summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analysts (LPAs) Brian Bertoli and Will Ea conducted a required annual inspection. LPAs met with Licensee Leonardo De La Cruz and DSP Mary Joy Tiongco and informed of the purpose of the visit. LPAs toured the facility site and observed the facility to be maintained in safe and sanitary condition. Food supply was well-stocked and well-organized. No hazards were observed. There are accessibility accommodations throughout the facility. Each client has their own bedroom, and each bedroom is fitted with appropriate furnishings and clean linens. LPAs reviewed three current client files. All files were observed to be complete. LPAs will review staff files at a later date. Using the CARE Inspection Tool, no deficiencies were found. LPAs issued an Advisory Note on using the correct LIC 602. An exit interview was conducted, and a copy of this report was provided to Leonardo De La Cruz, whose signature on this form confirms receipt.

met_with: Leonardo De La Cruz and Mary Joy Tiongco


state: CA

facility_name: WINDSOR MANOR

summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli made an unannounced visit to the facility and conducted a continuation of a required Annual Inspection. LPA met with Licensee Leonardo De La Cruz, Administrator Glenn Vargas and Direct Service Provider Mary Joy Tiongco and informed them of the purpose of the visit. LPA reviewed Staff records and other documents and completed the Care Tools inspection. LPA conducted one client interview. No deficiencies were cited. One Advisory Note was issues regarding clearance documentation. An exit interview was conducted and a copy of this report was left at the facility.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Glenn Vargas, Leonardo De La Cruz and Mary Joy Tiongco


summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Brian Bertoli met with staff Francisca Zamora regarding a complaint investigation at the Group Home. The purpose of the inspection was to deliver the findings for the above allegation. During the course of the investigation LPA Bertoli inspected the facility, conducted confidential interviews and reviewed records. The interviews and documentation did not confirm the allegation. The source of the bruising is unknown at this time. This department has investigated the allegation, and although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that Facility staff physically abused child resulting in multiple bruises; therefore, the above allegation is Unsubstantiated. An exit interview was conducted and no deficiencies were cited for this allegation. A copy of this report was given to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Brian Bertoli LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

report_type: Complaint Investigation

met_with: Franciisca Zamora

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analysts (LPAs) Kimberly Hall and Brian Bertoli made an unannounced visit to the facility and met with Leonardo De La Cruz. The purpose of the visit was to conduct a Case Management inspection. During the course of the inspection, LPAs inspected the facility, reviewed facility records, and conducted a confidential interview. The records and interview indicated that there is a staff person (S1 - see LIC 811 dated 11/21/25) that is regularly present at the facility and does not have the appropriate Criminal Record Clearance or Criminal Record Exemption with the Children's Residential Program. The status for S1 on the Guardian system shows 'In Process'. The original application date was July 12, 2024. LPAs are issuing a citation for Criminal Record Clearance and are assessing an Immediate Civil Penalty of $100 per day for a maximum of 5 days in violation for a total of $500. S1 worked on site since July '24. Glenn Vargas, Administrator entered the facility at AM. An exit interview was conducted with Leonardo De La Cruz and Glenn Vargas. Appeal Rights were discussed, and copy of this report was given to the facility.

met_with: Leonardo De La Cruz, Licensee, Glenn Vargas, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analysts (LPAs) Brian Bertoli conducted an unannounced Case Management visit to the facility and met with Leo De la Cruz. The purpose of the visit was to cite for deficiencies that resulted from an inspection and record review that occurred on 11/21/25. LPAs observed that the facility is not using a separate log for each Psychotropic Medication and did not have Parental Authorization to administer Psychotropic Medications to a youth. LPAs are citing for Children's Records 84070 (b)(15)(A) and (16). See attached LIC 809-D. An exit interview was conducted and Appeal Rights were discussed. A copy of this report was given to the facility.

met_with: Leo De la Cruz


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Brian Bertoli met with staff Francisca Zamora regarding a complaint investigation at the Group Home. The purpose of the inspection was to deliver the findings for the above allegation. During the course of the investigation LPAs Brian Bertoli and Kimberly Hall inspected the facility, conducted confidential interviews and reviewed records. The interviews and documentation did not confirm the above allegation. Records and interviews indicated that medications were being administered properly. This department has investigated the allegation, and although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that Staff did not administer medication properly; therefore, the above allegation is Unsubstantiated. An exit interview was conducted and no deficiencies were cited for this allegation. A copy of this report was given to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Brian Bertoli LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

met_with: Francesca Samora


summary: Facility Evaluation - 2 deficiencies

raw_content:
Narrative:
On 3/26/26 at 9: AM, Licensing Program Analyst (LPA) Kimberly Hall and Isabel Diego Licensing Program Manager (LPM) conducted an unannounced Annual/Required inspection. LPA Hall and LPM Diego met with Licensee Leonardo De La Cruz and Direct Care Staff (Francisca Zamora) and House Manager (Joy Tiongco) arrived later . LPA and LPM informed staff members of the purpose of the visit. The facility has a census of 4 clients. All clients are non-verbal except for one. No clients were in care upon arrival, and arrived around 2PM. All clients appeared to be in good spirit, one client was interviewed. At 10AM LPA toured the facility site and observed the one story facility to be clean, free from obstruction, and in good repair. LPA then toured the dining room. The tables and chairs were solid and the room was clean, organized. The living room consisted of a large sectional couch with plenty of seating space . Toys, games, and other activities were in a cabinet which also serves as storage. Room was at a comfortable temperature. The water temperatures were measured at 118F. . The menu was not posted. It was noticed that the non-perishable food supply needs to be increased to provide up to 3 meals x 4 clients. LPA advised the facility to obtain more canned goods. Sharp objects and cleaning solutions were locked away and inaccessible for clients in care. There are charged operable fire extinguishers, carbon monoxide and smoke detectors throughout the facility. All medications were locked and inspected. LPA and LPM advised the facility once a medication is complete they should immediately dispose the medications, due to two clients having several empty medications. Please refer to LIC 809-C for continuation page. The facility has 3 single and one master bedroom. Each client has their own bedroom, and each bedroom is fitted with appropriate furnishings, clean linens, and table space. LPA and LPM observed the master bedroom (C1)'s (Please see LIC-811 dated 3/26/26 for confidential names) bedroom to have mold inside the shower and the bath tub appeared to not be clean for a long period of time. Also the blinds had debris and large amount of dust on them . (C1)'s sliding closet had a mirror portion that was not properly attached to the frame, and hinge of the closet sliding doors. The second bedroom (C2) LPM tried to open the window blinds and the blinds popped off and dust fell off the blinds. LPA and LPM observed mold and debris along the window frame. The first aid kit was observed to be complete. There are no open bodies of water on the property. Personal rights was not posted, however during the inspection the licensee posted it. The facility did not have their complaint procedure posted nor did they have it available upon request. At 11: AM LPM and LPA reviewed all 4 client files and all files appeared complete. During inspection, it was learned that the facility is not giving a set allowance amount and giving the youth money upon request which is done more than monthly per cash resources. The facility is requested to update their program statement to reflect the allowance duration if this will be done weekly or what specific date in the month, and the specific amount of each youth's allowance. This is to be submitted to LPA Kim Hall by Friday April 17, 2026. Also, the clients can get extra money by doing chores around the house. This will also need to be included in the program statement update. LPA and LPM reviewed three staff files. (S1) the Administrators, certificate expired on 3/12/26 and the facility could not show proof of renewal. (S1) did not have a job description in his personnel file for the Administrator position, and only obtained a DSP job description. (S2) did not have an LIC Health Screening. The facility was not able to show proof of health screening for (S2). All staff had required training. LPA requested board minutes from the facility and the facility was unable to provide board minutes or confirm when the licensee had their last board meeting. LPA requested a copy of completed quarterly drills, the facility was unable to show proof. LPA interviewed one client and two staff. All other clients were non-verbal. The facility received three Technical Violations, 84076(c)(1) Food Service, 80087(a) Buildings and Grounds, 84077(a)(2) Client Records. The facility was cited for the following deficiencies: Type A for the following: 84063(a)(8)/84063(a)(9) 84063(a)(10) Accountability, 84072.2(a)(3) Complaint Procedures, HSC 1565(c), 80066(a)(10) Personnel Record, Type B for the following: 80023(a) Disaster and Mass Casualty Plan, Personnel Record 80066(a)(12)(B)(1), 84066(b)(1) Personnel Record, 84064(b) Administrator Qualifications and Duties. Annual inspection was completed via CARE Inspection Tools. An exit interview was conducted, and a copy of this report was provided to Leonardo De La Cruz, whose signature on this form confirms receipt.

