raw_content:
Investigation Findings:
13On September 3, 2025, Licensing Program Analyst (LPA) Justine Armstrong conducted an unannounced visit to Chateau #1 to conclude the investigation of the above allegation and deliver the findings. LPA met with Fazeela Shaikh, who granted access to the facility, and together, they discussed the investigation During the investigation process, all relevant parties have been accounted for. It was reported that Staff did not ensure that minors were accorded privacy while in care. After conducting confidential interviews and reviewing documents, there was insufficient evidence or testimony to substantiate the allegations. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violation occurred. The Department has decided that the allegation of Health Related Service is Unsubstantiated, but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies cited. An exit interview was completed, and a copy of this report was provided to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Enrique M Hernandez LICENSING EVALUATOR NAME: Justine Armstrong 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


state: CA

facility_name: CHATEAU #1

summary: Facility Evaluation

raw_content:
Narrative:
On June 6, 2024 at 9:17AM Licensing Program Analyst (LPA) Christine Wilson arrived at the above facility for the purpose of conducting a Pre-Licensing inspection. LPA Wilson met with the Facility Administrator (FA) and Consultant (FC)who granted access to the facility. This is a one story facility, located at S. Orange Grove Ave. Los Angeles, CA. 90019. which consists of three (3) bedrooms, two (2) bathrooms, an office for therapy, carport two (2) car garage used for laundry, and additional storage, living room, kitchen, dining area and hallway. The facility can also be accessed through entrance in the staff office, which is a sliding door. The facility is licensed to provide care and supervision for four (6) clients ages 12-17, ambulatory only. There is a pool on the premises. Per (FA) there will be no non-minor dependents with children serviced. There is no facility vehicle at the time of this inspection. The facility will intake both male and female clients. Per (FA) a facility van for (8) passengers will be purchased. At 9:40 am LPA conducted a walk through of the facility with staff (FM) and with consultant (FC). There are six (6) hard-wired smoke detector and (1)carbon monoxide detector; tested to be operable. There are (2) fire extinguishers with December 2024 expiration date. 9:53am Office: This room will be used as office space to serve as private setting for therapeutic services and for conducting private interviews. Medications and other medications will be stored in a locked cabinet. Recommendation is to place a door lock on the office door. (FC) stated there will be software used for e-records (Alleva or Best Notes EMR).Office has a phone for client phone calls. Room features three (3) chairs, table, computer, printer, scanner and desk with office chair. There is a smoke alarm in this room. There is a sliding door that leads to outdoor patio area. The door is equipped with an alarm sensor, and there is a ceiling fan. Continued on LIC809C Page 2 of Page Living Room: The living room is fully furnished. The living room is a common area with seating for eight (8), small shelves, television and in-operable fireplace with one (1) ottoman. All windows have screens. There is a smoke alarm tested to be operable. Dining Area: The dining area consists of (8) eight chairs and a large table Kitchen #1: The kitchen was observed to be clean and organized. The kitchen stove is gas operated with (4) burners, sink features a filtered water fountain. A double door refrigerator with bottom freezer. Disinfectants are under the kitchen sink, and sharp knives are also inaccessible in a lock box. Licensee will need to purchase a lock to lock disinfectant items in cabinets. There are (3) three bar stools and an island for dining. Hallway Closet: Contains hygiene and PPE products and additional cleaning products. Licensee will need to purchase a lock to lock disinfectant items in closet. There is thermostat set at a comfortable temperature. Bedroom #1: is equipped with (2) two twin size beds, linen, blankets, pillows, adequate lighting, and closet space. There are (2) two night stands and (2) two dressers, and a closet. Windows have screens and are operable. Personal hygiene products and caddys are also stored in the bedroom. There is (1) smoke alarm. Linen Closet: Additional linens and towels are stored in the closet. Personal hygiene products and caddys are also stored in the closet. Bathroom #1 is a full on-suite bathroom located adjacent to bedroom 1. Toilet, (1) sink and shower are in good condition. . Bedroom #2: is equipped with (2) two twin size beds, linen, blankets, pillows, adequate lighting, and closet space. There are (2) two night stands and (2) two dressers, and a closet. Windows have screens and are operable. Personal hygiene products and caddys are also stored in the bedroom. There is (1) smoke alarm. Bathroom #2 is a full bathroom and located adjacent to this room. Toilet, (1) sink and shower are in good condition. Continued on 812C page Page Bedroom #3: is equipped with (2) two twin size beds, linen, blankets, pillows, adequate lighting, and closet space. There are (2) two night stands and (2) two dressers, and a closet. Windows have screens and are operable. Personal hygiene products and caddys are also stored in the bedroom. There is (1) smoke alarm. (CM) leaves at this time. 10:12am: Outdoor Area: There is an exit to the outdoor area through the staff office or two (2) gates east and west. There is outdoor furniture for (6) persons, including a fire pit. There is an outdoor kitchen and garage with (2) Nest cameras, which staff have cellular access to. Outdoor kitchen should be free from combustible material. LPA observed lighter fluid, charcoals and dry wood. Per the (FA) these will be removed. Outdoor kitchen has a large outdoor oven with (4) oven doors, grille, stove and refrigerator with double paned glass doors. There is a 6ft high fence. There is a (4) ft deep pool. LPA observed there is an enclosure that is self-latching. The enclosure does not meet the height requirement (See PIN 23- CCLD YEAR-ROUND/DAILY REMINDER OF WATER SAFETY REQUIREMENTS AND MEASURES ). The height of the enclosure is 54 inches on the north side and 48.5 inches on the west side. Per (FA) the fence will be replaced. There is no pool cover. 10:25am Garage: This area is considered a multi-purpose storage and laundry room, and is utilized to store additional equipment; extra laundry and toiletry supplies and other donated items. The detergent, chemical and cleaning supplies are not stored in a locked cabinet above. Licensee will need to purchase a locked cabinet or storage bin to lock cleaning and laundering items in cabinets. 10:41am Car Port: Carport features an outdoor chandelier. There is a water vale located o the west side of the home. The HVAC and Boiler room with water heater is located on the east side of the home. Front of the home features a large porch, (2) rocking chairs, table and entrance has a keypad for safety.

report_type: Facility Evaluation

visit_type: Prelicensing

met_with: Facility Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On July 2, 2024 at 8:47AM Licensing Program Analyst (LPA) Christine Wilson arrived at the above facility for the purpose of concluding a Pre-Licensing inspection. LPA Wilson met with the Facility Administrator (FA) who granted access to the facility. This is a one story facility, located at S. Orange Grove Ave. Los Angeles, CA. 90019. which consists of three (3) bedrooms, two (2) bathrooms, an office for therapy, carport two (2) car garage used for laundry, and additional storage, living room, kitchen, dining area and hallway. The facility can also be accessed through entrance in the staff office, which is a sliding door. The facility is licensed to provide care and supervision for (6) clients ages 12-17, ambulatory only. There is a pool on the premises. There is no facility vehicle at the time of this inspection. The facility will intake both male and female clients. At 9:09 am LPA conducted a walk through of the facility with staff (FA) to observe those areas of the home, that LPA Wilson provided technical advisory to meet the requirements. Office: On this day, LPA Wilson observed there is now a lock on the office door. A small refrigerator for medications requiring refrigeration was observed. LPA Wilson advised a lock be placed on the refrigerator, which (FA) has and will install. 9:16 am Pool: During the previous inspection, LPA observed the enclosure does not meet the height requirement The height of the enclosure was 54 inches on the north side and 48.5 inches on the west side. The fence was to be replaced and there was no pool cover. On this day, LPA Wilson observed there is a 5ft mesh fence with self latching mechanism, and a pool cover which meet the requirements. Continued on 809C Page Page 2 9:19 am Garage Area: During the previous inspection, boxes, furniture, clothing and toys obstructed the space. On this day, LPA Wilson observed items removed and others organized with bins and shelving. LPA Wilson observed a large crack running the length of the garage space, and advised this could be a potential hazard. (FA) stated that a rug or covering will be placed on the garage floor. Garage: During the previous inspection, the detergent, chemical and cleaning supplies were not stored in a locked cabinet above. On this day, LPA Wilson observed items organized with bins and shelving, as well as a locked file cabinet for cleaning supplies. 9:22 am Kitchen #1: During the previous inspection, disinfectants were under the kitchen sink, and sharp knives were also inaccessible in a lock box. On this day, LPA Wilson observed two (2) combination locks to lock disinfectant items under the sink and as a double lock for sharps stored in cabinets above the microwave. All areas observed meet requirements. (FA) stated that she will create a Guardian profile for the facility and begin the background clearance check process today. A copy of this report was shared with the Facility Administrator and will be emailed.

