summary: Facility Evaluation

raw_content:
Narrative:
On 1/18/2023 at 10: AM, Licensing Program Analyst (LPA) Uchenna Ajaero made an unannounced Annual Inspection visit to the Institute for Children's Aid and met with Candace Milton, Assistant Director who assisted with the inspection. LPA Ajaero was informed that there are currently no participants in the transitional housing program. The program currently has social worker staff and social worker supervisors but they are not currently supervising participants at this time because they have none yet. LPA Ajaero conducted a tour of the facility. There are two buildings located within this premises. One building is used for the administrative offices and the second building is the Education center. At the Administrative building, LPA Ajaero observed that there is a large office space on the first floor, and three offices upstairs, with two restrooms. LPA observed that the office is clean and accessible to the public and it is open and operating as required. The filing system in the administrative building is set up for THP files for minors and non-minor dependents when participants are accepted. The Education center has three large rooms on the ground floor for private interviews, a waiting area for participants, and foster family visits, a full bath and a half bath. One of the offices contain backpacks and personal school items for the youths. LPA observed at the Administrative building that the fire extinguisher was last inspected on 4/22/22. LPA conducted four staff interviews. LPA did not observe any violations at this time and no citations were issued during this visit. Exit interview was conducted and a copy of the report was provided to Ms. Candace Milton.

met_with: Candace Milton, Assistant Director


state: CA

facility_name: INSTITUTE FOR CHILDREN'S AID

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced annual inspection at the agency and met with Child & Family Specialist Administrator Jean Addison-Appiah who assisted with the inspection. LPA and CFSA conducted a walk through of the buildings. LPA observed: this agency is in a two-story home structure. There is a lobby area with a front desk, one conference room, three bathrooms, seven offices, one storage area, one kitchen area, and a computer wire room. The agency has a second building on the property for meeting with clients, and where the case managers operate. It is also a two story home structure, with a lobby area/front desk, three conference rooms, two bathrooms, three offices, a file room, one kitchen area, and one storage room. The buildings were clean and in good repair. The temperature was appropriate for comfort. Files are maintained in a secure location. Telephone service is available for clients to use. The license is posted as required. There were no deficiencies observed. LPA observed the agency's Plan of Operation. LPA reviewed the Emergency Disaster Plan and found that sections from Health and Safety Code 1565(a) are missing. LPA issued an advisory note for the agency to review this HSC section and update their emergency disaster plan to include all information required. LPA reviewed the Board Meeting minutes and the Board is meeting as required. The agency has no clients in placement. No citations issued on this date. An exit interview was conducted with Assistant Director Candace Pena and a copy of this report was provided to her.

report_type: Facility Evaluation

visit_type: Annual

met_with: Jean Addison-Appiah


facility_name: INTERNATIONAL CHRISTIAN ADOPTIONS

summary: Facility Evaluation

raw_content:
Narrative:
On November 27 at approximately 8:50 am, Licensing Program Analyst (LPA) Joon Choi arrived at International Christian Adoptions (ICA) Transitional Housing Placement Program (THPP) and met with Director Mallary Manimtim for the purpose of conducting a pre-licensing inspection of the facility. LPA conducted a tour of the facility for a pre-license of a Transitional Housing Placement Program (THPP) for minors and non-minor dependents. The facility's headquarters/office is located in an industrial office park and the THPP facility is location in a home approximately 20 minutes away from the office. The ICA office includes available spaces for private interviews, family visits and social worker/staff desk areas. Client and personnel files are kept in locked file cabinets and are available for review by Licensing staff at any visit. The THPP home itself is located in a residential neighborhood and is a two story home with five bedrooms and furnished through out with all the necessary amenties including wi-fi internet access. The facility is staffed 24 hours a day / 7 days a week by ICA THPP staff. During the visit to the facility, LPA conducted a physical plan tour and completed Component II and Component III of the pre-licensing process. LPA also discussed a future Post-Licensing Visit and discussed solutions to problematic areas, overview of Title 22, THPP regulations, personal fingerprint requirements, abuse reporting requirements and licensing fees. LPA communicated the Department's and LPA's responsibility: Special Incident reporting requirements for LIC624, CC:internal procedures - AB388 reporting form LIC 624E. The facility will be notified once they are fully licensed as a THP/NMD facility. The license will expire one year from the effective date. Facility will be licensed for a capacity of 7 clients with the inclusion of 3 children of clients, for a total maximum of 10 persons housed in the THPP. Facility accepts only ambulatory clients, refugee clients, minor clients and non-minor dependent clients. The possibility of the facility requesting a capacity increase in the future, was also discussed. After a final review, the facility will be submitted for licensure. Exit interview was conducted, and a copy of this report along with a Technical Advisory was provided to Director Mallary Manimtim.

visit_type: Prelicensing

met_with: Mallary Manimtim, Director


summary: Facility Evaluation

raw_content:
Narrative:
On March 19, 2025 at 9:50 am, Licensing Program Analyst (LPA) Joon Choi arrived at International Christian Adoptions (ICA) Transitional Housing Program's (THPP) administrative office, and met with Director Mallary Manimtim (DIR) and Program Director Seandy Gonzalez (PD). The purpose of this visit was to conduct a post-licensing inspection for a Transitional Housing Placement Program (THPP) for children ages 16-17, non-minor dependents (NMDs), and pregant/parenting youth. A tour of the administrative office was conducted. Currently the THPP has three minor clients and three NMD clients placed in the one remote site home (among the clients, three toddler children are present, and one client is pregnant). The THPP office is located in an industrial office park and the THPP facility is location in a home approximately 20 minutes away from the office. The ICA office includes available spaces for private interviews, family visits and social worker/staff desk areas. Client and personnel files are kept in locked file cabinets and are available for review by Licensing staff at any visit. The THPP home itself is located in a residential neighborhood and is a two story home with five bedrooms and furnished through out with all the necessary amenties including wi-fi internet access. The facility is staffed 24 hours a day / 7 days a week by ICA THPP staff. THPP license was posted in the entry area. LPA reviewed LIC 500 personal report. THPP currently employs a Program Director (who is on call after hours), a Director, an Administrator, two social workers, a house manager, case aids, and six direct care staff (who cover all shifts, weekends, holidays, within the 24 hour day). With the assistance of DIR and PD, LPA reviewed five client files and five staff files. This THPP had physical hard copy files on hand. LPA also interviewed two staff (PD and DIR). Based on the post licensing inspection on this date, the THPP is in compliance. An exit interview was conducted with Director Mallary Manimtim and a copy of this report and a Technical Assistance (TA) was provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPA) Carolyn Flynn and Licensing Program Manager (LPM) Helga Wong met with Pamela Brown, Administrator (Adm) to conduct Component II of the orientation process at the San Jose Regional Office at 11: AM. The following items were discussed: Adm schedule Intake procedures Needs and Services/Transitional Independent Living Plan (TILP) Participant's Personal Rights Visitation/Overnight Restricted Health Condition Organization - Board Members Finances School/Work for participants relationships Additional information discussed will be added to the Program Statement and re-submitted to LPA Flynn. Component III - Pre-Licensing Visit will be scheduled by LPA Madi Fremont once LPA Flynn receives and approves the above listed items. An exit interview was conducted, and a copy of this report was discussed with Pamela Brown, Administrator, whose signature on this form confirm receipt of these documents

met_with: Pamela Brown


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Carolyn Flynn made an announced visit to the above listed facility to conduct a pre-licensing inspection at 10: AM on 09/03/2021. LPA was met by Licensee Pamela Brown who escorted LPA on a tour of the facility. LPA discussed that certificates for each apartment are required before clients can be admitted and need to be kept in the files. LPA reviewed the process that complaints will be conducted and verified that a Plan of Operations is secured on site. LPA also observed the conference area and private office with locked files. Licensee informed LPA that the telephone number has changed to 510-200-7642. LPA confirmed that rest of the office information and all is correct. LPA confirmed that Licensee does not have any further questions but did offer that she can contact LPA if questions do arise. LPA Flynn explained the timeline for getting the license. An exit interview was conducted, and a copy of this report was discussed with Pamela Brown, Licensee, whose signature on this form confirm receipt of these documents


summary: Facility Evaluation

raw_content:
Narrative:
On 11/23/22 at 10: AM, Licensing Program Analyst (LPA) Alyssa Ng made an unannounced required Annual inspection to Journey2Success' Administrative office. LPA met with Pamela Brown, Administrator. At 10: AM, LPA did a walk through inspection with Administrator of the office. The office has sufficient space for confidential meetings, all participant files and staff files are located in a locked cabinet in a secure location. The agency has their license posted in their office. The office is in compliance with Community Care Licensing (CCL) regulations. LPA spoke with Administrator about the residential unit. Administrator stated that the residential units have all working toilets, sinks and tubs. Administrator notified LPA that the program provides all participants with household essentials. At 11: AM, LPA reviewed 7 participants files with Administrator. LPA observed all 7 participants files to be complete and found no deficiencies. All documents are complete and up to date. LPA Ng discussed the facility capacity and limitations. The facility has a current capacity of 6. Facility was cited 86010(a) Limitations on Capacity and Ambulatory Status. (Please refer to 809D) At 12: PM LPA observed 2 staff files to be complete, all documentation is up to date and all staff training were up to date/current. LPA Ng interviewed 1 staff. During inspection, LPA requested a updated copy of the LIC Personnel Report to maintain their file current. A review of Licensing Information System on November 23, 2022 indicates that all facility staff associated to the facility had DOJ, FBI and child abuse index check clearances. Per Title Regulations, 1 deficiency were cited during this inspection. Exit interview conducted and a copy of the report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
Visit was attempted on 12/12/23 at 1: PM. LPA will return at a later date to conduct annual. See LIC 812 pertaining to attempted visit.


