summary: Facility Evaluation

raw_content:
Narrative:
On August 14, 2024 at 9: AM Licensing Program Analyst (LPA) Angelique Hill, made an unannounced visit to the facility for the purpose of a required annual inspection. During the inspection, LPA met with Caryn Romero, Program Director, who assisted with the inspection. LPA conducted a walk-through of the facility. There were no resource families or children present during the inspection. There were six staff present during the inspection. Three staff members were interviewed. LPA inspected and/or reviewed the following: Physical Plant Posting of license _X_ Personal Rights __X__ Working telephone __X_ Smoke Detector _X_ First Aid Kit inspected, Common Room available __X__ Office (locked and privacy) _X_ Fire Extinguishers inspected May 2024. Staffing/Volunteers Number of Staff files reviewed __five__ Criminal record clearances verified _five__ First Aid Certificate __five__ Job title/qualification verified __five__ Hour required training verified __five__ Client Records Number of Clients files reviewed five Needs and Services Plan five Cash Resources _five_ Core/Therapeutic Services Trauma Informed Practices are implemented as needed (including specialty mental health services and extracurricular activities and social supports) _x_ Special Health Care Needs (SHCN) SHCNs plan is not created by a licensed professional nor implemented. Staff has not received SHCNs training and there are zero clients with Special Health Care Needs.


state: CA

facility_name: ASPIRANET THPP

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
within the program. LPA Landry has received undisputed information indicating client #2 was reimbursed for the funds she loaned client #1 and there is no evidence of unsafe environment at this time. Due to conflicting statements LPA Landry is unable to determine if the above allegation occurred. Therefore, the allegation is unsubstantiated. "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. Exit interview conducted. Copy of Appeal Rights and this report was emailed to Facility Manager.

Investigation Findings:
13On Wednesday February 23, 2022 @12:00PM, Licensing Program Analyst (LPA) Kathy Landry conducted a virtual inspection with Facility Manager listed above. LPA Landry conducted an entrance interview and discussed the allegation listed above. Facility Manager confirmed 28 clients residing in the program at this time. This investigation initially began 11/13/2020. Since then more information has been received. Exact date unknown but client #1 borrowed money from client #2 (against program rules and agreement). Sometime afterward both clients were no longer friends when client #2 requested repayment of the money loaned to client #1. Facility Manager and Life Coach were consulted and tried to get both clients to resolve their issues. Both clients were reminded the transaction was against program rules & agreement. When the situation could not be resolved both clients were reminded of the consequences of their actions including loss of funds loaned to possible court proceedings to sue for the unreturned funds. A Safety Plan was also drafted for both clients. At this time LPA Landry has received conflicting statements regarding Personal Rights Violation where staff did not provide a safe environment for these two clients and their prohibited money transaction -----> UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Kathy Landry 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: ASPIRANET THPPFACILITY NUMBER: VISIT DATE: 02/23/2022

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

report_type: Complaint Investigation

met_with: Leticia Woodruff

complaint_status: unsubstantiated


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
Information provided to the Department alleged Nonminor Dependent#2 (NMD2), a roommate of NMD1, was involved in altercations with a male guest while NMD1 was present in the living unit. Furthermore, pets belonging to NMD2 reportedly soiled the carpet throughout the living unit. NMD2 admitted the carpet in the living unit was soiled by pets belonging to NMD2. Facility created a Corrective Action Plan (CAP) was put into place to have the pets removed from the home. Facility stated NMD2 did not comply with the request. On 08/09/2021, an unannounced inspection was conducted by LPA Larios to the living unit and observed a soiled carpet and the smell of animal waste was detected in the bedroom belonging to NMD1. Facility reported due to COVID-19 restrictions staff was not doing on-site inspections. Facility reported they are now having weekly home visits to living units. In addition, on 08/09/2021, LPA Larios and 12/10/2021, LPA Rosas conducted a records review on Nonminor Dependent#1 (NMD1) and Nonminor Dependent#2 (NMD2) and obtained copies of weekly contact notes, Special Incident Reports, Housing Agreements, and Agency Placement related documents. LPA Larios and LPA Rosas conducted interviews with witnesses and parties related to the investigation. On 07/29/2021, the Department assigned complaint investigation to the Monterey Park Children's Residential Program Regional Office- Foster Family Agency (FFA) #567806515 inaccurately. The correct corresponded facility is THPP+FC #565801976 and is assigned to the El Segundo Children's Residential Program Regional Office (ESCRP). On 11/19/2021, LPA Larios delivered findings to Foster Family Agency (FFA) and dismissed the complaint and forward to ESCRP to investigate. On 12/10/2021, the ESCRP received the complaint to investigate. Based on information gathered from interviews, photos and inspection conducted of the living unit on 08/09/2021, the allegation is substantiated, which poses a potential Health, Safety or Personal Rights risk to residents in care. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. The Department has concluded, based on the preponderance of the evidence obtained during this investigation, that the allegation of Neglect and Lack of Supervision is substantiated. During the inspection investigation the LPA observed deficiencies (see attached 809D), plan of corrections was discussed, and appeal rights were provided. LPA Rosas provided a copy of this licensing report to S1. Exit interview was conducted with A1 and a copy of this report was left at the facility.

Investigation Findings:
13On March 2, 2023, at 9:30am, Licensing Program Analyst (LPA) Olivia Rosas conducted an unannounced inspection to Aspiranet Transitional Housing Program Placement THPP 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 Christopher Larios 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 03/02/2023. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the allegation of staff did not ensure that youths living unit is safe and sanitary therefore, the findings are substantiated. On 07/29/2021, the Department received a complaint alleging Nonminor Dependent#1 (NMD1) was not afforded a living unit that was safe and sanitary by the Transitional Housing Program Placement (THPP). Report continues LIC-9099C SubstantiatedEstimated 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: ASPIRANET THPPFACILITY NUMBER: VISIT DATE: 03/01/2023

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

met_with: Staff#1 (S1)

complaint_status: SUBSTANTIATED


raw_content:
Narrative:
On July 29, 2021, the Department received a complaint alleging facility staff disclosed personal information regarding a Nonminor Dependent. Statements obtained from interviews conducted had conflicting statements. On 08/09/2021, LPA Larios and 12/10/2021, LPA Rosas conducted a records review on Nonminor Dependent#1 (NMD1) and Nonminor Dependent#2 (NMD2) and obtained copies of weekly contact notes, Special Incident Reports, Housing Agreements, and Agency Placement related documents. LPA Larios and LPA Rosas conducted interviews with witnesses and parties related to the investigation. There was not enough evidence and information to corroborate the allegations of Personal Rights. On 07/29/2021, the Department assigned complaint investigation to the Monterey Park Children's Residential Program Regional Office- Foster Family Agency (FFA) #567806515 inaccurately. The correct corresponded facility is THPP+FC #565801976 and is assigned to the El Segundo Children's Residential Program Regional Office (ESCRP). On 11/19/2021, LPA Larios delivered findings to Foster Family Agency (FFA) and dismissed the dismissed the complaint and forward to ESCRP to investigate. On 12/10/2021, the ESCRP received the complaint to investigate. 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 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 March 2, 2023, at 2:00pm, Licensing Program Analyst (LPA) Olivia Rosas conducted an unannounced inspection to Aspiranet Transitional Housing Program Placement THPP 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 Christopher Larios 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 03/02/2023. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the allegation of Staff did not keep minor's personal information confidential. 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: ASPIRANET THPPFACILITY NUMBER: VISIT DATE: 03/02/2023