met_with: Fazeela Shaikh (FA)


summary: Facility Evaluation

raw_content:
Narrative:
On 08/06/24 at 3:30pm, Licensing Program Analyst (LPA) Christine Wilson and System of Care (SoC) Analyst Ansar Muhammad, held a TA Meeting for Abounding Rivers STRTP Application via TEAMS. The meeting was help for the purpose of providing feedback on the second draft of the application. In Attendance: LPA Christine Wilson, Ansar Muhammad, System of Care (SoC) Analyst, Fazeelah Shaikh, Porche Randle , Andralyn Keys and Consultant Norma LPA Wilson informed applicant that they are registered to attend the Component STRTP meeting and will receive a registration letter from LPA Wilson. LPA Wilson will also send an inquiry to the CPMB liaison, regarding DOJ background clearance status. Applicants received request for re-write/ further clarification on the following: PLAN OF OPERATIONS D. Staff Plan G. Admission Determination Procedures J. Removal or Transfer Policies and Procedures Q. Continuous Quality Improvement (CQI), PROGRAM STATEMENT Trauma Informed Interventions and Treatment Practices Development, Implementation, and Modification of Needs and Services Plan Planned Activities Plan for Participation in Child and Family Team Identification of Home-Based Settings, Development of Individualized Aftercare Support Plan, & Documentation of Process to Implement Treatment and Services Continued on 809C page Page PROGRAM STATEMENT Participation of Family Members in Treatment & Outreach to Family Complaints and Grievances Children and Non-minor Dependents Personal Rights House Rules Positive Discipline Policies Mental Health Program Approval Emergency Intervention Plan Applicant asked LPA Wilson to find examples of language to possibly be utilized for taking youth with service pets. SoC Analyst will provide additional technical assistance prior to the third draft submission. Meeting ended at 4:21pm

met_with: Fazeela Shaikh


summary: Facility Evaluation

raw_content:
Narrative:
On 08/27/24 at 10:00am, Licensing Program Analyst (LPA) Christine Wilson and System of Care (SoC) Analyst Ansar Muhammad, held a TA Meeting for Abounding Rivers STRTP Application via TEAMS. The STRTP applicant has requested this TA meeting, prior to submitting the final application draft. In Attendance: LPA Christine Wilson, Ansar Muhammad, System of Care (SoC) Analyst, Fazeelah Shaikh, Porche Randle , Andralyn Keys and , Martin LaRoche and Norma Edwards LPA Wilson informed applicant that she will be out of the office and returning on September 4, 2024. Applicants received support for re-write/ further clarification on the following: PLAN OF OPERATIONS D. Staff Plan G. Admission Determination Procedures J. Removal or Transfer Policies and Procedures Q. Continuous Quality Improvement (CQI), PROGRAM STATEMENT Trauma Informed Interventions and Treatment Practices Development, Implementation, and Modification of Needs and Services Plan Planned Activities Plan for Participation in Child and Family Team Identification of Home-Based Settings, Development of Individualized Aftercare Support Plan, & Documentation of Process to Implement Treatment and Services Continued on 809C page Page PROGRAM STATEMENT Participation of Family Members in Treatment & Outreach to Family Complaints and Grievances Children and Non-minor Dependents Personal Rights House Rules Positive Discipline Policies Mental Health Program Approval Emergency Intervention Plan LPA Wilson informed applicant that she will be out of the office and returning on September 4, 2024. Applicant will meet again informally with System of Care (SoC) Analyst Ansar Muhammad, regarding TA refinement of the Plan of Operations, Staff Plan section. Meeting ended at 11:58am

met_with: License Applicants and Consultants


summary: Facility Evaluation

raw_content:
Narrative:
On 04/09/2025, at 10:00 am, Licensing Program Analyst (LPA) Nestor Gomez returned to the above-mentioned facility to continue the post-licensing inspection that was started on 03/05/2025. LPA Gomez met with Facility Manager (FM), Martin Usher who granted access to the facility. The following was observed during the Inspection: Staff Interviews: LPA conducted one (1) staff interview with FM. Staff Records Review: LPA reviewed staff records for the Facility Administrator (FA), Porche Randle and FM. Clients Records Review: LPA reviewed client record for and C1 which meet qualification. There were no deficiencies observed or cited at this time. Exit interview was conducted with the Facility Administrator and a copy of this report was emailed to the Facility Administrator.

met_with: Direct Care Staff - Martin Usher


summary: Facility Evaluation

raw_content:
Narrative:
On September 3, 2025, Licensing Program Analyst Justine Armstrong conducted an unannounced visit to the facility. During the unannounced visit, LPA . Armstrong met with the Administrator Fazeela Shakiah (S1) to discuss an Unusual Incident Report recieved on September 1, 2025 in regards to an incident that occurred on August 31, 2025 around 10:30 pm. The concerns on the Unusual Incident Report indicated a staff quit their position during the shift, however the agency was still within ratio. The Administrator S1 who informed LPA J. Armstrong there were two staff working that day, during the incident the second Administrator S2 was informed of an incident occurring which involved 2 clients and 1 staff, the staff involved (S3) informed S2 of quitting over the phone and left the facility before S2 arrived. Once S2 arrived at the facility within 15 minutes of being notified by S3, S2 stated there was 1 staff and a 1:1 aide present with 5 clients. The overnight staff was in route to be here at the facility for the overnight shift which starts at 11:00pm -7:00 am. S2 stayed for additional support for staff and clients. Lpa J. Armstrong advised the Administrator to have an on call staff available when a crisis is occurring and to disassociate S3 from Guardian. An exit interview was conducted a copy of the report was provided to the facility

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On September 18, 2025 at 11:00 am Licensing Program Analyst (LPA) Justine Armstrong conducted a Case Management - Incident inspection at the above-said facility, and met with the Shenice Bah Administrator (FA), Porche Randle (CoFounder) , the Therapist and one client (C2). In response to a Special Incident Report that was reported to Community Care Licensing (CCL) on September 16,2025. The incident, which occurred on September 15, 2025, involved a client (C1) and staff (S1) physical and verbal incident at the facility. LPA could not interview C1 due to C1 being at school. LPA obtained the following documents: a current staff and client roster. LPA requested a copy of C1's Needs and Service, Internal Investigation Report and CPI training for all staff. The Administrator will submit all requested documents by 9/23/2025. At this time, evidence was obtain however further investigation is required to determine whether any violation has occurred. Exit Interview conducted, and a copy of this report was left with the Facility Administrator (FA).

met_with: Shenice Bah


summary: Facility Evaluation

raw_content:
Narrative:
On October 9, 2025, at 1: PM, Licensing Program Analyst (LPA) Justine Armstrong and Licensing Program Manager (LPM) Enrique Hernandez conducted an informal meeting with Administrator Shenice Bah and Co-founders Faazela Shakiah and Porche Randle regarding CHATEAU # STRTP. The meeting took place at the El Segundo Regional Office, located at Continental Blvd, El Segundo, CA 90245. The purpose of the meeting was to address licensing concerns. El Segundo Children's Residential has concerns about the following things: · Review of licensee responsibilities under Title 22 and Interim Licensing Standards. · Staff supervision and training expectations · Mental Health Certificate Concerns DHCS and Accreditation · Communication expectations · Provisional license extension The department recommends that the Licensee submit the following: (Report Continued on LIC809C) 1. Additional staff training, including personal rights, trauma-informed care, behavior management, and a refresher course on Crisis Prevention Intervention (CPI) led by in-person instructors, as well as live training. Please provide the names of the instructors, the training agenda, and the sign-in sheet. Refer back to 87065. Supervision, Evaluation, and Training Requirements ILS 2. Request a status update on the approval of the DHCS Mental Health Program. We plan to offer on-site mental health support starting in January. The Licensee must adhere to Title 22 regulations and the guidelines set by Community Care Licensing (CCL). A copy of the Technical Support Program brochure, including contact information and references to CCL Provider Information Notices (PINs), has been provided. It is important to communicate with the License Program Analyst, J. Armstrong, whenever you need additional support or clarification regarding Title 22 regulations. Additionally, the Facility has requested training resources for Short-Term Residential Therapeutic Programs (STRTPs). A copy of this report was provided to the facility.

