summary: Facility Evaluation

raw_content:
Narrative:
On 10/30/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted an annual continuation visit to continue the inspection initiated on 10/2/24. LPA met with Assistant Director Kristine Martinez at the licensee's central administrative location and informed of the purpose of the visit. During the visit, LPA completed 1 additional staff interview. LPA observed all staff to be knowledgeable of facility policies and procedures, mandated reporter status, and individual resident goals and service needs. Based on the staff interviews and record review, and utilizing the Care Inspection Tool, no deficiencies were observed. LPA provided technical assistance on resident medical assessment documentation. See LIC 9102 dated 10/30/24. There are no deficiency citations. An exit interview was conducted, and a copy of this report and the licensee's appeal rights were provided to Assistant Director Kristine Martinez, whose signature on this form confirms receipt.


state: CA

facility_name: VICTOR TREATMENT CENTER - IRWIN HOUSE

summary: Complaint Investigation - Unsubstantiated - 1 allegation

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

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

report_type: Complaint Investigation

met_with: Administrator, Kristine Martinez

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Aphugh. LPA toured the facility inside and out. The group home is licensed to serve six clients, ages 6-18 years old. There are currently no clients in placement. LPA observed the facility to be clean, safe and sanitary. The following documents were in the facility: facility license, emergency disaster plan, facility sketch, menu, chores, activity calendar and personal rights. Facility had adequate 7 day non-perishable food supplies. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted, and a copy of the report was left at the facility with staff. .

report_type: Facility Evaluation

visit_type: Annual

met_with: Kristine Aphugh


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Martinez. LPA toured the facility inside and out. The group home is licensed to serve six clients, ages 6-18 years old. There are currently no clients in placement. LPA observed the facility to be clean, safe and sanitary. The following documents were in the facility: facility license, emergency disaster plan, facility sketch, menu, chores, activity calendar and personal rights. Facility had adequate 7 day non-perishable food supplies. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted, and a copy of the report was left at the facility with staff.

met_with: Kristine Martinez


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheyenne McCambridge on the above date at 10: AM. During the inspection, LPA McCambridge met with Assistant Executive Director in the main office. LPA reviewed two of child's records on site at the facility due to no clients currently being on psychotropic medication. LPAs reviewed two of child's psychotropic medications and medication records. LPA interviewed one of children currently taking psychotropic medication. One client declined to be interviewed. LPA interviewed two of staff on site starting at 1:00 pm. LPA reviewed two of staff personnel files on site at the facility starting at 10: PM. LPA toured of the facility inside and out at 12: PM LPA provided the Summary Report to Kristine Martinez upon completion. No deficiencies are being cited at this time. LPA conducted exit interview and left a copy of the document at the facility.

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On 10/3/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a random annual inspection. LPA met with Assistant Director Christine Martinez and informed of the purpose of the visit. LPA toured the facility site and observed no immediate safety risks. Bedrooms offer individual beds with clean linens. Kitchen and bathrooms are maintained in sanitary condition. There is food to meet the requirements of the clients in care. Knives and chemicals are locked away and made inaccessible to clients. Indoor and outdoor activity spaces are free of hazards. LPA reviewed 5 personnel files. Using the CARE Inspection tool, no deficiencies were observed. Files were organized and observed to be complete. All staff have a valid background clearance and have valid first aid certifications. Staff have received training meeting licensing requirements, including intervention and restraint training. A continuation visit will be conducted to complete review of client records and conduct remaining interview(s). No deficiency citations were issued at today's visit. An exit interview was conducted, and a copy of this report was left with Assistant Director.

met_with: Assistant Director Christine Martinez


summary: Facility Evaluation

raw_content:
Narrative:
On 10/16/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a case management annual continuation inspection. LPA met with Assistant Director Kristine Martinez and informed of the purpose of the visit, which was to continue the annual inspection initiated on 10/3/24. During today's inspection, LPA reviewed 5 client records. Using the CARE Inspection Tool, no deficiencies were observed. LPA observed files to be complete with emergency contact information, signed personal rights and facility policies forms, accurate cash/allowance and medication records, and up-to-date needs and services plans. The final portion of the inspection, client and staff interviews, will be conducted on a later date. An exit interview was conducted, and a copy of this report was left with Assistant Director.

met_with: Assistant Director Kristine Martinez


summary: Facility Evaluation

raw_content:
Narrative:
On 10/30/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted an annual continuation visit to continue the inspection initiated on 10/2/24. LPA met with Assistant Director Kristine Martinez at the licensee's central administrative location and informed of the purpose of the visit. During the visit, LPA completed 2 staff interviews. LPA observed all staff to be knowledgeable of facility policies and procedures, mandated reporter status, and individual resident goals and service needs. Based on the staff interviews and record review, and utilizing the Care Inspection Tool, no deficiencies were observed. LPA provided technical assistance on resident medical assessment documentation. See LIC 9102 dated 10/30/24. There are no deficiency citations. An exit interview was conducted, and a copy of this report and the licensee's appeal rights were provided to Assistant Director Kristine Martinez, whose signature on this form confirms receipt.


facility_name: VICTOR TREATMENT CENTER - JUNIPER HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Aphugh. LPA toured the facility, inside and out. The group home is licensed to serve six clients. There are currently no clients in placement. No residents were present during the inspection. The facility has four bedrooms and two bathrooms. Medications and sharps are locked in the staff office. First aid was fully stocked. No firearms are present and there are no bodies of water. The facility was observed to be clean, safe and sanitary. There was sufficient non-perishable food supplies for clients. LPA observed the facility license, client's personal rights, facility sketch, and other forms posted on the walls throughout the facility. Water temperature measured to be 110 degrees. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted, and a copy of the report was left at the facility with staff.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Martinez. LPA toured the facility, inside and out. The group home is licensed to serve six clients. There are currently no clients in placement. No residents were present during the inspection. The facility has four bedrooms and two bathrooms. Medications and sharps are locked in the staff office. First aid was fully stocked. No firearms are present and there are no bodies of water. The facility was observed to be clean, safe and sanitary. There was sufficient non-perishable food supplies for clients. LPA observed the facility license, client's personal rights, facility sketch, and other forms posted on the walls throughout the facility. Water temperature measured to be 110 degrees. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted, and a copy of the report was left at the facility with staff.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/3/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a random annual inspection. LPA met with Assistant Director Christine Martinez and informed of the purpose of the visit. LPA toured the facility site and observed no immediate safety risks. The facility is currently out of operation, so there are no staff or clients. The licensee will restock the facility's refrigerator and pantry and replace bed linens prior to returning to operational status and will notify the licensing agency upon that return. Due to the facility's operational status, no files were reviewed, and no interviews were conducted. No deficiency citations were issued at today's visit. An exit interview was conducted, and a copy of this report was left with Assistant Director.


facility_name: VICTOR TREATMENT CENTER - LANE HOUSE

summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
UnsubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion: 0