Deficiencies:
80023(a): Deficient Practice Statement
1
2
3
4Based on observation, staff interviews and record review, the licensee did not comply with the section cited above and could not show of the facility maintaining a current of written plan of action which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/17/2026
Plan of Correction
1
2
3
4
84064(b): Deficient Practice Statement
1
2
3
4Based on observation, interview with licensee and Adminstrator (S1) , and (S1) file  the licensee did not comply with the section cited above. (S1) certificate expired on 3/12/26 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/17/2026
Plan of Correction
1
2
3
4

visit_type: Annual

met_with: Leonardo De La Cruz (Licensee), Francisca Zamora (Care Giver) and Mary Joy Tiongco (House Manager)

title:
Disaster and Mass Casualty Plan

(a) Each licensee shall have and maintain on file a current, written disaster and mass casualty plan of action.

This requirement is not met as evidenced by

title:
Administrator Qualifications and Duties

(b) Effective January 1, 2000, all group homes shall have a qualified and currently certified administrator.

This requirement is not met as evidenced by


facility_name: WINTERHAVEN

summary: Facility Evaluation

raw_content:
Narrative:
On January 05, 2022, at approximately 11: AM, Licensing Program Analyst (LPA) Raymond Wu met with Administrator Sergio Castaneda for the purposes of conducting a final walkthrough before facility closure. During the walkthrough, LPA observed no clients in care and no indications that there were any clients still in care. The last client to move out of the home was in May of 2020. Administrator Castaneda discussed with LPA the future plans for the home. No deficiencies were observed on this date. An exit interview was conducted and a signed copy of this report was provided to the Administrator.

met_with: Administrator Sergio Castaneda


facility_name: WYATT COMMUNITY CARE I

summary: Facility Evaluation

raw_content:
Narrative:
On September 2, 2021, Licensing Program Analyst (LPA) Rachel Bruce conducted an unannounced annual required inspection at this facility. LPA was met at the facility by the Adminstrator, Debra Stevens. 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. The Licensee stated that they have this facility closed at the moment because COVID issues have slowed placement of clients. The Licensee stated that she is currently reviewing 2 potential placements and is hopeful they will have clients residing in teh home shortly. The facility was inspected indoors and outdoors. Hot water temperature measured at 106 degrees. LPA Bruce observed that there were no supply of perishables and non-perishables. LPA observed adequate supply of furnishings, linen and storage space for clients. Cleaning chemicals inaccessible to clients. There are no pets at the facility. Per the Administrator there are no weapons or bodies of water. No deficiencies were noted during this inspection. The visit was then concluded. Due to computer issues, this form has been recreated and will be sent to the Administrator for signature and return.


summary: Facility Evaluation

raw_content:
Narrative:
On this date, May 20, 2022 at 10: AM, an unannounced required annual inspection was conducted by Licensing Program Analyst (LPA) Wayne Aoki. LPA was met by facility Administrator Debra Stephens. LPA inspected the facility, inside and out. Centrally stored medications and sharps are maintained in a locked cabinet in the kitchen. LPA inspected the medications for the minor in care. The facility has a written emergency disaster plan. All facility smoke and carbon monoxide detectors were tested and appear to be in appropriate working order, fire extinguisher is properly charged and was last serviced September 1, 2021. 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. The facility is maintained at 73 degrees. Hot water temperature measured 117 degrees. There was 1 staff and 1 minor present during this inspection. Both staff and minor's files reviewed. Interviews with staff and minor in placement were conducted. LPA reviewed the facility's disaster plan, sampled medication and reviewed facility logs. LPA requested the following updated documents be sent to LPA by May 31, 2022: LIC 308, LIC 309, LIC 400, LIC 500 and LIC 610C There were no deficiencies cited during this inspection.

met_with: Debra Stephens


facility_name: YAHWEH'S GRACE YOUTH FACILITY

summary: Facility Evaluation

raw_content:
Narrative:
On May 28, 2025, at 10: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez and Licensing Program Manager (LPM) Jean Herring conducted the Component II /face to face meeting and met with Executive Director, Dirk Johnson and Administrator, Gina Sodero of New Start Youth Facility, Inc., at the Community Care Licensing (CCL) Regional Office in Monterey Park. The purpose of the meeting is to discuss the new application for group home and plan of operation (POO)/program statement (PS). The list of the items discussed were as follows: Application · LIC Line 1 - Licensee should be New Start Youth Facility, must match with line 5. Line 19- Licensing Agency Name: blank · Orientation Certificate LIC C - CEO Johnson's certificate will be submitted later. Organization and Administration · LIC 308 - Designation of Administrative Responsibility - Needs facility number Request current organizational chart Pg. 1 ·LIC 309 - Administrative Organization - Line 3 - Incorporation - should be 12/30/ Corporation Number - should be Line 5 - Needs Copy of Articles of Incorporation Line 9 - Number of Directors - Directors and 5 years/terms of office · Board Resolution will be amended to state Dirk Johnson is being authorized to submit a new application on behalf of the corporation. Finances · LIC 400 - Affidavit regarding client cash resources - - par 6 -will just check 1 (will handle cash) · LIC 401 - Monthly Operating Statement - New LIC 401 will be submitted. · LIC 401a - Supplemental Financial Information - missing. · LIC 402 - Surety Bond - A separate page (attachment) is needed indicating the address and facility number of Yahweh Grace Youth Facility. Personnel · LIC 500 - CEO and administrator will be associated to facility number 157807029. Clearances · LIC 508 - Criminal Record Statement & Out of State Disclosure - New LIC 508 for the administrator and CEO required. Finances · LIC 401a - Supplemental Financial Information - Missing Pg. Personnel · LIC 501 - needs new LIC 501 for Administrator · LIC 503 - Health Screening/TB -Need new Health Screening - for Administrator and CEO LIC 9106 - GH Program Statement Part l - Program Identification Applicant/Licensee - should be New Start Youth Facility Applicant/Licensee Mailing Address - Belvedere Ave, Bakersfield, CA Page 3: GH Program Statement Table of Contents - Missing Page 4: Applicant should be New Start /Address should match licensee address in LIC Page 7: A Summary #3 - Supplemental Services - Independent Living - not checked Tab Purpose Methods, Goals Page 2: YGYF SW will provide individual, family, group counseling. - LIC Pg.11 #5 not checked Population Served Page 3: Second paragraph - will accept privately placed participants also Methods and Goals page 2 - Referral Source - Kern Only Tab Page 7: Part ll: Program Services & Capabilities #2 box 7 not checked Pg. Program Goals Part ll: Program Services & Capabilities Page 7: #2 box 4 /Independent living not checked Page 7: #3 box 4 not checked TAB Discharge/Removal Page 43: 4th par. - should be YGYF 5th par. - needs correction to representative. TAB 12: House Rules Page 50: Unauthorized Absence Policy - "The resident may be searched prior to coming back into the house". Considered blanket policy - will be amended to include a statement that on case-to-case basis only and only if there is suspicion. TAB 13: Discipline Policies - What types of discipline not permitted (corporal punishment violation of personal rights) - will elaborate - will add Prone containment and like techniques shall not be included as part of a program's discipline policy nor written into individual NSP will be added. Pg. TAB 16: Children's Complaint /Grievance Procedure Page 94: par 4- needs correction to group home Licensee will submit the revisions by June 6, A copy of the LIC 809 and LIC 809Cs were provided to the administrator. Pg. 5

met_with: Dirk Johnson and Gina Sodaro


summary: Facility Evaluation

raw_content:
Narrative:
On June 16, 2025, at 10: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an announced pre-licensing inspection at the facility address of the proposed group home. LPA met Administrator, Gina Sodaro who gave a tour of the facility. There are no clients in placement. The facility is a one-story home that has 5 bedrooms and 2 1/4 bathrooms. The following was observed at the time of the inspection. The Children's Rights for Children's Residential, Ombudsperson's Children's Personal Rights and information, Emergency Disaster Plan, and CDSS Let US NO information and number posted on the wall near the entrance door of the facility. The facility has a staff office, a kitchen, a pantry, a dining area and a laundry room. There was a flat screen TV, sofa, fireplace with cover in the living room and another flat screen TV in the family room. There was a refrigerator, a gas stove, kitchen utensils, plates, and dinnerware in the kitchen drawers/cabinets. All the bedrooms have one full bed inside equipped with clean mattresses, linens and beddings. Only the master bedroom has 2 full beds and full bathroom. All the bedrooms have one dresser with 5 drawers and a spacious closet. There were linens, towels and hygiene supplies in a room in the hallway. There was small room in the hallway leading to the master's bedroom. There was a cabinet and chest/box with locks where medications, and sharp objects like knives will be stored. The first aid kit was complete. The facility has working telephone. The smoke/carbon monoxide detectors in bedrooms and hallways were working. There was 2 fire extinguishers mounted on the wall near the main entrance door and in the hallway. The water temperature in the bathroom sinks was tested and found (116 degrees Fahrenheit) within the temperature allowed by regulations. The centralized heating and air were working. All cleaning solutions were observed in the laundry area with a door that locks. There are cameras inside and outside the facility. The camera monitor in the staff office will not record any video footage. All cameras inside the facility were in the common areas. No cameras observed focused to any bedroom or captures any part of the bedrooms or bathrooms. There are no bodies of water in the premises. All passageways and walkways were unobstructed. The physical plant layout based on LPA's observation meets requirements of the regulations. The application will be submitted for approval and issuance of a license once final review of all documents are completed. The physical plant layout based on LPA's observation meets requirements of the regulations. The application will be submitted for approval and issuance of a license once final review of all documents are completed. An exit interview was conducted and copy of the report was provided to the administrator.

