summary: Complaint Investigation - Unsubstantiated - 3 allegations

raw_content:
Narrative:
...CONTINUED Confidential interviews indicated these inappropriate interactions were occurring regularly in C1 and C2's shared bedroom months before they were reported. Confidential interviews and records reviewed indicated that C2 turned 18 years old 12 days before the above allegation was lodged, and C2 was discharged from the group home within a week. Confidential interviews indicated that C1 had a trusting relationship with staff despite not reporting C2's behaviors previously. A confidential interview indicated that C1 may have reported C2's inappropriate behaviors after C2 turned 18 years old to get C2 removed from the home due to other conflict between the two clients. Confidential interviews yielded conflicting information regarding how often staff were checking on clients while in their bedrooms, even after the alleged incidents between C1 and C2 were reported; however, it was reported that staff were always present at the facility, available for clients if they needed help, and redirected clients who were engaging inappropriately with their peers. Confidential interviews and records reviewed indicated that there were no known sexualized behaviors for staff to be watchful of C2 prior to the above incidents being reported. A confidential interview indicated that C1 would close the bedroom door for privacy making it difficult for staff to maintain supervision of C1 and C2 prior to C2's discharge. Based on confidential interviews and records reviewed, the allegation that lack of supervision resulted in a minor engaging in inappropriate activity is unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted with Monica McDade, Administrator and a copy of this report and appeal rights were provided.

Investigation Findings:
13On April 3, 2025, at 3: PM, Licensing Program Analysts (LPAs) Jacob Salem and Lisa Bernabe met with Monica McDade, Administrator of Zen House to deliver the finding for the above-stated allegation. LPA Carol Anderson initiated a complaint inspection at the facility on 5/30/2024 at 10: AM and no immediate deficiencies were observed. During the investigation, LPA Salem interviewed Staff (S1-S3), Clients (C1-C3), and a county social worker. Pertinent records were obtained and reviewed. On May 23, 2024, Community Care Licensing (CCL) received an allegation that lack of supervision resulted in a minor (C2) engaging in inappropriate activity. It was reported that C2 was making sexualized comments to their roommate (C1) and masturbating in front of C1, who was 16 years old. It was reported that the ongoing occurrences started while C2 was a minor and continued after C2 turned 18 years old while still in the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: Jacob Salem LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # San Diego, CA Facility Name: Zen Housefacility Number: Visit Date: 04/03/ Narrative 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32...CONTINUED Confidential interviews indicated these inappropriate interactions were occurring regularly in C1 and C2's shared bedroom months before they were reported. Confidential interviews and records reviewed indicated that C2 turned 18 years old 12 days before the above allegation was lodged, and C2 was discharged from the group home within a week. Confidential interviews indicated that C1 had a trusting relationship with staff despite not reporting C2's behaviors previously. A confidential interview indicated that C1 may have reported C2's inappropriate behaviors after C2 turned 18 years old to get C2 removed from the home due to other conflict between the two clients. Confidential interviews yielded conflicting information regarding how often staff were checking on clients while in their bedrooms, even after the alleged incidents between C1 and C2 were reported; however, it was reported that staff were always present at the facility, available for clients if they needed help, and redirected clients who were engaging inappropriately with their peers. Confidential interviews and records reviewed indicated that there were no known sexualized behaviors for staff to be watchful of C2 prior to the above incidents being reported. A confidential interview indicated that C1 would close the bedroom door for privacy making it difficult for staff to maintain supervision of C1 and C2 prior to C2's discharge. Based on confidential interviews and records reviewed, the allegation that lack of supervision resulted in a minor engaging in inappropriate activity is unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted with Monica McDade, Administrator and a copy of this report and appeal rights were provided. SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: Jacob Salem LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: LIC9099 (FAS) - (06/04)Page: 2 of 2

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

met_with: Monica McDade, Administrator


state: CA

facility_name: ZEN HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
On May 14, 2021 at 2:00PM, Licensing Program Analyst (LPA) Carol Anderson conducted a follow-up pre-licensing inspection for the purpose to inspect Zen House Group Home Outdoor Activity Space and Indoor Activity Space. LPA met with Facility Administrator, Monica McDade. On February 12, 2021, LPA completed a pre licensing inspection via tele-inspection with Facility Administrator Monica McDade. During today's inspection, LPA toured the indoor and outdoor areas of the facility. LPA observed the following areas: Front yard: Fully fenced and a large space covered with dirt and trees. Backyard: Patio area was partially fenced on the side of the facility, one outdoor patio bench. Common area: Living room and dining room is available for client's indoor activities. Hot water temperature was tested and reading at 107 degrees. Smoke alarms were tested and properly working. All areas of the facility were evaluated to include the physical plant, food service area, medication storage area, required furnishings, and any potential hazards in and around the facility. No deficiencies noted. Facility Administrator, Monica McDade stated that front yard will be a grassy area for clients to play in the front yard. Facility Administrator stated the backyard will have a tether ball and various age appropriate toys and games available for clients. Facility Administrator, Monica McDade stated clients will be taken to public park in the area. Exit interview was conducted and a copy of this report was signed and given to Facility Administrator, Monica McDade.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Monica McDade


summary: Facility Evaluation

raw_content:
Narrative:
On August 13, 2021 at 11:00AM, Licensing Program Analysts (LPA) Carol Anderson conducted a post-licensing. LPA met with Licensee/Facility Administrator Monica McDade. Currently there is no clients residing at the facility at this time. The facility is a one-story house with three bedrooms, two bathrooms, kitchen, dining room, living room, laundry room, and a two-car garage. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris. There is adequate indoor and outdoor activity space. Medications will be locked in a closet in a hall closet. The facility smoke detectors and carbon monoxide detectors were tested and were observed to be in working order; fire extinguisher is properly charged and serviced. The facility has a fully equipped first aid kit and first aid manual. The facility does not have cameras. The Licensee stated there were no weapons in the facility. Cleansers/chemicals were stored locked in laundry area. Sharp knives were made inaccessible and stored in a locked cabinet. The following required forms were posted in the facility: Weekly Menu, Personal Rights form, and California "See Something Say Something Poster". Client and personnel files will be locked in file cabinet in the staff's area. The bedrooms are set up as follows: Bedroom 1: designated for one client, one twin bed, one dresser drawer, night stand, closet space, night lamp. Bedroom 2: designated for one client, one twin bed, one dresser drawer, night stand, closet space, night lamp. Bedroom 3: designated for two clients, twin beds, two dresser drawers, two night stands, closet space, night lamp. Each room has adequate clean linens, pillows, blankets, comforters, mattress pads, and mattresses. The hot water in the children's bathroom was measured to be 107 degrees Fahrenheit. Criminal Background and Child Abuse Clearances are complete and current for all employees. LPA requested LIC 308, LIC 309, LIC 408, LIC 500 and LIC 610C to be updated and submitted to Community Care Licensing (CCL) within 30 days The facility has demonstrated compliance with Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report was given to Licensee/Facility Administrator Monica McDade.


