raw_content:
Narrative:
continued from page 1 (9099) In the initial report it was reported that C1 did not go to school for 6 out of 7 months while placed at Casa Pacifica, and only went to school 34 days prior to being removed. Staff did not take minor to medical appointments and medical assessments. It was also reported that C1 eloped several times and staff did not do anything to stop her. Confidential interviews and a review of supportive documentation revealed that legal litigation delayed C1 from starting school at the non-public school on campus, and once she started school, at times she would refuse to go or was disruptive in the classroom. C1 met with her clinician weekly for individual therapy but was inconsistent with group therapy. Casa Pacifica recommended services such as Intensive Home-Based Services (IHBS) or Therapeutic Behavioral Services (TBS) however it was denied due to youth being placed in a residential treatment center. C1 did elope from the facility on several occasions and staff followed AWOL policy; incidents were discussed in CFT meetings monthly. Based on confidential interviews and review of supportive documentation, AGPA Woodard determined the personal rights allegations, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the finding is unsubstantiated. A copy of this report was left at the facility.

Investigation Findings:
13On December 17, 2022, at 12:30, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted an unannounced subsequent complaint inspection at Casa Pacifica STRTP for the purpose of concluding the investigation into the above personal rights allegations. Upon arrival, AGPA Woodard was greeted by Zachariah Mercado, Intake Specialist. On August 20, 2021 the Department received a complaint regarding staff not providing adequate supervision to children in care, services not being provided, and the facility not providing minor an opportunity to attend school regularly. Licensing Program Analyst (LPA) Kevin Sauk conducted the initial 10-day complaint inspection on August 23, 2021 where two interviews were conducted with FA and C1's clinician. On October 13, 2022, AGPA Woodard was reassigned the complaint to continue the investigation. On November 20, 2022, AGPA Woodard emailed various staff for various allegations that may have occurred at Casa Pacifica STRTP and received responses on November 21, 2022. continue on page 2 (9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Tonya Barnes-Woodard 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, FACILITY NAME: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 12/17/2022

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

met_with: Zachariah Mercado


state: CA

facility_name: CASA PACIFICA STRTP

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
continued from page 1 (9099) In the initial report it was reported that C1 has a history of depression/suicidal ideation and had multiple previous intentional foreign body ingestions. Minor ingested two safety pins, one open and one closed. C1 was admitted to the hospital. Confidential interviews and a review of supportive documentation revealed that C1 was on a phone call with family and after speaking to them began to cry. Staff attempted to calm C1 by using her coping skills. C1 went to her room and staff followed and watched minor through the glass of the door. C1 came out and gave staff a note stating she swallowed two safety pins. Staff called youths social worker to let them know they were taking her to the emergency room. Youth was evaluated and x-rayed and the doctors confirmed the two safety pins were inside C1's abdomen. C1 has a history of swallowing things and has even swallowed stuff while at the hospital. Based on confidential interviews and review of supportive documentation, AGPA Woodard determined the personal rights allegation that staff did not prevent youth from self-harming, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the finding is unsubstantiated. A copy of this report was left at the facility.

Investigation Findings:
13On December 17, 2022, at 12:30, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted an unannounced subsequent complaint inspection at Casa Pacifica STRTP for the purpose of concluding the investigation into the above personal rights allegation. Upon arrival, AGPA Woodard was greeted by Zachariah Mercado, Intake Behavioral Specialist. On June 2, 2021 the Department received a complaint regarding staff not preventing youth from self-harming. Licensing Program Analyst (LPA) Kevin Sauk conducted the initial 10-day complaint inspection on June 14, 2021 and conducted an interview with FA. On June 25, LPA conducted a subsequent inspection and conducted an interview with C1. On October 13, 2022, AGPA Woodard was reassigned the complaint to continue the investigation. On November 20, 2022, AGPA Woodard emailed various staff for various allegations that may have occurred at Casa Pacifica STRTP and received responses on November 21, 2022. continue on page 2 (9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Tonya Barnes-Woodard 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, FACILITY NAME: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 12/17/2022

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

report_type: Complaint Investigation

complaint_status: unsubstantiated


raw_content:
Narrative:
continued from page 1 (9099) In the initial report it was reported that on May 4, C1 ran away from her placement. While AWOL, she had consensual sexual relationship with a 21-year-old while in Sacramento. Confidential interviews and a review of supportive documentation revealed that C AWOLed from the facility with C2, C3, and C4. Two staff kept visual of each youth and filed a missing person's report online with Ventura County Sheriff's Office. On May 6, 21, C1 had not returned. On June 7, 2021 the CSW notified youth's clinician that C1 had been on the run since eloping on May 3, 2021 and youth was detained on May 26, 2021 in Sacramento County. The CSW seen C1 every month at Casa Pacifica and youth never disclosed any issues. Based on confidential interviews and review of supportive documentation, AGPA Woodard determined the personal rights allegation that staff did not prevent minor from AWOLing, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the finding is unsubstantiated. A copy of this report was left at the facility.

Investigation Findings:
13On December 17, 2022, at 12:30, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted an unannounced subsequent complaint inspection at Casa Pacifica STRTP for the purpose of concluding the investigation into the above personal rights allegation. Upon arrival, AGPA Woodard was greeted by Zachariah Mercado, Intake Specialist. On May 26, 2021 the Department received a complaint regarding staff not preventing minor from AWOLing. Licensing Program Analyst (LPA) Kevin Sauk conducted the initial 10-day complaint inspection on June 4, 2021 by phone due to the Coronavirus Pandemic where FA was interviewed, and a phone interview was conducted with the CSW on the same date. C1 was unable to be interviewed due to being on the run. On October 13, 2022, AGPA Woodard was reassigned the complaint to continue the investigation. On November 20, 2022, AGPA Woodard emailed various staff for various allegations that may have occurred at Casa Pacifica STRTP and received responses on November 21, 2022. continue on page 2 (9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Tonya Barnes-Woodard 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, FACILITY NAME: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 12/17/2022

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


raw_content:
Narrative:
continued from page 1 (9099) In the initial report it was reported that C1 and C2 eloped from the facility and returned an hour later under the influence. On the following day the clients disclosed that they met up with a male who gave them alcohol, THC, and triple C. Confidential interviews and a review of supportive documentation revealed that staff suspected C2 was plotting to elope from campus with C1. They walked out of the cottage without communicating with staff. Staff immediately radios the Lead Behavioralist on duty to get support for C2. Staff maintained visual and attempted to redirect the clients. C1 and C2 climbed over the Administration gate and began walking towards the main road. Staff radioed intake to let them know he lost visual. Clients returned an hour later. Around 350AM, C2 disclosed that she couldn't sleep, and she engaged in substance use during her elopement. Staff notified the nurse then transported the C1 and C2 to the hospital. Based on confidential interviews and review of supportive documentation, AGPA Woodard determined the personal rights allegation that staff did not adequately supervise group home minors, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the finding is unsubstantiated. A copy of this report was left at the facility.