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Aphugh LPA toured the facility, inside and out. The group home is licensed to serve six clients. Currently in placement are 5 clients. The facility has three bedrooms and two bathrooms. Medications, sharps, client files are locked in the staff office, No firearms are present and there are no bodies of water. The facility was observed to be clean, safe and sanitary. There was sufficient non-perishable and perishable food supplies for clients. LPA observed the facility license, client's personal rights, facility sketch, and other forms posted on the walls throughout the facility. Water temperature measured to be 110 degrees. Staff and client reviews were conducted at the administration office. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted, and a copy of the report was left at the facility with staff.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheyenne McCambridge on the above date at 2:00PM. During the inspection, LPA McCambridge met with Administrator Kristine Hernandez in the main office. LPA reviewed two of child's records on site at the facility. LPAs reviewed two of child's psychotropic medications and medication records. LPA interviewed two of the children currently taking psychotropic medication. LPA interviewed three of staff on site starting at 3:00 pm. LPA reviewed three of staff personnel files on site at the facility starting at 2: PM. LPA toured of the facility inside and out at 4: PM LPA provided the Summary Report to Kristine Hernandez, Administrator upon completion. No deficiencies are being cited at this time. LPA conducted exit interview with Administrator Kristine Hernandez.

met_with: Kristine Hernandez


summary: Facility Evaluation

narrative: Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Aphugh LPA toured the facility, inside and out. The group home is licensed to serve six clients. Currently in placement are 5 clients. The facility has three bedrooms and two bathrooms. Medications, sharps, client files are locked in the staff office, No firearms are present and there are no bodies of water. The facility was observed to be clean, safe and sanitary. There was sufficient non-perishable and perishable food supplies for clients. LPA observed the facility license, client's personal rights, facility sketch, and other forms posted on the walls throughout the facility. Water temperature measured to be 110 degrees. Staff and client reviews were conducted at the administration office. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted, and a copy of the report was left at the facility with staff.


summary: Facility Evaluation

narrative: On 10/3/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a random annual inspection. LPA met with Assistant Director Christine Martinez and informed of the purpose of the visit. LPA toured the facility site and observed no immediate safety risks. The facility is currently out of operation, so there are no staff or clients. The licensee will restock the facility's refrigerator and pantry and replace bed linens prior to returning to operational status and will notify the licensing agency upon that return. Due to the facility's operational status, no files were reviewed, and no interviews were conducted. No deficiency citations were issued at today's visit. An exit interview was conducted, and a copy of this report was left with Assistant Director.


facility_name: VICTOR TREATMENT CENTER - WRIGHT HOUSE

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Brian Bertoli met with Residential Counselor John McGriff regarding a complaint investigation at the Short-Term Residential Treatment Program Facility. The purpose of the inspection was to deliver the findings for the above allegation. The investigation was conducted by Investigations Bureau Investigator Austin Blatnick.. During the course of the investigation Investigator Blatnick conducted confidential interviews and reviewed records. LPA Bertoli inspected the facility and reviewed records. There was no conclusive evidence that the above allegation occurred. This department has investigated the allegation, and although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a Minor was sexually assaulted while in care; therefore, the above allegations are Unsubstantiated. An exit interview was conducted and no deficiencies were cited. A copy of this report was given to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Brian Bertoli LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: John McGriff


raw_content:
Investigation Findings:
13On 10//24/25 at 9:30AM, Licensing Program Analysts (LPA) Kimberly Hall and Brian Bertoli conducted an unannounced complaint investigation visit at the facility. LPA spoke with Kelly Hernandez, Executive Director and met with Sabrina Nesbit, Administrative Associate and informed of the purpose of the visit. The purpose of the visit was to deliver findings for the investigation of the above allegations. The allegation was investigated by the Community Care Licensing Division's Investigations Branch (IB) and reviewed by LPA Kimberly Hall. The investigation found that statements were inconsistent and conflicted with other statements and records. Although the allegation may have happened or is valid, based on confidential interviews, observations, and record review, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. Therefore, the allegations are Unsubstantiated. An exit interview was conducted, and a copy of this report was provided to Administrative Associate, Sabrina Nesbit. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Kimberly Hall LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Aphugh. LPA toured the facility inside and out. The Group Home is licensed to serve eight clients. Currently in placement are eight clients. LPA observed the facility to be clean, safe and sanitary. LPA reviewed staff and client files at the main office. The following documents are posted in the facility: facility license, emergency disaster plan, facility sketch, food menu, chores, activity calendar and personal rights. There are no bodies of water and no firearms at the facility. The facility has adequate non-perishable and perishable food supply. There were no Title 22 deficiencies at today's inspection. An exit interview was conducted and a copy of the report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Joel Segura and Cheyenne McCambridge conducted an announced psychotropic medication inspection of the facility. LPA Segura and McCambridge met with Danielle Stewart who facilitated the tour of the facility, inside and out. The group home is licensed to serve eight clients, children and non-minor dependents. Currently in placement are eight clients. There were no clients present during the initial inspection of the facility. There were only two clients who are subject to this inspection. The facility's buildings and grounds appeared to be in compliance, and no deficiencies were observed during the inspection of the grounds. The inspection of the grounds took place at approximately 9:15am. At 9:30am LPAs Segura and McCambridge conducted a review of two client files. In the course of conducting the file reviews LPAs also interviewed direct care staff Bruno Llerena due to availability later in the day. At approximately 11am LPAs conducted a medication count inspection with medical coordinator Debbie Thompson. In the course of conducting the medication count inspection LPAs found that the facility PMARs have a documentation conflict. The facility's practice is to have a weekly PMAR; however, the week begins at the after school dispensing window in the middle of the day. Continued on 809C The facility uses a PMAR printed and dated by the pharmacy. For C2 (C2, Client 2 see confidential names list LIC811 dated 08/17/2021) LPA found that the PMAR was dated for the week of 08/12-08/18 with columns labeled for the days of the week starting with Thursday through Wednesday. Medical coordinator indicated that since the medication weekly packs start effectively during the after school dosage, they end up documenting the last AM medication administered on Thursday the 19th on the space that corresponds for Thursday the 12th. The facility was advised to consider revising PMAR, see advisory note. At around 11:45pm LPA Segura conducted an interview with medical coordinator Debbie Thompson. Shortly after at approximately 12:30 an interview was also conducted with administrator Kristine Martinez. Staff file reviews were conducted by LPAs at around 12:30pm. No deficienceies were found during this inspection. There were no deficiencies noted at today's evaluation. Exit interview conducted and a copy of the report was left with the administrator Kristine Martinez.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection for the purposes of completing a Annual/Required and met with administrator Kristine Martinez. LPA toured the facility inside and out. The Group Home is licensed to serve eight clients. Currently in placement are five clients. LPA observed the facility to be clean, safe and sanitary. LPA reviewed staff and client files at the main office. The following documents are posted in the facility: facility license, emergency disaster plan, facility sketch, food menu, chores, activity calendar and personal rights. There are no bodies of water and no firearms at the facility. The facility has adequate non-perishable and perishable food supply. There were no Title 22 deficiencies at today's inspection. An exit interview was conducted and a copy of the report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheyenne McCambridge on the above date at 10:30AM. During the inspection, LPA McCambridge met with Assistant Executive Director Kristine Martinez in the main office. LPA reviewed two of child's records on site at the facility. LPA reviewed two of child's psychotropic medications and medication records. LPA interviewed two of the children currently taking psychotropic medication. LPA interviewed three of staff on site. LPA reviewed three of staff personnel files on site at the facility. LPA toured of the facility inside and out with Administrator Edward Webb. LPA provided the Summary Report to Kristine Martinez, upon completion. No deficiencies are being cited at this time. LPA conducted exit interview with Assistant Executive Director Kristine Martinez.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheyenne McCambridge on the above date at 1: PM. During the inspection, LPA McCambridge met with Administrator Edward Webb at the facility. LPA interviewed three of staff on site. LPA reviewed three of staff personnel files on site in the main office. LPA toured of the facility inside and out with Administrator Edward Webb. LPA did not interview or review client files due to none being in foster care placement. No deficiencies are being cited at this time. LPA conducted exit interview with Administrator Edward Webb.