summary: Facility Evaluation

raw_content:
Narrative:
On May 12, 202 at 10:30AM, Licensing Program Analysts (LPA) Carol Anderson conducted an annual/required. LPA met with Licensee/Facility Administrator Monica McDade. Currently there is no clients residing at the facility at this time. Also, no staff are employed at this facility at this time. The facility is a one story house with three bedrooms, two bathrooms, kitchen, dining room, living room, laundry room, and a two car garage. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris. There is adequate indoor and outdoor activity space. Medications will be locked in a closet in a hall closet. The facility smoke detectors and carbon monoxide detectors were tested and were observed to be in working order; fire extinguisher is properly charged and serviced. The facility has a fully equipped first aid kit and first aid manual. The facility does not have cameras. The Licensee stated there were no weapons in the facility. Cleansers/chemicals were stored locked in laundry area. Sharp knives were made inaccessible and stored in a locked cabinet. The following required forms were posted in the facility: Weekly Menu, Personal Rights form, and California "See Something Say Something Poster". Client and personnel files will be locked in file cabinet in the staff's area. The bedrooms are set up as follows: Bedroom 1: designated for one client, one twin bed, one dresser drawer, night stand, closet space, night lamp. Bedroom 2: designated for one client, one twin bed, one dresser drawer, night stand, closet space, night lamp. Bedroom 3: designated for two clients, twin beds, two dresser drawers, two night stands, closet space, night lamp. Each room has adequate clean linens, pillows, blankets, comforters, mattress pads, and mattresses. The hot water in the children's bathroom was measured to be 119 degrees Fahrenheit. Criminal Background and Child Abuse Clearances are complete and current for all employees. LPA requested LIC 308, LIC 309, LIC 408, LIC 500 and LIC 610C to be updated and submitted to Community Care Licensing (CCL) within 30 days The facility has demonstrated compliance with Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report was given to Licensee/Facility Administrator Monica McDade.

visit_type: Annual


summary: Facility Evaluation

raw_content:
Narrative:
On May 24, 2023, at 10:30AM, Licensing Program Analyst (LPA) Carol Anderson arrived at the facility to conducted an annual/required inspection. LPA knocked on the door, no answer. LPA contacted Licensee/Facility Administrator Monica McDade via cell phone. Licensee stated that she was with one client attending a school meeting and will return at by 11:30AM. On 11:30AM, LPA Anderson returned to the facility to conduct the annual/required inspection. The facility is a one story house with three bedrooms, two bathrooms, kitchen, dining room, living room and laundry room, and a two car garage. LPA interviewed one of four clients. Two clients were at school, Licensee was the only staff working at the time of inspection. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris. There is adequate indoor and outdoor activity space. Medications are locked in a closet in a hall closet. The facility smoke detectors and carbon monoxide detectors were tested and were observed to be in working order; fire extinguisher is properly charged and serviced. The facility has a fully equipped first aid kit and first aid manual. The hot water temperature was measured in the bathroom and is currently 114 degrees The facility has cameras located living room, dining area and cameras are in the backyard. The Licensee stated there were no weapons in the facility. Cleansers/chemicals were stored locked in laundry area. Sharp knives were made inaccessible and stored in a locked cabinet hall closet. Continue...... The following required forms were posted in the facility: Weekly Menu, Disaster plan, facility sketch, house rules, visitation policy and sign in sheet and Personal Rights form, and California "See Something Say Something Poster". Client files and staff files are locked in file cabinet in the staff's area. Also, staff files are maintained electronically on HR "Dropbox" database via Apple icloud. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. Based on today's visit there are no deficiencies observed at this time. An exit interview was conducted, a copy of this report was provided to Licensee/Facility Administrator Monica McDade.


summary: Facility Evaluation

raw_content:
Narrative:
On June 9, 2023, at 3:10PM, Licensing Program Analyst (LPA) Carol Anderson conducted an unannounced inspection of the facility. The purpose of the inspection is to conduct an annual continuation to interview staff and clients. LPA met with Licensee /Facility Administrator Monica McDade. LPA interviewed staff and clients. LPA conducted a safety inspection of the facility, there were no safety concerns observed. Based on today's visit there are no deficiencies observed at this time. An exit interview was conducted, a copy of this report was provided to Licensee/Facility Administrator Monica McDade.


summary: Facility Evaluation

raw_content:
Narrative:
On May 30, 2024, at 11:20AM, Licensing Program Analyst (LPA) Carol Anderson conducted an unannounced annual/required inspection at the facility. LPA met with Licensee/Facility Administrator Monica McDade. Currently there are three clients residing at this facility. LPA inspected the interior and exterior of the facility: Facility grounds are clean and free of debris. There is adequate indoor and outdoor activity space. Medications are locked in a closet in a hall closet. The facility smoke detectors and carbon monoxide detectors were tested and were observed to be in working order; fire extinguisher is properly charged and serviced. The facility has a fully equipped first aid kit and first aid manual. The hot water temperature was measured in the bathroom and is currently 116 degrees. The facility has cameras located living room, dining area and cameras are in the backyard. Per Licensee Monica McDade stated there were no weapons in the facility. Cleansers/chemicals were stored locked in laundry area. Sharp knives were made inaccessible and stored in a locked cabinet hall closet. The following required forms were posted in the facility: Weekly Menu, Disaster plan, facility sketch, house rules, visitation policy and sign in sheet and Personal Rights form, and California "See Something Say Something Poster". Client files and staff files are locked in file cabinet in the staff's area. Also, staff files are maintained electronically on HR "Drop box" database via Apple cloud. Due to time constraints, the annual/required inspection is being extended for another date and time to review staff and client files and interview staff and clients. Based on today's inspection there are no deficiencies cited An exit interview was conducted, a copy of this report was provided to Licensee/Facility Administrator Monica McDade.


summary: Facility Evaluation

raw_content:
Narrative:
On September 5, 2025 at 10: AM, Licensing Program Analyst (LPA) Lucero Jauregui arrived to the facility unannounced and met with Monica McDade, Licensee/ Administrator. The purpose of the visit is to conduct an annual inspection. Facility serves 4 male ambulatory clients, age range from 13 to 18 years old. The facility is a one story home with three bedrooms, living room, dinning area, kitchen, two bathrooms, patio, and garage. The bedrooms are set up where there are no more than two clients per bedrooms. Two bedrooms are occupied by one client and one bedroom is occupied by two clients with a bathroom. Each bedroom has adequate drawer and closet space for clients belongings. In bedroom hallway there is a washer, dryer, bathroom, and closet. Closet in the hallway contains clean towels and bed sheets. The hot water temperature was measured to be 120.2 degrees Farenheit. LPA advised Licensee water temperature to be adjusted. Medication is maintained locked in tall file cabinet in the common area. There is a closet in common area for staff use that is maintained locked at all times. Sharps, first aid kit and fire extinguisher is maintained in staff closet. There is a garage in the back patio used for storage and an extra refrigerator. Per Administrator garage is maintained locked at all time. A physical plant inspection was conducted and included the following checks: Fire extinguisher is charged and in service. Smoke detector was tested and in working order. There is adequate indoor and outdoor space for client use. There is exercise equipment in the back patio for client use. There are sufficient board games, games, arts and crafts for client educational and recreational use. LPA observed chemicals and hazardous materials maintained locked. Continued..... LPA observed the following items posted: Emergency Disaster Plan, Facility License, Administrator Certificate, If you See Something Say Something, House Rules, Visiting Policy and Facility Sketch. Client files are maintained locked in medication file cabinet, staff files are maintained online and are accessible for review. LPA reviewed 4 client files and 6 staff files (see LIC Confidential Name List dated September 5, 2025). Client and Staff files contained all required items. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. LPA conducted one staff interview. LPA was unable to conduct client interviews due to clients not present at time of inspection. Per Administrator there are no firearms or weapons in the home. Based on today's inspection and observations there are no deficiencies cited at this. An exit interview was conducted with Monica McDade. A copy of this signed report and appeal rights were provided to Monica McDade.

