summary: Facility Evaluation

raw_content:
Narrative:
On 11/13/24, Licensing Program Analyst (LPA) Reagan Cohen arrived at the above facility, for the purpose of conducting an Annual/Required inspection for the facility. LPA met with Licensee, Alesha Briggs who granted access into the home. The LPA toured the facility both inside and out. Currently residing in the home is the Licensee, two biological children, and one client. The facility is licensed for 3 clients ages 6-17 ambulatory only. The home was inspected and the following was observed: This is a one-story house, with a backyard and a garage in the back. Living Room/Dinning Room: There is adequate furniture which is in good condition. The area is is equipped with a sofa, a reclining chair, and a television. Home entrance is protected by a screen door, followed by wooden door. Windows operational with vertical blind and screens are operational. Dinning area contains a four seated dining set with four straight back chairs. There is a wall heater next to the dinning table with a cover around it. Smoke alarms located in every bedroom were tested during the inspection and they were all in working condition. There is a working telephone in the den. There is a den behind the kitchen. It has adequate seating with a sofa and chairs. There is a desk and chair, a TV, board games, puzzles, and other activities. There second wall heater with a cover in the second living room. Posted in the den is the disaster plan, facility sketch, foster care ombudsmen poster, and personal rights statement. Kitchen: Is equipped with an operable 4 burner stove, refrigerator/freezer, small kitchen counter appliances, locked cabinet for sharps and client medication inaccessible to clients in care. Below the sink is a locked cabinet for cleaning solutions. In the kitchen the first aid kit was checked and is complete with scissors, tweezers, thermometer, and gauzes, antiseptic. Fire Extinguisher was fully charged and available in the kitchen. Bedroom #1: is for the licensee and is located off of the dinning room and is equipped with queen bed, and a closet. Bedroom #2: is for the licensee's biological child and is located off of the dining room opposite bedroom #1 and is equipped with 1 twin bed and a bassinet, clean bedding, adequate closet space, and has one working window with a screen. Bedroom #3: is vacant, and is located after the kitchen off of the den, equipped with 1 twin sized bed clean bedding, adequate closet and drawer space. Has a working window with a screen and bars with a working release switch. Bedroom #4: is for client #1, and is located after the kitchen off of the second living room, equipped with 2 twin sized beds clean bedding, adequate closet and drawer space. Has a working window with a screen and bars with a working release switch. All rooms are clean, safe, and sanitary. Bathroom #1: is located off of the dinning room adjacent to bedroom #1 and #2. It is clear of all cleaning solutions with a working toilet, sink, and shower. Bathroom #1: is located off of the second living room. It is clear of all cleaning solutions with a working toilet, sink, and shower. There are an adequate supply of toiletries and towels/linens. Outdoor activity space (back yard) free of obstructions, with outdoor games and a basketball hoop. The garage is locked and being used for storage. The home will utilize Tesla to transport clients in care. Current automobile insurance is with StateFarm Insurance Company. Insurance and registration is current. LPA will return to continue inspection including staff and client file reviews, staff and client interviews, facility file reviews, and completing the CARE Tools Checklist. Exit Interview was conducted and a copy of this report was given to the Licensee.

met_with: Licensee Alesha Briggs


state: CA

facility_name: CERETHER HOME CARE

summary: Facility Evaluation

raw_content:
Narrative:
On 7/30/25 at 3: PM LPA Reagan Cohen arived at the above facility for the purpose of conducting a Case Management visit. LPA meet with Administrator Alesha Briggs. LPA requested a copy of the staff and client roster. LPA requested to review staff files specifically their security clearances. LPA observed the clearance letter for S2. LPA asked about other potential employees S3 and S4. Administrator explained that those adults were potential employees but were not hired and never worked in the facility. LPA talked with Administrator regarding the previous complaint investigation that happened against the facility. LPA observed that S1 was not cleared on Guardian. Administrator explained that they believe S1 has the proper clearance from Guardian and that all the proper paperwork was submitted, but could not produce any paperwork to prove it. A Deficiency and Citation were administered and recorded on 809-D. Exit Interview was conducted with Administrator and a copy of this report and appeal rights were given to the Administrator.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Alesha Briggs


