reliford. Confidential interviews and record review revealed that on 7/20/2021, C2 and C3 believed C1 went through their belongings so C2 and C3 went into C1's bedroom, C2 threw a sandal at C1, hitting C1 in the head and C3 slapped C1 in the face, causing C1 to get a bloody nose. Other confidential interviews revealed C2 and C3 slapped and punched C1 several times. Confidential Interviews and record review revealed staff did not observe the assault on C1, however there were two staff, S1 and S2 on duty and present in the facility at the time of the incident. Confidential interviews revealed after the incident occurred, S1 offered C1 medical attention and S1 had C1 sleep in the living room for the remainder of the night. All confidential interviews revealed that there are usually two staff on shift except during overnight shift and that staff check on clients every 15 minutes. It was also reported that this incident occurred within 5-10 minutes of S1, C2 and C3 returning to the STRTP. The interview with CSW revealed there were no concerns of supervision in the STRTP. Based on confidential interviews and record review, C1 was physically assaulted by C2 and C3 while in care, however, it is not supported or proven by evidence that it occurred due to lack of supervision. Therefore, the above allegation is unsubstantiated. A copy of this report, LIC 811 and appeal rights were explained and given to Senior Facility Manager Cedric Reliford.

Investigation Findings:
13On September 10, 2021 at 3:17 pm, Licensing Program Analyst (LPA), Jessica Rubio met with Berhe Group Home (STRTP), Senior Facility Manager Cedric Reliford, to discuss the investigative finding of the allegation listed above. On July 30, 2021 at 12:33 pm, LPA Jose Gonzalez conducted a safety inspection of the facility. No safety hazards were observed and no deficiencies were cited. During the investigation, LPA Jessica Rubio conducted confidential interviews with four clients (C1, C2, C3, C4), three staff (FM, S1, S2), county social worker of C1 (CSW) and Child and Family Team Facilitator for C1 (CFTF). LPA Rubio obtained and reviewed copies of the staff roster and the needs and services plan for C1. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Christina Barnes LICENSING EVALUATOR NAME: Jessica M Rubio LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., Suite Riverside, CA Facility Name: Berhe Group Home, INC.FACILITY NUMBER: 366401709

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

met_with: Cedric Reliford


state: CA

facility_name: BERHE GROUP HOME, INC.

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
On August 30, 2022, Community Care Licensing received information alleging that Client #1 (C1) was being hit by other clients in care due to lack of supervision. It was specified that C1 has been physically abused by C3 when staff were not present. It was also alleged that another client, Client #3 slapped C1 across the face while they were in a back portion of the STRTP when staff was not present with no further details. A confidential interview reported not having any knowledge of the allegation. Another confidential interview stated C1 was the aggressor and was not bullied by any peers. A different confidential interview reported hitting C1 on the head because C1 was being annoying, however, staff intervened. It was added that staff did not allow clients to play video games as a form of punishment. Based on confidential interviews, the allegation that C1 was hit by other clients in care due to a lack of supervision may have occurred, however, it 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 along with the appeal rights was provided to Facility Manager Wendy Flowers.

Investigation Findings:
13On August 30, 2023, at 1:15PM, Licensing Program Analyst (LPA) Adaleyci Caballero met with Berhe STRTP Facility Manager Wendy Flowers to discuss the investigative finding for the above stated allegation for Client #1. Lpa B. Torres began the investigation at the facility on September 7, 2022, at 2:35PM. On July 12, 2023, LPA A. Caballero interviewed Client #3, Client #4, Client #5, Client #6, and Staff #2. Lpa a. Caballero reviewed client and staff rosters and previous incident reports. Client #1 refused to be interviewed. LPA conducted a telephone interview with Client #2. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Adaleyci Caballero LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., Suite Riverside, CA Facility Name: Berhe Group Home, INC.FACILITY NUMBER: VISIT DATE: 08/30/2023

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

report_type: Complaint Investigation

met_with: Facility Manager-Wendy Flowers

complaint_status: unsubstantiated


raw_content:
Narrative:
For the allegations regarding staff physically assaulted youth in care, staff allowed youth in care to be physically assaulted by another adult, and staff physically restrained youth in care. It was alleged that a STRTP staff member entered C1's room punched C1 on the back of the head and threw C1's head against the wall causing C1's earring to fall out of C1's ear. Furthermore, it was indicated that a staff allowed the staff's relative to slap and beat up C1. It was also reported that the adults at the STRTP abuse C1 by pushing C1 and verbally abuse C1. Confidential interviews denied witnessing any form of physical abuse at the STRTP to any client. Confidential interviews reported that all STRTP staff treat clients well. Other confidential interviews stated C1 was the aggressor at the STRTP. A confidential interview reported witnessing C1 get restrained by staff because C1 was being destructive. A confidential interview stated some restraints had to happen for the safety of the clients in care, but everything has been documented. One interview shared that all the allegations remain truthful with no further details. Regarding the allegations that staff used inappropriate forms of discipline and staff took youth in care to staff's personal residence, it was specified that when clients get in trouble, they are sent to Staff #1's (S1's) personal residence as punishment. It was specified that C1 was taken to S1's home to mow S1's lawn. Confidential interviews stated not hearing about C1 mowing S1's lawn as punishment. Other confidential interviews denied going to S1's residence. One confidential interview shared that the allegations are true and C1 was taken to S1's home with no further details. Based on confidential interviews, the allegations that staff physically assaulted youth in care, staff allowed youth in care to be physically assaulted by another adult, staff physically restrained youth in care, staff used inappropriate forms of discipline, and staff took youth in care to staff's personal residence may have occurred, however, it is not supported or proven by evidence. Therefore, these allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report along with the appeal rights was provided to Facility Manager Wendy Flowers.

Investigation Findings:
13On August 30, 2023, at 12:48PM, Licensing Program Analyst (LPA) Adaleyci Caballero met with Berhe STRTP Facility Manager Wendy Flowers to discuss the investigative findings for the above stated allegations involving a client in the facility. On July 10, 2023, Community Care Licensing received information alleging that staff physically assaulted youth in care, staff allowed youth in care to be physically assaulted by another adult, staff physically restrained youth in care, staff used inappropriate forms of discipline, and staff took youth in care to staff's personal residence. On July 10, 2023, at 12:15PM, LPA Caballero initiated the investigation at the facility and a safety inspection was conducted. There were no immediate hazards observed. During the visit, LPA interviewed two staff and four clients. During the investigation, LPA interviewed Client #1(C1). County Social Worker was not interviewed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Adaleyci Caballero LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., Suite Riverside, CA Facility Name: Berhe Group Home, INC.FACILITY NUMBER: VISIT DATE: 08/30/2023

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


raw_content:
Narrative:
Community Care Licensing received information on October 11, 2023, alleging that staff did not provide adequate supervision, resulting in youths engaging in inappropriate sexual activities. It was specified that client #1(C1) and another client were observed in the garage with their pants down. It was specifically stated that C1 had an erected penis but refused to answer any more questions. A confidential interview reported that C1 and client #2 (C2) were observed in the garage by themselves by Staff #2(S2). The same interview indicated that S2 was preparing the kitchen table for dinner when C1 and C2 snuck out of the common area to go to the garage. A confidential interview stated the therapist staff #3(S3) was at the STRTP doing therapy sessions and at one point was sitting with the clients in the common area; however, S3 stepped out. One interview indicated that S2 assumed S3 and Staff #4(S4). were keeping an eye on the clients. Another confidential interview reported S3 was in the office doing therapy sessions with clients not in the common area. One confidential interview indicated having concerns on the care and supervision from the STRTP after this alleged incident. Other confidential interviews stated C1 and C2 were not observed naked or with an erected penis. Additional interviews reported that there were no witnesses to this alleged incident. Based on confidential interviews, the allegation that staff did not provide adequate supervision, resulting in youth engaging in inappropriate sexual activities in the premises may have occurred, however, there was not a preponderance of evidence to support or deny this allegation. Therefore, this allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report along with the appeal rights was provided to Facility Manager Wendy Flowers via email.