met_with: Monica McDade, Licensee/ Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On August 22, 2023, at 4:10 pm, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Monica McDade, Facility Administrator, to assess a Civil Penalty. LPA Linley conducted confidential interviews and a record review and noted there were three individuals who did not have a criminal record clearance prior to working at the facility. Photos and videos showed Staff #1 and Staff #2 working at the facility and a record review indicated Staff #3 was also working at the facility. LPA reviewed Guardian to ensure that staff had a criminal record clearance and the staff were not cleared to work with children. LPA Linley requested copies of the staff roster and asked for any supporting documents the facility may have. Monica McDade, LPA Linley is administering three civil penalties during this visit. The facility is being cited for the violation of California Code of Regulations, Title 22, Division Six, regulation 80019(e) Criminal Record Clearance. Record review confirms S1, S2, and S3 have worked in the facility without a criminal record clearance. An immediate civil penalty is being issued for $1,500. An exit interview was conducted with Monica McDade, Program Administrator. A copy of this report and appeal rights were provided to Monica McDade Program Administrator


facility_name: ZND RESIDENTIAL, INC

summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Lidia Tinoco conducted an unannounced visit to ZND Residential Group Home in order to deliver the findings of the above allegations and met with Administrator, Zeb Graves. On March 19, 2021 the above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Home, interviews with the Reporting Party, children, Resource and a review of facility and children's records. The complaint alleged that the group home staff injured a minor in care. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the allegation occurred. Therefore, the allegation is UNSUBSTANTIATED at this time. A copy of this report was discussed and provided to Zeb Graves along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

report_type: Complaint Investigation

met_with: Zeb Graves

complaint_status: unsubstantiated


raw_content:
Investigation Findings:
13Complaint Specialist C.K. Kinney(CS) traveled to ZND Residential and met with Zeb Graves to deliver findings of investigation. Investigator Barragan conducted investigation that included review of documentation, interviews of staff and of clients. Due to inconsistencies in the information obtained a preponderance of the evidence could not be found the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed unsubstantiated. No deficiencies observed or cited during this inspection. Copy of this report and LIC Appeal Rights left at the facility at conclusion of the inspection UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Charles Kinney LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2


summary: Facility Evaluation

raw_content:
Narrative:
On 06/29/ An unannounced annual inspection was conducted by LPA (Licensing Program Analyst) Lidia Tinoco and CS (Complaint Specialist) Charles Kinney at ZND Residential Group Home. LPA's met with Zeb Graves and inspected the facility, inside and out. Centrally stored medications are maintained in a locked cabinet. Sharps and Toxic chemicals are kept locked. The facility has a written emergency disaster plan. All facility smoke detectors were tested and appear to be in appropriate working order, fire extinguisher is properly charged. Individual beds were observed with appropriate clean linens and are in good repair. There is at least one-week supply of nonperishable and a two-day supply of perishable foods. Facility has cameras in common areas of the facility. Administrator Zeb Graves is present at the facility a minimum of 20 hours a week, as verified by staff schedule and interviews. The facility employs 1 facility manager and 2 direct care staff. 3 records of personnel/ staff members were reviewed with Zeb Graves to ensure staff meet regulatory requirements. All personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. Personnel Files are maintained on-site. No youth are placed at the facility at this time. There were no deficiencies to be cited on this date.


summary: Facility Evaluation

raw_content:
Narrative:
On October 28, 2022, Licensing Program Analyst (LPA) Les Inouye made an unannounced annual required inspection at this facility. LPA was met by Zeb Graves An inspection of the facility was conducted, and the following was observed: No clients were residing in the home; therefore, no client nor staff files were inspected on this date. Licensee stated that they have this facility closed at the moment due to converting to a STRTP. LPA is reviewing the ZND residential application at this time. The facility was inspected indoors and outdoors. Hot water temperature measured at 117 degrees. There are no bodies of water at the facility. Facility Grounds are clean and free of debris or observable hazard. Adequate indoor and outdoor activity space and materials observed. Chemicals appropriately locked. Locked and centrally stored medications observed. First aid kit complete with appropriate manual observed. Adequate storage space observed. Individual beds in good repair observed, equipped with good springs, clean mattresses and pillows observed. Individual beds were observed with appropriate clean linens in good repair. Adequate supply of additional bedding and linens observed. No firearms or weapons are in the facility. LPA left a copy at the facility. The visit was then concluded


facility_name: 2ND HOME INC-SAMPLE

raw_content:
Investigation Findings:
13Complaint Specialist C.K. Kinney(CS) traveled to 2nd Home-Sample and met with House Manager Emily Logan to deliver findings of investigation. CS conducted investigation that included review of documentation and confidential interviews. Based on inconsistencies in the information obtained CS could not reach a preponderance of the evidence that the allegations occurred as reported. 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. Copy of this report and Appeal Rights left at the facility at conclusion of inspection. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Charles Kinney LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

met_with: Emily Logan


raw_content:
Investigation Findings:
13On this date, Licensing Program Analyst (LPA) Leslie Inouye conducted a complaint inspection for the Short Term Residential Therapeutic Program (STRTP) for the purpose of delivering the findings for the above complaint allegation. LPA met with Administrator Maria Corona. During the course of investigating the allegation, LPA conducted interviews with staff members and the children, conducted a record review and obtained information. The information revealed inconsistencies, that the clients placed in the facility are afraid of staff members. During interviews client claimed that the staff they were afraid of is the same staff they would go to if they had feelings of leaving the facility. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the above allegation occurred, therefore the above allegation is unsubstantiated UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Les Inouye LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

met_with: Maria Corona


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Leslie Inouye conducted a follow up complaint inspection at the Short Term Residential Therapeutic Program (STRTP) and met with Emily Logan . The purpose of the inspection was to deliver the findings for the above complaint allegation. During the course of investigating the allegation, LPA conducted interviews and reviewed documentation. Based on the findings, Staff#1 performed a manuel restraint on client #1. Due to the size ratio of staff and client a manuel restraint was not appropriate to ensure the safety of the client. During the manuel restraint staff #2 assisted in a 2 person hold which ensured everyones safety. Based on the information that was gathered, there is a preponderance of evidence that initial assessment and staffing was not appropriate for the needs of the clientel when emergency interventions are required. Appropriate staffing for emergency interventions was not available and clients that was restrained were potientially subject to injury. Facility cited for violation of General Regulations 870078(a) Responsibility for Providing Care and Supervision. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Les Inouye 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 24-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, E SHAW AVE FACILITY NAME: 2ND HOME INC-SAMPLEFACILITY NUMBER: 107207223

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Leslie Inouye conducted a follow up complaint inspection at the Short Term Residential Therapeutic Program (STRTP) 2nd Home - Sample and met with Emily Logan. The purpose of the inspection was to deliver the findings for the above complaint allegation. During the course of investigating the allegation, LPA conducted interviews and reviewed documentation. Based on the findings, Staff #1 did act inappropriately with client #1. During supervision, client #1 approached Staff #1. Staff #1 inappropriately used a disengagement technique and used a pen to create personal space. Staff #1 made contact (with the Pen) with Client #1 which caused a bruise on the abdomen. Based on the information that was gathered, there is a preponderance of Staff was inappropriate with client. Facility cited for violation of Interim Licensing Standards, Short-Term Therapeutic Program, Articles 1 through 10, Regulation 87072 (c)(16) Personal rights. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Les Inouye 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 24-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FRESNO RO, E SHAW AVE FACILITY NAME: 2ND HOME INC-SAMPLEFACILITY NUMBER: 107207223


summary: Facility Evaluation

raw_content:
Narrative:
On the date above a pre licensing visit was conducted at Sample House by Licensing Program analyst (LPA) Les Inouye. Sample House is currently operating Group Home facility transitioning to a Short Term Residential Treatment Program (STRTP) facility. I was met by Administrator Jennifer Fish and Emily Logan. A review of the Physical Plant was conducted including the Indoor Activity Space, Fixtures Furniture Equipment and Supplies and Outdoor Activity Space. Kitchen was clean and non-perishable and perishable items were observed in the kitchen. Bedrooms were observed, 3 single occupancy for a capacity of 3. The house currently preparing to convert to a STRTP and additional furnishings are being stored at the facility. All rooms were appropriately furnished with storage area was observed. All chemicals and cleaning supplies were locked and secured. Smoke Alarms and Carbon Monoxide detectors were observed and operating. Hot water temperature was measured at 119 degrees. Back yard, there is no pool or hot tub, yard consisted of a lawn area with covered patio area. The physical plant review was observed to be clean, safe, and free of hazards. A review of the Program Statement and Plan Of Operation is ongoing by CCL and updates will reviewed. At this time, it is recommended that the facility be licensed as an STRTP.