summary: Facility Evaluation

raw_content:
Narrative:
On 2/11/ LPA made an unannounced visit to the facility. LPA met with Licensee Alesha Briggs. The purpose of the visit was for LPA to get signatures for the amended LIC 9099 report for complaint 34-CR-20250904113021 originally dated 11/13/26. LPA met with Licensee and explained why the LIC 9099 needed to be amended due to aditional evidence that needed to be investigated. LPA interviewed staff regarding the additional evidence. LPA will return to interview the client. Exit Interview Conducted and a copy of this report was given to the Licensee.


facility_name: CHANCE TO BEGIN

summary: Complaint Investigation - Unsubstantiated

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

report_type: Complaint Investigation

met_with: Licensee Patricia Cooper

complaint_status: unsubstantiated


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
Based on LPA's observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegations (Resource parent does not obtain medical treatment timely for child in care, Due to not receiving timely medical care, child had not been fed for over 24 hours, and Due to not receiving timely medical care, child received burn from gastric fluid) are found to be SUBSTANTIATED. California Code of Regulations, (Title 22, CCR 83075(c) and Title 22, CCR 83072(d)(7)), are being cited on the attached LIC 9099D. Staff did not follow instructions to take child to receive medical treatment on a timely matter for special health care needs and did not follow Physician's instructions. Due to not receiving timely medical care, the client was not fed for over 24 hours and received burns and skin breakdown from gastric fluid. Deficiencies are being cited based on LPA's observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22, see LIC 9099D. An exit interview was conducted, and appeal rights were reviewed and developed with the Administrator. A copy of this report was left with the Administrator, Patricia Cooper.

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

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

visit_type: Complaint Investigation

met_with: Patricia Cooper, Administrator

complaint_status: SUBSTANTIATED


raw_content:
Narrative:
This is a violation of California Code of Regulations, Title 22, Division 6, Chapter 4, Article 6, Section 83075(g) Psychotropic medication shall only be used in accordance with the written directions of the physician prescribing the medication and in accordance with authorization requirements specified in Sections 369.5(a)(1) and 739.5(a)(1) of the Welfare and Institutions Code and Section 83070(b)(11) and California Code of regulations Title 22, Division 6, Chapter 1, Article 6, Section 80075(b) Clients shall be assisted as needed with self-administration of prescription and nonprescription medications. The facility is being issued citations on the attached page LIC 9099-D. An exit interview was conducted, appeal rights discussed, and a copy of this report was left with Patricia Cooper, Licensee, whose signature on this form confirms receipt.