summary: Facility Evaluation

raw_content:
Narrative:
On 12/29/23 at 10: AM, Licensing Program Analyst (LPA) Brenda Rodriguez and Licensing Program Manager (LPM) Helga Wong conducted an unannounced visit to the above facility. The purpose of this visit was to complete the required annual inspection. LPA Rodriguez and LPM Wong met with Administrator Pamela Brown, at the above facility to conduct the required annual inspection. LPA Rodriguez conducted the physical plant inspection, reviewed plan of operations plan and reviewed the disaster preparedness plan. Personnel Files are maintained on-site in locked cabinets. LPA Rodriguez reviewed six client files. LPA Rodriguez discussed the following with the Administrator: client files, disaster preparedness plan, and plan of operations plan. No staff was present to conduct interviews. At this time, the inspection is not complete. LPA Rodriguez will be back at a later day to complete the required annual inspection. LPA Rodriguez conducted an exit interview, and a copy of this document was printed and given to Administrator Pamela Brown.

met_with: Administrator: Pamela Brown


summary: Facility Evaluation

raw_content:
Narrative:
On 01/02/24 at 10: AM, Licensing Program Analyst (LPA) Brenda Rodriguez conducted an attempted unannounced visit to the above facility. See LIC 812 pertaining to attempted visit.

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On 01/17/24 at 10: AM, Licensing Program Analyst (LPA) Brenda Rodriguez conducted an unannounced visit to the above facility. The purpose of this visit was to complete the required annual inspection. LPA Rodriguez met with Administrator Pamela Brown, at the above facility to conduct the required annual inspection. LPA Rodriguez reviewed four staff files. All personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. Personnel Files are maintained on-site in locked cabinets. LPA Rodriguez discussed the following with the Administrator: staff files, disaster preparedness plan and drills, client files, and operations. LPA Rodriguez conducted one staff interview. The inspection is complete. Three technical assistance were cited at this time. LPA Rodriguez conducted an exit interview, and a copy of this document was emailed to Administrator Pamela Brown.


summary: Facility Evaluation

raw_content:
Narrative:
This confirms that on 01/17/23, Licensing Program Analyst (LPA) Brenda Rodriguez completed the required annual inspection for the above facility.


facility_name: KAMALI'I FOSTER FAMILY AGENCY + THPP

summary: Facility Evaluation

raw_content:
Narrative:
On July 30, 2021 at 09: AM Licensing Program Analysts (LPA's) Anastasia Flores and Valerie Wilson was greeted and granted access to facility by Program Administrator, Sarah Dehay. At 9: AM LPA's toured the facility with Ms. Dehay. The purpose of the visit is to conduct a pre-licensing inspection of the facility Kamalii'l Foster Family Agency THPPP for Non-Minor Dependents (NMD). The office resides on business facility premises with a locked door. The office consists of four chairs and one front desk with a computer and telephone that will be utilized by staff. In the staff office there is a table, chairs and office desk with computer, telephone and a locked filing cabinet for staff files. In the second office there is a shelf utilized for THP + files, LPA informed Ms Dehay the office will need to obtain a locked filing cabinet for the NMD files. There is ample parking for residents and staff. The following were discussed: · Eric Mortensen is not yet associated to the facility license #337900041 · The facility will create a separate entrance for the THPP for Non-Minor Dependents (NMD) Program and provide LPA Flores with a photograph via email when the changes have occurred. LPA informed Ms. Dehay that due to confidentiality the Foster Family Agency cannot have the same entrance as the THPP-NMD program. · The facility will have signs created and placed on the doors for the public view. · The facility will be sure to have an updated LIC500 sent to LPA Flores prior to being licensed. · The facility will be sure to have any and all employees fingerprinted and have background clearance completed prior to be hired. · Facility will send Education transcripts for Administrator and job application to agency. · Facility will have a doorbell installed for the other entrance and proof of installation will be sent via photo. () · Component III for Transitional Housing Placement Program (THPP) for Non-Minor Dependents (NMD) was discussed by LPA Flores. · During this component LPA discussed Post Licensing Visits that Community Care Licensing (CCL) may provide, solutions to problematic areas, overview of Title 22, THPP regulations; personal fingerprint requirements, abuse reporting requirements and licensing fees. LPA communicated about LPA's responsibility; Special Incident reporting requirements, for LIC624, CC: internal procedures, AB388 reporting form LE624E. LPA and applicant discussed where to locate a copy of the special incident report and provided applicant the email address and directions on reporting incidents to Community Care Licensing Riverside Office. LPA advised that this pre-licensing report and application will be reviewed by the Department. Facility accepts only ambulatory clients. The facility will be notified once they are provisionally licensed as a THPP/NMD facility. License will expire one year from effective date. Facility will be licensed for a capacity of 25 clients. It was discussed the possibility of expansion for the facility license in the future as stated in the program statement. An exit interview and a copy of this report was conducted and handed to facility representative.

met_with: Sarah Dehay


summary: Facility Evaluation

raw_content:
Narrative:
On August 31, 2022 at 9:20 am, Licensing Program Analysts (LPA) Toni Castillo met with Administrator Sarah DeHav who granted access to the facility. The purpose of this inspection was to conduct an unannounced post-licensing inspection for a Transitional Housing Placement Program (THPP) for Non-Minor Dependents (NMD). The administrative office was toured both inside and out with the Administrator. Currently the THPP has nine NMD placement's and five remote site apartments. The remote apartments are all within two hours of the administrative office. The THPP Administrative office is located in Riverside County. The office is located in a retail business establishment. The office consists of a reception area, a meeting/conference rooms, one case manager offices, administrative offices, locked storage area, two interview rooms, two bathrooms, and a kitchen area. The office is equipped with working office equipment, furniture, and supplies. THPP license was posted in the entry area. LPA reviewed LIC 500 personal report. THPP currently employs CEO/Program Director, Administrator (who is on call after hours) and a Case Manager. LPA reviewed five NMD files. This THPP utilizes a secured electronic computer program to maintain client and staff files which was available for LPA to review. LPA also reviewed all staff files which was a total of three. Based on the post licensing inspection on this date, the THPP is in compliance. An exit interview was conducted with Administrator Sarah DeHav and a copy of this report was emailed to the facility.

met_with: Administrator Sarah DeHav


summary: Facility Evaluation

raw_content:
Narrative:
On June 7, 2023 at 10:00 am, Licensing Program Analysts (LPA's), Darlene Almaraz-Oseguera and Emina Preciado, arrived at Kamali'i Foster Family Agency (FFA) and Transitional Housing Placement Program (THPP) for the purpose of conducting an unannounced required two year inspection for the THPP for Non-Minor Dependents (NMD's). LPA's were granted access to the facility; Met and toured the facility with Sarah DeHay, Administrator. Currently the THPP has 17 participants and 11 remote site apartments. The remote apartments are all within two hours of the administrative office. The THPP Administrative office is located in Riverside County. The office is located in a retail business establishment. The office consists of a reception area, a meeting/conference room, one case manager offices, administrative offices, locked storage area, two interview rooms, two bathrooms, and a kitchen area. The office is equipped with working office equipment, furniture, and supplies. THPP license was posted in the entry area. LPA's reviewed LIC 500 personal report. THPP currently employs CEO/Program Director, Administrator (who is on call after hours) and two Case Managers. Facility provided a copy of the drill log of the emergency disaster and mass casualty plan. Staff was informed that each Social Worker should maintain a 1 to 12 ratio, which should never be exceeded. Staff is aware of submitting unusual incident reports as needed to the Department and to include all Law Enforcement contacts. During the inspection, LPA's reviewed three staff files and five participant files. The THPP utilizes a secured electronic computer program to maintain client and staff files which was available for LPA's to review. All five staff reviewed met the minimum qualifications and training requirements. A review of records shows that all staff have FBI, DOJ, and Child Abuse Index Check clearances. All five participants files reviewed were complete and had the required documents. Based on observation and record review, there were no deficiencies noted at this time. Exit interview conducted and a copy of this report was provided to, Administrator, Sarah DeHav.

met_with: Sarah DeHay, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA), Darlene Almaraz-Oseguera arrived at the proposed suite addition for Kamali'i Foster Family Agency + Transitional Housing Placement Program (THPP), at 08:35 am on March 29, 2024, to conduct an inspection. The facility was toured with Administrator Sarah DeHay. The suite is located in the same building as the current THPP which is a business establishment and secure area. There are two suites leased by the THPP (A & B) in the building. The entrance to the suite is a private reception area with a waiting area, which is on the second floor. There is an area for reception staff with telephones, copy machines and fax machines. LPA observed four offices for social work staff with desks and locking cabinets. There is a large conference room to be used as a training and conference room for staff and participants. There is office equipment and furniture throughout the office space. The phone number to the office is (951) 674- 9400. The office space was observed to meet the requirements of Title Regulations at this time. After a final file review, the suite will be submitted for approval for the use of the additional suite #D. An exit interview was conducted, and a copy of the report was provided to Sarah DeHay.