visit_type: Prelicensing

met_with: Gina Sodaro


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Carrie Palmer conducted an unannounced visit to the above facility on 11/13/25 at 12:30pm for the purpose of conducting a Required Post Licensing Inspection. LPA Palmer met with the Administrator Gina Sodaro and the Assistant Administrator Shakila Mackey and discussed the purpose of the visit. During the inspection, LPA Palmer completed the following domains: Physical Plant, Operational Requirements, Emergency Intervention Plan, Staffing, Staffing Records and Staff interviews. LPA Palmer conducted 3 staff file reviews. There are 5 clients in care at the time of inspection. Physical Plant: This is a one-story home that has 5 bedrooms each with a mounted TV, two bathrooms and a half, a staff office, a visitation room, a backyard with a dining area and a television/family room. The facility has a private bathroom for staff, a locked medication cabinet and extra storage in the hallway closet. There is a living room, dining, and kitchen area. All bedroom have one bed for one client except 1 room which has two beds and two clients share this room. All rooms have bedding, drawers, and closet space for the clients' use. There are cameras located throughout the facility. Medications and knives were stores and locked in there own closet. Chemicals were stored away from children and were not stored with food. Page 1 of Continued... LPA Palmer was able to see written compliant procedures posted. The facility was able to provide their emergency drill binder to include drills for fire, earthquake, violent and threatening situations, utility failure and bomb threat. Staff Records: During the review of 3 staff records, it was determined that staff received background checks prior to working at the facility. It was also observed that staff receives ongoing training that consists of, but not limited to the following: Mandated Reporter Training, Accountability - HIPPA, Job Shadowing, Trauma Informed Care, Hour Training on Client Daily Routines, Supervision of Children, Code of Ethics, Planned Activities, etc. Job Descriptions were also observed within the staffs files and the administrators certificate is up to date. And exit interview was conducted and an 809 and an 811 was provided to the administrator. No deficiencies sites. Page 2 of 2

met_with: Gina Sodaro, Administator


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On January 28, 2026, at 09:45 a.m., Licensing Program Analyst (LPA) Brent Lockhart and Licensing Program Manager (LPM) Jean Herring conducted an unannounced Case Management inspection at Yahweh's Grace Youth Facility. LPA and LPM met with Ally Naus and Tamorra Davis, Lead Facility Managers . LPA and LPM toured the facility and conducted file review for C1. During the inspection LPA and LPM observed three (3) deficiencies related to Medication Records and Reporting Requirements. Additionally, LPA and LPM observed two (2) missing panels along the picket fence in the backyard. During today's inspection, LPA and LPM issued three (3) Type B citations and one (1) Technical Violation Advisory Note. A signed copy of this report was provided to the Facility Representative along with LIC 809D, LIC 9102TV, and LIC 811. Appeal Rights explained.

Deficiencies:
84061(i): 1
2
3
4
5
6
7

title:
1
2
3
4
5
6
7(i)	The licensee shall submit reports to the Department, using form LIC 624-LE or a report containing all the information required in LIC 624-LE, regarding any incident that involves law enforcement contact with a child residing in the facility.  This requirement is not met as evidenced by

description:
1
2
3
4
5
6
7


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
On December 12, 2025, the Department received a complaint report alleging that on December 10, 2025, staff members hit C1 hit with a shoe and slapped C1's arm with their palm. Additionally, it was alleged that staff threw water at C1. Investigation revealed that on December 10, 2025, C1 threw water on herself while in the car on the way to school after continuing to be upset and exhibiting behaviors that had started earlier that day at the facility. All parties interviewed denied that C1 was hit or slapped by anyone at the facility. LPA did not observe injuries or bruises on C1 during the initial inspection at the facility. Based on the information gathered during the investigation, it is determined that the above allegations are Unsubstantiated. An Unsubstantiated finding means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted. A copy of the reports along with LIC 811 were provided to Lead Facility Manager, Ally Naus. No deficiencies were cited at this time.

Investigation Findings:
13On March 5, 2026 at 12:15 p.m., Licensing Program Analyst (LPA) Brent Lockhart conducted an unannounced follow up inspection visit at Yahweh's Grace Youth Facility, Group Home (GH). During the visit, LPA met with Facility Manager (FM), Ally Naus to deliver the findings regarding the allegations. During the investigation, LPA reviewed the GH complaint history, and interviewed one (1) staff, one client, and two (2) professional contacts on December 16, 2025. On January 22, 2026, LPA interviewed 2 staff members. On January 22, 2026, LPA interviewed three (3) clients. On January 28, 2026, LPA conducted a second interview with a client and interviewed one staff member. On February 2, 2026, LPA interviewed one staff member and one professional contact. On February 4, 2026, LPA attempted an in person with one of the clients. LPA reviewed documents provided by the GH including but not limited to LIC9020 register of clients, LIC Facility Personnel list, Needs and Services Plan (NSPs), for clients 1-5 (C1-C5)(See LIC Confidential Names list dated 12/16/25), GH medical logs, relevant Special Incident Reports (SIRs). (Continued...) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Brent Lockhart 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 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION MONTEREY PARK CRP RO, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: YAHWEH'S GRACE YOUTH FACILITYFACILITY NUMBER: VISIT DATE: 03/05/2026

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

met_with: Lead Facility Manager - Ally Naus


facility_name: YAHWEH GROUP HOME

raw_content:
Narrative:
The LPA was unable to corroborate the allegations. There was no preponderance of the evidence to substantiate the allegations. So, although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegations are unsubstantiated. There are no deficiencies to be cited regarding these allegations. A copy of this complaint was provided to the facility representative.

Investigation Findings:
13On January 8, 2024 at 11:15 a.m., Licensing Program Analyst (LPA), Karen McGee, delivered thef findings of a complaint investigation to the facility. The LPA met with Facility Manager, Kayla Johnson. On September 4, 2024, the Monterey Park Children's Residential Program (MPCRP), received a complaint with the above mentioned allegations. Confidential interviews were conducted that included, but were not limited to: Administrative Assistant, Shakila Mackey on September 11, 2024 at the facility; child Ref. #1 at the facility on October 17, 2024; and Facility Manager Ref. #2 via telephone on January 6, 2025. The LPA reviewed Ref. #1's Needs and Services Plan and incident reports. The investigation revealed that the allegation was maintained. The Facility Manager denied the allegations indicating that no hands were placed on children and children are not allowed to fight, but are separated when they try. The investigation revealed that there were no other witnesses to the allegation. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Karen McGee 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 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION MONTEREY PARK CRP RO, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: YAHWEH GROUP HOMEFACILITY NUMBER: VISIT DATE: 01/08/2025

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

met_with: Kayla Johnson


raw_content:
Narrative:
1. Staff hit minor while in care. The personnel (S1, S2, and S3) refuted the claim and affirmed that S1 was absent on the date of the purported incident (October 14, 2024). Furthermore, it was noted that C1 did not report the matter to any staff member present on that day or subsequently to staff S2 and S3. Staff members S2 and S3 reported that they did not witness any marks on C1. They emphasized that such behavior from staff is unacceptable and will be addressed immediately. S2 also mentioned their extensive experience working with their team over the years, highlighting their training in trauma-informed care and various de-escalation strategies. Additionally, staff indicated that C1 has a documented history of aggressive conduct towards both staff and clients, as well as a tendency to fabricate stories to manipulate circumstances for personal gain. Additionally, a statement obtained from C2 indicated that they felt safe residing at the facility and that staff had a good relationship with the clients, C2 denied hearing or witnessing any staff member mistreat or physically abuse any client, however, staff would raise their voices to redirect clients. Information gathered from SSW1 and SSW2 corroborated the previously mentioned details, indicating that C1 exhibited no signs of marks or bruises, and S1 was not present during the incident in question. Furthermore, SSW2 noted that the facility staff demonstrated a high level of attentiveness and support, regularly communicating with them about issues related to C1. SSW2 also pointed out that C1 has a history of aggressive behavior and tends to fabricate stories to manipulate circumstances in their favor. Additionally, SSW2 expressed no concerns regarding the care and supervision provided by the facility staff for her client. Therefore, based on the information received, the above allegation(s) is determined to be unsubstantiated. Although the allegation(s) may have happened are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegation(s) are found to be unsubstantiated. Appeal Rights were provided and discussed with the Foster Family Agency. There are no deficiencies to be cited at this time. An exit interview was conducted and a copy of the report along with the (LIC 811) was left with the Group Home Asst. Administrator.