visit_type: Prelicensing

met_with: Jennifer Fish


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPAs) Lisa Slusher travelled to the facility listed above to conduct a prelicensing inspection. Facility Inspection conducted. 1. Facility Grounds are free of hazard. 2. Adequate indoor and outdoor activity space and materials observed. 3. Chemicals appropriately locked. 4. Locked and centrally stored medications observed. Observed medication logs and discussed procedures for psychotropic medications. 5. First aid kit complete with appropriate manual observed. 6. Adequate storage space observed. 7. Individual beds in good repair observed. 8. The house has 3 bedrooms, double occupancy, all are located on a single floorr, all are equipped with required furnishings. 9. Adequate food storage space observed. Supply of two days of perishable foods and a week of nonperishable foods observed upon inspection. 10. Weekly menu posted and accessible to clients. 11. Dining room equipped with large table and chairs accommodating of all clients. 12.Facility has two full restrooms in the house for client use, both are operable. 13. Appropriate forms posted in view of facility clients. 14. No firearms or weapons are allowed in the facility. The following items were discussed and reviewed by LPA during Inspection 1. LIC Reviewed to ensure appropriate staffing ratios, including Administrator, Social Work personnel, and Direct Care staff. The facility does not utilize Peer Partners at this time. Facility will submit an updated LIC 500 to LPA. 2. Administrator Emily Logan is present on-site a minimum of 20 hours per week. 3.Personnel Records reviewed on this date. 4. Facility has current Mental Health Program Approval, Expiring in October 2023.

met_with: Jennifer Fish, Emily Logan


summary: Facility Evaluation

raw_content:
Narrative:
On this date, an unannounced annual inspection follow-up is conducted on this date. Client (5) and staff interviews conducted. There are no deficiencies to be cited on this date.


summary: Facility Evaluation

raw_content:
Narrative:
On this date, a post licensing inspection is completed by LPA (Licensing Program Analyst) Lisa Slusher. Prior to this date, an updated license was provided to the licensee. The license is no longer provisional as the provider has full MHPA and accreditation through CARF. Received updated staff schedule which verifies appropriate client/staff ratios. An annual continuation inspection is also completed on this date with interviews documented on that inspection. Staff and client files reviewed prior to this date.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Tamara Melikian and Reyna Martinez on January 22, 2024 at 1: PM. This case management inspection is conducted pursuant to Health and Safety Code 1538.9(a)(2). During the inspection, LPAs met with Emily Logan, Administrator and inspected the facility inside and out. LPAs reviewed 2 child's records and 2 staff personnel files on site at the facility. LPAs reviewed 2 child's psychotropic medications and medication records. LPAs interviewed 2 staff on site to discuss the facilities policies and procedures of operation. LPAs attempted to interview 2 children currently on psychotropic medication but both children refused. LPAs provided a copy of the licensing report to Emily Logan, Administrator. No deficiencies are being cited at this time. LPAs conducted exit interview with Emily Logan, Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On September 12, 2024, Licensing Program Analyst (LPA) Leslie Inouye conducted an unannounced Annual Inspection at 2nd Home Sample located in Clovis CA. LPA met with Jennifer Fish. A physical plant inspection was completed and included the following checks. Adequate indoor and outdoor activity space and materials observed. The facility is maintained at 72 degrees. All facility smoke detectors are in appropriate working order, fire extinguisher is properly charged and serviced in March 2024. Facility maintains an adequate supply of perishable and non-perishable foods. All required forms are posted. Medications are locked and centrally stored. Individual beds were observed. The facility process of being approved through Fresno County Department of Behavioral Health, to be completed April 2024. No firearms or weapons are observed in the facility. LPA reviewed 4 client files, and 7 staff files. LPA interviewed 2 staff and 2 client. LPA discussed the medication logs, all required forms, intake process, needs and services plan with updates, STRTP, mental health services, and disaster preparedness plan and emergency intervention plan. 1 deficiency are being cited on today's visit. A copy of this report was left at the facility at the conclusion of today's inspection.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Reyna Martinez on January 23, 2025 at 10: AM. This case management inspection is conducted pursuant to Health and Safety Code 1538.9(a)(2). During the inspection, LPA met with Emily Logan, Administrator and inspected the facility inside and out. LPA reviewed 3 child's records and 2 staff personnel files on site at the facility. LPA reviewed 3 child's psychotropic medications and medication records. LPA interviewed 2 staff on site to discuss the facilities policies and procedures of operation. LPA was unable to conduct any interviews due to the children currently on psychotropic medication due to the children being in school. LPA will interview children at a later time. LPA provided a copy of this licensing report to Emily Logan, Administrator. No deficiencies are being cited at this time. LPA conducted exit interview with Emily Logan, Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date Licensing Program Analyst (LPA) Les Inouye arrived at 2nd Home - Sample at Sample Ave Clovis. LPA was met by Administrator Andres. LPA explained the purpose of the inspection to follow up on information submitted on an Incident report. regarding Client #1.

met_with: Andres Lopez-Solorio


summary: Facility Evaluation

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Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Melissa Renovato and Briana Placencia on February 5, 2026 at 9: AM. This case management inspection is conducted pursuant to Health and Safety Code 1538.9(a)(2). During the inspection, LPAs met with Emily Logan, Administrator and inspected the facility inside and out. LPAs reviewed 2 child records and 2 staff personnel files on site at the facility. LPAs reviewed 2 child psychotropic medications and medication records. LPAs interviewed 2 staff on site to discuss the facilities policies and procedures of operation. LPAs were unable to conduct any interviews as the children currently on psychotropic medication are at school. LPAs will interview children at a later time. LPAs provided a copy of this licensing report to Emily Logan, Administrator. LPAs conducted exit interview with Emily Logan, Administrator


facility_name: SECOND HOME, INC. - SAN JOSE

raw_content:
Investigation Findings:
13On this date, Licensing Program Analyst (LPA) Lourey Bartolome contacted Second Home Inc. - San Jose and met with Jennifer Fish to discuss the findings on this investigation. Licensing Program Analyst conducted the investigation that included review of documentation and interviews. Based on the information obtained, the above mentioned allegation could not be proven with a preponderance of the evidence. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur, therefore the allegation is deemed unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Melanie Krage LICENSING EVALUATOR NAME: Lourey Bartolome LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2


raw_content:
Investigation Findings:
13On this date, Licensing Program Analyst (LPA) Lourey Bartolome contacted Second Home Inc. - San Jose and met with Jennifer Fish to discuss the findings on this investigation. Licensing Program Analyst conducted the investigation that included review of documentation and interviews. Based on the information obtained, the above mentioned allegations could not be proven with a preponderance of the evidence. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur, therefore the allegations are deemed unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Melanie Krage LICENSING EVALUATOR NAME: Lourey Bartolome LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2


