facility_name: MERAKEY-AMANDA

raw_content:
Narrative:
Confidential interviews revealed C1 exited the facility through the delayed egress door while being supervised by staff and C1 was followed by two staff on foot and one staff in a vehicle. Confidential interviews stated staff verbally attempted to re-directed C1 to return to the facility however C1 refused. Confidential interviews stated that in emergency situations it is the least restrictive technique that will be effective and should be employed for safety. Confidential interviews stated staff followed the emergency intervention procedures in maintaining supervision and safety of C1 however, it was reported that it was unforeseen if the facility staff could have done more to supervise C1 and prevent C1 from trespassing. Based on confidential interviews, although the allegations that Client #1 (C1) exited the facility without supervision and staff are not adhering to the emergency intervention plan to address C1's behaviors, may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this signed report was provided to Facility Representative.

Investigation Findings:
13On 10/21/2022, at 11:00 a.m. Licensing Program Analyst (LPA) Marisol Lopez arrived at the facility unannounced and met with Program Representative Nicole Massie, of Merakey-Amanda to discuss the investigative findings for the allegations noted above. On 01/26/2022, at 11:00 a.m., Licensing Program Analyst (LPA) Marisol Lopez conducted an unannounced complaint investigation at the above facility and met with Facility Representative Cesar Argueta. LPA conducted a safety inspection, and no deficiencies were observed at that time. The investigation consisted of confidential interviews with one program director, one facility administrator, one service coordinator, five facility staff, one of one client (C1), five of seven adults (N1-N7), and review of incident reports. On 01/20/2022, the Department received an allegation that Client #1 (C1) exited the facility without supervision and that staff are not adhering to the emergency intervention plan to address C1's behaviors. It was reported that C1 exited the facility unsupervised, and trespassed into a neighbor's yard, hitting a neighbor on the shoulder. (see continuation form LIC9099-C dated 10/21/22) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Marisol Lopez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-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, METROPOLITAN DR. # FACILITY NAME: MERAKEY-AMANDAFACILITY NUMBER: VISIT DATE: 10/21/2022

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

met_with: Nicole Massie


state: CA

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Confidential interviews stated that during an AWOL, staff follow the emergency intervention procedures in maintaining supervision of the client, re-direct client, and contact law enforcement as needed however, it was reported that the facility could have done more to supervise clients. Based on confidential interviews, although the allegation that staff are not providing adequate supervision, may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this signed report was provided to Facility Representative.

Investigation Findings:
13On 10/21/2022, at 11:55 a.m. Licensing Program Analyst (LPA) Marisol Lopez arrived at the facility unannounced and met with Program Representative Nicole Massie, of Merakey-Amanda to discuss the investigative findings for the allegation noted above. On 3/7/2022 at 1: PM, Licensing Program Analyst (LPA) Gloria Meza-Gonzalez conducted an unannounced complaint investigation at the above facility and met with Program Administrator (PA) AnnMarie Stanton. LPA Meza- Gonzalez conducted a safety inspection, and no deficiencies were observed at that time. The investigation consisted of confidential interviews with one facility administrator, one service coordinator, three facility staff, one of one client (C1), five of seven adults (N1-N7), and review of incident reports. On 03/03/2022, the Department received an allegation that staff are not providing adequate supervision. Confidential interviews stated clients are never left unattended, and staff supervise all clients in and out of the facility. Confidential interviews stated that in an emergency situation, it is the least restrictive technique that will be effective and should be employed to maintain the clients and staff safety. (see continuation form LIC9099-C dated 10/21/22) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Marisol Lopez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-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, METROPOLITAN DR. # FACILITY NAME: MERAKEY-AMANDAFACILITY NUMBER: VISIT DATE: 10/21/2022

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

report_type: Complaint Investigation

complaint_status: unsubstantiated


raw_content:
Narrative:
Confidential interviews stated each client is transported wearing a seat belt and staff follow traffic guidelines. Confidential interviews stated there were no witnesses to the incident however it was alleged the incident occurred . Based on confidential interviews, although the allegation that facility staff endangered clients in a vehicle, may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this signed report was provided to Facility Representative.

Investigation Findings:
13On 10/21/2022, at 12:25 p.m. Licensing Program Analyst (LPA) Marisol Lopez arrived at the facility unannounced and met with Program Administrator Nicole Massie, of Merakey-Amanda to discuss the investigative findings for the allegation noted above. On July 15, 2022, at 10:35 a.m., LPA Lopez conducted an unannounced complaint investigation at the above facility and met with Program Representative Nicole Massie. LPA conducted a safety inspection, and no deficiencies were observed at that time. The investigation consisted of confidential interviews with one facility administrator, one service coordinator, three facility staff, one of two clients (C1-C2), one adult (N1), and review of incident reports. On 07/15/2022, the Department received an allegation that facility staff endangered clients in a vehicle. It was reported that staff did not stop and almost hit a vehicle while there were clients in the facility vehicle. Confidential interviews contradicted the information and stated the clients are transported individually, only having one client in the vehicle per transport, and each client was transported safely. (see continuation form LIC9099-C dated 10/21/22) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Marisol Lopez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-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, METROPOLITAN DR. # FACILITY NAME: MERAKEY-AMANDAFACILITY NUMBER: VISIT DATE: 10/21/2022

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


raw_content:
Narrative:
Confidential interviews stated C1 feels safe with all staff, C1 has never been handled in a rough manner by any staff and C1's personal rights have not been violated. Confidential interviews denied the allegation occurred however there were no other witnesses. Based on confidential interviews, although the allegation that Staff handled Client #1 (C1) in a rough manner while in care, may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this signed report was provided to Facility Representative.

Investigation Findings:
13On 10/21/2022, at 2:00 p.m. Licensing Program Analyst (LPA) Marisol Lopez arrived at the facility unannounced and met with Program Representative Nicole Massie, of Merakey-Amanda to discuss the investigative findings for the allegation noted above. On 08/19/2022 at 10:15 a.m., LPA Lopez conducted an unannounced complaint investigation at the above facility and met with Program Representative Nicole Massie. LPA conducted a safety inspection, and no deficiencies were observed at that time. The investigation consisted of confidential interviews with one facility administrator, one service coordinator, three facility staff, one of two clients (C1-C2), and review of incident reports. On 08/11/2022, the Department received an allegation that Staff handled Client #1 (C1) in a rough manner while in care. It was reported that staff pushed C1 which led to C1 eloping, however it was later stated that staff was annoying C1. Confidential interviews stated the incident was reported due to the possibility of a staff violating C1's personal rights. (see continuation form LIC9099-C dated 10/21/22) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Marisol Lopez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-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, METROPOLITAN DR. # FACILITY NAME: MERAKEY-AMANDAFACILITY NUMBER: VISIT DATE: 10/21/2022

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


raw_content:
Narrative:
Confidential interviews also stated C1 enjoys swinging on the swing set for long periods of time and C1 hugs the chains when swinging, potentially leaving marks on C1's arms at times. Confidential interviews stated staff use the least restrictive techniques when working with C1 in order to avoid injuries by clients or staff. Confidential interviews stated all injuries have been reported however it was alleged C1 sustained an unexplained bruise. Based on confidential interviews, although the allegation that Client #1(C1) sustained unexplained injuries while in care, may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this signed report was provided to Facility Administrator.

Investigation Findings:
13On November 03, 2022, at 2:35 p.m. Licensing Program Analyst (LPA) Marisol Lopez arrived at the facility unannounced and met with Program Administrator Samantha Chavez, of Merakey Amanda to discuss the investigative findings for the allegation noted above. On July 15, 2022 at 09:10 a.m., Licensing Program Analyst (LPA) Marisol Lopez conducted an unannounced complaint investigation at the above facility and met with Program Representative Nicole Massie. LPA conducted a safety inspection, and no deficiencies were observed at that time. The investigation consisted of confidential interviews with one facility administrator, one service coordinator, three facility staff, one of two clients (C1-C2), and review of incident reports. On 07/08/2022, the Department received an allegation that Client #1(C1) sustained unexplained injuries while in care. It was reported that C1 does not communicate, and it was observed C1 had bruising to C1's upper and lower arms. Confidential interviews stated C1 has a tendency of destructive behaviors causing slight bruising to C1's arms. (see continuation form LIC9099-C dated 11/03/2022) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Marisol Lopez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-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, METROPOLITAN DR. # FACILITY NAME: MERAKEY-AMANDAFACILITY NUMBER: VISIT DATE: 11/03/2022

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

met_with: Samantha Chavez


summary: Complaint Investigation - Substantiated - 3 allegations

raw_content:
Narrative:
Documents reviewed indicated that the work orders have taken months to fulfill. Confidential interviews and observations revealed there are cabinets with no doors in the kitchen, broken windows and holes in the wall covered with plywood. Based on confidential interviews, the allegations that facility is in disrepair and facility is unkempt are SUBSTANTIATED because the preponderance of evidence has been met. This posed an immediate Health, Safety, or Personal Rights risk to children in care, the facility will be cited for violating Title 22, Division 6, Chapter 1, Article 07. Physical Environment, Buildings and Grounds 80087 (a)The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. An exit interview was conducted, and plan of corrections was developed with Nicole Massie, Administrator. A copy of this report and appeal rights were provided to Nicole Massie, Administrator.