met_with: Faazela Shakiah


summary: Facility Evaluation

raw_content:
Narrative:
On October 30, 2025, Licensing Program Analyst Justine Armstrong conducted an unannounced visit to the facility. During the unannounced visit, LPA . Armstrong met with the Facility Manager Shenice Bah (S1) to review the location of the cameras at the facility due to Program Statement and Facility Map being updated. S1 gave LPA J. Armstrong a tour to review the locations of the cameras. LPA viewed three cameras in the backyard one by the garage, one pointing towards the grass area, and one in the outdoor kitchen space. LPA viewed three cameras inside the home one in the living room, one in the dining room, and one in the hallway. There were no cameras in the bathrooms or clients room protecting the clients personal rights.. LPA verified if there was audio and S1 informed LPA there is no audio from the cameras. LPA noted the camera icon on the facility maps are faced a different direction than the cameras on site, LPA advised S1 to fix the camera icons on the facility map and resubmit via email to Justine.armstrong@dss.ca.gov. Overall the facility is incompliance with California Penal Code § An exit interview was conducted a copy of the report was provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On December 11, 2025 at 11:00 a.m, Licensing Program Analyst (LPA) Justine Armstrong conducted an unannounced visits for the purpose of conducting the annual inspection of the above-mentioned facility. Lpa J. Armstrong met with the Administrator, Shenice Bah who granted access to the facility. This is a one story facility which consists of three (3) bedrooms, two (2) bathrooms, an office for therapy and staff operations, carport two (2) car garage used for laundry, and additional storage, living room, kitchen, dining area and hallway. The facility can also be accessed through entrance in the staff office, which is a sliding door. The facility is licensed to provide care and supervision for (6) clients ages 12-17, ambulatory only. There is a pool on the premises. There is one (1) facility vehicle at the time of this inspection. Hot water was tested and measured between 105-120°F, which is within the regulatory range. LPA observed the following during inspection: Living Room:The living room has a TV that sits on top of the non-operable fireplace, two sofas, a desk with a computer, a shelves above the computer desk with books, and a small table with the sign in sheet. There was the postings of the Personal Rights, Facility license, Emergency Disaster Plan, Complaint numbers information, and the LIC Roster. Lpa J. Armstrong advised the facility to put a metal safety cover in front of the non-operable fire place. (Report Continued on LIC809C) Dining Room: The dining room is accessible through the living room with one table with six (6) chairs and a working fire extinguisher. Kitchen: The kitchen was equipped with a 4 burner gas stove top, refrigerator, and microwave. Under the sink was a locked cabinet that contained cleaning supplies. A weekly menu is posted, and there are enough perishable and non-perishable foods for at least one week. Hallways: There are three hallways the first hallways lead to bedroom #1 ,The second hallway leads to the other two bedrooms and to bathroom #1. the second hallways has a linen closest and a storage closest with extra supplies (activities, fire extinguisher, and home supplies). The third hallway leads to the second bathroom and the staff/therapy room. Bedrooms: Bedroom #1 is occupied by one client (1) with two twin beds, a dresser, and closest space. Bedroom #2 is occupied by two (2) clients with two full beds, a separate closest for each client and 2 dressers. Bedroom #3 is occupied by two (2) clients with two twin beds, closest space, and a dresser. This room has a door way to bathroom #1 , however the door is locked and can not be accessible through the client room. Bathrooms: Both bathrooms are clean and functional, with a working toilet, sink, shower, and bathtub. In bathroom #2 the toilet handle is broke, however a maintence order was sumbitted to repair this fixture. The toilet is still able to flush. Therapy Room/Office Space: The office space have two locked file cabinet one is used for the client medication and the other is used for staff files and sharp items. There are four (4) desk and chairs. (Report Continued on LIC809C) Garage and Backyard: The detached garage which remains locked used for storage and laundry with a washer and dryer, clients and staff have access to use this space. There is a pool located in the backyard with a gate and pool cover, the pool area meets Title 22 80087 (e)(1) buildings and grounds regulations. The backyard also have an outside kitchen area with a barbecue grill, a concrete table, refrigerator space and pizza oven that do not work. The side of the facility has a yoga area with yoga pillows and equipment. The backyard is spacious, clean, and free of hazards. Cameras: There also three (3) cameras outside the facility one in the backyard one by the garage, one pointing towards the grass area, and one in the outdoor kitchen space. There are three (3) cameras inside the facility one in the living room, one in the dining room, and one in the hallway. There were no cameras in the bathrooms, clients bedroom, and office/therapy room protecting the clients personal rights. Facility Vehicle: LPA J. Armstrong observed a 2024 silver Subaru 7 passenger vehicle parked on-site. The vehicle registration is valid through October 2, 2026 and the insurance is valid through April 28, 2026. Lpa J. Armstrong only completed the physical plant, disaster preparedness and operations, LPA J. Armstrong will be back at a later date to complete the annual inspection. A copy of this report was provided to the facility there were no deficiencies sited at this time.

visit_type: Annual


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Investigation Findings:
13On October 30,2025, at 1: P.M, Licensing Program Analyst (LPA) Justine Armstrong made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation(s) and deliver the findings for LPA Nestor Gomez. LPA spoke with Shenice Bah the Facility Manager and together, discussed the investigative findings. During the investigative process by Licensing program Analyst (LPA), Nestor Gomez, all relevant parties have been accounted for. Supporting evidence includes staff interviews, client interviews, emails, C1's Intervention summary, C1's preservation plan, and SIRs. The validity of the allegations could not be determined. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Enrique M Hernandez LICENSING EVALUATOR NAME: Justine Armstrong LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

report_type: Complaint Investigation

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On January 15, License Program Analyst Justine Armstrong and License (LPA) Program Manager Enrique Hernandez (LPM) conducted an unannounced Case Management visit to the above facility. LPA and LPM met with the Facility Manager Shenice Bah (FM). This visit was to amend a report that took place on December 11, 2025. LPA Armstrong reviewed the updated report with FM and obtain new signatures for the updated report.


summary: Facility Evaluation

raw_content:
Narrative:
On January 15, 2026, Licensing Program Analyst Justine Armstrong and License Program Manager Enrique Hernandez conducted an unannounced visit to the above facility. During the unannounced visit, LPA . Armstrong met with the Facility Manager Shenice Bah (FM) to discuss a Special Incident Report that was received by Community Care Licensing (CCL) on December 21, 2025. This report is regarding the sexual assault of a client that occurred while the client was on runaway which reportedly occurred on December 21, 2025. FM disclosed the client did not inform the facility directly about the sexual assault incident, instead the client informed law enforcement when the client returned to the facility and law enforcement came to the facility to conduct a well-ness check of the client. Once learning of this information law enforcement took the client to the hospital. The facility notified DCFS hotline to make an sexual assault incident report and submitted an addendum report on December 24, 2025 to Community Care Licensing. No further investigation is needed for this Case Management.


summary: Facility Evaluation

raw_content:
Narrative:
On October 3, 2025, at 9:45 a.m. Licensing Program Analyst (LPA) Justine Armstrong conducted an unannounced follow-up Case Management - Incident inspection at Chateau # STRTP to review the findings from the initial inspection that took place on September 19, 2025. LPA Armstrong met with Shenice Bah the facility administrator, together, they discussed the Special Incident Reports that were submitted to Community Care Licensing (CCL) on September 15, 2025. This follow-up inspection was prompted by a Special Incident Report regarding an incident that occurred on September 15, 2025. The incident involved a client (C1) and staff member (S1) and included both physical and verbal altercations.After reviewing all confidential interviews and documentary evidence, it was confirmed that staff member #1 (S1) violated C1's personal rights by failing to adhere to the proper de-escalation procedures during a crisis on the above date. According to California Code of Regulations, Title 22, Division Six, regulation 80072(a)(3) regarding Personal Rights, the following deficiency has been cited (see LIC 809-D). An exit interview was conducted, and a copy of this report was provided


raw_content:
Narrative:
Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violation occurred. The Department has decided that the allegation is Unsubstantiated, but if any additional information is received, this complaint can be amended, and the findings can be changed. An exit interview was completed, and a copy of this report was provided to the facility.

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

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


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

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


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Emelyn Sanchez P. and Andrew Upshaw on February 10, 2026 at 9: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPAs Sanchez P. and Upshaw met with Shenice Bah, Administrator and inspected the facility inside and out. At 10: AM Shenice Bah, Administrator had to leave and Fazeela Shaikh, Co-Founder and CEO then arrived and the inspection continued. LPAs reviewed 1 of child's records and 5 of staff personnel files on site at the facility. LPAs reviewed 1 of child's psychotropic medications and medication records. LPAs interviewed 1 of staff on site to discuss the facilities policies and procedures of operation, another staff will be interviewed at a later time. LPAs interviewed 1 child currently prescribed psychotropic medication. LPAs provided a copy of this licensing report to Fazeela Shaikh, Co-Founder and CEO. No deficiencies are being cited at this time, LPAs issued a technical violation. LPA conducted exit interview with Fazeela Shaikh, Co-Founder and CEO and a copy of the report was left at the facility.

met_with: Shenice Bah, Administrator/ Fazeela Shaikh Co-Founder CEO


summary: Facility Evaluation

raw_content:
Narrative:
On February 27, 2026, Licensing Program Analyst Justine Armstrong conducted an unannounced visit to the facility mentioned above. During this visit, LPA Armstrong met with Facility Manager Deanna Mackey to discuss a Special Incident Report received by Community Care Licensing (CCL) on February 16, 2026. This report pertains to the failure to administer psychotropic medication as scheduled, which reportedly occurred on February 16, 2026. After reviewing documentation, the facility confirmed that the client missed their scheduled morning psychotropic medication due to an oversight. According to California Code of Regulations, Title 22, Division Six, Interim Licensing Standards STRTP, Health Related Services 87075(c), the following deficiency has been cited (Continued on LIC 809-D). An exit interview was conducted, and a copy of this report was provided.

met_with: Deanna Mackey


summary: Facility Evaluation

raw_content:
Narrative:
On April 23, 2026, Licensing Program Analyst (LPA) Justine Armstrong conducted an unannounced visit to the above facility. During the unannounced visit, LPA . Armstrong met with the Facility Manager Deanna Mackey (FM) to discuss a Special Incident Report that was received by Community Care Licensing (CCL) on April 3, 2026. This report is regarding allegations of inappropriate sexual behavior between a client and staff that was previously employed at the facility. On April 3, 2026 the client informed the facility of the inappropriate sexual behavior allegations which reportedly occurred around March 2026. The facility filed an Unusual Incident Report and informed the client CFT team disclosing the information. The facility also notified DCFS hotline to make an child abuse report. On April 23, 2026 an Addendum report was submitted to CCL stating LAPD set up an interview with the client and the client attorney to discuss the allegations; the meeting is set for April 30,2026 at 3: P.M. FM will provide LPA an update once the meeting is completed with LAPD. LPA obtained copies of signed confidentiality contract agreement for all staff, LIC 500, and client roster. This Case Management requires further investigation. A health and safety check was done and a copy of the report was provided to the facility.