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

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

met_with: Patricia Cooper, Licensee


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

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


summary: Facility Evaluation

raw_content:
Narrative:
On 11/05/21 at 11:50AM, Licensing Program Analyst (LPA) Mariah Hawkins made a visit to the facility for a required annual inspection. LPA met with Licensee Patricia Cooper and informed of the purpose of visit. LPA used the CARE Inspection Tool to conduct the inspection. The facility has maintained compliance and is in good condition. The following were observed: (1) Child C1's (See LIC Confidential Names) file did not include a TB test result. Licensee stated that an appointment would be scheduled. LPA issued a citation of California Code of Regulations, Title 22, Section Client Medical Assessment. LPA also advises that Licensee have the physician complete LIC 602. (2) Child C1 did not have a personal rights form signed by the authorized representative (social worker / Regional Center case manager). LPA advises, per California Code of Regulations, Title 22, Section Personal Rights, that Licensee send this to be signed by social worker. (3) Staff temporarily not working in the facility for 1 year or longer due to COVID-19, but which Licensee intends to have return to work, do not have current first aid certificates on file. LPA advises, per California Code of Regulations, Title 22, Section Health Related Services, that Licensee ensure staff are recertified prior to returning. (4) Staff temporarily not working in the facility for 1 year or longer due to COVID-19, but which Licensee intends to have return to work, do not have current health screenings and TB tests on file. LPA advises, per California Code of Regulations, Title 22, Section Personnel Records, that Licensee ensure staff obtain health screenings and TB tests prior to returning. (5) Licensee confirmed that drills are completed every other month but are not fully logged. LPA advises, per California Code of Regulations, Title 22, Section Disaster and Mass Casualty Plan, that Licensee ensure all drills are logged to ensure, and verify, completion. (6) Licensee has been using LIC 9040 as the register of clients, but as this form does not include all of the required information, including ambulatory status and medical contacts, LPA advises, per California Code of Regulations, Title 22, Section 80071, that Licensee use the LIC 9020 moving forward, which LPA provided at visit. LPA also advises that this form be update to reflect the current child(ren) in placement. Licensee also confirmed that a request to change the capacity will be submitted. LPA provided the LIC 200 and advises that Licensee submit the form and updated program plan for approval in order for LPA to process the request for updated fire clearance. An exit interview was conducted, appeal rights provided, and a copy of this report left with Licensee Patricia Cooper, whose signature on this form confirms receipt.

visit_type: Annual


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On 11/28/22 at 10:50AM, Licensing Program Analyst (LPA) Mariah Hawkins and LPA George Karkazis made a visit to the facility for a required annual inspection. LPAs met with Licensee Patricia Cooper and informed of the purpose of the visit. The CARE Inspection Tool was used to complete today's inspection. A tour was conducted of the site and grounds and facility and resident records were reviewed. The below issues were observed. Hot water was measured above the permitted range. The water heater was lowered and hot water measured within range by the end of the visit. Psychotropic medication for resident R1 (See LIC Confidential Names, dated 11/28/22) was not logged on a separate log. Also the log for November was copied from a previous month, resulting in the log being pre-filled. R1 does not have a complete physician's report (LIC 602), and the last two pages were missing. R1's most recent complete needs and services plan is from 2019. Resident R2's file did not contain a written needs and services (from previous placement) or pre-placement appraisal. LPAs are issuing citations of Title 22, Sections 80069(c),80068.3(a), 83020(b)(12)(H)(1), 83070(b)(9), and 83070(b)(12). A continuation inspection will be conducted to complete the annual inspection. An exit interview was conducted, appeal rights provided, and a copy of this report provided to Licensee Patricia Cooper, whose signature on this form confirms receipt.

Deficiencies:
80069(c): Client Medical Assessments

(c) The medical assessment shall include the following


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On 12/15/22 at 12:38PM, Licensing Program Analysts (LPAs) Mariah Hawkins and George Karkazis conducted an annual continuation at the facility. LPAs met with Licensee Patricia Cooper and informed of the purpose of the visit. During the initial visit on 11/28/22, a tour and interviews/observations were conducted, and the file review was initiated. During today's visit, the file inspection was completed. The CARE Inspection Tool was used to complete the inspection. The following areas require follow-up. 1) Caregivers S1 and S2 (See LIC Confidential Names List, dated 12/15/22) files are missing valid first aid certificates. LPAs are issuing a citation of California Code of Regulations, Section 83075. See attached LIC 809-D. 2) Residents R1 and R2 (See LIC 811) files do not contain up to date logs of cash resources and personal property (valuables, clothing, etc.). LPAs are issuing a citation of California Code of Regulations, Section 80026. See attached LIC 809-D. Additionally, the plans of correction for deficiencies cited at the previous visit, due 12/19/22, were observed to be complete at today's visit, and clearances were issued at visit. An exit interview was conducted, appeal rights provided, and a copy of this report was left with Licensee Patricia Cooper, whose signature on this form confirms receipt.