met_with: Edward Webb


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheyenne McCambridge on the above date at 9:30AM. During the inspection, LPA McCambridge met with Director Kelly Hernandez at the facility. LPA interviewed three of staff on site. LPA reviewed three of staff personnel files on site in the main office. LPA toured of the facility inside and out. LPA did not interview or review client files due to none being in foster care placement. No deficiencies are being cited at this time. LPA conducted exit interview with Director Kelly Hernandez.

met_with: Kelly Hernandez


summary: Facility Evaluation

raw_content:
Narrative:
On 10/3/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a random annual inspection. LPA met with Assistant Director Kristine Martinez and informed of the purpose of the visit. LPA toured the facility site and observed no immediate safety risks. Bedrooms offer individual beds with clean linens. Kitchen and bathrooms are maintained in sanitary condition. There is food to meet the requirements of the clients in care. Knives and chemicals are locked away and made inaccessible to clients. Indoor and outdoor activity spaces are free of hazards. LPA reviewed 5 personnel files. Using the CARE Inspection tool, no deficiencies were observed. Files were organized and observed to be complete. All staff have a valid background clearance and have valid first aid certifications. Staff have received training meeting licensing requirements, including intervention and restraint training. A continuation visit will be conducted to complete review of client records and conduct remaining interview(s). No deficiency citations were issued at today's visit. An exit interview was conducted, and a copy of this report was left with Assistant Director.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/16/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a case management annual continuation inspection. LPA met with Assistant Director Kristine Martinez and informed of the purpose of the visit, which was to continue the annual inspection initiated on 10/3/24. During today's inspection, LPA reviewed 5 client records. Using the CARE Inspection Tool, no deficiencies were observed. LPA observed files to be complete with emergency contact information, signed personal rights and facility policies forms, accurate cash/allowance and medication records, and up-to-date needs and services plans. The final portion of the inspection, client and staff interviews, will be conducted on a later date. An exit interview was conducted, and a copy of this report was left with Assistant Director.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/30/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted an annual continuation visit to continue the inspection initiated on 10/2/24. LPA met with Assistant Director Kristine Martinez at the licensee's central administrative location and informed of the purpose of the visit. During the visit, LPA completed 2 staff interviews. LPA observed all staff to be knowledgeable of facility policies and procedures, mandated reporter status, and individual resident goals and service needs. Based on the staff interviews and record review, and utilizing the Care Inspection Tool, no deficiencies were observed. LPA provided technical assistance on resident medical assessment documentation. See LIC 9102 dated 10/30/24. There are no deficiency citations. An exit interview was conducted, and a copy of this report and the licensee's appeal rights were provided to Assistant Director Kristine Martinez, whose signature on this form confirms receipt.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli conducted a follow-up case management visit with the Short-Term Residential Therapeutic Program and met with Residential Service Supervisor Edward Webb, who assisted with the inspection. The purpose of the visit was to gather information regarding complaint 21-CR-20240612112806. LPA Bertoli and Edward Webb discussed the complaint and LPA Bertoli conducted confidential interviews. No deficiencies were cited and a copy of this report was given to the facility and has been sent to Kristine Aphugh. This report has been reviewed with Edward Webb and an exit interview has been conducted.

met_with: Ed Webb


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) made an unannounced visit to the facility and met with Relief Residential Counselor Kara DeFreitas. The purpose of the visit was to initiate a complaint investigation. It was determined that the complaint was for another facility and LPA transferred the complaint to the correct facility.

met_with: Kara DeFreitas


facility_name: VICTOR TREATMENT CENTERS- THE COTTAGE

raw_content:
Investigation Findings:
13On January 23, 2021, at 3:30PM Licensing Program Analyst (LPA), Rosslyn Gray concluded the investigation. During the investigation, There were no statements or documented evidence to support that the allegations occurred, "Staff not answering facility phone calls; Minors were without toiletries for a long period of time; Staff serving food that is not thoroughly cooked; Food served is not of the quality to meet the needs of the minors in care". LPA conducted confidential interviews that revealed that the direct phone line to the facility was operable; in addition, the child and children were accorded to have access to personal phones. The facility ensured that there was adequate supply of food for all clients; and that food menu was posted. All staff were trained to cook basic meals 3 times a day 7 days a week. The facility ensured that they were fully stocked with hygiene products and PPE's inspected by the department during the Pandemic. There were no deficiencies cited at this time. Based on the interviews conducted, the above allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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

met_with: UNAVAILABLE


facility_name: VICTOR TREATMENT CENTERS-GREEN HOUSE

raw_content:
Investigation Findings:
13On December 15, 2021, at 5: PM Licensing Program Analyst (LPA), Rosslyn Gray concluded the investigation. During the investigation, LPA conducted confidential interviews and reviewed documentary evidence. There was no evidence to support that Facility staff did not prevent youth from going AWOL. Documentary evidence and confidential interview revealed that the child had history of going AWOL and was on an Approved Home Pass when she went AWOL. There were no statements or evidence to corroborate the allegation. There were no deficiencies cited at this time. Based on the interviews conducted, the above allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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


raw_content:
Investigation Findings:
13On January 23, 2021, at 7:25PM Licensing Program Analyst (LPA), Rosslyn Gray concluded the investigation. During the investigation, there were not documented evidence to support that the allegations that "Staff did not properly supervise minors while in care; Staff did not properly report incidents involving a minor. LPA conducted confidential interviews that revealed that were no evidence to prove that inappropriate sexual behavior was displayed and the reporteed details in the allegations were denied. A Serious Incident Report (SIR) was written and submitted regarding the incident. LPA confirmed that staff met client ratio and was present to provide supervision at all times. It was determined that a Forensic Examination was not needed. Evidence confirm that an Emergency 3-Day removal was summitted and the authorize representative removed the child as requested. All parties involved including law enforcement were congruent with the outcome of the investigation. There were no deficiencies cited at this time. Based on the interviews conducted, the above allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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


facility_name: VICTOR TREATMENT CENTERS-ROMBERGER HOUSE

raw_content:
Investigation Findings:
13THIS REPORT WAS AMENDED DUE TO THE INCORRECT DATE OF COMPLETION On January 13, 2022, at 7: PM Licensing Program Analyst (LPA), Rosslyn Gray concluded the investigation. During the investigation, LPA conducted confidential interviews and reviewed documentary evidence. There was no evidence to support that "Facility staff did not prevent youth from engaging in CSEC activity". Documentary evidence and confidential interview revealed the facility implemented various plans in attempt to prevent child from engaging in CSEC behaviors. The child went AWOL follow ten (10) days of placement. The child's authorized representative closed the child's bed within 1-3 days. There were no statements or evidence to corroborate the allegation. There were no deficiencies cited at this time. Based on the interviews conducted, the above allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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

met_with: UNAVALABLE


facility_name: VISTA DEL MAR CHILD AND FAMILY SERVICES

raw_content:
Narrative:
The following deficiencies are cited per California Code of Regulations, Title Regulations, Division 6, chapters 1 & 5. due to the facility violating the same regulation subsection within a 12 month period. Exit interview was conducted with the administrative assistant, and appeal Rights were issued and a copy of this report was left at the facility. -Continue on 9099D Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has decided that the allegations of personal rights is Unsubstantiated. There were no deficiencies cited per California Code of Regulations, Title Regulations, Division 6, chapter 1 & 5. Exit interview was conducted with the Administrative Assistant and a copy of this report was left at the facility.