Investigation Findings:
13On January 17, 2025, at 11: AM, Licensing Program Analyst (LPA) Winston Moroney conducted a complaint inspection at the above Group Home and met with the Asst. Administrator. The inspection aimed to deliver the finding(s) regarding the complaint allegation(s). On October 16, 2024, the Community Care Licensing Division of the California Department of Social Services received a complaint from the Centralized Complaint and Information Bureau (CCIB) with the following allegation(s): This LPA conducted the investigation of the above allegation(s) and it consisted of but was not limited to a review of records, including the client's needs and services plans, medical records, and interviews with three staff members (S1, S2, and S3) on 11/13/24, Client (C2) on 10/28/24, Kern County Emergency Response Supervising Social Worker (SSW1), on 11/13/24, Kern County Supervising Social Worker (SSW2) on 10/28/24. C3 was unable to provide a statement as they are non-verbal, and C1 chose not to participate in an interview; therefore, no statements were acquired from either individual. (Reference Confidential Names Form LIC 811, dated January 17, 2025). The Following Allegation(s) were reported: UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Winston Moroney 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 32-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, CORPORATE CNTR DR. #200a Monterey Park, CA Facility Name: Yahweh Group Homefacility Number: Visit Date: 01/17/ 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 31 321. Staff hit minor while in care. The personnel (S1, S2, and S3) refuted the claim and affirmed that S1 was absent on the date of the purported incident (October 14, 2024). Furthermore, it was noted that C1 did not report the matter to any staff member present on that day or subsequently to staff S2 and S3. Staff members S2 and S3 reported that they did not witness any marks on C1. They emphasized that such behavior from staff is unacceptable and will be addressed immediately. S2 also mentioned their extensive experience working with their team over the years, highlighting their training in trauma-informed care and various de-escalation strategies. Additionally, staff indicated that C1 has a documented history of aggressive conduct towards both staff and clients, as well as a tendency to fabricate stories to manipulate circumstances for personal gain. Additionally, a statement obtained from C2 indicated that they felt safe residing at the facility and that staff had a good relationship with the clients, C2 denied hearing or witnessing any staff member mistreat or physically abuse any client, however, staff would raise their voices to redirect clients. Information gathered from SSW1 and SSW2 corroborated the previously mentioned details, indicating that C1 exhibited no signs of marks or bruises, and S1 was not present during the incident in question. Furthermore, SSW2 noted that the facility staff demonstrated a high level of attentiveness and support, regularly communicating with them about issues related to C1. SSW2 also pointed out that C1 has a history of aggressive behavior and tends to fabricate stories to manipulate circumstances in their favor. Additionally, SSW2 expressed no concerns regarding the care and supervision provided by the facility staff for her client. Therefore, based on the information received, the above allegation(s) is determined to be unsubstantiated. Although the allegation(s) may have happened are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegation(s) are found to be unsubstantiated. Appeal Rights were provided and discussed with the Foster Family Agency. There are no deficiencies to be cited at this time. An exit interview was conducted and a copy of the report along with the (LIC 811) was left with the Group Home Asst. Administrator. SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Winston Moroney LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: LIC9099 (FAS) - (06/04)Page: 2 of 2

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

met_with: Shakila Mackey


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
The investigation revealed that the facility staff-to-client ratio is one staff for every three clients. It revealed that on October 13, 2024 between 10:30 a.m. and 11 a.m., the Facility Manager Ref. #2 was assisting a client in the bathroom and in charge of supervising two additional clients. Another staff had left the facility with another client on an outing at the same time. It revealed that one of the other clients, Ref. #1(seven years old), that the Facility Manager Ref. #2 was supervising was watching television in the den area. The investigation revealed that Ref. #1 pushed out a screen and climbed out of a living room window. It revealed that a police officer observed Ref. #1 at an intersection at 10:54 a.m. and along with a neighbor returned Ref. #1 to the facility. According to statements, the staff became aware that Ref. #1 was missing at the same time that Ref. #1 was returned to the facility. According to statements, it took the staff approximately 10 minutes to assist the other client in the bathroom. Ref. #1's initial Case Plan, Ref. #1 indicates that Ref. #1 is a special needs child. The CSW indicated that Ref. #1 had a history of eloping behavior. The investigation revealed that after the incident, the facility installed audio alarms on the windows to prevent future occurrences. It revealed that the facility had previously installed alarms on the doors when Ref. #1 was placed. Based upon the information above, including Ref. #1's diagnosis, age and history of attempting to elope, the complaint is valid because the standard of a preponderance of evidence has been met. It is determined that the complaint is substantiated. It is determined that a citation be issued. The facility is being cited for violation of: Title 22, Section 84065.5(c), Staff/Child Ratios: If the children require special care and supervision because of age, problem behavior or other factors, the number of on-duty child care staff shall be increased. - (see 809d). The LPA conducted an Exit Interview and emailed the facility representative a copy of the 9099s, 9099Ds, Appeal Rights (LIC9058) and Proof of Correction (LIC9098).

Investigation Findings:
On February 19, 2025 at 6 p.m., Licensing Program Analyst (LPA), Karen McGee, conducted a follow-up inspection to the facility for the purpose of delivering an amended Complaint Investigation Report regarding the finding on the complaint and to issue a citation. The LPA met with Kanetra Bolden, Facility Manager. On October 14, 2024, the Monterey Park Children's Residential Program (MPCRP), received a complaint with the above mentioned allegations. Confidential interviews were conducted that included, but were not limited to: Client (see Confidential Names, LIC Ref. #1 dated February 6, 2025) at the facility on October 17, 2024; Administrator, Gina Sardano, via telephone on January 31, 2025; a Facility Manager, Ref. #2, via telephone on February 3, 2025; and the County Social Worker (CSW) via telephone on February 5, 2025. The LPA reviewed the incident reports, Ref. #1's Case Plan and police report. The investigation revealed that the facility denied the allegation. It revealed that the facility provided MPCRP a Law Enforcement Contact Report on October 13, 2024 and reported to the CSW the date the incident happened. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Karen McGee 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 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION MONTEREY PARK CRP RO, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: YAHWEH GROUP HOMEFACILITY NUMBER: VISIT DATE: 02/19/2025

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

visit_type: Complaint Investigation

met_with: Kanetra Bolden

complaint_status: SUBSTANTIATED


raw_content:
Narrative:
On May 05, 2025, the Department received a complaint alleging that the Group Home staff do not prevent the minors from attacking another minor while in care. Staff purportedly allowed a minor to attack another minor while standing by idly. Interviews with staff reported that the clients became upset after the two clients began throwing water at one another and that staff separated the two as they became physical with each other. While the staff were separating the clients, the clients continued to engage each other. Staff was able to get them apart, and then created separation between the two including removing one client from the scene by going on a drive while the other stayed back. During the investigation, LPA was provided with two photographs of an arm and a hand reportedly belonging to the client. Staff interviews stated that the client was offered ice and refused to be taken to urgent care. Confidential interviews conducted by LPA revealed contradicting statements regarding the incident including differing accounts of what exactly took place during the incident, and also statements indicating that staff did separate the minors from each other when they engaged after provoking one another. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the allegation is determined to be Unsubstantiated. No deficiencies were cited at this time. Exit interview conducted. A signed copy of this report, LIC9099-C, and LIC811 were provided to David Rivas, Direct Service Provider. LIC9099-C amendment page was signed by Byron Butler, Lead Facility Manager. Appeal rights provided. This is an amended version of the original report created on 08/04/25.