raw_content:
Investigation Findings:
13On this date, Licensing Program Analyst (LPA) Leslie Inouye conducted a complaint inspection for the Short Term Residential Therapeutic Program (STRTP) for the purpose of delivering the findings for the above care and supervision complaint allegation. LPA met with Alison Tolladay. During the course of investigating the allegation, LPA conducted interviews with staff members and the children in placement, conducted a record review and obtained information. The information revealed inconsistencies in the reporting of the event, the persons involved and the time in which the event occured. Supervision during the allegation was appropriate. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the above allegation occurred, therefore the above allegation is unsubstantiated UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Les Inouye LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

met_with: Alison Tolladay


summary: Facility Evaluation

raw_content:
Narrative:
On November 1, 2021, Licensing Program Analyst (LPA) Les Inouye conducted an annual inspection of the facility indicated above. Met at the agency by House Manager Emily Logan and Administrator Jennifer Fish. An inspection of the physical plant was conducted. LPA observed adequate food supply, appropriately maintained yard, adequate bedding, storage space, activity space, hot water that measured 110 degrees and lamps, toiletries and a facility that is safe, sanitary and in good repair. Staff files and were inspected on this date. In addition, client files and medication logs were inspected on this date. At 10: Entrance interview and physical plant inspection. At 11: AM, Client file review was conducted. At 2: PM, Staff files review was conducted. The exit interview was conducted at 4: PM and a copy of this report given to Lindsay Quiring. It is requested that the licensee submit the following updated forms to CCL: LIC 308, 309, 500. In addition, client files and medication logs were inspected on this date.


summary: Facility Evaluation

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Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Reyna Martinez on April 25, 2024 at 10: AM. This case management inspection is conducted pursuant to Health and Safety Code 1538.9(a)(2). During the inspection, LPA met with Andres Lopez-Solorio, Administrator and inspected the facility inside and out. LPA reviewed 3 child's records and 2 staff personnel files on site at the facility. LPA reviewed 3 child's psychotropic medications and medication records. LPA interviewed 2 staff on site to discuss the facilities policies and procedures of operation. LPA interviewed no children currently psychotropic medication as they were in school at this time. LPA will attempt interview with children at a later time. LPA provided a copy of the licensing report to Administrator, Andres Lopez-Solorio. No deficiencies are being cited at this time. LPA conducted exit interview with Andres Lopez-Solorio, Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Lisa Slusher travelled to the facility listed above to conduct an Annual Inspection. Met at the facility by Facility Manager with one client present. Facility manager Andres Lopez-Solario arrived a short time later, and Executive Director Jennifer Fish also met with this LPA. Mental Health Program Approval through Fresno County expiring in April 21,2025 . The facility is accredited through CARF and their accreditation through 9/2026 . 1. Facility Grounds are well kept, with ample activity features and space 2. Adequate indoor activity space and items observed. 3. Cleaning solutions stored in locked cabinets. 4. Locked and centrally stored medications observed. Licensee has made provisions for contraceptives to be held in individually locked containers by clients. Observed medication logs and discussed procedures for psychotropic medications. 5. First aid kit complete with appropriate manual observed. 6. Adequate storage space observed. 7. Individual beds in good repair observed. 8. The house has 4 bedrooms, a mixture of single and double occupancy all located on one single level. Bedrooms are accommodating of all required furnishings. 9. Adequate food storage space observed. Supply of two days of perishable foods and a week of nonperishable foods observed upon inspection. 10. Weekly menu posted and accessible to clients. 11.Dining room equipped with large table and chairs accommodating of all clients. 12.Facility has two full restrooms in the house for client use, both are operable 13. Facility has no animals or firearms personnel files reviewed, 3 client records reviewed. LPA requests the following updated forms/items: LIC 308, Designation of facility responsibility; LIC 309, Administrative Organization; LIC 400, Affadavit regarding client cash resources; LIC 500, personnel report; LIC 610, Emergency Disaster plan; LIC 9020, client roster; current lease agreement/control of property


summary: Facility Evaluation

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Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Briana Placencia on May 14, 2025 at 9: AM. This case management inspection is conducted pursuant to Health and Safety Code 1538.9(a)(2). During the inspection, LPA met with Andres Lopez-Solorio, Administrator and inspected the facility inside and out. LPA reviewed 2 child's records and 2 staff personnel files on site at the facility. LPA reviewed 2 child's psychotropic medications and medication records. LPA interviewed 2 staff on site to discuss the facilities policies and procedures and plan of operation. LPA was unable to conduct any interviews as the children currently on psychotropic medication are at school, they will be interviewed at a later time. LPA provided a copy of this licensing report to Andres Lopez-Solorio, Administrator. No deficiencies are being cited at this time. LPA conducted exit interview with Andres Lopez-Solorio, Administrator.


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) Les Inouye conducted an unannounced Case Management inspection to the Short Term Residential Therapeutic Program (STRTP) and met with Jennifer Fish. . Based on information received by phone call and Initial Incident Reporting by Jennifer Fish it has been determined the STRTP failed to provide appropriate supervision in compliance with 87065.2 (a)(2). Based on the LPA's observations, interviews and records review which were conducted, there is a preponderance of evidence to substantiate a violation of regulation based on Title 22, Division 6, Chapter 1 and are being cited on the attached LIC 809D A copy of the report and Appeal Rights was provided to the FFA.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Les Inouye conducted an unannounced Case Management inspection to the Short Term Residential Therapeutic Program (STRTP) and met with Jennifer Fish. . Based on documents (Incident Reports) provided by Debbie Bordner it has been determined the STRTP failed to provide (IR's) in compliance with 80061(b). Based on the LPA's observations and records review which were conducted, there is a preponderance of evidence to substantiate a violation of regulation based on Title 22, Division 6, Chapter 1 and are being cited on the attached LIC 809D A copy of the report and Appeal Rights was provided to the FFA.


facility_name: SECOND HOME, INC. - TENAYA HOUSE

raw_content:
Investigation Findings:
13On this date, Licensing Program Analyst (LPA) Leslie Inouye conducted a complaint inspection for the Short Term Residential Therapeutic Program (STRTP) for the purpose of delivering the findings for the above complaint allegation. LPA met with Heiddy Arr. During the course of investigating the allegation, LPA conducted interviews with staff members and the clients, conducted a record review and obtained information. The information revealed inconsistencies. Clients are aware that staff are positioned to supervise during sleeping hours. It is unclear if the inappropriate touching occured in which there would have been a breakdown in supervision. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the above allegation occurred, therefore the above allegation is unsubstantiated UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Les Inouye LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

met_with: Chris Kertzman


raw_content:
Investigation Findings:
13On this date, Licensing Program Analyst (LPA) Leslie Inouye conducted a complaint inspection for the Short Term Residential Therapeutic Program (STRTP) for the purpose of delivering the findings for the above complaint allegation. LPA met with Teresa Rubio . During the course of investigating the allegation, LPA conducted interviews with staff members and clients, conducted a record review and obtained information. The information revealed that there was physical contact between clients but supervision could not have prevented all alledged contact. Staff members did not witness all interactions and appropriate discipline was taken on observed/verifiable incidents. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the above allegation occurred, therefore the above allegation is unsubstantiated UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lidia Tinoco LICENSING EVALUATOR NAME: Les Inouye LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

met_with: Teresa Rubio


summary: Facility Evaluation

raw_content:
Narrative:
On 07/27/2021, an unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Tamara Melikian at 9;15AM. During the inspection, LPA met with Program Director Jennifer Fish and Administrator Teresa Rubio and inspected the facility inside and out. LPA reviewed four children's records and reviewed two staff personnel records for the facility. LPA interviewed two staff at 9:30AM. One child refused to be interviewed on this date. The three other children on psychotropic medication were interviewed at 10:00AM. A medication count was conducted at 10:30AM. LPA conducted exit interview with Jennifer Fish, Program Director at 11:30AM. There are no deficiencies to be cited on this date.