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


summary: Facility Evaluation

raw_content:
Narrative:
On 11/30/21 at 9:30am, Licensing Program Analyst, (LPA) Olivia Rosas made announced visit to Aspiranet Transitional Housing Placement plus Foster Care (THP + FC) for the purpose of conducting an Annual/Random Inspection. LPA Rosas met with Staff#1(S1) THP+FC Supervising Social Worker who granted access to the Administrative Office and an inspection was conducted together. Individuals mention in this report are identify on the Confidential Names List (LIC811) dated 11/30/21. The annual fees are current. LPA Rosas inspected following during the inspection The facility is licensed to provide Transitional Housing Placement plus Foster Care (THP + FC) and Non-Minor Dependents (NMD) to forty-eight (48) participants ages eighteen (18) through twenty one (21). There are currently thirty-three (32) participants in placement including remote sites in the Ventura County (sites are in Ventura, Oxnard, Newbury Park, Moorepark and Simi Valley). Facility has two (2) Social Workers (1 per 12 participants) and one (1) Social Worker Supervisor (1 per Social Workers) and one (1) Supervising Social Worker. The facility is currently operating within staff ratio. The administrative office is located at Adolfo Road, Camarillo CA 93012. The office is located on the first floor of the Aspiranet office building and is set up as follows: Upon entering the building the office has a lobby and reception area. Temperature and health checks are conducted at the reception area entrance in the sign-in area. There is an Office for behavioral health staff, Foster Care (FFA supervisor), THPP staff, THPP Supervisor, Facilities Director/THPP Administrator, Behavioral Health clinicians, Foster Care Social Worker/Adoption Social Workers, Adoption Supervisor, Visitation/Multi-purpose room, File Room, Copy/Mail Box room. In the center of the office is a large conference room that can be split into two separate conference rooms. LPA observed locked file cabinets in Program Manager office that contained the participants' files, and discharged files in the locked cabinets. LPA Rosas obtained a copy of the Emergency Exiting Plan for the building. Report continues on LIC 809-C Page 1 of LPA Rosas reviewed following during the inspection: LPA Rosas received the following forms for review, copy of applicable waiver and exceptions, Register of participants, Current Census, Personnel Report (LIC 500), Emergency Disaster Plan Protocols, Emergency Disaster Plan for Children's Residential Facilities (LIC 610C). The certification/decertification list of participants living units. The facility has hard files in addition they keep files and documents in digital system called Watson Care Management (WCM). Staff Records Review: LPA Rosas attempted to review four (4) staff records. Staff files are stored in Aspiranet Human Resources (HR) Headquarters in San Francisco and they are not able to provide copies of confidential employee documents. LPA will make appointment with HR to be on-site to be able to access confidential files. LPA reviewed the Personnel Report and confirmed that facility has two (2) Social Workers (1 per 12 participants) and one (1) Social Worker Supervisor (1 per Social Workers) who carries social worker caseload. The facility is currently operating within staff ratio. LPA review of Facility's Personnel Report Summary on 11/29/2021 that indicates that all personnel have criminal record clearance has obtain the necessary clearances with DOJ, FBI, and Child Abuse Response. The facility has social worker personnel available on a 24-hour basis to respond to any emergency. Clients Records Review: LPA reviewed three (3) clients records which meet requirement. LPA reviewed the Admission Agreements, date of placement in unit, Emergency Contact information, and Needs and Services Plan. The facility keeps a file with required forms and uses a digital WCM system for TILP, Case Notes, and other required documents. The documents are available upon request and can be printed for review. Staff Interviews: LPA Rosas conducted a confidential interview with one (1) staff. LPA obtained contact information for Social Workers to conduct interviews at a later time. Client Interviews: LPA was not able to conduct participant interviews. LPA Rosas obtained register of participants with contact information to conduct interviews at a later time. LPA Rosas by email send the following PINS to S PIN 20-17-CRP: New Background Check Requirements, Assembly Bill 819 (Chapter 777, Statutes of 2019), PIN 21-20-CRP: Statewide Launch of New Inspection Tools for Children's Residential Licensees, PIN 21-05-CRP: The Family Urgent Response System (FURS). 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.

report_type: Facility Evaluation

visit_type: Annual


facility_name: ASPIRANET THP+FC RIVERSIDE OFFICE

summary: Facility Evaluation

raw_content:
Narrative:
On March 8, 2023 at 09:15 am, Licensing Program Analyst's (LPA's) Darlene Almaraz-Oseguera and Emina Preciado met with Program Director, Michele Gracia, who granted access into the facility. The purpose of this inspection was to conduct a required two-year annual inspection for the Transitional Housing Placement Program (THPP) for Non-Minor Dependents. The Administrative Office is located at Central Avenue Unit 5, Riverside CA 92506. Presently, the facility is licensed to provide Transitional Housing Placement for non-minor participants ages eighteen (18) through twenty-one (21). There are currently 33 participants residing in the program, which include 21 remote sites throughout Riverside County. The office consists of a lobby/reception area, a resource area equipped a computers and work areas for the participants. The office has cubicles/offices for the Program Director, Supervisor, and Life Coaches, in addition there is a kitchen area for the staff. There are working telephones, office equipment, furniture, and supplies located throughout the office space. LPA observed Participant files were stored in a locked cabinet within a locked storage room. Staff files are kept in the headquarters office in San Francisco and LPA's were provided electronic copies. Currently the facility is staffed with three full-time Life Coaches (social workers), one part-time Life Coach (social worker), one Housing Specialist, one Supervising Social Worker, and one Program Director. The Program Director was informed that each Social Worker should maintain a 1 to 12 ratio, which should never be exceeded. Program Director is aware of submitting unusual incident reports as needed to the Department and to include all Law Enforcement contact. LPA's reviewed seven staff records. All staff met the minimum qualifications and training requirements. A review of records shows that all staff have FBI, DOJ and Child Abuse Index Check clearances. LPA's reviewed eight non-minor dependent files. All files reviewed were complete and had the required documents. Facility provided a copy of the drill log of the emergency disaster and mass casualty plan. The facility is in compliance no deficiency were notes at this time. Exit interview was conducted with Michele Gracia, a copy of this report was provided to the facility representative.

met_with: Michele Gracia


summary: Facility Evaluation

raw_content:
Narrative:
On October 30, 2025, at 09:40 am, Licensing Program Analyst's (LPA's) Cynthia Robinson and Jessica Peete met with Program Director, Michele Gracia, who granted access into the facility. The purpose of this inspection was to conduct a Random annual inspection for the Transitional Housing Placement Program (THPP) for Non-Minor Dependents. The Administrative Office is located at Central Avenue Unit 5, Riverside CA 92506. Presently, the facility is licensed to provide Transitional Housing Placement for non-minor participants ages eighteen (18) through twenty-one (21). There are currently 46 participants residing in the program, which includes 25 remote sites throughout Riverside County. The office consists of a lobby/reception area, a resource area equipped with computers and work areas for the participants. The office has cubicles/offices for the Program Director, Supervisor, Housing Specialist and Life Coaches, in addition there is a kitchen area for the staff. There are working telephones, office equipment, furniture, and supplies located throughout the office space. Currently the facility is staffed with four full-time Life Coaches (social workers), one Housing Specialist, one Supervising Social Worker, one Administrative Assistant and one Program Director. Program Director is aware of submitting unusual incident reports as needed to the Department and to include all Law Enforcement contacts. Participant files are kept in an electronic database system and Program Director, Michele Gracia assisted LPA's Cynthia and Jessica for client file reviews. Staff files are maintained electronically with Human Resources and LPA's were provided electronic copies. LPA's reviewed five staff records. All staff met the minimum qualifications and training requirements. A review of records shows that all staff have FBI, DOJ and Child Abuse Index Check clearances. (Continued on LIC 9099C...) LPA's reviewed five non-minor dependent files. All files reviewed were complete and had the required documents. Facility provided a copy of the drill log of the emergency disaster and mass casualty plan. The facility is in compliance no deficiency were notes at this time. LPA's conducted three staff interviews and no client interviews were conducted due to NMD's being in off site housing. Exit interview was conducted with Michele Gracia, a copy of this report was provided to the facility representative.

met_with: Michele Garcia, Program Director


facility_name: ASPIRANET THP+FC SAN BERNARDINO OFFICE

summary: Facility Evaluation

raw_content:
Narrative:
On November 22, 2021 at 09: AM, Licensing Program Analysts (LPA's), Anastasia Flores and Leslie Covarrubias met with Core Program Supervisor, Andrea Castillo and Core Program Director Stephen Morales who granted access to the facility. The purpose of this inspection was to conduct an annual inspection for the Transitional Housing Placement Program (THPP) for Non-Minor Dependents. The administrative office was toured both inside and out with Ms. Castillo at 10: AM. Presently, the THPP is licensed to provide care for 75 participants ages eighteen (18) through twenty-one (21). There are currently 25 participants utilizing the program. The participants reside in nine remote sites throughout San Bernardino County. The THPP Administrative office is located in San Bernardino CA. The office is located on the first floor of a retail business establishment. The office consists of a lobby/reception area, a resource area equipped with a computer and work area for the THPP participants, offices for the Management team (Administrator, Program Director, Program Manager, Program Supervisor), cubicles for the Life Coach's (Social Workers/Case Manager), Housing Specialist. There was a kitchen area for the staff, and additional conference room. The office space was equipped with working office equipment, furniture, and supplies. LPA's observed the THPP participant files were stored in a locked storage room. The storage room housed files for two different Aspiranet programs which utilize the same office space. Each of the program files were located in separate locked filing cabinets. THPP personnel files were not readily available, LPA's were informed the facility is not allowed to store the personnel files at this location and will have them readily available on the next site visit. Currently the THPP is staffed with three full-time life coaches (social workers), one housing specialists and one Core Program Supervisor (Supervising Social Worker/Program Manager) and one Core Program Director. () During the inspection, LPA's reviewed five participant records. LPA observed that two of five Participant files (P1, P4) did not contain results for tuberculosis test. Based on the record review, the THPP did not ensure the participant medical assessment are not current and up to date. The facility is being cited for non-minor dependent regulations, 86069(b)(1) participant medical assessments. Exit interview was conducted with Core Program Director Stephen Morals and Core Program Supervisor Andrea Castillo. A copy of this report, the Confidential Names List ( LIC 811) dated November 22, 2021 and the appeal rights were handed to facility representative. LPA' will conduct a tour of one remote site upon departure of the annual inspection.