Investigation Findings:
13On December 17, 2022, at 12:30, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted an unannounced subsequent complaint inspection at Casa Pacifica STRTP for the purpose of concluding the investigation into the above personal rights allegation. Upon arrival, AGPA Woodard was greeted by Zachariah Mercado, Intake Specialist. On March 17, 2021 the Department received a complaint regarding staff not adequately supervising group home minors. Licensing Program Analyst (LPA) Kevin Sauk conducted the initial 10-day complaint inspection on March 26, 2021 by phone due to the Coronavirus Pandemic and a subsequent inspection on June 17, 2021 where one interview was conducted with C1. On October 13, 2022, AGPA Woodard was reassigned the complaint to continue the investigation. On November 20, 2022, AGPA Woodard emailed various staff for various allegations that may have occurred at Casa Pacifica STRTP and received responses on November 21, 2022. continue on page 2 (9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Tonya Barnes-Woodard 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, FACILITY NAME: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 12/17/2022

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


raw_content:
Narrative:
continued from page 1 (9099) In the initial report it was reported that while C1 was on a HOLD she accessed a laptop for recreation and was quickly able to access her Instagram and a website called "LOL" which is a teen dating site. C1 was able to post and quickly contact two men over the age 18. Confidential interviews and a review of supportive documentation revealed that cell phones are allowed at Casa Pacifica if the policy is followed. Clients need to be on step four in their program to have access. Confidential interviews revealed that C1 didn't make it to step 4 and did not have access to a cellphone on the grounds and C1 attended high school off-site and could possibly have access through a friend. Based on confidential interviews and review of supportive documentation, AGPA Woodard determined the lack of supervision allegation that minor was able to engage in inappropriate activity while in care, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred at the facility grounds, therefore the finding is unsubstantiated. A copy of this report was left at the facility.

Investigation Findings:
13On December 17, 2022, at 12:30, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted an unannounced subsequent complaint inspection at Casa Pacifica STRTP for the purpose of concluding the investigation into the above lack of supervision allegation. Upon arrival, AGPA Woodard was greeted by Zachariah Mercado, Intake Specialist. On March 16, 2021 the Department received a complaint regarding a minor engaging in inappropriate activity while in care. Licensing Program Analyst (LPA) Kevin Sauk conducted the initial 10-day complaint inspection on March 26, 2021 by phone due to the Coronavirus Pandemic and a subsequent inspection on June 25, 2021 where one interview was conducted with FA. On October 13, 2022, AGPA Woodard was reassigned the complaint to continue the investigation. On November 20, 2022, AGPA Woodard emailed various staff for various allegations that may have occurred at Casa Pacifica STRTP and received responses on November 21, 2022. continue on page 2 (9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Tonya Barnes-Woodard 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, FACILITY NAME: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 12/17/2022

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


raw_content:
Narrative:
continued from page 1 (9099) In the initial report C1 disclosed that S1 hit her with an opened hand on the side of her forehead, tore her shirt and scratched her on her side after she threw something at him. The scratch was photographed by the health clinic. Later that afternoon, C1 said the scratch was from having contact with a bush. Confidential interviews revealed that a review of video footage was reviewed and S1 never entered C1's room. S1 denies the allegation and stated he didn't recall any negative reactions with C1 and never entered her room. S1 works the NOC shift and room checks are done every 15 minutes and are done from the hallway. C1 was not interviewed do to being on AWOL status. Based on confidential interviews and review of supportive documentation, AGPA Woodard determined the personal rights allegations, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the finding is unsubstantiated. A copy of this report was left at the facility

Investigation Findings:
13On January 8, 2023 at 2: PM, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted an unannounced subsequent complaint inspection at Casa Pacifica STRTP for the purpose of concluding the investigation into the above personal rights allegations. Upon arrival, AGPA Woodard was greeted by Jim Tallarida, Intake Specialist. Licensing Program Analyst (LPA) Kevin Sauk conducted the initial 10-day complaint inspection on July 6, 2021, and a subsequent inspection July 9, 2021. On October 13, 2022, AGPA Woodard was reassigned the complaint to continue the investigation. AGPA Woodard conducted the investigation by contacting staff via email for multiple allegations that were being investigated. continue on page 2 (9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Tonya Barnes-Woodard 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, FACILITY NAME: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 01/08/2023

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

met_with: Jim Tallarida


raw_content:
Narrative:
LPA Rosas conducted interviews with residents, staff, and pertinent parties regarding to allegations. The staff and clients described the care and supervision of the facility. LPA Rosas, reviewed facility daily schedule and obtained copy of LIC500 and ratio was in compliance with regulations. LPA Rosas obtained facility training records from Relias. Interviews did not indicate that staff failed to intervene during incidents between clients, although an altercation between clients did take place. Facility staff did take measures to prevent future incidents. There was not enough evidence and information to corroborate the allegations of Neglect and lack of supervision. On 12/14/2021, 04/19/2022, 05/05/2022, 11/17/2022, LPA Rosas conducted facility inspection and found facility to be following building and grounds regulations. LPA's observed adequate perishable and nonperishable food supplies in the cottage. LPA observed a key locked lockers inside of the cottage that store hygiene supplies, and additional solutions inside of the staff office. The overstock hygiene supplies are stored in a lock cabinet in the laundry room. In addition, LPA Rosas observed a posted weekly menu in the cottage fridge. There was not enough evidence and information to corroborate the allegations of Personal Rights. Facility reported that residents and staff tested positive for COVID-19. Resident were immediately asked to isolate in bedroom until the results were received. Facility used isolation/quarantine in cottage (Rainbow) for at least 10 days, per facility COVID-19 emergency protocol. Interviews indicated that staff was using Personal Protective Equipment (PPE) gear when interacting with COVID-19 positive residents. In addition, the staff used face masks when in the cottage with residents. There was not enough evidence and information to corroborate the allegations of facility is not following COVID-19 guidelines. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has decided that the allegations of Neglect/Lack of Supervision, Personal Rights, and Other are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was left at the facility.