summary: Facility Evaluation

raw_content:
Narrative:
On November 18, 2021, Licensing Program Analyst (LPA) Les Inouye conducted an annual inspection of the facility indicated above. Met at the agency by House Manager Teresa Rubio. An inspection of the physical plant was conducted. LPA observed adequate food supply, appropriately maintained yard, adequate bedding, storage space, activity space, hot water that measured 118 degrees. The back yard was inspected and was free of hazards. Back yard storage was secured. The swimming pool was properly fenced and the gate is self closing and latching. Staff files and training logs were inspected on this date. In addition, client files including client cash logs and medication logs were inspected on this date. At 9: Entrance interview and physical plant inspection. At 11: AM, Staff file review was conducted. At 1: PM, Client files review was conducted. The exit interview was conducted at 4: PM and a copy of this report given to Teresa Rubio . Deficiency was observed and documentation is on the LIC809-D.


summary: Facility Evaluation

raw_content:
Narrative:
On 07/06/2022, Licensing Program Analyst (LPA) Vanessa Galvan traveled to 2nd Home INC., Tenaya Facility in Fresno, CA. An unannounced SB Psychotropic Medication Inspection was conducted by LPA Galvan at 10:00AM. During the inspection, LPA met with Teresa Rubio, Administrator and inspected the facility inside and out. Three clients, 2 staff, and 1 administrator were present in the facility. LPA reviewed three children's records for the facility at 10:10PM. LPA reviewed two staff and medication training records for the facility at 12:00PM. LPA interviewed two clients and one client refused at 1:00PM. A medication count was conducted with Facility Administrator at 1:40PM. LPA interviewed one staff and administrator at 2:15PM. There were no deficiencies cited on this date. LPA conducted exit interview with Teresa Rubio, Facility Administrator. LPA provided a copy of the summary report and LIC 811 to Teresa Rubio, Facility Administrator upon completion.


summary: Facility Evaluation

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Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Tamara Melikian on November 29, 2023 at 12:50PM. This case management inspection is conducted pursuant to Health and Safety Code 1538.9(a)(2). During the inspection, LPA Melikian met with Program Director Jennifer Fish and House Manager Teresa Rubio and inspected the facility inside and out. LPA reviewed 1 child's record and 2 staff personnel files on site at the facility. LPA reviewed 1 child's psychotropic medications and medication records at the facility. LPA interviewed 2 staff on site to discuss the facilities policies and procedures of operation. LPA interviewed 1 child on site. LPA provided a copy of the licensing report to Program Director, Jennifer Fish. There are no deficiencies to be cited on this date. LPA conducted exit interview with Jennifer Fish, Program Director.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Reyna Martinez and Briana Placencia on December 2, 2024 at 10: AM. This case management inspection is conducted pursuant to Health and Safety Code 1538.9(a)(2). During the inspection, LPAs met with Teresa Rubio, Administrator and inspected the facility inside and out. LPAs reviewed 1 child's records and 2 staff personnel files on site at the facility. LPAs reviewed 1 child's psychotropic medications and medication records. LPAs interviewed 2 staff on site to discuss the facilities policies and procedures of operation. LPAs interviewed no children currently psychotropic medication as they were in school at this time. LPAs will attempt interview with children at a later time. LPAs provided a copy of the licensing report to Administrator, Teresa Rubio. No deficiencies are being cited at this time. LPA conducted exit interview with Teresa Rubio, Administrator.


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On January 22, 2025, Licensing Program Analysts (LPAs) Olivia Medrano, Miriam Flores, and Sonia Sanchez conducted an unannounced Annual inspection at 2nd Home - Tenaya STRTP located in Fresno, CA. LPAs met with Director Jennifer Fish. The facility is accredited through CARF with accreditation through September 2026, and they are approved through Fresno County Department of Behavioral Health through April 21, 2025. 9:00 - 9:30 am - A physical plant inspection was completed and included the following checks. Adequate indoor and outdoor activity space and materials observed. The facility is maintained at 70 degrees. All facility smoke detectors are in appropriate working order, fire extinguisher is properly charged and was serviced in March 18, 2024. All required forms are posted. There are non-functioning cameras in shared living areas. Medications are locked and centrally stored. Individual beds were observed. STRTP was approved on November 1, 2018. Last disaster drill was completed on December 25, 2024. According to the facility manager, there are no firearms or weapons in the facility. The facility has a fenced swimming pool with a self-latching gate. 9:30 - 11:30 am LPAs reviewed three client files and five staff files. 11:30- 12:00 pm LPAs interviewed one staff. 12:30 - 3:30 pm - LPAs interviewed two staff and three clients. LPAs discussed medication logs, needs and services plan with updates, buildings, and grounds and transportation for clients. Three Type B citations were cited during this inspection. ILS 87095.65(e) Emergency Intervention Training, ILS 87065.1(e)(1) Training Requirements, and Safeguards for Cash Resources ILS 80026(h). A copy of this report was left with the Director and a copy of appeal rights.

Deficiencies:
80026(h): Safeguards for Cash Resources, Personal Property, and Valuables

(h) Each licensee shall maintain accurate records of accounts of cash resources, personal property, and valuables entrusted to his/her care, including, but not limited to the following


summary: Facility Evaluation

raw_content:
Narrative:
Licensee Jennifer Fish Made contact with LPA Les Inouye to submit exception information for staff member Jason Mason (JM) to be Facility Manager. LPA reviewed information submitted. LPA contacted Licensee to inform her that an exception is not needed JM. JM qualifies for Facility Manager based on experience. Licensee asked if JM would qualify for an Administrator based on being a Certified Group Home administrator prior to 1/1/2017, 87064(c)(4). Licensee stated that JM took the test in December 2016 and was notified in February 2017, 1 month late. LPA advised Licensee to submit for an exception based on the dates above and listing work experience with 2nd Home, LT Children's and Family Services and Quality. The information will be reviewed and a determination will be provided.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Briana Placencia on October 16, 2025 at 9:45am. This case management inspection is conducted pursuant to Health and Safety Code 1538.9(a)(2). During the inspection, LPA met with Emily Logan, Administrator and inspected the facility inside and out. LPA reviewed 3 child's records and 2 staff personnel files on site at the facility. LPA reviewed 3 child's psychotropic medications and medication records. LPA interviewed 2 staff on site to discuss the facilities policies and procedures of operation. LPA was unable to interview any youth as they were not present. LPA will interview the youth at a later time. LPA provided a copy of the licensing report to Emily Logan, Administrator. No deficiencies are being cited at this time. LPA conducted an exit interview with Emily Logan, Administrator.

met_with: Emily Logan - Administrator


facility_name: 4 KIDS 2 KIDS-SAFE HOUSE (STRTP)

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Facility provided multiple Special Incident Reports (SIR) and Law Enforcement (LE) Contact Reports detailing how staff was present and attempted to prevent clients from drinking alcohol and not running way. On 04/28/2021, Client#1 (C1), Client#2 (C2), Client#3 (C3), Client#4 (C4) began to drink alcohol that was contraband from previous runway incident by C4. The clients barricaded themselves in the room and threatening staff. Law Enforcement was contacted and additional staff to help to calm the clients. On 04/29/2021, the clients decided to runway and staff follow till they lost track of them. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has decided that the allegations of Neglect and Lack of Supervision are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was left at the facility.