facility_name: CHILDHELP-CHARLES STANDFORD HOPKINS

raw_content:
Narrative:
hand and not physically beating him up. Confidential interviews reported that no other clients have physically assaulted C1. Other confidential interviews reported that C1 instigates other clients and staff by interfering with living unit activities, which frustrates other clients. Confidential interviews reported that staff had prevented other clients from physically attacking C1 due to C1's behavior, such as moments where C1 interferes with facility outings and this creates anger among other clients. Community Care Licensing received another allegation that facility staff (S1, S2, S3, S4, S5, S6, or S7) restrained a minor (C1), causing injuries. Confidential interviews reported that facility staff have restrained C1 in the past and have "hurt C1 badly, causing injuries." Confidential interviews reported that C1 had a purple bruise on C1's face. Other confidential interviews reported that photos were taken of C1, and there was no bruising on C1's face or body. Confidential interviews reported that there had been three incidents in which facility staff utilized manual restraints on C1. Confidential interviews reported that after reviewing three Special Incident Reports (SIRs), there was no mention of C1 claiming to be injured and/or staff reporting that there were injuries to C1. Confidential interviews reported that staff has never used excessive physical force on C1 or other clients during manual restraints. Confidential interviews reported that the facility staff had used the minimum physical contact necessary to guide C1, per their Pro-ACT training. Community Care Licensing received another allegation that the minor (C1) sustained bruising/scarring due to a lack of supervision while in care. Confidential interviews reported that an unspecified combination of C2, C3, C4, C5, or C6 "hit C1 all over C1's body." Confidential interviews reported that it was unknown when this incident occurred. Confidential interviews reported that C1 had a scar on their left arm as a result of a stab wound from a knife used by another client (unnamed). Confidential interviews reported that C1 was never stabbed with a knife, but as previously mentioned, C5 "scratched C1 on his hand." Confidential interviews reported no incident involving a client-on-client stabbing with a knife in C1's living unit. Confidential interviews reported that C1's living unit staff and peers denied being a part of, hearing about, or witnessing any incident of a client being stabbed, hit, pinched, or scratched. Based on inconsistent confidential interviews, the allegations that the minor is being physically assaulted daily by other minors while in care, facility staff restrain minor, causing injuries, and due to lack of supervision minor sustained bruising/scarring while in care, may have occurred, however, is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted. A copy of this report and appeals rights was explained and given to Lawrence Story Executive Director.

Investigation Findings:
13On 05/12/2023 at 10: AM, Licensing Program Analyst (LPA) Joon Choi conducted an unannounced visit to ChildHelp Charles Stanford Hopkins Short Term Residential Treatment Facility (STRTP) and met with Executive Director Lawrence Story, to deliver the investigative findings for the allegations listed above. On 04/04/2023, LPA Choi made the initial visit to the facility and interviewed four clients (C1, C2, C3, and C4). C5 and C6 refused to be interviewed, interviewed five staff (S1, S2, S3, S4, and S5), obtained pertinent paperwork, and conducted an initial health and safety inspection of Cottage 2A. No immediate health and safety hazards were observed. On 04/18/2023, LPA Choi conducted a follow-up visit to the facility and interviewed two additional staff (S6 and S7). On 03/29/2023, Community Care Licensing received an allegation that a minor (C1) is being physically assaulted daily by other minors (C2, C3, C4, C5, and C6) while in care. Confidential interviews reported that clients C2, C3, C4, C5, and C6 - "beat up C1 daily." Confidential interviews reported that one client (C5) "bothers" C1 by scratching and/or pinching him on C1's CONTINUED ON THE NEXT PAGE UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Joon R Choi 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 19-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, MAIN ST., SUITE FACILITY NAME: CHILDHELP-CHARLES STANDFORD HOPKINSFACILITY NUMBER: VISIT DATE: 05/12/2023

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

met_with: Lawrence Story, Executive Director


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) Toni Castillo met with Amanda Bell Manager of Quality, Lawrence Story Executive Director and Manuel Barragan Director of Support Services for the purpose of a pre-licensing visit for a short term residential treatment program ( STRTP) to be licensed with a capacity of 16 in order to meet department of health care services (DHCS) requirements for the Institute for Mental Health Diseases IMD program. During the visit LPA completed a health and safety assessment of the facility (site # Charles Standford Hopkins site). This site is designated for males. During the assessment LPA observed the site has two wings each wing mirrors one another. Each wing has space for 8 placement's. Wing A: consists of 4 bedrooms, 2 twin beds, closet and dresser space, desks, ample lighting, hygiene supplies, mattress covers, fitted and flat sheets, comforters and pillows. Restroom with 4 sinks, 3 showers and 3 toilets. Kitchen area with a pantry for snacks. Dining room with tables and chairs for 8 clients. Smoke detectors and carbon monoxide were tested and are in operable working order, water temperature is no more then 120 degrees, there are no bodies of water. Family room with sofas and recreation space. Wing B: consists of 4 bedrooms, 2 twin beds, closet and dresser space, desks, ample lighting, hygiene supplies, mattress covers, fitted and flat sheets, comforters and pillows. Restroom with 4 sinks, 3 showers and 3 toilets. Kitchen area with a pantry for snacks. Dining room with tables and chairs for 8 clients. Smoke detectors and carbon monoxide were tested and are in operable working order, water temperature is no more then 120 degrees, there are no bodies of water. Family room with sofas and recreation space. Daily meals are prepared in a centralized kitchen and brought to each wing. Laundry and nursing office is in a centralized location, where all medication is stored and locked. Bulletin board with all required documents posted. Personal rights, grievance procedures, emergency and disaster plan. food menu, daily schedule and activity schedule. There are no corrections needed at this time. LPA observed the physical plant to be well maintained for a capacity of 16.

met_with: Amanda Bell


summary: Facility Evaluation

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Narrative:
LPA Toni Castillo conducted a meeting with applicant Childhelp-Charles Standford Hopkins. The purpose of the meeting was to complete Component II and III. Present at the meeting were Amanda Bell Manager of Quality, Lawrence Story Executive Director and Manuel Barragan Director of Support Services. During the meeting LPA discussed with Amanda Bell and the overall operation and services provided in the facility. This is a 16 bed short term residential treatment facility (STRTP) application. During the meeting the program statement, plan of operation including AWOL and emergency intervention was discussed. The application forms was also discussed. The following documents are needed for revision: -Updated LIC 200 (change to initial application (need original signatures) -A new LIC 610 emergency disaster form with correct pending license number and original signatures. -All staff need to be associated to this pending license number through Guardian system, Applicant can -submit a LIC 508 for CCL to associate staff. -Facility sketch in order to request a fire clearance. -Updated LIC 500 staff roster Exit Interview was conducted. It was discussed with facility representative that in the event of any other corrections be needed LPA will notify applicant.


summary: Facility Evaluation

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Narrative:
On February 28, 2022 at 3:00 pm, Licensing Program Analyst (LPA), Joon Choi conducted an unannounced case management inspection and met with Amanda Bell, the Quality Assurance Manager of ChildHelp Yvonne Fedderson and Sara O'Meara Short Term Residential Treatment Facility (STRTP), to discuss the incident report dated 01/28/2023 regarding Client 1 (C1). On 02/24/2022, Community Care Licensing received an incident report from the STRTP Facility. Per the incident report, on 01/28/2023, the facility reported that staff #1 (S1) did not follow correct Pro-Act restraint guidelines according to the Facility's Emergency Intervention Plan, when utilizing a restraint on FC1. It was reported that S1 utilized a single-person (single staff) restraint hold on C1, during an incident in which C1 was reported to be escalated in behavior. LPA Choi observed in the video that S1 did in fact utilize a restraint hold on C1, and that S1 restrained C1 by themselves, instead of, with the assistance of another staff member, which is mandated in Pro-Act training. LPA Choi was advised by QA that according to the facility's Emergency Intervention Plan and Pro-Act Training, S1 should have waited for the assistance of a second staff, at which time, both staff would have positioned themselves on either side of the client and utilized the minimum amount of force necessary to get C1 to baseline. LPA Choi observed S1 grab C1's shoulders and arms and physically move C1 to the front door exit. After S1 released C1, C1 fell to the ground. LPA Choi was advised by QA that after an administrative review of the video of the incident, that S1 was placed on leave from work. Based on confidential interviews, a records review of facility documentation, and the facility's video of the incident; the STRTP is being cited for violation of STRTP ILS, Personal Rights 87072(c)(11), To be free of physical...emotional, or other abuse, and from corporal or unusual punishment,...infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature...This poses an immediate health, safety or personal rights risk to the children placed in care. Continued on the Next Page Exit interviewed conducted. A copy of this report, a technical violation for reporting requirements, LIC 811, and appeal rights were given and explained to Quality Assurance Manager Amanda Bell.

met_with: Amanda Bell, Quality Assurance Manager


facility_name: CHILDHELP-JOANN

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Confidential witness statements revealed that S1 did push C1 against the wall. Based on confidential interviews and records reviewed, the preponderance of evidence standard has been met regarding the allegation that S1 pushed C1 while in care, therefore the allegation is found to be substantiated. California Code of Regulations, Title 22, 87072 (c)(11) Personal Rights, are being cited on the attached LIC 9099D. An exit interview was conducted and a copy of this report, along with the appeal rights were explained to Program Coordinator Heather Michelson. Due to printer malfunction, this report will be emailed to Program Coordinator Heather Michelson. Based on confidential interviews, and records reviewed, the allegation that S1 hit C1 while in care is unsubstantiated. Meaning, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted and a copy of this report, along with the appeal rights were explained to Program Coordinator Heather Michelson. Due to printer malfunction, this report will be emailed to Program Coordinator Heather Michelson.