met_with: Stephen Morales


summary: Facility Evaluation

raw_content:
Narrative:
On December 9, 2021 at 10: AM, Licensing Program Analysts (LPAs), Anastasia Flores and Jessica Rubio met with Core Program Director Stephen Morales who granted access to the facility. The purpose of this inspection was to continue an annual inspection for the Transitional Housing Placement Program (THPP) for Non-Minor Dependents. LPA's observed the THPP personnel files which were stored in an administrative office located in San Francisco, Ca. Currently the THPP is staffed with three full-time life coaches (social workers), one housing specialists, one Core Program Supervisor (Supervising Social Worker/Program Manager), one Core Program Director and one Administrative Assistant II. During the inspection, LPA's reviewed seven out of seven staff files. LPA Flores communicated with Mr. Morales the staff files need to be kept available to Community Care Licensing (CCL). The facility is being cited for Non-Minor Dependent regulations, Title 22, division 6, chapter 7; 86066 (e) Personnel Requirements. Based on interview and record review the licensee did not comply with the regulation and seven out of seven staff files are kept at another location not immediately available to CCL. Exit interview was conducted with Core Program Director Stephen Morals and a copy of this report, the Confidential Names List ( LIC 811) dated 12/09/21, LIC809D and the appeal rights were handed to Core Program Director.

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On April 11, 2023 at 11:40 am, Licensing Program Analyst's (LPA's), Darlene Almaraz-Oseguera and Emina Preciado, met with Core Program Director, Christina Ruiz, who granted access into the facility. The purpose of this inspection was to conduct a random two-year annual inspection for the Transitional Housing Placement Program (THPP) for Non-Minor Dependents. The Administrative Office is located at E. Carnegie Drive Suite San Bernardino, CA 92408. The facility is licensed to provide Transitional Housing Placement for 75 non-minor participants ages eighteen (18) through twenty-one (21). There are currently 29 participants utilizing in the program, which include nine remote sites throughout San Bernardino County. The THPP Administrative office is located in San Bernardino CA. The office is located on the first floor of a retail business establishment. The office consists of a lobby/reception area, a resource area equipped with a computer and work area for the THPP participants, offices for the Management team (Administrator, Program Director, Program Manager, Program Supervisor), cubicles for the Life Coach's (Social Workers/Case Manager), Housing Specialist. There was a kitchen area for the staff, and additional conference room. The office space was equipped with working office equipment, furniture, and supplies. LPA's observed the THPP participant files were stored in a locked storage room. The storage room housed files for two different Aspiranet programs which utilize the same office space. Each of the program files were located in separate locked filing cabinets. THPP personnel files were not readily available, LPA's were informed the facility is not allowed to store the personnel files at this location, however, electronic copies were provided. Currently the THPP is staffed with three full-time Life Coaches (Social Workers), one Housing Specialists, one Core Program Supervisor (Supervising Social Worker/Program Manager), one Core Program Director, and one Administrative Assistant II. The Program Director was informed that each Social Worker should maintain a 1 to 12 ratio, which should never be exceeded. Continued on page Program Director is aware of submitting unusual incident reports as needed to the Department and to include all Law Enforcement contact. LPA's reviewed four staff records. All staff met the minimum qualifications and training requirements. A review of records shows that all staff have FBI, DOJ and Child Abuse Index Check clearances. LPA's reviewed seven non-minor dependent files. All files reviewed were complete and had the required documents. Facility provided a copy of the drill log of the emergency disaster and mass casualty plan. The facility is in compliance no deficiency were notes at this time. Exit interview was conducted with Core Program Director, Christina Ruiz. And a copy of this report along with LIC 811, Confidential Names List, was provided to the facility representative.

met_with: Core Program Director, Christina Ruiz


facility_name: BAYFRONT YOUTH AND FAMILY SERVICES THP+FC

summary: Facility Evaluation

raw_content:
Narrative:
On 12/21/2021 at 9:30 am, Licensing Program Analyst (LPA) Bernice Karnsrithong arrived at the facility to conduct an unannounced annual/required inspection. LPA arrived at the facility office at 9:30am and met with Chief Operating Officer, Cynthia Sarmiento who provided the tour of the facility. The facility is currently licensed to provide transitional housing placement plus foster care services to non-minor dependents. The facility office is in a two-story building located in a commercial space. The agency has CARF certification valid until August 16 2023. All THP + FC staff and client records will be maintained at this Administrative Office when there are clients. The facility has an emergency preparedness and disaster plan located in the first floor that is available for inspection. Currently there are no location for housing right now since the facility has no clients. Currently there are no THP + FC site staff and administration is actively looking for locations for future client placement. LPA Karnsrithong conducted an interview with Chief Operating Officer who is the current active employee for the facility. Administrative staff are mostly working remote and will only come in to the office once or twice a week due to COVID-19. During the inspection, LPA Karnsrithong had observed the following: First Floor: There are seven (7) office rooms located in the first floor. There are three (3) restrooms for administrative and staff to use. There is a receptionist desk upon entrance of the building. There is a work station for the accounting manager in the first floor as well. There is a large conference room that has seating and a large table for private meetings and interviews. The room is connecting to a kitchenette and the office of the CEO. There is an open reception area that's connected via sliding glass door to an outside atrium area. There is ample storage space, for files and supplies. (Page 1 of 2) Parking is also available outside the building. The license is posted in the receptionist area and is visible to all upon entering the office. Mental Health and CARF certification are also posted in the receptionist area. There are three (3) operating fire extinguishers and a first aid kit located in the first floor. Facility sketch plan is located on areas where fire extinguishers are located, one in the receptionist area, and one in the conference room. Second Floor: A staircase will take you to the second floor office. Quality Assurance (QA), Information Technology (IT) Maintenance Department offices are located in the second floor. There is a kitchenette that has a stove, microwave, and toaster for staff to use. There are two (2) working fire extinguishers in the second floor. There are two (2) enclosed office rooms being used by the QA director and IT department. There are two (2) restrooms located in the second floor. QA department houses all the documentation and monitoring for the agency and the facility. There is an employee lounge located in the second floor that is in a patio setting. There is a sliding door that leads to the employee lounge. The employee lounge is not accessible for clients. Exit interview was conducted with the Chief Operating Officer. A copy of this report will be emailed to the facility at a later date. There were no deficiencies cited at this time. (Page 2 of 2)

met_with: Chief Operating Officer


summary: Facility Evaluation

raw_content:
Narrative:
On 11/29/2023 at 10: AM, Licensing Program Analyst (LPA) Charmetha White arrived at Bayfront Youth and Family Services for the purpose of conducting an unannounced annual/required inspection of the administrative office. LPA met with Administrator/Chief Operating Officer, Cynthia Sarmiento. LPA was granted access and toured the facility. This program is licensed to provide transitional housing placement plus foster care services (THP+FC) for up to six (6) non-minor dependents. The census at the time of this inspection is zero (0). The administrative office is a two-story building located in a commercial area. The facility is set up as follows: First Floor: At the entrance of the building there is a receptionist desk and a waiting area. To the right of the entrance there is a hallway that consist of the Administrator's office, the human resource office, three (3) additional offices, two (2) workstations, and two (2) restrooms. To the left of the entrance there is a hallway that consist of the Chief Executive's office, one (1) restroom, and a conference room. The conference room is equipped with a large table and seating for at least 10 people. The room is used for meetings, and private interviews with clients should then need to meet with staff. There is also a small kitchenette connected to the back of the conference room. There are three (3) regulation fire extinguishers on this floor and a complete first aid kit. Second Floor: Is accessible from an outside staircase. This floor consists of two (2) offices, two (2) restrooms, a small kitchen, and an employee patio lounge. This floor houses the maintenance department, the information technology team, and quality assurance. The kitchen is equipped with a stove, toaster oven, and microwave. There are two (2) regulation fire extinguishers on this floor. The administrator's office contains a doubled keyed locked storage cabinets for client files. Staff files are kept locked in the human resource office. Report continued on LIC 809C. (Page 1 of 2) LPA observed the license is posted in the receptionist area and is visible to all upon entering the office. The facility has an emergency preparedness and disaster plan located on the first floor that is available for inspection. The program will utilize the remote site housing model and ensure the following services will be applicable: 1.) Participants have their own bedroom; 2.) No more than two participants share a bathroom: 3.) No more than two participants share a refrigerator; 4.) On-site supervisor available 24/7 to support, assist and oversee the needs of the participants: 5.) Assigned Social Workers assist and meet with participants a minimum of once a week (face-to-face); and 6.) Supervision, if needed, for the distribution of prescription medication. Currently there are clients placed in the program and no housing locations. Currently the only staff are the Administrator and Chief Executive Officer. There are no deficiencies observed or cited at this site visit. An exit interview was completed and a copy of this report was left with Administrator/Chief Operating Officer.