Investigation Findings:
13On July 20, 2022, at 10:00am, Licensing Program Analyst (LPA) Nancy O'Connell conducted an unannounced inspection to Kids Kids- Safe House Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegations and to deliver the findings. LPA O'Connell, met with Staff#1 (S1) and together discussed the investigation details. During the investigation process, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted inspection and conducted interviews. In addition, 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 June 20, 2022. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas determined the Neglect and Lack of Supervision allegations happen but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. Report continues on LIC-9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nancy O'Connell LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 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: KIDS KIDS-SAFE HOUSE (STRTP)FACILITY NUMBER: VISIT DATE: 07/20/2022

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

met_with: Marylou Escoto, S1


raw_content:
Narrative:
LPA Rosas and AGPA Barnes-Woodard, conducted interviews that provided conflicting information on who in the facility used EPI pen. LPA Rosas received documentation from facility that noted client allergies for Client#1 (C1), Client#2 (C2), Client#3 (C3), Client#4 (C4), and Client#5 (C5). It was identify that C5 had EPI pen. Interviews with pertinent parties did not provide additional information regarding who used an EPI pen or had allergies. It was unclear what medical information was not available for the clients in placement. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has decided that the allegations of Personal Rights and Medication 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 July 20, 2022, at 10:00am, Licensing Program Analyst (LPA) Nancy O'Connell conducted an unannounced inspection to Kids Kids- Safe House Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegation and to deliver the findings. LPA O'Connell, met with Staff#1 (S1) and together discussed the investigation details. During the investigation process, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted inspection and conducted interviews. In addition, 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 June 20, 2022. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas determined the Medication allegation may had happen but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. Report continues on LIC-9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nancy O'Connell LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 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: KIDS KIDS-SAFE HOUSE (STRTP)FACILITY NUMBER: VISIT DATE: 07/20/2022

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


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Investigation Findings:
13On 12/14/22 at 10:30am, Licensing Program Analyst (LPA) Nancy O'Connell made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation and deliver the finding. LPA spoke with Marylou Escoto and together, discussed the investigative finding. On 8/2/22, the department received a complaint alledging that a minor engaged in inappropriate contact with another minor. During the investigative process, LPA O'Connell conducted confidential interviews with all relevant parties and collected information on the above allegation. After reviewing all the statements and the information obtained, the above allegation is supported, as the confidential interviews confirmed that C2 has demonstrated a history of inappropriate behaviors that necessitate the provision of additional supervision to ensure the safety of C2 and other residents in care. Further record reviews show that the placing agency authorized the provision of one to one supervision for C2 on 6/6/22, and was backdated to 5/23/22 due to the licensee confirming that one to one services had already begun in order to "ensure the safety of the client and assist with her stabilization." Further confidential interviews, and record reviews revealed that C2 has not been assigned a one to one staff on a consistent basis, and in alignment with the authorization from the placing agency, thereby leading to opportunities for the minor to engage in aggressive and inappropriate behaviors with other residents. Based on LPAs observations, record reviews and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Based on California Code of Regulations, and Interim licensing Standards (ILS), a deficiency is being cited at this time. See 9099D for details. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nancy O'Connell LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 31-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, VENTURA BLVD., STE. WOODLAND HILLS, CA FACILITY NAME: KIDS KIDS-SAFE HOUSE (STRTP)FACILITY NUMBER: 425802125

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

met_with: Marylou Escoto, Administrator (FA)


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Investigation Findings:
13On 12/14/22, Licensing Program Analyst (LPA) Nancy O'Connell conducted an unannounced inspection in order to deliver findings related to a complaint investigation. LPA spoke with FM to discuss the findings. During the investigative process by Licensing program Analyst, all relevant parties have been accounted for. Supporting evidence includes: conflicting interviews with house residents and staff related to witnessing any instances of residents being locked in a bedroom. Further, based on observation by LPA, bedroom doors do not have the ability to be locked, and only the bathroom accessible to residents can be locked from within. Additionally, interviews conducted regarding staff hitting a resident revealed that during an escalated incident, the alledged victim was physically redirected in accordance with approved restraint/redirection techniques. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nancy O'Connell LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

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

met_with: Marylou Escoto, Facility Administrator (FA)


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Investigation Findings:
13On April 4, 2023 at 9:10am, Licensing Program Analyst (LPA) Nancy O'Connell made unannounced inspection to the above-listed facility for the purpose of conducting an initial investigation on the above allegation. LPA O'Connell met with the Facility Manager who provided access to the facility. On 3/30/23, the Department received a complaint alleging there was an uncleared adult working within the facility. Due to receiving a recent complaint regarding the same allegation, the allegation is found to be substantiated based on evidence obtained previously. Based on LPA observations, interviews, and record reviews, the preponderance of evidence standard has been met regarding this allegation, therefore the above allegation is found to be SUBSTANTIATED. There will not be a deficiency cited at this time as a deficiency has been delivered previously during related complaint (dated 3/16/23). An exit interview was conducted and a copy of this report will be emailed to the FM. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nancy O'Connell LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

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

met_with: Mary Andrade, Facility Manager (FM)


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Investigation Findings:
13On June 28,2023 at1:00pm, Licensing Program Analyst (LPA) Nancy O'Connell made unannounced inspection to the above-listed facility for the purpose of concluding the investigation on the above allegations and deliver the findings. LPA O'Connell met with Marylou Escoto and discussed the investigative findings. On 3/16/23, the Department received a complaint alleging staff are not trained. During the investigative process, LPA O'Connell conducted confidential interviews with all relevant parties and collected information on the above allegations. After reviewing all the statements and the information obtained, the above allegation is supported, as the confidential interviews confirmed that primary residential counselors, responsible for the direct care of clients, are not afforded with necessary training to manage symptoms/behaviors presented by target population that the program serves. Further confidential interviews revealed that staff have not been provided with comprehensive and completed ProAct training, which is used for the purpose of de-escalation, redirection, and conceptualization of trauma based behaviors. This training and training of a similar nature provide staff with the tools to administer trauma-informed care, and support client/staff safety. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter number), are being cited on the attached LIC 9099D. Exit Interview conducted, and a copy of this report was left at the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nancy O'Connell LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 31-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, VENTURA BLVD., STE. WOODLAND HILLS, CA FACILITY NAME: KIDS KIDS-SAFE HOUSE (STRTP)FACILITY NUMBER: 425802125

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

met_with: Marylou Escoto, Facility Administrator, (FA)


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Investigation Findings:
13On June 28,2023 at 1:00pm Licensing Program Analyst (LPA) Nancy O'Connell made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation and deliver the findings. LPA spoke with Marylou Escoto and together, discussed the investigative findings. During the investigative process by Licensing program Analyst (LPA), Nancy O'Connell, all relevant parties have been accounted for. Supporting evidence includes: conflicting interviews which describe minimal or ineffectual attempts by staff to disengage client physical altercations. Further, interviews and record reviews reveal that the facility is staffed at the required ratios, but the needs of clients may fluctuate at times, causing delays in response times by staff members. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nancy O'Connell LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

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

met_with: Marylou Escoto, FAcility Administrator (FA)


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Investigation Findings:
13On 9/6/23 at 9:30am Licensing Program Analyst (LPA) Nancy O'Connell and LPA Jhane Haynes made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegations and deliver the finding. LPA spoke with HOS and together, discussed the investigative finding. During the investigative process by Licensing program Analyst (LPA), Nancy O'Connell, all relevant parties have been accounted for. Supporting evidence includes: conflicting interviews with house residents and staff attesting to the occurrence of the identified allegations. Further, evidence reflects that the facility maintains appropriate medication administration procedures and policies. Lastly, statements to corroborate the occurrence of inappropriate communication with residents could not be obtained. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nancy O'Connell LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