met_with: Sarah DeHay


summary: Facility Evaluation

raw_content:
Narrative:
On April 30, 2024 at 10:00 am Licensing Program Analyst (LPA), Darlene Almaraz-Oseguera, conducted a case management inspection at Kamali'i Foster Family Agency (THPP). LPA met with facility Administrator, Sarah DeHay. The purpose of the inspection is in regard to an incident of the death Non-Minor Dependent (NMD), please reference LIC 811, Confidential Names List, dated 04/30/2024. While at the agency, LPA reviewed NMD files. LPA received copies of pertinent information contained in the files. The death of the NMD will be followed-up on as the Department receives information from law enforcement and coroner's office. No violations cited at this site visit. A copy of this report along with LIC 811, Confidential Names List, was given to Administrator, Sarah DeHay.


summary: Facility Evaluation

raw_content:
Narrative:
On July 30, 2024 at 1:15 pm, Licensing Program Analysts (LPA's), Cynthia Robinson and Leslie Covarrubias, arrived at Kamali'i Foster Family Agency (FFA) and Transitional Housing Placement Program (THPP) for the purpose of conducting an unannounced required two year inspection for the THPP for Non-Minor Dependents (NMD's). LPA's were granted access to the facility; Met and toured the facility with Sarah DeHay, Administrator. Currently the THPP has 31 participants and 19 remote site apartments. The remote apartments are all within two hours of the administrative office. The office is located in a retail business establishment. The office consists of a reception area in the front, a meeting/conference area that holds a large conference table with a large tv and a large couch for a seating area, four administrative offices, a printer room with additional storage, and a kitchen area. The office is equipped with working office equipment, furniture, and supplies. THPP license was posted in the entry area. LPA's reviewed LIC 500 personnel report. THPP currently employs CEO/Program Director, Chief Operations Officer, Administrator (who is on call after hours) and three Case Managers. Facility provided a copy of the drill log of the emergency disaster. Staff was informed that each Social Worker should maintain a 1 to 12 ratio, which should never be exceeded. Staff is aware of submitting unusual incident reports as needed to the Department and to include all Law Enforcement contacts. During the inspection, LPA's reviewed four staff files and five client files. The THPP utilizes a secured electronic computer program to maintain client and staff files which was available for LPA's to review. All five staff reviewed met the minimum qualifications and training requirements. A review of records shows that all staff have FBI, DOJ, and Child Abuse Index Check clearances. All five client files reviewed were complete and had the required documents. (Continue on next page...) Based on observation and record review, there were no deficiencies noted at this time. Exit interview conducted and a copy of this report was provided to, Administrator, Sarah DeHay.


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On February 20, 2026, at 10:30 pm, Licensing Program Analyst (LPA), Cynthia Robinson arrived at Kamali'i Foster Family Agency + Transitional Housing Placement Program (THPP) for the purpose of conducting an unannounced required inspection for the THPP for Non-Minor Dependents (NMD's). LPA was granted access to the facility; Met and toured the facility with Lindsey Nelson, THPP Supervisor. Currently the THPP has 36 participants and 11 remote site apartments. The remote apartments are all within two hours of the administrative office. The office is located in a retail business establishment. The office consists of a reception area in the front, a meeting/conference area that holds a large conference table with a large tv and a large couch for a seating area, four administrative offices, a printer room with additional storage, and a kitchen area. The office is equipped with working office equipment, furniture, and supplies. THPP license was posted in the entry area. LPA's reviewed LIC 500 personnel report. THPP currently employs CEO/Program Director, Chief Operations Officer, Administrator (who is on call after hours), THPP two Supervisors, four full time Case Managers, and one Housing Specialist. Staff was informed that each Social Worker should maintain a 1 to 12 ratio, which should never be exceeded. Staff is aware of submitting unusual incident reports as needed to the Department and to include all Law Enforcement contacts. (Continued on LIC 809C...) During the inspection, LPA reviewed five client and five staff files. LPA was assisted by Lee Burton, Chief Operations Officer to review all five staff reviewed met the minimum qualifications and training requirements. A review of records shows that all staff have FBI, DOJ, and Child Abuse Index Check clearances. The THPP utilizes a secure electronic computer program to maintain client and staff files which was available for LPA to review. All five client files reviewed were complete and had the required documents except for the NMD's Needs and Services Plans (NSP's) missing required signatures. The facility will be cited for this violation. Please see LIC 809D. Exit interview was conducted and a copy of this report was provided to, Lee Burton, Chief Operations Officer.

Deficiencies:
86268.3: 03/20/2026
Plan of Correction
1
2
3
4

met_with: Lee Burton, Chief Operations Officer

title:
(e)	The Needs and Services Plan shall be signed by the participant, the licensee, and the placing agency, and shall be maintained in the participant's records as specified in Section 86270. Based on record review, the licensee did not comply with the section cited above in five out of five NMD's file which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date

description:
03/20/2026
Plan of Correction
1
2
3
4


facility_name: KRISTA FOSTER HOMES THPP/THP+FC

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Katherine Deaton emailed this report on 11/8/2021 to Krista Foster Homes (THPP). This report was not sent timely. The purpose of the case management was to review the Social Work Exception for Rebekah Fujimura, Agency Social Worker (ASW) issued by CCL that expired on 7/11/2020. Review of the exception was conducted on 5/5/2020. ASW has a BA in Social Work and therefore requires an exception pursuant to Title Section 86065.3(e). The LPA contacted Bob Phillips, Administrator and ASW's Supervisor, who confirmed ASW's performance has been satisfactory and that she has great communication and writing skills. ASW does not have a full caseload and offers appropriate resources to foster youth with behavioral issues. The LPA also contacted ASW who stated they have the tools they need to succeed. The LPA reviewed recent contact notes. These notes were comprehensive and addressed the youths' needs appropriately. An extension to ASW's Social Worker Exception has been granted with a new end date of 7/11/2021.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPAs) Lyta Vue and Kellie McKinley arrived unannounced to the facility and met with Bob Phillips, Executive Director (ED) for the purpose of conducting a Required Annual Inspection of the THP Program. LPAs was given a tour by the Bob Phillips, Executive Director. LPAs toured the facility, The facility is clean, safe, and sanitary. Facility provides a visitation room if needed and all medications and cleaning chemicals are stored away out of reach. LPAs conducted interviews with five facility staff, and records were reviewed of all 5 facility staff and 5 clients. All records and files were made available upon request and kept in a secure and locked file cabinet located within the office of the Receptionist and Office Manager, in which is a secured room. All signed Needs and Services Plans were observed to be present (where applicable), as were signed Consents for Emergency Medical and/or Dental Treatment; Personal Rights acknowledgments were also found in the records as part of the Admission or Participation Agreements. Based on California code of Regulations 1565(c) Health and Safety Code , Title Regulations 1565;(c) A facility shall conduct a drill at least quarterly for each shift. The Licensee is cited for not having updated emergency drill. Exit interview conducted; a copy of this report was provided to the facility. Appeal rights were provided.

met_with: Bob Phillips-Executive Director


summary: Facility Evaluation

raw_content:
Narrative:
On 3/20/25, Licensing Program Manager (LPM) Hillary Hall and Licensing Program Analyst (LPA) Bianca Mendez arrived unannounced at the facility and met with Bob Phillips, Administrator. The purpose of the visit was to conduct a Required Bi-Annual Inspection of the facility. The last Bi-Annual inspection for the facility was on 6/5/2023. LPM and LPA utilized the CARE Tool to complete the inspection. LPM/LPA conducted an inspection of the physical plant, and checked for all necessary requirements. The facility is clean, safe, and sanitary. Facility provides a visitation room and all cleaning chemicals are stored away out of reach. The facility maintained an acceptable room temperature. The facility has five offices for staff. LPM/LPA observed the proper postings including: facility license, complaint hotline, and emergency disaster plan. The restrooms for clients and staff were clean. Smoke alarms were in working order, fire extinguishers were current, and a first aid kit was fully stocked. Evacuation drills for the facility were completed quarterly. LPM/LPA observed client files were stored electronically and in paper form. Electronic files had password protection. Paper files were in a locked cabient. The facility has no outstanding fees. The facility has Non-Minor Dependent clients and zero minor clients. Clients all live in remote site apartments. No client resides more than two hours from the facility. The facility employs Case Managers, and one Administrator. Continued on 809C Continued from LPM/LPA reviewed three case manager files. Case manager files had completed criminal record clearances and met minimum education and experience qualifications. LPM/LPA interviewed three case managers. Case managers were missing training on policies regarding law enforcement contact and sexual and reproductive health. LPM/LPA reviewed five client files. One client was missing signed agreement for discharge and removal policies and Technical Violation 9102 was provided. Client files had current Needs and Service Plans, signed by the client and placing agency. One citation given on this date per Interim Licensing Standards 86065(f)(3,4). A signed copy of this LIC-809, LIC-809C, and LIC-809D report was provided to the Administrator. An exit interview was conducted. Appeal rights were provided *Date on 809 is incorrect as inspection occurred on 3/20/25

met_with: Bob Phillips, Administrator


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
During the complaint investigation into the allegation: THP/THPP staff mismanaged client's funds, interviews and records reviewed were consistent. All five interviews reported that during a budget audit, errors were found indicating funds were inaccurate on the client's budget sheet and the client was overpaid. LPA reviewed budget sheets which indicated the dates and amounts where errors were discovered. The agency admitted to the finance errors and the staff who made the errors is no longer with the agency. Based on LPA's interviews which were conducted, and records reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. One citation is being issued for violating Interim Licensing Standards: Section 86226(c)(2)(B) SAFEGUARDS FOR CASH RESOURCES, PERSONAL PROPERTY, AND VALUABLES (c) If the cash resources, personal property, and valuables of a nonminor dependent are entrusted to the licensee, these items shall be safeguarded as specified in this subsection. (2) The licensee shall: (B) Maintain accurate records of the cash resources, personal property, and valuables belonging to a nonminor dependent. A signed copy of this LIC-9099 report, the LIC-9099C, and LIC-9099D were provided to the facility. An exit interview was conducted. Appeal rights were provided.