met_with: Cynthia Sarmiento - Administrator/Chief Operating Officer


facility_name: BEYOND EMANCIPATION

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Christopher Rollins made an unannounced required Annual inspection to Beyond Emancipation Administrative office. LPA met with Kamela Stewart Housing Division Manager (HDM) and Lavina Desilva Director of Programs (DP). The Transitional Housing Placement Plus Foster Care program (THP-FC) services non-minors dependents. At 11: AM, LPA did a walk through inspection with HDM and DP of the office. The office has sufficient space for confidential meetings, all participant files and staff files are located in a locked cabinet in a secure location. The agency has their license posted in their office. The office is in compliance with Community Care Licensing (CCL) regulations. LPA spoke with HDM and DP about the residential units. HDM stated that all residential units have at least one toilet, sink and tub in working order. HDM stated that all disinfectants and cleaning supplies are locked up and inaccessible. HDM notified LPA that the program provides all participants with household essentials and that there are no weapons or firearms stored in the housing units. At 12: PM, LPA reviewed 2 participants files and 4 staff files with HDM and DP. LPA observed Participants files to be complete and found no deficiencies. All documents are complete and up to date. LPA observed 4 staff files to be complete, all documentation is up to date and all staff training were up to date/current. During inspection, LPA requested a updated copy of the LIC Personnel Report, LIC C to maintain their file current. LPA receive an updated copy of COVID-19 safety plan, updated list of the Participant Residential Units and Leasing Agreements. LPA also spoke with DP and HDM about updating the Program Administrator documents. A review of Licensing Information System on August 10, 2021 indicates that all facility staff associated to the facility had DOJ, FBI and child abuse index check clearances. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted and a copy of the report was left at the facility. .

met_with: Lavina Desilva-Director of Programs and Kamela Stewart- Housing Division Director


summary: Facility Evaluation

raw_content:
Narrative:
On 8/31/22 at 9: AM, Licensing Program Analysts (LPA's) George Karkazis and Mariah Hawkins conducted an unannounced required 2-year inspection at the transitional housing placement program. LPA's met with Director Lavina De Silva and informed of the purpose of the visit. The CARE inspection tool was used to conduct this inspection. LPA's toured the facility and observed the office to be in good repair, clean, well organized, and to have confidential meeting spaces. LPA's toured two residential units and observed the following: The first unit was clean and in good repair. The second unit was unoccupied, and certain parts were not safe for occupation due to being under renovation and remodeling. LPA's reviewed three staff files and two residents files and interviewed one staff. Neither resident currently in care were interviewed due to one resident being on a home stay following the birth of their child and one resident being asleep during visit to residential unit. The following deficiency was found during today's inspection: - No emergency and disaster plan was available at the residential units and no documentation that the plan had been provided to participants/residents was in facility records accessible during today's visit. LPA's are issuing a citation of California Code of Regulations, Title 22, Section 86023. See attached LIC 809-D. The following advisories were issued (See LIC 9102s): - LPA's observed that the facility conducts safety drills one to two times per year. LPA's advised that drills be conducted on a quarterly basis. - LPA's observed that one staff member did not have mandated reporter training accessible during inspection. LPA's advise that all staff responsible for the facility or with authority to represent the facility ensure they have access to all required documentation. - LPA's observed that only the administrator has access to current participant files, so LPA's were not able to review current participant records during visit. LPA's reviewed past participant records. LPA's advise that the facility ensure all staff responsible for the facility or with the authority to represent the facility have access to all required documentation. - LPA's observed that participant records did not contain needs and services plans but did have transitional independent living plans (TILPs). LPA's advise that needs and services plans be generated that are consistent with the participants' TILPs. - LPA's observed that needs and services were not updated annually due to not being generated. LPA's advise that the facility begin generating needs and services plans and updating plans at least annually. An exit interview was conducted, appeal rights were provided, and a copy of this report was provided to Director Lavina De Silva, whose signature on this form confirms receipt.

met_with: Director Lavina De Silva


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPA) George Karkazis and Nicole del Calvo made an unannounced required Annual inspection to Beyond Emancipation. LPA's met with Jenny Fick, Interim Housing Director and Dina Gibson, Interim Human Resource Director. The Transitional Housing Placement Plus Foster Care program (THP-FC) services non-minors dependents. At 12:00PM, LPA's did a walk through inspection with Jenny Fick, Interim Housing Director of the office. The office has sufficient space for confidential meetings, all participant files and staff files are located in a locked cabinet in the administrative offices. The agency has their license posted in their office. The office is in compliance with Community Care Licensing (CCL) regulations. LPA spoke with Jenny Fick about the residential units. Jenny Fick stated that all residential units have at least one toilet, sink and tub in working order. Jenny Fick stated that all disinfectants and cleaning supplies are locked up and inaccessible. Jenny Fick notified LPA's that the program provides all participants with household essentials and that there are no weapons or firearms stored in the housing units. At 11:00AM, LPA's reviewed 5 participants files and 5 staff files with DIna Gibson. LPA observed Participants files to be complete and found no deficiencies. All documents are complete and up to date. LPA observed 5 staff files. S1 & S2 did not have background clearance, and S3 & S4 did not have health screen or TB record on file. At this the facility is being cited for California Code of Regulation 80018(e)(1) Criminal Record Clearance, with civil penalty, 86066(a)(11) Health Screening, 86066(a)(12) Tuberculosis. LPA's Karkazis and Del Calvo provided education/training pertaining to Guardian and fingerprint clearance Exit interview conducted, appeal rights provided, and a copy of the report was given to Dina Gibson.


facility_name: BILL WILSON CENTER THPP

summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Evidence for the allegation "Minor is not being adequately supervised", as follows: Five (5) out of seven (7) individuals interviewed (C1, S1, S2, S3, and IPM) told this LPA that C1 is following the program rules and that C1 has received adequate supervision. Staffing schedules from (3/07/2021 - 4/03/2021) show that there has been adequate supervision at the THPP residence. Staffing schedules were obtained from Bill Wilson Center representatives on (3/26/2021). Two (2) out of seven (7) individuals interviewed (SPO and PO) told this LPA that C1 is not receiving adequate supervision. The individuals interviewed have concerns about the lack of an employee residing onsite at the THPP Bill Wilson Center and that the THPP representatives told (PO and SPO) that the program is an independent living program and there are not twenty-four hours, seven days a week (24/7) staff coverage. Based on this LPA's review of records and interviews the THPP representatives have increased supervision for C1 based on the needs of the client, therefore the allegation is unsubstantiated. Evidence for the allegation "Minor did not receive services", as follows: Five (5) out of seven (7) individuals interviewed (C1, S1, S2, S3, and IPM) told this LPA that C1 is following the program and that C1 is receiving services. Based on interviews and observations by this LPA there was a disconnect between what services should be referred by the Probation Department representatives and what services the THPP should be providing. Based on the THPP program the services are being provided; C1 is interning at the (Young Women's Freedom). Per IPM, C1 is very engaged in the internship. C1 is involved with life coaching and does peer advisory for other youth in the program. C1 comes in daily, weekdays, Monday through Thursday. Per IPM, C1 has been an intern since March (2021) but involved with the center since (2019). C1 is reliable and comes in on time. C1 rarely misses coming in. Since March C1 has only been absent two (2) or three (3) times. In addition, C1 attends a support group (New Hope for Youth), which helps her with services, such as, finding career opportunities and counseling. Bill Wilson Center representatives conduct weekly house meetings to address any needs or services for the youth in placement and to fulfill Assembly Bill (AB) 12 requirements. Evidence for the allegation "Minor is not attending school", as follows: Five (5) out of seven (7) individuals interviewed (C1, S1, S2, S3, and IPM) told this LPA that C1 is following the program and that C1 has been attending school. Based on interviews C1 had difficulty at the beginning of the program because of online learning due to COVID-19 restrictions. Based on interviews, C1 is on track to graduate and is attending classes as she is eager to graduate. C1's biological father has the education rights. Therefore, Bill Wilson Center representatives do not have direct access to school records. LPA Raissi attempted to contact C1's biological father for further details. C1's biological father did not return LPA Raissi call. Based on absence records obtained by PO from (2/22/2021 - 4/1/2021) there were absences, but C1 was attending classes and this was in the time-frame when C1 was having difficulty adjusting to the online classes. LPA Raissi could not retrieve further records due to C1's biological father having the educational rights for C1. Five (5) out of seven (7) persons interviewed (C1, S1, S2, S3, and IPM) were in favor of C1's progress in the THPP program and denied the allegation(s). Based on two (2) out of seven (7) persons interviewed (PO and SPO) were in favor of the allegation(s) and do not think that the Bill Wilson Center THPP program is an adequate placement for C1. During this investigation, it was revealed that the Juvenile Court Judge asked to pursue C1's placement at the Bill Wilson Center THPP program. Based on interviews, records obtained, and observations by this LPA there is not enough evidence to prove the allegation(s). Therefore, the complaint findings are Unsubstantiated. Although the allegation(s) 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(s) are Unsubstantiated. No deficiencies were cited. Exit interview conducted, appeal rights discussed, and a copy of the report was left at the agency with Cheryl Rouse.