Investigation Findings:
13On January 25, 2023, at 9:30am, Licensing Program Analyst (LPA) Olivia Rosas conducted an unannounced inspection to Casa Pacifica Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegations and to deliver the findings. LPA Rosas, met with Staff#1 (S1) and together discussed the investigation details. During the investigation process, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted an inspection and conducted interviews. LPA Rosas interviewed witnesses and pertinent parties related to the investigation. Individuals mention in this complaint are identify on the Confidential Names List (LIC811) dated 01/25/2023. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the allegations of staff does not prevent minors from engaging in inappropriate behavior, facility is not providing hygiene products to minor, and facility is not following COVID-19 guidelines. The allegations may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. Report continues LIC-9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Olivia Rosas 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: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 01/25/2023

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

met_with: Staff#1 (S1)


raw_content:
Narrative:
LPA Rosas conducted interviews with residents, staff, and pertinent parties regarding to allegations. The staff and clients described the care and supervision of the facility. LPA Rosas, reviewed facility daily schedule and obtained copy of LIC500 and ratio was in compliance with regulations. LPA Rosas obtained facility training records from Relias. Facility has ongoing training for new and current staff by having 20 hours of training when hired and 40 hours of yearly training. On 12/14/2021, 04/19/2022, 05/05/2022, 11/17/2022, LPA Rosas conducted facility inspection and found facility to be following building and grounds regulations. LPA's observed adequate day and NOC staff ratio followed regulations. There was not enough evidence and information to corroborate the allegations of NOC shift not being trained and facility being out of ratio. Facility reported to the Department that residents and staff tested positive for COVID-19. Resident were immediately asked to isolate in bedroom until the results were received. Facility used isolation/quarantine in cottage (Rainbow) for at least 10 days, per facility COVID-19 emergency protocol. Interviews indicated that staff uses Personal Protective Equipment (PPE) gear when interacting with COVID-19 positive residents. In addition, the staff used face masks when in the cottage with residents. There was not enough evidence and information to corroborate the allegations of facility is not following COVID-19 guidelines and staff are not wearing PPE properly. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has decided that the allegations of Ratio, Qualifications, and Other are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was left at the facility.

Investigation Findings:
13On January 25, 2023, at 9:30am, Licensing Program Analyst (LPA) Olivia Rosas conducted an unannounced inspection to Casa Pacifica Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegations and to deliver the findings. LPA Rosas, met with Staff#1 (S1) and together discussed the investigation details. During the investigation process, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted an inspection and conducted interviews. LPA Rosas interviewed witnesses and pertinent parties related to the investigation. Individuals mention in this complaint are identify on the Confidential Names List (LIC811) dated 01/25/2023. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the allegations of facility is out of ratio, NOC shift staff are not trained, Staff are not wearing PPE properly, and staff are not following COVID guidelines. The allegations may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. Report continues LIC-9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Olivia Rosas 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: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 01/25/2023

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


raw_content:
Narrative:
LPA Rosas conducted confidential interviews and reviewed Child and Family Team Meeting Minutes, Needs and Service Plan, Special Incident Reports and facilities emergency intervention policies and procedures. Facility reported that Client#1 (C1) would runway from the facility with other residents. C1 would return with contraband or intoxicated with alcohol. C1 would become dysregulated when limits were set by staff. LPA Rosas inspected the facility and visually viewed C1. C1 expressed not having pain or discomfort or injuries from manual restrained and denied medical attention. Interviews revealed that two or three staff are present during restraints. Facility and interviews denied the allegations of inappropriately handled minor and staff member threatened minor. LPA Rosas conducted interviews with residents, staff, and pertinent parties regarding to allegations. The staff and clients described the care and supervision of the facility. LPA Rosas, reviewed facility daily schedule and obtained copy of LIC500 and ratio was in compliance with regulations. LPA Rosas obtained facility training records from Relias. Facility has ongoing training for new and current staff by having 20 hours of training when hired and 40 hours of yearly training. Confidential interviews indicated that restraints are conducted when clients in care pose imminent danger to self and others, staff must be SAFE hold trained and two or more staff must conduct the restraint. The facility also used variety of redirecting techniques to calm clients during crisis. There was not enough information to corroborate the allegations. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has decided that the allegations of Neglect/Lack of Supervision and Personal Rights are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was left at the facility.

Investigation Findings:
13On January 25, 2023, at 9:30am, Licensing Program Analyst (LPA) Olivia Rosas conducted an unannounced inspection to Casa Pacifica Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegations and to deliver the findings. LPA Rosas, met with Staff#1 (S1) and together discussed the investigation details. During the investigation process, LPA Rosas interviewed witnesses and pertinent parties related to the investigation. Individuals mention in this complaint are identify on the Confidential Names List (LIC811) dated 01/25/2023. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the allegations of facility staff member inappropriately handled minor and facility staff member threatened minor. The allegations may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. Report continues LIC-9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Olivia Rosas 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: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 01/25/2023

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


raw_content:
Narrative:
LPA Rosas conducted confidential interviews and reviewed Child and Family Team Meeting Minutes, Needs and Service Plan, Special Incident Reports and facilities emergency intervention policies and procedures. Facility reported that Client#1 (C1) would runway from the facility with other residents. C1 would return with contraband or intoxicated with alcohol. The residents who runaway would contraband alcohol back to the facility to barricade in their rooms to drink. The incidents reported having staff present during the events. The facility always has two to three staff to supervise clients in placement. All persons interviewed reported how facility encourages clients to stay in the cottage. All persons interviewed denied the allegations, and employees strictly enforce the no drug policy. Residents are searched (visually) upon their return to the facility and room searches are done to check for contraband if suspected. Interviews did not indicate that staff failed to intervene during incidents between clients barricading in their rooms to drink alcohol. Facility staff did take measures to prevent future incidents from happening. There was not enough evidence and information to corroborate the allegations of neglect and lack of supervision LPA Rosas reviewed reporting requirements with facility. Facility was able to provide Special Incident Reports and Law Enforcement Contact Reports for C1 and residents involved in the incidents. Special incident reports are submitted to the Department, Social Worker and other pertinent parties related to the incident. There were no witnesses identified to corroborate the allegation. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has decided that the allegations of Neglect/Lack of Supervision and Reporting Requirements are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was left at the facility.

