facility_name: BRIGHTON SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On June 9, 2025, at 11:00AM, Licensing Program Analyst (LPA) Rachel Vanegas and Licensing Program Manager (LPM) Jennifer Smith met with Brighton Small Family Home Applicant, Brighton Ateku, at the Riverside Children's Residential Regional Office for the purpose of conducting a Component II meeting. LPA and LPM discussed corrections and revisions needed for the Program Statement. The following is a summary of the corrections and revisions discussed and requested. These revisions are due by close of business on June 23, 2025. A10. Personnel Report - Provide days and times for 24hr/7days per week childcare and supervision on the LIC 500 - Updated LIC215 or providing an updated resume Program Statement Corrections Needed B7. Facility Program Description - Please revise page numbers to match Table of Contents - Please update client population intended for your program (no longer wishes to include medically fragile minors) and include client age ranges. Please remove reference to Non-Minor Dependents throughout the program statement. - Please modify Source of Clients section. (Pages 4 and 5) - Please write out any use of acronyms prior to using the acronym (Page 6) **** - Please ensure that unsupervised visit reference is in accordance with court orders [Pg. 7] - Please remove any mention for "non-ambulatory" children [Pg. 8] - Please revise section 2C on Page 8 to remove reference to Medically Fragile children B9. Admission Policies - Please revise mention of LIC 610C for "Intake Process/Admission Policies" to reflect correct document for admission agreement. - Please revise reference to Medically Fragile children on Person's Accepted section on Page 9 and throughout the program statement. - Please provide further clarity for mental health services described on Pg. 10 - Please revise "Procedures for accepting emergency placement" to elaborate what "cleared up" means. Pg. 10 - Please provide a sample of Admission Agreement created with the use of the LIC 604 which is to be used as a guide but cannot be used as the admission agreement as stated on the document and include a reference to the use of the Pre-Admission Form to be used during admission process. [Pg. 10] Please replace attachment Admission Form LIC 604 with Admission Agreement. (Pg. 67). - Please replace mention of Regional Center IPP with "Needs and Service Plan - LIC 625." Page 11 - Please remove any mention of "Foster Home" or reference to "Foster Children" or "Foster Parents" throughout the program statement. Small Family Homes are not foster homes and youth are not to be referenced as foster youth - Please clarify the process for safeguarding cash resources on Pg. 6 in alignment with Pg. 14 - Please provide expectation for your Retention Period identified on Pg. 32. This is not regulated by Community Care Licensing. II. Basic Services - Medical/Dental - Please explain what "CHDP" means, or remove if not applicable. [Pg. 33] - Please revise Pg. 46 to include "Facility Name" and not the template insert section. Also, the LIC 610C does not have space for Physician, Dentist, etc. for each client. Revise the Medical/Dental section of this page to provide more clarity on where this information will be stored due to confidentiality for each client's information and information not being displayed on the LIC 610C. **** - Please clarify what "straight medical" is on Pg. 47, along with clarification for what the LIC 627B and LIC 622A are to be used for - Please provide more information regarding what BATES discharge - Penal Code 300 is in reference to [Pg. 48] - Please include that there can be temporary administration of psychotropic medication authorized on the JV220(A) Physician's Statement while the JV223 is pending [Pg. 48] - Please revise the name for form LIC 622A on Pg. 49 as it is incorrectly identified - Please indicate that medication refusals will be documented on the appropriate LIC form specific to the type of medication, LIC 622A or LIC 622B and include reporting requirements for medication refusal. - Please revise the section of medication storage, not all medication will be stored in the refrigerator [Pg. 52] II. Basic Services - Transportation, Roster of Staff and Personnel Record - Please revise the transportation section to include correct guidelines for the California Child Car Seat Law o For example: Children under 8 must use a booster in the back seat - Please revise roster of staff and personnel records - LIC 610C is not the document used for this; it is the LIC 500. Also, remove indication of "foster child" for this document as clients are not listed on the LIC 500 and not to be referred to as foster children. o LIC 9020 is utilized as a roster for clients - revise accordingly. II. Basic Services - Emergency Evacuation Plan - Please review and revise relocation site and reference for LIC 215 on Pg. 57 - Please revise "fire drills" on Pg. 57 to state "Disaster Drills" - Please review and revise the spacing on Pg. II. Basic Services - Records/Forms - Please indicate were school incidents, etc. will be documented **** - Please review and revise the "Notice of Utilizing Specific Forms" on Pg. 60. The form is the same but titled differently in this section - Please review and revise the "Child Abuse Report Form" on Pg. 60 as this section has incorrect information listed - Please review and reorganize the LIC 613B form on Pg. 70 so that Personal Rights are reviewed prior to the signature page - Please remove duplicate LIC 622A and include the LIC 622B that you mention is part of the forms you will utilize - Please review and revise the attached Drill form to allow for various drill types, not only fire. Pg. 57 - Please review and include information regarding Camera Uses and Locations in accordance with Children's Residential Program Provider Information Notice 24- LPA Vanegas and LPM Smith conducted an exit interview and a copy of this report along with the signed LIC 281C, Care Tools Pre-licensing form, and Children's Residential Program Provider Information Notice 24-09 were reviewed and provided to the applicant, Brighton Ateku.

met_with: Applicant - Brighton Ateku


state: CA

summary: Facility Evaluation

raw_content:
Narrative:
On July 14, 2025 at 10: AM, Licensing Program Analyst's (LPAs) Rachel Vanegas and Carissa Aviles arrived at Brighton Small Family Home (SFH) to conduct a pre-licensing inspection. LPAs met with Applicant Brighton Ateku who led a tour of the home. The home was toured both inside and out with the applicant. Currently there are no clients in placement. The home is a one story building with four bedrooms and two bathrooms which are set up as follows: Bedroom #1 (Master) has one bed sleeps the Applicant Bedroom #2 (Clients) has two single beds and will sleep two clients Bedroom #3 (Clients) has two single beds and will sleep two clients Bedroom #4 (Clients) has two single beds and will sleep two clients The home also consists of a great room/living room, kitchen, dining area, two bathrooms, a laundry room located in the garage, a two car garage, and the backyard. There is a properly fenced and secure fire place in the living room. The Client's bedrooms were arranged so that no more than two client's will be in a room. No room commonly used for other purposes is used as a bedroom and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There were combo smoke/carbon monoxide detectors in every bedroom and hallway. The combo detectors were checked and in properly functioning order. The home's central air conditioning module was located in the back yard. The home's water heater was located in the garage. The home appliances were in working order at the time of this inspection. *Continued on the next page* The client and staff files will be locked in a filing cabinet located in the living room. There was adequate food storage space. LPAs observed a two day supply of perishable and a seven day supply of non-perishable food. A trash can for storage of solid waste had a tight-fitting lid and was present in the kitchen. The sharp knives are in a locked kitchen cabinet, inaccessible to clients. The medications will be located in a locked filing cabinet in a storage closet in the living room. The hot water in the kitchen was measured and registered at 121.4 degrees Fahrenheit. The home's First Aid kit was accessible and is located in the storage closet in the living room and contained all required supplies. There was one fire extinguisher present in the home located in the kitchen near the sink. It was observed to be properly charged and inspected by the fire department. There are no firearms or weapons in the home as stated by the applicant. There is no pool at the home at the time of this inspection. There is one above ground hot tub that does not contain water at the time of this inspection and will remain empty per the applicant. It is properly secured with a latched pool cover. The backyard where clients will have access to play is fenced. The home has three security cameras located on the outside perimeter of the home (door bell, front driveway, and backyard). The following corrections need to be made to the home: Complaint hot line and Grievance Procedure/Policy needs posted. One dresser/drawers needs to be moved into client room 2 and client room 3. Lock on master bedroom. Properly secure the laundry detergent and cleaning chemicals located in the garage to be inaccessible to clients. Obtain games/toys/activities, etc. for indoor and outdoor use for clients. Water heater temperature was adjusted at the time of this visit. Confirmation of temperature within regulated range (105 - 120 degrees Fahrenheit) will be sent to LPA Vanegas. Component III was completed during this visit. An exit interview was conducted a copy of this report and appeal rights were reviewed and provided to the applicant, Brighton Ateku. Application will be forwarded to the Licensing Program Manager for Licensing upon receipt and confirmation of corrections made.