Investigation Findings:
13On August 4, 2025, at 03:45 p.m., Licensing Program Analyst (LPA) John Bonilla conducted a follow-up complaint investigation at Yahweh Group Home, Inc., a Group Home (GH), for the purpose of delivering findings on the above allegation. LPA met with David Rivas, Direct Service Provider. LPA's investigation consisted of the following: On 05/12/25, LPA conducted 10 day at facility, toured facility, and interviewed a client and an adult while conducting a collateral visit at a local school. On 05/13/25, LPA interviewed Reporting Party. On 05/14/25, LPA interviewed the facility administrator over the phone. On 06/10/25, LPA interviewed two (2) staff and two (2) clients during a follow-up inspection at the facility. On 07/28/25, LPA reviewed the GH's complaint history and reviewed documents gathered throughout investigation including but not limited to LIC Personnel Report, Staff Schedule for May 2025, staff phone list, LIC Register of Facility Clients, Needs and Services Plans for Clients 1-5 (See LIC Confidential Names list dated 05/12/25) and a Special Incident Report dated 05/04/2025 . LPA also reviewed pertinent GH records, Department databases, and reports from other agencies. (Continued...) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: John Bonilla 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 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION LA & TRI-COASTAL CR, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: YAHWEH GROUP HOMEFACILITY NUMBER: VISIT DATE: 08/04/2025

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

met_with: David Rivas, Direct Service Provider


summary: Facility Evaluation

raw_content:
Narrative:
On Feb. 15, 2024, at 3:25PM, Licensing Program Analyst (LPA) Carrie Palmer conducted an announced Pre-licensing inspection at the above facility address. LPA met with Gina Sodaro, Administrator, Shakila Mackey, Administrator and Dirk Johnson, CEO. The facility will be licensed for a capacity of six (6) ambulatory male clients ages 7-17 and services will also be provided to non-minor dependents. LPA toured the facility with both Administrators. . This is a one-story home that has three bedrooms each with a mounted TV, two bathrooms, a staff office, a visitation room, a backyard and a television/family room. The facility has a staff office used for storing staff/client files, a locked medication cabinet and extra storage in the hallway closet. There is a living room, dining, and kitchen area. There were sofas and a television in the living room and there is a table and chairs in the dining area. . Each bedroom has two beds with beddings, linens, drawers, and closet space for the clients' use. One out of the three bedrooms have its own private bathroom inside of the room. There are 4 cameras located throughout the facility located in the following areas: 1 cameras in living room 1 camera in the visitation room, two cameras in the hallway, five cameras outside around the perimeter of the house. There was a refrigerator, a gas stove, kitchen utensils, plates, and dinnerware in the kitchen drawers/cabinets. The first aid kit was observed to be new and complete. The home has working telephones. There were working smoke/carbon monoxide detectors near the living room, hallway and in each bedroom. The centralized heating and air were working. All medications will be stored in a locked box/cabinet with a lock located in the hallway closet. All client, staff and facility files will be stored in a locked cabinet in the staff office. Also observed were laptops, a fax/copy machine in the office for staff use. All required postings were posted near the kitchen area. The home meets California Code of Regulations, Title 22, Division 6 physical plant requirements and will be ready to be issued a license pending final review of the application. An exit interview was conducted.

met_with: Gina Sodaro, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Carrie Palmer conducted an unannounced visit to the above facility on 06/26/2024 at 11: AM for the purpose of conducting a Required Post Licensing Inspection. LPA met with the Administrator Gina Sodaro and discussed the purpose of the visit. During the inspection, LPA Palmer completed the following domains: Physical Plant, Operational Requirements, Emergency Intervention Plan, Staffing, Staffing Records and Staff interviews. The Special Needs Domain was not completed; as the facility is not currently serving children with special health care needs. LPA Palmer conducted 5 staff file reviews. There are 3 client in care at the time of inspection. One client is nonverbal. Physical Plant: This is a one-story home that has three bedrooms each with a mounted TV, two bathrooms, a staff office, a visitation room, a backyard and a television/family room. The facility has a staff office used for storing staff/client files, a locked medication cabinet and extra storage in the hallway closet. There is a living room, dining, and kitchen area. Each bedroom has two beds with beddings, linens, drawers, and closet space for the clients' use. One out of the three bedrooms have its own private bathroom inside of the room. There are 4 cameras located throughout the facility. Medications were stores and locked. Chemicals were stored away from children and were not stored with food. Continued.... Operations: The facility has an indoor and outdoor activity plan, which is hung in plain view. LPA Palmer, was able to see board meeting minutes, written compliant procedures posted to include a drop box for staff and clients to communicate their concerns. LPA reviewed the medication log to determine that one child (FC3) is on 3 psychotropic medications; however, one medication was not logged as being administered to the child, but was administered per staff. Staff corrected the non-compliance during the visit. Disaster Preparedness and Emergency Intervention: The facility was able to provide their emergency drill binder to include drills for fire, earthquake, violent and threatening situations, utility failure and bomb threat. Staff Records: During the review of 5 staff records, it was determined that staff received background checks prior to working at the facility. It was also observed that staff receives ongoing training that consists of, but not limited to the following: CPI Training, Delivering Effective Training's and Professional Development of Direct care Staffing, Basic Concepts of Trauma Informed Care, Mental Health Treatment, Understanding and Responding to AWOL Behaviors and Behavior Intervention and Treatment Planning. Job Descriptions were also observed within the staffs files and the administrators certificate is up to date. One of the three staff files did not include the staffs job description. The facility corrected the non-compliance during the visit. S1's file did not contain a TB test in the file. Staffing schedules should list job titles and days off. And all state should be trained on Reasonable and Prudent Parent Standards. And exit interview was conducted and an 809 and an 811 was provided to the administrator. No deficiencies sites


summary: Facility Evaluation

raw_content:
Narrative:
Child Files LPA Palmer, LPA Maico, and LPA Chambers conducted an unannounced post licensing visit with the above-mentioned facility on 7/26/24 at 10:50am. The visit was for the purpose of reviewing children's files. During the inspection review, 5 of 5 clients files were reviewed and the following were observed: client records were available to the licensing agency, all records were stored away in a locked cabinet and were deemed confidential, each clients file showed the clients name, date of birth, sex, admission date, the name address and telephone number of authorized representative. Three (3) out of Five (5) clients were on medication and the Medication Administration Record (MAR) was referenced in each child's file. During the review of the client resources and an interview with the staff, it was determined that the facility encourages the client's social worker to keep all cash resources. The record of client/residents safeguarded Cash Resources Form reflects allowances for the children. A separate log for each psychotropic medication prescribed to the child is located in a locked closet. All needs and services plans are in compliance to include the child's needs for services. An exit interview was conducted and an 809 and an 811 was provided to the administrator. No deficiencies cited


summary: Facility Evaluation

raw_content:
Narrative:
.Person(s) present: LPM Tira Logan Shanks, LPA Carrie Palmer, Administrator Gina Sodaro, Assistant Administrator Shakila Mackey Community Care Licensing Department of Social Services (CCL) and Yahweh Group Home (the facility) met on 4/23/25 to discuss a substantiated complaint investigation regarding the lack of supervision, which resulted in a minor leaving their facility without permission through the window. LPM Logan Shanks began the meeting by reviewing the complaint details and findings. LPM Logan Shanks also shared that during the time of the incident, the facility was not out of ratio since there were two staff and 3 children present. The guidelines state that there should be one staff present for every 3 clients unless a higher level of supervision is required by the placement agency. LPM Logan Shanks asked the facility what their plan moving forward so that a child leaving the facility unnoticed, doesn't happen again? The facility responded by stating, they knew the child was gone and as a result, the facility called the police, which is why the police knew where to bring the child once the child was found. The facility also mentioned that the day that the child left the facility, they placed alarms on the windows; as there were already alarms on the front and back door. Further, the facility shared that they appealed the substantiated findings on 3/6/25 because the LPA that substantiated stated the facility needed a one on one for the child that left the home, but the facility states the child doesn't warrant one on one services. Additionally, per Yahweh, CCL confirmed receipt of the appeal. LPM Logan Shanks stated the facility should receive a response to the appeal in the month of April 2025. The facility currently has 4 children in placement. page 1 of At the conclusion of the meeting, Yahweh GH shared that they had exit audio alarms on the windows and as a result of the incident, they immediately installed exit alarms on the doors. According to Yahweh, after following up with the placement agency the client does not require one on one supervision. An exit interview was conducted, and a copy of the report was provided to the staff on 4/29/25. page 2 of 2

met_with: Gina Sodaro. Administrator


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced annual inspection was conducted by Licensing Program Analysts (LPA) Carrie Palmer on Tuesday, May 13, 2025 at 1:40pm. During this visit, LPA Palmer met with Kayla Johnson, Lead Facility Manager and discussed the nature of the visit. LPA Palmer reviewed the following domain: Physical Plant and Disaster Preparedness. LPA Palmer received a copy of the LIC 500 and the Client Roster. The facility is licensed for a capacity of 6 clients. Current census is 4. This is a one-story home that has three bedrooms two bathrooms, a staff office, a visitation room, a backyard and a television/family room. The facility has a staff office used for storing staff/client files, a locked medication cabinet and extra storage in the hallway closet. There is a living room, dining, and kitchen area . Each bedroom has two beds with beddings, One out of the three bedrooms have its own private bathroom inside of the room. There are 4 cameras located throughout the facility located in the following areas: 1 cameras in living room 1 camera in the visitation room, two cameras in the hallway, five cameras outside around the perimeter of the house. The first aid kit are present. The home has working telephones. The centralized heating and air were working. All medications were stored in a locked box/cabinet with a lock located in the hallway closet. All client, staff and facility files were stored in a locked cabinet in the staff office. The facility was observed to be clean, safe, sanitary, in good repair and passageways were unobstructed. There were no bodies of water on the premises. A copy of this report and the LIC 811 were provided during the visit. An exit interview was conducted. No deficiencies cited during the visit.