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

met_with: Cheryl Rouse


raw_content:
Narrative:
Based on confidential interviews, Investigator found that C1 was given and used marijuana inside the facility. The preponderance of evidence standard has been met, and thus the allegation is substantiated. LPA delivered a citation for Interim Licensing Standards (ILS) 86287(i) (see 9099D). LPA conducted an exit interview and Appeal Rights were read with Risa Palega, Program Manager, at 9:45AM whose signature confirms the receipt of this document. Based on confidential interviews and daily shift logs, it was not confirmed that a client was harassed by other clients. Of the three clients involved, two had conflicting accounts of the incidents and the third was not able to be contacted. C1 alleged harassing messages but was not able to provide the messages to the Investigator. The preponderance of evidence standard has not been met, and thus this allegation is unsubstantiated. LPA conducted an exit interview with Risa Palega, Program Manager, at 9:45AM whose signature confirms the receipt of this document.

Investigation Findings:
13On 5/13/2022 at 9:20AM, Licensing Program Analyst (LPA) Selena Hood conducted an unannounced visit to the above licensed facility for the purpose of delivering the findings on the listed allegations. LPA met with Risa Palega, Program Manager. This investigation was conducted by the Community Care Licensing Investigations Branch (IB). During the course of the investigation, IB Investigator, Eddie Phung, conducted confidential interviews between 2/19/2022 and 5/6/2022 for six clients, three facility staff, and a social worker. Investigator also attempted to interview C2 but was not able to make contact. Investigator reviewed the daily shift logs from 10/22/2021 and 10/26/2021, three client files, and the incident report. Investigator did a records review of a police investigation done by the Los Gatos Police Department. Continued on LIC9099C... SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Selena Hood 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 26-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. First Street, Ste. FACILITY NAME: BILL WILSON CENTER THPPFACILITY NUMBER: VISIT DATE: 05/13/2022

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

met_with: Risa Palega


raw_content:
Narrative:
LPA delivered a citation for THPP Interim Licensing Standards 86272 (a)(1); Personal Rights;and 86276; Food Service (see LIC9099D). An exit interview was conducted at 1: PM with Ms. Madrigal , and a copy of this report, along with appeal rights, was emailed to her. A

Investigation Findings:
13On 12/2/2022 at 9:00AM, Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced visit to the listed licensed agency. The purpose of this visit was to deliver the findings for the above allegation. LPA met with Santa Madrigal, Receptionist. This complaint involves a staff member not meeting the needs of clients in care by failing to provide food, and being physically and verbally abusive towards clients. LPA reviewed notes, staff records, daily logs for all clients, alleged victim's Needs and Services Plan, and incident reports. Additionally, during the course of this investigation, LPA interviewed confidential parties. LPA also made multiple attempts to contact the main staff involved in the allegations, who failed to return all telephone messages, and texts sent to her personal cell phone. The preponderance of evidence standard has been met, therefore the above allegations, are found to be SUBSTANTIATED. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Vaishali Singh-Sood 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 26-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. First Street, Ste. FACILITY NAME: BILL WILSON CENTER THPPFACILITY NUMBER: 435200948

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

met_with: Santa Madrigal


raw_content:
Narrative:
It was also noted an investigating Social Worker displayed a huge concern for S1 regarding her behavior in the allegations. Both clients who had assaultive incidents with S1 confirmed the S1 had assaulted each of them on separate occasions. Due to a concern of safety with S1, on March 17, 2023, S1 was subsequently given a 30 days notice for termination from the facility's Administrator. As such, the allegations listed above are substantiated. Based on today's visit, Children's Residential Title Regulations, Section 86172(b)(2); Personal Rights; deficiency was cited. An exit interview was conducted at 3: PM with Ms. Cervantes, and a copy of this report was emailed to Administrator, Debbie Pell. It is noted that this that the findings have remained the same, but additional information has been added to the LIC 9099, and that this new LIC 9099 supersedes the original LIC 9099 dated 3/9/2023.

Investigation Findings:
13On 3/29/2023, at 11: AM, Licensing Program Analyst (LPA) Vaishali SIngh-Sood conducted an unannounced visit to the facility. The purpose of this visit was to re-deliver the findings on the listed allegations. LPA met with Brenda Cervantes, Program Assistant. At the time of the visit, there were two youth and three staff in the facility. Over the course of the investigation, confidential interviews, a file review, and evidence obtained regarding the aforementioned allegations. Based on confidential interviews, and documents reviewed, there is a preponderance of evidence that two clients in care with similar allegations had sustained injuries while in care by Staff 1 (S1). The two clients were both yelled at, and spoken to with inappropriate language by S1 on separate instances. Moreover, S1 pushed one client, and chioked another client. There are photographs that were provided by one of the reporting parties that clearly reveals injuries on one of the client's neck by S1 in approximately four places. The investigating Social Worker who conducted the investgation believed the client who had sustained neck injuries. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Vaishali Singh-Sood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. First Street, Ste. This is an official report of an unannounced visit/investigation of a complaint received in our office on 07/05/2022 and conducted by Evaluator Vaishali Singh-Sood PUBLICCOMPLAINT CONTROL NUMBER: 26-CR- FACILITY NAME:BILL WILSON CENTER THPPFACILITY NUMBER: ADMINISTRATOR:CHERYL ROUSEFACILITY TYPE: ADDRESS: THE ALAMEDATELEPHONE: (408) 243- CITY:SANTA CLARASTATE: CAZIP CODE: CAPACITY:75CENSUS: 6DATE: 03/29/ UNANNOUNCEDTIME BEGAN: 11: AM MET WITH:Brenda CervantesTIME COMPLETED:03: PM 9Staff locked minor out of the group home. INVESTIGATION FINDINGS: 13On 3/29/2023 at 11: AM, Licensing Program Analyst (LPA) Vaishali SIngh-Sood conducted an unannounced visit to the facility. The purpose of this visit was to re-deliver the findings on the listed allegation. LPA met with Debbie Pell, Program Administrator.. At the time of the visit, there were two youth and three staff. Over the course of the investigation, confidential interviews, a file review, and evidence obtained regarding the aforementioned allegation was conducted. However, due to a lack of evidence, this LPA was unable to substantiate the allegation. The allegation may have happened, but there is not a preponderance of the evidence to prove that the it occurred. Therefore, this investigation is being closed as unsubstantiated. An exit interview was conducted at 3: PM with Ms. Cervantes, and a copy of this report was emailed to Administrator, Ms. Pell. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Vaishali Singh-Sood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 2 of Control Number 26-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. First Street, Ste. FACILITY NAME: BILL WILSON CENTER THPPFACILITY NUMBER: 435200948

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

met_with: Brenda Cervantes


raw_content:
Narrative:
It was also noted an investigating Social Worker displayed a huge concern for S1 regarding her behavior in the allegations. Both clients who had assaultive incidents with S1 confirmed the S1 had assaulted each of them on separate occasions. Due to a concern of safety with S1, on March 17, 2023, S1 was subsequently given a 30 days notice for termination from the facility's Administrator. As such, the allegations listed above are substantiated. Based on today's visit, Children's Residential Title Regulations, Section 86172(b)(2); Personal Rights; deficiency was cited. An exit interview was conducted at 3: PM with Ms. Cervantes, and a copy of this report was emailed to Program Administrator, Debbie Pell. It is noted that this that the findings have been changed for one of the allegations, and that this new LIC 9099 supersedes the original LIC 9099 dated 2/15/2023.