report_type: Facility Evaluation

visit_type: Prelicensing


summary: Facility Evaluation

raw_content:
Narrative:
On October 28, 2025 at 01:20PM, Licensing Program Analyst (LPA) Rachel Vanegas arrived at Brighton Small Family Home (SFH) to conduct a post-licensing inspection. LPA met with Licensee - Brighton Ateku who led a tour of the home. The home was toured both inside and out with the Licensee. The home is a one story building with four bedrooms and two bathrooms which are set up as follows: Bedroom #1 (Master) has one bed sleeps the Licensee. Bedroom #2 (Clients) has two single beds. One bed sleeps one client. One bed is vacant. Bedroom #3 (Clients) has two single beds. Both beds are vacant. Bedroom #4 (Clients) has two single beds. Both beds are vacant. The home also consists of a great room/living room, kitchen, dining area, two bathrooms, a laundry room located in the garage, a two car garage, and the backyard. There is a properly fenced and secure fire place in the living room. The Client's bedrooms were arranged so that no more than two client's will be in a room. No room commonly used for other purposes is used as a bedroom and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There were combo smoke/carbon monoxide detectors in every bedroom and hallway. The combo detectors were checked and in properly functioning order. The home's central air conditioning module was located in the back yard. The home's water heater was located in the garage. The hot water temperature was checked in the kitchen and registered at 105. Degrees F. The home appliances were in working order at the time of this inspection. *Continued on the next page* The client and staff files are locked in a filing cabinet located in a storage closet in the living room. There was adequate food storage space. LPA observed a two day supply of perishable and a seven day supply of non-perishable food. The sharp knives are in a locked kitchen cabinet, inaccessible to clients. The medications are located in a locked filing cabinet in a storage closet in the living room. The home's First Aid kit was accessible and is located in the storage closet in the living room and contained all required supplies. There was one fire extinguisher present in the home located in the kitchen near the sink. It was observed to be properly charged and inspected by the fire department. There are no firearms or weapons in the home as stated by the Licensee. There is no pool at the home at the time of this inspection. There is one above ground hot tub that does not contain water at the time of this inspection and remains empty per the Licensee. It is properly secured with a latched hot tub spa cover. The backyard where clients have access to play is fenced. The home has three security cameras located on the outside perimeter of the home (door bell, front driveway, and backyard). LPA reviewed one client file for Client 1 (C1). LPA observed required documents including signed placement agreements, Health and Education Passport, Authorization of Medical Care Form signed by the Authorized Representative, etc. Client file for C1 did not contain a signed Personal Rights Form (LIC 613B) or a copy of the current court order or written authorization of the child's parent or guardian for each psychotropic medication. LPA reviewed one staff files for Staff 1 (S1). LPA observed that one out of one files reviewed contained needed documents including CPR/First Aid certificates, Drivers License, Job Duties, Criminal Background Clearance Forms, documentation/verification of tuberculosis (TB) screening, etc. Based on observation and record review, the facility is issued two Technical Violations in accordance with California Code of Regulations (CCR) Section 837070(b)(11) for not having a copy of the current court order or written authorization of the child's parent or guardian for each psychotropic medication and CCR Section 83070(b)(13) for not having a signed acknowledgment of Personal Rights signed by the authorized representative on file. An exit interview was conducted and a copy of this report, LIC 811, and appeal rights were reviewed and provided to the Licensee - Brighton Ateku.

met_with: Licensee - Brighton Ateku


facility_name: BROOKFIELD DEVELOPMENTAL HOME

summary: Facility Evaluation

raw_content:
Narrative:
On October 09, 2024, Licensing Program Analyst (LPA) Rafael Enriquez met with applicant Matthew & his wife Ayobukola Alabi for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the notification of incomplete application (LIC 184), letter of Incomplete Application, and additional correspondence to assist with the revisions needed to the application. Copy of this report was emailed to applicant and a signed copy will be placed in the facility file.

met_with: Applicant- Matthew Alabi


summary: Facility Evaluation

raw_content:
Narrative:
On January 2, 2025 on 9: AM Licensing Program Analyst (LPA) Maryjane Perez arrived at Brookfield Developmental Home Small Family Home (SFH) to conduct pre-licensing inspection for an initial license. LPA met with applicants Matthew and Ayobukola Alabi who led a tour of the entire home. The applicants are applying for a capacity of six children ages 3-17 years old. The home is a one story building with 4 bedrooms and 2 bathrooms. The home consists of an entry way with visitation/ sign in log, there is bedroom #1 that will be utilized as foster children's bedroom which is fully furnished with two twin size beds with storage space , 2 night stands, closet space and trash cans. Bedroom #2 will be utilized for other foster children and consists of two twin size beds with storage space , 2 night stands, closet space and trash cans. There is also bedroom #3 that will be utilized as foster children's bedroom and consists of two twin size beds with storage space , 2 night stands, closet space and trash cans. All three bedrooms will be utilized for foster children and are all currently vacant and have proper bedding essentials. There is a bathroom with fully functioning toilet, shower/bath, and sink with water temperature reaching 116.2 degrees F. There is a furnished living room with couch, television, home phone and games/books. There is a kitchen with fully stocked refrigerator and pantry, abundance of perishable and nonperishable foods, locked box full of sharp objects such as knives, forks, and scissors stored in pantry. There is a locked kitchen cabinet storing cleaning supplies, another cabinet storing first aid kit with all required elements and a locked cabinet storing client records, personnel records and cash resources . There is a dining room table with enough seating for foster children. There is a hallway across from kitchen that has personal rights, visitation policy, emergency disaster plan, menu, and weekly schedule posted on a bulletin board. The hallway also has a locked cabinet with house medication and a locked section for clients medication with a lock boxed that could be used for refrigerated medication and a fire extinguisher that is up to date. There is a master- bedroom with king size bed and bathroom for applicants that will be locked at all times. Bedrooms were arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawers and closets for children's belongings. The laundry room is open for foster children use with adult supervision but laundry detergent, laundry supplies, sanitizers and carpet cleaning substances are locked in cabinets. There is another fire extinguisher that is up to date located in laundry room as well. There is a storage closet that holds an abundance of linen, towels, extra pillows and hygiene supplies for multiple foster children. There is a garage that is free of hazards and debris that stores two deep freezers for meats and extra frozen foods, there is vacuum, broom and mop located there as well. The garage will be open for foster children to utilize for exercise, playing, or visitations as there is a television, stereo, and empty space for movement. The backyard is enclosed by a gate that has a side gate closed with a latch. There is a lounge seating area with shaded gazebo, a locked shed storing storage for housing such as decorations and extra home supplies. The smoke detectors and carbon monoxide detectors were checked, and they were working properly. Appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients/children will have access. All trash cans for storage of solid waste had tight fitting lids. As stated by applicant, there were no weapons/firearms, there were no pools or other bodies of water, nor a fireplace in the home. There are no deficiencies observed at this time. Component III orientation was completed on November 14, 2024. The request for licensure will be forwarded to Licensing Program Manager for final review and approval. An exit interview was conducted. A copy of this report was provided to applicants Matthew and Ayobukola Alabi.

met_with: Applicants- MATTHEW & AYOBUKOLA ALABI


summary: Facility Evaluation

raw_content:
Narrative:
On January 7, 2026, Licensing Program Analyst (LPA) Joon Choi conducted a post-licensing inspection for Brookfield Developmental Home Small Family Home (SFH). LPA met with Licensees Matthew Alabi and Ayobukola Alabi (LIC1, LIC2)). The facility was toured both inside and out with the licensees. Currently there is one client placed in the facility. The facility is licensed for a capacity to serve 6 minor clients. The residence is a single story, four bedroom home with 2 full bathrooms (one for the clients and a master bathroom only accessible to the licensees). Three bedrooms can be designated for clients. The licensee's master bedroom will never be used to share with an infant and/or minor client(s). The facility consists of a living room (common area), a kitchen, an enclosed pantry, dining area, front entrance / hallway, enclosed laundry room, garage, and a fully paved backyard. Within the facility there is a storage closet for towels, linen and supplies. Any client bedroom can accommodate a client if they become non-ambulatory. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawers and closet space for children's belongings. The smoke/carbon monoxide detector is in the front hallway and was checked to be working properly. Both fire extinguishers had inspection tags and are good until November 2028. Telephone service and appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients would have access. A locked medication cabinet is available and in the hallway. Sharp objects/knives are locked in the enclosed pantry. There were no guns or weapons as stated by applicant at this time. The hot water temperature was tested and noted to be holding at 112.6 degrees There was adequate food storage supply of two days of perishable foods and a week of non-perishable food. The food was all properly stored. There is an enclosed waste bin built into the kitchen island. The Facility Sketch and Emergency Disaster Plan were posted in the hallway. There was no pool or other body of water; and the backyard where client(s) will have access to play was completely fenced and free of hazards. The garage is closed to the clients and had access to the tankless water heater. During the visit, LPAs interviewed two staff and one client. With the assistance of LIC1, LPA reviewed one current client file and four former client files; there were no deficiencies. With the assistance of LIC1, LPA reviewed two staff files; there were no deficiencies, and one technical advisory was provided. With the assistance of LIC1, LPA conducted a health and safety inspection of the facility's physical plant, reviewed the facility's operations, and reviewed client and staff files. Exit interview was conducted and a copy of this report and technical advisories were provided to LIC1.

met_with: Matthew Alabi, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On 3/16/2026, Licensing Program Analyst (LPA) Joon Choi conducted a case management visit with Brookfield Developmental Home Small Family Home (SFH) Licensee Matthew Alabi. The reason for the case management was explained to the Licensee. Today, during interviews for a complaint associated to this facility (19-CR-20260312131859) it was disclosed that the licensee used an unauthorized restraint hold (one person restraint) on a client C1, and licensee failed to report the incident. Licensee also disclosed there was a police visit to this home in response to the behaviors of C1, and this was also not reported via a Special Incident Report (SIR). The licensee is being cited for violation of General Licensing Requirements, Reporting Requirements 80061(b)(1)(E): (b)...a written report containing the information specified...shall be submitted to the licensing agency within seven days following the occurrence of such event (1) Events reported shall include the following: (E) Any unusual incident...which threatens the physical or emotional health or safety of any client. The licensee is also being cited for violation of General Licensing Requirements, Personal Rights 80072(a)(3): (a)...each client shall have personal rights which include, but are not limited to, the following: (3) To be free from...infliction of pain, humiliation, intimidation...or other actions... LPA conducted an exit interview and Licensee was provided a copy of this report LIC 809, along with LIC Deficiencies page and appeals rights.