Investigation Findings:
13This is an amended report from the original report dated 03/09/18. Licensing Program Analysts (LPA) Esther Luna made an unannounced visit to the Vista Del Mar Child and Family Services or the purpose of concluding the investigation on the above allegations and to deliver the findings. LPAs met with adminstrative assistant to discuss the findings. During the investigation process, it was determined that Staff #1 and Staff #2 use inappropriate restraint on client #1. LPA review video surveillance of the restraint on client #1, and observed staff #1 laying over the client #1 lower leg as a form of restraint. It was also observed, that staff #2 was sitting on client #1 leg during the restraint. LPA also observe staff #1 conducted a one hand restraint and pulled client #1 to a sitting position on the sofa by himself for a period of time until staff #2 arrived. (See confidential name list LIC 811 dated 03/05/2018). Meanwhile LPA was unable to obtain a statement from client #1 due to her awol and whereabouts are unknown. Through the course interviews LPA was able to conclude that the allegation of personal rights violation occurred. The department has concluded, based on the preponderance of evidence this investigation is substantiated- Continue on 9099D SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Esther Luna LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, BRISTOL PARKWAY STE. CULVER CITY, CA FACILITY NAME: VISTA DEL MAR CHILD AND FAMILY SERVICESFACILITY NUMBER: 191600721

met_with: Unit Director- Lynn Cohen


raw_content:
Narrative:
There was no physical evidence to show that Child #1 attempted suicide or was given a pencil sharpener/razor while under the care of facility staff. There were no witnesses or documentary evidence to support that the allegations occurred. It has been determined that the allegations are Unsubstantiated at this time meaning, although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove or disprove that a violation occurred. There were no deficiencies cited during the investigation. A copy of this report was emailed to Ms. Jeon for signature.

Investigation Findings:
13On May 13, 2021, Regina Martin, Licensing Program Analyst (LPA) spoke with Susie Jeon Facility Director for the purpose of delivering complaint findings. The above-mentioned allegations were investigated by the California Department of Social Services (CDSS) Community Care Licensing Division (CCLD) Investigations Bureau, Investigator Robert Kujawa. On January 19, 2021, CCLD received a complaint investigation alleging child engaged in self-injurious behavior while in care and child was allowed access to hazardous items. Information obtained during the investigation including interviews and Incident Reports did not provide enough evidence to support allegations. Child #1 indicated that while AWOL (absent without permission) he would get multiple items he could use to self-harm. Child #1 also indicated that he was given a pencil sharpener to use by Staff #1 and used the blades to self-harm. Staff #1 denied that she provided Child #1 with a pencil sharpener. Staff #1 indicated that Child #1 was under continuous watch due to his history of self-harming. (Continued on page LIC9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Alan Henry LICENSING EVALUATOR NAME: Regina Martin LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: VISTA DEL MAR CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 05/13/2021

met_with: Susie Jeon


raw_content:
Investigation Findings:
13On June 21, 2021 at 12:24 pm Out of State Group Home Anaylst Sarah Waklee called Vista Del Mar Child and Family Services Unit Director to discuss the above allegations. Analyst Waklee was unable to contact the youth named in the complaint due to the youth being AWOL. Based on confidential interviews with three staff, one youth and the Social Worker for the youth named in the complaint, Analyst Waklee determined that the allegation is unsubstantiated. An unsubstantiated finding means, although the allegation may have happened, the preponderance of evidence does not prove it. A copy of this report was provided to Vista Del Mar Director. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Sarah Waklee LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

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

met_with: Unit Director, Suzie Jeon


raw_content:
Narrative:
.Based on the interviews conducted and documentary evidence obtained the information did not produce corroborating evidence to support the above said allegation. Due to inconsistent statements LPA Phillips was not able to determine if the above said allegations occurred, therefore the allegations are found to be Unsubstantiated meaning that although the allegations may have happened or is valid there is not a preponderance of evidence to prove that the alleged incidents occurred. No deficiencies cited at the time of this investigation. Exit interview was conducted, and copy of this report will be emailed to administrator.

Investigation Findings:
13On December 8, 2021 at 1: PM Licensing Program Analyst (LPA), Zena Phillips conducted a follow-up complaint investigation visit to Vista Del Mar Child And Family Services and met with Amy Jaffee, Administrator. The purpose of the visit was to deliver findings for the above complaint allegation. During the course of investigating the allegation: Facility staff did not prevent youths from engaging in a physical altercation. LPA Phillips conducted confidential interviews with related parties, reviewed facility records and Incident Reports. Based on the interviews conducted and statements obtained during the investigation the above allegations cannot be substantiated because LPA Phillips obtained inconsistent statements from staff and residents in care. Evidence obtained revealed that Staff tried multiple times to redirect children to stay inside facility, but children left facility. Also, confidential interviews with Child 2, Child 3 and Child 6 revealed that staff tried to prevent children from leaving facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290b El Segundo, CA Facility Name: Vista Del Mar Child and Family Servicesfacility Number: Visit Date: 12/08/ Narrative 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32.Based on the interviews conducted and documentary evidence obtained the information did not produce corroborating evidence to support the above said allegation. Due to inconsistent statements LPA Phillips was not able to determine if the above said allegations occurred, therefore the allegations are found to be Unsubstantiated meaning that although the allegations may have happened or is valid there is not a preponderance of evidence to prove that the alleged incidents occurred. No deficiencies cited at the time of this investigation. Exit interview was conducted, and copy of this report will be emailed to administrator. SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: LIC9099 (FAS) - (06/04)Page: 2 of 2

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

met_with: Alicia Hellum/Unit Supervisor


raw_content:
Narrative:
Also Staff 1 stated Teen Lounge is available for additional hours as late as 10: PM if needed. Residents can just ask and may go to Teen Lounge after 8: PM with staff in attendance. Child 2 & Child 3 stated phone service is no issue and wifi is available. Staff 1 stated residents have own phone line for use in Handler unit with permission from staff. Also phones in the open wing for use as necessary. Based on the interviews conducted and documentary evidence obtained the information did not produce corroborating evidence to support the above said allegation. Due to inconsistent statements LPA Phillips was not able to determine if the above said allegation occurred, therefore the allegation is found to be Unsubstantiated meaning that although the allegation may have happened or is valid there is not a preponderance of evidence to prove that the alleged allegation exist.. No deficiencies cited at the time of this investigation. Exit interview was conducted, and copy of this report will be emailed to Jimmy Tyler/ Supervisor.