Investigation Findings:
13On January 24, 2023, at 12:07pm, Licensing Program Analyst (LPA) Adrian Mendez arrived unannounced to the facility and met with Program Coordinator Heather Michelson of Childhelp-JoAnn to discuss the investigative finding for the allegation noted above. LPA conducted an inspection with the facility on February 9, 2022, at 1:34pm, no deficiencies were noted. During the investigation LPA interviewed six children (C1, C2, C3, C4, C5, C6), one confidential witness (A1), and three facility staff (S1, S2, S3). During the investigation LPA reviewed one Serious Incident Report (SIR) dated 02/02/2022, and C1's Needs and Services Plan. On February 8, 2022, the Department received an allegation that a staff pushed minor while in care. It was reported that C1 and S1 were in the kitchen joking around when the incident then escalated due to C1 trying to turn the stove on and grab the hot pots as staff just finished making dinner. It was also reported that S1 pushed C1 against the wall during the incident out of anger. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Adrian Mendez 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 CCLD Regional Office, THE CITY DR., SUITE FACILITY NAME: CHILDHELP-JOANNFACILITY NUMBER: VISIT DATE: 01/26/2023

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

met_with: Heather Michelson


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
Based on confidential interviews, the preponderance of evidence standard has been met and the allegation that the staff did not ensure that youth's hygiene needs were being met is substantiated. The STRTP facility is being cited for violation of the Interim Licensing Standards Version 5 regulation 87072(c)(8)(b) Personal Rights. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with XXX. A copy of this report, LIC 811, and appeal rights was provided to the Administrator.

Investigation Findings:
13On May 31, 2024, at 12: PM, Licensing Program Analyst (LPA) Guadalupe Munoz arrived unannounced at the facility and met with Program Director, Brittnie Peluso, to discuss the investigative finding for the allegation noted above. LPA conducted an inspection of the facility on 10/19/2023 at 10:45 am and no deficiencies were observed. LPA Interviewed four staff (S1-4) and interviewed one client (C1), client (C2) declined to interview. LPA obtained and reviewed the following documents: C1's Needs and Service Plan, Staff Schedule, and Incident Reports. On 10/16/2023, Community Care Licensing (CCL) received an allegation that staff did not ensure that youth's hygiene needs were being met. Specifically, it was reported that C1's nails were long and dirty. Confidential interviews confirmed that C1 had requested for their nails to be trimmed on at least two occasions however facility staff did not trim C1's nails when requested. In addition, C1's school contacted the facility to request C1's nails to be trimmed. Interviews confirmed that it took approximately a week or more for C1's nails to be trimmed by facility staff. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Guadalupe Munoz 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: CHILDHELP-JOANNFACILITY NUMBER: VISIT DATE: 05/31/2024

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

met_with: Brittnie Peluso

complaint_status: SUBSTANTIATED


raw_content:
Narrative:
observe from the sidewalk while C1 caused the property damage in the neighborhood. Confidential interviews and document reviewed indicated that C1 had escalated behaviors and it was noted that C1 needed heightened supervision. Confidential interviews indicated that staff have increased checking on C1, however, they have not increased the ratio of staff to the clients needs. It is unknown if a one to one staff could have prevented C1 from causing property destruction. Based on confidential interviews, the staff did not prevent child from breaking windows of cars and houses in the neighborhood may have occurred, however, is not supported or proven by 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 XXX. A copy of this report, LIC 811, and appeal rights was provided to the Administrator.

Investigation Findings:
13On May 31 2024, at 1: PM, Licensing Program Analyst (LPA) Guadalupe Munoz arrived unannounced at the facility and met with Britnie Peluso, Program Director, to discuss the investigative finding for the allegation noted above. LPA conducted an inspection of the facility on 3/25/24 at 11:00 am and no deficiencies were observed. LPA Interviewed four staff (S1-4) and attempted to interviewed one client (C1), client (C2) declined to interview. LPA obtained and reviewed the following documents: C1's Needs and Service Plan, Staff Schedule, Client Roster and Incident Reports. On 03/19/2024, Community Care Licensing (CCL) received an allegation that staff did not prevent child from breaking windows of cars and houses in the neighborhood. Confidential interviews confirmed that C1 caused property damage to homes and vehicles in the neighborhood. Interviews revealed that at the time of incident there was only one staff present in the home with two children, C1 and C2, therefore when C1 left the facility grounds, staff could not follow C1 because C2 was still in the facility; staff could only UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Guadalupe Munoz 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: CHILDHELP-JOANNFACILITY NUMBER: VISIT DATE: 05/31/2024

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


raw_content:
Narrative:
Confidential interviews confirmed that cardboard and duct tape was unable to contain the glass from falling. Interviews confirmed that there was concern for the children due to the risk of children being injured by broken glass. Based on confidential interviews, the preponderance of evidence standard has been met and the allegation that facility does not provide a safe environment for the youths is substantiated. The STRTP facility is being cited for violation of the Title 22, Division Chapter 1, Article 07. Physical Environment regulation 80087 (a) Buildings and Grounds. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with XXX. A copy of this report, LIC 811, and appeal rights was provided to the Administrator.

Investigation Findings:
13On May 31, 2024, at 1: PM, Licensing Program Analyst (LPA) Guadalupe Munoz arrived unannounced at the facility and met with Brittnie Peluso, Program Director to discuss the investigative finding for the allegation noted above. LPA conducted an inspection of the facility on 12/22/2023 at 11:00 am and no deficiencies were observed. LPA Interviewed six staff (S1-6) and attempted to interview one client (C1). LPA obtained and reviewed the following documents: C1's Needs and Service Plan, Staff Schedule, client roster and Incident Reports. On 12/19/2023, Community Care Licensing (CCL) received an allegation that facility does not provide a safe environment for the youths. Specifically, it was stated that a facility window was broken and covered up by cardboard, and shards of glass were observed on the living room floor. Confidential interviews confirmed that shards of glass continued to fall into the children's living space throughout 12/16/23 until the window was replaced on 12/18/23. Confidential interviews revealed that the maintenance man was called to fix the window the day it was broken, however, staff was told that it would not be fixed for two days. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Guadalupe Munoz 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: CHILDHELP-JOANNFACILITY NUMBER: VISIT DATE: 05/31/2024

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


raw_content:
Narrative:
indicated that C1 had not been searched when returning to the facility on 12/01/23 and it was suspected that C1 may have had marijuana hidden on them at that time. Confidential interviews indicated that once the staff noticed the marijuana use, staff followed facility drug and alcohol policy and conducted room searches and attempted a search of youth however youth declined. It is unknown if a search of C1 on 12/01/23 would have prevented youth using marijuana in the facility. Based on confidential interviews, that facility staff did not prevent youth from using marijuana at facility may have occurred, however, is not supported or proven by 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 XXX. A copy of this report, LIC 811, and appeal rights was provided to the Administrator.

Investigation Findings:
13On July 3,2024, at 10: AM, Licensing Program Analyst (LPA) Guadalupe Munoz arrived unannounced at the facility and met with Brittnie Peluso, Program Manager, to discuss the investigative finding for the allegation noted above. LPA conducted an inspection of the facility on 12/15/23 at 10:45 am and no deficiencies were observed. LPA Interviewed three staff (S1-3) and attempted to interviewed one client (C1), client (C2) declined to interview. LPA obtained and reviewed the following documents: C1's Needs and Service Plan, Staff Schedule, Client Roster, and Incident Reports. On 12/11/2023, Community Care Licensing (CCL) received an allegation that facility staff did not prevent youth from using marijuana at facility. Confidential interviews confirmed that youth were using marijuana at the facility. Interviews revealed that on multiple occasions the facility smelled of marijuana and it was possible C1 and C2 were the youth using marijuana. Confidential interviews and documents reviewed UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Guadalupe Munoz 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: CHILDHELP-JOANNFACILITY NUMBER: VISIT DATE: 07/03/2024