Investigation Findings:
13Licensing Program Analyst (LPA) Lyta Vue arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Administrator Bob Phillips. LPA Vue conducted the complaint investigation. LPA initiated the investigation with the facility on 03/06/26 and met with Administrator Bob Phillips. During the course of the investigation, LPA interviewed one (1) client, one Administrator, two (2) Case Managers, (1) additional Agency Staff, and one (1) County Social Worker. LPA reviewed records including LIC 500 with staff schedule, client's most recent Needs and Service/IPP, Agency Social Worker case notes, CFT notes, and client cash values/budget sheet. LPA also reviewed county records. Report continued on 9099c SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Lyta Vue 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: KRISTA FOSTER HOMES THPP/THP+FCFACILITY NUMBER: VISIT DATE: 03/26/2026

report_type: Complaint Investigation

met_with: Administrator Bob Phillips

complaint_status: SUBSTANTIATED


facility_name: LEADING PURPOSE, INC

summary: Facility Evaluation

raw_content:
Narrative:
On November 1, 2022, at 9:00am, Licensing Program Analyst (LPA) Charmaine Linley, conducted a pre-licensing inspection for a change in relocation from Chandon Laguna Niguel, CA 92677 to the above facility address. LPA toured the office with Elizabeth Urenda, Administrator. The office consists of a three storied office building, which is convenient to the public. The building includes a front desk, lobby area, multiple offices, and six conference room. The office is on the second floor of the office building. The Administrator provided a copy of the lease, as well. Emergency Disaster Plan, Personal Rights, Foster Care Ombudsman phone number will be posted in a prominent area for participants to view. The Administrator will take a picture and send to the LPA once the forms are posted. License will be posted as soon as it is issued. Participants files are locked in file cabinets in the office. Staff files are locked in file cabinets in the office. Telephones, computers, fax and copying machines are operable. The bathrooms are located outside the suite. Fire extinguishers are current, there are fire sprinklers, smoke detectors, and carbon monoxide detectors located in each office. A complete first aid kit is readily accessible and located downstairs in the lobby at the front desk. The facility has demonstrated compliance with Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted, Due to printer malfunction, a copy of this report will be emailed to Elizabeth Urenda, Administrator.

met_with: Elizabeth Urenda, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On February 7, 2023 at 10:10 am, Licensing Program Analyst (LPA) Charmaine Linley made an unannounced post-licensing visit. The purpose of this inspection was to conduct an unannounced post-licensing inspection for a Transitional Housing Placement Program (THPP) for Non-Minor Dependents (NMD). LPA toured the office with Elizabeth Urenda, Administrator. The office consists of a three storied office building, which is convenient to the public. The building includes a front desk, lobby area, multiple offices, and six conference room. The office is on the second floor of the office building. The Emergency Disaster Plan, Personal Rights, Foster Care Ombudsman phone number are posted in a prominent area for participants to view. Participants files are locked in file cabinets in the office. Staff files are locked in file cabinets in the office. Telephones, computers, fax and copying machines are operable. The bathrooms are located outside the suite. Fire extinguishers are current, there are fire sprinklers, smoke detectors, and carbon monoxide detectors located in each office. A complete first aid kit is readily accessible and located downstairs in the lobby at the front desk. Currently the THPP has fifteen NMD's placement's and eight remote site apartments. The remote apartments were all within two hours of the administrative office. LPA reviewed three NMD files. The files were stored in locked cabinets within the Director's office. LPA also reviewed all staff files which was a total of three. The staff files were in a locked cabinet in the Administrator's office. The facility is being cited for Title 22, Division 6 regulations, Health and Safety Codes 1565, and Interim Licensing Standards 86275. The facility has been issued (2) type A and (15) type B citations. Please refer to LIC 809(d). An exit interview was conducted, Due to printer malfunction, a copy of this report, 809(d)'s, LIC 811, and appeal rights will be emailed to Elizabeth Urenda, Administrator.


summary: Facility Evaluation - 4 deficiencies

raw_content:
Narrative:
On July 22, 2024, at 9:30 am Licensing Program Analyst (LPA) Charmaine Linley made an unannounced visit to the facility. The purpose of this inspection was to conduct a Random/ Annual Inspection for the Transitional Housing Placement Program (THPP) for Non-Minor Dependents (NMD). LPA toured the office with Andrew Castillo, Program Director. The office consists of a three storied office building, which is convenient to the public. The building includes a front desk, lobby area, multiple offices, and six conference rooms. The office is on the second floor of the office building. The Emergency Disaster Plan, Personal Rights, Foster Care Ombudsman phone number are posted in a prominent area for participants to view. Participants files are locked in file cabinets in the office. Telephones, computers, fax and copying machines are operable. The bathrooms are located outside the suite. Fire extinguishers are current, there are fire sprinklers, smoke detectors, and carbon monoxide detectors located in each office. A complete first aid kit is readily accessible and located downstairs in the lobby at the front desk. Currently the THPP has sixteen NMD's placed and ten remote site apartments. The remote apartments were all within two hours of the administrative office. LPA reviewed three NMD files. The files were stored in locked cabinets within the Director's office. LPA was unable to review staff files as the Facility Administrator had the employee files located at their residence. LPA reviewed the Personnel Roster and Guardian to ensure that staff had a criminal record clearance, record review indicated that Staff #1 (S1) and Staff #3 (S3) have clearances that were pending and Staff #2 (S2) was not listed on the Guardian website. LPA Linley requested copies of any supporting documents the facility may have and what they provided was incomplete it was only the DOJ clearance. The facility was reminded to send LPA an updated LIC 500 with all individuals associated to the facility and to send LPA a copy of the client roster when there are changes to the roster. *** The facility is being cited for violations of the Title 22, Division 6 regulations, California Code of Regulations 86019(e) Criminal Record Clearance, three individuals were working at the facility and did not have a complete Criminal Record Clearance, 86066(a) Personnel Records, three staff members (S1-3) did not have their personnel files available to review, 86030.5(a), Identification of Transitional Housing Placement Program Participant Living Units, three units did not have a Certificate of Compliance, 86068.3(b), Modifications to Needs and Services and Transitional Independent Living Plans, Client #2 (C2) did not have any dates listed on their Needs and Services Plan and the Authorized Representative did not sign off on the Needs and Services Plan, 86069(a), Participant Medical Assessments, Clients 1-3 (C1-3) did not have written medical assessments or documentation of denial of the medical assessment, and Health and Safety Code 1565(b) Other Provisions, four out of four staff members did not have training on the emergency/disaster plan and shift responsibilities. Please refer to LIC 809(d). An exit interview was conducted, Appeal rights were reviewed. Due to printer malfunction, a copy of this report, 809(d)'s, LIC 811, and appeal rights were emailed to Elizabeth Urenda, Administrator and Andrew Castillo, Program Director.

Deficiencies:
86019(e): Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility
86066(a): Personnel Records

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information
86068.3(b): Deficient Practice Statement
1
2
3
4Based on record review, the licensee did not comply with the section cited above in Client #2 did not have the dates listed or the Authorized Representative signature on their Needs and Services plan, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/22/2024
Plan of Correction
1
2
3
4
86069(a): Deficient Practice Statement
1
2
3
4Based on record review, the licensee did not comply with the section cited above in three out of three clients did not have a written medical assessment of the participant, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/22/2024
Plan of Correction
1
2
3
4

met_with: Andrew Castillo

title:
Modifications to Needs and Services and Transitional Independent Living Plans

(b) The licensee shall ensure that each participant's written Needs and Services Plan is updated as often as necessary to assure its accuracy, but at least annually. These modifications shall be maintained in the participant's file.

This requirement is not met as evidenced by

title:
Participant Medical Assessments

(a) 	Prior to or within 30 calendar days following the acceptance of a participant, the licensee shall obtain a written medical assessment of the participant, as specified in Section 80069(b), which enables the licensee to determine his/her ability to provide necessary health related services to the participant. The assessment shall be used in developing the Needs and Services Plan.