Investigation Findings:
13On 3/29/2023, at 10: AM, Licensing Program Analyst (LPA) Vaishali SIngh-Sood conducted an unannounced visit to the facility. The purpose of this visit was to re-deliver the findings on the listed allegations. LPA met with Brenda Cervantes, Program Assistant. At the time of the visit, there were two youth and three staff in the facility. Over the course of the investigation, confidential interviews, a file review, and evidence obtained regarding the aforementioned allegations. Based on confidential interviews, and documents reviewed, there is a preponderance of evidence that two clients in care with similar allegations had sustained injuries while in care by Staff 1 (S1). The two clients were both yelled at, and spoken to with inappropriate language by S1 on separate instances. Moreover, S1 pushed one client, and chioked another client. There are photographs that were provided by one of the reporting parties that clearly reveals injuries on one of the client's neck by S1 in approximately four places. The investigating Social Worker who conducted the investigation believed the client who had sustained neck injuries. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Vaishali Singh-Sood 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 26-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. First Street, Ste. FACILITY NAME: BILL WILSON CENTER THPPFACILITY NUMBER: VISIT DATE: 03/29/2023

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


raw_content:
Investigation Findings:
13On 2/29/2024 at 9: AM, Licensing Program Analysts (LPA) Vaishali SIngh-Sood and Jasmine Cardeno conducted an unannounced visit to the facility. The purpose of this visit was to deliver the findings on the listed allegation. LPAs met with Debbie Pell, Program Administrator. At the time of the visit, there were two youth and three staff. Over the course of the investigation, confidential interviews, a file review, and evidence obtained regarding the aforementioned allegation was conducted. However, due to a lack of evidence, and the reporting party failed to return all calls to this LPA, this LPA was unable to substantiate the allegation. The allegation may have happened, but there is not a preponderance of the evidence to prove that it occurred. Therefore, this investigation is being closed as unsubstantiated. An exit interview was conducted at 10: AM with Ms. Pell, and a copy of this report was emailed to Administrator, Ms. Pell. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Vaishali Singh-Sood 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: Debbie Pell


summary: Facility Evaluation

raw_content:
Narrative:
On July 7, 2021 at 2: PM Licensing Program Analyst (LPA) Sam Raissi was met by Division Director, Cheryl Rouse at the Transitional Housing Placement Program (THPP) agency listed above this report. The purpose of this visit was to open a Case Management inspection. During the course of investigating a complaint (refer to complaint report # 26-CR-20210319151408) it was revealed that the Bill Wilson Center THPP House Monitor was no longer residing at the THPP staff site. The above agency should have notified CCL and this LPA of the change. Staff schedules obtained from Bill Wilson Center representatives show that there was adequate supervision for the clients in care. Therefore, the agency will be given an Advisory Note, Technical Assistance LIC 9102-TA (attached to this report). No citation was given for this visit. A copy of this report was given to Cheryl Rouse.


summary: Facility Evaluation

raw_content:
Narrative:
On August 18, 2021, at 12: PM Licensing Program Analyst (LPA) Sam Raissi conducted an unannounced inspection to the Bill Wilson Center - Transitional Housing Placement Program (THPP) agency for the purpose of conducting an Annual/Required inspection. LPA Raissi met with Division Director, Cheryl Rouse and Program Manager, Risa Palega. The THPP is licensed to serve seventy-five clients, minor and non-minor dependents. Currently in placement are 35 clients. This LPA toured the agency, reviewed the staff and client files, and certificates of compliance for the THPP sites. The agency had the necessary documents. A review of Licensing Information System on August 18, 2021 indicates that all agency staff are associated to the facility had DOJ, FBI, and child abuse index check clearances. According to the Cheryl Rouse, there are no weapons, and/or bodies of water at the agency which meets title 22 regulations. There are currently no exceptions on file, and there have not been any deficiencies cited in the past year. There were no deficiencies noted at today's inspection. The agency was issued an Advisory Note -Technical Assistance (LIC 9102TA). Exit interview conducted and a copy of this report was sent to Cheryl Rouse.


summary: Facility Evaluation

raw_content:
Narrative:
An informal meeting was conducted today with the facility via Teams Meeting today. Attendees of the facility: Debbie Pell Counties:Eden Veloy CCL: Helga Wong - Licensing Program Manager (LPM), and Vaishali Singh-Sood- Licensing Program Analyst (LPA) Discussion: - Current substantiated complaint re personal rights violations - Current substantiated complaint re inappropriate altercation and community between staff member and client - 3 year complaint history Facility will do the following and submit them by 4/30/23: -Submit written plan on staff training (Prudent Parenting, Crisis Management, and De-escalation techniques) -Ffacility plans to measure staff understanding and implementation of training. -Written plan on how the facility will contact and connect with the community (MHPA & Monterey County Sheriff Dept.) -LIC 500 to ensure adequate staffing at the facility


summary: Facility Evaluation

raw_content:
Narrative:
On October 30, 2024, at 10: AM Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced inspection to the Bill Wilson Center - Transitional Housing Placement Program (THPP) agency for the purpose of conducting an Annual/Required inspection. LPA Singh-Sood met with Program Manager, Angeleena Yeldell. The THPP is licensed to serve 12 clients, minor and non-minor dependents. Currently in placement are 9 clients. This LPA toured the agency, reviewed the staff and client files, and certificates of compliance for the THPP sites. The agency had the necessary documents. On October 30, 2024, a review of Guardian indicated that all agency staff who are associated to the facility had DOJ, FBI, and child abuse index check clearances. According to Ms. Yeldell, there are no weapons, and/or bodies of water at the agency which currently meets Title 22 regulations. There are currently no exceptions on file, and there have not been any deficiencies cited in the past year. There were no deficiencies noted at today's inspection. At 3: PM, an exit interview conducted with Ms. Yeldell, and a copy of this report was provided at that time.

met_with: Angeleena Yeldell


summary: Facility Evaluation

raw_content:
Narrative:
On October 8, 2025 at 9: AM Licensing Program Analyst (LPA) Omar Sawyer and LPA Shikya Belfield made an unannounced Case Management inspection at the above facility. The purpose of this inspection is to conduct an Incident Report Follow-up. LPA Belfield and LPA Sawyer met with, Licensee Daniel Gutierrez who assisted with the inspection. The purpose of the visit was to obtain more information from the facility regarding an incident report that was submitted to Community Care Licensing (CCL) by the facility on 6/9/25. LPA Belfield requested copies of receipts for pest control services received at participant living units. At this time more information is needed regarding the incident. This inspection will be concluded at a later date. An exit interview was conducted with Daniel Gutierrez, Licensee. A copy of this report was left with Licensee whose signature confirms receipt.

met_with: Daniel Guitierrez


summary: Facility Evaluation

raw_content:
Narrative:
On November 4, 2025 at 10: AM Licensing Program Analyst (LPA) Omar Sawyer and LPA Shikya Belfield made an unannounced Case Management inspection at the above facility. The purpose of this inspection is to conduct an Incident Report Follow-up for two incident reports received by the department. LPA Belfield and LPA Sawyer met with, Administrator Trista Tugman who arrived at 11: AM and assisted with the inspection. A case management inspection was conducted on 10/8/2025 regarding incident report stating that the THPP had bedbugs. LPA Belfield received a copy of a report for pest control services. It was observed that the facility is attempting to remedy the issue however, more efforts are needed to address the issue in the home. LPA Belfield discussed with administrator the need for follow up services to the THPP and that proof will need to be submitted to the department regarding the action taken to resolve the issue of bedbugs. Technical Violation issued for California Code of Regulations Title 22, Division Six, Section 80087(a)(1) Buildings and Grounds. An incident report was received by the department on 10/28/2025 regarding reporting requirements and the late reporting to law enforcement of a missing participant P1 (see confidential names list dated 11/4/25). Based on interview conducted and supportive documentation to support time line of efforts made by the facility, there was no delay in reporting or communication with P1. Case management regarding these incidents is concluded. An exit interview was conducted and a copy of this report was left with Administrator Trista Tugman whose signature confirms receipt.

met_with: Administrator Trista Tugman


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On December 16, 2025, at 9: AM Licensing Program Analysts (LPAs) Mona Lam and Amee Li conducted an unannounced inspection at the Bill Wilson Center - Transitional Housing Placement Program (THPP) agency for the purpose of conducting an Annual/Required inspection. LPAs met with Brenda Smith, Program Manager. The THPP is licensed to serve 75 clients, minor and non-minor dependents. Currently in placement are eight (8) clients. LPAs toured the agency and inspected five staff files and five client files. According to staff record review and Guardian, five agency staff had DOJ, FBI, and CACI clearances. During the inspection of staff files, LPAs found that multiple staff trainings were missing. As a result, LPAs issued one Type B Deficiency under California Code of Regulations (CCR) 86065(f). LPAs also found that documentation of the completion of emergency or disaster preparedness training was missing for two out of five staff files. A Technical Violation was issued under Health and Safety Code (HSC) 1565(b). During the inspection, LPAs found that the register of participants contains the participants' names, but does not include their ambulatory status. LPAs advised the facility to add the ambulatory status of participants to the register. Additionally, the register of participants was missing the name, address, and telephone number of attending physicians for all participants. LPAs advised for the previously listed information to be added to the register. Two Technical Assistances were issued for the above-listed issues. Continued on LIC 809-C. LPAs inspected five client records and found that they contain phone numbers of person(s) to be contacted in an emergency when the participant's authorized representative cannot be contacted. However, they do not contain their designated addresses. LPAs advised to add the emergency contact's addresses to each client record. LPAs issued a Technical Assistance to address this issue. According to client file review, one client is currently employed. LPAs found that the current phone number and address of employment for this client were missing, and issued a Technical Violation under CCR 86170(b)(11). The agency was issued one Type B violation, two Technical Violations, and four Technical Assistances. At 4: PM, an exit interview was conducted with Brenda Smith, Program Manager, and a copy of this report and appeal rights were provided prior to exiting the facility.