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


summary: Facility Evaluation

raw_content:
Narrative:
On June 17, 2021, at 10:39AM Licensing Program Analyst (LPA) Adrian Mendez, conducted an unannounced Post Licensing/Annual inspection of the facility. The facility converted from a Group Home to STRTP (Short Term Therapeutic Program) on June 25, 2019. LPA was met at the facility by Administrator Mark Jones, and Facility Manager Gascott "Binso" Cooper. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris. There is adequate indoor and outdoor activity space. Sports equipment/toys/books/games were observed for children's recreation time. All facility smoke detectors and carbon monoxide detectors were tested and observed to be in working order; fire extinguisher is properly charged and serviced. Licensee maintains an adequate supply of perishable and non-perishable foods to prepare the items on the posted menu. All required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster, the Emergency Disaster Plan was also posted. Medications are locked and centrally stored in the garage/staff office of the facility. Medication records were reviewed and observed to be completed with dates and staff initials on dispensing records. Individual beds were observed with clean linens, pillows, comforters, and mattresses in good repair. Three bedrooms contained two twin beds. The facility has two bathrooms. The water temperature of the kitchen sink was tested at 10:58am and registered at 118.5 degrees which is within the appropriate range of 105 degrees to 120 degrees. Per facility staff, no firearms or weapons are allowed in the facility. Administrator Mark Jones is present at the facility a minimum of 20 hours a week. Appropriate staff/client ratios were verified during this inspection. Cont. on 809-C The facility employs three Clinical Support Staff, three facility managers and nine direct care staff that are used in accordance with regulatory requirements. Licensee obtained Mental Health (MH) Certification in November 2020. Licensee has obtained National Accreditation through COA. The Accreditation is valid through October of 2021. Licensing fee payments are current. LPA discussed the following with the Administrator: Incident reporting, including incidents related to Assembly Bill 388 law enforcement contacts as well as incidents involving emergency interventions. LPA discussed procedures for Child and Family Team (CFT) meetings, including an overview of required Core Services and Supports. Based upon the inspection of facility records and interviews with staff and clients, the Licensee appears to be meeting CFT and Core Services/Supports requirements. Due to time constraints and employee files being housed in an off-site location, LPA will return to the facility to conduct a continuation of staff file reviews. Two facility staff, and five clients were interviewed during the inspection. No deficiencies were found. Exit interview was conducted and a copy of this report was provided to Administrator Mark Jones.

met_with: Gascott Cooper


summary: Facility Evaluation

raw_content:
Narrative:
On June 30, 2021, at 10:32AM Licensing Program Analyst (LPA) Adrian Mendez conducted an unannounced annual continuation inspection from June 15, 2021. LPA arrived at the facility and met with Program Coordinator Heather Michelson. Five personnel/facility staff files were reviewed to ensure they contained all required documentation per Title Regulations. Personnel Files are maintained off-site in the Human Resource office. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. No deficiencies were noted during time of inspection. An exit interview was conducted and a copy of this report was explained and provided to Program Coordinator Heather Michelson.


summary: Facility Evaluation

raw_content:
Narrative:
On June 29, 2023 at 08: AM, Licensing Program Analyst (LPA) Joon Choi conducted an unannounced annual inspection at ChildHelp Joann Short Term Residential Therapeutic Program (STRTP). LPA was met by Program Coordinator (PC) Heather Michelson. The facility is situated in a residential neighborhood and is a 6 bedroom, 3 bathroom - two story home with a living room/common area, dining room, kitchen, two car garage, and backyard with a patio. Please note, that the two upstairs bedrooms are used as a therapy office and a staff office. Also, two bathrooms are utilized for staff and one full bathroom is for the clients to share. There is a staff restroom in the staff's office upstairs and one downstairs. The garage is also used as a staff office. The facility's two registered vehicles are parked in the drive way full-time. LPA observed the following postings located in the front entry way and common area: facility license, grievance procedures, Personal Rights, Foster Youth Bill of Rights, the (contact information for the California Foster Care Ombudsman is on the Foster Youth Bill of Rights poster), visitation policies, and grievance procedures. LPA began a physical plant inspection at 9: AM assisted by Shift Supervisor Britnie Peluso. LPA inspected the facility's kitchen, dining area, refrigerator/freezers, food storage areas, garage, living room/common area, staff office, therapy office, three client bedrooms (B1,B2,B3) and one client bathroom. The bedrooms were arranged so that no more than two clients are were assigned to a room, and there is one client per bed and a shared closet. Each client room had the appropriate linens, pillows, comforters, and mattresses are in good repair. Each client had their own personal lockbox as well. Extra linens and client hygiene supplies are stored in two separate hallway closets. Additionally, each client was assigned a fully functional dresser drawer with adequate space for each client's belongings. The living room had two couches and a functional television. The dining room had a dining table with enough chairs for all the clients and some staff. There was a client activity schedule posted in the living room and a menu posted in the kitchen. Cleaning supplies such as chemicals are kept locked in the garage and downstairs staff restroom. Sharp utensils and cooking knives are inaccessible to clients and locked in a cabinet in the dining room. Licensee maintains an adequate supply of food and a variety of snacks for clients. LPA observed a minimum seven day non-perishable foods in the pantry and a two day perishable supply of food in the kitchen and garage refrigerators. Board games are kept in a separate closet in a downstairs closet. Continued Next Page There is adequate indoor and outdoor activity space; all exits, and walkways were free from obstruction. Client files were kept in a locked cabinet upstairs near the staff office. Per the Shift Supervisor, there are no weapons or guns on facility grounds. The facility's outside grounds (front yard, backyard and sides) were also inspected and were found to be clean, well maintained, and free of observable hazards. The backyard has a bike rack with bicycles for clients and there was one locked storage shed that had client's extra belongings and extra mattresses for the facility. The facility has an operable carbon monoxide detector located in the hallway and smoke detectors are located in each client bedroom and the common area. LPA observed the facility had three fire extinguishers, with one located in the kitchen, garage and upstairs. Each fire extinguisher was fully charged and inspected in May of 2023. The medications are centrally stored in the garage / staff office, in a locked cabinet. The facility had three First Aid Kits and were complete and kept in the garage. The washer and dryer are located inside of the garage and are accessible to clients with staff supervision. The laundry detergents are kept locked in a cabinet in the garage. The Kitchen had a fully stocked refrigerator and the gas stove and dishwashing machine were operational. There were no cleaning supplies observed to be in the kitchen. The kitchen cabinets had plenty of pots, pans, plates and bowls for the clients to use. The hot water in the client bathroom measured 109.7 degrees Fahrenheit and was within the specified 105 to 120 degree range. LPA observed that each client's hygiene items such as shampoo, toothpaste, soap, lotion, and deodorant were locked in a closet in the hallway. Facility staff explained that clients are given access to their hygiene prior to showering/bathing. LPA was also advised that clients are allowed to keep certain hygiene items in their rooms such as deodorant which they take to school. The facility has two vehicles used to transport clients to appointments and recreational activities. Each vehicle had no damage. The inside upholstery was intact for each vehicle. The brake lights and signals were operational. There was a fully stocked first aid kit in each vehicle as well as current registration and proof of insurance. At 09: AM, LPA observed that the client restroom had a slow draining sink, but the facility had work order in place so no citation was given. At 10: AM, LPA began interviews and conducted two staff interviews (S1, S2) and two client interviews (C1, C2). Continued on the Next Page At 11: AM, assisted by the Clinical Manager Brittany Kelly, Program Coordinator Heather Michelson and Shift Supervisor Brittnie Peluso, LPA began review of four Client Files. At 12: PM with the assistance of Program Coordinator, we then reviewed the facility's Operational Requirements. All of the documentation pertaining to these areas of the inspection were provided, and no deficiencies were noted. At 1: PM with the assistance of Program Coordinator, we then reviewed the facility's Disaster Preparedness Requirements. All of the documentation pertaining to these areas of the inspection were provided, and no deficiencies were noted. Based on observations and record reviews, no deficiencies were cited during this visit. Due to time constraints, LPA will return to complete the inspection at a later date. An exit interview was conducted, and a copy of this report was provided to Program Coordinator Heather Michelson.

met_with: Heather Michelson, Program Coordinator


summary: Facility Evaluation

raw_content:
Narrative:
On 07/3/2023 at 9: AM, Licensing Program Analyst (LPA) Joon Choi conducted an unannounced Annual Continuation visit at ChildHelp Joann Short Term Residential Therapeutic Program (STRTP). LPA was met by Administrator Joseph Alvarado. LPA Choi visited the facility on 06/29/2023 to complete a Physical Plant inspection and review the facility's Operational Requirements, Disaster Preparedness, and Client Files (C1-C4). At 10: AM, assisted by the Administrator, LPA began the review of five Staff Files and (S1-S5). Based on records review, two of the five staff files reviewed were missing signatures for the Child Abuse Reporting Requirements form, which is in violation of Interim Licensing Standards (ILS) 87065.1(d)(5) documentation of successful completion of training shall be maintained in the personnel record of each direct care staff. At 11: AM, assisted by the Administrator, LPA began review of the facility's Emergency Intervention Plan. All the documentation pertaining to this area of the inspection was provided, and no deficiencies were noted. At 12: PM, assisted by the Administrator, LPA began review of the facility's Core Therapeutic Services. All the documentation pertaining to this area of the inspection was provided, and no deficiencies were noted. Based on observations made during the inspection, see LIC D, a deficiency is being cited. An exit interview was conducted, a copy of this report and appeals rights were provided to Administrator Joseph Alvarado.