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

met_with: Christina Menghrajani, Head of Service (HOS)


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Investigation Findings:
13On 9/6/23 at 9:30am Licensing Program Analyst (LPA) Nancy O'Connell and LPA Jhane Haynes made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation and deliver the findings. LPA spoke with S1 and together, discussed the investigative findings. During the investigative process by Licensing program Analyst (LPA), Nancy O'Connell, all relevant parties have been accounted for. Supporting evidence includes: conflicting interviews with house residents attesting to the occurrence of the identified allegations. Statements that would corroborate the occurrence of aforementioned allegations were not provided. Further, evidence shows that the facility maintains policies to ensure the provision of medication, telephone services, and respectful interactions with staff and clients. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nancy O'Connell LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

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


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Investigation Findings:
13On 04/24/2024 at 09:52AM, Licensing Program Analyst (LPA) Jhane Haynes made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation and deliver the complaint findings. LPA spoke with Head of Service(HOS) and together discussed the investigative findings. During the investigation LPA Haynes interviewed and accounted for all relevant parties. Based on interviews conducted, it was reported youth are allowed phone calls with attorneys and social workers at any time and personal calls as allotted by house phone policy. It was also reported that medical attention is sought for youth in the home, and relevant parties are notified of incidents. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. There are no deficiencies to be cited at this time. An exit interview was conducted, and a copy of this report was emailed to the facility administrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Jhane Haynes LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Head of Service


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Investigation Findings:
13On 05/17/2024 at 09:49AM, Licensing Program Analyst (LPA) Jhane Haynes made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegations and deliver complaint findings. LPA spoke with Facility Administrator(FA) and together discussed the investigative findings. During the investigation, LPA Haynes interviewed and accounted for all relevant parties. Based on interviews conducted, it was reported staff do not engage in altercation with youth and will remove selves to reduce further escalation on clients in care. It was also reported clients choose a preferred time to be woken by staff. Statements to corroborate unauthorized person having access to confidential information were not provided. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. There are no deficiencies to be cited at this time. An exit interview was conducted, and a copy of this report was emailed to the facility administrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Jhane Haynes LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Marylou Escoto Facility Administrator(FA)


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Investigation Findings:
13On 05/17/2024 at 09:49AM, Licensing Program Analyst (LPA) Jhane Haynes made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation and deliver the complaint findings. LPA spoke with Facility Administrator (FA) and together discussed the investigative findings. During the investigation LPA Haynes interviewed and accounted for all relevant parties. Based on interviews conducted, it was reported youth have gone shopping with allowance earned. Allowance is given weekly but harsh weather may delay the time scheduled for shopping. Expired food is promptly disposed by and checked by staff daily. It was also reported overnight staff sit on stairs and conduct room checks hourly. Furniture was observed and reported in good repair. Statements to corroborate allegations could not be obtained. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. There are no deficiencies to be cited at this time. An exit interview was conducted, and a copy of this report was emailed to the facility administrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Jhane Haynes LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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


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Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward investigated the above allegation. LPA interviewed clients, staff members and medical personnel. All clients named in the complaint denied that they had tested positive for any sexually transmitted disease (STD). Likewise, medical professionals denied that C2 and C3 had tested positive for an STD. Per medical personnel, C7 did test positive for an STD. However they are uncertain where or how C7 contracted the disease. C7 is no longer in residence at Kids Kids. Based on the information obtained during the investigation, the above allegation is resolved as unsubstantiated. unsubstantiated means that although an allegation may have happened or is valid, there is not a preponderance of evidence to prove that it did happen. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Ashely Giles, Facility Manager


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Investigation Findings:
13On 06/26/2024 at 10:20AM Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of concluding the investigation initiated 04/24/24. LPA spoke with Facility Administrator(FA) and discussed the investigative findings. During the investigation LPA Haynes interviewed and accounted for all relevant parties. Based on interviews conducted, it was reported when youth engage in peer conflict, staff will attempt to remove youth from setting and offer coping mechanism to return to baseline. Youth involved were removed from the home due to safety of staff and other youth in care. Interviews also reflect mental health behaviors were addressed with attending school counselor and a safety plan was created with youth and shared with facility. Statements to corroborate the above allegations could not be obtained. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegations are UNSUBSTANTIATED. There are no deficiencies to be cited at this time. An exit interview was conducted, and a copy of this report was emailed to the administrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Jhane Haynes LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Facility Administrator(FA)


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Narrative:
Additionally, concerning claims that staff members failed to protect minors' personal belongings, statements indicated that clients' items are stored securely in the office or a cabinet safe box, and the facility provided the Nintendo Switch back to C1. Furthermore, reports alleged that both C2 and C3 used a vape pen at the facility; however, C2 and C3 denied these claims, and no statements were obtained to corroborate the allegations. If any additional information is received, this complaint can be amended, and the findings can be changed. Per California Code Regulation, Title 22, Division 6, Chapters 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), there are no deficiencies to be cited at this time. Exit interview was conducted and a copy of this report will be emailed to the Facility Administrator.

Investigation Findings:
13On 11/8/2024 at 9:45am Licensing Program Manager (LPM) Enrique Hernandez made an unannounced inspection to Kids Kids to conclude the investigation on the above allegations and deliver the findings. LPA spoke with Facility Administrator Marylou Escoto and together discussed the investigative findings. During the investigative process by Licensing Program Analyst (LPA) Jhane Haynes, all relevant parties were accounted for. Based on the interviews, there was no evidence or statements to support the allegations that Staff did not prevent inappropriate interactions between minors, Staff did not safeguard minor's personal belongings and Staff do not prevent minors from smoking a vape pen inside of the facility. The Department has concluded that the above allegations are Unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. Supporting evidence includes the following: It was reported that Staff Member #3 (S3) was present during the argument between Client #1 (C1) and Client #2 (C2) and instructed both clients to stop arguing and the S3 follow the policies and procedures from the facility. Continue on LIC9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Enrique M Hernandez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 31-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, VENTURA BLVD., STE. WOODLAND HILLS, CA FACILITY NAME: KIDS KIDS-SAFE HOUSE (STRTP)FACILITY NUMBER: VISIT DATE: 11/08/2024

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

met_with: Facility Administrator/Marylou Escoto


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Investigation Findings:
13On 5-8-25, at 10:00am Licensing Program Analyst (LPA) Nancy O'Connell made unannounced inspection to the above-listed facility for the purpose of concluding the investigation on the above allegations and deliver findings. LPA O'Connell met withDr. Paulette Melina Psy.D, Head of Services (HOS). On February 2, 2025, the Department received a complaint alleging staff inappropriately handled client in care. During the investigative process, LPA Gomez conducted confidential interviews with all relevant parties and collected information on the above allegations. After reviewing all the statements and the information obtained, the above allegation is supported, as the confidential interviews confirmed that staff inappropriately handled client in care. Based on LPAs observations and interviews which were conducted and recorded for review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Per California Code of Regulations, (Title 22, 80072(a)(3)), there is one deficiency being cited on the attached LIC 9099D. Exit Interview conducted, and an electronic copy of this report was left at the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nancy O'Connell LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 31-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION WOODLAND HILLS S.Ro, Ventura Blvd., STE. WOODLAND HILLS, CA FACILITY NAME: KIDS KIDS-SAFE HOUSE (STRTP)FACILITY NUMBER: 425802125

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