Investigation Findings:
13On May 25, 2023, at 8: AM, Licensing Program Analyst (LPA) Lucero Jauregui conducted an unannounced complaint inspection. The purpose of the inspection is to deliver the findings for the above allegation. LPA Jauregui met with Nicole Massie, Administrator. LPA Marisol Lopez conducted an inspection of the facility on March 3, 2023, and no deficiencies were noted. During the investigation, LPA Lopez obtained list of work orders and conducted five staff interviews (S1-S5). LPA Adrian Mendez conducted one staff interview and one client interview (S1, C1) and LPA Jauregui conducted record review of Amanda Lane Work Orders. On March 15, 2023, Community Care Licensing (CCL) received the allegations that facility is in disrepair and facility is unkempt. Confidential interviews revealed C1 has behaviors and engages in property destruction daily where it has become difficult to keep up with repairs. Confidential interviews revealed there is only staff conducting maintenance at the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: LUCERO JAUREGUI 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 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SO. Cal Sc/res, Metropolitan Dr. # FACILITY NAME: MERAKEY-AMANDAFACILITY NUMBER: VISIT DATE: 05/25/2023

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

met_with: Nicole Massie, Administrator

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Unsubstantiated - 3 allegations

raw_content:
Narrative:
It was stated that C2 was not provided dental care. Confidential interviews revealed C2 was taken to the dentist by biological mother on 9/27/22, however, there was no follow up appointment for wisdom teeth removal. Confidential interviews and documents reviewed revealed that staff took C2 to an appointment to receive a wisdom teeth consultation till 2/09/23; It was unclear to the delay of the appointment. Based on confidential interviews, the allegation that staff are not competent to provide the services necessary to meet C2's needs while in care may or may not have occurred, however, it is not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted and a copy of this report and appeal rights were provided to Nicole Massie, Administrator.

Investigation Findings:
13On June 13 2023, at 11: AM, Licensing Program Analyst (LPA) Lucero Jauregui conducted an unannounced complaint inspection. The purpose of the inspection is to deliver the findings for the above allegation. LPA Jauregui met with Nicole Massie, Administrator. LPA Marisol Lopez conducted an inspection of the facility on November 3, 2022, and no deficiencies were noted. During the investigation, LPA Lopez obtained incident reports, current client roster and staff roster with contact information, conducted one staff interview (P1) and one client interview (C1). LPA Adrian Mendez conducted one staff interview and one client interview (S2, C1) and LPA Jauregui conducted one client interview (C2), one staff interview (S2), and document review of C1 and C2s dental records. On October 31 ,2022, Community Care Licensing (CCL) received the allegation that staff are unable to meet the needs of minor(s) in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: LUCERO JAUREGUI 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 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SO. Cal Sc/res, Metropolitan Dr. # FACILITY NAME: MERAKEY-AMANDAFACILITY NUMBER: VISIT DATE: 06/13/2023

Allegations:
- UnsubstantiatedEstimated Days of Completion:
- Unsubstantiated Estimated Days of Completion:
- Unsubstantiated Estimated Days of Completion: 0


raw_content:
Narrative:
Confidential interviews indicated C1 needs assistance wiping, getting dressed, and to shower. Confidential interviews indicated when C1 is done using the bathroom, staff wipe until C1 no longer allows them to. Confidential interview indicated C1 allows staff to wipe as much as C1 can tolerate. Confidential interviews indicated C1 walks away and that means that C1 no longer wants to be wiped. Confidential interviews indicated staff would try again with wiping until C1 allows them to. Confidential interviews indicated staff wipe until the wipe is no longer dirty. Confidential interview indicated showers are offered by turning on the shower and guiding C1 to it. According to confidential interviews, sometimes staff's attempt works, and other times it does not. Confidential interviews indicated rashes and redness are common on C1. Confidential interview indicated C1 gets a rash on the inside of their thighs. Confidential interview indicated they have observed C1 get a rash after sprinting. Confidential interviews indicated staff apply ointment the best they can to address the skin irritation. Confidential interview indicated it can get difficult for staff to apply ointment in that area due to C1 not following direction, walking around while staff make attempts, and C1 bending over for only a few seconds. Confidential interview indicated C1 sometimes allows staff or sometimes pushes them away. Confidential interview indicated the facility asked to use moisture barrier cream for rashes, however, according to confidential interview, staff were denied by C1's authorized representative. Based on confidential interviews, the allegations that facility staff did not ensure minor's hygiene needs were met may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated. An exit interview was conducted, and a copy of this signed report and appeal rights were provided to Elizabeth Gauci.

Investigation Findings:
13On March 24, 2025 at 10: AM Licensing Program Analyst (LPA) Lucero Jauregui arrived at the facility unannounced and met with Elizabeth Gauci to discuss the investigative finding for the allegation noted above. LPA Jauregui and LPA Abby Saeteurn conducted an inspection of the facility on August 14, 2024, and no deficiencies were noted. During the investigation, LPA Jauregui interviewed six staff (S1-S4, S8-S9), one witness and two San Diego Regional Center Representatives. C1 was unable to be interviewed due to their limited verbal abilities. Pertinent documents were obtained. On August 12, 2024, Community Care Licensing (CCL) received allegation that facility staff did not ensure minor's hygiene needs were met. It was reported that during a visit, C1's relative noticed C1 had feces stuck to their groin area. It was reported that C1 was not properly wiped and that C1's skin appeared irritated and red. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: LUCERO JAUREGUI 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 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # FACILITY NAME: MERAKEY-AMANDAFACILITY NUMBER: VISIT DATE: 03/24/2025

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

met_with: Elizabeth Gauci, Backup Administrator


raw_content:
Narrative:
It was reported that staff did not comply with reporting requirements. It was reported that the facility failed to report seizures within a 24-hour agreement period. It was also reported that the facility did not report C1's injuries from falls. Confidential interview indicated seizures have been reported via telephone to the client's authorized representative within 24 hours and emergency services have been contacted if C1 needed to be transported to the hospital. It was reported that staff did not ensure the facility was free from pests. It was reported that there was an ant infestation in the facility with black ants crawling on the wall and in client bedrooms. Confidential interviews indicated during the summer there were issues with ants entering the facility. Confidential interviews indicated the issue was addressed by pest control. Record review indicated the facility has a contract with pest control which serviced the home to address the ants. It was reported that staff did not provide minor with drinking water. It was reported that there was no water provided to clients to drink, and kitchen cabinets were locked due to client behaviors. Confidential interviews indicated C1 has a water bottle to take on van rides. Confidential interviews indicated staff offer C1 water throughout the day. Confidential interviews indicated kitchen cabinets were locked for safety at times when a client had behaviors engaging in property damage in the kitchen. Confidential interviews denied water being denied to clients. It was reported that staff did not provide information to minor's authorized representative upon request. It was reported that medical information was not provided to C1's authorized representative when requested. It was reported that information could only be provided by the Administrator. Confidential interviews indicated Direct Support Professionals were allowed to provide information relative to events that occurred during their shift to avoid providing inaccurate information. Confidential interviews indicated that, although information was not provided or required to be provided upon request, information was provided to C1's authorized representative by the end of the day. Continued..... Based on confidential interviews and records reviewed, the allegations that staff did not comply with reporting requirements, staff did not ensure the facility was free from pests, staff did not provide minor with drinking water, and staff did not provide information to minor's authorized representative upon request, may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the allegations are unsubstantiated. An exit interview was conducted and a copy of this signed report and appeal rights were provided to Elizabeth Gauci. It was reported that the battery in C1's communication device would be dead with no way of charging it. Confidential interviews indicated that C1's clothes were accessible; however, C1 chose not to use them. Confidential interviews indicated C1's communication device is was always accessible to C1. Record review indicated that staff were to charge C1's communication device overnight and make it accessible to C1. Confidential interview indicated there were times when C1's communication device was not charged overnight, and the device was not available for use by C1 because the battery was dead. Based on confidential interviews and record review, the allegation that staff withheld minor's personal belongings is SUBSTANTIATED because the preponderance of the evidence standard has been met. This posed potential health, safety, or personal rights risk to youth in care. The facility is being cited for violation of Title 22, Division 6, Chapter Article 06. Continuing Requirements Responsibility for Providing Care and Supervision. [See Lic9099d]. An exit interview was conducted and Plan of Corrections was developed with Elizabeth Gauci and Nicole Massie, Administrator. A copy of this signed report, LIC9099D and appeal rights were provided to Elizabeth Gauci. .