Investigation Findings:
13On January 12, 2024, at 9:20AM, Licensing Program Analyst (LPA) Adaleyci Caballero met with Berhe Group Home Inc. Facility Manager Wendy Flowers to discuss the investigative finding for the above stated allegation involving clients in care. LPA began the investigation at the facility on October 18, 2023, at 8:40AM and interviewed one member of staff. During the investigation, LPA interviewed four out of six clients and four staff. County Social Worker was interviewed. Clients #1 and #2 refused an interview. LPA reviewed an incident report from clients' files. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Adaleyci Caballero LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., Suite Riverside, CA Facility Name: Berhe Group Home, INC.FACILITY NUMBER: VISIT DATE: 01/12/2024

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


raw_content:
Narrative:
facility, however confidential interviews were unable to confirm or dispute the inappropriate behaviors occurred between C1 and S1. Based on record review and confidential interviews the allegation alleging staff (S1) sexually abused minor (C1) in care, may or may not have occurred, however it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights Berhe Goup Home Inc., Senior Facility Manager, Wendy Flowers,

Investigation Findings:
13On May 3, 2024 at 1:31pm Licensing Program Analyst (LPA), Nicole Strickland met with Berhe Group Home Inc., Senior Facility Manager, Wendy Flowers, to deliver the finding(s) for the above stated allegation. The investigation was conducted by Special Investigator (SI) Oliva Spindola and LPAs C. Urena and N. Strickland and included interviews with Staff #1 (S1), Child #1 (C1), and County Social Worker (CSW). In addition, county records and facility records were reviewed. On December 18, 2023, Community Care Licensing (CCL) received an allegation alleging staff (S1) sexually abused minor (C1) in care. Specifically, it was reported that on an unknown date S1 touched C1 all over C1's body. Confidential interviews and record review could not confirm when the alleged assault occurred. In addition, confidential interviews revealed conflicting statements. Confidential interviews and record review were able to confirm C1 had sexualized behaviors and at times would be inappropriate with others at the UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION ORANGE COUNTY RO, THE CITY DR., Suite Orange, CA Facility Name: Berhe Group Home, INC.FACILITY NUMBER: VISIT DATE: 05/03/2024

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

met_with: Facility Manager, Wendy Flowers


summary: Facility Evaluation

raw_content:
Narrative:
On December 15, 2022, Licensing Program Analysts (LPAs) Michael Almaraz and Jose Gonzalez conducted an unannounced Annual Inspection of the facility. At 9: AM, the facility was inspected inside and out with Wendy Flowers, Facility Manager. The home is a one-story residence with three bedrooms and two bathrooms. Three clients were present at time of inspection. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. The bathrooms were clean and in good repair. The temperatures in rooms that clients occupy are maintained between 68 and 85 degrees (F). The hot water temperature was tested and noted to be 115 degrees. All hazardous items have been properly made inaccessible to areas where clients will have access. Cleansers/chemicals are locked and stored and locked in a cabinet. Sharp knives are inaccessible and stored in a locked cabinet in the kitchen. The First Aid Kit is located in the locked upper kitchen cabinet and contains all required items. The facility's smoke detectors located in each bedroom and common areas were checked and were operable. The carbon monoxide detector located in hallway was operable. There are no guns or weapons in the facility as stated by licensee at this time. The following required posted items were observed accessible to clients: Grievance Procedures, Personal Rights, Ombudsman Poster, Visitation policies, and current menu. Clients medications were observed to be inaccessible and stored in a lock box and locked in the kitchen cabinet. 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 as well. The facility outside grounds was also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. Facility has no pool/bodies of water on premises. Administrator, Judy Berhe, is present at the facility a minimum of 20 hours a week, as verified by staff schedules. Staff/client ratios were verified during this inspection, and they were in accordance with the regulations. Licensee had obtained their Mental Health (MH) Certification on May 10, 2022. Facility obtained National Accreditation through CARF. Six clients (C1, C2, C3, C4, C5) and five staff records (S1, S2, S3, S4, S5) were reviewed on this date to ensure they contained all required documentation per Interim Licensing Standards. Three out of the six clients were unavailable at the time of the inspection. Facility appears to be meeting the terms and conditions of their license. Based on the facility inspection and file reviews on this date, there are no deficiencies found at this time. LPAs provided a copy of these reports, along with appeal rights, to Wendy Flowers.

report_type: Facility Evaluation

visit_type: Annual

met_with: Wendy Flowers


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Leslie Covarrubias on February 2, 2023 at 8: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Covarrubias met with Wendy Flowers, Facility Manager and inspected the facility inside and out. LPA reviewed five of child's records and three of staff personnel files on site at the facility. LPA reviewed five of child's psychotropic medications and medication records. LPA interviewed three of staff on site to discuss the facilities policies and procedures of operation. LPA will interview two of children currently prescribed psychotropic medication at their schools. LPA Covarrubias issued a technical violation and provided a copy of this licensing report to Wendy Flowers.

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On May 11, Licensing Program Analyst (LPA) Linda Haynes met with Lead Staff Ruby Lightner to amend the LIC 809D for complaint number 61-CR-20251202155703.

met_with: Ruby Lightner


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
The allegation of sexual abuse to minor specifically refers to S1 having an inappropriate relationship with C1. Confidential interviews, video surveillance, and record review provided consistence evidence of S1 having an inappropriate relationship with C1 which included massages, inappropriate touching and oral sex. The allegation staff provided minor with vape pen specifically refers to S1 providing C1 a vape pen. Confidential interviews, video surveillance, and record review revealed S1 provided C1 with a vape pen and C1 smoking the vape pen in the presence of S1. Based on confidential interviews, video surveillance, and record review, the preponderance of evidence standard has been met, and the allegations of sexual abuse to C1 by S1 and S1 provided C1 with a vape pen are substantiated. The facility is cited for violation of Short-Term Residential Therapeutic Program Interim Licensing Standards (ILS) Version Section 87072 (C)(16) Personal Rights and Health and Safety Code (HSC) 1550(c) Conduct inimical. The facilities violation of CCR regulation 87072(C)(16) requires the facility to be assessed an immediate civil penalty per Health and Safety Code 1548(f)(1)(C). An Enhanced Civil Penalty (ECP) determination is pending. If an ECP is assessed a Community Care Licensing (CCL) representative will return to the facility to deliver the penalty assessment. A copy of this report, Appeal Rights, and LIC 811 were reviewed and provided to Lead Staff Ruby Lightner.