visit_type: Case Management


facility_name: BROWN'S HOME HARBOR

summary: Facility Evaluation

raw_content:
Narrative:
On June 17, 2025, at 11:00AM, Licensing Program Analysts (LPAs) Rachel Vanegas and Carissa Aviles met with Brown's Home Harbor Small Family Home Applicant, Christine Brown and Spouse Lloyd Brown Jr. at the Riverside Children's Residential Program Regional Office for the purpose of conducting a Component II meeting. LPAs discussed corrections and revisions needed for the Program Statement. The following is a summary of the corrections and revisions discussed and requested. These revisions are due by close of business on July 02, 2025. A2. Applicant Information (LIC 215) - Please request and provide reference letters from current employment identified A5. Affidavit Regarding Client Cash Resources (LIC 400) - Please complete and provide this document. It is missing. A6. Surety Bond (LIC 402) - Please review and correct this document to select and display the appropriate facility type (Small Family Home) A9. Budget Information (LIC 420) - Please complete and provide this document. It is currently missing. A10. Personnel Report (LIC 500) - Please review and revise this document to reflect 24hr/7days a week care and supervision for client's in care A11. Personnel Record (LIC 501) - Please complete this document for Staff listed in application file ** ** A13. Criminal Record Statement - Please complete LIC O-O-S in Guardian for the applicant and spouse, background clearances are still pending. A14. Emergency Disaster Plan (LIC 610C) - Please review and revise this document to include the names for Fire/Paramedics and Police or Sheriff services A15. Facility Sketch (LIC 999) - Please review and revise the facility sketch to include identification of all "Doors" Program Statement Corrections Needed B7. Facility Program Description B. Target Population - Please clarify client population intended for your program: Identify client age ranges and ambulatory status. - Please review and revise identified Target Population (DD, PH...) and spell out words before using abbreviations - Please identify source of placement for clients - Please review and expand on your admission policy section and provide a sample admission agreement D. Education - Please include a statement to reflect compliance with the foster youth bill of rights for Education G. Recreation - Please complete and provide a Water Safety Training Certificate I. Protection - Please review and revise this section to include notification to the client's authorized representative for any complaints reported, etc. - Please include documentation for timelines for in-house complaint review - Please include complaint hot line resources and additional reporting requirements for Community Care Licensing for grievance and complaint reporting ** ** - Please review and clarify that access to a phone for emergency calls or calls related to complaint reporting, etc. cannot be restricted and will be available for clients in care - Please review and revise statement regarding personal rights being on display, etc. to include revision of Personal Rights Children's Residential Facilities (LIC613B) during intake and signature of acknowledgement from the client and authorized representative at that time K. Unplanned Termination - Please review and revise to include a timeline for how long the child's property, etc. will be securely stored L. Medical Emergencies - Please review and clarify L.1 "Check the child" to provide information regarding what this will entail II. Basic Services A. Food - Please review and provide a statement for alternative meals to be available if/when a client does not attend school (planned or unplanned) - Please review the modified outlined written menu and ensure that in between meal snacks are available twice per day - Please include a statement regarding alternative meal accommodations due to food aversions or dislikes, physician prescribed meals, etc. B. Clothing - Please review and include in B.1 how you will track monthly clothing allowance usage, etc. D. Personal Allowance/Paid Jobs - Please review and revise this section to reflect compliance with Foster Youth Bill of Rights and age appropriateness of a token system E. Medical/Dental - Please include regulated health screening for clients within 30 days of placement and inclusion of tuberculosis screening documentation ** ** - Please review and include reporting requirements of 24hr notice and then a full written report within 7 days for incidents involving medical treatment for a client in care F. Medication Policy/Procedures - Please review and provide further clarity for liability of medication refills - Please review and include reference and use of the Medication Administration Record (MAR) LIC 622A and Psychotropic Medication Administration Record (PMAR) LIC 622B for documentation of medication for clients in care - Please review and include the use of documentation for medication refusal by a client for prescribed medications - Please include that there can be temporary administration of psychotropic medication authorized on the JV220(A) Physician's Statement while the JV223 is pending - Please review and further state where you will document destroyed medications (LIC 622) Personal Rights - Please include all foster youth bill of rights, they currently are not all listed. G. Transportation - Please review and include guidelines for the California Child Car Seat Law III. Organizational Information F. Emergency Evacuation Plan - Please review and revise inclusion of an evacuation map that is referenced for this section - Please review and include disaster drill compliance and documentation G. Record Reporting - Please review and specify where documentation identified in this section will be reported and stored - Please include reporting requirement timelines (24hr notice to Community Care Licensing and a full incident report within 7 days of the incident occurring.) etc. ** ** - Please include reporting notification to Community Care Licensing when the Licensee will be out of the home for longer than 48hrs B9. Admission Policies - Please expand and include more information regarding your admission/intake process and include a copy of your admission agreement - Please include timeline of "within 30 days of placement" for the Needs and Services plan to be completed and signed by appropriate parties for clients in care (Authorized Representative, Client, Licensee) - Please include reference to and acknowledgement of the regulated health screening for clients within 30 days of placement and inclusion of tuberculosis screening documentation B10. Sample Menu - Please include a full sample meal menu B11. Control of Property - Please include supporting documentation such a property deed B12. Bacterial Analysis of Private Water Supply - Please include documentation stating water supply for the home B16. First Aid Card - Please complete and provide Water Safety Training Certificate(s) Please review and include information regarding Camera Uses and Locations in accordance with Children's Residential Program Provider Information Notice 24- LPA Vanegas and LPA Aviles conducted an exit interview and a copy of this report along with the signed LIC 281C, Care Tools Pre-licensing form,and Children's Residential Program Provider Information Notice 24-09, and appeal rights were reviewed and provided to the applicant, Christine Brown.

met_with: Applicant - Christine Brown


summary: Facility Evaluation

raw_content:
Narrative:
On August 8, 2025 at 10: AM, Licensing Program Analyst (LPA) Rachel Vanegas arrived at Brown's Home Harbor, Small Family Home (SFH) to conduct a pre-licensing inspection. LPA met with Applicant Christine Brown who led a tour of the home. The home was toured both inside and out with the applicant. Currently there are no clients in placement. The home is a two story building with five bedrooms and three bathrooms which are set up as follows: Bedroom #1 (Master) has one bed sleeps the Applicant and spouse. The room is locked and inaccessible to client's in care. Bedroom #2 (Applicant's Child) has one single bed and sleeps the applicant's child. The room is locked and inaccessible to client's in care. Bedroom #3 (Applicant's Child) has one single bed and sleeps the applicant's child. The room is locked and inaccessible to client's in care. Bedroom #4 (Applicant's Child) has one single bed and sleeps the applicant's child. The room is locked and inaccessible to client's in care. Bedroom #5 (Clients) has two single beds and will sleep two clients. The home also consists of a great room/living room, kitchen, dining area, three bathrooms, a locked laundry room, a two car garage, an upstairs loft, and the backyard. There is a properly secure electric fire place in the living room. The client's bedroom is arranged so that no more than two client's will be in a room. No room commonly used for other purposes is used as a bedroom and no bedroom serves as a passageway to another room. *Continued on the next page* There was adequate closet and dresser space for the client's personal belongings. There were smoke detectors in every bedroom and hallway and a carbon monoxide detector in the hallway upstairs. All detectors were checked and in properly functioning order. The home's central air conditioning module was located in the back yard. The home's water heater was located in the garage. The home appliances were in working order at the time of this inspection. The client and staff files will be locked in a locked storage cabinet located above a desk in the living room. There was adequate food storage space. LPA observed a two day supply of perishable and a seven day supply of non-perishable food. A trash can for storage of solid waste had a tight-fitting lid and was present in the kitchen. All sharp knives are in a locked kitchen drawer, inaccessible to clients. The medications will be located in a locked kitchen cabinet in the kitchen. There is an additional lock box for medication storage located in the kitchen. Cleaning chemicals are located in a locked kitchen cabinet under the sink and also in the locked laundry room. The cleaning chemicals and laundry detergent are inaccessible to clients. The hot water in the kitchen was measured and registered at 103.2 degrees Fahrenheit. The home's First Aid kit was accessible and is located in the storage closet in the living room and contained all required supplies. There was one fire extinguisher present in the home located in the pantry near the kitchen. It was observed to be properly charged and inspected by the fire department. There are no firearms or weapons in the home as stated by the applicant. There is a pool located in the backyard that measures 5.5ft deep. The pool is properly fenced and secured inaccessible to clients with an installed 5ft netted gate that has a self-latching lock door. The backyard where clients will have access to play is fully fenced. The home will have three security cameras located on the outside perimeter of the home (front driveway, front yard, and backyard pool area). The following corrections need to be made to the home: Water heater temperature was adjusted at the time of this visit. Confirmation of temperature within regulated range (105 - 120 degrees Fahrenheit) will be sent to LPA Vanegas. Component III was completed during this visit. An exit interview was conducted a copy of this report and appeal rights were reviewed and provided to the applicant, Christine Brown. Application will be forwarded to the Licensing Program Manager for Licensing upon receipt and confirmation of corrections made.


facility_name: BROWN FAMILY CARE HOME-SFH

summary: Facility Evaluation

raw_content:
Narrative:
On 2/23/ Licensing Program Analyst (LPA) Jean Stidman met with Angie Brown Licensee for the purpose of an Annual inspection. LPA was unable to complete the inspection due to technical issues. LPA will return at a later date to complete the Inspection. The facility had three clients and three staff present during the inspection.

visit_type: Annual

met_with: Angie Brown Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On 3/14/23 at 9: AM Licensing Program Analyst (LPA) Kim Pawlowicz initiated an unannounced annual inspection with the above agency. LPA met with Angie Brown, Administrator. The facility serves non-ambulatory clients ages 0-17. Current census is 2. LPA toured the two-story facility, inside and out with the assistance of Angie Brown, Direct Support Professional. The outside of the facility was clean, free of debris, and no safety hazards were observed. The facility consists of five bedrooms and two bathrooms. There is adequate space for leisure activities. Smoke/Carbon detectors and fire extinguishers are in working order. There are no bodies of water or firearms on the premises. The facility is stocked with food and surplus supplies needed to care for clients. Clients have adequate space for their personal belongings. LPA reviewed two client files and five staff files. LPA interviewed the two staff that were currently on shift. Both clients are non-verbal therefore, client interviews were not conducted. No Title 22 deficiencies were cited at today's inspection. Exit interview was conducted and a copy of this report was given to Angie Brown, Administrator.