Investigation Findings:
13On January 25, 2023, at 9:30am, Licensing Program Analyst (LPA) Olivia Rosas conducted an unannounced inspection to Casa Pacifica Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegations and to deliver the findings. LPA Rosas, met with Staff#1 (S1) and together discussed the investigation details. During the investigation process, LPA Rosas interviewed witnesses and pertinent parties related to the investigation. Individuals mention in this complaint are identify on the Confidential Names List (LIC811) dated 01/25/2023. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the allegations of staff did not prevent a minor from having access to alcohol and staff did not properly report an incident involving a minor. The allegations may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. Report continues LIC-9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Olivia Rosas 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: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 01/25/2023

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


raw_content:
Narrative:
On 11/16/2021, facility reported a Special Incident Report (SIR) that Client#1 (C1) disclosed that incident occurred where Client#2 (C2) touched C1 inappropriately. The incident occurred on 11/14/2021 late at night and there were three staff on-duty during the time it occurred. Facility called Ventura County Sheriff's Department (VCSD) to file the report. VCSD interview parties involved. C1 was taken to Family Justice Center in Ventura County for a physical examination. C1 and C2 were placed on a safety alert. Interviews did not indicate that staff failed to supervise residents. C1 and C2 had separate bedrooms and residents sneak into each other's bedrooms. Although an altercation between clients did take place. Facility staff did take measures to prevent future incidents. There was not enough evidence and information to corroborate the allegations of Neglect and lack of supervision. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. The Department has decided that the allegation of Neglect/Lack of Supervision are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was left at the facility. Page 2 out of 2.

Investigation Findings:
13On February 16, 2023, at 12:30pm, Licensing Program Analyst (LPA) Olivia Rosas conducted an unannounced inspection to Casa Pacifica Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegation and to deliver the findings. LPA Rosas, met with Staff#1 (S1) and together discussed the investigation details. During the investigation process, Associate Governmental Program Analyst Tonya L. Barnes-Woodard and LPA Rosas interviewed witnesses and pertinent parties related to the investigation. Individuals mention in this complaint are identify on the Confidential Names List (LIC811) dated 02/16/2023. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the allegation of minors engaged in inappropriate interactions while in care. The allegation may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. Report continues LIC-9099C Page 1 out of 2. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Olivia Rosas 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: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 02/16/2023

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


raw_content:
Narrative:
In November 2021, the facility reported numeral Special Incident Reports that disclosed elopement from a group of residents and upon return appear to be under the influence or would contraband vape pens, and alcohol. The residents would run in groups inside empty bedrooms and would use the bed mattress and bodies to barricade inside of the bedroom. When inside of the bedroom they engaged in substance abuse such as drinking alcohol, smoke and sexual engagement. Staff would attempt to stop the barricades, but residents would coordinate how to run as groups to barricade inside of the bedrooms. The residents would be unresponsive to staff intervention or support. Staff would attempt to open the bedrooms by pushing the doors. Staff would use their body to block the doors to stop residents from barricading in the room. Staff would stay in the door and try to talk to the residents to open the door. Staff would confiscate the alcohol and vape pens. Facility attempts to stop residents from smoking or using alcohol with verbal prompts, therapeutic services, and safety plans. Facility reported residents will meet with their cottage supervisor and clinician following the incident to process behaviors and safety concerns. Facility would discuss recent safety concerns regarding elopement and substance use during Child Family Team (CFT) meeting. All persons interviewed reported how facility encourages clients to stay in the facility and not runway. All persons interviewed denied the allegation, reported illegal drugs and alcohol are not permitted in the facility, and employees strictly enforce the no drug policy. Residents are searched (visually) upon their return to the facility and room searches are done to check for contraband. Facility staff did take measures to prevent future incidents by locking empty bedrooms and trying to prevent the barricading before happening. Interviews did not indicate that staff failed to supervise residents and that residents coordinated the barricades. There was not enough evidence and information to corroborate the allegations of Neglect and lack of supervision. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. The Department has decided that the allegation of Neglect/Lack of Supervision are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was left at the facility. Page 2 out of 2

Investigation Findings:
13On February 16, 2023, at 12:30pm, Licensing Program Analyst (LPA) Olivia Rosas conducted an unannounced inspection to Casa Pacifica Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegation and to deliver the findings. LPA Rosas, met with Staff#1 (S1) and together discussed the investigation details. During the investigation process, LPA Rosas interviewed witnesses and pertinent parties related to the investigation. Individuals mention in this complaint are identify on the Confidential Names List (LIC811) dated 02/16/2023. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the allegation of minors drank alcohol in the facility and staff did not provide adequate supervision of minors. The allegation may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. Report continues LIC-9099C Page 1 out of UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Olivia Rosas 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: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 02/16/2023

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


raw_content:
Narrative:
All persons interviewed reported how facility staff do not speak inappropriately or make them feel uncomfortable. Based on confidential interviews and documentary evidence did not suggest that residents are being harassed or threatened by other residents in the cottage. Interviews did not indicate that staff failed to supervise residents. The facility always has two to three staff to supervise residents in the cottage and change staff ratios based on the need. Confidential interviews indicated that restraints are conducted when residents in care pose imminent danger to self and others, staff must be SAFE trained, and two or more staff must conduct the restraint. The facility also used variety of redirecting techniques to calm clients during crisis. There was not enough information to corroborate the allegation. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated. The Department has decided that the allegation of Neglect/Lack of Supervision are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was left at the facility. Page 2 out of 2

Investigation Findings:
13On February 16, 2023, at 12:30pm, Licensing Program Analyst (LPA) Olivia Rosas conducted an unannounced inspection to Casa Pacifica Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegations and to deliver the findings. LPA Rosas, met with Staff#1 (S1) and together discussed the investigation details. During the investigation process, Associate Governmental Program Analyst Tonya L. Barnes-Woodard and LPA Rosas interviewed witnesses and pertinent parties related to the investigation. Individuals mention in this complaint are identify on the Confidential Names List (LIC811) dated 02/16/2023. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the allegations of minor is being harassed while in care and minor is being threatened by another client in the home. The allegations may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. Report continues LIC-9099C Page 1 out of UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Olivia Rosas 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: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 02/16/2023