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

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

complaint_status: SUBSTANTIATED


facility_name: BERKELEY COTTAGE

summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Lidia Tinoco conducted an unannounced visit to the Berkeley Cottage STRTP in order to deliver the findings of the above allegations and met with Angelica Espinoza. The above allegation was referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, Interviews and a review of facility and children's records. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation occurred. Therefore, the allegation is UNSUBSTANTIATED at this time. A copy of this report was discussed and provided to Angelica Espinoza along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

met_with: Angelica Espinoza


summary: Complaint Investigation - Substantiated - 1 deficiency - 3 allegations

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Lidia Tinoco conducted a complaint inspection, the purpose of the inspection was to deliver the findings for the above complaint allegations and met with Angelica Espinoza. During the course of the investigation, Community Care Licensing (CCL) conducted interviews, conducted a review of records, and inspected the facility. The interviews conducted along with documents reviewed showed evidence of staff not providing adequate supervision. Type A: This poses an immediate health and safety risk to clients in care. Based on the LPA's observations, interviews and records review, the preponderance of evidence standard has been met, therefore, the above allegations are found to be substantiated. A copy of the report and Appeal Rights was provided to the agency. Facility was cited for The Interim Licensing Standard (ILS) Chapter 7. Version Articles 1 through 10. The Agency is being cited for violations of Section 87065.2(b) Personel Duties. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco 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 24-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, E SHAW AVE FACILITY NAME: BERKELEY COTTAGEFACILITY NUMBER: 500305469

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

Deficiencies:
87065.2(b): (1) Supervision, protection, and care of children at all times, individually and in groups.
(2) Assistance to each child in working with a group and in handling individual problems.
(3) Administration of discipline and setting of limits for behavior that are consistent with trauma-informed care standards.
(4) Notation of the child's progress; identification of the possible need for additional professional services; and communication of such findings to professional staff...

title: Personnel Duties. Direct care staff shall perform the following duties


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Lidia Tinoco conducted an unannounced visit to the Berkeley Cottage STRTP in order to deliver the findings of the above allegations and met with Administrator, Dawn Lee. The above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, Interviews and a review of facility and children's records. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the allegations occurred. Therefore, the allegations are UNSUBSTANTIATED at this time. A copy of this report was discussed and provided to Dawn Lee along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

met_with: Dawn Lee


investigation_findings: 13On the above date, Licensing Program Analyst (LPA) Lidia Tinoco conducted an unannounced visit to the Berkeley Cottage STRTP in order to deliver the findings of the above allegations and met with Administrator, Dawn Lee. The above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, Interviews and a review of facility and children's records. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the allegations occurred. Therefore, the allegations are UNSUBSTANTIATED at this time. A copy of this report was discussed and provided to Dawn Lee along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3


summary: Facility Evaluation

raw_content:
Narrative:
On this date, Licensing Program Analyst (LPA) Lidia Tinoco traveled to the Creative Alternatives Main Office in Merced and conducted an unannounced Case Management for the Berkeley Cottage and met with Director Brandi Boehme. The purpose of the inspection is to discuss multiple incident reports regarding medication errors by Staff. LPA Tinoco reviewed incident reports from the Berkeley Cottage facility. It was discovered that there have been 1 medication errors due to staff for this facility (See LIC812 for details) in 2021. This Facility is currently not operating. LPA Tinoco discussed with Director Brandi the concerns with the amount of incident reports regarding medication errors being received, LPA also addressed what the licensee has been done at the agency level to prevent this from happening, and what the ongoing plans are moving forward to minimize these incidents. Director Brandi stated that a company wide training on administration of medication. An exit interview was conducted, and a copy of the report and appeal rights were provided to the facility.

met_with: Brandi Boehme


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced annual inspection was conducted by LPA (Licensing Program Analyst) Lidia Tinoco on at Berkeley Cottage. LPA met with Brandi Boehme and inspected the facility, inside and out. Currently the facility is inactive and has been inactive since March 2021. All facility smoke detectors were tested and appear to be in appropriate working order, fire extinguisher is properly charged. The facility currently keeps their food supply at an off site warehouse where they store non-perishables, fresh foods, and dairy that would be ready to be transported to the home would they choose to become active again. Individual beds were observed with appropriate clean linens and are in good repair. The facility is maintained at 72 degrees. No bodies of water were observed. No firearms or weapons are allowed in the facility. Licensee has obtained Mental Health Certification Including the following: Mental Health Program Approval valid through 9/24/21, Medi-Cal site certification issued on January 1, 2019 and a county contract through June 30, 2022. Licensee has obtained National Accreditation through CARF. The Accreditation is valid through September 30, 2023. Due to the facility being inactive no records of personnel/ staff members were reviewed and no records of clients were reviewed. There were no deficiencies to be cited on this date. A copy of this report was left with Brandi Boehme


summary: Facility Evaluation

raw_content:
Narrative:
On this date, Licensing Program Analyst (LPA) Lidia Tinoco traveled to the Creative Alternatives Main Office in Merced and conducted a Case Management for the Berkeley Cottage and met with Director Brandi Boheme and Administrators Monica Alexander, Aaron Holloway and Dawn Lee. The purpose of the inspection is to discuss multiple incident reports regarding medication errors by Staff for 2022. LPA Tinoco reviewed incident reports from the Berkeley Cottage facility. It was discovered that there have been 4 medication errors due to staff for this facility (See LIC812 for details) in 2022. LPA Tinoco discussed with Director Brandi the concerns with the amount of incident reports regarding medication errors being received, LPA also addressed what the licensee has been done at the agency level to prevent this from happening, and what the ongoing plans are moving forward to minimize these incidents. Director Boehme also noted that starting April 1, 2022 the Facility Administrators are in charge of Medication Reconciliation which will help with supervision of medications. A plan to provide a Medication training to the facility is ongoing. No Deficiencies were cited. An exit interview was conducted, and a copy of the report and appeal rights were provided to the facility.

met_with: Brandi Boehme, Monica Alexander, Aaron Holloway, Dawn Lee


facility_name: BERKELEY LODGE

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Lidia Tinoco conducted an unannounced visit to the Creative Alternatives main office in Merced in order to deliver the findings of the above allegations regarding the Berkeley Lodge and met with Director Brandi Boehme. During the course of the investigation, Community Care Licensing (CCL) conducted interviews with facility staff and foster youth as well as conducted a review of records. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation occurred. Therefore, the allegation that the group home staff did not provide appropriate supervision resulting in inappropriate interactions is UNSUBSTANTIATED at this time. LPA Tinoco conducted exit interview with Brandi Boehme. A copy of this report was provided to the Facility Representative. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2


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Investigation Findings:
13On the above date, Licensing Program Analyst (LPA), Lidia Tinoco conducted a complaint inspection, the purpose of the inspection was to deliver the findings for the above complaint allegations. LPA met with Program Director Brandi Boehme. The above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the facility, interviews and a review of facility and foster children's records. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation occurred. Therefore, the allegations are UNSUBSTANTIATED at this time. A copy of this report was discussed and provided along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco 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, E SHAW AVE This is an official report of an unannounced visit/investigation of a complaint received in our office on 09/29/2022 and conducted by Evaluator Lidia Tinoco PUBLICCOMPLAINT CONTROL NUMBER: 24-CR- FACILITY NAME:BERKELEY LODGEFACILITY NUMBER: ADMINISTRATOR:ALEXANDER, MONICAFACILITY TYPE: ADDRESS: N. BERKELEY AVENUETELEPHONE: (209) 667- CITY:TURLOCKSTATE: CAZIP CODE: CAPACITY:8CENSUS: 8DATE: 12/22/ UNANNOUNCEDTIME BEGAN: 02: PM MET WITH:Brandi BoehmeTIME COMPLETED:02: PM 9Staff Inappropriately Restrain the Children Facility is in Disrepair INVESTIGATION FINDINGS: 13On the above date, Licensing Program Analyst (LPA), Lidia Tinoco conducted a complaint inspection, the purpose of the inspection was to deliver the findings for the above complaint allegations. LPA met with Program Director Brandi Boehme. During the course of the investigation, Community Care Licensing (CCL) conducted interviews, as well as conducted a review of records and a facility inspection. The information obtained during the investigation showed a prepoderance of evidence to prove the allegations occured. This poses an immediate health and safety risk to clients in care. Facility was cited for the California Code of Regulations (CCR) 80087(a) Buildings and Grounds and Intermim Licensing Standards (ILS) 87095.65(f) Emergency Intervention Staff Training. A copy of the report and Appeal Rights was provided to the agency. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco 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 24-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, E SHAW AVE FACILITY NAME: BERKELEY LODGEFACILITY NUMBER: 500308363