Deficiencies:
80026(h): Each licensee shall maintain accurate records of accounts of cash resources, personal property, and valuables entrusted to his/her care, including, but not limited to the following


summary: Facility Evaluation

raw_content:
Narrative:
On 1/19/23, Licensing Program Analyst (LPA) Mariah Hawkins conducted a case management visit at the facility to provide technical assistance and review records for completion. LPA met with Licensee Patricia Cooper and informed of the purpose of the visit. There was one resident present, and the other resident was on a psychiatric hold at the hospital. LPA observed resident to be clean, happy, and to enjoy interaction with Licensee. LPA reviewed resident records and observed all corrections to be complete. Notice of corrections were issued. LPA also provided technical assistance with updating Licensee's program plan to address care of children with special health care and high needs. LPA read through the requirements and agreed to provide specific regulations for Licensee to refer to. No deficiencies were observed at today's visit. An exit interview was conducted and a copy of this report left with Licensee, whose signature on this form confirms receipt.


facility_name: CHARITY KIMANI SFH

summary: Facility Evaluation

raw_content:
Narrative:
On September 25, 2025, at 10:30AM, Licensing Program Analyst (LPA) Rachel Vanegas met with Charity Kimani Small Family Home Applicant, Charity Kimani, at the Riverside Children's Residential Regional Office for the purpose of conducting a Component II meeting. LPA 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 October 10, 2025. Guardian: The applicant is "In Process" with the Small Family Home #366000046. Section A Documents A2. Applicant Information (LIC 215) Please provide training certificates and/or college transcripts to reflect applicable training requirements for qualifications and experience verification. A3. Designation of Facility Responsibility (LIC 308) Please review this document and associate the identified person "Julius Mwangi" to the facility Guardian roster. A9. Budget Information (LIC 420): Please review and revise. The income listed does not state the source. **Continued on the next page** A10. Personnel Report (LIC 500) Please review and revise to account for care and supervision for 24hrs a day, 7 days a week. A11. Personnel Record (LIC 501) Please provide training certificates and/or college transcripts to reflect applicable training requirements for qualifications and experience verification. A12. Health Screening Report - Facility Personnel (LIC 503): Please provide a health screening and tuberculosis test screening results dated within one year. Please ensure that the original document is submitted. A14. Emergency Disaster Plan (LIC 610C) Section II: Please identify agency/resource names for the phones numbers provided. Section IV: Please review and revise relocation authorization letters to remove reference to youth in care as "foster children". Please also indicate and verify that the relocation residence is not another licensed facility. A15. Facility Sketch (LIC 999) All windows and doors must be identified on the sketch of the facility. Indicate exit routes by number as shown on the LIC 610C Emergency Disaster Plan. All room sizes (Dimensions) need to be identified on the sketch of the facility. Please provide a facility sketch for the outside yard. The sketch of the outdoor space must show dimensions and location of major equipment and swimming pools. It must also identify utility shut-off locations. Section B Documents B7. Facility Program Description Please review and revise the Table of Contents to ensure that page numbers match the rest of the document Please clearly state placement source(s) for clients intended for your program Please remove reference to the Admission Forms as "LIC 604". The LIC 604 is only a guide for reference, not the Admission Form. **Continued on the next page** Please review and revise references to Regional Center, Medically Fragile, Clients with Special Health Care Needs, and Non-Minor Dependents throughout the document Please revise references to Administrator, as this facility type does not have Administrator's. Program Methods Please update client population intended for your program. Please remove reference to Non-Minor Dependents throughout the program statement. Please expand on the therapeutic interventions identified on #5 (Pg. 3) Please clarify "Case Worker" on #2, #3, and #7 (Pg. 3) Please modify Source of Clients section (Pg. 4) Please ensure that unsupervised visit reference and connection with birth family is in accordance with court orders (Pg. 5) Please remove reference to Non-Ambulatory clients (Pg. 6) Please identify how often staff training will be provided and by who (Pg. 6) Admission Policies and Procedures Please review and revise reference to physical therapy, occupational therapy, etc. to be provided by a medical practitioner or trained professional, etc. and not by the Licensee or Staff. (Pg. 7) Please revise mention of LIC 610C for "Persons Responsible for Admitting" to reflect correct information (Pg. 8) Please remove references to Regional Center throughout the document Please revise "Procedures for accepting emergency placement" to elaborate what "cleared up" means. (Pg. 9) Please replace mentions of Regional Center IPP with "Needs and Service Plan - LIC 625." 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 include revision of and signatures of Personal Rights with Authorized Representatives and Clients at the time of intake. (Pg. 9) **Continued on the next page** Please include that the Needs and Services Plan shall be completed by the Licensee within 30 days of placement Please remove #7 on Pg. 10, it does not apply. Please review and revise authorized representative responsibility for payment, not the client. (Pg. 10) Please provide expectation for your Retention Period identified on Pg. 11. This is not regulated by Community Care Licensing. Please also clarify Disposal of Unclaimed Items on Pg. 12, as this information contradicts the information on Pg. 11. Basic Care/Personal Care Please identify the clothing budget that you discuss being provided for clients in care (Pg. 13) Please include transportation to/from school, recreational activities, etc. (Pg. 13). Please identify the timeline for internal investigation that you will conduct