met_with: Angie Brown, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPAs) Kayla Green and Jean Stidman made an unannounced Annual inspection on 2/20/23 at 9:30 am. During the inspection LPA met with Angie Brown Licensee who assisted with the inspection. LPAs conducted a walk-through of the facility inside and out. Facility staff-client ratio at time of inspection three staff and three kids were present during the inspection. LPAs observed the facility is a two story home with four bedrooms and two bathrooms. LPAs inspected and/or reviewed the following: Physical Plant Posting of license_ok_ Personal Rights_ok_ Disinfectants/Cleaning solutions inaccessible_ok_ Refrigerator Temperature at or below 45 degrees F _N/A Freezer Temperature at or below 0 degreesN/A Nonperishable Foods one week and fresh perishable foods two days minimum_ok_ Menu present and posted_N/A_ Working telephone _ok_Carbon monoxide detector_ok_ Smoke Detector ok First Aid Kit fully stocked_ok__ Common Room available_ok_ Dining area (enough seating, furniture good condition, not broke or damaged) N/A Medication centrally stored, locked/inaccessible ok Hot Water between 105-120 degree F (Properly labeled if over 125 degree F)_110 degrees Fire Extinguisher (note inspection date) charged September 2023_ Toilets wash basin, bath and shower fixtures in good repair/no leaks/hot water temperature _ok_ Soap and Paper towels ok_ Laundry Facilities(available)_ok_ Bedrooms-required linen and furnishings _ok_ Locked Facilities (sheds) _ok Bedroom (required bedding/furniture, furniture in good repair) ___ok Exit interview conducted and a copy of this report left at the facility with Angie Brown Licensee


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
Licensing Program Analysts (LPAs) Kayla Green and Jean Stidman made an unannounced Annual inspection on 2/23/23 at 8:45 am. During the inspection LPAs met with Angie Brown Licensee who assisted with the inspection.Facility staff-client ratio at time of inspection three staff and four clients were present. Number of staff interviewed four and one client. LPAs inspected and/or reviewed the following: Disaster and mass casualty plan updated and available__X_ Quarterly Drills conducted and documented__X_ Disaster preparedness supplies verified __X__ Number of Staff files reviewed _five Criminal record clearances verified _five_First Aid Certificate__five__ Facility citation violation of California Code of Regulations, Title 22, Division 6, regulation 80066(a)(10) and 80066(a)(11) Personnel Records LPA observed two facility staff are missing health screening and one staff is missing Tuberculosis test. Facility citation violation of California Code of Regulations, Title 22, Division 6, regulation 83064(i) Licensee Duties and Responsibilities all staff are missing training on the reasonable and prudent parent standard. Number of Clients files reviewed four Individual Program Plan four Centrally Stored Medication and log reviewed four Psychotropic Medication and log reviewed two__Cash Resources__four_ SHCN plan created by licensed professional and implemented as required for four clients Staff received training __X__ Facility citation violation of California Code of Regulations, Title 22, Division 6, regulation 83070(b)(11) Child's Records three clients records missing documentation of a copy of the current court order, or written authorization of the child's parent or guardian, for each psychotropic medication. The following items were reviewed for compliance in the regional office prior to the facility inspection: Annual fees, Emergency Disaster Plan, Personnel Roster, Facility Sketch, LIC 500, and Waivers and Exceptions An exit interview was conducted and a copy of this report and appeal rights was left with Angie Brown Licensee.

Deficiencies:
83064(i): Deficient Practice Statement
1
2
3
4Based on record review, the licensee did not comply with the section cited above in five out of five staff records which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/23/2024
Plan of Correction
1
2
3
4

title:
Licensee Duties and Responsibilities

(i) The licensee shall complete training related to the reasonable and prudent parent standard as specified in Health and Safety Code section 1522.44(c).

This requirement is not met as evidenced by


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPAs) Maie Soliman and Jean Stidman conducted an unannounced Case Management inspection to the facility on 12/18/2024 beginning at 11: AM. LPAs met with Angie Brown, Licensee, and discussed the purpose of the visit was in response to an incident that occurred on 12/14/2024. On today's date, LPA reviewed one client's file and obtained copies of the following documents: Progress notes and Medication Administration Records dated 10/18/24-12/14/24, Medical Equipment Order Forms dated 10/16/24, prescription documentation dated 10/14/24, Placement Agreement, medical documentation dated 10/18/24-11/26/24, Needs and Services Plan, and the Preplacement Appraisal. LPA Soliman requested licensee email LPA documentation of communication with the child's county social worker and medical professionals. LPA Soliman requested the licensee email medical documentation from December 2024. LPA Soliman interviewed the Licensee and one staff. LPA Soliman conducted an inspection of the small family home, inside and outside. No deficiencies were cited on today's date. An exit interview was conducted and a copy of this report was given to the Licensee.

met_with: Angie Brown Licencee


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPAs) Maie Soliman and Avelina Martinez made an unannounced Annual inspection on 01/16/2025 at 08: AM. During the inspection LPAs met with Angie Brown Licensee who assisted with the inspection. LPAs conducted a walk-through of the facility inside and out. Facility staff-client ratio at time of inspection One staff and one youth were present during the inspection. LPAs observed the facility is a two story home with four bedrooms and two bathrooms. LPAs inspected and reviewed the following: Physical Plant Posting of license_ok_ Personal Rights_ok_ Disinfectants/Cleaning solutions inaccessible_ok_ Refrigerator Temperature at or below 45 degrees F ok Freezer Temperature at or below 0 degrees ok Nonperishable Foods one week and fresh perishable foods two days minimum ok Menu present and posted ok Working telephone _ok_Carbon monoxide detector_ok_ Smoke Detector ok First Aid Kit fully stocked okCommon Room available_ok_ Dining area (enough seating, furniture good condition, not broke or damaged) ok Medication centrally stored, locked/inaccessible ok Hot Water between 105-120 degree F ok Fire Extinguisher (note inspection date) charged 09/ Toilets wash basin, bath and shower fixtures in good repair/no leaks/hot water temperature _ok_ Soap and Paper towels _ok_ Laundry Facilities(available)ok_ Bedrooms-required linen and furnishings _ok_ Locked Facilities (sheds) _ok Bedroom (required bedding/furniture, furniture in good repair) _ok vehicle inspection ok Client Records Number of Clients Medication and log reviewed four Psychotropic Medication and log reviewed two. Clients Records review were not concluded on 01/16/2025. LPAs will return to conduct a continuation annual visit at a later date to complete the review. An exit interview was conducted with Licensee Angie Brown and a copy of this report was left with Licensee.

met_with: Angie Brown


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPAs) Maie Soliman and Avelina Martinez made an unannounced Annual inspection on 01/22/2025 at 09: AM. During the inspection LPAs met with Angie Brown Licensee who assisted with the inspection. LPAs conducted a walk-through of the facility inside and out. Facility staff-client ratio at time of inspection One staff and one youth were present during the inspection. LPAs observed the facility is a two story home with four bedrooms and two bathrooms. LPAs inspected and reviewed the following: Client Records Number of Clients files reviewed four Individual Program Plan one Centrally Stored Medication and log reviewed four Psychotropic Medication and log reviewed two Cash Resources four JV Reviewed one Four out of four Centrally Stored Medication logs were missing the start date. One out of four Needs and Service Plan was not updated by an authorized representative or social worker. The one in file is dated today and there is no records of previous ones. Two out of four Needs and Services Plans were not signed by the representative or social worker. One medication label did not match the PMAR. In addition the January 14th bubble pack medication was not administered as prescribed. Medication Clonidine should be administered two times per day, however, after conducting a pill count, there were extra pills that were not accounted for. The PMAR was initialed twice.

met_with: Angie Brown, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPA) Maie Soliman made an unannounced Annual inspection on 01/23/2025 at 08: AM. During the inspection LPA met with Angie Brown Licensee who assisted with the inspection. LPAs conducted a walk-through of the facility inside and out. Facility staff-client ratio at time of inspection two staff and one youth were present during the inspection. LPA observed the facility is a two story home with four bedrooms and two bathrooms. LPA inspected and reviewed the following: Disaster Preparedness Disaster and mass casualty plan updated and available 12/02/ Drills conducted and documented 11/16/2024. Disaster preparedness supplies verified 01/16/2025. Emergency Disaster Plan (per H&S Code 1565) Special Health Care Needs (SHCN) SHCN plan created by licensed professional and implemented as required yes Staff received training yes. Staffing Number of Staff files reviewed five Criminal record clearances verified five First Aid Certificate five Certified Administrators certificate valid and current one Job title/qualification verified five Hours required training verified five. The following items were reviewed for compliance in the regional office prior to the facility inspection: Annual fees -Annual Emergency Intervention Log - Personnel Roster, Facility Sketch, LIC 500, LIC 610C and LIC 308 - Waivers and Exceptions


summary: Facility Evaluation

raw_content:
Narrative:
On 3/8/ Licensing Program Analyst (LPA) Jean Stidman met with Angie Brown Licensee for the purpose of an Annual inspection Continuation. LPA was unable to cite the facility previously due to technical issues. Facility cited California Code of Regulations Title 22 for Staff Records 83066(a)(1), 80065(g)(1), 83064(e) for S4 missing date of specialized training, S1, S2, S3, and S6 missing health screening and S1, S2, and S TB Test within 12 months prior to or 30 days after date of hire, all staff missing ongoing training. Facility cited California Code of Regulations Title 22 for client records 83070(b)(12)(H) and for C1 missing parental permission and C2 missing JV220 forms for psychotropic medication and - 83070(b)(11) medication administration records missing staff initials for all three clients for medications given on 2/11/20, 2/14/22, 2/17/22, 2/18/22 and 2/19/22. See LIC809D