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


raw_content:
Narrative:
On 04/26/2021, the Department received Special Incident Report (SIR) during individual therapy session Client#1 (C1), reported to clinician that Client#2 (C2) touches her inappropriately even though C1 and staff have asked C2 to stop. Facility contacted law enforcement and the CFS agency. The CFS agency did not take the case and law enforcement follow-up with the allegations. C1, and C2 been placed on safety status heightened supervision regarding boundaries and interactions with residents. On 5/3/2022, the Department received SIR that C1, Client#3(C3), Client#4 (C4), Client#5 (C5) barricaded in C1 bedroom and engaged inappropriately. Staff made several attempts to open the door, however they were unsuccessful due to residents sitting in front of the door. Staff attempted to gain visual of youth through the window on the door as well as the window to outside and were unable to do so due to residents having the windows blocked. Staff repeatedly prompted the residents to exit the room and attempted to engage youth in activities outside of the room, however, all residents were unreceptive to leaving the room. The residents were placed on a safety alert following the incident for heightened supervision. Facility contacted law enforcement based on comments made by C1. C3 was interviewed by Ventura County Sheriff's Department at approximately in regard to allegations made by C4. Law enforcement requested offsite testing of resident's clothes and to perform a rape kit at the CAT center in Northridge. On 05/05/2022, LPA Rosas viewed video footage dated 05/02/223, where C1, C3, C4,C5 ran to C1 room to barricade and staff making attempts to open the resident room. LPA Rosas conducted interviews with residents, staff, and pertinent parties regarding to allegations. The staff and clients described the care and supervision of the facility. LPA Rosas, reviewed facility daily schedule and obtained copy of LIC500 and ratio was in compliance with regulations. LPA Rosas obtained facility training records from Relias. Facility has ongoing training for new and current staff by having 20 hours of training when hired and 40 hours of yearly training. 05/05/2022, LPA Rosas conducted facility inspection and found facility to be following building and grounds regulations. LPA's observed adequate day and NOC staff ratio followed regulations. Facility staff did take measures to prevent future incidents. There was not enough evidence and information to corroborate the allegations of Neglect and lack of supervision. Report continues LIC-9099C Page 2 out of Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. The Department has decided that the allegation of Neglect/Lack of Supervision are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was left at the facility. Page 3 out of 3

Investigation Findings:
13On February 16, 2023, at 12:30pm, Licensing Program Analyst (LPA) Olivia Rosas conducted an unannounced inspection to Casa Pacifica Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegation and to deliver the findings. LPA Rosas, met with Staff#1 (S1) and together discussed the investigation details. During the investigation process, LPA Rosas interviewed witnesses and pertinent parties related to the investigation. Individuals mention in this complaint are identify on the Confidential Names List (LIC811) dated 02/16/2023. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the allegation of minor is being sexually abused by other minor in care. The allegation may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. Report continues LIC-9099C Page 1 out of UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Olivia Rosas 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: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 02/16/2023

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


raw_content:
Narrative:
LPA Rosas conducted interviews with residents, staff, and pertinent parties regarding to allegation. The staff and clients described the care and supervision of the facility. LPA Rosas ensured to thoroughly review the records of the primary active staff. The facility provided evidence of staff training transcripts stored in RELIAS Training Program digital system with a schedule to complete Hours for new hires and ongoing training for various topics including Trauma Informed, and Pro-Act training. LPA reviewed the Personnel Report (LIC 500) and confirmed that Direct Care Staff Ratio present for clients in placement. LPA Rosas during inspections observed adequate day and NOC staff ratio followed regulations. Confidential interviews and documentary evidence did not indicate that staff failed to supervise residents. The facility always has two to three staff to supervise residents in the cottage and change staff ratios based on the need. Confidential interviews indicated that restraints are conducted when residents in care pose imminent danger to self and others, staff must be SAFE trained, and two or more staff must conduct the restraint. The facility also used variety of redirecting techniques to calm clients during crisis. LPA Rosas, reviewed of records for Client#1 (C1) was not able to identify which resident was having inappropriate interactions in another resident. There was not enough evidence and information to corroborate the allegations of Neglect and lack of supervision. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. The Department has decided that the allegation of Neglect/Lack of Supervision are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was left at the facility.

Investigation Findings:
13On March 9, 2023, at 10:00am, Licensing Program Analyst (LPA) Olivia Rosas conducted an unannounced inspection to Casa Pacifica Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegation and to deliver the findings. LPA Rosas, met with Staff#1 (S1) and together discussed the investigation details. During the investigation process, LPA Rosas interviewed witnesses and pertinent parties related to the investigation. Individuals mention in this complaint are identify on the Confidential Names List (LIC811) dated 02/16/2023. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the allegation of minors engaged in inappropriate touching while in care. The allegation may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. Report continues LIC-9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Olivia Rosas 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: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 03/09/2023

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


raw_content:
Narrative:
LPA Rosas conducted interviews with residents, staff, and pertinent parties regarding to allegation. On 10/31/2022, Child#1 (C1), Child#2 (C2), Child#3 (C3), Child#4 (C4) eloped from the facility. On 10/31/2022, C3 returned to the facility. On 11/05/2022, facility staff picked up C2, C3, C4 from Huntington Beach Police Department. Facility took C1 and C2 the Emergency Room as they appeared to be intoxicated. The residents were found by Huntington Beach Police Department in hotel in Huntington Beach with possible connection to Commercial Sexual Exploitation of Children (CSEC) activity but not confirmed by facility and residents. C2 had been absent from school due to medical appointments and being eloped from the facility. On 11/14/2022, C2 returned to school. LPA Rosas ensured to thoroughly review the records of the primary active staff. LPA reviewed the Personnel Report (LIC 500) and confirmed that Direct Care Staff Ratio present for clients in placement in the cottage. Interviews disclosed how clients are provided daily therapy services, individual therapy, and rehabilitative services. Facility uses verbal prompts, therapeutic services, and safety plans for residents to encourage them not to runway or use drugs. Residents are searched (visually) upon their return to the facility for contrabands.. The facility encourages residents to not elope from the facility. Law enforcement was notified of resident elopements from the facility. The staff and clients described the care and supervision of the facility. Confidential interviews and documentary evidence did not indicate that staff failed to supervise residents. Residents ignored facility re-directives and interventions and decided to eloped from the facility. Facility staff took measures to prevent future incidents. Confidential statements obtained produced no corroborating evidence to corroborate the allegation of Neglect and lack of supervision. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. The Department has decided that the allegation of Neglect/Lack of Supervision are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was left at the facility.