Investigation Findings:
13On July 1, 2025 at 11: AM, Licensing Program Analyst (LPA) Lucero Jauregui arrived at the facility unannounced and met with Elizabeth Gauci and Nicole Massie, Administrator to discuss the investigative finding for the allegations noted above. LPA Jauregui conducted an inspection of the facility on September 27, 2024, and no deficiencies were noted. During the investigation, LPA Jauregui interviewed five staff (S1-S3, S5-S6). LPA attempted to interview Client 1 (C1) but was unable to obtain a statement due to child's limited verbal abilities. Pertinent documents were obtained. On September 23, 2024, Community Care Licensing (CCL) received allegations staff did not comply with reporting requirements, staff did not ensure the facility was free from pests, staff did not provide minor with drinking water, and staff did not provide information to minor's authorized representative upon request. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: LUCERO JAUREGUI 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 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # FACILITY NAME: MERAKEY-AMANDAFACILITY NUMBER: VISIT DATE: 07/01/2025

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

met_with: Elizabeth Gauci and Nicole Massie


raw_content:
Narrative:
It was reported that staff did not maintain accurate records. It was reported that S4 is not accurately documenting incidents. Confidential interview indicated C1's initial Individual Behavior Support Plan (IBSP) contained incorrect information regarding C1's previous placements. Record review confirmed C1's previous placement and is in accordance with C1's Individual Behavior Support Plan (IBSP). It was reported that staff did not administer medication as prescribed. It was report that staff is not administering the correct dosages of medication to C1. It was reported that C1 had an adverse reaction to a medication given causing C1 to shake and have vocalization. Confidential interviews indicated medication is administered by one staff member and verified by a second staff member. Confidential interviews indicated medication has been administered correctly. Confidential interview indicated C1's medication was changed by a medical professional, which resulted in C1 having a change in their body posture and movement. Confidential interview indicated there was a follow up appointment and C1's medication was changed. It was reported that staff did not seek medical attention for minor in a timely manner. It was reported that C1 had an episode due to administration of an incorrect dosage of medication, and staff did not seek medical attention. Confidential interviews indicated that C1 has seizures that are documented. Record review indicated staff are to call for emergency services if the seizures last longer than 5 minutes or more seizures in a 30-minute time frame. The investigation did not yield evidence that C1's seizure lasted longer than 5 minutes or that multiple seizures occurred within 30 minutes. It was reported that licensee did not ensure that facility phone was operable for minors in care. It was reported that the phones remained inoperable for more than four days and staff did not return phone calls. Confidential interviews indicated there is a phone located in the staff office in the common area of the facility. Confidential interviews indicated there are unexpected power outages where the landline and wi-fi is down. Confidential interview indicated the phone line has been down up to 24 hours at a time, and if clients want to use the phone during an outage, clients have personal cell phones that can be used if necessary. Continued..... Based on confidential interviews and records reviewed, the allegations that staff did not maintain accurate records, staff did not administer medication as prescribed, staff did not seek medical attention for minor in a timely manner, and licensee did not ensure that facility phone was operable for minors in care, may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the allegations are unsubstantiated. An exit interview was conducted and a copy of this signed report and appeal rights were provided to Elizabeth Gauci.

Investigation Findings:
13On July 1, 2025 at 10: AM, Licensing Program Analyst (LPA) Lucero Jauregui arrived at the facility unannounced and met with Elizabeth Gauci to discuss the investigative finding for the allegations noted above. LPA Jauregui conducted an inspection of the facility on September 27, 2024, and no deficiencies were noted. During the investigation, LPA Jauregui interviewed five staff (S1-S3, S5-S6). LPA attempted to interview C1 but was unable to obtain a statement due to child's limited verbal abilities. Pertinent documents were obtained. On September 20, 2024, Community Care Licensing (CCL) received allegations staff did not maintain accurate records, staff did not administer medication as prescribed, staff did not seek medical attention for minor in a timely manner, and licensee did not ensure that facility phone was operable for minors in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: LUCERO JAUREGUI 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 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # FACILITY NAME: MERAKEY-AMANDAFACILITY NUMBER: VISIT DATE: 07/01/2025

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

met_with: Elizabeth Gauci, Back up Administrator


raw_content:
Narrative:
Confidential interviews indicated staff interact with and redirect the clients well. A confidential interview indicated staff use a playful tone when speaking with the clients; however, staff use a serious tone when they want to convey when it's not play. Confidential interviews indicated staff use a firm tone with C1 when C1 is escalated. Confidential interview indicated it triggers C1 if C1 is spoken to in a raised voice. Confidential interviews denied observing staff yelling at either of the clients. Confidential interviews also denied having concerns with staff speaking inappropriately to the clients. Based on confidential interviews and lack of evidence to corroborate the allegation, the allegation that staff spoke to minor in an inappropriate manner is unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this signed report and appeal rights were provided to Nicole Massie, Administrator.

Investigation Findings:
13On September 9, 2025 at 10: AM, Licensing Program Analyst (LPA) Lucero Jauregui arrived at the facility unannounced and met with Nicole Massie, Administrator to discuss the investigative finding for the allegation noted above. LPA Jauregui conducted an inspection of the facility on February 5, 2025, and no deficiencies were noted. During the investigation, LPA Jauregui interviewed six staff (S1-S6) and two Regional Center Service Coordinators (SC1- SC2). LPA attempted to interview two clients (C1- C2) but was unable to obtain a statement due to clients' limited verbal abilities. On January 30, 2025, Community Care Licensing (CCL) received allegation that staff spoke to minor in an inappropriate manner. It was reported that S1 raises their voice at C1 when C1 is agitated causing C1 to become more agitated. It was reported it was asked for S1 to stop raising their voice at C1 but it continues to happen. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: LUCERO JAUREGUI 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 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # FACILITY NAME: MERAKEY-AMANDAFACILITY NUMBER: VISIT DATE: 09/09/2025

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


raw_content:
Narrative:
It was reported that S1 became agitated with C1's authorized representative for inquiring about the hospital's instructions. It was reported that C1's authorized representative became hostile and yelled at S1. Confidential interviews indicated C1 attended a medical appointment and S1 scheduled C1's follow up appointment based on the hospital's discharge paperwork. Confidential interviews indicated S1 sent a text message to C1's authorized representative notifying of a follow up appointment being scheduled for C1. Confidential interviews indicated shortly after the notification being sent C1's authorized representative arrived at the facility, was allowed inside the facility by staff, and C1's authorized representative made their way to the staff office, entered the code on the padlock, and entered the staff office. Confidential interviews indicated C1's authorized representative and S1 reviewed C1's discharge paperwork and instructions for the follow up appointment. Confidential interviews indicated C1's authorized representative became upset and yelled at S1. Another confidential interview indicated S1 became upset and yelled at C1's authorized representative to leave the facility. Confidential interviews indicated the staff office door was always closed and remained closed. Confidential interview indicated C2 was out on an outing during the interaction and C1 was asleep in their bedroom. Confidential interview indicated S5 was providing supervision outside of C1's bedroom. Confidential interview indicated S5 heard yelling through the staff office and C1 did not wake up nor was disturbed. It was reported that facility staff did not allow a minor to have a visitor. It was reported that S1 and C1's authorized representative had a conversation regarding C1's medical care that ended with S1 demanding C1's authorized representative to leave the facility denying C1's right to have a visitor after attending a medical appointment. Confidential interviews indicated C1's authorized representative and S1 engaged in a conversation that was not productive. Confidential interviews indicated S1 told C1's authorized representative to leave the staff office and they could have their visit with C1. Confidential interview indicated C1's authorized representative exited the staff office and went into C1's bedroom. Confidential interview indicated C1's authorized representative gave C1 a kiss and was walked out of the facility by S5. Confidential interviews indicated C1 does not get denied visits. Continued...... Based on confidential interviews and records reviewed, the allegations facility staff yelled in the presence of minors and facility staff did not allow minor to have a visitor may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the allegations are unsubstantiated. An exit interview was conducted with Nicole Massey, and a copy of this signed report and appeal rights were provided to Alicia Garza, Lead RBT.