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Investigation Findings:
13On the above date, Licensing Program Analyst (LPA), Lidia Tinoco conducted an unannounced visit to the Berkeley Lodge STRTP in order to deliver the findings of the above allegations and met with Administrator, Monica Alexander. On 04/29/2024, the above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, confidential interviews, and review of records. Based on the investigation conducted the department found that there was conflicting information regarding these issues. Although the allegations may have happened of are valid, there is not a preponderance of evidence to prove the allegations occurred. Therefore, the allegations are Unsubstantiated at this time. A copy of this report was provided at the conclusion of the inspection along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Monica Alexander


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Investigation Findings:
13On the above date, Licensing Program Analyst (LPA), Lidia Tinoco conducted an unannounced visit to the Berkeley Lodge STRTP in order to deliver the findings of the above allegations and met with Administrator, Monica Alexander. On 05/17/2024, the above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, confidential interviews, and review of records. Based on the investigation conducted the department found that there was conflicting information regarding these issues. Although the allegations may have happened of are valid, there is not a preponderance of evidence to prove the allegations occurred. Therefore, the allegations are Unsubstantiated at this time. A copy of this report was provided at the conclusion of the inspection along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA), Lidia Tinoco conducted an unannounced visit to the Berkeley Lodge STRTP in order to deliver the findings of the above allegations and met with Administrator, Monica Alexander. On 6/27/24, the above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, confidential interviews, and review of records. Based on the information obtained, there is a preponderance of the evidence to prove the above allegations occurred therefore these allegations are Substantiated. The Facility was cited for ILS, Version 5, Section 87095.00(c). See LIC9099D. Plans of Corrections were reviewed and developed with Monica Alexander. A copy of this report and appeal rights were provided at the conclusion of the inspection. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco 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 24-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FRESNO RO, E SHAW AVE FACILITY NAME: BERKELEY LODGEFACILITY NUMBER: 500308363


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA), Lidia Tinoco arrived at the Berkeley Lodge STRTP and met with Administrator, Monica Alexander for the purpose of delivering the findings of the investigation. On 08/01/2024, the above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, confidential interviews, and review of records. Based on the investigation conducted the department found that there was conflicting information regarding these issues. Although the allegations may have happened of are valid, there is not a preponderance of evidence to prove the allegations occurred. Therefore, the allegations are Unsubstantiated at this time. A copy of this report was provided at the conclusion of the inspection along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA), Lidia Tinoco conducted an unannounced visit to the Berkeley Lodge in order to deliver the findings of the above allegations and met with Administrator, Monica Alexander. On December 09, 2024, the above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, confidential interviews, and review of records. Based on the information obtained, there is a preponderance of the evidence to prove the above allegations occurred therefore these allegations are Substantiated. The Facility was cited for ILS, Version 5, Section 87095. Emergency Interventions Prohibition. See LIC9099D. Plans of Corrections were reviewed and developed with Monica Alexander. Proof of correction documents were provided to LPA Tinoco on this date and the deficiencies were cleared. A copy of this report and appeal rights were provided at the conclusion of the inspection. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco 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 24-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FRESNO RO, E SHAW AVE FACILITY NAME: BERKELEY LODGEFACILITY NUMBER: 500308363


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA), Lidia Tinoco conducted an unannounced visit to the Berkeley Lodge STRTP in order to deliver the findings of the above allegations and met with Administrator, Monica Alexander. The above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, confidential interviews, and review of records. Based on the investigation conducted the department found that there was conflicting information regarding these issues. Although the allegations may have happened of are valid, there is not a preponderance of evidence to prove the allegations occurred. Therefore, the allegations are Unsubstantiated at this time. A copy of this report was provided at the conclusion of the inspection along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco 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


facility_name: BETTY'S HOUSE OF CARE

summary: Facility Evaluation

raw_content:
Narrative:
On June 4, 2025, at 2: PM, Component II of the application process for Betty's House Of Care STRTP located at Bonito Ave Long Beach, CA. 90802 was held at the El Segundo Children's Residential Regional Office in El Segundo. Attending Component II were the following individuals: Licensing Program Analyst (LPA), Charmetha White, Applicant, Aisha Emaguna and Proposed Administrator Leonard Fowler. The following information and forms were discussed at the meeting: · LIC 624A - Death Report · LIC 624 - Unusual Incident/Injury Report · LIC 624LE - Law Enforcement Contact · ILS 87061 - Reporting Requirements · PIN 25- CRP - Guardian Training for Licensees and Providers · PIN 24- CRP - Chaptered Legislation Affecting Children's Residential Facilities and Homes: Summary and Implementation · PIN 24- CRP - Naloxone Distribution Project · PIN 24- CRP - Video Cameras in Children's Residential Congregate Care Facilities · PIN 24- CRP - Revisions To The Out-Of-State Disclosure & Criminal Record Statement (Form LIC 508D) Program Statement was reviewed and discussed. Pre-Licensing Inspection is scheduled for June 10, 2025. A copy of this report was issued to the Applicant, Aisha Emaguna.

met_with: Applicant - Aisha Emaguna and Proposed Administrator -Leonard Fowler


summary: Facility Evaluation

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Narrative:
On June 10, 2025 at 10: AM, Licensing Program Analysts (LPA's) C. White and A. Moratalla arrived at Betty's House of Care located at Bonito Ave Long Beach, CA. 90802 for the purpose of conducting a Pre-Licensing Inspection. LPA's was met by Applicant, Aisha Emaguna and Proposed Administrator, Leonard Fowler. The facility is requesting to be licensed as a Short Term Residential Program to provide to provide care and supervision to six (6) male children, ages 10 -14 years old, ambulatory only. Currently the census is zero (0). The home is set up as follows: This is a single story 3 bedroom, 2 ½ bathroom, home located in a residential area. The home consists of a living room, dining room, kitchen, laundry area, a backyard, and a detached shed. Living room: is equipped a sofa and two (2) chairs. There is also built in glass enclosed shelves that contains books and toys. Dining room: is equipped with six (6) chairs and two (2) long desk that have built in electrical ports. Kitchen: is equipped with a refrigerator/freezer, a four (4) burner gas stove (all burners were operational at the time of the inspection), a microwave, and a dishwasher. Sharp knives are kept locked in a cabinet located in the laundry area and made inaccessible to children in care. LPA observed a covered trash can, a locked pantry, ample plates, cups, and eating utensils. LPA observed ample nonperishable food items in the pantry. The applicant will ensure that three (3) nutritious meals and snacks will be provided to the clients. Laundry area: is adjacent to the kitchen. The area has a washer, dryer, a built-in cabinet, and a door leading to the side of the house. Detached shed: is equipped with a desk, chair, several file cabinets, and a closet. This area will be utilized by the Mental Health Team. Report continued on LIC 809C (Page 1 of 3) Bedroom #1 and Bedroom #2: are equipped with two (2) twin beds, drawers, a closet. Bedroom #3: is equipped with two (2) twin beds, drawers, a closet, and a portable wardrobe storage closet. The room contains a ½ bath and a door leading to the back yard. (Applicant was informed to change remove the lock from the bathroom door and to change the lock on the door leading to the backyard). Bathroom #1: is located in the hallway next to bedroom #2. The bathroom contains a toilet, sink, and a tub/shower combination. Bathroom #2: is located outside near the detached shed. The bathroom contains a toilet, sink, and a shower. All bathrooms were checked and found to be in working order. The backyard and front yard are fenced in. Vehicle: The applicant will use a Blue Dodge Grand Caravan to transport clients. The vehicle is in good condition with current registration through 08/08/2025 and insurance with Geico that expires 1/15/2025. LPAs observed two (2) fire extinguishers. Extra linens are stored in hallway cabinets. The smoke alarm and carbon monoxide detectors were tested and found to be in working order. Disinfectants and cleaning solutions are kept in a locked cabinet in the laundry area and in a locked closet in the hallway near the front entrance. Medications will be kept locked closet near the front entrance of the home. LPA observed the home to be clean, safe, and sanitary. Passageways, stairways, inclines, ramps and open porches are unobstructed. The front and backyard were clean and free of debris. LPA's informed Applicant, Aisha Emaguna, that the following needs to be fixed prior to licensure: 1. Landline/Phone 2. Disaster Booklet 3. Thermometer for clients 4. Thermometer for freezer & fridge Report continued on LIC 809C (Page 2 of 3) 5. Study Area for children. Table and lamp 6. Visitor section - w/ privacy - maybe outside 7. Tag for the fire extinguishers (2) 8. Remove plastics off the mattresses 9. Dead bolt bedroom#3 10. Bathroom knob in BR#3 - no locks 11. Piece of thing on the outside wall needs to be taken out 12. Locks for the home supplies - by the hallways 13. Locks on the top closet in bedroom#3 14. Pantry - change lock (Best Practice/BP) 15. Toolbox of the sharp objects 16. Get more cleaning supplies and store in the shed 17. Storage for Client and Staff File (lock file) 18. Door Sensors on the front door and laundry door. 19. Post menu and Complaint procedure This concludes the pre licensing inspection. An exit interview was conducted. A copy of this report left with the applicant, Aisha Emaguna.