This requirement is not met as evidenced by


facility_name: LEADING PURPOSE, INCORPORATED

summary: Facility Evaluation

raw_content:
Narrative:
On May 11, Licensing Program Analyst 's (LPA's) Toni Castillo and Darlene Oseguera, arrived at the agency for the purpose of conducting an unannounced post annual licensing inspection for the agency's Transitional Housing Program (THP) LPA's met and inspected the facility with Program Administrator Elizabeth Urenda. Facility utilizes apartment complex housing model. The agency currently has 5 apartments designated for THP+ NMD. There are 10 non minor dependents (NMD) youth who are currently in placement with the agency. LPA's conducted an inspection of the agency. Files are located in locked file cabinets within a locked office. There are no physical plant deficiencies. Staffing: The agency employs the following assigned staff under the THP program. Program Administrator, Elizabeth Urenda and Case Manager Melissa Sandoval. LPA's received updated participant and certified apartment information. Current Personnel Report (LIC 500) and client roster. Staff files were unavailable for review. However LPA's verified Criminal Background and Child Abuse Clearances which are complete and current for all employees. LPA's reviewed 10 non minor dependent files. During client file review, LPA's observed 3 of 10 client files (C1, C2. C3) were missing client and authorized representative signatures on the Needs and Service Plan and 6 out of 10 client files were missing the needs and service plan for C4, C5, C6, C7, C8 and C9. Therefore, the facility is cited under the Non-Minor Dependent regulations, section 86168.3 (f) Needs and Service Plan.The facility is also cited due to having no staff files located at facility for review. An exit interview was conducted and a copy of this report , deficiencies with appeal rights was provided to Program Administrator, Elizabeth Urenda.

met_with: Program Administrator Elizabeth Urenda


summary: Facility Evaluation

raw_content:
Narrative:
On October 7, 2022, at 10:00AM Licensing Program Analyst (LPA) Charmaine Linley conducted an announced pre-licensing inspection with Administrator, Elizabeth Urenda, and was given a tour of the Remote Site Model home located in Costa Mesa. This is a single site facility that is moving over from the Laguna Niguel single site facility. The home is a single story with three bedrooms and two bathrooms. The facility is licensed to have a capacity of six ambulatory clients. The residence has a desk, a large living room, and a recreation room that leads outside to the backyard. The yard also has additional chairs for sitting. The kitchen is equipped with working appliances and stocked with eating utensils, cups, glasses, plates, bowls and dishes and pans for food preparation. The kitchen has a table to eat at. The facility files (clients files and staff files) are going to be held at the corporate office in Irvine. There is ample parking for residents and staff. The garage will hold a washer and dryer for the clients, the washer and dryer has been ordered, and is waiting to be delivered. The facility has ample storage space in the garage. The garage will be emptied prior to accepting clients. The windows had blinds for privacy. The fireplace has been capped and is non-operable, which does not require a barrier at this time. There is a fire extinguisher in the kitchen and the garage. Bedroom 1 has one twin size bed, one dresser, and one closet. The bedroom does not have a mattress as a client in another location will be moving to the facility and will be bringing their mattress with them. At this time, there is only one bed in bedroom one with the capacity to add in another bed to allow two clients to reside in the bedroom. Bedroom 2 has two twin sized beds, two dressers, and a closet. Bedroom 3 has two twin size beds, two dressers, and a closet. All bedroom windows had blinds for privacy. No more than two clients will share any of the bedrooms. *** Prior to clients moving, the facility will obtain a working telephone line and send the invoice of service to LPA Linley. The facility will send photos of the washer, dryer, TV in living room, and pictures of the debris removed from the garage and backyard. Prior to clients moving in, the facility will send an updated LIC 610 form and any other forms with the updated single site address. The facility will post a copy of the license, personal rights, and the contact information for Community Care Licensing in the facility. The facility meets the Regulatory requirements and is ready for licensure at the conclusion of the visit. Exit interview conducted. A copy of this report was emailed to the Administrator and a copy will be placed in the facility file.

met_with: New Single-Site Facility


facility_name: LIVING ARROWS

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove the alleged violations occurred. The Department has decided that the allegation is unsubstantiated but if additional information is received this complaint can be amended and the finding can be changed. There are no deficiencies to be cited at this time. Exit interview conducted and a copy of this report was left at the facility with Angelique Rangel, Administrator.

Investigation Findings:
13On June 29, 2022 at 10: Am., Licensing Program Analyst (LPA), Kuliema Calloway and Licensing Program Manager (LPM), Kevin Sauk arrived at the facility to deliver the findings of the complaint investigations conducted by LPA Enrique Hernandez. LPA and LPM met with Angelique Rangel, Adminstrator and discussed the investigative findings. During the investigation process, confidential interviews revealed that no one has seen any clients being sexually inapproapriate with one another. Although one statement stated otherwise, after the confidential interview the allegation was denied. The social worker has no concern with the facility and was never informed by any of the participants about the allegation. Continued on LIC C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Kuliema Calloway 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 31-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, VENTURA BLVD., STE. WOODLAND HILLS, CA FACILITY NAME: LIVING ARROWSFACILITY NUMBER: VISIT DATE: 06/30/2022

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

met_with: Angelique Rangel, Administrator

complaint_status: unsubstantiated


raw_content:
Investigation Findings:
13On 12/14/22, at 1:10pm, Licensing Program Analyst (LPA) Nancy O'Connell made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegations and deliver the findings. LPA spoke with the office assistant and together, discussed the investigative findings. On 8/2/22, the Department received a complaint reporting allegations related to neglect and lack of supervision of transitional aged youth residing in Transitional Housing Placement Program. During the course of investigation, record reviews and interviews were conducted in order to determine findings of allegations. Regarding the provision of supervision of residents in care, record reviews conducted reflect that the licensee maintained the required staffing coverage during the assigned hours within the program. Further review reflects that emergency procedures are established within the program and made available to residents. Upon interview of staff and residents, it was confirmed that case management services are provided on a weekly basis, thereby providing residents with access to support and the opportunity to report concerns and obtain support from staff. Lastly, needs and services plans were reviewed and demonstrate the incorporation of mental health service goals for each resident. Due to the age of residents, all mental health services remain voluntary. There are no deficiencies to be cited at this time. A copy of this report was reviewed with the staff and due to technical difficulties, a copy of the report was emailed to the facility administrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nancy O'Connell LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

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

met_with: Kelly Kennedy, Office assistant


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
to client records, and has operated in the capacity of an employee, while making executive decisions on behalf of the facility management staff. Based on LPA observations and interviews which were conducted along with record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. According to California Code of Regulations, Title 22, one deficiency is being cited on the attached LIC 9099D. An exit interview was conducted and a copy of this report was provided to the office administrator upon exit.

Investigation Findings:
13On March 16, 2023 at 3:00pm, Licensing Program Analyst (LPA) Nancy O'Connell made unannounced inspection to the above-listed facility for the purpose of concluding the investigation on the above allegations and deliver the finding. LPA O'Connell met with the Office administrator and discussed the investigative finding. On 1/25/23, the Department received a complaint alleging there was an uncleared adult on premises interacting with participants. During the investigative process, LPA O'Connell conducted confidential interviews with all relevant parties and collected information on the above allegation. After reviewing all the statements and the information obtained, the above allegation is supported, as the confidential interviews confirmed that P1 has been in the facility office, maintained access Continued on LIC9099C SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nancy O'Connell 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 31-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, VENTURA BLVD., STE. WOODLAND HILLS, CA FACILITY NAME: LIVING ARROWSFACILITY NUMBER: VISIT DATE: 03/16/2023

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

met_with: Kelly Kennedy, Office Administrator (OA)


raw_content:
Narrative:
Based on the documentary evidence, interviews, and statements obtained during the investigation process, LPA was unable to determine if the above said allegations occurred therefore the allegations are determined to be unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. There are no deficiencies to be cited at this time. Exit interview was conducted and a copy of this report was left with the facility bookkeeper.

Investigation Findings:
13On 12/20/2023 at 09: Licensing Program Analyst (LPA) Jhane Haynes made an unanounced follow up visit to Living Arrows for the purpose of concluding the investigation and deliver findings on the above allegations. LPA met with Bookkeeper (BK) Alaina Upthegrove in leui of FA's absence and together discussed the investigative findings. During the investigation LPA Phillips interviewed and accounted for all available relevant parties; and gathered pertinent information regarding the allegations. Staff denied the allegations listed above and reported no client information was being shared with former staff. Confidential interviews revealed residents have not been charged fees after relocating. Interviews conducted and documentary evidence, stipend log, email correspondence, and program policy regarding clients moving out the information gathered did not produce corroborating evidence to support the allegations. (Continued to LIC9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Jhane Haynes 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 31-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION WOODLAND HILLS S.Ro, Ventura Blvd., STE. WOODLAND HILLS, CA FACILITY NAME: LIVING ARROWSFACILITY NUMBER: VISIT DATE: 12/20/2023

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

met_with: Alaina Upthegrove Bookkeeper(BK)


raw_content:
Narrative:
It was reported that the facility failed to provide medical assistance to C1 during the incident involving Client #2 (C2). At the time of the verbal altercation between C1 and C2. Staff 1 (S1) was present and was trying to de-escalate the situation between them. C1 had already called 911 before S1 contacted the paramedics after C2 threw a can of aerosol at C1's stomach. Statements indicated that there had been no prior incidents between C1 and C2. Following this incident, C2 was removed from the home for violating the participant manual. The Department has decided that the allegation is unsubstantiated but if additional information is received this complaint can be amended and the finding can be changed. There are no deficiencies to be cited at this time. Exit interview was conducted and a copy of this report will be emailed to the Facility Administrator.