met_with: Kayla Johnson, Lead Facility Manager.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced annual inspection was conducted by Licensing Program Analysts (LPA) Carrie Palmer on July 17, 2025 at 9:40am. During this visit, LPA Palmer met with Kayla Johnson, Lead Facility Manager and discussed the nature of the visit. LPA Palmer reviewed the following domain: Written Plan of Operations, Emergency Preparedness, staff files and Children's Files. LPA Palmer received a copy of the updated LIC 500 and the Client Roster. The facility is licensed for a capacity of 6 clients. Current census is 4. Emergency Intervention Plan Staff provided LPA Palmer with information from Foster Parent College regarding trainings for staff. The following trainings were taken by staff: Prudent Parenting, Caring for Children Who have been Sexually Abused, The Role of a Mandated Reporter (Child Abuse), Understanding Behavior of Foster Care Children, Cultural Issues, Child Safety and Supervision, Escalating Behaviors, House Safety, etc. These trainings include the dates, hours and description of the training The facility receives ongoing training. Page 1 of Childs Files - LPA Palmer reviewed with the staff, 4 of 4 children's files. All files are kept in the office in a locked cabinet. 4 of 4 files have a Health and Education Passport to include information regarding health background, education history (schools), doctors appointments, last physical exam dates, current diagnosis, etc. 4 of 4 files included a signed admission agreement, name address and phone number of the authorized representative. Only one child is on psychotropic medications. The JB220A was present in a child's file. The Physicians Report for CCL Facilities was present in all files to identify over the counter medications. The facility keeps an allowance binder for all clients to show the spending patterns for each child. The Preplacement Appraisal Information form was present in 3 of 4 files to include dietary needs. LPA Palmer and staff were unable to locate the Preplacement Appraisal Information in the file during the visit for C1. During an interview with the staff, staff explained that if a child refuses meds, they will document on the back of the med form log and write "R" for refusal to include the date, hour, medication name and reason for refusal and who was notified of the refusal. No one has refused medication at this time, but if a child refuses, CCL is notified. 3 of 4 physical exams were present in the file during the review. During an interview with the staff, it was shared that C3 has an appointment with the doctor, but no prior physical in the file during the visit. Staff informed LPA Palmer during the visit that a conversation with the youth happens regarding roommate compatibility and a roommate compatibility form was presented to the LPA during the visit. Page 2 of 3 . Staff files - LPA Palmer reviewed 5 staff files. Staff obtains fingerprinting. Criminal record clearance or an exemption prior to employment. Drivers' Licenses were present in all 5 files. Job descriptions, health assessments, Administrator Certifications, were present. The facility uses an app called Breakroom to record the staff schedule. Facility Managers have been trained prior to acting in the role. Within 7 calendar days of the completion of an 8 hour training for staff, assessments are conducted by the administrator or designee for staff comprehension of the training's. All staff have their first aid certifications. There are children with a diagnosis of mental health disorders who are seen by the House Social Worker who also is a Licensed Marriage and Family Therapist (LMFT). Clients with Special Health Care Needs N/A A copy of this report and the LIC 811 were provided during the visit. An exit interview was conducted. No deficiencies cited during the visit

met_with: Kayla Johnson, Lead Facility Manager and Shakila Mackey, Assistant Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On October 15, 2025, at 12:30 p.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management- Other inspection for the purpose of delivering an amended report of complaint 32-CR-20250505223031, originally delivered on August 04, 2025. LPA met with Byron Butler, Lead Facility Manager. No deficiencies were cited during this inspection. Exit interview conducted. A signed copy of this report was provided to Byron Butler, Lead Facility Manager. No further action required.

met_with: Byron Butler, Lead Facility Manager


raw_content:
Narrative:
A third witness indicated that the FM did not hurt anyone. The FM denied putting her hands on any of the clients. The investigation revealed that none of the witnesses shared the FM hitting or slamming incident that occurred at the facility with BPD. The investigation revealed an incident in which the FM who was not on duty picked up C1, C2 and C3 from a store after the Clients had left the facility without permission. While the FM denied having biological children, the FM failed to disclose to the LPA that the FM had teenage relatives in the car when she picked up the Clients. The investigation revealed that the relatives were a 12 and 14 years old, male and female relative, respectively. It revealed conflicting statements regarding whether the 12 and 14 year old got into physical altercations with the clients. The investigation revealed that C2, who is 14 years old, punched the 14 year old female and the female punched C2 in return. The investigation revealed conflicting statements as to whether the FM hit or punched any of the Clients during the incident. An interview with the CSW revealed that the CSW was not informed of any hitting. The BPD report indicated that the investigating officer was given inconsistent statements and there were no injuries to determine that a crime had occurred. The LPA was unable to obtain sufficient evidence to corroborate the allegation. There was no preponderance of the evidence to substantiate the allegation. So, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegation is unsubstantiated. There are no deficiencies to be cited regarding this allegation. A copy of this complaint was provided to the facility representative.

Investigation Findings:
13On January 15, 2025 at 2:25 p.m., Licensing Program Analyst (LPA), Karen McGee, delivered the findings of a complaint investigation to the facility. The LPA met with Lead Facility Manager, Kayla Johnson. On September 2, 2025, Monterey Park Children's Residential Program (MPCRP), received a complaint with the above mentioned allegation. Confidential interviews were conducted that included, but were not limited to: three Clients (C1), C2 and C3, at their respective placements and schools on November 6, 2025, January 7, 2026 and January 8, 2026, respectively; one Facility Manager (FM), Tamorra Davis, via telephone on January 10, 2026; and C1's County Social Worker (CSW) via telephone on October 13, 2025. The LPA conducted an interview with the Administrator on February 12, 2026. The LPA reviewed the Incident Reports and Bakersfield Police Departments (BPD) report. The LPA's investigation revealed conflicting statements from the witnesses. While there was at least one incident that appeared to be similar, there were no details provided from the witnesses to corroborate the incident. One witness indicated that while at the facility the FM grabbed their shirt and slammed them, while another witness indicated as they passed by C1's bedroom the FM swung C1 on the bed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Karen McGee 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 -CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION MONTEREY PARK CRP RO, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: YAHWEH GROUP HOMEFACILITY NUMBER: VISIT DATE: 01/15/2026

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


raw_content:
Narrative:
There were statements that C1 was observed with bruises on C1's hands and forearms and on one occasion was observed with a chipped tooth; was kept in C1's bedroom for a long period of time and eloped from the facility. The investigation revealed that C1 is non-verbal and engages in self injurious behavior which is due to C1's diagnosis. The investigation revealed that C1 sustained a chipped tooth one night as a result of C1's self injurious behavior. The investigation revealed that the staff noted the incidents on the Daily Communication Page and Shift Progress Notes. The statement that C1 was locked in C1's bedroom was recanted and the staff that was accused of keeping C1 in their bedroom for a long period of time denied the allegation indicating that when they are on duty C1 is usually at school. The investigation revealed that the facility was in staff-to-client ratio when C1 eloped from the facility. A review of records revealed that the facility reported the incident on a Law Enforcement Contact Report. A review of the Needs & Services Plan did not indicate a history of running away. The Bakersfield Police Department Report indicated that the Officer was not able to substantiate any evidence indicating that C1's injuries were the result of any activity other than self injurious behavior. The LPA was unable to obtain sufficient evidence to corroborate the allegations. There was no preponderance of the evidence to substantiate the allegations. So, although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegations are unsubstantiated. There are no deficiencies to be cited regarding these allegations. A copy of this complaint was provided to the facility representative.

Investigation Findings:
On February 27, 2025 at 1:45 p.m., Licensing Program Analyst (LPA), Karen McGee, delivered the findings of a complaint investigation. The LPA met with Lead Facility Manager, Kayla Johnson. On October 1, 2025, Monterey Park Children's Residential Program (MPCRP), received a complaint with the above mentioned allegation. Confidential interviews were conducted that included, but were not limited to: Facility Manager, Tamorra Davis, at the facility on October 3, 2025, the Lead Facility Manager via telephone on February 3, 2026, the Administrator via telephone February 12, 2026, Facility Manager, Cyncere Wright via telephone on February 19, 2026; LPA Amber Hunter conducted a telephone interview with the County Social Worker (CSW); the LPA was unable to interview Client (C1) and C2, who are non-verbal. The LPA attempted a few telephone calls for C3 with no without success. The LPA conducted an interview with C4 at school on February 27, 2026. The LPA reviewed the following documents: C1's Needs and Services Plan, Case Plans for C2, C3 and C4 in the CWS/CMS, incident reports and Law Enforcement Contact Report, Daily Communication Page, Shift Progress Notes, and Bakersfield Police Department Report. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Karen McGee 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 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION MONTEREY PARK CRP RO, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: YAHWEH GROUP HOMEFACILITY NUMBER: VISIT DATE: 02/27/2026