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Maie Soliman made an unannounced Annual inspection on 04/9/2026 at 10: AM. During the inspection LPA met with Angie Brown Licensee who assisted with the inspection. LPA conducted a walk-through of the facility inside and out. LPA observed the facility is a two story home with four bedrooms and two bathrooms. LPA inspected and reviewed the following: Physical Plant Posting of license_ok_ Personal Rights_ok_ Disinfectants/Cleaning solutions inaccessible_ok_ Refrigerator Temperature at or below 45 degrees F 44. Freezer Temperature at or below 0 degrees ok Nonperishable Foods one week and fresh perishable foods two days minimum ok Menu present and posted ok Working telephone _ok_Carbon monoxide detector_ok_ Smoke Detector ok First Aid Kit fully stocked ok Common Room available_ok_ Dining area (enough seating, furniture good condition, not broke or damaged) ok Medication centrally stored, locked/inaccessible ok Hot Water between 105-120 degree F 122 degree F Fire Extinguisher (note inspection date) expires 07/ Toilets wash basin, bath and shower fixtures in good repair/no leaks/hot water temperature _ok_ Soap and Paper towels _ok_ Laundry Facilities(available)ok_ Bedrooms-required linen and furnishings _ok_ Locked Facilities (sheds) _ok Bedroom (required bedding/furniture, furniture in good repair) _ok vehicle inspection ok Client Records Number of Clients Medication and log reviewed three Psychotropic Medication and log reviewed __one___. Clients Records review were not concluded on 04/9/2026. LPA will return to conduct a continuation annual visit at a later date to complete the review. An exit interview was conducted with Licensee Angie Brown and a copy of this report was left with Licensee.


facility_name: BUI THUO SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On November 18th, 2025, Licensing Program Analyst (LPA) Claudia Aguilera and Licensing Program Manager Abdoulaye Traore met with Applicant Bui Muturi Thuo for the Component II of the application process. LPA Aguilera went over revisions needed for the application prior to license. The due date is December 18th, 2025. LPA Aguilera provided applicant with a copy of the LIC 184, Notice of Incomplete Application and additional correspondence to assist with the revisions needed to the application. A copy of this report was provided to the Applicant, Bui Muturi Thuo.

met_with: Applicant


summary: Facility Evaluation

raw_content:
Narrative:
On January 30th, 2026, Licensing Program Analyst (LPA) Claudia Aguilera arrived at Bui Thuo Small Family Home (SFH) to conduct pre-licensing inspection for an initial license. LPA met with applicant Bui Thuo who led a tour of the entire home. The applicant is applying for a capacity of three ambulatory children, ages 1-17 years old. The home is a two-story building with three bedrooms and three bathrooms. The downstairs consisted of an entry way with a living room that had couches, a TV, screened fireplace, books, basket with blankets, and small toys. Additionally, there was a pool table and piano for entertainment. A storage closet was also observed to contain household items. The kitchen had a large island with adequate seating for eating. The kitchen contained a locked cabinet for storing knives/ sharp objects, and medications. The first aid kit was also located in the kitchen and contained all necessary items. The refrigerator was fully stocked with perishable food. There was plenty of dishes and utensils for client use. Bathroom #1 was located downstairs and was also observed and inspected to be fully functioning. The fire extinguisher was also located in the kitchen and was observed to be operable along with the required postings such as visitation policy, emergency disaster plan, and personal rights. The laundry room was also observed to be downstairs which stores laundry detergents and laundry essentials and remains locked at all times. The upstairs consisted of Bedroom #1 which is currently occupied by 17-year-old foster youth, which consisted of a full size bed, closet, and dresser. Bedroom #2 is vacant to serve two ambulatory foster children which consisted of one queen bed and one twin size bed, closet space, lighting, drawers, a desk with chair, and all the required bedding. Bathroom #2 was fully functioning with a sink, toilet and shower. Bedroom #3 was inspected and is occupied by the applicant which consisted of a king size bed and Bathroom #3. An additional fire extinguisher was located upstairs. The yard surrounds the home which is fully fenced, backyard included a trampoline with safety mesh where children will have access to play and was free of hazards. There is an above ground pool with a deck which currently does not meet the five feet gate regulation or hard cover. No weapons/firearms are kept in the home as stated by applicant. The garage was also inspected and observed to store extra household items, one vehicle. The applicant was advised to supervise foster children when in the garage. The water temperature was tested and measured at 115 degrees Fahrenheit. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. The smoke detectors and carbon monoxide detectors were checked and are working properly. All hazardous items have been properly made inaccessible to areas where children will have access. All appliances were in working order, and all trash cans for storage of solid waste had tight fitting lids. Based on this inspection of the home, the facility will need the following corrections: · The pool fence must meet the five feet regulation, or a hard cover must be installed that meets pool cover regulations. After corrections are completed, the applicants will notify LPA so that another inspection can be completed. Component III orientation was also completed this day of January 30th, An exit interview was conducted and a copy of this report was provided to applicant Bui Thuo.

met_with: Applicant- Bui Thuo


summary: Facility Evaluation

raw_content:
Narrative:
On March 18th, 2026, Licensing Program Analyst (LPA) Claudia Aguilera arrived at Bui Thuo Small Family Home (SFH) and met with applicant Bui Thuo who led a tour of the home. The purpose of this visit is to ensure the pool corrections were made from the last inspection done on January 30th, 2026. The applicant is applying to serve three ambulatory children ages 1 to 17 years old. The backyard has an above ground pool that contains water and is ready for use. LPA observed a five foot fence that surrounds the pool with a gate that is self latching and swings away from the pool. There is second gate that does not self-latch, applicant will place a lock. The following correction still need to be made: · Lock for the second gate After the correction is completed, the applicant will notify LPA, once the correction is completed the application will be forwarded to Licensing Program Manager Abdoulaye Traore for licensure. An exit interview was conducted and a copy of this report was discussed and provided to applicant Bui Thuo.

met_with: Applicant, Bui Thuo


facility_name: BUJOL'S; WE'RE FAMILY MATTERS

summary: Facility Evaluation

raw_content:
Narrative:
On February 2, 2024 at 10:00am, Licensing Program Analyst (LPA) Deborah Lee conducted a Component II, Face-to-Face meeting with Bujol We're Family Matters Small Family Home LPA met with Licensee, Jon Bujol and Latricia Murray. The purpose of the meeting was to discuss the pending Small Family Home application and Program Statement review. LPA discussed and advised licensee to submit a complete Program Statement by March 4th, 2024. The following concerns were discussed: Missing Items: Current DL/ID card (obtained copy during meeting) LPA advised applicant to include discipline policy in Program Statement Program Statement: Program Statement is incomplete and did not follow the mandatory format. Mr. Bujol and Ms. Murray were provided with a copy the Program Statement format guideline to assist them in creating their Program Statement. FOLLOW - UP: A Pre-Licensing Inspection at facility will be conducted on March 4, 2024 at 10:00am. An exit interview was conducted, and a copy of this report was given to the Licensee.

met_with: Jon Bujol and LaTricia Murary


summary: Facility Evaluation

raw_content:
Narrative:
On March 4, 2024, Licensing Program Analyst (LPA) Deborah Lee arrived at the above facility, for the purpose of conducting a Pre- licensing inspection for a Small Family Home License. LPA met with applicant, Jon Bujol who granted access into the home. The applicant and LPA toured the facility both inside and out. Currently residing in the home is applicant, his mother, and his two siblings . Applicant is requesting to be licensed for 2 clients ages 3-17 ambulatory only. The home is set up as follows: This is a one story house with 4 bedrooms, 3 bathrooms, Living Room, Dining area, kitchen, laundry/sitting room area, Garage converted to a Den. The home was inspected and the following was observed: The home was equipped with comfortable mattresses, clean lines, blankets, and pillows that are in good repair. The home is clean, safe, sanitary, and in good repair. Phone land line, electric and gas were in working condition. Living Room/Family Room: There is adequate furniture which appears to be in good condition. is equipped with mounted TV on the main wall, sectional sofa, electric fireplace below mounted TV and side wall there is an aquarium. The front door has a bar screen and wooden door. Alarms were tested during the inspection and they all appeared to be in working condition. Alarms are a combination smoke detector/carbon monoxide. In hallway immediately to left from entrance is free of clutter. Bedroom 1, linen closet and storage closets are located off the in hallway. The laundry area/sitting room is located off of the main hallway. LPA observed laundry detergent on top of the washer and dryer that was not locked away. LPA advised applicant to find a secured area for the laundry detergent that they are not accessible to client's in care. page 1 of Formal Dining Area has a large table that seats six (6) and postings (personal rights, facility sketch, emergency numbers, and evacuation plan) on wall in dinning area. There is a functioning fire extinguisher mounted on the wall Kitchen: Is equipped with a 4 burner stove located on an island counter; a separate oven. There is a microwave on the counter top. There is a working Refrigerator/freezer. There is a small breakfast nook area with a table that seats 4. Bedroom #1: was equipped with two size beds-build in drawer space, and a chest of drawers with TV on top of chest of drawers and adequate closet space, lighting was adequate in this room. This room will be occupied by two clients. Bedroom #2: was equipped with 1 king sized bed, dresser drawers and closet space is available, lighting was adequate in this room. Room has on suite bathroom. Occupied by applicant. Bedroom #3: Is being occupied by the applicant's siblings who are disabled twins (regional center clients). They are non-verbal and diagnosed with Cornelia Delange Syndrome. Bedroom #4: Is converted into laundry room/seating area Bathroom #1 is located in the hallway, it is clean, and sanitary Bathroom #2 is located in applicant's room Bathroom #3 is located off laundry area, it is clean and sanitary. The home garage is converted to a den that equipped with sectional, mounted TV coffee table, and a bar. All smoke/carbon monoxide combo detectors were tested and were operating properly in the home at the time of the inspection. The medication will be centrally located in the in a locked closet located in the main hallway, by bedroom #1. Knifes are locked in a cabinet in the kitchen. Cleaning solutions will be inaccessible to the clients in care , they were observed a locked cabinet in the hall. There are no bars on the windows. There is adequate linen supply in the hallway closet. Page 2 of Outdoor activity space (front and back yard) is free of obstructions and hazards. Back yard is equipped with outdoor patio furniture, electric grill and gym equipment that is secure. Trash cans outside are observed with the lid on. There are no bodies of water on the primases. There are no firearms or dangerous weapons in the home. There are no pets in the home. The first aid kit is checked and is complete with scissors, tweezers, thermometer, and gauzes, antiseptic and applicant did not have 1st Aid Manual. There are 2 operable Fire Extinguisher available in the home. Prior to being licensed the following is required: · Applicant and staff need to be associated to the facility. LPA advised applicant to create a Guardian Profile to complete process. · Applicant need to have laundry detergent stored in a locked area The home will utilized Kia KS to transport clients in care. Current automobile insurance is with Mercury Insurance Company. Exit Interview was conducted and a copy of this report will be page 3 of 3