Investigation Findings:
13On October 27, 2025 at 3: PM, Licensing Program Analyst (LPA) Lucero Jauregui arrived at the facility unannounced and met with Alicia Garza and Nicole Massey Administraor (via telephone) to discuss the investigative finding for the allegation noted above. LPA Jauregui conducted an inspection of the facility on June 11, 2025, and no deficiencies were noted. During the investigation, LPA Jauregui interviewed five staff (S1-S5). LPA attempted to interview two clients (C1-C2) but was unable to obtain a statement due to children's limited verbal abilities. Pertinent documents were obtained. On June 6, 2025, Community Care Licensing (CCL) received allegations that facility staff yelled in the presence of minors and facility staff did not allow a minor to have a visitor. It was reported that C1 attended a medical appointment and C1's authorized representative asked S1 for clarification on hospital's instructions regarding a follow up appointment for C1. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: LUCERO JAUREGUI 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 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # FACILITY NAME: MERAKEY-AMANDAFACILITY NUMBER: VISIT DATE: 10/27/2025

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

met_with: Alicia Garza, Lead Registered Behabior Technician (RBT)


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Narrative:
access to inappropriate objects. It was reported that clients have thrown objects over the fence into the neighbor's yard that could have potentially hurt other people, such as master locks and canned food. Confidential interviews revealed conflicting interviews. Confidential interviews revealed C1 has thrown items over the fence into the neighbor's backyard. Confidential interviews revealed the facility has moved canned goods into the locked garage, secured locks on the gate, and ordered a net to extend above the fence line, so C1 cannot throw items into the backyard. The allegation that clients have access to inappropriate objects, 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 appeal rights were discussed with Nicole Massie, Facility Administrator. Due to printer malfunction, a copy of this report, along with the LIC 811, and appeal rights will be emailed to the Facility Administrator. A signed copy of this report will be kept in the Facility file.

Investigation Findings:
13On December 14, 2022, at 3:15 pm, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Nicole Massie, Facility Administrator of Merakey-Amanda, to discuss the investigative finding for the allegation noted above. LPA conducted an inspection of the facility on 09/16/2022 at 10:30 am and no deficiencies were observed. LPA attempted to interview one client (C1), however, C1 declined to be interviewed. LPA interviewed five staff (S1-5). LPA reviewed the following documents during the investigation: C Individual Support Plan - IBST Meeting, Administrator's Certificate, Administrator's Training, Administrator's CPI Training verification, S4, and S CPI Training Certificates, IDD Orientation Training Record form, New Staff Orientation Training Record form, Special Incident Reports, C1 & C Face Sheet, Staff Schedule, Staff Contact List, C Needs and Services Plan, C Placement Agreement, and C Risk Assessment and Individual Emergency Intervention Plan. On September 15, 2022, Community Care Licensing (CCL) received an allegation that clients have UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 2 of Control Number 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: MERAKEY-AMANDAFACILITY NUMBER: VISIT DATE: 12/14/2022

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

met_with: Nicole Massie, Facility Administrator


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
On September 15, 2022, Community Care Licensing (CCL) received an allegation that the staff is not trained to care for clients. It was reported that clients have been outside of the facility and staff cannot de-escalate the clients. It was reported that C1 had a bat and hit the staff with the bat and the following day C1 had access to a pipe and attacked the staff. Based on confidential interviews and records revealed C1 has a history of aggressive behavior. Confidential interviews and records reviewed revealed that C1 hit S3 with their hands, S3 fell down and C1 attempted to hit S1 with their arm. Confidential records revealed S4 and S5 had not been trained on the facility's approved Emergency Intervention Training until after the incident occurred. Confidential interviews and records reviewed staff members were not hit with a bat or pipe during this incident. Based on confidential interviews, records reviewed, and the facility's program statement, the preponderance of evidence standard has been met regarding the allegation that staff is not trained to care for clients. This posed a potential Health, Safety, or Personal Rights risk to C1 in care, the facility will be cited for violating Title Regulations, Division 6, 89965(i). Personnel Requirements. An exit interview was conducted and appeal rights were discussed with Nicole Massie, Facility Administrator. Due to printer malfunction, a copy of this report, along with the LIC 811, and appeal rights will be emailed to the Facility Administrator. A signed copy of this report will be kept in the Facility file.

Investigation Findings:
13On December 14, 2022, at 3: PM, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Nicole Massie, Facility Administrator of Merakey-Amanda, to discuss the investigative finding for the allegation noted above. LPA conducted an inspection of the facility on September 16, 2022, at 10:30 am and no deficiencies were observed. LPA attempted to interview one client (C1), however, C1 declined to be interviewed. LPA interviewed five staff (S1-5). LPA reviewed the following documents during the investigation: C Individual Support Plan - IBST Meeting, Administrator's Certificate, Administrator's Training documents, Administrator's CPI Training verification, S4, and S CPI Training Certificates, IDD Orientation Training Record form, New Staff Orientation Training Record form, Special Incident Reports, C1 & C Face Sheet, Staff Schedule, Staff Contact List, C Needs and Services Plan, C Placement Agreement, C Risk Assessment and Individual Emergency Intervention Plan, and video recording of C1 outside of the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 4 of Control Number 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: MERAKEY-AMANDAFACILITY NUMBER: VISIT DATE: 12/14/2022

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


summary: Facility Evaluation

raw_content:
Narrative:
On July 08, 2021 at 10: AM Licensing Program Manager (LPM) Abdoulaye Traore, Licensing Program Analyst (LPA) Marisol Lopez and LPA Shanae Pharaoh arrived at Merakey-Amanda Enhanced Behavioral Support Home (EBSH). LPA's and LPM met with applicants Administrator Leslie Carter, Assistant Director Alex Brummer and Director Michelle Cozad who led a tour of the home. The purpose of the inspection is to conduct the pre-licensing inspection. The home was toured inside and out with the applicants. Applicants are applying for a maximum capacity of four clients. The home was approved for 2 ambulatory clients and 2 non-ambulatory clients clients age 1-17. The home is a one-story residence with four bedrooms and two bathrooms. The home will serve four clients between the age of 12-17 years old. Bedroom # The room consist of a full-size bed, dresser, night stand, and closet space. It sleeps one client- vacant. Bedroom # The room consist of a- full-size bed, dresser, night stand, and closet space. It sleeps one client- vacant Bedroom # The room consist of full-size bed, dresser, night stand, and closet space. It sleeps one client- vacant Bedroom# 4 the room consist of full-size bed, dresser, night stand, and closet space. It sleeps one client- vacant. Bedrooms were arranged so that no more than one child shares a room. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. There is sufficient linens, blankets, towels and pillows. The smoke detectors and carbon monoxide detectors were checked and were working properly. There are two fire extinguisher's in the home, one is located by entrance and one in living room, and both have a current inspection tag. Office will remain locked and staff/client files will be kept on site. Camera's were observed only in common areas. All hazardous items have been properly made inaccessible to areas where children will have access. The medication will be locked in hallway cabinet. Cleansers/chemicals were locked and stored in a cabinet in the garage. In locked garage there is an extra refrigerator, washer/dryer, emergency supply back pack and extra PPE. There is a lockbox for refrigerated medications. Sharp knives were inaccessible and stored in the locked kitchen cabinet. First Aid kit was accessible and had all required items including the thermometer. There were no guns or weapons as stated by administrator. The hot water temperature was tested and noted to be at 105 degrees. Applicants understands that the water temperature must be maintained within the regulation range of 105-120 degrees. Trash cans for storage of solid waste had tight fitting lids. Personal Rights, The Facility Sketch, Emergency Disaster Plan and visitation policy were posted. The backyard was observed to be clean and free of hazards. The facility has two doors with 30 seconds delayed egress. LPA verified and confirmed the delayed egress doors were functional during the inspection. The facility had the emergency intervention plan and emergency evacuation procedures in place. LPM completed the component III Orientation and discussed Incident reporting, including incidents related to Assembly Bill 388 law enforcement contacts as well as incidents involving emergency interventions. Based on this inspection, the home is appropriate for a capacity of 2 ambulatory clients and 2 non-ambulatory clients. LPA observed there was a pool located in the rear of the home. The pool will be covered and applicant will provide pictures of proof the pool has been filled-in, in order to complete the pre-licensing. Once completed, the request of License will be forwarded to Licensing Program Manager for final approval and pending the Department of Developmental Services Certificate of Program Approval. An Enhanced Behavioral Supports Home shall not be licensed by the Department until the Certificate of Program Approval, granted by the Department of Developmental Services, has been received in accordance with Health and Safety Code section 1567.62. Exit interview conducted and a copy of this report was discussed and provided to applicant this date