Investigation Findings:
13On 11/8/2024 at 11:15am Licensing Program Manager (LPM) Enrique Hernandez made an unannounced inspection to Living Arrows to conclude the investigation on the above allegations and deliver the findings. LPA spoke with Facility Administrator Marylou Escoto and together discussed the investigative findings. During the investigative process by Licensing Program Manager (LPM) Enrique Hernandez, all relevant parties were accounted for. Based on all of the interviews conducted, the Department has concluded that the above allegations to be Unsubstantiated, meaning that although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. Supporting evidence includes the following: Although the facility could have improved communication with Client #1(C1) regarding who would provide transportation for them, there needed to be better communication regarding C1's transportation to their baby shower.C1 changed their mind about who would take them, contributing to the confusion. Continue on LIC9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Enrique M Hernandez 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 31-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, VENTURA BLVD., STE. WOODLAND HILLS, CA FACILITY NAME: LIVING ARROWSFACILITY NUMBER: VISIT DATE: 11/08/2024

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


summary: Facility Evaluation

raw_content:
Narrative:
On July 29, 2021 at 9:00am Licensing Program Analyst (LPA) Enrique Hernandez made an unannounced visit inspection to Living Arrows THPP Administrative Office located at E Main Street, #116, Ventura, CA 93001 for the purpose of conducting an Annual/Required Inspection. LPA met with CEO Kris Hart who granted access to the Administrative Office and together toured the office. The office building and is set up as follows: The administrative office Suite #116 accommodates only THPP staff and consists of entrance with a code to get into the office. LPA observed a station with a sign in sheet and temperature check. The office is a two-room office with a bathroom in good working order at the time of the inspection. The building is equipped with a large conference room that can be used for meetings or training to maintain social distance. The main office space consists of two desks and chairs and a small side table with informational packets for clients. The second room is an attached conference room available with two desks and two computers licensee states is available to conduct private interviews and a small group of training. Staff and client records are maintained in the Administrative Office inside locked cabinets. All posting requirements were met. The facility is licensed to provide Transitional Housing Placement plus Foster Care (THP + FC) and Non-Minor Dependents (NMD) to 74 participants ages eighteen (18) through twenty-one (21). There are currently four (4) participants in placement in the Ventura County. Facility has hired Social Workers (1 per 12 participants) and Social Worker Supervisor (1 per Social Workers). The facility is currently operating within staff ratio. Continue on LIC809-C A review of staff records on 7/28/2021 indicates that all individuals who require background checks have received criminal record and child abuse index check clearances or exemptions. Except for two people (Shannon Dobler and Ashley Rufener). CEO stated that they are not currently working until they get cleared. LPA Hernandez together with THP CEO and (Administrator/ Case management) conducted a collateral inspections (see 812's dated 7/29/2021) to the following remote site to ensure compliance to Title Regulations. Due to time constraint LPA Hernandez will return and continue with the annual inspection to be able to review reviewed staff records and client records. There were no deficiencies observed or cited during today's inspection. Exit interview was conducted and a copy of this report was left with the administrator of the facility whose signature on this form confirm receipt of this document.

met_with: Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On 09/09/2021 at 9:15am, Licensing Program Analyst (LPA) Enrique Hernandez conducted an unannounced inspection, at the above-said facility, for the purpose of conducting a Case Management Annual Continuation Inspection. LPA was met by the Facility Administrator Angelique Rangel and Kelly Kennedy and CEO Kris Hart, who granted access into the Administrative Office LPA Hernandez interviewed and reviewed three staff files (S1, S2, and S3) LPA Hernandez conducted the file review for six clients (C1, C2, C3, C4, C5, and C6 [See Confidential Names form (LIC811), dated 09/09/2021, for names.] During the file review of the staff LPA also observed that the job duties for two staff were not in their file. Also during the client's file review LPA observed and was told by the Administrator Angelique that they do not conduct a examination for communicable tuberculosis. The administrator stated that they test participants for COVID-19. The CEO stated that they will begin testing clients upon arrival for tuberculosis. Exit interview was conducted and a copy of this report was left with the administrator of the facility whose signature on this form confirm receipt of this document.


summary: Facility Evaluation

raw_content:
Narrative:
On 08/30/2023 at 9:30am Licensing Program Analyst (LPA) Nancy O'Connell and LPA Jhane Haynes made an unannounced visit inspection to Living Arrows THPP Administrative Office located at E Main Street, #116, Ventura, CA 93001 for the purpose of conducting an Annual/Required Inspection. LPA met with Marylou Andrade, facility administrator and Judith Rodriguez Case Manager, who granted access to the Administrative Office and together toured the office. The office building and is set up as follows: The administrative office Suite #116 accommodates only THPP staff and consists of entrance with a code to get into the office. LPA observed a station with a sign in sheet and temperature check. The office is a two-room office with a bathroom in good working order at the time of the inspection. The building is equipped with a large conference room that can be used for meetings or training. The second room is an attached conference room available with two desks computers. Staff and client records are maintained in the Administrative Office inside locked cabinets and through electronic record. All posting requirements were met. The facility is licensed to provide Transitional Housing Placement plus Foster Care (THP + FC) and Non-Minor Dependents (NMD) to 74 participants ages eighteen (18) through twenty-one Continued on LIC809C. (21). There are currently nine (9) participants in placement in the Ventura County. During the time of inspection, LPA O'Connell and Haynes conducted an inspection of the physical plant, emergency preparedness, and operations procedures. As part of the annual inspection, LPA O'Connell and LPA Haynes traveled to THPP remote site #1 in order to conduct a site inspection. LPA O'Connell and LPA Haynes inspected the property and observed functional carbon monoxide detectors, required posted documents, locked files, and emergency procedure binder. The kitchen was inspected and the refrigerator maintained required amount of food for clients. The backyard was clean, and orderly and free of obstructions or safety hazards. The interior portion of the facility was clean, and orderly. Due to time constraints, LPA O'Connell will return to complete the annual review. There were no deficiencies observed or cited during today's inspection. Exit interview was conducted and a copy of this report was emailed to the administrator of the facility.

met_with: Marylou Escoto, Facility Administrator (FA)


facility_name: LOVE FOCUS YOUTH OUTREACH

summary: Facility Evaluation

raw_content:
Narrative:
On the above date, a virtual component II orientation is conducted by LPA (Licensing Program Analyst) Lisa Slusher with Administrator and Board member Margaret Mungai. LPA forwarded letter with requested corrections on 8/18/21. Corrections ( Pages) were submitted on 8/22. LPA is reviewing corrections at this time. Discussed Fingerprinting and the Guardian system, and the need for the agency to create an account. Agency will in the meantime send associations for appropriate staff to this LPA, and will have staff fingerprint if required. Discussed Foster Care Rates Status. Pre-licensing inspection tentatively scheduled for 9/2/21 at the Facility in Merced, CA.

met_with: Margaret Mungai


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analysts Eduardo Barragan and Lisa Slusher travelled to the CTC THP + NMD office in Merced CA . LPAs were met by Administrator Margaret Mungai, for the purpose of a scheduled pre-licensing inspection for an initial licensure for a THP + NMD program.. A general overview of their program and a tour of the facility was provided. This facility has a reception area, waiting area, and office space for staff. Observed fixtures and furniture, equipment and supplies necessary for this operation. Also observed locked cabinets for client and staff files in order to ensure confidentiality and a fully stocked first aid kit. Discussed daily ongoing functions including incident reports. Initial incident reports are to be submitted by the next working day to CCLFresnoIncidents@dss,ca,gov. A full report shall follow within 7 days. There is sample confidential space for meeting with clients on an as needed basis. Agency has received Administrative approval to manage background clearances through Guardian, and will ensure that all staff are appropriately cleared and associated prior to presence in the facility. Agency has contacted the FCARB (Foster Care Rates and Audits Bureau) about obtaining funding. Once licensed, LPA will forward information to FCARB. LPAs observed staff files and sample participant files. The above licensee is recommended for licensure on this date as a THP+NMD serving clients age 18-21 in Merced county and other counties within a two hour radius, pending approval of program Statement updates. . On a quarterly basis, facility is to submit a roster of THP+NMD clients that includes client names, dates of birth, county worker and current address of placement as well as a current LIC 500. Discussed possible exception for a Social Work Supervisor/Social Worker Supervisor. Agency will send transcripts (Masters and Doctorate) for SWS as well as documentation of requirements for becoming a registered addiction specialist along with the exception request for regulation sections 86065.2 (Social Worker Supervisor) and 86065.3 (Social Work).


summary: Facility Evaluation

raw_content:
Narrative:
On this date, an unannounced annual inspection is conducted by Licensing Program Analyst (LPA) Rachel Bruce who was met at the facility by Executive Director, Margaret Numgai and Office Manager Carolyne Njogu. The agency currently has no clients but maintains a 5 bed facility at Childs Ave, Merced, CA. Employed currently is one social worker, two LCSW, a social worker intern, a volunteer who maintains the facility, Office Manager, CEO and Executive Director. Staff interviews conducted during visit. A general overview of their program and a tour of the facility was provided. This facility has a reception area, waiting area, and office space for staff. LPA Bruce observed fixtures and furniture, equipment and supplies necessary for this operation. Also observed locked cabinets for client and staff files in order to ensure confidentiality. When living units are occupied, inspections will be conducted monthly to ensure the facility is meeting required guidelines. Regardless of occupancy, the facility will ensure that firearms or other weapons are not stored in THP living units and that fire extinguishers and carbon monoxide detectors are in proper working order. There are no participant files to review on this date. Paid staff and volunteer files were reviewed. No citations issued at today's visit. A review of personnel records on this date indicates that facility personnel are appropriately fingerprint cleared. Exit interview conducted with Margaret Numgai, and a copy of this report along with appeal rights was provided to the agency.