met_with: Jon Bujol,applicant


summary: Facility Evaluation

raw_content:
Narrative:
On September 20, 2024, Licensing Program Analyst (LPA) Kenrick Ellis arrived at the above facility for the purpose of conducting a Post-Licensing inspection. LPA met with Latricia Murray access was not granted into the home. LPA was informed that today was not an ideal time to inspect the home. LPA attempted Post-Licensing visit, and will make another unannounced visit at a later date.

met_with: Latricia Murray, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On October 4, 2024, Licensing Program Analyst (LPA) Kenrick Ellis arrived at the above facility for the purpose of conducting a Post-Licensing inspection. LPA met with Licensee who granted access to the home. A health and safety assessment was conducted upon arrival. The Licensee and LPA toured the interior exterior of the home. Currently residing in the home is Licensee, Adult 1, Adult 2 and 2 minor children. There are currently no placement's residing in the home. The census today is zero. This case management will take place as the post-licensing visit with Bujol's we're family matters. The home is set up as follows: This is a one-story home with 4 bedrooms, 3 bathrooms, living room, dining area, kitchen, laundry area/sitting room, and a garage that has been converted into a den. Bedroom #1: was equipped with two twin size beds, adequate drawers and closet space, and adequate lighting. Bedroom #2: was equipped with 1 king size bed, dresser drawers and closet space, and adequate lighting bedroom is occupied by Licensee. Bedroom #3: is equipped with two twin beds, adequate closet space and lighting. Bedroom is occupied by the Licensee's two minor siblings. Bedroom #4: has been converted into a laundry room/seating area. Bathroom #1 is located in the hallway and was observed to be clean sanitary and in good repair. Bathroom #2 is located in Licensee's bedroom and was observed to be clean sanitary and in good repair. Den Area- Garage has been converted into a den area with sectional couch and play area. Bathroom #3 is located near the laundry area, and was observed to be clean sanitary and in good repair. Living room/Family room: there is adequate furniture which appears to be in good condition. Formal dining area: equipped with a table and 6 chairs. There is a functioning fire extinguisher mounted on the wall. Kitchen: Is equipped with a 4-burner stove, oven, microwave , and refrigerator/freezer. There is a breakfast nook area with a table and 4 seats. All smoke/carbon monoxide combo detectors were observed to be in working condition. The medication is locked in hallway closet. Knifes are locked in a cabinet in the kitchen. Cleaning solutions inaccessible to the clients in care and locked in cabinet located in the hallway. There is adequate linen supply in the hallway closet. Outdoor activity space is free of obstructions and hazards. Backyard is equipped with outdoor patio furniture, electric grill and gym equipment that is secure. There are no firearms or dangerous weapons in the home. Posting requirements were met. LPA Kenrick Ellis discussed sleeping arrangement for adult 2 and noticed one health and safety technical violation has been issued citing California Code of regulations Title 22 Buildings and Grounds(b) An exit interview was conducted and a copy of this report was provided to Licensee.

met_with: Jon Bujol, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On October 16, 2024, Licensing Program Analyst (LPA) Kenrick Ellis arrived at the above facility for the purpose of conducting case management. LPA met with Licensee who granted access to the home. A health and safety assessment was conducted upon arrival. The Licensee and LPA toured the interior exterior of the home. Currently residing in the home is Licensee, Adult 1, Adult 2 and Adult 3 and Adult 4. There are currently no placement's residing in the home. The census today is zero. This case management is initiated to address the need for a new facility sketch, the sleeping arrangements of Adult 2 and fingerprint clearance of Adult 3 and Adult 4. The home is set up as follows: This is a one-story home with 4 bedrooms, 3 bathrooms, living room, dining area, kitchen, laundry area/sitting room, and a garage that has been converted into a den. Bedroom #1: was equipped with two twin size beds, adequate drawers and closet space, and adequate lighting. Bedroom #2: was equipped with 1 king size bed, dresser drawers and closet space, and adequate lighting bedroom is occupied by Licensee. Bedroom #3: is equipped with two twin beds, adequate closet space and lighting. Bedroom is occupied by the Licensee's two siblings. Bedroom #4: Serves as a laundry area and bedroom for Adult 2. Bathroom #1 is located in the hallway and was observed to be clean sanitary and in good repair. Bathroom #2 is located in Licensee's bedroom and was observed to be clean sanitary and in good repair. Den Area- Garage has been converted into a den area with sectional couch and play area. Bathroom #3 is located near the laundry area, and was observed to be clean sanitary and in good repair. Living room/Family room: there is adequate furniture which appears to be in good condition. Formal dining area: equipped with a table and 6 chairs. There is a functioning fire extinguisher mounted on the wall. Kitchen: Is equipped with a 4-burner stove, oven, microwave , and refrigerator/freezer. There is a breakfast nook area with a table and 4 seats. All smoke/carbon monoxide combo detectors were observed to be in working condition. The medication is locked in hallway closet. Knifes are locked in a cabinet in the kitchen. Cleaning solutions inaccessible to the clients in care and locked in cabinet located in the hallway. There is adequate linen supply in the hallway closet. Outdoor activity space is free of obstructions and hazards. Backyard is equipped with outdoor patio furniture, electric grill and gym equipment that is secure. There are no firearms or dangerous weapons in the home. No deficiencies cited at this time. Facility Administrator will need to submit a new facility sketch indicating changes to Bedroom #4. Adult 3 and Adult 4 will need to be fingerprint cleared. A copy of this report was emailed to the administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On August 1, 2025, Licensing Program Analyst (LPA) Kenrick Ellis arrived at the above facility for the purpose of conducting a Post-Licensing inspection. LPA met with Licensee who granted access to the home. A health and safety assessment was conducted upon arrival. The Licensee and LPA toured the interior exterior of the home. Currently residing in the home is Licensee, Adult 1, Adult 2, Adult 3 and Adult 4. There are currently no placement's residing in the home. The home is set up as follows: This is a one-story home with 4 bedrooms, 3 bathrooms, living room, dining area, kitchen, laundry area/sitting room, and a garage that has been converted into a den. Bedroom #1: was equipped with two twin size beds, adequate drawers and closet space, and adequate lighting. Bedroom #2: was equipped with 1 king size bed, dresser drawers and closet space, and adequate lighting bedroom is occupied by Licensee. Bedroom #3: is equipped with two twin beds, adequate closet space and lighting. Bedroom is occupied by the Licensee's two minor siblings. Bedroom #4: has been converted into a laundry room/seating area. Bathroom #1 is located in the hallway and was observed to be clean sanitary and in good repair. Bathroom #2 is located in Licensee's bedroom and was observed to be clean sanitary and in good repair. Den Area- Garage has been converted into a den area with sectional couch and play area. Bathroom #3 is located near the laundry area, and was observed to be clean sanitary and in good repair. Living room/Family room: there is adequate furniture which appears to be in good condition. Formal dining area: equipped with a table and 6 chairs. There is a functioning fire extinguisher mounted on the wall. Kitchen: Is equipped with a 4-burner stove, oven, microwave , and refrigerator/freezer. There is a breakfast nook area with a table and 4 seats. All smoke/carbon monoxide combo detectors were observed to be in working condition. The medication is locked in hallway closet. Knifes are locked in a cabinet in the kitchen. Cleaning solutions inaccessible to the clients in care and locked in cabinet located in the hallway. There is adequate linen supply in the hallway closet. Outdoor activity space is free of obstructions and hazards. Backyard is equipped with outdoor patio furniture, electric grill and gym equipment that is secure. There are no firearms or dangerous weapons in the home. Posting requirements were met. LPA conducted one staff interview. An exit interview was conducted and a copy of this report was provided to Licensee


facility_name: BURNSIDE SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with licensee Lynn Lewis to conduct the Annual Required Inspection. The inspection began at 11: AM. The following was observed; This is a two story home located in a residential section of Los Angeles. There are six bedrooms and three bathrooms. The home is licensed to care for six clients. There is currently one client in care. There were no security bars, swimming pools or firearms on the property. Smoke detectors and carbon monoxide detectors are working and placed in hallways and bedrooms. The fireplace is gated. LPA observed multiple fire extinguishers which were all fully charged. All waste cans were covered as required. The yard area was free of hazards. Kitchen stove and refrigerator were clean and working properly. Food supply met Title 22 standards. All knives and hazardous items were stored in locked areas. Bathroom fixtures were clean and well maintained.. LPA reviewed staff and client records. All were substantially complete and up to date. The client was in school and could not be interviewed. There were no deficiencies cited on this date.