Investigation Findings:
13On March 23, 2023, at 11:00am, Licensing Program Analyst (LPA) Olivia Rosas conducted an unannounced inspection to Casa Pacifica Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegation and to deliver the findings. LPA Rosas, met with Staff#1 (S1) and together discussed the investigation details. During the investigation process, LPA Rosas interviewed witnesses and pertinent parties related to the investigation. Individuals mention in this complaint are identify on the Confidential Names List (LIC811) dated 03/23/2023. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the allegation of facility staff are not adequately supervising minor while in care. The allegation may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. Report continues LIC-9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Olivia Rosas 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: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 03/23/2023

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


raw_content:
Narrative:
Confidential statements revealed on 5/2/2022, four residents willingly barricaded themselves inside a bedroom inside Caldwell Cottage at the Casa Pacifica Facility. The youth covered the window and prevented facility staff from gaining access into the room. While in the room, the youth reportedly engaged in sexual activity. None of the youth called out for help or reported any problems while in the barricaded room. The staff attempted to get into the room, but their efforts were stymied by the residents pushing against the door. Although the staff members were unable to forcefully open the barricaded door enough to get inside, staff were able to remove the item covering the window and see into the room. The staff remained at the door and remained in contact with the residents barricaded inside the room and monitored what was going on by listening at the door. The staff heard the residents laughing, giggling, and whispering. Results from Ventura County Sherriff's Detective determined no crime. Record review determined facility was operating within approved staff ratio at the time of the incident. Based on confidential statements and record review, the allegation concerning Lack of supervision resulting in inappropriate interactions between minors cannot be substantiated due to a lack of evidence. The findings are therefore determined Unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. There are no deficiencies cited per California Code of Regulations, Title 22 at this time. Exit interview completed. A copy of this report and LIC811 was provided to Facility Representative Intake Specialist.

Investigation Findings:
13On May 5, 2023, at 5: PM, Licensing Program Analyst (LPA), Regina Martin conducted a follow-up complaint inspection to deliver findings concerning the above-mentioned allegation. LPA met with Facility Representative Zachariah Mercado, Intake Specialist to discuss the outcome. The investigation was referred and conducted by Community Care Licensing Investigations Bureau, Investigator Douglas Real. On May 6, 2022, the El Segundo Children's Residential Program Regional Office received a complaint referral alleging a lack of supervision as youths reportedly engaged in nonconsensual sexual acts while in care. The investigation consisting of review of facility file, plan of operation, review of client records and review of associated report from the Ventura County Sherriff's Department, as well as confidential interviews with, but not limited to, three youth residents, four facility staff members and assigned Detective, revealed a lack of evidence to prove the alleged. (Continued on page LIC9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Regina Martin LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 31-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FACILITY NAME: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 05/05/2023

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

met_with: Zachariah Mercado, Intake Specialist


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
During the investigation, claims of C1 being forced to remain in their room by three staff members and sexually abused for several hours on January 31, 2023, could not be substantiated. Confidential interviews revealed no witnesses and or denial of seeing staff members keep C1 in their room on the day in question. Video footage reviewed did not support the allegation. Law enforcement determined no corroborating evidence to establish a crime. Based on gathered information and inconsistencies, the findings concerning sexual abuse and neglect towards C1 are therefore determined Unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. There were no deficiencies cited per Short-Term Residential Therapeutic Program Interim Licensing Standards or California Code of Regulations, Title 22, at this time. Exit interview completed. A copy of this report and LIC811 was provided to the Facility Representative.

Investigation Findings:
13On June 15, 2023, at 1: PM, Licensing Program Analyst (LPA), Regina Martin conducted a follow-up complaint inspection to deliver findings concerning alleged sexual abuse and neglect against a youth resident while in care. LPA Martin met with Kimberly Bennett, Administrator and Theresa Plant, Regional Director to discuss the outcome. On February 13, 2023, CCL, El Segundo Children's Residential Program Regional Office received a complaint referral claiming sexual abuse as Youth #1 (C1) was reportedly sexually assaulted by three facility staff members. The investigation was referred and conducted by Community Care Licensing (CCL) Investigations Bureau, Investigator Douglas Real. On February 22, 2023, LPA Martin initiated the complaint investigation obtained and reviewed requested records. The investigation, including review of facility file history, Youth's file, incident reports, related reports from the Ventura County Sherriff's Department, review of associated facility video surveillance footage, review of forensic interview as well as confidential interviews with, assigned Detective, facility residents and related staff members, revealed a lack of evidence to prove the alleged. (Continued on page LIC9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Regina Martin LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 31-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FACILITY NAME: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 06/15/2023


raw_content:
Investigation Findings:
13On August 11, 2023 at 12:49 pm, Licensing Program Analyst (LPA) Christine Wilson made an unannounced inspection to Casa Pacifica Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegations: (1) Staff made inappropriate comments to youth while in care. (2) Staff inappropriately touched youth while in care. The investigation included records review and confidential interviews with clients and facility staff members. Although it was reported that staff (S1) made inappropriate comments to C1, and that S1 inappropriately touched C1, there were no witnesses or other forms of documentation that would corroborate the above allegations. Based on all interviews conducted, and documents obtained, the Department has found the above allegations to be unsubstantiated, meaning that, the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. There are no deficiencies to be cited at this time. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Christine Wilson LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Stephen Salter, Clinical Program Manager/Head of Services


raw_content:
Investigation Findings:
13On 8/8/23, at 1:00pm, 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 allegation and deliver the finding. LPA spoke with Kimberly Bennett and together, discussed the investigative finding. During the investigative process by Licensing program Analyst (LPA) Olivia Rosas, Associate Governmental Program Analyst (AGPA) Tonya Barnes Woodard, and LPA Nancy O'Connell, all relevant parties have been accounted for. Interviews and evidence reflect that staff maintain required supervision of residents in order to ensure safety and intervention as necessary. Further, investigative findings conclude that the facility maintains the required policies needed to address instances of threats, harassment and bullying. Lastly, interviews conducted do not support the occurrence of the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. 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: Kimberly Bennett, Clinical Program Director (RPD)


raw_content:
Investigation Findings:
13On 8/15/23, at 1:00pm, 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 allegation and deliver the finding. LPA spoke with Kimberly Bennett and together, discussed the investigative findings. During the investigative process by Licensing program Analyst (LPA) Olivia Rosas, Associate Governmental Program Analyst (AGPA) Tonya Barnes Woodard, and LPA Nancy O'Connell, all relevant parties have been accounted for. Interviews and evidence reflect that, food is made available to clients at all times, staff maintain required supervision of residents in order to ensure safety and intervention as necessary. Further, investigative findings conclude that the facility maintains the required policies needed to address instances of threats, harassment and bullying. Lastly, interviews conducted do not support the occurrence of the allegations. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. 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: Kimberly Bennett, Clinical Program Director (CPD)