Investigation Findings:
13On March 03, 2022 at 1: PM Licensing Program Analyst (LPA), Zena Phillips conducted a follow-up complaint investigation visit to Vista Del Mar Child And Family Services and met with Jimmy Tyler/ Supervisor. The purpose of the visit was to deliver findings for the above complaint allegation. During the course of investigating the allegation: LPA Phillips conducted confidential interviews with related parties, reviewed facility records and Incident Reports. Based on the interviews conducted and statements obtained during the investigation the above allegation cannot be substantiated because LPA Phillips obtained inconsistent statements from staff and residents in care. Evidence obtained revealed that facility has adequate phone service and wifi available for residents use. The Teen Lounge is availabe from 8: AM to 8: PM 7 (seven) days per week. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: VISTA DEL MAR CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 03/03/2022

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

met_with: Jimmy Tyler /Supervisor


raw_content:
Narrative:
in the beginning and staff provided additional monitoring and intervention to prevent threats. Child 2 admitted there was time that Child 1 and self did not get along but that was some time ago and they are cool now. Due to inconsistent statements LPA Phillips was not able to determine if the above said allegations occurred, therefore the allegations were found to be Unsubstantiated meaning that although the allegations may have happened or are valid there is not a preponderance of evidence to prove that the alleged incident occurred. No deficiencies cited at the time of this investigation. Exit interview was conducted, and copy of the report will be emailed to Amy Jaffe/ Administrator

Investigation Findings:
13On March 25, 2022 at 1: PM Licensing Program Analyst (LPA), Zena Phillips conducted a follow-up complaint investigation visit to Vista Del Mar Child And Family Services and met with Amy Jaffe/ Administrator. The purpose of the visit was to deliver findings for the above complaint allegation. During the course of investigating the allegation listed above. LPA Phillips conducted confidential interviews with related parties, reviewed facility records and Incident Reports. Based on the interviews conducted and statements obtained during the investigation the above allegations cannot be substantiated because LPA Phillips obtained inconsistent statements from staff and residents in care. Evidence obtained revealed that staff did intervene on behalf of Child 1 during verbal incidents with resdients. Staff 1, Staff 2 & Staff 3 revealed that Child 1, Child 2 & Child 3 did not get along UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: VISTA DEL MAR CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 03/25/2022

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

met_with: Amy Jaffe/ Administrator


raw_content:
Narrative:
Evidence obtained revealed that staff was dealing with other pressing matters in neighboring unit and redirected Child #1 to wait to look for cell phone. Interviews and video footage reveal that Child #1 escalated and began trashing Handler Unit and attempted to hit Staff #4. Child #1 admitted throwing stuff from refrigerator, banging on television , throwing pots and pans due to not getting cell phone. Child #1 admits staff tried to calm Child #1 down but very upset and not calming down due to wanting phone. Child #1 was placed in Pro Act wall restraint followed by floor restraint until Child #1 was calm. Child #1 admits feeling sore after restraint but did not see nurse as no injuries. Child #1 admits staff helped find phone under sofa. Due to inconsistent statements LPA Phillips was not able to determine if the above said allegation occurred, therefore the allegations are found to be Unsubstantiated meaning that although the allegations may have happened or is valid there is not a preponderance of evidence to prove that the alleged allegation exist.. No deficiencies cited at the time of this investigation. Exit interview was conducted, and copy of this report will be emailed to Amy Jaffe Administrator.

Investigation Findings:
13On June 15, 2022 at 10: AM Licensing Program Analyst (LPA), Zena Phillips conducted a follow-up complaint investigation visit to Vista Del Mar Child And Family Services and met with Amy Jaffe/ Administrator. The purpose of the visit was to deliver findings for the above complaint allegations. During the course of investigating the allegations for : Staff caused injuries to a minor in care. Staff assaulted a minor while in care. Staff did not provide a minor access to personal belongings. LPA Phillips conducted interviews with related parties and reviewed the following documentation: LPA Phillips viewed Video Footage dated 02/15/2022; Special Incident Report #797658dated 02/16/2022; Staff #3 and Staff # ProAct Certifications. Based on the interviews conducted and statements obtained during the investigation the above allegations cannot be substantiated because LPA Phillips obtained inconsistent statements from staff and resident in care. Evidence obtained revealed that UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: VISTA DEL MAR CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 06/15/2022

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

met_with: Amy Jaffe/Administrator


raw_content:
Narrative:
Confidential interviews were congruent that staff provides transportation to and from school; ensure that all children arrive to school on time, and children that refuse to attend are not transported. There is no evidence or witnesses to determine that the staff did not provide a minor with clothes while in care. Confidential interviews determine that all minors are provided with a clothing allowance on monthly bases and given the options accumulate clothing funds. Due to lack of evidence obtained during the investigation, LPA determines that the allegations are Unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that a violation occurred. There are no deficiencies cited at this time. An exit interview was conducted, and a copy of this report was left with the Facility Manager.

Investigation Findings:
13On July 6, 2023, at 10:00AM Licensing Program Analyst (LPA), Rosslyn Gray made an unannounced visit at VISTA DEL MAR CHILD AND FAMILY SERVICES-STRTP to conclude the investigation. Prior to entering the facility LPA Gray conducted a health and safety risk assessment. During the investigation, LPA Gray interviewed all available relevant parties and gathered pertinent information in reference to the allegations. The Licensee denied the allegations. Based on confidential interviews and review of documentary evidence, there is no evidence or witnesses to support, or to determine that Personal Rights and Neglect/Lack of Supervision, occurred. There is no evidence or witnesses to determine that the staff did not follow a minor's dietary plan while in care and did not providing adequate food service. Records and confidential interviews were congruent that staff makes effort to meet the dietary needs of all children in placement that include specialized food services and that the facility provides ample food 3 meals a day including snacks. There is no evidence or witnesses to determine that minors are not attending school regularly. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: VISTA DEL MAR CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 07/06/2023

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

met_with: Facility Administrator


raw_content:
Narrative:
Documentary evidence obtained and reviewed from the Los Angeles Police Department (LAPD) report and client's file history revealed a lack of evidence to support alleged sexual abuse. Documented statements obtained from Y1 by LAPD indicates a lack of evidence (dates, times or details) to prove the alleged. Video camera footage observed of the alleged incident found no evidence of abuse. Due to hospitalization status, Y1 was not interviewed by CCLD Investigator during this investigation. Based on an analysis of available information, the allegation is determined Unsubstantiated at this time. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. There are no deficiencies per California Code of Regulations or Interim Licensing Standards (ILS) cited at this time. Exit interview completed. A copy of this report and LIC811 was provided to Facility Representative.

Investigation Findings:
On January 17, 2024, at 11: AM, Licensing Program Analyst (LPA), Regina Martin conducted a follow-up complaint inspection to deliver findings concerning the above-mentioned allegation. LPA Martin met with Jimmy Tyler, Facility Supervisor to discuss the investigative outcome. On November 28, 2023, Community Care Licensing Division (CCLD) received an allegation of sexual abuse towards Youth #1 (Y1) by an unidentified staff person as youth was reportedly raped by a male staff member at Vista Del Mar STRTP. The allegation was referred to CCLD Investigator Peter Zertuche for assignment. On December 8, 2023, LPA Martin met with Facility Supervisor, informed of investigation, and obtained related client file history and facility records. Records reviewed indicates Youth #1 was placed at Vista Del Mar Child & Family Services in August 2023. (Continued on page LIC9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Regina Martin LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: VISTA DEL MAR CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 01/17/2024

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

met_with: Jimmy Tyler


raw_content:
Narrative:
C3 stated that staff never told him to sexually assault anyone. C3 stated that it may have been a misinterpretation because he is from another country. There was no evidence that youth are not accorded privacy with her personal possessions. Staff provides lockers for the clients personal possessions. Staff are not allowed to collect the clients belongings when they elope from the facility. This has been deemed traumatizing because of the history of clients moving place to place. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred; therefore, the above allegation is Unsubstantiated. There are no deficiencies being cited at this time.