report_type: Facility Evaluation

visit_type: Prelicensing

met_with: Leslie Carter


summary: Facility Evaluation

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Narrative:
On July 28, 2022 at 09: AM Licensing Program Analyst (LPA) Marisol Lopez conducted an unannounced inspection of Merakey-Amanda Enhanced Behavioral Support Home (EBSH). LPA met with Administrator Samantha Chavez and Program Representative Nicole Massie. The purpose of the inspection is to conduct a required annual inspection. The home was toured inside and out. The home is set up for 2 ambulatory clients and 2 non-ambulatory clients clients age 1-17. The home is a one-story residence with four bedrooms and two bathrooms. The current census is two clients between the age of 12-17 years old Bedroom # The room consist of a full-size bed, dresser, night stand, and closet space. It sleeps one client- vacant. Bedroom # The room consist of a full-size bed, dresser, night stand, and closet space. It sleeps one client (C1). Bedroom # The room consist of a full-size bed, dresser, night stand, and closet space. It sleeps one client- vacant. Bedroom# 4 the room consist of a full-size bed, dresser, night stand, and closet space. It sleeps one client (C2). Bedrooms were arranged so that no more than one child shares a room. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. There is sufficient linens, blankets, towels and pillows. The smoke detectors and carbon monoxide detectors were checked and were working properly. There are two fire extinguishers in the home, one is located by entrance and one in living room, and both have a current inspection tag. Office is maintained locked and staff/client files are kept on site. Camera's were observed only in common areas. All hazardous items have been properly made inaccessible to areas where children will have access. The medications are locked in hallway cabinet. Cleansers/chemicals were locked and stored in a cabinet in the garage. In locked garage there is an extra refrigerator, washer/dryer, emergency supply back pack and extra PPE. There is a lockbox for refrigerated medications. Sharp knives were inaccessible and stored in the locked kitchen cabinet. First Aid kit was accessible and had all required items including the thermometer. There were no guns or weapons as stated by administrator. The hot water temperature was tested and noted to be at 110 degrees and maintained within the regulation range of 105-120 degrees. Trash cans for storage of solid waste had tight fitting lids. Facility has a work order for repairs being conducted that includes replacing door frames, two bed frames and kitchen cabinets. All required postings were visible: Personal Rights, The Facility Sketch, Emergency Disaster Plan and visitation policy were posted. The backyard was observed to be clean and free of hazards. The facility has two doors with 30 seconds delayed egress. LPA verified and confirmed the delayed egress doors were functional during the inspection. The facility had the emergency intervention plan and emergency evacuation procedures in place. LPA inspected the physical plant, operational requirements, disaster preparedness, emergency intervention plan and reviewed two of two client files (C1-C2) (see confidential name list, LIC811, dated 07/28/2022) and six of six staff files (S1-S6). LPA conducted three of three staff interviews (S1-S3) and 0 of 2 client interviews (C1-C2). Based on record review, the licensee did not comply as one (C2) of two clients (C1-C2) did not have a copy of the current court order, or written authorization of child's parent or guardian, for each psychotropic medication; and one (C2) of two clients (C1-C2) did not have the results of an examination for communicable tuberculosis and other contagious/infectious diseases which poses a potential health, safety or personal rights risk to persons in care. The facility is being issued a citation in accordance with the Title 22, CCR 84070(b)(12) and CCR 80069(c)(1). See LIC809-D dated 07/28/22 for the cited deficiency. An exit interview was conducted, and this report, appeal rights and LIC 811 was reviewed with Program Representative Nicole Massie and a copy of this report was provided.

visit_type: Annual


summary: Facility Evaluation

raw_content:
Narrative:
On July 18, 2025 at 8: AM Licensing Program Analyst (LPA) Lucero Jauregui conducted an inspection of the facility. LPA met with Joey Rios, Lead Direct Support Professional who provided LPA with an indoor tour of the facility. LPA met with Nicole Massie, Administrator who provided and outdoor tour of the faciliy. The home is set up for 2 ambulatory clients and 2 non-ambulatory clients clients age 1-17. The home is a one-story residence with four bedrooms and two bathrooms which is set up as followed: Bedroom # The room consist of a full-size bed, dresser, night stand, and closet space. It sleeps one client (C2) Bedroom # The room consist of a full-size bed, dresser, night stand, and closet space. It sleeps one client and currently vacant. Bedroom # The room consist of a full-size bed, dresser, night stand, and closet space. It sleeps one client and currently vacant. Bedroom# 4 the room consist of a full-size bed, dresser, night stand, and closet space. It sleeps one client (C1). Bedrooms were arranged so that no more than one child shares a room. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. There is sufficient linens, blankets, towels and pillows. There are two fire extinguishers in the home, one is located by the entrance and one in the living room, and both have a current inspection tag. Office is maintained locked and staff/client files are kept on site. There are 4 cameras in common areas of the facility, and 5 in the exterior of the facility. Continued.... All hazardous items have been properly made inaccessible to areas where children will have access. Cleansers/chemicals were locked and stored in a cabinet in the garage. In locked garage there is an extra refrigerator, washer/dryer, emergency supply back pack.. Sharp knives were inaccessible and stored in the locked kitchen cabinet in a lock box. Medication is maintained in the staff office and staff office is inaccessible to clients. First Aid kit was accessible and had all required items. There were no guns or weapons as stated by administrator. The hot water temperature was tested and noted to be at 112.6 degrees and maintained within the regulation range of 105-120 degrees. Trash cans for storage of solid waste had tight fitting lids. All required postings were visible: Personal Rights, The Facility Sketch, Emergency Disaster Plan, and Facility Policies. The backyard was observed to be clean and free of hazards. The facility has two doors with 30 seconds delayed egress. LPA verified and confirmed the delayed egress doors were functional during the inspection. The facility had the emergency intervention plan and emergency evacuation procedures in place. LPA inspected the physical plant, operational requirements, disaster preparedness, emergency intervention plan and reviewed two of two client files (C1-C2) (see confidential name list, LIC811, dated 07/18/24) and five of five staff files (S1-S5). LPA conducted two out of two staff interviews (S2-S4) and 0 of 2 client interviews (C1-C2) due to the clients limited verbal abilities. Based on today's inspections there are no deficiencies cited at this time. An exit interview was conducted and a copy of this signed report and LIC 811 was provided to Nicole Massie, Administrator. .


summary: Facility Evaluation

raw_content:
Narrative:
On October 20, 2021 at 10: AM Licensing Program Analyst (LPA) Danielle Garcia and LPA Marisol Lopez arrived at Merakey-Amanda Enhanced Behavioral Support Home (EBSH). LPA's met with Administrator Leslie Carter, who led a tour of the home. The purpose of the case management is to conduct the post-licensing inspection. The home was toured inside and out. The home is set up for 2 ambulatory clients and 2 non-ambulatory clients clients age 1-17. The home is a one-story residence with four bedrooms and two bathrooms. The current census is one client between the age of 12-17 years old Bedroom # The room consist of a full-size bed, dresser, night stand, and closet space. It sleeps one client- vacant. Bedroom # The room consist of a- full-size bed, dresser, night stand, and closet space. It sleeps one client (C1) Bedroom # The room consist of full-size bed, dresser, night stand, and closet space. It sleeps one client- vacant Bedroom# 4 the room consist of full-size bed, dresser, night stand, and closet space. It sleeps one client- vacant. Bedrooms were arranged so that no more than one child shares a room. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. There is sufficient linens, blankets, towels and pillows. The smoke detectors and carbon monoxide detectors were checked and were working properly. There are two fire extinguisher's in the home, one is located by entrance and one in living room, and both have a current inspection tag. Office is maintained locked and staff/client files are kept on site. Camera's were observed only in common areas. All hazardous items have been properly made inaccessible to areas where children will have access. The medications are locked in hallway cabinet. Cleansers/chemicals are locked and stored in a cabinet in the garage. In locked garage there is an extra refrigerator, washer/dryer, emergency supply back pack and extra PPE. There is a lockbox for refrigerated medications. Sharp knives were inaccessible and stored in the locked kitchen cabinet. First Aid kit is accessible and has all required items including the thermometer. The hot water temperature was tested and noted to be at 108 degrees. Applicants understands that the water temperature must be maintained within the regulation range of 105-120 degrees. Trash cans for storage of solid waste had tight fitting lids. Personal Rights, The Facility Sketch, Emergency Disaster Plan and visitation policy were posted. The backyard was observed to be clean and free of hazards. The facility has two doors with 30 seconds delayed egress. LPA verified and confirmed the delayed egress doors were functional during the inspection. The facility had the emergency intervention plan and emergency evacuation procedures in place. LPA discussed incident reporting, including incidents related to Assembly Bill 388 law enforcement contacts as well as incidents involving emergency interventions. Based on inspection and record review staff failed to accurately document medication log. The facility is being cited for California Code of Regulations, Title Health & Safety Code section: 1507.6(b)(2)(B). A copy of this report was provided to Program Administrator along with appeal rights.