visit_type: Prelicensing


summary: Facility Evaluation

raw_content:
Narrative:
On June 25, 2025 at 9: AM, Licensing Program Analysts (LPA's) C. White and A. Moratalla arrived at Betty's House of Care located at Bonito Ave Long Beach, CA. 90802 for the purpose of conducting a second Pre-Licensing Inspection. LPA's were met by Applicant, Aisha Emaguna and Proposed Administrator, Leonard Fowler. The facility is requesting to be licensed as a Short Term Residential Program to provide to provide care and supervision to six (6) male children, ages 10 -14 years old, ambulatory only. Currently the census is zero (0). The home is set up as follows: This is a single story 3 bedroom, 2 ½ bathroom, home located in a residential area. The home consists of a living room, dining room, kitchen, laundry area, a backyard, and a detached shed. Living room: is equipped a sofa and two (2) chairs. There is also built in glass enclosed shelves that contains books and toys. Dining room: is equipped with six (6) chairs and two (2) long desk that have built in electrical ports. Kitchen: is equipped with a refrigerator/freezer (with temperature thermometers for both), a four (4) burner gas stove (all burners were operational at the time of the inspection), a microwave, and a dishwasher. Sharp knives are kept locked in a cabinet located in the laundry area and made inaccessible to children in care. LPA observed a covered trash can, a locked pantry, ample plates, cups, and eating utensils. LPA observed ample nonperishable food items in the pantry. The applicant will ensure that three (3) nutritious meals and snacks will be provided to the clients. Laundry area: is adjacent to the kitchen. The area has a washer, dryer, a built-in cabinet, and an exit door leading to the side of the house. Detached shed: is equipped with a desk, chair, several file cabinets, and a closet. This area will be utilized by the Mental Health Team. Report continued on LIC 809C (Page 1 of 2) Backyard: Contains an enclosed pop-up tent for private visitation purposes. Bedroom #1 and Bedroom #2: are equipped with two (2) twin beds, drawers, a closet, a desk, chair, and a lamp. Bedroom #3: is equipped with two (2) twin beds, drawers, a closet, a desk, chair, a lamp, and a portable wardrobe storage closet. The room contains a ½ bath and a door leading to the back yard. This door has a deadbolt lock for security purposes. Bathroom #1: is located in the hallway next to bedroom #2. The bathroom contains a toilet, sink, and a tub/shower combination. Bathroom #2: is located outside near the detached shed. The bathroom contains a toilet, sink, and a shower. All bathrooms were checked and found to be in working order. Vehicle: The applicant will use a Blue Dodge Grand Caravan to transport clients. The vehicle is in good condition with current registration through 08/08/2025 and insurance with Geico that expires 1/15/2025. LPAs observed the facility to have two (2) regulation fire extinguishers. The facility has a working telephone. Extra linens are stored in hallway cabinets. The smoke alarm and carbon monoxide detectors were tested and found to be in working order. The First Aid kit was checked and found to be complete with scissors, tweezers, thermometer, gauzes, antiseptic, and First Aid Manual Guide. Disinfectants and cleaning solutions are kept in a locked cabinet in the laundry area and in a locked closet in the hallway near the front entrance. Medications will be kept locked closet near the front entrance of the home. There are no security bars on the bedroom windows. There are chimes on the exit doors. There are no firearms or dangerous weapons in the facility. There are no bodies of water on the premises. LPA observed the home to be clean, safe, and sanitary. Passageways, stairways, inclines, ramps and open porches are unobstructed. The front and backyard are fenced in and were clean and free of debris. All posting requirements, including the Emergency Plan, and grievance procedure were met and posted on the wall. The LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. Licensee will ensure to utilize the Unusual Incident Report LIC 624, and LIC 624LE to document incidents. Clients and Staff Records will be stored in locked file cabinets located in a locked hallway closet. There were no deficiencies cited at this time. This facility is within Title 22 regulation standards and is placement ready.


summary: Facility Evaluation

raw_content:
Narrative:
On June 25, 2025, at 11: AM, Licensing Program Analyst (LPA), Charmetha White, Licensing Program Analyst (LPA), Aimee Moratalla made a Case Management Other visit for the purpose of conducting the Component III portion of the application process for Betty's House Of Care STRTP located at Bonito Ave Long Beach, CA. 90802. Attending Component III were the following individuals: Applicant, Aisha Emaguna, and Proposed Administrator Leonard Fowler. Component III Orientation Summary The purpose of the Component III Orientation was to review program-specific regulatory requirements, discuss operational responsibilities, and ensure the applicant and key personnel fully understand the ongoing compliance expectations outlined in the California Code of Regulations, Title 22, and the Interim Licensing Standards for STRTP. Topics discussed included, but were not limited to: staff qualifications, client personal rights, incident reporting procedures, documentation requirements, emergency intervention protocols, and the importance of maintaining full regulatory compliance across all operational areas of the facility. Participants actively engaged in the discussion and were encouraged to ask questions throughout. All parties were advised that Component III is a mandatory requirement in the STRTP licensing process, and that successful completion does not guarantee licensure. The applicant and proposed administrator demonstrated understanding of the material presented and were reminded to contact the Department with any future questions or concerns.

met_with: Applicant - Aisha Emaguna; Proposed Administrator - Leonard Fowler.