Investigation Findings:
13On May 31, 2024 at 10am, Licensing Program Analyst (LPA) Donald Martin and Licensing Program Analyst (LPA) Kenrick Ellis conducted a follow up complaint inspection and spoke with Supervisor, James Tyler. The purpose of this inspection was to deliver findings for the above complaint allegation. During the course of investigation the allegation for staff encourage youth to sexually assault other youth in care and youth are not accorded privacy with her personal possessions, interviews were conducted and documents were obtained and reviewed. The interviews did not produce corroborating evidence to support said allegation. Interviews revealed inconsistent statements and no witnesses to suggest allegation occurred. from the interviews, there was no evidence that staff encouraged youth to sexually assault other youth in care. C3 was an ORR client and UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Donald C Martin LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: VISTA DEL MAR CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 05/31/2024

met_with: James Tyler-Supervisor


raw_content:
Narrative:
It was reported during confidential interviews staff conduct consistent checks on minors and additional checks are conducted for minors with history of self harm. Due to inconsistent statements LPA Phillips & LPA Ellis was not able to determine if the above said allegations occurred, therefore the allegations were found to be Unsubstantiated meaning that although the allegations may have happened or are valid there is not a preponderance of evidence to prove that the alleged incidents occurred .No deficiencies cited at the time of this investigation. Exit interview was conducted, and copy of the report will be emailed to Jimmy Tyler/YDC Supervisor.

Investigation Findings:
13On 06/12/ Licensing Program Analyst (LPA) Zena Phillips and (LPA) Kenrick Ellis conducted a follow-up complaint investigation visit to VISTA DEL MAR CHILD AND FAMILY SERVICES and met with Tamisha Diaz/Case Manager. The purpose of the visit was to deliver findings for the complaint allegations listed above. During the investigation, Confidential interviews were conducted, facility file review, special incident reports and documentary evidence did not substantiate the allegations: Staff caused injuries to a minor. Staff hit a minor while in care. Staff do not prevent a minor from causing self harm. Confidential interviews reveal no injuries were observed nor reported and medical attention was not given due to unauthorized absence. All Staff deny that they caused injuries to a minor. Documentary evidence reveal upon return from unauthorized absence minor was screened by nurse and no visible injuries. Staff deny that minor was hit. Confidential interviews reveal that staff would not hit a minor in care. The allegation that: Staff did not prevent minor from causing self harm. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: VISTA DEL MAR CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 06/12/2024

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

met_with: Tamisha Diaz/Case Manager


raw_content:
Narrative:
LPA Phillips was unable to determine if the above said allegation occurred, therefore the allegation is determined to be unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to Amy Jaffe/ Administrator

Investigation Findings:
13On July 23, 2024, Licensing Program Analyst (LPA) Zena Phillips conducted a follow up complaint inspection at VISTA DEL MAR CHILD AND FAMILY SERVICES and spoke with Renee Capeloto/Unit Director. The purpose of this inspection was to deliver findings for the above complaint allegation. During the course of investigation the allegation LPA Phillips cinducted confidential interviews, review of Special incident Reports, Child and Family Team meeting notes, and LIC 500 staff schedule. Confidential interviews reveal that minors do not share rooms at this time and not allowed in the other minor's rooms. It was reported to LPA Phillips windows are locked and can be opened by maintenance staff or during fire emergency. Staff deny that they did not prevent minor in home from sexually abusing other minors. Documentary evidence and confidential interviews did not corroborate the allegation occured. Due to inconsistency in statements obtained during the investigation. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: VISTA DEL MAR CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 07/23/2024

met_with: Renee Capeloto/Unit Director


raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward investigated the allegations that staff touched minors inappropriately, staff used inappropriate restraints, a minor was injured during a restraint, staff locked minor out of the facility and staff speaks inappropriately to clients. LPA interviewed C1. C2 and C3 declined to be interviewed. LPA interviewed S1 and S2 who were accused of committing the allegations. Both denied that the allegations are true. S3 is no longer employed by Vista Del Mar and LPA was unable to determine the exact identity of S4. There was no specific date given and no SIRs involving C1, C2 or C3 were found for the 4 weeks prior to the date of the report. Based on conflicting accounts, lack of documentation or evidence and lack of witnesses, the above allegations are resolved as unsubstantiated. Unsubstantiated means that although an allegation may have occurred or is valid, there is not enough evidence that it did happen. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Javier Rodriguez, Unit Director


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

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

met_with: Jimmy Tyler, Facility Supervisor


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Investigation Findings:
13On July 28, 2025 at 10:15 am, Kenrick Ellis, Licensing Program Analyst (LPA), conducted an unannounced visit to Vista Del Mar for the purpose of concluding a complaint investigation of the above allegation. LPA met with Alma Marquez, Administrator and discussed the complaint allegation. A health and safety assessment was conducted. During the investigation LPA conducted two client interviews and three staff interviews. During the investigation LPA also reviewed Personnel Report (LIC500), client roster, and incident reports. The confidential interviews produced evidence to support the allegation that staff's conduct posed a threat to the health and safety of minors in care. Statements indicated that Child 1 (C1) was prevented from obtaining drinking water from the kitchen by staff (S4). Statements indicated that C1 and staff (S4) engaged in a verbal conflict which escalated into C1 throwing a cup of water at staff. Statements indicated that S3 was able to intervene and separate staff (S4) and C1 to avoid further verbal conflict. Statements indicated that staff (S4) received Trauma Informed and Children's Bill of Rights training. Facility cited for violation of California Code of Regulations, Title Division Six, regulation 80072 (a)3. Staff prevented C1 from obtaining water from the kitchen. Exit Interview was conducted with Alma Marquez, Administrator and a copy of this report was provided. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Kenrick Ellis LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: VISTA DEL MAR CHILD AND FAMILY SERVICESFACILITY NUMBER: 191600721

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

met_with: Alma Marquez ,Administrator

complaint_status: SUBSTANTIATED


raw_content:
Investigation Findings:
13On July 28, 2025 at 9:30 am, Kenrick Ellis, Licensing Program Analyst (LPA), conducted an unannounced visit to Vista Del Mar for the purpose of concluding a complaint investigation of the above allegations. LPA met with Alma Marquez, Administrator and discussed the complaint allegations. A health and safety assessment was conducted. During the investigation LPA conducted two client interviews and three staff interviews. During the investigation LPA also reviewed Personnel Report (LIC500), client roster, and incident reports. The interviews did not produce evidence to support the allegations.During the investigation there were inconsistent statments that staff (S4) physically engaged with Minor (C1) during this incident. C1 was not observed to have any physical injuries.There were no statements or documentary evidence to suggest that C1 required medical attention as a result of this incident. Statements indicated that staff (S4) and C1 engaged in a verbal conflict. There was no evidence to suggest that staff(S4) was yelling at C1 during this incident. Statements indicated that the staff (S4) left the kitchen area to avoid further conflict with minor C1. There were no deficiences cited at this time. Exit Interview was conducted with Alma Marquez, Administrator and a copy of this report was provided. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Kenrick Ellis LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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


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Narrative:
In addition, based on interview statements, LPA was able to confirm that an incident did occur between C1 and C2 but there were conflicting statements regarding the details of the incident. Therefore, the allegation of "Facility staff are not preventing inappropriate interactions between minors in care" is UNSUBSTANTIATED. Exit interview was completed and copy of the report and appeal rights were discussed and provided to Supervisor Jimmie Tyler.