met_with: Joseph Alvarado, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On August 2, 2023 at 12:45 pm, Licensing Program Analyst (LPA) Charmaine Linley conducted an unannounced visit at the facility. The purpose of the visit was to interview one client regarding an incident at a prior placement, however the client had run away the night before and had not returned. No other information needed at this time. No deficiencies were cited. Exit interview was conducted and a copy of this report was explained to Heather Michelson, Compliance Coordinator. Due to printer malfunction, this report will be emailed to Heather Michelson, Compliance Coordinator.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheraki Davis on 08/17/2021 at 11: AM. During the inspection, LPA met with Gascott Cooper, House Supervisor and Robin Withers (Johnson), Senior Childcare Worker and inspected the facility. LPA reviewed one child's psychotropic record on site at the facility at 11: AM. During the review of one child's record, LPA observed child 1 (C1) psychotropic medications were not on a separate psychotropic medication administration record (PMAR). LPA observed the medication listed together on form LIC 622A for non-psychotropic medication. LPA reviewed two staff personnel files on site at the facility at 1: PM. LPA began two staff interviews at 12: PM. LPA interviewed one child currently taking psychotropic medication at 11: AM. LPA conducted exit interview with Gascott Cooper, House Supervisor at 2: PM. LPA provided the Summary Report, LIC 809D, Appeal Rights, to Cascott Cooper, House Supervisor upon completion. One deficiency was observed (refer to LIC 809D) and cited from the Interim Licensing Standards during the inspection.


facility_name: CHILDHELP-JOHNSON

summary: Complaint Investigation - Unsubstantiated - 3 allegations

raw_content:
Narrative:
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the staff provided inadequate supervision leading to C1 and C2 engaging in inappropriate relations while in care did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted with Arlene Martinez, Head of Service. A copy of this report and appeal rights were provided to Arlene Martinez, Head of Service.

Investigation Findings:
13On August 15, 2022, at 12: PM, Licensing Program Analyst (LPA) Eduardo Barragan conducted a complaint inspection at ChildHelp-Johnson and met with Arlene Martinez, Head of Service. The purpose of the inspection was to deliver the findings for the above complaint allegation. LPA Adrian Mendez conducted an inspection of the facility on October 28, 2021, and no deficiencies were noted. The Department has investigated the complaint alleging staff provided inadequate supervision leading to minors engaging in inappropriate relations while in care. LPA Barragan spoke with staff, clients and reviewed Needs and Services plans and staff notes. LPA interviewed two of two clients (C1, C2) and three of three staff (S1, S2, S3) were interviewed. Confidential interviews revealed conflicting statements, some interviews indicated that the incident did not happen and other interviews stated that the incident did happen. There were no witnesses to the alleged incident. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Eduardo Barragan 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 SO. Region Ac/res., 770 the City Dr., SUITE FACILITY NAME: CHILDHELP-JOHNSONFACILITY NUMBER: VISIT DATE: 08/15/2022

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

met_with: Arlene Martinez, Head of Service


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Latricia Rogers conducted a annual inspection. The facility converted from a Group Home to STRTP (Short Term Therapeutic Program) on December 2020. LPA was met at the facility by Residential Supervisor, Shuridine Edwards, Heather Michelson, Program Coordinator of Quality and Mark Jones, Residential Program Manager. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris and observable hazards. There is adequate indoor and outdoor activity space. Sports equipment/toys/books/games were observed for children's recreation time. All facility smoke detectors and carbon monoxide detectors are in appropriate working order; fire extinguisher is properly charged and serviced. Licensee maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. All required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster. Medications are locked and centrally stored in Employees office. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. The hot water in the client's bathroom was measured to be 109 degrees. Facility does not have cameras in common areas of the facility. Per facility staff, no firearms or weapons are allowed in the facility. Facility appears to be meeting the terms and conditions of their license. Shuridine Edwards, Residential Supervisor is present at the facility a minimum of 20 hours a week, as verified by staff schedule and interviews. Appropriate staff/client ratios were verified during this inspection. The facility employs 1 facility managers and 11 direct care staff. Licensee has Mental Health Certification with Los Angeles County. Licensee has MH Certification as of November 16, 2020. Licensee has obtained National Accreditation through Council on Accreditation. The Accreditation is valid through October 2021. Licensing fee payments have been paid and there is currently a balance of 0. LPA discussed the following with the Residential Supervisor: Incident reporting, including incidents related to Assembly Bill 388 law enforcement contacts as well as incidents involving emergency interventions. LPA discussed procedures for Child and Family Team (CFT) meetings, including an overview of required Core Services and Supports. Based upon the inspection of facility records and interviews with staff and clients, the Licensee appears to be meeting CFT and Core Services/Supports requirements. Personnel files were reviewed to ensure they contained all required documentation per Title Regulations. Personnel Files are maintained at corporate office in Beaumont, Ca. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. A review of client records was also completed on this date. Staff interviews were conducted. File Reviews revealed 2 clients missing TB tests. LPA issued a Technical Advisory notice to the facility.

met_with: Shuridine Edwards- Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On July 28, 2023 at 08: AM, Licensing Program Analyst (LPA) Joon Choi conducted an unannounced annual inspection at ChildHelp Johnson Short Term Residential Therapeutic Program (STRTP). Please note: although the facility is open, there are currently no clients placement as the facility is undergoing renovations. LPA was met by Program Manager (PM) Dana Butler. The facility is situated in a residential neighborhood and is a four bedroom, two full bathrooms (one for staff, one for clients) - one story home with a living room/common area, dining room, kitchen, two car garage, therapy room and backyard with a patio and storage shed. The garage is used as a staff office. The facility's two registered vehicles are parked in the drive way full-time. LPA observed the following postings located in the front entry way and common area: facility license, grievance procedures, Personal Rights, Foster Youth Bill of Rights, the (contact information for the California Foster Care Ombudsman is on the Foster Youth Bill of Rights poster), visitation policies, and grievance procedures. LPA began a physical plant inspection at 8: AM assisted by PM. LPA inspected the facility's kitchen, dining area, refrigerator/freezers, food storage areas, garage, living room/common area, staff office, therapy office, three client bedrooms (B1, B2, B3, B4) and one client bathroom. The bedrooms were arranged so that no more than two clients are were assigned to a room (two bedrooms have two beds, and the other two bedrooms have one bed), and there is to be one client per bed and a shared closet. Each client room had the appropriate linens, pillows, comforters, and mattresses are in good repair. Each client had their own dresser drawer. Extra linens are stored in a hallway closet. There is no hygiene as of yet, as there are currently no clients in the facility. The living room / common area had two couches and a functional television. The dining room had a dining table with enough chairs for all the clients and some staff. Cleaning supplies such as chemicals are kept locked in the garage. Sharp utensils and cooking knives are locked in a cabinet in the kitchen. Licensee will maintain an adequate supply of food and a variety of snacks for clients, once they are place. Board games are kept in a separate closet in the front entry way. Continued on the Next Page There is adequate indoor and outdoor activity space; all exits, and walkways were free from obstruction. Client files will be kept in the the staff office/garage. Per PM, there are no weapons or guns on facility grounds. The facility's outside grounds (front yard, backyard and sides) were also inspected and were found to be clean, well maintained, and free of observable hazards. The backyard has a grass lawn and one locked storage shed that had room for storage and bicycles. The facility has an operable carbon monoxide detector located in the bedroom hallway and by the water heater, and smoke detectors are located in each client bedroom and one in the common area. LPA observed the facility had two fire extinguishers, with one located in the kitchen and staff office / garage. Each fire extinguisher was fully charged and inspected in May of 2023. The medications will be centrally stored in the garage / staff office, in a locked cabinet. The facility had one First Aid Kit in the garage, but PM explained the facility would acquire more, when clients are placed. The washer and dryer are located adjacent to the kitchen and are accessible to clients with staff supervision. The laundry detergents are kept locked in a cabinet above the washer and dryer. The Kitchen had a functioning refrigerator and the induction stove and dishwashing machine were operational. There were no cleaning supplies observed to be in the kitchen. The kitchen cabinets had plenty of pots, pans, plates and bowls for the clients to use. The hot water in the client bathroom measured 109.5 degrees Fahrenheit and was within the specified 105 to 120 degree range. There are no client hygiene items as of yet. PM explained that clients will be given access to their hygiene prior to showering/bathing. LPA was also advised that clients will also be allowed to keep certain hygiene items in their rooms such as deodorant which they take to school. The facility has two vehicles used to transport clients to appointments and recreational activities. Each vehicle had no damage. The inside upholstery was intact for each vehicle. The brake lights and signals were operational. There was a fully stocked first aid kit in each vehicle as well as current registration and proof of insurance. At 9: AM, LPA conducted one staff interviews (S1). At 9: AM with the assistance the PM, we then reviewed the facility's Operational Requirements. All of the documentation pertaining to these areas of the inspection were provided, and no deficiencies were noted. Continued on the Next Page At 9: AM, assisted by the PM, LPA reviewed the facility's Emergency Intervention Procedures. All of the answers pertaining to these areas of the inspection were automatically inputted by Care Tools as n/a, and no deficiencies were noted. Please note: client records were also automatically inputted by Care Tools as N/A. At 9: AM with the assistance of Program Coordinator, we then reviewed the facility's Disaster Preparedness Requirements. All of the documentation pertaining to these areas of the inspection were provided, and no deficiencies were noted. At 9: AM with the assistance of Program Coordinator, we then reviewed the facility's Core Therapeutic Services. All of the documentation pertaining to these areas of the inspection were automatically inputted by Care Tools as "n/a", and no deficiencies were noted. At 9: AM, LPA began one staff file review, with the assistance of Compliance Coordinator Heather Michelson and Program Manager Dana Butler. Please note, there were no client files to review. Based on observations and record reviews, no deficiencies were cited during this visit. An exit interview was conducted, and a copy of this report was provided to Program Manager Dana Butler.