for client complaints (Pg. 14) Medication Management, please identify the way that medication administration will be documented and on what forms, LIC 622A or LIC 622B (Pg. 15) Please further identify how Authorized Representatives will be informed of a client complaint that you internally investigate (Pg. 19) Please include Complaint Hotline information (Pg. 19) Please specify that Personal Rights reviewed with Authorized Representatives and Clients will be signed and placed in the clients record (Pg. 19) Please review Pg. 21, it is currently blank. Please provide more information regarding the "Dress Code" identified in the House Rules (Pg. 22). There is currently no outlined dress code, but against the rules so please provide more information and clarity. Please remove reference to physical force with regard to redirection (Pg. 25) Describe how and when the child and authorized representative will be informed of the discipline policy and sign the discipline policy form. (Pg. 25) Please revise reference to "51/50" as it is a mental health evaluation (Pg. 26) Please remove reference to "Birth Parents" throughout the Runaway Plan (Pg. 26) Please review and clarify the information regarding Handling Complaints ... on Pg. 27 to provide consistent information with what is already stated on Pg. 18. Please review and clarify the information compliance with internal interviews, etc. on Pg. 28 to provide consistent information with what is already stated on Pg. 19. Please review and clarify the Child's Rights listed on Pg. 29 if they are different than what is listed on Pg. 19. **Continued on the next page** Please review Pg. 31, it is currently blank. Please identify mealtimes on the meal menu (Pg. 32) Activites Please specify who is providing therapies listed (Mental/Physical/Occupational) Pg. Transportation Please specify the vehicle maintenance frequency (Pg. 44) Please specify that smoking is prohibited in any vehicle transporting children regardless of when the children are present and that this prohibition applies when the motor vehicle is moving or at rest. (Pg. 45) Medical and Dental Care Provide a statement that any medication refusal by a client is considered a "Special Incident" and a report will be sent to Community Care Licensing. Provide a statement that medication errors will need to be reported and documented to CCL, per reporting requirements timeframes. 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 specify where health records will be stored (pg. 48) Please specify how and where training will be verified for staff/licensee providing and documenting injections for clients in care (Pg. 48) Please identify proper documentation of medication administration for medication administration (LIC 622A) and psychotropic medication administration (LIC 622B) Please identify how often you will conduct medication storage audits (Pg. 49) Please identify the regulatory code's references, as you cannot copy and paste a regulatory code (Pg. 49) Medical Emergencies Please specify reporting requirements and use of LIC 624 for documentation of incidents (Pg. 50) Please remove reference to Foster Agency as this does not apply (Pg. 50) Describe where first aid supplies and a current edition of a first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency will be stored. **Continued on the next page** Please include a statement regarding the licensee and all staff maintaining current Cardiopulmonary Resuscitation (CPR) and First Aid training Dental Emergencies Please explain what "CHDP" means or remove if not applicable. (Pg. 50) Please remove all references to clients in care as "foster children" (Pg. 51) Please identify where emergencies are documented, how they are reported, and to whom. (Pg. 51) Needs and Services Plan (NSP) Please revise reference to the NSP as the Individualized Health Care Plan, these are different documents (Pg. 53) Please review and revise reference to the Licensee's responsibility in completing the NSP within 30 days of placement (Pg. 53) Please replace mention of Regional Center IPP with "Needs and Service Plan - LIC 625." (Pg. 53) Please include Authorized Representative and Client signatures are also required with the Licensee's signature for the NSP (Pg. 53) Case Resources and Personal Property Please identify the monetary amount of allowance that will be provided to clients in care (Pg. 56) Please review and revise this section to reflect compliance with Foster Youth Bill of Rights and age appropriateness of a token system for allowance to clients of all ages, not only teenagers as you stated (Pg. 56) Cash Resource Policy Please review and revise, your surety bond allows for a maximum of $750 to be safeguarded. This is not per child as stated (Pg. 56) Storage of Personal Property Please review and revise to ensure alignment with what is stated on Pg. 12 (Pg. 56) **Continued on the next page** Staff Training Please identify the timeline for staff onboarding training and the frequency and source of on-going staff training (Pg. 57) Please include the information for documentation of staff training (Pg. 57) Please review and revise the background check clearance requirements for any adult that will be providing care and supervision for clients in care (Pg. 57) Personnel Records Please include the requirements for all staff to have current CPR and First Aid training, Health Screening (including Tuberculosis Screening), Job Duties Statement, Date of Hire, Background Clearances, etc. (Pg. 57) Please include files retention policy for all staffing records, three years even after termination or separation. Reporting Requirements Please revise the email address you identify for incident reporting, it is incorrect (Pg. 61) Please include reporting notification to Community Care Licensing when the Licensee will be out of the home for longer than 48hrs Video Cameras Please review and include information regarding Camera Uses and Locations in accordance with Children's Residential Program Provider Information Notice 24- Admission Agreement Please include the facility address on this document (Pg. 70) Please remove the policy for discharge for Group Homes (Pg. 71) Please review Pg. 77, it is currently blank. Policy for Use of Surveillance Cameras Please review this document and revise for alignment with the Video Camera Policy (pg. 88) LPA Vanegas 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, Charity Kimani.