Deficiencies:
86065(f): Reporting Requirements

(f) All THPP personnel shall, at a minimum, receive training that provides knowledge of and skill in the following areas, as evidenced by safe and effective job performance

met_with: Brenda Smith, Program Manager


facility_name: BOYS REPUBLIC THP+FC

summary: Facility Evaluation

raw_content:
Narrative:
On December 15, 2021 at around 1:00pm, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted a case management inspection at the Transitional Housing Program (THP) facility and met Lanier Riley, THP Supervisor. The purpose of the inspection was to follow-up a Special Incident Report (SIR) the Department received regarding a nineteen (19) year old client (C1) who was hospitalized due to drug overdose. C1 was discharged from the hospital the same day. At around 1:20pm, LPA reviewed C1's file and finished the review at 1:35pm. LPA conducted an interview of the THP Supervisor while reviewing the file.. LPA gathered the information that the Probation Officer (PO) is looking for a facility for C1 that can provide a 24 hour supervision like a Drug Treatment Program. During his stay at the THP, he will be provided additional physical and mental health services. Prior to the incident, the THP staff conducts apartment checks on the clients every Tuesday and as needed depending how well the clients are doing in their program. The clinician of the program also sees the clients every week depending on their availability, since the clients work. After the incident, the staff increased the visitation and also conducts random checks and in addition calls them in the unit. Based on the information gathered, at this time no further follow-up is necessary regarding the incident. An exit interview was conducted and a copy of the report and LIC 811 were provided to the facility representative.

met_with: Lanier Riley and Lori Kezos


summary: Facility Evaluation

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Narrative:
On September 29,2022 at 10:30 am, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an unannounced Required - Year inspection to the Transitional Housing Program Plus Foster Care (THP+FC) facility. LPA met with the Lori Kezos, Administrator. The THP+FC has five (5 ) duplexes and eight (8) participants in placement. PHYSICAL PLANT The facility license is placed in a prominent, public accessible location. All participant records are maintained in a secure area or locked file cabinets in the administrative office. The THP+FC administrative office has telephone service on the premises. OPERATIONAL REQUIREMENTS The facility maintains a register of clients and is available to the department. The THP+FC is currently operating within licensing regulations. STAFF RECORDS Staff records are available upon LPA request. LPA reviewed two (2) personnel records (refer to Confidential Names form LIC 811 dated 09/29/22) and interviewed two (2) staff. CLIENT RECORDS LPA reviewed three (3) client records. Client records are maintained locked onsite in the THP office. Copies of original and modified Needs and Services Plans (NSPs) and Transitional Independent Living Plan (TILP) were present in each file reviewed. A deficiency citation is issued at the time of the inspection. An exit interviewed was conducted and a copy of the LIC 809, LIC 809C, LIC 809D and appeal rights were provided to Administrator Kezos.

met_with: Lori Kezos


summary: Facility Evaluation

raw_content:
Narrative:
On September 13, 2023 at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an unannounced annual/random inspection to the Transitional Housing Program Plus Foster Care (THP+FC) facility. When LPA arrived, LPA met with Maria Meza, Assistant Supervisor. Administrator Lori Kezos arrived shortly. The THP+FC has five (5) duplex units and four ()4 participants in placement. Assistant Supervisor, Meza provided a copy of the staff schedule, client roster, Emergency Disaster Plan, and Administrative Organization. PHYSICAL PLANT The facility license is posted in a prominent location. All participant records are maintained in a secure area or locked file cabinets in the administrative office. The THP+FC administrative office has telephone service on the premises. OPERATIONAL REQUIREMENTS The facility maintains a register of clients available upon request. The facility is currently operating within licensing regulations. STAFF RECORDS Staff records are available upon request. LPA reviewed two (2) personnel records (refer to Confidential Names form LIC 811 dated 09/13/23 and interviewed two (2) staff. CLIENT RECORDS LPA reviewed three (3) client records. Client records are maintained locked onsite in the THP office. A deficiency citation is issued at the time of the inspection. An exit interviewed was conducted and a copy of the LIC 809, LIC 809C, LIC 809D and appeal rights were provided to Administrator Kezos.


summary: Facility Evaluation

raw_content:
Narrative:
On September 13, 2024 at 9: AM, Licensing Program Analysts (LPAs) Brent Lockhart, Christopher Williams and Gilbert Gutierrez conducted an unannounced annual/random inspection to the Transitional Housing Program Plus Foster Care (THP+FC) facility. LPAs met with Supervisor, Lanier Riley who gave the tour of the facility. THP+FC has 5 duplex units and 5 participants in placement. Supervisor, Riley provided a copy of the staff schedule, client roster, Emergency Disaster Plan. . PHYSICAL PLANT The facility license, Emergency Disaster Plan, staff schedule and Foster Youth Rights are posted in a prominent location. All participant records are maintained in a secure area or locked file cabinets in the administrative office. The THP+FC administrative office has telephone service on the premises. LPAs also inspected THPP units. OPERATIONAL REQUIREMENTS The facility maintains a register of clients available upon request. The facility is currently operating within licensing regulations. STAFF RECORDS Staff records are available upon request. LPAs reviewed 4 personnel records (refer to Confidential Names form LIC 811 dated 09/13/24 and interviewed 1 staff. CLIENT RECORDS LPA reviewed 5 client records. Client records are maintained locked onsite in the THP office. LPAs interviewed 2 participants. A deficiency citation is issued at the time of the inspection. An exit interviewed was conducted and a copy of the LIC 809, LIC 809C, LIC 809D, LIC 9102s and appeal rights were provided to Supervisor Riley.

met_with: Lanier Riley


summary: Facility Evaluation

raw_content:
Narrative:
On November 8, 2021 at around 9:45am, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted a case management inspection at the Transitional Housing Program (THP) facility and met Lori Kezos, Administrator. The purpose of the inspection was to follow-up a Special Incident Report (SIR) the Department received regarding an eighteen (18) year old client (C1) who died at the hospital few days after a car accident. At around 10:00am, LPA reviewed the client file and finished the review at 10:30am. LPA conducted an interview of the THP Supervisor and the Administrator at around 10:45am. LPA gathered the information that the THP staff conducts apartment checks on the clients every Tuesday and as needed depending how well the clients are doing in their program. The clinician of the program also sees the clients every week depending on their availability, since the clients work. The last time C1 was seen at the THP was last October 25, 2021 regarding his career goals. Proof of contacts with C1 was provided to this LPA. Further, on October 30, 2021,the facility staff received a call from C1's relative that he was in a car accident. At the time, they don't have the details. The car accident incident was not reported to the Department for that reason. On November 4, 2021, they received another call from C1's relative that he passed away the night of November 3, 2021.. New information received from the relative was that C1 was not driving the car at the time of the accident. He was with his girlfriend and her stepfather was the driver. Based on the information gathered, at this time no further follow-up is necessary regarding the incident. A citation is issued to the facility for failure to make a report to the Department an unusual incident under Title Regulations. Per the SIR,staff was informed not only about the car accident but also that C1 was transported to the hospital after the accident. Section 80061: Each licensee or applicant shall furnish to the licensing agency reports as required by the Department, including, but not limited to, those specified in this section.. An exit interview was conducted and a copy of the report.


facility_name: B.W.I.T. LUXURIOUS FOSTERING

summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13On 4/5/24, Licensing Program Analyst (LPA) Mariah Hawkins and Licensing Program Manager (LPM) Isabel Diego conducted a complaint investigation visit to deliver findings for the above allegation. LPA and LPM met with Director Audra Stance and informed of the purpose of the visit. Based on confidential observations, interviews, and record review, a resident was issued a 7-day discharge notice on 2/24/24 with an exit date set at 3/2/24 was not paid their weekly stipend the week of 2/29/24. Additionally, only a $20 payment was made the week of 2/5/24. The preponderance of evidence standard has been met, and therefore the above allegation is found to be substantiated. LPA is issuing a citation of Transitional Housing Placement Nonminor Dependent (AB12) Interim Licensing Standards (ILS) Section Safeguards for Cash Resources, Personal Property, and Valuables, Subsection (e). See attached LIC 9099-D. An exit interview was conducted, appeal rights were provided, and a copy of this report was left with Director Audra Stance. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Mariah Hawkins 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 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO RO, TRAEGER AVE., Suite San Bruno, CA Facility Name: B.W.I.T. LUXURIOUS FOSTERINGFACILITY NUMBER: 015650131

met_with: Director Audra Stance


raw_content:
Narrative:
Page 2...when speaking to residents. The preponderance of evidence standard has been met, and therefore the above allegations are found to be substantiated. LPA is issuing citations of Transitional Housing Placement Program Nonminor Dependent (AB 12) Interim Licensing Standards (ILS) Sections: Personal Rights, Subsection (a), which requires that the personal rights listed in Welfare and Institutions Code 16009.1 be accorded, which in turn provides in Subsection (a)(8) the right "to contact the Community Care Licensing Division of the State Department of Social Services or the State Foster Care Ombudsperson regarding violations of rights, to speak to representatives of these offices confidentially, and to be free from threats or punishment for making complaints;" Personal Rights, Subsection (a)(1); Safeguards for Cash Resources, Personal Property, and Valuables, Subsection (e). An exit interview was conducted, appeal rights were provided, and a copy of this report was left with Director Audra Stance.