raw_content:
Investigation Findings:
13On 8/15/23, at 1:00pm, 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 finding. LPA spoke with Kimberly Bennett and together, discussed the investigative finding. During the investigative process by Licensing program Analyst (LPA) Olivia Rosas, Associate Governmental Program Analyst (AGPA) Tonya Barnes Woodard, and LPA Nancy O'Connell, all relevant parties have been accounted for. Interviews and evidence reflect that the facility implements policies to prevent and/or decrease instances of unauthorized absences of minors in care. Additionally, evidence reflects that the facility implements policies to address the need for medical intervention for minors in care. Statements gathered by staff and residents reflect awareness of facility polices in practice to address unauthorized absences as well as obtaining medical care when needed. Evidence to support the occurrence of a violation was not obtained. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. 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:


raw_content:
Investigation Findings:
13On 8/30/23, at 2:00pm Licensing Program Analyst (LPA) Nancy O'Connell and LPA Jhane Haynes made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation and deliver the finding. LPA spoke with S1 and together, discussed the investigative findings. During the investigative process by Licensing program Analyst (LPA) Olivia Rosas, Associate Governmental Program Analyst (AGPA) Tonya Barnes Woodard, and LPA Nancy O'Connell, all relevant parties have been accounted for. Interviews and evidence reflect that staff maintain required supervision of residents in order to ensure safety and intervention as necessary. Further, investigative findings conclude that the facility maintains the required policies needed to address instances of threats, harassment and bullying. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was emailed to the facility. 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: Kimberly Ballard, S1


raw_content:
Investigation Findings:
13On 8/30/23, at 2:40pm Licensing Program Analyst (LPA) Nancy O'Connell and LPA Jhane Haynes made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation and deliver the finding. LPA spoke with S1 and together, discussed the investigative findings. During the investigative process by Licensing program Analyst (LPA) Olivia Rosas, and LPA Nancy O'Connell, all relevant parties have been accounted for. Interviews and evidence reflect that the no assault occurred while minor was under the care and supervision of the facility/staff. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was emailed to the facility. 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:


raw_content:
Investigation Findings:
13On 12/11/2023 at 02:50PM, Licensing Program Analyst (LPA) Jhane Haynes made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation and deliver the finding. LPA spoke with Stephan Salter Head of Service (HOS) and together discussed the investigative findings. During the investigative process by Licensing program Analyst (LPA), Olivia Rosas, LPA Nancy O'Connell, and Associate Governmental Program Analyst (AGPA) Tonya Woodard, all relevant parties have been accounted for. Supporting evidence includes: interviews with staff and clients that do not corroborate the occurrence of target allegation. Interviews reflect that clients are supervised and interactions between staff and clients are in alignment with approved STRTP policies. Further, witnesses to corroborate the occurrence of any violation could not be located. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. 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 3

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

met_with: Stephan Salter Head of Service (HOS)


raw_content:
Narrative:
9099C Page Based on LPA observations and interviews, there is not enough evidence to support the allegation, that staff are not providing adequate food service to minors. Based on all interviews conducted and documents obtained, the above allegations are unsubstantiated; meaning, the allegations may have happened, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the finding is unsubstantiated. There are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report was emailed the facility. 9099-C Page This a report to amend the 07/02/ LIC9099 report from Substantiated complaint finding to an Unsubstantiated complaint finding. Based on all interviews conducted and documents obtained, the above allegations are unsubstantiated; meaning, the allegations may have happened, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the finding is unsubstantiated. There are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report was emailed the facility.

Investigation Findings:
13On 07/02/2024 at 12:27pm, Licensing Program Analyst (LPA) Christine Wilson made an unannounced inspection to the above listed facility, for the purpose of concluding the investigation on the above allegations. LPA Wilson was greeted by the Chief Clinical Officer (CCO) who allowed access to the facility. At 12:57pm, LPA Wilson conducted an additional confidential interview with student (C3). Throughout the course of the investigation LPA Wilson conducted records review and confidential interviews with, facility staff members students and clients. Information obtained revealed that staff have received training for Theraputic Crisis Intervention and utilized an approved hold on youth. Further Information obtained revealed that a different youth ran into staff while gaining access to an unauthorized area, however there is not sufficient evidence to find, that staff inappropriately punished minor. Records obtained revealed that the licensee takes measures to ensure the facility is free of pests and that facility undergoes monthly pest control services. (Report continues on LIC-9099C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Christine Wilson 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: CASA PACIFICA STRTPFACILITY NUMBER: VISIT DATE: 07/02/2024

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

met_with: Chief Clinical Officer (CCO)


raw_content:
Investigation Findings:
13On December 11, 2024 at 11:09 am, Licensing Program Analyst (LPA) Christine Wilson made an unannounced inspection to the above listed facility for the purpose of concluding the investigation on the above allegation. LPA Wilson met with the Assistant Director of Campus Services STRTP Administtrator. Based on the confidential interviews with all relevant persons, conducted during the investigation process, record review, and statements obtained, LPA Wilson concluded the allegations are unsubstantiated. Although the staff have been trained in TCI and a restraint would have been justified, the least restrictive and trauma informed approach was utilized. Further there was enough staff supervision on hand. Although the allegations may have happened, there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the finding is unsubstantiated. There are no deficiencies to be cited, at this time, regarding the above allegations. Copy of this report was left with the Assistant Director of Campus Services STRTP Administtrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Christine Wilson LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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


raw_content:
Investigation Findings:
13On 5/8/25, at 9:15am, Licensing Program Analyst (LPA) Nancy O'Connell made an unannounced complaint inspection to the above facility for the purpose of concluding the investigation on the above allegation and delivering the findings. LPA met with Kimberly Ballard and together, discussed the investigative findings. It was reported that staff are not preventing minor(s) from abusing other minor while in care, Staff are not preventing minor(s) from harassing other minor in care, and Licensee is not ensuring that minor is provided a comfortable environment while in care. During the investigation by Licensing program Analyst (LPA) Christine Wilson and Lanice White all relevant parties have been accounted for. Interviews conducted could not determine the validity of the allegations. Parties accounts differed or denied that the allegations occurred. There is no evidence that confirms the allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and an electronic copy of this report was provided to the facility. 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 1