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


facility_name: YOUTH CONNECTED PROGRAM

raw_content:
Narrative:
of evidence. Based on confidential interviews and records reviewed the allegation that staff withheld food from C1, which may have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Enrique Montiel. Due to printer malfunction, a copy of this report, LIC 811, and appeal rights was emailed to the Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On August 26, 2024, at 11:00 am, Licensing Program Analyst (LPA) Charmaine Linley conducted an unannounced complaint inspection at the above facility. LPA Linley met with Enrique Montiel, Program Director. The purpose of the inspection was to deliver the findings of the complaint investigation. LPA Linley conducted an inspection of the facility on May 13, 2024, at 10:39 am and no deficiencies were found. LPA Linley interviewed one client (C1) and four staff (S1-4). During the investigation, the following documents were reviewed: Dorm Schedule, C1's Needs and Services Plan, C1's Child Family Team Meeting Notes, Sample Menu, Social Worker Case Notes, and Dorm notes. On May 10, 2024, Community Care Licensing (CCL) received an allegation that staff withheld food from C1. It was reported that staff did not tell C1 that dinner was served and later when they went to eat dinner, C1 was told they needed to complete their chore before eating dinner. Confidential interviews revealed conflicting statements. Thus, confidential interviews did not corroborate the allegation with a preponderance UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley 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 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION ORANGE COUNTY RO, THE CITY DR., SUITE FACILITY NAME: YOUTH CONNECTED PROGRAMFACILITY NUMBER: VISIT DATE: 08/26/2024

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

met_with: Enrique Montiel


summary: Facility Evaluation

raw_content:
Narrative:
On October 15, 2021 at 11:14am, Licensing Program Analyst (LPA) Adrian Mendez arrived unannounced at the facility to conduct a Post-Licensing/Required Annual inspection of the facility. The facility was inspected inside and out with Director of Compliance and Quality Assurance Annie Bach. The group home/dorm consists of three stories, each level is identical and contains an A side and a B side. Each side (A & B) contain three full bathrooms, one quarter bathroom, four bedrooms, a quiet room, kitchen, dinning area, living room, and laundry room. The staff office is between side A and side B which allows access from both sides. There is an elevator to access the upper stories of the building. The building is a smart technology building that can be locked down in case of an emergency. There are currently no children placed at the facility at this time. Bedrooms will be occupied by two residents; two twin beds, all required linens, new mattresses and custom made bedframes that have a side desk. All bedrooms contained adequate shelf and closet space for resident's belongings. The staff offices contained office supplies, emergency and disaster supplies and first aid kit. There was also space for resident files and cabinets to lock medications in staff office. The staff office also contains a small refrigerator for medications. The bathrooms were clean and in good repair. The temperature measured in one of the client restrooms was 114.2 degrees F which is within required range. The kitchens have a large island that gives ample amount of space for six children. The island has pop-out electrical outlets if the children choose to work on their laptops on the counter. The kitchens have two ovens, microwave oven, and a large refrigerator. The kitchen has a large drawer that locks and will hold sharp objects if necessary. The kitchen, dining and living room area is an open concept. The dining areas have large tables with ample amount of seating for children and guests to be accommodated. The living room areas have large sectional sofas, a big screen television and a small table with chairs.Cont. 809-C Each side (A & B) contains a laundry room, which has two washers and dryers. There is also a locked cabinet that can be used for storage of chemicals or if a child wants to lock their hygiene. There are unlocked cabinets that will contain hygiene kits and hygiene back-up supplies. There is a quiet room that has a sofa and seating for a CFT or family visit, and will also be used by the children to read and play games. There were books, board games and activity books available for the children in the quiet room. Adjacent to the quiet room there is an attached quarter bathroom which can be used by children, staff and visitors. The dorms are located on the Samueli Academy grounds and each side has a large patio space that is currently unfurnished, and has electrical outlets. On the bottom level there is an additional large patio with a barbecue for the children to use with family and friends. All hazardous items were made inaccessible to areas where residents do not have access. Cleansers/chemicals were stored in a locked closet with in the dorms. The facility's smoke detectors/carbon monoxide detectors are in the hallways and bedrooms also include a sprinkler system and light up per ADA requirements. There were no guns or weapons in the facility as stated by Annie Bach. LPA observed a sufficient supply of 7-day non-perishable food for six residents and a sufficient supply of 2-day perishable food. There was a variety of snacks available for residents as well. The facility outside grounds were also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. Personnel files were reviewed to ensure they contained all required documentation per Title Regulations. Personnel Files are maintained on an online database. LPA reviewed four staff files, no discrepancies were observed. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances. Based on the facility inspection and file reviews this date, there are no deficiencies found at this time. A copy of this report was reviewed with Director of Compliance and Quality Assurance Annie Bach. Due to printer malfunction, this report will be emailed to Director of Compliance and Quality Assurance Annie Bach.

met_with: Annie Bach


summary: Facility Evaluation


summary: Facility Evaluation

raw_content:
Narrative:
On October 18, 2023 at 10:00 am, Licensing Program Analysts (LPAs) Charmaine Linley and Jacqueline Garcia arrived unannounced at the facility to conduct a Required Annual inspection of the facility. The facility was inspected inside and out with Director of Compliance and Quality Assurance Annie Bach and Program Director Enrique Montiel. The group home/dorm consists of three stories, each level is identical and contains an A side and a B side. Each side (A & B) contain three full bathrooms, one quarter bathroom, four bedrooms, a quiet room, kitchen, dining area, living room, and laundry room. The staff office is between side A and side B which allows access from both sides. There is an elevator to access the upper stories of the building. The building is a smart technology building that can be locked down in case of an emergency. There are eight clients placed at the facility. Bedrooms are occupied by two residents and there are two twin beds with no more than one resident per bed, all required linens, and custom-made bedframes that have a side desk. All bedrooms contained adequate shelf and closet space for resident's belongings. The staff offices contained office supplies, emergency, and disaster supplies and first aid kit. There was also space for resident files and cabinets to lock medications in staff office. The staff office also contains a small refrigerator for medications. The bathrooms were clean and in good repair. The temperature measured in one of the client restrooms was 105 degrees F which is within required range. The kitchens have a large island that gives ample amount of space for six children. The island has pop-out electrical outlets if the children choose to work on their laptops on the counter. The kitchens have two ovens, microwave oven, and a large refrigerator. The kitchen has a large drawer that locks and will hold sharp objects if necessary. The kitchen, dining and living room area is an open concept. The dining areas have large tables with ample amount of seating for children and guests to be accommodated. The living room areas have large sectional sofas, a big screen television and a small table with chairs. *** Each side (A & B) contains a laundry room, which has two washers and dryers. There is also a locked cabinet that can be used for storage of chemicals or if a child wants to lock their hygiene. There are unlocked cabinets that contains hygiene kits and hygiene back-up supplies. There is a quiet room that has a sofa and seating for a CFT or family visit and is also used by the children to read and play games. There are books, board games and activity books available for the children in the quiet room. Adjacent to the quiet room there is an attached quarter bathroom which can be used by children, staff and visitors. The dorms are located on the Samueli Academy grounds and each side has a large patio space that has outdoor furniture and has electrical outlets. On the bottom level there is an additional large patio with a barbecue for the children to use with family and friends. All hazardous items were made inaccessible to areas where residents do not have access. Cleansers/chemicals were stored in a locked closet within the dorms. The facility's smoke detectors/carbon monoxide detectors are in the hallways and bedrooms also include a sprinkler system and light up per ADA requirements. There were no guns or weapons in the facility as stated by Annie Bach. LPAs observed a sufficient supply of 7-day non-perishable food for eight residents and a sufficient supply of 2-day perishable food. There was a variety of snacks available for residents as well. The facility outside grounds were also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. Personnel files were reviewed to ensure they contained all required documentation per Title Regulations. Personnel Files are maintained on an online database. LPAs reviewed five staff files, no discrepancies were observed. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances. LPAs also reviewed five out of eight children's files. All files had required documents. Based on the facility inspection and file reviews, there are no deficiencies found at this time. A copy of this report was reviewed with Director of Compliance and Quality Assurance Annie Bach and Program Director Enrique Montiel. Due to printer malfunction, this report will be emailed to Director of Compliance and Quality Assurance Annie Bach. A copy of this report will be placed in the facility file.