met_with: Major & Lynn Lewis


facility_name: BUSY BEE'S FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On December 31, Licensing Program Analyst (LPA) Babatunde Aborchie, met with applicant Dorn Bashirah this date for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the LIC 184, Notice of Incomplete Application, and additional correspondence to assist with the revisions needed to the application. Copy of this report was provided to applicant.


summary: Facility Evaluation

raw_content:
Narrative:
On January 7, 2026, Licensing Program Analyst (LPA) Babatunde Aborchie arrived at Busy Bee's Small Family Home (SFH) pre-licensing inspection. Applicant is applying to be licensed to serve clients who are medically fragile and mentally disabled, ages 0-17 with a capacity of three clients (all ambulatory clients). The Facility was toured both inside and out with the licensee. The home is a two-story building with five bedrooms, two and half bathrooms. During the inspection, LPA observed that the downstairs floor consisted of the kitchen, a living room, a family room, a dining area with a large table and one bedroom. Bedroom #1, it was furnished with a twin bed, it sleeps one biological son, age 16 years. The medications will be stored and locked in a locked cabinet located in the kitchen by the refrigerator. Sharp knives were inaccessible and stored in a locked cabinet above the kitchen sink. The First Aid Kit was in the kitchen cabinet by the refrigerator, containing all required items. The garage was inspected and used for cars and storage. The water temperature was tested and measured at 115 degrees F. LPA observed a minimum of seven-day non-perishable and a three-day perishable supply of food. There was a variety of snacks available for clients. In addition to the downstairs space, there was also a half bathroom fully functioning and hallway closets used for storage. A trash can was observed to have tight fitting cover. The following required posted items were observed accessible to clients: personal rights, visitation policy, and current menu. Two fire extinguishers were observed and operable. Upstairs was bedroom #2, it was furnished with a full-sized bed and a twin sized bed it would sleep two clients. It was vacant. Bedroom #3, it was furnished with one queen sized bed, it sleeps a biological son, age 13 years. Bedroom #4, it was furnished with a full-sized bed, it sleeps a biological son, age 24 years. Bedroom #5, master bedroom, for licensee, it was furnished with a king-sized bed and a crib. The licensee's bedroom is not accessible to the clients. All bedrooms were arranged for one child per bed. No room was commonly used for other purposes other than a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawer and closet space for each child's belongings. The smoke and carbon monoxide detectors were checked and working. Cleansers/chemicals were locked and stored in the laundry room. The upstairs space includes an additional bathroom to be used by the clients. All hazardous items have been properly made inaccessible to areas where clients have access. All windows and screens were in good repair. There were no guns or weapons in the home as stated by Licensee. There was a total of three cameras, on located outdoors and two indoors which meets the title 22 camera policy. The facility outside grounds were also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. The facility was found to comply. Based on today's inspection and observations, there are no deficiencies being cited at this time. The request to be licensed for medically fragile and mentally disabled clients will be forwarded to Licensing Program Manager for final approval. LPA conducted a component III orientation during the visit. An exit interview was conducted, and a copy of this report was discussed and provided to Licensee.

met_with: Licensee


facility_name: CANOPY SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On October 13, 2025, Licensing Program Analyst (LPA) Babatunde Aborchie arrived at Canopy Small Family Home (SFH) pre-licensing inspection for a relocation. Currently, there are three clients in placement, and the home is licensed for a capacity of four clients (one non-ambulatory and three ambulatory clients). The Facility was toured both inside and out with the licensee. The home is a two-story building with Seven bedrooms and five and half bathrooms. During the inspection, LPA observed that the downstairs consisted of the kitchen, a living room, a family room, a dining area with a large table and two bedrooms. Bedroom #1, it is self-containing room, it would sleep one non-ambulatory client, currently vacant. Bedroom #2, it is self-containing room, it would be used as a guest room, it was vacant. The medications will be stored and locked in a locked cabinet located in the kitchen above the microwave. Sharp knives were inaccessible and stored in a locked cabinet under the kitchen sink. The First Aid Kit was in the kitchen cabinet by the refrigerator, containing all required items. The garage was inspected and used for cars. The water temperature was tested and measured at 112 degrees F. LPA observed a minimum of seven-day non-perishable and a three-day perishable supply of food. There was a variety of snacks available for clients. In addition to the downstairs space, there was also a half bathroom fully functioning and hallway closets used for storage. A trash can was observed to have tight fitting cover. The following required posted items were observed accessible to clients: personal rights, visitation policy, and current menu. The clients' medication log records were kept updated with no discrepancy. Two fire extinguishers were observed and operable. Downstairs consisted of a laundry room that always remained locked. Upstairs was bedroom #3, it would sleep biological son, age 5 year-old. It was vacant. Bedroom #4, it would sleep one ambulatory client, it was vacant. Bedroom #5, it would sleep two ambulatory client, it was vacant. Bedroom #6, it would be used as the second guest room, it was vacant. Bedroom #7, master bedroom, for licensee and spouse and it was vacant; The licensee's bedroom is not accessible for the clients. All bedrooms were arranged for one child per bed. No room was commonly used for other purposes other than a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for each child's belongings. The smoke and carbon monoxide detectors were checked and working. Cleansers/chemicals were locked and stored in the second laundry room. The upstairs space includes an additional bathroom used for the clients. All hazardous items have been properly made inaccessible to areas where clients have access. All windows and screens were in good repair. There were no guns or weapons in the home as stated by Licensee. There was a total of six cameras, all located outdoors which meets the title 22 camera policy. The facility outside grounds were also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. Clients' files and staff files were reviewed and found to comply. Based on today's inspection and observations, there are no deficiencies being cited at this time. The request to be licensed for relocation will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted, and a copy of this report was discussed and provided to Licensee.


summary: Complaint Investigation - Unsubstantiated - 1 allegation

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Narrative:
On January 11, 2024, Community Care Licensing (CCL) received a complaint alleging that minor sustained an unexplained fracture(s) while in care. During the investigation, there was no corroborating evidence to support the above allegation. Although the Department received information that the client sustained unexplained fractures while in care. The Investigator received inconsistent information that would indicate that the fractures of C1 were a result from abuse or neglect in care. Confidential interviews reported that the fractures observed on C1 can be a result from an existing medical condition and the application of a medical device used to meet C1's medical needs in care. Investigator Santana reviewed medical records and exams and the information was inconsistent in supporting abuse or neglect in care. Other confidential interviews reported that a combination of therapeutic regimens and the application of a medical device in care may or may not have contributed to the fractures to C1. There were no other known witnesses to the allegation and due to age and limit verbal communication C1 could not comment on whether the fractures were a result of abuse, neglect or if the allegation is untrue. Based on confidential interviews the allegation that minor sustained an unexplained fracture(s) while in care, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report along with the appeal rights was provided to Licensee.

Investigation Findings:
13On May 8, 2024, 9: AM, Licensing Program Analyst (LPA), Cynthia Urena met with Canopy Small Family Home (SMFH) Licensee Emma Jackson to deliver the investigative finding for the above stated allegation. On January 19, 2024, at 11: AM, Investigator Jose Santana with the Community Care Licensing Division Investigations Branch (IB) initiated the investigation at Canopy Small Family Home. Investigator Santana collected pertinent documents to assist with the investigation process. Interviews were conducted with two resource parents, four witness, a county staff member, and four medical professionals. Due to age and limited verbal communication Investigator Santana was unable to conduct an interview with a client involved therefore, no additional information regarding the allegation was obtained. Additionally, Investigator Santana conducted a comprehensive record review of medical reports, medical examinations, and a police report to further assist with the investigation process. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Cynthia Urena 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 PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: CANOPY SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 05/08/2024

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

report_type: Complaint Investigation

met_with: Licensee, Emma Jackson

complaint_status: unsubstantiated


summary: Facility Evaluation

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Narrative:
On August 15, 2023 at 10: AM Licensing Program Analyst (LPA) Babatunde Aborchie began a Pre-Licensing inspection for a Small Family Home license. LPA met with applicant Emma Jackson who led a tour of the home. The facility was toured both inside and out with the applicant. Applicant is applying for a capacity of 3 ambulatory clients. The home consists of: Downstairs: Bedroom #1, It was furnished with a queen bed. It sleeps applicant's mother. There were also a family room, a living room, dining area a kitchen, two pantries, storage and one bathroom. Upstairs: Bedroom #2, The room consisted of two twin beds. It sleeps one foster child. Bedroom #3, The room was furnished with a twin bed and a crib. It sleeps biological son age 3 years. Bedroom #4, The room was furnished with a queen bed. It was used as a guest room - Vacant. Bedroom #5, Master bedroom. The room consisted of one king sized bed. It sleeps the applicant and spouse. Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate drawer and closet space for children's belongings. The smoke detectors were checked and were working properly. Inside the facility the fireplace was properly screened. Telephone service and appliances were in a working order. Medications are locked in the kitchen cabinet area. Cleansers/chemicals were locked and stored in the laundry room cabinet. Sharp knives were inaccessible and stored in locked kitchen cabinet. There were no guns or weapons as stated by applicant at this time. The hot water temperature was tested and noted to be 110 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit were accessible with all required items and it was in a drawer in the loft. A Fire extinguisher was observed and properly charged. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request to be licensed for small family home will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to Applicant/Licensee