met_with: Dana Butler, Program Manager


raw_content:
Narrative:
Confidential interviews reported a bruise on the arm and a two-inch bruise on the leg of Client 1 (C1). Confidential interviews reported that these bruises resulted from C1 being physically pushed by another client (C2). Confidential interviews reported that this incident was witnessed by a facility staff member (unknown). Confidential interviews reported that the facility's Emergency Intervention Plan states that staff shall use verbal counseling, body positioning, and as a last resort, manual restraints when clients fight or engage in excessive physical horse-playing. Confidential interviews reported that C1 wasn't in a physical fight with C2. Confidential interviews reported that C2 pushed C1 while "horse-playing" in the bedroom. Confidential interviews reported that it was unknown if a staff member witnessed this incident. Confidential interviews reported that a review of the Facility's Special Incident Reports didn't have a record of a fight or horse-playing incident between C1 and C2 that resulted in bruising. Confidential interviews reported that a review of the facility's surveillance videos did not show any pushing or fighting incident between C1 and C2 within the time period addressed in the complaint in the common areas. Other confidential interviews reported no documented instances when staff failed to intervene properly when clients in the cottage engaged in horse-playing or fighting behaviors. Based on inconsistent confidential interviews, the allegation that staff failed to follow Emergency Intervention Plan resulting in a physical altercation between clients, may have occurred, however, is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted. A copy of this report, LIC 811 and appeal rights was explained and given to Quality Assurance Manager Amanda Bell.

Investigation Findings:
13On 03/13/2023 at 11: AM, Licensing Program Analyst (LPA) Joon Choi conducted an unannounced visit to ChildHelp Yvonne Fedderson and Sara O'Meara Short Term Residential Treatment Facility (STRTP) and met with Quality Assurance Manager Amanda Bell (QA), to deliver the investigative findings for the allegation listed above with. On 01/10/2023, LPA Sarah Lo and Licensing Program Manager (LPM) Cheraki Davis visited the facility, obtained pertinent paperwork, and conducted an initial health and safety inspection of Cottage 1A. No immediate health and safety hazards were observed. On 01/31/2023, LPA Choi conducted a follow-up visit to the facility and interviewed clients and staff. On 02/09/2023, LPA Choi made another follow-up visit to the facility and conducted a health and safety inspection of Cottage 1A. No immediate health and safety hazards were observed. LPA interviewed County Social Worker (CSW), clients (C1-C5) and staff (S1-S9). On 02/02/2023, Community Care Licensing received an allegation that staff (unknown) failed to follow Emergency Intervention Plan resulting in a physical altercation between clients (C1 and C2). CONTINUED ON THE NEXT PAGE UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Joon R Choi 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 19-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, MAIN ST., SUITE FACILITY NAME: CHILDHELP-YVONNE FEDDERSON & SARA O'MEARAFACILITY NUMBER: VISIT DATE: 03/13/2023

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


raw_content:
Narrative:
Confidential interviews reported that a client (C1) was trying to exit their room by moving around S6. Confidential interviews reported that S6 pushed C1 to the ground as C1 was trying to walk past them. Confidential interviews reported that C1 got up and pushed S1 back after S1 pushed C1 onto their bed. Confidential interviews reported that a client disclosed to their authorized representative that S6 physically pushed C1 to the floor and to their bed, as C1 was trying to walk past S6. Confidential interviews reported that C1 wanted to move past S1 to fight another client (C6). Other confidential interviews reported that there were no incidents involving C1 or any other clients in the living unit, which involved staff physically pushing clients. Confidential interviews reported that there was no video surveillance footage or documents of Special Incident Reports that involved a staff member pushing a client. Confidential interviews reported that staff was unsure if the pushing occurred in the client's bedroom where there weren't video cameras or a possibility it could have happened in a blind spot where videos were not able to capture any recording. Community Care Licensing received another allegation that facility staff (S6) made inappropriate comments toward a minor (C1). Confidential interviews reported that a staff member (S6), told a client (C1), "I will f you up." Confidential interviews reported that S6 said this statement to C1 during the alleged pushing incident mentioned above. Confidential interviews also reported that when C1 was experiencing a difficult situation, staff members (S6, S7, S8, and S9) were taunting C1 and not utilizing professional language. Confidential interviews reported that a client disclosed to their authorized representatives that (S6-S9) were not using appropriate language to help C1 calm down when C1 was struggling with their behavior. Other confidential interviews reported that the staff members assigned to C1's living unit have never cursed at clients and always used a warm and professional approach when interacting with clients. Based on inconsistent confidential interviews, the allegations that facility staff pushed minor to the ground and on to a bed and facility staff made inappropriate comments toward minor, may have occurred, however, is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted. A copy of this report, LIC 811, and appeal rights were explained and given to Quality Assurance Manager Amanda Bell.

Investigation Findings:
13On 03/21/2023 at 01: PM, Licensing Program Analyst (LPA) Joon Choi conducted an unannounced visit to ChildHelp Yvonne Fedderson and Sara O'Meara Short Term Residential Treatment Facility (STRTP) and met with Quality Assurance Manager Amanda Bell, to deliver the investigative findings for the allegations listed above. On 02/16/2023, LPA Joon Choi visited the facility, obtained pertinent documents, conducted an initial health and safety inspection of Cottage 1B, and interviewed three staff and two clients. No immediate health and safety hazards were observed. On 02/28/2023, LPA Choi made a follow-up visit to the facility, conducted a health and safety inspection of Cottage 1B, and interviewed an additional client and two staff. No immediate health and safety hazards were observed at the follow-up visit. LPA interviewed clients (C1-C7) and staff (S1-S5 and S7-S9). LPA attempted to interview S6 but was unsuccessful due to S6 no longer being an employee at the STRTP and not returning LPA's telephone calls. On 02/14/2023, Community Care Licensing received an allegation that facility staff (S6) pushed a minor (C1) to the ground and onto a bed. CONTINUED ON THE NEXT PAGE UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Joon R Choi 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 19-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, MAIN ST., SUITE FACILITY NAME: CHILDHELP-YVONNE FEDDERSON & SARA O'MEARAFACILITY NUMBER: VISIT DATE: 03/21/2023

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


raw_content:
Narrative:
Confidential interviews reported that another client (C2) witnessed the incident. Other confidential interviews reported that C2 left the unit with C1 in the same incident. Confidential interviews reported that C2 also witnessed S4 kick C1. Confidential interviews reported that one of the other clients (C3) did not witness the incident. Confidential interviews reported that S4 did not kick C1 and that C1 and C2 eventually returned to the living unit after being visually supervised and redirected by S4 and S5. Other confidential interviews reported that the Special Incident Report (SIR) obtained does not mention any physical contact between S4 and C1. Confidential interviews reported that since this incident happened outside of the living unit, no surveillance cameras picked up any video evidence of this incident. Confidential interviews reported that S4 denies kicking or hitting C1. Based on inconsistent confidential interviews, the allegation that staff kicked minor, may have occurred, however, is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted. A copy of this report and appeals rights was explained and given to Executive Director Lawrence Story.

Investigation Findings:
13On 05/12/2023 at 10: AM, Licensing Program Analyst (LPA) Joon Choi conducted an unannounced visit to ChildHelp Yvonne Fedderson and Sara O'Meara Short Term Residential Treatment Facility (STRTP) and met with Executive Director Lawrence Story, to deliver the investigative finding for the allegation listed above. On 04/18/2023, LPA Choi made the initial visit to the facility, interviewed three staff (S1, S2, and S3), obtained pertinent paperwork, and conducted an initial health and safety inspection of Cottage 1B. No immediate health and safety hazards were observed. Client 1 (C1), Client 2 (C2), Client 3 (C3), Staff 4 (S4), Staff 5 (S5), and Staff 6 (S6) were interviewed at a later date. Client 4 (C4) was unable to be located. On 03/29/2023, Community Care Licensing received an allegation that staff (S4) kicked a minor (C1). Confidential interviews reported that C1 left their living unit without permission, and S4 was called to assist. Confidential interviews reported that S4 attempted to redirect C1 back to the living unit, but when C1 refused and walked away from S4, S4 kicked the back of C1's foot. CONTINUED ON THE NEXT PAGE UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Joon R Choi 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 19-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, MAIN ST., SUITE FACILITY NAME: CHILDHELP-YVONNE FEDDERSON & SARA O'MEARAFACILITY NUMBER: VISIT DATE: 05/12/2023

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