Investigation Findings:
13On 09/18/25, at 09:50AM, Licensing Program Analyst (LPA) Andrea Aceves made an unannounced visit Vista Del Mar-STRTP to conclude the investigation and to deliver the findings on the above allegation. LPA Andrea met with Supervisor Jimmie Tyler. During the investigation, LPA Andrea interviewed all available parties and reviewed LIC500-Personnel Report, C1and C2's Needs and Services Plan, LIC624LE (Law Enforcement Contact report) and Special Incident Report (SIR) pertaining to the incident. It was reported that "Facility staff are not preventing inappropriate interactions between minors in care". Staff and client interview statements and incident reports were reviewed. Per interviews, LPA was able to confirm that C1 was outside on an approved therapeutic walk prior to incident. LPA established that C2 left his unit and went outside without permission. Staff followed C2 outside and thereafter, lost line of supervision of C2. See LIC9099C. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Andrea Aceves LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: VISTA DEL MAR CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 09/18/2025

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

met_with: Jimmie Tyler


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Narrative:
In regard to the second allegation, LPA was able to confirm that during room clean-up, C1's mattress was taken from her for hygiene purposes and provided with a new one. Per interview statements, any other personal belongings are securely bagged and stored in a safe location. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur, therefore the allegations are unsubstantiated. Exit interview was completed and copy of the report and appeal rights were discussed and provided to Supervisor Jimmie Tyler.

Investigation Findings:
13On 09/18/25, at 10: AM, Licensing Program Analyst (LPA) Andrea Aceves made an unannounced visit to the above facility to conclude the investigation and to deliver the findings on the above allegations. LPA met with Supervisor Jimmie Tyler. During the investigation, LPA Andrea interviewed all available parties and reviewed LIC500-Personnel Report, Needs and Services Plan. It was reported that (1) Staff do not prevent youth from engaging in physical altercations with other youth in care, (2) Staff did not ensure youth's personal belongings were safely secure. Based on staff interview statements and Special Incident Reports (SIRs) from 01/05/25 and 08/11/25, LPA was able to confirm that C1 was involved in physical altercations with peers and staff were able to intervene immediately on both occasions. In addition, staff are mindful of client milieu and remain proactive with clients in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Andrea Aceves LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: VISTA DEL MAR CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 09/18/2025

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


summary: Facility Evaluation

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Narrative:
Licensing Program Manager, Angela King, Licensing Program Analyst, Sethany Yem, and Licensing Program Analyst, David Torres conducted a case management inspection on July 15, 2021, at 9:00 am, based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. 6 out of Direct Care Staff and 10 out of 20 youth files as identified on the LIC 811 confidential names dated July 15, 2021, were reviewed. 5 out of Direct Care Staff and 7 out of 20 youth were interviewed. The Plan of Operation including policies and procedure were reviewed. A copy of this report was discussed and provided to Suzie Jeon, Unit Director STRTP.

met_with: Suzie Jeon, Unit Director


summary: Facility Evaluation

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Narrative:
On _08/24/2021 at _9: AM Licensing Program Analyst (LPA) Zena Phillips & Meghan McGee made an unannounced visit to Vista Del Mar Family Services for the purpose of an Annual/Required Licensing Inspection. LPA met with Amy Jaffe Administrator and conducted a tour of the facility. There are currently nineteen (19) children placed in the facility. The program accepts clients from Department of Children & Family Services, Dept. of Probation and Private Placement's, and school district funded placement. This STRTP is licensed to serve 24 children ages 12-17 years of age, ambulatory only. This facility will also provide care to non-minor dependents. The facility has cameras that monitors both cottages/wings (Handler #1 and #2), living room, the rotunda room (also known as the lobby), and kitchen. The facility is located in a residential area with three cottages/wings, 18 bedrooms, several bathrooms, kitchen/dining room, 2 laundry rooms, and one clinician offices in each unit (three in total). Handler #1 is designated for the co-ed wing with boys and girls. Handler #2 is designated for the girls. The third wing is the administrative wing with offices for the administrators, clinician and all other staff. There was adequate closet and storage space for the clients. There are washers and dryers that were operable in Handler #1 and Handler #2. Handler #1- Bedrooms with 2 twin beds, with closet space, and desks. Bedrooms has 1 single bed, and with closet space and desks. Handler #2- Bedrooms with 2 twin beds, has closet space, and desks. Bedrooms with 1 twin size bed, with closet space, and desks. Overall, the facility appeared clean, safe and sanitary. The building is in good repair. The Facility has Offices for the Administrator, Clinician and other staff. All beds are in good repair. Each client has adequate closet and ample clothing. Each client has complete sets of towels, sheets, blankets and bedspreads. There is adequate hygiene and grooming supplies in both Handler #1 and #2. The kitchen is sanitary and in good repair. A physical plant inspection was completed and included the following checks: Facility is clean, safe, sanitary and in good repair. LPA observed one-week supply of non-perishable and two days of perishable foods, including nutritious snacks. All prescribed medications are locked and centrally stored in the Health Center; Medications are accessible only to employees supervising stored medications. No firearms or weapons are present in the facility. Medications and cleaning supplies are kept locked. The first aid kit is fully stocked. The hot water temperature is within the mandated range. The home is equipped with a fire alarm system; smoke alarm/carbon monoxide detector and verified that the fire clearance was inspected and found to be in compliance with the fire code. All fire extinguishers are charged. There are working telephone service for client's personal use. All trash cans have tight-fitting lids. All exits are free of hazards and all doors open freely. Facility posts child's rights if licensed to provide for six or more children. Clients in care are supervised and protected at all times. Facility operates within license conditions and limitations including capacity limitations. LPA Phillips will return at a later date to review staff and client records and staff and client Interviews. No deficiencies were sited at this time. Exit interview was conducted and report was provided to facility administrator.

met_with: Amy Jaffe


summary: Facility Evaluation

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Narrative:
On 08/27/2021 at 9: AM PM Licensing Program Analyst (LPA's) Zena Phillips, made an announced visit to Vista Del Mar Child And Family Services for Case Management Annual Continuation Inspection. LPA reviewed the following during the inspection: Staff records review; the information regarding the Emergency Preparedness. LPA reviewed Criminal Records and confirmed that all current and former staff were also cleared. LPA reviewed The Administrator, Social Worker and Direct Care staff records. LPA reviewed the facility binder that included specific trainings, following a quiz for all staff: Specific Trainings include the following: Policies & Procedures; Health & Safety: Emergency Procedures: Medication; Trauma-Informed Care; Boundaries; Job Duties; and information about the Stakeholders. LPA observed the Board of Directors Meeting Notes and confirmed that meetings are held quarterly. LPA Interviewed staff and clients that present during the initial inspection. There were no deficiencies cited at this time. LPA will return to interview additional staff and clients that were not present during the continuation of inspection. Exit Interview was conducted and a copy of this report was left at facility.