met_with: Emma Jackson


summary: Facility Evaluation

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Narrative:
On June 19, 2025, Licensing Program Analyst (LPA) Babatunde Aborchie arrived at Canopy Small Family Home (SFH) for capacity increase. Applicant is applying for an increase to 4 clients, with one being non-ambulatory client. There is currently three clients in placement, ages 18 months, 5 years and 11 years old. The home was licensed to serve a capacity of three ambulatory disabled clients. The Facility was toured both inside and out with staff/spouse. The home is a two-story building with five bedrooms and three bathrooms. During the inspection, LPA observed that the downstairs consisted of the kitchen, a living room, family room, the garage, a dining area with a large table and one bedroom. Bedroom #1 it was furnished with a full-size bed, a closet, drawer and a door to the outside with a ramp. It is currently vacant; it will sleep one non-ambulatory client. Sharp knives were inaccessible and stored in a locked cabinet by the kitchen window. The garage was inspected and used for cars. The water temperature was tested and measured at 115 degrees F. LPA observed a minimum of seven-day non-perishable and a three-day perishable supply of food. There was a variety of snacks available for clients. In addition to the downstairs space, there was also two pantries and a cabinet used for storage in the bathroom. A trash can was observed to have tight fitting lid. The following required posted items were observed accessible to clients: personal rights, visitation policy, and current menu. The clients' medication log records were kept updated with no discrepancy. One fire extinguisher was observed and operable. The upstairs was a bedroom #2, it was fully furnished with two twin size beds, closet and lots of storage spaces; it sleeps one foster child. Bedroom #3 was fully furnished with two twin size beds, it sleeps biological son and a foster child, both boys aged 5 years old. Bedroom #4 was fully furnished with one twin bed and a crib, closet space, and lots of storage spaces. It sleeps an eighteen-month-old foster child. Bedroom #5, Master bedroom. The room consisted of one king sized bed. It sleeps the Licensee and spouse. All bedrooms were arranged for one child per bed. No room was commonly used for other purposes other than a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawer and closet space for each child's belongings. The medication was stored in a box upstairs by the loft. The first aid kit was store in the cabinet upstairs by the loft. The smoke and carbon monoxide detectors were checked and working. Cleansers/chemicals were locked and stored in the laundry room and the garage. The upstairs space includes a loft a laundry room that always remained locked, an additional bathroom used for the clients. All hazardous items have been properly made inaccessible to areas where clients have access. All windows and screens were in good repair. There were no guns or weapons in the home as stated by Licensee/spouse. There was a total of four cameras, all located outdoor which meet the title 22 camera policy. The facility outside grounds were also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. Client's files and staff files were reviewed and found to comply. Based on today's inspection and observations, there are no deficiencies being cited at this time. An exit interview was conducted, and a copy of this report was discussed and provided to Licensee.

met_with: Staff/Spouse


facility_name: CARE

summary: Facility Evaluation

raw_content:
Narrative:
On August 23, 2022 at 2:04pm, Licensing Program Analyst (LPA) Adrian Mendez arrived unannounced at the facility to conduct a Required Annual inspection. LPA met with House Manager Ronald Almuete. During the inspection, LPA conducted client file reviews. A sample of three of three client files were reviewed during the inspection. All client files had the required documents per Title Regulations. All client files are kept in a locked staff office. Based on the facility inspection, and files reviewed there are no deficiencies found at this time. An exit interview was conducted, and a copy of this report was explained to House Manager Ronald Almuete. Due to printer malfunction, this report will be emailed to House Manager Ronald Almuete.

met_with: Ronald Almuete


summary: Facility Evaluation

raw_content:
Narrative:
On August 24, 2022 at 10:31am, Licensing Program Analyst (LPA) Adrian Mendez arrived unannounced at the facility to conduct an Annual Continuation inspection of the Required Annual inspection that began on 08/23/2022. LPA met with House Manager Ronald Almuete. During the inspection, LPA conducted staff file reviews. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. The bathrooms were clean and in good repair. The hot water in the kitchen sink was measured at 111.4 degrees, which is within regulatory requirements. All hazardous items have been properly made inaccessible to the clients. The medications were stored and locked in a cabinet in the medication closet in the hallway. Cleansers/chemicals are locked and stored in a locked supply closet. Sharp knives are inaccessible and stored in the kitchen. The First Aid Kit is located in the medication cabinet and contained all required supplies. The facility's smoke/carbon monoxide detectors in the hallways were checked and were operable. There are no guns or weapons in the facility as stated by House Manager Ronald Almuete. The following required posted items were observed accessible to clients: Facility License, Personal Rights, and Emergency Disaster Plan. The facility outside grounds was also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. LPA discussed and reviewed the following inspection components; Operational Requirements, and Clients with Special Health Care Needs. All the staff files are stored and secured in the staff office of the facility. LPA reviewed five staff files. All the staff have met the training and qualification requirements per regulation requirements. Per a review of the Community Care Licensing Information System (LIS), all staff met DOJ/FBI criminal record clearances and Child Abuse Index Check requirements. Two facility staff were interviewed. Cont. on 809-C Based on the facility inspection, and files reviewed there are no deficiencies found at this time. An exit interview was conducted, and a copy of this report was explained to House Manager Ronald Almuete. Due to printer malfunction, this report will be emailed to Licensee Michael Bradbury.


summary: Facility Evaluation

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Narrative:
On December 7, 2023 at 9:52 am, Licensing Program Analyst (LPA) Karen Beal conducted an annual inspection of the facility. The facility was toured inside and out with facility Caregiver, Paulo Cidia at AM. At this time, the home currently have three (03) non minors Dependent (NMD) in care. All NMD are non-verbal. The single story home is set up as follows: The home is set up as follows: Bedroom #1 contains two twin beds and sleeps two clients. Bedroom #2 contains two twin beds and sleeps one client. Bedroom #3 is the master bedroom and sleeps the licensee. Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate drawer and closet space for children's belongings. The bathrooms were clean and in good repair. The hot water in the client kitchen was measured 113.7 degrees meeting regulatory requirements. All hazardous items have been properly made inaccessible to areas where NMD will have access. Cleansers/chemicals are locked and stored in the hall cabinet in the hallway. Sharp knives are inaccessible and stored in a locked cabinet over the oven in the kitchen area. The First Aid Kit is located in the locked cabinet in the hallway had all required supplies. The facility's smoke detectors in all the bedrooms and hallway were checked and were operable. The carbon monoxide detector located in front living room area was operable. There are no guns or weapons in the facility as stated by the Licensee. The following required posted items were observed accessible to clients: Grievance Procedures, Personal Rights, Ombudsman Poster, Visitation policies, and current menu **Continued from LIC 9099** Clients medications were observed to be inaccessible and stored in locked cabinet in the hallway. The medication logs are kept updated and the dispensing records had no discrepancies. LPA observed a minimum 7-day non-perishable and a 2-day perishable supply of food. The facility outside grounds was also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. There is no swimming pool/bodies of water located on the premises. NMD and staff files were reviewed during the inspection. Three (03) NDM and five (5) staff files were reviewed. All staff that work at the facility have Department of Justice and Child Abuse Clearance Index clearances. A review of administrative records indicate that the facility has paid their current licensing fees. Based on the facility inspection and file reviews on this date, there are no deficiencies found at this time. A copy of this report was reviewed along with a Confidential Names List (LIC 811).

met_with: Paulo Cudia, DSP


summary: Facility Evaluation

raw_content:
Narrative:
On August 26,2024 at 10:00 am, Licensing Program Analyst (LPA) Guadalupe Munoz conducted an required unannounced annual inspection of the facility. The facility was toured inside and out with facility Ronald Almuete, House Manager The facility is a Small Family Home licensed for ambulatory and non ambulatory children ages 3-17 years old. The home currently has three clients. All clients are non-verbal. The single story home is set up as follows: Bedroom #1 contains two twin beds and sleeps two clients. Bedroom #2 contains two twin beds and sleeps one client. Bedroom #3 is the master bedroom and sleeps the licensee. Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate drawer and closet space for clients belongings. The bathrooms were clean and in good repair. The hot water in the client bathroom was measured 106.1 degrees meeting regulatory requirements. All hazardous items have been properly made inaccessible to areas where clients will have access. Cleansers/chemicals are locked and stored in the hall cabinet in the hallway. The First Aid Kit is located in the locked cabinet in the hallway had all required supplies. The facility's smoke detectors in all the bedrooms and hallway were checked and were operable. The carbon monoxide detector located in front living room area was operable. LPA observed a minimum 7-day non-perishable and a 2-day perishable supply of food. Sharp knives are inaccessible and stored in a locked cabinet over the oven in the kitchen area. Continued from LIC 809** There are no guns or weapons in the facility as stated by the Licensee. The following required posted items were observed accessible to clients: Grievance Procedures, Personal Rights, Ombudsman Poster, Visitation policies. Clients medications were observed to be inaccessible and stored in locked cabinet in the hallway. The medication logs are kept updated and the dispensing records had no discrepancies. The facility outside grounds was also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. There is no swimming pool/bodies of water located on the premises. Prior to site visit, LPA conducted a facility file review and all required documents were included and administrative records indicate that the facility has paid their current licensing fees. Client and staff files were reviewed during the inspection. Three (03) client and five (3) staff files were reviewed. All staff that work at the facility have Department of Justice and Child Abuse Clearance Index clearances. Based on the facility inspection and file reviews on this date, the SFH is being cited for Title Continuing Care Requirements Section 80010(a) Limitations on Capacity and Ambulatory Status and Health and Safety Code (HSC) Section 1522(c)(1) Administration. A copy of this report was reviewed with Ronald Almuete, House Manager and a copy of this report along with a Confidential Names List (LIC 811) dated 8/26/24 was provided.