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

met_with: Kimberly Ballard, Administrator (FA)


summary: Facility Evaluation

raw_content:
Narrative:
On May 28, 2021, Regina Martin, Licensing Program Analyst (LPA) conducted a Case Management inspection and met with Facility Representative for the purpose of delivering investigation findings. The investigation was conducted by Community Care Licensing Division (CCLD), Investigations Bureau, Investigator Dennis Seng. On September 18, 2020, CCLD received a self reported -Incident alleging lack of supervision resulting in Child #1 sexually assaulting Child #2 (see Confidential Names form LIC811, dated 5/28/2021). Information obtained during the investigation including interviews, review of medical records and review of related reports from Ventura Sheriff's Department (VSD) did not provide enough evidence to support allegation. Child #1 denied allegations and reported that Child #2 fabricated the allegation because she no longer wanted to be her roommate. Child #2 indicated that Child #1 sexually assaulted her. Interview statements indicated that Child #2 provided conflicting statements and admitted to making up the allegation. There were no witnesses or documentary evidence to support that the allegation occurred. It has been determined that the allegation is Unsubstantiated at this time meaning, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove or disprove that a violation occurred. There were no deficiencies cited during the investigation. Exit interview conducted. A copy of this report was emailed to Director of Clinical Services and Facility Administrator

report_type: Facility Evaluation

visit_type: Case Management

met_with: Anna Guerin Director of Clinical Services


summary: Facility Evaluation

raw_content:
Narrative:
On 06/14/2021, Licensing Program Analyst (LPA) Kevin Sauk conducted a Case Management - Incident inspection at Casa Pacifica STRTP, and met with Facility Administrator (FA), in response to a Special Incident Report, submitted to Community Care Licensing (CCL) on January 22, 2021 in order to investigate a possible violation. The incident, which occurred on 01/16/2021, involved client (C1), who disclosed in the middle of the restraint that C1's left leg was injured, but staff did not stop the restraint until the nurse arrived to assess the client's injury. [See LIC Confidential Names List form (LIC811), dated 06/14/2021, for names] Because client (C1) was discharged from this facility on 01/27/2021, LPA only interviewed the Facility Administrator (FA), and a Facility Nurse (FN). LPA also received Progress Notes from the Facility Nurse (FN) who assessed C1 at the time of the incident. Further investigation is needed in order to resolve this Case Management - Incident Inspection, and to determine whether a violation had occurred. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 3.1, there are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report was left at the facility.

met_with: Facility Administrator (FA)


summary: Facility Evaluation

raw_content:
Narrative:
On 06/14/2021, Licensing Program Analyst (LPA) Kevin Sauk conducted a Case Management - Incident inspection at Casa Pacifica STRTP, and met with Facility Administrator (FA), in response to a Special Incident Report, submitted to Community Care Licensing (CCL) on January 22, 2021 in order to investigate a possible violation. The incident, which occurred on 06/03/2021, involved client (C1), who was restrained to prevent the client from running away from the facility. [See LIC Confidential Names List form (LIC811), dated 06/14/2021, for names] LPA only interviewed the Facility Administrator (FA), because client (C1) had just runaway from the facility. Further investigation is needed in order to resolve this Case Management - Incident Inspection, and to determine whether a violation had occurred. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 3.1, there are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 06/14/2021, Licensing Program Analyst (LPA) Kevin Sauk conducted a Case Management - Incident inspection at Casa Pacifica STRTP, and met with Facility Administrator (FA), in response to a Special Incident Report, submitted to Community Care Licensing (CCL) on January 22, 2021 in order to investigate a possible violation. The incident, which occurred on 06/08/2021, involved client (C1), who was restrained to prevent the client from running away from the facility. [See LIC Confidential Names List form (LIC811), dated 06/14/2021, for names] LPA interviewed the Facility Administrator (FA), and client (C1). In the middle of the interview with C1, C1 refused to continue. Further investigation is needed in order to resolve this Case Management - Incident Inspection, and to determine whether a violation had occurred. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 3.1, there are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report was left at the facility.

met_with: Facility Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 06/17/2021, Licensing Program Analyst (LPA) Kevin Sauk conducted a Case Management - Incident inspection at Casa Pacifica STRTP, and met with Facility Administrator (FA), in response to a Special Incident Report that was submitted to Community Care Licensing (CCL), in order to investigate a possible violation. The incident, which occurred on 06/07/2021, involved client (C1), who came into the room of client (C2), during the night shift, and gave C2 a hickey on the neck, and touched C2's private area, which was not consensual. [See LIC Confidential Names List form (LIC811), dated 06/17/2021, for names] Because client (C2) was sleeping, LPA interviewed the Facility Administrator (FA), and client (C2). Further investigation is needed in order to resolve this Case Management - Incident Inspection, and to determine whether a violation had occurred. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 3.1, there are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 06/25/2021, Licensing Program Analyst (LPA) Kevin Sauk conducted a Case Management - Incident inspection at Casa Pacifica STRTP, and met with Facility Administrator (FA), in response to a Special Incident Report that was submitted to Community Care Licensing (CCL), in order to investigate a possible violation. The incident, which was received by the department, on 02/08/2021, involved client (C2), who reportedly touched client (C1) inappropriately [see LIC Confidential Names List form (LIC811), dated 06/25/2021, for names]. LPA interviewed both client (C1), and client (C2), where C1 confirmed that C2 touched C1 inappropriately, and where C2 refused to disclose further information. C1 and C2 confirmed that this incident occurred when C1 was first placed in this facility and when they were roommates, and that they no longer share a bedroom, and no longer share a cottage, after the alleged incident was reported. At this time, the Department has made no determination on whether a violation has occurred. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 3.1, there are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report was left with the Intake Coordinator (IC).


facility_name: CCI-OAK

summary: Facility Evaluation

raw_content:
Narrative:
On this date, a visit is made with CCI Inc. The purpose of this meeting is to discuss the plan for the pending application for a low capacity STRTP. The agency has indicated the intent to withdraw this application. The agency is to submit a board resolution withdrawing the application, or submit the necessary documents to proceed with the application by 11/10/22.

met_with: Veronica Manzo


facility_name: CCI BRAWLEY

raw_content:
Investigation Findings:
13On June 10, 2025, Licensing Program Analyst (LPA) Danny Macias conducted an unannounced visit to the Short Term Residential Therapeutic Program (STRTP) in order to deliver the findings of the above allegations and met with Program Manager (PM) Kyle Murray. On March 21, 2025, the above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, confidential interviews, and review of records. Based on the investigation conducted, the department found that there was conflicting information regarding these issues. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the allegations occurred. Therefore, the allegations are UNSUBSTANTIATED at this time. An exit interview was conducted and a copy of this report and appeal rights was left with Kyle Murray at the conclusion. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tamara Melikian LICENSING EVALUATOR NAME: Danny Macias LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Kyle Murray