summary: Facility Evaluation

raw_content:
Narrative:
On April 1, 2026, Licensing Program Analyst (LPA) C. White made an unannounced visit to Betty's House of Care for the purpose of conducting Post Licensing Inspection. LPA met with Licensee, Aisha Emaguna and Administrator, Leonard Fowler. This facility is licensed to provide care and supervision to six (6) male children, ages 10 -14 years old, ambulatory only. Currently the census is zero (0). The home is set up as follows: This is a single story 3 bedroom, 2 ½ bathroom, home located in a residential neighborhood. The home has a living room, dining room, kitchen, laundry area, backyard, and a detached shed. Living room: is equipped a sofa and two (2) chairs, built in glass enclosed shelves that contains books and toys. Dining room: is equipped with two (2) long desk that have built in electrical ports and six (6) chairs. Kitchen: is equipped with a refrigerator/freezer, a four (4) burner gas stove (all burners were operational at the time of the inspection), a microwave, and a dishwasher. There is also a wooden table with six (6) chairs. Sharp knives are kept in a locked tool box located in a locked in a cabinet in the laundry area and made inaccessible to children in care. LPA observed a covered trash can, a locked pantry, ample plates, cups, and eating utensils. The facility has ample nonperishable food items in the pantry. There were no perishable foods in the home as there are no clients in care at this time. The Licensee will ensure that three (3) nutritious meals and snacks will be provided to the clients. Laundry area: is adjacent to the kitchen. The area has a washer, dryer, a built-in cabinets, and a door leading to the side of the house. Backyard: Contains an enclosed pop-up tent for private visitation purposes. Detached shed: is equipped with a desk, chair, several file cabinets, and a closet. This area will be utilized by the Mental Health Team. Bedroom #1 and Bedroom #2: are equipped with two (2) twin beds, drawers, a closet, a desk, chair, and a lamp. Report continued on LIC 809C (page 1 of 2) Bedroom #3: is equipped with two (2) twin beds, drawers, a closet, a desk, chair, a lamp, and a portable wardrobe storage closet. The room contains a ½ bath and a door leading to the back yard. This door has a deadbolt lock for security purposes. Bathroom #1: is located in the hallway next to bedroom #2. The bathroom contains a toilet, sink, and a tub/shower combination. Bathroom #2: is located outside near the detached shed. The bathroom contains a toilet, sink, and a shower. All bathrooms were checked and found to be in working order. ½ Bathroom: is located inside bedroom #3 and it contains a toilet and sink. LPA observed the facility to have two (2) regulation fire extinguishers. The facility has a working telephone. Extra linens are stored in hallway cabinets. The smoke alarm and carbon monoxide detectors were tested and found to be in working order. The First Aid kit was checked and found to be complete with scissors, tweezers, thermometer, gauzes, antiseptics, and First Aid Manual Guide. Disinfectants and cleaning solutions are kept in a locked cabinet in the laundry area. Medications will be kept in a locked cabinet in the staffing office. Medications requiring refrigeration will be kept in a combination lock box in the refrigerator. There are no firearms or dangerous weapons in the facility. There are no bodies of water on the premises. LPA observed the facility to be clean, safe, and sanitary. Passageways and porch were unobstructed. The front and back yard were free of debris and hazardous material. Vehicle: The facility has a Blue Dodge Grand Caravan to transport youth in care. LPA inspected the vehicle and found the horn, lights, and all seat belts in working order. LPA observed the vehicle to have valid car registration and car insurance with Nonprofits Insurance Alliance of California. LPA discussed and advised the Licensee to ensure the following: Children are supported and encouraged to participate in extracurricular activities. Children are allowed and encouraged to contact the licensing agency or the Foster Care Ombudsperson, in confidence, without threats or punishment for making complaints. Children are afforded dignity in personal relationships with others in the home. LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. All posting requirements and Emergency Plan were met. The Licensee ensure all staff working in the facility will have DOJ/FBI criminal record clearances, and Child Abuse Index Checks. Facility will operate within license conditions & limitations including capacity limit. An Exit interview was conducted, and a copy of this report was left at the facility with the Licensee. (Page 2 of 3)


facility_name: BLISSFUL LIVING GROUP HOME, INC.

raw_content:
Narrative:
Facility staff denied witnessing the incidents but disclosed that clients in care either complained about the behavior of the staff to them or heard clients discussing the behavior of the staff. Two staff recalled reporting the incidents to administration, but administration was not aware of the behavior of the staff. Staff admitted that in some context during conversation with clients, inappropriate comments may have been made, but was not intentional. Staff reported being unaware that some comments made were offensive. Based on the above information, the preponderance of evidence standard was met so therefore, the allegation is substantiated. This poses an immediate Health, Safety, or Personal Rights risk to clients in care. The facility is cited under STRTP Interim Licensing Standards 87072(d)(11) Personal Rights. The finding of the allegation and a plan of correction was discussed with the facility representative. A copy of this signed report, the LIC 9099-D, LIC Confidential Names Form dated 11/3/21, and Appeal Rights forms were provided at the conclusion of the inspection. Other clients denied being inappropriately touched by staff. Other facility staff denied witnessing staff inappropriately touching any client in care; clients never reported to other staff that they were inappropriately touched by staff. Staff denied inappropriately touching any client in care. Based on information obtained, the allegation is unsubstantiated. Although the allegation may have happened or is valid, there was no preponderance of evidence found to prove or disprove that the allegation occurred. An exit interview was conducted. A copy of this signed report, the LIC Confidential Names Form dated 11/3/21, and Appeal Rights forms were provided to the facility representative at the conclusion of the inspection.

Investigation Findings:
13On November 3, 2021, Licensing Program Analyst (LPA) Irene Yamamoto conducted a complaint inspection at the facility to deliver the findings of the allegation. The allegation was investigated by the Department's Investigations Branch (IB), assigned to Investigator Philippe Miles. Investigator Miles conducted confidential interviews with clients, staff and other related parties and reviewed pertinent records from the facility files. It was alleged that staff makes inappropriate and derogatory comments towards clients in care. Confidential interviews reveal a pattern of offensive references made towards clients in care by one staff such as, "sexy tranny, sexy chocolate and faggot." The same staff makes insensitive comments to clients regarding their clothes and/or physical characteristics. Sexually offensive comments towards clients are made by staff based on staff's presumed behavior of clients. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Irene Yamamoto LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200a Monterey Park, CA Facility Name: Blissful Living Group Home, INC.FACILITY NUMBER: VISIT DATE: 11/03/2021

met_with: Raymond Maberry, Administrator


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
As S1 stood by the door, other clients pushed S1 aside and began to physically assault C1. The other clients who managed to go inside the bedroom reported wanting to de-escalate the situation which C1 denied. The other clients confirmed that S1 closed the door and told the clients to "handle it." C1 reported being attacked by the other clients so C1 acted in self-defense against C2 and the other clients. S1 initially denied closing the door but admitted to doing so after further questioning by Investigator Williams. S1 reported not realizing the situation could get out of control like it did and that the clients were only supposed to talk. The other staff (S2) reported being on the phone downstairs while S1 handled the incident upstairs. When S2 went upstairs, S1 was directing all the clients to go back to their bedrooms and C2 reported being stabbed by C1. S2 does not recall what S1 did or say during the incident. S2 admitted not giving any verbal redirection to clients to de-escalate the incident because S2 "was in shock." The incident resulted a law enforcement response to the facility. C2 was observed by law enforcement with seven punctures to the right hand, seven punctures to the right wrist, a scratch to the right forearm and a scratch to the right collarbone area. C1 sustained a bruise on the left eyebrow area and pain to the neck. Law enforcement recovered a hair pick on facility property which was identified as the weapon used to stab C2. It was described as eight inches in length with eleven metal prongs approximately six inches long with a two-inch handle. C1 was detained at the conclusion of law enforcement's response. Based on information obtained and records reviewed, there is a preponderance of evidence found to support a substantiated finding of neglect/lack of supervision that staff allowed clients to engage in physical altercation resulting in clients sustaining serious injuries. This poses an immediate Health, Safety, or Personal Rights risk to clients in care. The facility is cited under California Code of Regulations, Title 22, Section 80078(a) Responsibility for Providing Care and Supervision. The finding of the allegation and a plan of correction was discussed with the facility representative. A copy of this signed report, the LIC 9099-D, LIC Confidential Names Form dated 11/8/21, and Appeal Rights forms were provided. Exit interview conducted.