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On December 08, 2022, at 10: AM, Licensing Program Analyst's (LPA's) Eduardo Barragan and Lucero Jauregui went to Merakey-Amanda and met with Nicole Massie, Program Administrator, to assess a Civil Penalty. LPA Barragan conducted a record review on the staff schedule with LPA Chamaine Linley on December 07, 2022, and LPA's noted that there were five staff that did not have a criminal record clearance prior to working at the facility. LPA's reviewed the dates the staff members worked and reviewed Guardian to ensure that staff did not have a criminal record clearance and they didn't. LPA Barragan requested copies staff roster, and asked for any supporting documents the facility may have. Nicole Massie, Program Administrator confirmed that (S1-S5) had been working at the facility. LPA's Barragan and Jauregui are administering five civil penalty's during this visit. The facility is being cited for the violation of California Code of Regulations, Title 22, Division Six, regulation 80019(e) Criminal Record Clearance. Record review confirms S1, S2, S3, S4 and S5 have worked in the facility without a criminal record clearance. An immediate civil penalty is being issued for $500. An exit interview was conducted with Nicole Massie, Program Administrator. A copy of this report and appeal rights were provided to Nicole Massie, Program Administrator

met_with: Nicole Massie, Program Administrator


raw_content:
Narrative:
Confidential interviews indicated C1 removed the clothing and the drawers from the dresser. Confidential interview indicated C1 removed the drawers and stacked them. Confidential interview also indicated C1 leaned on the dresser and punched the top of it while watching television. Confidential interview indicated the drawers in the dresser were unable to be opened and closed properly. A confidential interview indicated the dresser was observed broken while in C1's bedroom. During the investigation, LPA observed C1's clothing stored in laundry baskets in the bedroom closet and an empty broken dresser in the garage. Confidential interview indicated the dresser from C1's bedroom had been broken for one month. Based on confidential interviews and LPA observation, the allegation that licensee did not ensure furniture used by minor was in good repair is SUBSTANTIATED because the preponderance of the evidence standard has been met. This posed a potential health, safety, or personal rights risk to youth in care. The facility is being cited for violation of Title 22, Division 6, Section 84088(c)(4)(A) Fixtures, Furniture, Equipment and Supplies. [See Lic9099d]. An exit interview was conducted and a plan of correction was developed with Administrator Nicole Massy (via phone). A copy of this signed report, LIC 9099D and appeal rights were provided to Josh Munderlogh, Lead Registered Behavior Technician (RBT). Confidential interviews indicated the dresser in C1's bedroom was in disrepair and removed from the bedroom. Confidential interviews indicated C1 had clothing available and dressed themselves with the assistance of staff. Confidential interview indicated C1's clothing was placed in bins in their bedroom. Confidential interviews indicated C1 would take the clothes out of their bedroom leaving them on the floor. Confidential interviews indicated C1 had access to their communication device. Another confidential indicated C1 guided staff to communicate their needs. During the investigation, LPA observed C1's bedroom. LPA observed C1's clothing folded in laundry baskets placed on the floor in C1's bedroom closet. Based on confidential interviews and LPA observation, the allegation staff did not ensure minor had access to their personal belongings may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated. An exit interview was conducted, and a copy of this signed report and appeal rights were provided to Josh Munderlogh, Lead Registered Behavior Technician (RBT).

Investigation Findings:
13On March 5, 2026 at 10: AM, Licensing Program Analyst (LPA) Lucero Jauregui arrived at the facility unannounced and met with Josh Munderlogh, Lead Registered Behavior Technician (RBT) and Administrator Nicole Massy (via phone) to discuss the investigative finding for the allegation noted above. LPA Jauregui conducted an inspection of the facility on December 22, 2025, and no deficiencies were noted. During the investigation, LPA Jauregui interviewed two staff (S1-S2) and one San Diego Regional Center Service Coordinator. LPA attempted to interview two clients (C1-C2) but was unable to obtain a statement due to children's limited verbal abilities. Pertinent documents were obtained. On December 18, 2025, Community Care Licensing (CCL) received allegation that licensee did not ensure furniture used by minor was in good repair. It was reported that the dressers in C1's bedroom had been broken for four months. Specifically, it was reported that the drawers in the dresser were broken and C1's clothing and personal belongings were stored in the garage. It was reported that furniture was ordered but updates on the order were not provided. Continued.... SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: LUCERO JAUREGUI 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 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # FACILITY NAME: MERAKEY-AMANDAFACILITY NUMBER: VISIT DATE: 03/05/2026

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:


facility_name: MERAKEY - JUSTAMERE

raw_content:
Narrative:
Of the three clients interviewed, one reported snack was not provided consistently, one reported snacks were provided too often, and the third reported that snacks were accessible, but another client would eat all the snacks. While the kitchen fridge was temporarily broken, clients needed staff assistance to access the spare fridge in the locked garage. During the facility inspection, LPA observed sufficient food and large boxes of snacks accessible to the clients. Regarding the allegation of: Staff did not ensure that facility refrigerator is repaired,18 confidential interviews reported that the refrigerator in the kitchen broke, but the facility had an extra refrigerator in the garage where all the perishable food was stored. The new refrigerator was ordered, and it was shipped in 3 days. All 18 interviews reported that although the clients didn't have access to a refrigerator in the facility, they had access to the refrigerator in the garage. LPA observed the newly replaced kitchen fridge, as well as the back-up fridge in the garage. Regarding the allegation of: Facility does not follow the required ratio for minors in care, consistent statements were made during interviews that when the facility is out of ratio, a staff is asked to stay late or come in early. Staff leads are the floaters and are to assist with supervision when short staffed to maintain ratio. Leads will report to the Administrator and the Administrator will make calls to staff from other facilities and upper management to ensure ratio is maintained. LPA reviewed the staff schedule and observed ratio to have been maintained. Based on LPA's observations, interviews, and record reviews, although the allegations may have happened, or are valid, there is not a preponderance of evidence to prove the violations did, or did not, occur. Therefore, the allegations are UNSUBSTANTIATED. A signed copy of this LIC-9099 report and LIC-9099C were provided to the facility. An exit interview was conducted. Appeal rights were provided.

Investigation Findings:
13Licensing Program Analyst (LPA) Sara Luman-Gonzalez arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Malia Iulio, Shift Lead. LPA Vue conducted the complaint investigation. LPA Vue opened the investigation with the facility on 04/30/2024 and conducted a Health and Safety Inspection. During the course of the investigation, LPAs Vue and Thorn conducted eighteen (18) confidential interviews, including 13 current and former staff, and 3 clients. LPA Vue reviewed records from the facility including most current Needs and Service Treatment Plan or IPP, prior complaint history, and Serious Incident Reports. LPA also reviewed additional records such as Staff Schedule, Staff Contact Information, Client Safeguarded Cash Resources Records, and LIC 500. During interviews conducted and records reviewed regarding the allegation of: Facility does not allow minors to have access to food, statements provided were inconsistent. There was no concern reported of the provision of meals. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Sara Luman-Gonzalez 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: MERAKEY - JUSTAMEREFACILITY NUMBER: VISIT DATE: 07/26/2024

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

met_with: Malia Iulio, Shift Lead


summary: Complaint Investigation - Unsubstantiated

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Narrative:
One client out of three interviewed, alleged they were restrained ten times and the restraints were not warranted. Upon review of the Serious Incident Report submitted about the three restraints, LPA found the restraints were properly documented and reported, and followed regulatory procedures, to maintain the safety of the client and other clients present. Based on LPA's interviews which were conducted and records reviewed, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. A signed copy of this LIC-9099 report, the LIC-9099C, and appeal rights were provided to the facility. An exit interview was conducted.