met_with: Margaret Numgai, Executive Director


summary: Facility Evaluation

raw_content:
Narrative:
On this date, an unannounced annual inspection was conducted by Licensing Program Analyst (LPA) Brinae Pointer who was met at the facility by Office Manager Carolyne Njogu. LPA was informed by the staff of them being an Enhanced Care Management Community Support facility, and the THPP+NMD having no clients at the time. LPA was informed by staff of Director Margaret Mungai, being more capable of answering any questions related to the THPP, and they would be arriving to the facility in the next 15-30 minutes. Director Margaret arrived at 11:50AM. The agency currently has no clients but is currently seeking grants in efforts of building housing on the previously acquired land. The Director reports there have been no clients in care for more than a year. Director reports they have since written to CDSS to report the program is not closed, but will house youth when they have a facility. Currently, there are no staff employed to operate the facility, due to there being no facility or youth housed by the agency. A general overview of their program and a tour of the facility was provided. This facility has a reception area, waiting area, and office space for staff. LPA Pointer observed fixtures and furniture, equipment and supplies necessary for this operation. LPA also observed locked cabinets for client and staff files in order to ensure confidentiality. Employed currently is the Office Manager and Director. There are no participant files to review on this date. Directors files were reviewed on this date indicating that personnel are appropriately fingerprint cleared. Director noted they will provide proof of 1st aide/ CPR renewal completion to LPA via email. Staff interviews conducted during visit. There are no deficiencies cited upon the conclusion of this inspection.

met_with: Margaret Mungai, Director


facility_name: LOVE NEVER FAILS

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Monica Pavia made an announced prelicensing inspection, on above date. LPA met with applicant, Vanessa Russell and toured the office building. The applicant is applying for a Transitional Housing Placement Program (THPP) license. The office has sufficient space for confidential meetings with participants, if needed. Files will be kept locked in a filing cabinet in an office, on site. The THPP has a Community Engagement Center/training center at this location for participants to utilize. All staff at the participant living unit will be fingerprint cleared prior to accepting any admissions. Background cleared staff will accompany all participants to the Community Engagement Center, located at the address listed above. LPA is waiting for the granted fire clearance from Hayward Fire Department. This facility is ready for licensure once the fire clearance is received and Licensing Program Manager (LPM), has reviewed and approved the application. LPA will notify you of licensure date and email facility license.

met_with: Vanessa Russell


summary: Facility Evaluation

raw_content:
Narrative:
On 08/25/23 at 10: AM, Licensing Program Analyst (LPA) Alyssa Ng made an unannounced Post Licensing Inspection to Love Never Fails Administrative office. LPA met with Vanessa Russell, Administrator. At 10: AM, LPA did a walk through inspection with Administrator of the office. The office has sufficient space for confidential meetings, all participant files and staff files are located in a locked cabinet in a secure location. The agency has their license posted in their office. The office is in compliance with Community Care Licensing (CCL) regulations. LPA spoke with Administrator about the residential unit. Administrator stated that the residential units have all working toilets, sinks and tubs. Administrator notified LPA that the program provides all participants with household essentials. At 11: AM, LPA reviewed 1 participant file with Administrator. The participant was in the program for 2 days so there was insufficient information. LPA discussed the forms needed to be maintained in the client, staff, and the facility file. At 12: PM LPA observed 3 staff files to be complete, all documentation is up to date and all staff training were up to date/current. LPA Ng interviewed 2 staff. During inspection, LPA requested a updated copy of the LIC Personnel Report to maintain their file current. A review of Licensing Information System on August 25th, 2023 indicates that all but one facility staff associated to the facility had DOJ, FBI and child abuse index check clearances. The facility have been in contact with Guardian regarding that one staff. Administrator assured me that the staff member who is not cleared have not been around any participants. Per Title Regulations, 0 deficiencies were cited during this inspection. Exit interview conducted and a copy of the report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 5/7/2024 at 1: PM, Licensing Program Analyst (LPA) Jasmine Cardeno and LPA Mona Lam made an unannounced visit to Love Never Fails Administrative Office to conduct a required annual inspection. The Facility Love Never Fails currently has no clients in care as of 5/7/2024. During the time of the inspection, there was 1 facility staff and 2 office staff members that were present. At 1: PM, LPA Cardeno met an office staff member (ITBIC Outreach and CEC Manager), Viviana Soto, and notified her that she will be conducting a required annual inspection for the THPP, and will need to meet with Facility Administrator, Vanessa Russell, on-site at the Love Never Fails Administrative Office. At 1: PM, LPA Cardeno contacted Facility Administrator, Vanessa Russell, via telephone call and left a voicemail message to let Vanessa Russell know that the Facility Administrator will need to meet at the office on-site in order to conduct the required annual inspection. At 2: PM, Vanessa Russell notified LPA Cardeno via text message, that she was on the way to Love Never Fails Administrative Office to meet with LPAs. At 2: PM, LPA Cardeno and LPA Lam met with Facility Administrator, Vanessa Russell, who helped facilitate the inspection and do a walk-through of the office. The Love Never Fails Office has sufficient space for confidential meetings and staff files are located in a locked cabinet in a secure location. The agency has their license posted in a prominent location in their office. The office is in compliance with Community Care Licensing (CCL) regulations. Vanessa Russell stated that the Love Never Fails Transitional Housing Placement Program currently does not have clients in care as of 5/7/2024. LPA Cardeno reviewed 1 staff file to be complete with all documentation being up to date and current. LPA Cardeno discussed the forms needed to be maintained in the facility files including the posting of the up to date Certificate of Compliance. LPA Cardeno conducted 1 staff interview. There were 0 deficiencies cited during this inspection. An exit interview was conducted, and a copy of the report was given to Facility Administrator, Vanessa Russell, whose signature on this from confirms the receipt.

met_with: Vanessa Russell, Facility Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 5/22/2024 at 12: PM, Licensing Program Analyst (LPA) Celeste Aparicio made an unannounced visit to Love Never Fails Administrative Office to conduct a required annual inspection. LPA met on site with office staff member ITBIZ Program Manager, Viviana Soto, and informed them on the purpose of the visit. LPA then spoke over the phone with Business Operations Manager/HR, Huda Alawi and Administrator Vanessa Russell who helped facilitate the inspection via telephone. During the inspection, Administrator Vanessa Russell stated that there are no current participants in the Love Never Fails Transitional Housing Placement Program (THPP). It was found that since being licensed the THPP has never had clients in care. The CARE Tool was used to conduct this inspection. LPA conducted a walk through of the Administrative office and observed sufficient space for confidential meetings and supplies. The agency has their license posted in a prominent location in their office. Using the CARE Tool LPA reviewed the Physical Plant, Operations, Staff Files, and Disaster Preparedness. Staff files are maintained electronically, LPA was able to view the staff files through a shared google document. LPA observed staff files to be complete and up to date. At this time, no deficiencies were observed or cited. An exit interview was conducted, and a copy of the report was given to ITBIZ Program Manager, Viviana Soto whose signature on this from confirms the receipt.

met_with: Viviana Soto


facility_name: MARY'S HELP THPP/THP+FC

summary: Facility Evaluation

raw_content:
Narrative:
On 06/23/2021, at approximately PM, Licensing Program Analyst (LPA) Chad Cabigon attempted to conduct the Required Annual Inspection for this Transitional Housing Placement Program. LPA first contacted Vivi Smally over the phone to do a COVID-19 screening--Mrs. Smally was not at the program's office and stated that she was not available this day due to having personal appointments. LPA informed Mrs. Smally that the inspection will be re-attempted either by the end of this week or early next week. Mrs. Smally stated that the program currently has two clients. On 06/30/2021, starting at approximately PM, Licensing Program Analyst (LPA) conducted an onsite Annual/Required inspection of this Transitional Housing Placement Program (THPP). LPA met with Office Administrator Vivi Smally in the program office located at the above address. Two client files, staff records, and the participant unit's Certificate of Compliance were reviewed. Personnel criminal record clearances were also verified by LPA. A tour of the participant unit's interior and exterior areas was conducted; this unit was a detached two-story single-family residence located at Oakwood Ave., Vallejo 94591. The THPP's two non-minor ambulatory dependent clients are the only residents of this house, each having their own room. There is a full bathroom on the first floor, another full bathroom on the second floor, and a third en-suite full bathroom located in the master bedroom. All bathrooms were inspected and found to have toilets, sinks, and bathtubs or showers in working order. The refrigerator was stocked with perishable goods sufficient for at least three days. There was a landline telephone located in a common area. No indication of firearms or any other weapons were observed by LPA; the common areas, including the yards, were free from clutter, and the egresses were unobstructed. The house was equipped with appropriate furnishings and supplies. No citations were issued as a result of this inspection. Exit interview conducted; a copy of this report is being provided to Mary's Help.

met_with: Vivi Smally


facility_name: MY BROTHER'S KEEPER TRANSITIONAL HOUSING

summary: Facility Evaluation

raw_content:
Narrative:
On June 7,2023, at 10: AM., Licensing Program Analyst (LPA) Carol Anderson conducted an announced pre-licensing inspection to the above facility. LPA Anderson met with President Antwone O'Quinn. LPA Anderson toured the administrative office for the Transitional Housing Placement Plus Foster Care (THP+FC). The participants' apartment units will be in within a two hour radius from the Administration office. LPA Anderson inspected the office. The following areas were observed: The Administrative Office located in the Emerald Plaza Building in San Diego. There is reception area/waiting room located in suite 400. There are three conference rooms in suite 400 that will be used to conduct confidential interviews. All participants' and staff files will be locked in file cabinets inside suite 400. Staff desk will be in suite 400. All documents have been received and the physical plant meets the minimum requirements of Title 22 regulations. An exit interview was conducted, a copy of this report was discussed and left with President Antwone O'Quinn.