Investigation Findings:
13On 4/5/24, Licensing Program Analyst (LPA) Mariah Hawkins and Licensing Program Manager (LPM) Isabel Diego conducted a complaint investigation visit to deliver findings for the above allegations. LPA and LPM met with Director Audra Stance and informed of the purpose of the visit. Based on confidential observations, interviews, and record review, a resident was notified via text around 1:30AM by the Director that they were being terminated due to disrespecting the Director by stating they will be filing a complaint against the facility. The resident was notified by text around 1:30AM that they will have 7 days to move out. Additionally, the resident was denied access to their residential unit to retrieve their belongings, resulting in multiple items not being packed and therefore missing and not returned to the resident. Lastly, evidence indicates that staff made inappropriate statements to residents and frequently used inappropriate tone and language... SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Mariah Hawkins 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 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO RO, TRAEGER AVE., Suite San Bruno, CA Facility Name: B.W.I.T. Luxurious Fosteringfacility Number: Visit Date: 04/05/ Narrative 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32page 2...when speaking to residents. The preponderance of evidence standard has been met, and therefore the above allegations are found to be substantiated. LPA is issuing citations of Transitional Housing Placement Program Nonminor Dependent (AB 12) Interim Licensing Standards (ILS) Sections: Personal Rights, Subsection (a), which requires that the personal rights listed in Welfare and Institutions Code 16009.1 be accorded, which in turn provides in Subsection (a)(8) the right "to contact the Community Care Licensing Division of the State Department of Social Services or the State Foster Care Ombudsperson regarding violations of rights, to speak to representatives of these offices confidentially, and to be free from threats or punishment for making complaints;" Personal Rights, Subsection (a)(1); Safeguards for Cash Resources, Personal Property, and Valuables, Subsection (e). An exit interview was conducted, appeal rights were provided, and a copy of this report was left with Director Audra Stance. SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Mariah Hawkins LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: LIC9099 (FAS) - (06/04)Page: 2 of Control Number 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO RO, TRAEGER AVE., Suite San Bruno, CA Facility Name: B.W.I.T. LUXURIOUS FOSTERINGFACILITY NUMBER: 015650131

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


raw_content:
Investigation Findings:
13On 8-30-24 11:30AM, Licensing Program Analyst (LPA) George Karkazis conducted a complaint inspection at BWIT Luxurious Fostering and met with Administrator Audra Stance. The complaint alleged that the facility is operating outside disciplinary measures and client wrongfully moved from one living unit to another living unit. LPA conducted confidential interviews which provided conflicting information. LPA conducted document research which indicates that proper procedures were followed and responsible parties were notified. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the allegations occurred. Therefore, the allegations are UNSUBSTANTIATED. An exit interview was conducted and a copy of this report was given to Audra Stance, Administrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: George Karkazis 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: Audra Stance, Administrator


raw_content:
Narrative:
The facility is given a Type B citation under California Code of Regulations (CCR) 86022(e) Plan of Operation (See attached LIC 9099-D). An exit interview was conducted, appeal rights provided, and a copy of this report was left with Audra Stance, whose signature on this form confirms receipt.

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

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

met_with: Audra Stance


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

met_with: Administrator - Audra Stance


raw_content:
Investigation Findings:
13*** Amended correct deficiency and corrected findings.*** On 11/21/24 at 3: PM, Licensing Program Analyst (LPA) Jonathan Medina conducted a complaint inspection at BWIT and spoke with Audra Stance, Administrator. The purpose of the inspection was to deliver the findings for the above complaint allegations. Based on LPA's interview with staff, clients, and record review(s), the preponderance of evidence standard has been met, therefore the above allegations, facility operated outside of plan of operation and staff are not treating clients in care with dignity and respect are SUBSTANTIATED. Facility is being cited for violation of California Code of Regulations (CCR), Title 22, Division 6, Chapter 1: 80022(k) Plan of Operation and (ILS), AB Nonminor dependents, THPP, Article 06: 86272(a) Personal Rights. Please refer to attached 9909D. At this time, two deficiencies were given. An exit interview was conducted, appeal rights provided and discussed, and a copy of this report was given to Audra Stance, Administrator. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Carolyn Flynn LICENSING EVALUATOR NAME: Jonathan Medina 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 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO RO, TRAEGER AVE., Suite San Bruno, CA Facility Name: B.W.I.T. LUXURIOUS FOSTERINGFACILITY NUMBER: 015650131

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

met_with: Audra Stance - Administrator


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

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


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

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


met_with: Jammesie Jones - Compliance Manager

investigation_findings: UnsubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:

allegations: UnsubstantiatedEstimated Days of Completion: Unsubstantiated Estimated Days of Completion: Unsubstantiated Estimated Days of Completion:


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Monica Pavia made an announced prelicensing inspection, on above date. LPA met with applicant, Audra Stance and toured the office building. The applicant is applying for a Transitional Housing Placement Program (THPP) license. Files will be kept locked in a filing cabinet in the office, on site. If needed, confidential meetings can be held at the THPP office with a locked door. All staff at the participant living units will be fingerprint cleared prior to accepting any admissions. LPA discussed records required for staff and participants. This facility is ready for licensure once the Licensing Program Manager (LPM), has reviewed and approved the application. LPA will notify you of licensure date and email facility license.

visit_type: Prelicensing


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Vaishali Singh-Sood made an announced post-licensing inspection at the Foster Family Agency (FFA), on above date at 9: AM. LPA met with Executive Assistant, Vissana Khounvichith, who assisted with the inspection. B.W.I.T Foster Family Agency office will house personnel occasionally for the FFA including the Administrator and social work staff. Currently the Agency has two social workers and one Social work Supervisor. LPA observed sufficient office space and a location where files are kept double locked and secured. LPA also observed sufficient space for social work staff to have work space as well as locked cabinet areas. Observed was a current fire extinguisher. At this time, Agency does not have facility sketch posted and will post by the end of business today 9/13/2023. Bathrooms are located outside agency office and are locked. Agency staff have keys to access restrooms as needed. During a review of the mass casualty and disaster plan, information was missing regarding points of contact. Agency agrees to complete the updates by the end of business 9/14/2023, and will submit to the department by that day. The agency currently has one family who is approved, and one that is in process of having their approval completed. A review of the guardian system shows all staff are cleared to work in the Agency. Office organization is as follows: Second story small office with one main area with entrance and waiting. Coffee station, office / mail, reception are (all of which are shared). Office space for all staff and social work staff with locked cabinet space. Training is conducted on Zoom, or in the office. Based on this pre-licensing inspection, the FFA is in compliance according to Title Regulations and Interim Licensing Standards (ILS version 6). After a final file review, the facility will be submitted for licensure. An exit interview was conducted at 12: PM, and a copy of this report was given emailed to Ms. Stance.

met_with: Vissana Khounvichith


summary: Facility Evaluation

raw_content:
Narrative:
On 4/15/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a random annual inspection and met with Director Audra Stance. LPA informed of the purpose of the visit. Using the CARE Inspection Tool, LPA inspected facility client and personnel records. Documentation reviewed today reflects that staff have background clearances. Client records were observed to be complete, except for safeguarded cash records, which do not clearly document the amonut of money provided and saved. Records of electronic payments were supplied. Additionally, LPA advised of telephone requirements in housing units and the requirement to include facility license number in advertisements. A continuation visit is needed to complete the review of the personnel records. One deficiency citation was issued: AB Nonminor Dependent THPP Interim Licensing Standards (ILS) Section 86270. See attached LIC 809-D. An exit interview was conducted, appeal rights were provided, and a copy of this report was left with Director Audra Stance, whose signature on this form confirms receipt.


summary: Facility Evaluation

raw_content:
Narrative:
On 5/22/24, Licensing Program Analysts (LPAs) Mariah Hawkins and Mona Lam conducted an annual continuation inspection. LPAs met with Director Audra Stance and informed of the purpose of the visit. During the initial visit on 4/15/24, participant/client records and some personnel records, including background clearances, were reviewed. At today's visit, LPAs inspected personnel records and followed-up on the participant/client cash records reviewed at the initial visit. LPAs also discussed necessary revisions to the recently submitted age exception requests. LPAs observed one staff file to be missing health screening documentation and advised that documentation be maintained. No citations were issued at today's visit. An exit interview was conducted, appeal rights discussed, and a copy of this report was left with Director Audra Stance.