Investigation Findings:
13On November 8, 2021, Licensing Program Analyst (LPA) Irene Yamamoto met with the facility representative at the Monterey Park Regional Office in order to discuss the finding of the allegation. The allegation was investigated by the Department's Investigations Branch (IB), assigned to Investigator Marlon Williams. Investigator Williams conducted confidential interviews with clients, staff and other related parties. Investigator Williams also reviewed pertinent records from the facility files and other agency records. It was alleged that staff allowed clients in care to engage in physical altercation resulting in serious injuries. Confidential interviews reveal that on 7/12/21, one staff (S1) was having a private conversation with a client (C1) outside the facility when another client (C2) asked to speak to S1. As C1 walked back inside and C2 walked outside towards S1, C2 reported being spat on by C1. C1 went to a bedroom upstairs and C2 followed to confront C1. S1 reported following the clients upstairs but the bedroom door was already closed. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Irene Yamamoto LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200a Monterey Park, CA Facility Name: Blissful Living Group Home, INC.FACILITY NUMBER: VISIT DATE: 11/08/2021

met_with: Felicia Alexander, Administrator


raw_content:
Narrative:
It was alleged that facility staff violated the personal rights of one client in care on multiple occasions by making inappropriate comments towards them. In an interview conducted, one client stated that the inappropriate comments would happen occasionally and generally stemmed from one staff member. The client stated that they felt safe in the home despite feeling disrespected and invalidated at times. In interviews conducted, two other clients stated that they have never witnessed or heard of staff making inappropriate comments towards any of the clients in the home. Both clients stated that they felt safe in the home and had no complaints. In an interview conducted, one staff member denied the allegation and stated that they did not interact with the first client regularly and had not seen or heard of any staff members making inappropriate comments towards them. The staff member stated that they were friendly with the clients and did not have any issues caring for them. In an interview conducted, a second staff member also denied the allegation and stated that they had never seen or heard of any staff members intentionally violating the personal rights of clients in care by making inappropriate comments towards them. In an interview conducted, a social worker stated that they were aware of the allegation but did not have immediate concerns for the client's safety in the home. In an interview conducted, the county investigator stated that they did not have any immediate concerns about the client's safety in the home and that it appeared the situation in the home between the client and staff had stabilized. Based on interviews conducted and records reviewed, there is not a preponderance of evidence to suggest that the allegation occurred. Although the allegation may have happened or may be valid, the preponderance of evidence standard has not been met. Therefore, the allegation is deemed UNSUBSTANTIATED. An exit interview was conducted and a copy of this report was provided to the Licensee.

Investigation Findings:
13On August 18, 2023 at approximately 12: PM, LIcensing Program Analyst (LPA) Raymond Wu conducted an unannounced complaint inspection visit at the facility for the purposes of delivering findings for the above allegation. LPA met with the representative named above and discussed the purpose of the visit. As part of the investigation, interviews with clients were held on 05/10/2023 and 07/31/2023. Interviews with staff were held on 05/10/2023. Interviews with outside parties were conducted on 05/31/2023 and 06/09/2023. Records were reviewed on 05/10/2023 and 08/14/2023. (Continued) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Yan Yeung LICENSING EVALUATOR NAME: Raymond Wu LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200a Monterey Park, CA Facility Name: Blissful Living Group Home, INC.FACILITY NUMBER: VISIT DATE: 08/18/2023

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

met_with: Facility Manager Jay Galloway


raw_content:
Narrative:
Continue from page 1 . . . The staff denied the allegations and stated that the client was not touch inappropriate on his private area. The staff stated that clients do a self search by putting their pockets inside out, taking their shoes off, shaking their shirt or moving the elastic band to make sure contraband is not being taken into the facility. The staff stated that the clients are given three meals per day plus snacks and that the clients can get more food if the clients are still hungry. The staff stated that groceries are shopped once per week and that essential food is shopped as needed. The confidential interviews revealed conflicting statements about the allegations. There was information that indicated that the a staff touch inappropriately around a client's buttock when conducting a search and other information indicated that the client have not been touched inappropriately by the staff conducting a search. Other information revealed that the clients get three meal per day plus snacks but that sometimes food starts to run low because clients eat a lot during the week. Information indicated that clients can get more food servings after the first meals and that snacks are available to them. Based on the interviews and records reviewed, the allegations are found to be unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove the allegations. Copies of LIC9099, LIC9099C, LIC811 and Appeals rights were provided and discussed with the facility representative mentioned above. There were no deficiencies cited. Continue from page 1 . . . The information obtained from staff and clients revealed that a staff searched clients by putting his hands up and down the client's pants/bottoms in searching for contraband. Based on the staff statements and confidential interviews the allegation is found to be substantiated. A substantiated finding means that the preponderance of evidence standard has been met and the allegation is found to be true. Exit interview completed. The following deficiencies cited and a copy of this report and appeal rights were left with facility representative mention above.

Investigation Findings:
13On August 18, 2023, Licensing Program Analyst (LPA) Heriberto Perez conducted a follow-up complaint inspection to the above facility and met with Jessie Galloway, Facility Manager. The purpose of the inspection was to deliver the revised finding for the above complaint allegations. During the course of the investigation, LPA interviewed County Social Worker (CSW) via telephone on 04/17/23, LPA interviewed two clients and two staff on 04/20/23, LPA interviewed two clients on 04/26/23, LPA interviewed County Social Worker (CSW2) via telephone on 07/25/23 and LPA interviewed one staff via telephone on 07/26/23 (see Confidential Names Form LIC 811 dated August 18, 2023). LPA also reviewed documents including but not limited to Client's Need and Service Plans, Special Incident Reports (SIR), other documents and County Investigation report. It was alleged Staff inappropriately touched minor and Staff does not ensure that minors have adequate food. 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: Blissful Living Group Home, INC.FACILITY NUMBER: VISIT DATE: 08/18/2023

met_with: Jessie Galloway, Facility Manager


raw_content:
Narrative:
It was alleged that staff are not ensuring minor attends school. Staff denied the allegation. C1 has an issue with going to school. Staff encourage C1 to go to school but C1 refuses to go. The facility staff tried to work with the school to see if school staff member could go to the facility to work with C1. The facility staff also tried independent study multiple times but it did not work. They also tried change school and C1 attended school for a short period of time, and C1 refused to go to school again. C1 was removed from the facility on April 25, 2024. The statements obtained from the confidential interviews did not provide sufficient information to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that alleged violation occurred, therefore the allegation is unsubstantiated. There were no deficiencies cited during this inspection. An exit interview was conducted. A copy of this report, Confidential Names Form, and Appeal Rights were provided to the facility representative via electronic mail.

Investigation Findings:
13On July 2, 2024, at 11: AM, Licensing Program Analyst (LPA) Karen Suh conducted a follow-up complaint inspection to deliver the finding of an investigation concerning to the allegation above. The LPA met with Alicia Brown, Facility Manager, and discussed the finding. The investigation included confidential interviews that consisted of but were not limited to: LPA Rarela interviewed three staff on January 29, 2024; LPA Suh interviewed three staff on June 11, 2024 and June 12, 2024. The LPA was unable to contact County Social Worker (CSW) after several attempts. The LPA was unable to interview three clients. The LPA contacted C1's (see Confidential Names LIC811, dated July 2, 2024) current placement multiple times to interview but the LPA did not receive any response from the current caregiver and two clients declined to be interviewed. The LPA obtained and reviewed C1's Needs and Services Plan, correspondents of email regards C1's school, classes, school attendance and refusal. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Yan Yeung LICENSING EVALUATOR NAME: Karen Suh LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200a Monterey Park, CA Facility Name: Blissful Living Group Home, INC.FACILITY NUMBER: VISIT DATE: 07/02/2024

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

met_with: Alicia Brown


summary: Complaint Investigation - Substantiated - 3 allegations

raw_content:
Narrative:
Page The Department received a complaint alleging staff (S1) hosted minors at her home, fondled a client's (C1) genitals and kissed C1 mouth to mouth in her bedroom. In addition, it was alleged S1 transported C1 and another client to a strip club. Record review revealed S1 denied having inappropriate sexual contact with C1. However, S1 admitted she took two clients to a strip club on 4/14/24. In addition, S1 admitting she hosted both clients at her home on that same day and previously on multiple occasions. The alleged victim was interviewed by multiple agencies and provided consistent statements, which included divulging prior incidents of unwarranted advances and nonconsensual kissing by S1. Based on information gathered from interviews conducted and record review the allegations are substantiated. The Department has investigated the allegations and, based on the totality of evidenced obtained, determined the preponderance of evidence has been met. Facility is cited for violation of STRTP Interim Licensing Standards 87072(c)(1) Personal Rights. A copy of this report, LIC811 dated 9/9/24, LIC9099D and appeal rights were provided to the above-mentioned facility representative. Exit interview conducted. Per the new Civil Penalty laws, Health and Safety (H&S) Code section 1548(E), an Enhanced Civil Penalty (ECP) determination is pending due to the substantiated allegation. If an ECP is warranted, a Community Care Licensing (CCL) representative will return to the facility to deliver the penalty assessment.