Investigation Findings:
13Licensing Program Analyst (LPA) Sara Luman-Gonzalez arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Malia Iulio, Shift Lead. LPA Aleza Ruiz conducted the complaint investigation. LPA Ruiz and LPM Hillary Hall opened the investigation with the facility on 6/14/2024 and met with Teja Ordonez-Phillips, Administrator. During the course of the investigation, LPA and LPM interviewed three current staff. LPA reviewed records including: Placement Roster, Training logs, Serious Incident Reports, and Needs and Service Plans/Individualized placement plans for clients. LPA also reviewed prior complaint history including 13 current and former staff interviews and three client interviews. Interviews with staff were inconsistent regarding the details of an incident where a client was restrained three times in one day. Record review indicated a total of three restraints were documented for one client, and zero for the other three clients, which was corroborated by staff interviews. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Sara Luman-Gonzalez 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: MERAKEY - JUSTAMEREFACILITY NUMBER: VISIT DATE: 07/26/2024


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Narrative:
On the matter of lack of intervention to mitigate self-harming (including accessibility to a metal backscratcher), sufficient records of a client's medical condition were found, along with statements from staff, that should've reasonably informed the appropriate care and supervision that staff should have provided to the client- the client's wounds worsening could reasonably be attributed to having given access to a potentially harmful object. As for staff not following a minor's care plan, records indicate that there was insufficient compliance to the plans nor was there enough follow-up done by healthcare professionals that the facility has on staff. Based on LPA's review of records and interviews, the preponderance of evidence standard has been met; therefore the above allegations are found to be Substantiated. CCR (California Code of Regulations) Title 22, Division 6, Chapter 1, Article Section 80078(a) and Chapter 5, Article Section 84078(b) are being cited on the attached LIC 9099D. A copy of this report is being provided to the facility along with the Appeal Rights; exit interview conducted. LPA confirmed the receipt of, and reviewed, an incident report submitted by the facility regarding the client in question-in the report, a date as early as 03/30/2025 was referenced in which the client was taken to a medical facility for assessment of a wound. The report indicated that the authorized representative was notified of events having to do with the seeking of medical care from that date up to the date of hospitalization. However, due to the nature of the wound's progress, earlier communication could have been made by the facility with the authorized representative and/or individuals attached to the case. Not enough corroborating evidence was found to support the allegation that the facility did not ensure a minor attended school; the interviewed client, themselves, stated that there was "never a problem going to school," and that a bus picked the youth up regularly. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the allegations are Unsubstantiated. Exit interview conducted; a copy of this report and of the Appeal Rights are being provided to the facility

Investigation Findings:
13On 08/15/2025, at 2: PM, Licensing Program Analyst (LPA) Chad Cabigon conducted an unannounced inspection of this Group Home to deliver the findings of, and close, the complaint investigation. LPA met with Administrator Harrisha Willis and Lead DSP LaDonya Reed and the following report was discussed: On 04/21/ LPA initiated the complaint investigation into allegations that 1) Staff did not prevent minor from self harming, 2) Staff did not prevent minor from having access to a harmful object, and 3) Staff are not following minor's care plan. Multiple onsite inspections were conducted throughout the course of the investigation wherein interviews were conducted in-person with staff and youth. Additional interviews were conducted with clients' family members and other personnel attached to the clients' cases. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Connie Goldie LICENSING EVALUATOR NAME: Chad Cabigon 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: MERAKEY - JUSTAMEREFACILITY NUMBER: VISIT DATE: 08/15/2025

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: Harrisha Willis, LaDonya Reed


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Narrative:
Statements independently obtained from multiple interviewees, along with documented reports from involved service providers, corroborate repeat instances of staff sleeping while on shift and in ratio for the provision of care and supervision to clients. Based on LPA's interviews and a records review, the preponderance of evidence standard has been met; therefore, the allegation is found to be Substantiated. California Code of Regulations (CCR) Title 22, Div. 6, Chapter 5, Article 6, Section 84065.2(b)(1) is being cited on the attached LIC 9099D. Exit interview conducted; a copy of this report is being provided to the facility along with the Appeal Rights. The referenced client had purportedly purchased a vehicle with their own money in a transaction that was done during an approved outing. Not enough evidence was found to reasonably hold the facility accountable for not being able to advise the client against engaging in such a transaction. Regarding a possible reporting requirement deficiency, not enough information was available to support there being a reporting non-compliance within the context of staffing decisions that the facility made. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the allegations are Unsubstantiated. Exit interview conducted; a copy of this report and of the Appeal Rights are being provided to the facility.

Investigation Findings:
13On 08/15/2025 at 3: PM Licensing Program Analyst (LPA) Chad Cabigon conducted an unannounced inspection of this Group Home to deliver the findings of, and close, the complaint investigation. LPA met with Administrator Harrisha Willis and Lead DSP LaDonya Reed and the following report was discussed: On 04/21/ LPA initiated the complaint investigation into an allegation that Facility did not provide the appropriate level of care and/or supervision. Multiple onsite inspections were conducted throughout the course of the investigation wherein interviews were conducted in-person with staff and youth. Additional interviews were conducted with clients' family members and other personnel attached to the clients' cases. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Connie Goldie LICENSING EVALUATOR NAME: Chad Cabigon 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: MERAKEY - JUSTAMEREFACILITY NUMBER: VISIT DATE: 08/15/2025

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: Harrisha Willis, Ladonya Reed


summary: Facility Evaluation

raw_content:
Narrative:
A pre-licensing inspection was conducted by Licensing Program Analyst (LPA) Tana Kinder on 1/23/2023 with the facility Administrator. Criminal record clearances were reviewed, and the facility is in compliance. Community Care Licensing file, incident reports, facility roster, facility profile and complaint history were reviewed prior to visit at the agency. The licensing fees are current. The EBSH Facility has a capacity of four. There is 1 staff member associated to the Merakey-Justamere license and 44 associated to the Walk of Life-Justamere license. There are 2 clients residing at the facility under the Walk of Life-Justamere License. There were 5 staff working at the EBSH Facility at the time of the inspection. LPA reviewed 1 staff file, which was complete and up to date. The staff file reviewed had required training hours, education, administrator certification and fingerprint clearance. Personal rights, menu, Walk of Life-Justamere License and emergency exit plan were posted. The facility was inspected jointly with Teja Ordonez-Phillips, facility Administrator of the EBSH Facility. There are 4 bedrooms and 2 bathrooms. Each client's bedroom had a firm mattress, with a bed cover, sheets, blanket and pillows. Additionally, there is a sensory room for the clients to play in. The common area has couches and chairs to sit in, a TV and an in-door basketball hoop game for the clients. The facility is in good repair. There are cabinets in the laundry room with additional linen if needed for the bedrooms and the bathrooms. Additionally, each bedroom also has extra linen available. Client and staff files are in locked cabinets, in a locked office. The passageways from the front to the back of the facility are unobstructed. LPA observed 2 locked sheds in the backyard with facility supplies and client belongings and 1 locked shed with toys/equipment for the clients. LPA observed enough perishable/non-perishable food for 2 clients for 4 days/2 weeks. Smoke detectors are in working order. There is a carbon monoxide monitor and 2 fully charged and current fire extinguishers. continued... Disinfectants and cleaning solutions were in a locked cabinet in the laundry room. Sharps were kept locked in the office. The kitchen was stocked with plates, utensils and drinking cups sufficient for 4 clients. The water temperature from the bathroom faucet was 113.7 degrees. Medication disbursement is logged using the program, Quick MAR and is cross reconciled with the bubble packs and bottles medications are stored in. The client's hygiene kits were stocked and stored in a locked cabinet in the bathroom. A fully stocked first aid kit is kept in the staff office. The back fence between the garden and the shed was missing slats and will be replaced. The fertilizer and paintings in the shed for the clients to access their toys will be moved to the storage shed at the back of the grounds. A box or other system/location will be implemented to store extra monthly medications separately from the medications that are currently being used. Exit interview conducted and discussed with the facility Administrator. A copy of the pre-licensing inspection report was provided to the Administrator.