summary: Facility Evaluation

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Narrative:
On 08/30//2021 at 9: AM PM Licensing Program Analysts (LPA's) Zena Phillips with Dennis Jarmin, made an announced visit to Vista Del Mar Child And Family Services for Case Management Annual Continuation Inspection LPA Phillips & Jarmin conducted interviews with present staff and residents and other staff were left message for call back. Present residents were interviewed, all others will be interviewed at a later date. Other staff were not available and messages left on voicemail for call back. Residents were in school and not returning until after 3: PM. LPA Phillips will follow up with Unit director to meet with residents. No deficiencies cited at this time. Exit interview was conducted with Amy Jaffe_ and a copy of this report will be emailed to Administrator


summary: Facility Evaluation

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Narrative:
On 02/10/2022, Licensing Program Analyst (LPA) Zena Phillips made an unannounced visit to Vista Del Mar Child And Family Services, Handler Unit for the purpose of conducting a Case Management visit. LPA met with Amy Jaffe Administrator who granted access to the facility. This facility is currently licensed to provide care and supervision for twenty four (24) ambulatory only clients. The current census at time of visit is 16 clients in care. LPA discussed with Administrator that the purpose of the visit was to review client and staff files for compliance. LPA reviewed personnel and client files. Specific information related to this Case Management was requested and obtained during this visit. LPA reviewed 3 (three) staff files, which included Teacher Assistant, Youth Development Counselor and Adult Assistant. The staff files were reviewed for training completion within required time frame from date of hire and ongoing training. LPA reviewed 3 (three) resident files Needs and Service Plan. LPA reviewed date of admission to the facility and date of initial plan completion. LPA reviewed goals set forth in the program and review of update of goals. LPA discussed with Administrator findings of case management and LPA observed staff and client files were in compliance and no deficiencies cites at this time. Exit interview was conducted with Amy Jaffe/ Administrator and a copy of this report will be emailed to Administrator.


summary: Facility Evaluation

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Narrative:
On 02/10/2022, at 1:20PM, Licensing Program Analyst (LPA) Zena Phillips conducted a Case Management inspection to Vista Del Mar Child And Family Services due to address change request.. LPA met with Facility Administrator/ Amy Jaffe, who granted access into the facility, and who provided a tour of exit and entrance gate located on Edith Street. The current license capacity for the STRTP is 24 with current census of 16. The wrought iron automated gate has a sliding mechanism to allow entrance to facility. The mail box is located from street view to the right of entrance. The entrance is free and clear of any obstructions allowing cars ease of entry into the grounds from Edith Street entrance. LPA discussed with Administrator that guest will have access to enter and exit property from Edith Street. Administrator provided pictures of the gate entrance for LPA to attach to file. LPA observed that entrance is adequate for entering and exiting the facility. Exit interview was conducted and copy of report will be email to Administrator/ Amy Jaffe.


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst Dina Camara, Licensing Program Analyst Dahl Larios, and Licensing Program Manager Angela King conducted a case management inspection 11/08/22 at 9:30 am based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. During this inspection, 7 out of Direct Care Staff and 5 out of 17 youth files were reviewed. 3 out of Direct Care Staff and 3 out of 17 youth were interviewed. (See the Confidential Names List, LIC 811, dated 11/08/2022). The Plan of Operation including policies and procedures were reviewed. Minutes from the board of directors' meetings related to the facility's incidents involving contact with law enforcement were reviewed. Based on the analysis of the confidential interviews and youth file review including the Needs and Service assessments, Quarterly Report, and Family Safety and Crisis Plan, the licensee uses trauma-informed and evidence-based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. Licensing Program Manager Angela King observed documentation of completed training on policies and procedures on when and how to involve law enforcement in response to an incident. Training records show staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance to their Emergency Intervention Plan when there is an immediate risk of serious harm to a child or others. There are no deficiencies cited at this time. A copy of this report was discussed and provided to Maricela Morales, Quality Assurance & Electronic Health Records System Manager.

met_with: Maricela Morales, Quality Assistance/EHRS Manager


summary: Facility Evaluation

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Narrative:
On November 29, 2022 at 11:00AM, Licensing Program Analyst (LPA) Zena Phillips made an announced visit to STRTP for the purpose of conducting a Case Management, (Licensee Initiated). LPA met with Amy Jaffe, Administrator who granted access to the facility and together with LPA Phillips, a tour was conducted. The purpose of this visit is licensee is requesting a change, reducing capacity from twenty-four (24) to a capacity of sixteen (16) children. The facility is currently licensed to provide care and supervision for twenty (24) children, ages 12-17 years, ambulatory only. There is a gated pool on the premises. Naloxone Hydrochloride waiver is on file. The census on the date of this visit is seventeen (17). Facility administrator reported to LPA Phillips there are currently three (3) discharges pending. LPA Phillips observed more than three (3) vacant rooms with all bed linens removed. The facility has cameras that monitors both cottages/wings (Handler #1 and #2), living room, the rotunda room (also known as the lobby), and kitchen. The facility is located in a residential area with three cottages/wings, 18 bedrooms, several bathrooms, kitchen/dining room, 2 laundry rooms, and one clinician offices in each unit (three in total). Handler #1 is designated for the co-ed wing with boys and girls. Handler #2 is designated for the girls. The third wing is the administrative wing with offices for the administrators, clinician and all other staff. There was adequate closet and storage space for the clients. There are washers and dryers that were operable in Handler #1 and Handler #2.). Handler #1- Bedrooms with 2 twin beds, with closet space, and desks. Bedrooms has 1 single bed, and with closet space and desks. Handler #2- Bedrooms with 2 twin beds, has closet space, and desks. Bedrooms with 1 twin size bed, with closet space, and desks. cont on 809 c Facility grounds are clean and free of debris and observable hazards. Adequate indoor and outdoor activity space and materials were observed. There are no firearms or weapons located at the facility. All posting requirements have been met. Facility is currently operating within the limits of their license. Based on the observations made during today's visit, no deficiencies were cited. Exit interview was conducted, and a copy of this report will be emailed to Amy Jaffe/ Administrator .


summary: Facility Evaluation

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Narrative:
On July 20 2023 at 9: AM Licensing Program Analyst (LPA) Zena Phillips arrived at the above facility for the purpose of conducting a Case Management Investigation. LPA Phillips met with Amy Jaffe Administrator who granted access to the facility. The purpose of inspection visit was due to an incident report #878368 received on 07/17/2023. During the case management, LPA Phillips has conducted confidential interviews and reviewed documentary evidences. LPA still needs to conduct additional interviews to conclude this Case Management investigation. There are no deficiencies cited at this time. Exit interview was conducted with Tamisha Diaz, Case Manager. A copy of this report will be provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On July 20 2023 at 10: AM Licensing Program Analyst (LPA) Zena Phillips arrived at the above facility for the purpose of conducting a Case Management Investigation. LPA Phillips met with Amy Jaffe Administrator who granted access to the facility. The purpose of inspection visit was due to an incident report #873549. During the case management, LPA Phillips has conducted confidential interviews and reviewed documentary evidences. LPA still needs to conduct additional interviews to conclude this Case Management investigation. There are no deficiencies cited at this time. Exit interview was conducted with Tamisha Diaz, Case Manager . A copy of this report will be provided to the facility.

met_with: Amy Jaffe/Adminstrator


summary: Facility Evaluation

raw_content:
Narrative:
On July 20 2023 at 9: AM Licensing Program Analyst (LPA) Zena Phillips arrived at the above facility for the purpose of conducting a Case Management Investigation. LPA Phillips met with Amy Jaffe Administrator who granted access to the facility. LPA Phillips requested incident report and discharge documents. Not all parties were available at the time of the visit. A decision cannot be rendered. This case management needs further investigation. Exit interview was conducted with Tamisha Diaz, Case Manager. There are no deficiencies cited at this time and a copy of this report will be provided.