met_with: Antwone O'Quinn


summary: Facility Evaluation

raw_content:
Narrative:
On May 14, 2024, at 12:30PM, Licensing Program Analyst (LPA) Carol Anderson conducted an unannounced annual/required inspection. There was no one at the facility at the time. LPA contacted Execute Director President Antwone O'Quinn via telephone stated that he will be there in 30 minutes. At 1:30PM, LPA Anderson toured the administrative office for the Transitional Housing Placement Plus Foster Care (THP+FC), with Antwone O'Quinn. Currently there are 11 participants' living in apartments throughout San Diego County. The Administrative Office is in the Emerald Plaza Building in San Diego. There is a reception area/waiting room located in the lobby area and staff break room. There are three conference rooms to conduct confidential interviews. The administrative office consists of several staff workstations. Emergency Disaster Plan, Personal Rights, Foster Care Ombudsman are posted in a prominent area for participants to view inside the administrative office. Telephones, computers, fax and copying machines are operable. LPA reviewed six participants' files and three staff files. Fire extinguishers are current, there are fire sprinklers, smoke detectors, and carbon monoxide detectors located in the building. A complete first aid kit readily accessible located inside the administrative office. A review of Guardian on May 14, 2024, indicates that all facility staff associated to the facility had DOJ, FBI, and child abuse index check clearances. There were no deficiencies cited for today's inspection. An exit interview was conducted, a copy of this report was discussed and left with President Antwone O'Quinn.


summary: Facility Evaluation

raw_content:
Narrative:
On August 15, 2024, at 10:30AM, Licensing Program Analyst (LPA) Carol Anderson met with Executive Director Antwone O'Quinn for purpose to conduct an announced, licensee initiated case management inspection. The above-named agency is requesting a capacity increase for the Transitional Housing Placement Program (THPP). The Transitional Housing Placement Program is currently licensed to serve 30 participants. The agency is requesting an increase from 30 participants of a total of capacity of 100 participants. Agency staff provided verification there will be social workers among this caseload to serve these participants. According to Transitional Housing Placement: Section 86020 -Fire Clearance. The THPP shall secure and maintain for each THPP participant living unit any fire clearance required by and approved by the fire authority having jurisdiction. The THPP shall request a fire clearance for the THPP participant living unit prior to residence of a non-ambulatory individual. The non-ambulatory individual may be the participant, persons approved by the licensee and authorized by the licensing agency to remain in the apartment, the child of a THPP participant, a THPP employee, or the employee's child(ren). The increase of capacity is approved as of August 15,2024.

met_with: Antwone O'Quinn, Executive Director


facility_name: MY HOME AT THE LYONS HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
On October 30, 2024, at AM, a Component II and III Office Visit was held to discuss the application received for My Home At The Lyons House Eugenia Place, Suite Carpinteria, CA 93013. Attending Component II and III were the following individuals: Jennifer Heinen-Stiffler , Applicant, Erika Butler. Licensing Program Analyst, and JoAunne Griffin, Licensing Program Manager. The purpose of this Component II and III meeting was to review and discuss the incomplete application and Program Statement and to resolve any outstanding concerns that may have existed. The following incomplete application forms were discussed at the meeting: 1. Fingerprint clearance and associations. 2. Staff Schedule - Section 21 3. Program Forms and Requirement Pre Licensing Inspection will be scheduled within the next 14 to 21 days. A copy of this report was provided to Applicant, Jennifer Heinen-Stiffler, COO.

met_with: Jennifer Heinen-Stiffler, COO


summary: Facility Evaluation

raw_content:
Narrative:
On November 18, 2024, at 10:00 am, Licensing Program Analyst (LPA) Nestor Gomez and Licensing Program Manager (LPM) Kevin Sauk conducted an announced visit for the purpose of a pre-licensing inspection for the above-mentioned facility. Licensing staff met with the COO (Chief Operating Officer) Jennifer Heinen-Stiffler who granted access, and who provided a tour of the office for the inspection. The office is located at Eugenia Place, Suite 104, Carpinteria, CA 93101. The program only has one single site location that is 20 minutes away from this administrative office. This single site location is currently still under construction. The office is set up as follows: Suite 104 is located on the first floor of a two story commercial building. This suite contains a large conference room for large and private meetings, as wells as a copy room, server room, storage room and an exercise room. There are a total of eight cubicles in the office space. Four cubicles are located on the left side and 4 on the right side of the office space. There are a total of 10 offices in the suite. Exit interview was conducted and a copy of this report was emailed to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 3/26/25, at 9:45am, Licensing Program Analyst (LPA) Nancy O'Connell conducted an unannounced visit for the purpose of a Post-Licensing inspection for the above-listed facility. LPA was granted access to the facility office and was met by Amy Tovias, Facility Administrator, at 10:50am. FA granted access, and who provided a tour of the entire suite for the inspection. The office is set up as follows: The office is located in a two-story commercial building in suite #104. The Transitional Housing Placement Program (THPP) administrative office is located within the suite that maintains additional offices for the YMCA organization. The THPP office is located near the front entrance of the suite and to the right of the exercise room. The program only has one single site location that is 20 minutes away from this administrative office. This suite contains a large conference room that can be used for confidential meetings, as wells as a copy room, server room, storage room and an exercise room. Four cubicles are located on the left side and 4 on the right side of the office space. There are a total of 10 offices in the suite. LPA observed the following: · Client/personnel records are stored electronically and FA maintains access to all records · Required signage postings were observed in administrative office · There is designated space for clients to conduct confidential meetings with social workers/authorized representatives within the designated THPP office as well as in the conference room. Continued on LIC809C.r · LIC500 was reviewed and all staff were confirmed to have a criminal records clearance · Client roster was reviewed and contained all required information Administrator was informed that the administrative office is the licensed location for the facility and where all required visits will be conducted. LPA O'Connell explained that the remote site, where youth reside, will be visited and inspected as necessary only. The licensee is required to ensure that the remote site is maintained according to county/state requirements. Exit interview was conducted and a copy of this report was emailed to the facility administrator.

met_with: Amy Tovias, Facility Administrator (FA)


summary: Facility Evaluation

raw_content:
Narrative:
On 4/7/25, at 9:00am, Licensing Program Analyst (LPA) Nancy O'Connell and LPA Andrea Aceves conducted an unannounced visit for the purpose of a Post-Licensing inspection follow-up for the above-listed facility. LPAs were granted access to the facility office and was met by Amy Tovias, Facility Administrator. FA provided a tour of the assigned THPP office for the inspection. LPA observed the following within THPP office: · Posted provisional facility license · Functional telephone to be used for confidential phone calls · Certificate of compliance for remote site unit · Filing cabinets for staff/client files · Space for confidential meetings with clients/authorized representatives · LIC610 with all required information listed During the time of inspection, LPA O'Connell reviewed records for C1[See Confidential Names form (LIC811), dated 4/3/25, for names]. and confirmed the assigned THPP Social Worker meets all regulatory requirements. LPA O'Connell confirmed that the remote site unit meets licensing requirements. Exit interview was conducted and a copy of this report was emailed to the facility administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 12/1/25, at 9:15am, Licensing Program Analyst (LPA) Nancy O'Connell conducted an unannounced visit for the purpose of a Post-Licensing inspection for the above-listed facility. LPA was granted access to the facility office and was met by Amy Tovias, Facility Administrator, at 10:50am. FA granted access, and who provided a tour of the entire suite for the inspection. The office is set up as follows: The office is located in a two-story commercial building in suite #104. The Transitional Housing Placement Program (THPP) administrative office is located within the suite that maintains additional offices for the YMCA organization. The THPP office is located near the front entrance of the suite. The program only has one single site location that is 15 minutes away from this administrative office. This suite contains a large conference room that can be used for confidential meetings, as wells as a copy room, server room, storage room and an exercise room. LPA observed the following: · Client/personnel records are stored electronically and FA maintains access to all records · Required signage postings were observed in administrative office · There is designated space for clients to conduct confidential meetings with social workers/authorized representatives within the designated THPP office as well as in the conference room. Continued on LIC809C. ·LIC500 was reviewed and all staff were confirmed to have a criminal records clearance · Client roster was reviewed and contained all required information As part of the inspection, LPA O'Connell traveled to the remote site and was met by FA in order to conduct a physical inspection. The remote site maintains a sub-administrative office which meets all regulatory requirements. The remote site maintains an additional office which may be used for staff and confidential meetings/telephone calls for clients. LPA O'Connell observed the home to be clean, with all appliances in functional condition. LPA observed bedrooms to contain standard required items (beds, bedding, lighting, drawer/closet space). Upon inspection, LPA observed cameras located in and around the property and confirmed that cameras are not audio-capable, and are only used for safety reasons. During the inspections, LPA conducted staff and client interviews. See LIC811, dated 12/1/25, for names. Client/Staff Interviews: LPA conducted a confidential interviews with: C2, S1, S2, and FA. During the time of inspection, LPA reviewed The related Care Tool for Transitional Housing Placement Programs and completed the following sections: Physical Plant, Operations, Disaster Preparedness. Per California Code Regulation, there are no deficiencies cited during this inspection. Due to time constraints, LPA will return to complete the Annual review. Exit interview was conducted and a copy of this report was emailed to the facility administrator.