met_with: Facility Adminstrator


summary: Facility Evaluation

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Narrative:
On September 20, 2023, at 1: PM, Licensing Program Analyst (LPA), Shalisa Stiger made an unannounced visit to conduct a case management regarding an incident report received by The Department on 09/15/2023 regarding medication error resulting from an on site visit from Department of Developmental Services. LPA met with the Administrator who assisted with the inspection. The facility consists of 4 bedrooms and 2 bathrooms. Each client's bedroom has a bed, dresser and closet space for belongings. The common area has couches and chairs to sit in, a TV and sensory rooms for crafts and activities. The facility is clean and in good repair. Client and staff files are in locked cabinets, in a locked office. The passageways from the front to the back of the facility are unobstructed. LPA observed perishable/non-perishable food for clients and the facility will do a grocery run today. Disinfectants and cleaning solutions were in a locked cabinet under kitchen sink. Sharps were kept locked in the office. Medication is stored and locked in the medication office. Lastly, LPA Stiger observed the backyard consisting of a basketball hoop, sitting areas, and musical sensory equipment. The backyard was clean and free from debris. LPA Stiger observed medication(s) and MAR documentation corrections. LPA observed the medication timeframe showing 8am-8pm on bubble packs and correction was made in log. The Administrator advised LPA Stiger the LVN will receive documentation training by Alta region. Additionally, lead staff is due to be re-trained in Medication passing and signing by 9/22/2023 and all staff will be re-trained in medication on 9/27/2023. The facility wrote an incident report and submitted it to the Department on 9/13/2023. LPA Stiger observed and obtained a copy of the SIR. An exit interview was conducted, and a copy of this report was emailed to the Administrator. This case management investigation is closed.

met_with: Teja Ordonez Phillips, Administrator


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) Dawn Eunice conducted a Post Licensing inspection to the above Group Home and met with the above named individual. LPA observed the following items posted: - Personal Rights - Emergency Disaster - Exit signs - Foster Care Bill of Rights - Facility Sketch with emergency exit routes identified This Group Home (GH) has 4 bedrooms and 2 bathrooms; one bathroom is used for non-ambulatory clients. This GH has an office space, this office space is equipped computers, a copier, desks, chairs, locking cabinets, paper and usual office supplies (pens, paper, etc.). The home has a working telephone. During today's visit there are 3 children placed and this facility employes 20 staff. The staff to child ratios are: 2 to 1 for one client, and the two other clients have 1 to 1 supervision. The kitchen is clean, there is a menu binder, cups, plates, and cook ware. The Administrator indicates staff utilize Ukeru pads in an emergency; LPA observed 8 of them throughout the home. The program allows restraints, but no child placed currently needs/or has been restrained. Additionally, the program can accept children with special health care needs and those with incontinence; one child uses a wheel chair. Client and staff files are kept in locked cabinets to maintain confidentiality. There are three emergency exits, a first aid kit, and 2 fire extinguishers. There are 2 living rooms where children/families can interact. The furniture is in good repair and clean. LPA obtained a roster of staff. LPA obtained a LIC 500 and ensured individuals listed are fingerprint cleared using the Guardian database. LPA obtained Ms. Phillips' Administrator Certificate and interviewed staff and children. LPA reviewed children Medications are properly stored, locked and logged onto a medication form. This home has two sensory rooms with soft pillows, furniture, kinetic sand, lights, etc. This facility has a non ambulatory wheel chair with big soft wheels so a client can go onto grass, sand and rocks. This facility meets Interim Licensing Standards mandates and is clean safe, sanitary and in good repair. LPA recommends the facility obtains permanent license with management approval.


summary: Facility Evaluation

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Narrative:
On April 4, 2024 at approximately 09: AM, Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced for the purpose of conducting a Annual/Required inspection. LPA was greeted at the door by Lead RBT, Lawrence Williams, and was granted access into the facility. Administrator, Teja Ordonez-Phillips arrived 1 hour later. During a file review, LPA observed that the Administrators Certificate expired on March 24, 2024 (See LIC 9102-Technical Assistance). Administrator is in the process of renewing the Administrators Certificate and showed proof to the LPA. Clients were not present at the facility during this Annual/Required inspection. Clients were at their respective educational institution. LPA and Lead RBT, Lawrence Williams toured the facility at 09: AM. LPA observed the facility to be clean and at a comfortable temperature with all exits free from obstruction. During the tour, LPA observed that 2 of 2 fire extinguishers are not up to date (See LIC 9102-Technical Violation). LPA inspected 4 of 4 rooms and found those rooms to be appropriate. LPA observed linens on beds. The following documents were posted: License, Personal Rights, and Emergency Disaster Plan. Currently the facility has 2 ambulatory clients and 1 non-ambulatory client in care. LPA observed that the one non-ambulatory client is residing in Room #3. There was a sufficient supply of both perishable and nonperishable foods as required by Title Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations at the time of the inspection. There was a supply of cleaners, hygiene products and paper products available for clients. All bathrooms designated for clients in the common areas at the facility were supplied with individual paper towels and hand soap dispensers. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. A tour of all clients bedrooms were conducted, and bedrooms inspected have lighting and appropriate furnishing. Facility medication room at the facility was locked and inaccessible to clients in care. Toxins, hazardous items and sharps are inaccessible to clients in care. First Aid kit was inspected and found to be appropriate during the inspection. All client medication orders and medication administration records were reviewed and found to be appropriate during the review. (Report continued on LIC 809C) LPA reviewed a sample of staff files. Staff files consisted of: Criminal record clearances, Active First Aid Certificate, Job title/qualifications, and training hours which were verified during this Annual/Required inspection. LPA reviewed Client Records which consisted of: Needs and Service plan, Individual Behavior Support Plan, Physician Assessment Report, Admission Agreements, Personal Rights, Medical Consent Forms and the Individual Program Plan (IPP) provided by Alta California Regional Center. Medical history were updated. P & I was reviewed. LPA and Administrator observed that the 1 of 3 client P & I records were not up to date. The amount of money balance should be $685.68 as reflected in the P & I. Administrator counted the money which only contained $125.68. (See LIC 809D and LIC 812-Observation/Photo dated for April 4, 2024). During the record review, a Non-Ambulatory client record revealed that a in-home health care nurse attends to the clients needs on a part-time basis. The in-home health agreement was secured in the clients file, reviewed and found to be appropriate. LPA requested the following documents to be sent: LIC 500- Personnel Report LIC 308- Designation of Responsibility LIC 309- Administrative Organization LIC 400- Affidavit regarding Client Cash Resources Most up-to-date Liability insurance Control of Property Register of Clients Annual Continuation will be conducted at a later date and time which will include Staff interviews and client interviews, Emergency Disaster Plan review and Emergency Interventions will be discussed at a date and time. Deficiencies cited from the California Code of Regulations. Appeal Rights were given. Failure to correct the deficiency and/or repeated deficiencies within a 12-month period may result in Civil Penalties. Exit interview was conducted, and a copy of this report was signed and given to the Administrator.

met_with: Lead RBT, Lawrence Williams Administrator, Teja Ordonez-Phillips


summary: Facility Evaluation

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Narrative:
On April 9, 2024 at approximately 10: AM, Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced for the purpose of conducting a Case Management-Annual Continuation. LPA was greeted at the door by Lead RBT, Alicia Bowles, and was granted access into the facility. During today's Case Management-Annual Continuation, LPA reviewed the Emergency Disaster Plan and the Emergency Interventions with the Administrator. LPA toured the facility which was found to be clean and at a comfortable temperature with all exits free from obstruction. In addition, LPA observed the Sensory Room which was appropriate and free from hazardous objects. LPA reviewed Pro-Act restraint certificates for a sample of staff members. The sample of staff members had a certificate reflecting 16 hours of Pro-Act restraint training. During the review of the Emergency Disaster Plan, LPA observed that the Administrator is in the process of updating/revising the facilities Emergency Disaster Plan (See LIC 9102-Technical Advisory). LPA requested the following document: -Updated Emergency Disaster Plan Staff interviews were conducted. Clients are at their respective education institution and could not be interviewed during today's Case Management-Annual Continuation. No deficiencies were observed or cited during today's Case Management-Annual Continuation. An exit interview was conducted with the Administrator, and a copy of this report was signed and given to the Administrator.

met_with: Administrator, Teja Ordonez-Phillips