met_with: Annie Bach and Enrique Montiel


summary: Facility Evaluation

raw_content:
Narrative:
On 05/09/25 at 09:00 am, Licensing Program Analysts (LPA) Gilbert Marquez and Licensing Program Manager (LPM) Ann Valenzuela met with Chief Compliance Officer (CCO) Annie Bach to conduct an annual inspection of the facility. The facility is licensed to serve dependents and non-minor dependents in the 7th through the 12th grade. The current census is nine clients. The facility was inspected inside and out with CCO. The group home consists of three stories, and each level is identical and have an A side and a B side. Each side (A & B) contain three full bathrooms, one quarter bathroom, four bedrooms, a quiet room, kitchen, dining area, living room, and laundry room. The staff office is between side A and side B which allows access from both sides. There is an elevator to access the upper stories of the building. The building is a smart technology building that can be locked down in case of an emergency. The staff offices are located on the third floor. The offices contain office supplies, emergency disaster supplies and first aid kit. There are five offices and the dining living area is utilized as a training area. Cleansers/chemicals were stored in a locked closet within the dorms. All hazardous items were made inaccessible to areas where residents do not have access. **Continued on LIC809C** All beds were observed with appropriate bedding and mattress in good repair. Bedrooms contained adequate drawers and closet space.The bathrooms were clean and in good repair. The temperature measured in one of the client restrooms was 120 degrees Farenhiet which is within required range. The kitchen has a large drawer that locks and will hold sharp objects if necessary. Each side (A & B) contains a laundry room, and there is also a locked cabinet that can be used for storage of chemicals or if a child wants to lock their hygiene. There are unlocked cabinets that contains hygiene kits and hygiene back-up supplies. There is a quiet room that has a sofa and seating for a Client and Family Team (CFT) meetings or family visit and is also used by the children to read and play games. The facility's smoke detectors/carbon monoxide detectors are in the hallways and bedrooms also include a sprinkler system and light up per ADA requirements. There were no guns or weapons in the facility as stated by CCO. LPA observed a minimum seven-day non-perishable and two-day perishable supply of food. There was a variety of snacks available for residents as well. The facility outside grounds were also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. All required forms are posted including Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster, and the Emergency Disaster Plan. Clients' medications were observed to be inaccessible and stored in a locked cabinet within the walk through offices which are located between each dorm. In addition, each walk through office had a first aid kit. LPA observed cameras in the shared space of the dorms and are placed around the front outside of the facility. All client files are stored and maintained on a secure internet database. LPA reviewed five client files (C1 - C5), please refer to Confidential Names List LIC 811, to ensure clients had all required documents per Title 22. Client files had required signed Needs and Services Plans, Health screenings, and signed Personal Rights forms. LPA reviewed five client medication records. Staff records are stored via a secured records portal. LPA reviewed five staff files (S1 - S5) to ensure staff had all required documents per Title 22 regulations. Per a review of Guardian, all staff have a criminal record clearance. Staff files had resumes, health screenings, and training logs. **Continued on LIC809C PAGE 3** **Continued from LIC809C PAGE 2** LPA conducted two staff interviews (S1, S4) and two client interviews (C1, C4). Based on the facility inspection and file reviews, there are no deficiencies found at this time. An exit interview was conducted, and a copy of this report, Confidential Names List (LIC 811) were provided to with Chief Compliance Officer, Annie Bach. A copy of this report will be placed in the facility file.

met_with: Annie Bach, Chief Compliance Officer


facility_name: ZEN HOUSE

raw_content:
Narrative:
Center Initial Services Summary, C2 face sheet, Functional Behavior Assessment and Behavior Intervention Plan, and Staff Schedule. On 11/21/2022, Community Care Licensing (CCL) received allegations that staff are conducting restraints which are not in their program statement, staff are not recording medication distribution appropriately, enemas are given without a nurse and restricted health care plan, and staff allowed C2 to walk alone from bus stop unsafely. Confidential interviews revealed that S2 restrained C2 on two separate occasions. Documents reviewed revealed that C2 was restrained on four occasions. A review of the program statement indicated that the facility does not use restraints. For the allegation that staff is not recording medication distribution appropriately, it was reported that on 10/26/2022, S7 signed off on C1's medication administration records for medication times that had not yet been administered and the medications remained in the bubble pack. Confidential interviews and records reviewed revealed that S7 signed off on the medication before the administration time and the medication remained in the bubble pack. Regarding the allegation that C2 was given an enema without a nurse and restricted health care plan, confidential interviews revealed that C2 was given an enema on several occasions by staff members. A review of the facility program statement indicated that the facility was not approved for specialty health care services which is needed to provide restricted health care. Lastly, for the allegation that staff allowed C2 to walk alone from the bus stop in an unsafe manner, confidential interviews revealed that when S1 picked up C2 from the bus stop and they were in the vehicle, C2 tried to hit S1. S1 told C2 to walk back to the facility and they drove the vehicle alongside C2 while C2 walked to the facility. Based on confidential interviews and record review, the allegations that staff are conducting restraints which are not in their program statement, staff are not recording medication distribution appropriately, enemas are given without a nurse and restricted health care plan, and staff allowed C2 to walk alone from bus stop unsafely are Substantiated. The preponderance of evidence standard has been met. The facility is cited for violation of the California Code of Regulations, Title Division Six, regulations Plan of Operation(b)(4); 80075(k)(7) Health-Related Services; Individualized Health Care Plans for Specialized Group Homes 84069.2(a); and Transportation 84074(d). An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Monica McDade. Due to printer malfunction, a copy of this report, LIC 811, and appeal rights will be emailed to the Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On September 15, 2023, at 11:10 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced to the facility and met with Monica McDade, Facility Administrator, to discuss the investigative findings for the allegations noted above. LPA Carol Anderson conducted an inspection of the facility on 11/28/2022 at 10:26 am. No deficiencies were observed. LPA Anderson interviewed one staff (S1), San Diego Regional Center Representative (SDRC2), and Authorized Representative (AR) and attempted to interview one client (C2), however, C2 was unable to verbally communicate with LPA. LPA Linley interviewed six staff (S1-6), was unable to interview one staff (S7), despite multiple attempts to contact them, and Authorized Representative (AR). LPA reviewed the following documents: C2's behavior logs, Photos and text messages from Authorized Representative, Incident Reports, San Diego County Sheriff's Department Incident Reports, S7 disciplinary action, Guardian Roster, LIC 500, C Medication Administration Records, C Admission Agreement, C Individual Program Plan (IPP), C2 release of client information, C2 consent for emergency medical treatment, house rules, personal rights, San Diego Regional SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley 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 CCLD Regional Office, FACILITY NAME: ZEN HOUSEFACILITY NUMBER: VISIT DATE: 09/15/2023

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

met_with: Monica McDade


raw_content:
Narrative:
Based on confidential interviews and records reviewed, the allegation that staff engaged in a physical altercation with C1, which may have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Monica McDade. Due to printer malfunction, a copy of this report, LIC 811, and appeal rights will be emailed to the Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On 12/18/2023, at 11:30 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Monica McDade, Facility Administrator, to discuss the investigative finding for the allegation noted above. Lpa C. Anderson conducted an inspection of the facility on 08/23/2023 at 2:45 pm and no deficiencies were observed. LPA Linley interviewed one client (C1), and four staff (S1-4), LPA was unable to interview two individuals (S5, A1), despite multiple attempts to contact them. LPA reviewed the following documents during the investigation: C1's Admission Agreement, C1's Individual Program Plan (IPP), C1's physical health report, two videos, a printout from Guardian, and a copy of A1's employee file. On 08/23/2023, Community Care Licensing (CCL) received an allegation that facility staff engaged in a physical altercation with C1. Confidential interviews revealed conflicting statements. Confidential interviews did not corroborate the allegation with a preponderance of evidence. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley 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 CCLD Regional Office, FACILITY NAME: ZEN HOUSEFACILITY NUMBER: VISIT DATE: 12/18/2023

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


raw_content:
Narrative:
Confidential interviews revealed a witness could not recall if staff was present during the incident. Conflicting confidential interviews indicated that staff used verbal prompt to calm down C1 and C2 during the physical altercation, however, C1 and C2 ignored staff direction. Confidential interviews did not yield evidence to corroborate that the altercation occurred because of lack of supervision. Based on interviews and documentation reviewed, the allegation that due to lack of supervision, minors engaged in a physical altercation which resulted in injuries is not supported or proven by the evidence gathered; therefore, the allegation is determined to be 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 and a copy of this report and appeal rights were provided to Licensee Monica McDade.

Investigation Findings:
13On October 18, 2024, at 1:09PM, Licensing Program Analyst (LPA) Carol Anderson arrived at the facility and met with Licensee Monica McDade to deliver the finding of the above allegation. LPA initiated a complaint inspection at the facility on 1/08/2024 at 2:00PM, and no immediate deficiencies were observed. During the investigation, interviews were completed with Client 1 (C1), Staff (S1), and Licensee. LPA attempted to interview Client 2 (C2) several times, however, LPA did not receive a return call. In addition, LPA reviewed C1 and C2's files and other pertinent documents. LPA reviewed law enforcement police report as well as incident reports. On December 29, 2023, Community Care Licensing (CCL) received a complaint alleging that due to lack of supervision, minors engaged in a physical altercation which resulted in injuries. Confidential interviews revealed conflicting statements that C1 and C2 were involved in a physical altercation, and C1 was transported by paramedics to the hospital with resulting injuries to C1's forehead. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: Carol Anderson 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. # FACILITY NAME: ZEN HOUSEFACILITY NUMBER: VISIT DATE: 10/18/2024

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