Investigation Findings:
13An unannounced follow up complaint inspection was conducted by Licensing Program Analyst (LPA) Christopher Larios on 9/9/24 at 12: PM. During the inspection LPA Larios met with Facility Manager (FM) Alicia Brown and delivered findings regarding the above-mentioned complaint allegations. The investigation was conducted by Community Care Licensing Division (CCLD) Investigations Branch (IB) Investigator Marlon Williams. During the course of the investigation, Investigator Williams conducted interviews with a Social Service Practitioner (SSP) on 7/19/24, a Pomona Police Department (PPD) detective and facility Residential Treatment Counselor (RTC) on 8/6/24, a client (C1) on 8/15/24, a former Facility Manager (FM) on 8/19/24, a second RTC and FM, and the facility Administrator on 8/20/24. Also, LPA Larios conducted a record review on 4/19/24 and obtained copies of, but not limited to, staff and client rosters, incident reports, daily logs and training records. In addition, LPA Larios obtained another agency's investigation narrative on 9/5/24. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Christopher Larios LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200a Monterey Park, CA Facility Name: Blissful Living Group Home, INC.FACILITY NUMBER: VISIT DATE: 09/09/2024

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


raw_content:
Narrative:
Based on the staff statements and confidential interviews the allegation is found to be substantiated. A substantiated finding means that the preponderance of evidence standard has been met and the allegation is found to be true. Exit interview completed. The following deficiencies cited and a copy of this report and appeal rights were left with facility representative mention above.

Investigation Findings:
13On December 19, 2024 at 9:00AM, Licensing Program Analyst (LPA), Pedro Ramos conducted a follow-up complaint inspection at the facility and spoke to Alicia Brown, Facility Manager. The purpose of the inspection was to deliver findings for the above complaint allegation. During the course of the investigation, LPA reviewed facility records and conducted interviews with 4 staff, 4 clients on 8/19/24. It was alleged due to lack of supervision, minors performed oral sex on another minor. Interviews revealed that staff#1-2 had allowed clients to sit behind them at a movie theater. Client#2-3 performed oral sex on client#1. Staff#1 had stepped away from her seat which was closest to the clients. When staff#1 came back to her seat she saw the incident. Staff#2 was sitting two rows away from the clients and stated she did not see the incident. Clients# 2-3 stated they did have oral sex with client#1 and stated it happened while staff was not looking as they were in the front seats and clients were in the seats behind them. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tira Logan LICENSING EVALUATOR NAME: Pedro Ramos 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: Blissful Living Group Home, INC.FACILITY NUMBER: VISIT DATE: 12/19/2024

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

met_with: Alicia Brown, Facility Manager


raw_content:
Narrative:
It was alleged staff spoke to minor in an inappropriate manner and staff does not treat minor with dignity or respect. Staff denied the allegations. Staff stated C1 was taken to the medical clinic they usually take the clients. Staff stated C1 was told he was going to school after the doctor visit and he was eventually dropped off at school. Staff stated he jumped out of the car. She stated she never said anything inappropriate to C1, but he "flipped" her off when he got out of the car. C1 was removed from the facility on November 8, 2024 and placed with a relative. Other staff interviewed stated C1 was manipulative and did not follow direction and would over exaggerate. Other clients did not want to make a statement. The statements obtained from the confidential interviews did not provide sufficient information to corroborate the allegations. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that alleged violations occurred, therefore the allegations are unsubstantiated. There were no deficiencies cited during this inspection. An exit interview was conducted. A copy of this report, Confidential Names Form, and Appeal Rights were provided to the facility representative via electronic mail.

Investigation Findings:
13On February 20, at 12: PM, Licensing Program Analyst (LPA) Pedro Ramos conducted a follow-up complaint inspection to deliver the finding of an investigation concerning to the allegations above. The LPA met with Alicia Brown, Facility Manager, and discussed the findings. The investigation included confidential interviews that consisted of but were not limited to:LPA Ramos interviewed three staff on October 10, 2024 and client#1. The LPA was able to interview County Social Worker (CSW). The LPA was unable to interview three clients (see Confidential Names LIC811, dated February 20, 2025) . The LPA obtained and reviewed C1's Needs and Services Plan and incident reports. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tira Logan LICENSING EVALUATOR NAME: Pedro Ramos 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: Blissful Living Group Home, INC.FACILITY NUMBER: VISIT DATE: 02/20/2025

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


summary: Facility Evaluation

raw_content:
Narrative:
On May 8, 2026, Licensing Program Analyst (LPA) Claudia Portillo conducted an unannounced follow-up case management inspection at the facility listed above and met with the facility representative to address concerns identified during a prior complaint investigation at the Short-Term Residential Therapeutic Program (STRTP). LPA Portillo obtained information during interviews conducted with staff and clients that a staff member left a knife unattended in which a client may have utilized to use as a threat to injure a staff member during an altercation. LPA reviewed the law enforcement (LE 624 form) in which indicated that a client had a knife on his hand to use towards a staff member. The report indicates that a staff member utilized crisis communication to calm the client and client gave the knife to staff. The report states that the police arrived to the facility to interview the client for pushing a staff and asking staff if she wanted to press charges against client. In addition, the officers had spoken to clients regarding the allegations that a staff member had pushed him. The report does not indicate the police interviewed client about the knife. Based on the information obtained through record review and confidential interviews, the preponderance of evidence standard was not met to indicate the client had a knife in his possession. Based on the information obtained, technical violations will be issued. An exit interview was conducted. Copies of LIC 809, LIC 811, and TV were provided to the representative.

met_with: Erika Segura, Case Manager


raw_content:
Narrative:
Confidential interviews with minors in care did not corroborate the allegations. Minors reported not witnessing the alleged incident. Minors indicated that profanity is commonly used among peers and, at times, directed toward staff. One client reported hearing a staff member use a single profanity toward a minor; however, no additional information or corroboration was obtained. Staff denied the allegations, reporting that no physical force was used and that any contact was incidental, describing the interaction as an accidental bump. Staff also denied speaking inappropriately to the minor and stated that redirection statements may have been misinterpreted as inappropriate language. Interviews with additional staff and clients did not yield any witnesses to corroborate that staff pushed the minor. Staff further indicated that clients may misinterpret redirection as criticism. Based on the information obtained through record review and confidential interviews, the preponderance of evidence standard was not met. Although the alleged incidents may have occurred, there is insufficient evidence to substantiate the allegations. Therefore, the allegations are determined to be unsubstantiated

Investigation Findings:
13On May 8, 2026, Licensing Program Analyst (LPA) Claudia Portillo conducted an unannounced visit to the Short-Term Residential Therapeutic Program (STRTP) and met with the facility representative to deliver findings regarding a complaint received by the Department on March 17, 2026. The complaint alleged that staff pushed a minor in care and spoke inappropriately to a minor in care. LPA conducted a review of staff files and foster children's records. Pertinent documents were obtained on March 25, 2026. Confidential interviews were conducted with two clients and one staff member on March 25, 2026; three staff members on April 14, 2026; the County Investigator on April 16, 2026; and one client on April 28, 2026 (see LIC 811 for confidential names). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Claudia Portillo 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: Blissful Living Group Home, INC.FACILITY NUMBER: VISIT DATE: 05/08/2026