met_with: Applicant - Charity Kimani


summary: Facility Evaluation

raw_content:
Narrative:
On December 22, 2025 at 10: AM, Licensing Program Analyst (LPA) Rachel Vanegas arrived at Charity Kimani Small Family Home (SFH) to conduct a pre-licensing inspection. LPA met with Applicant - Charity Kimani 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 three bedrooms and two bathrooms which are set up as follows: Bedroom #1 (Master) has one bed and sleeps the Applicant Bedroom #2 (Client) has one single bed and will sleep one client Bedroom #3 (Client's) has two single beds and will sleep two client's The home also consists of a great room/living room, one securely fenced electric fire place in the living room, a kitchen, dining area, two bathrooms, a laundry room, a two car garage, and the backyard. The client's bedrooms are arranged so that no more than two client's will be in one 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 each client's belongings. There were smoke detectors in every bedroom and hallway. The smoke detectors were checked and in properly functioning order. There is one and carbon monoxide detector in the hallway. The carbon monoxide detector was 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 hot water in the kitchen was measured and registered at 111.9 degrees Fahrenheit. *Continued on the next page* The client and staff files will be located in a locked kitchen cabinet. The sharp knives are located in a locked kitchen drawer near the kitchen stove, inaccessible to clients. The medications will be located in a locked kitchen cabinet near the kitchen sink, inaccessible to clients. Cleaning chemicals and laundry detergent are securely stored under the kitchen sink in a locked kitchen cabinet. A trash can for storage of solid waste had a tight-fitting lid and was present in the kitchen. There was adequate food storage space. LPA observed a two day supply of perishable and a seven day supply of non-perishable food. The home's First Aid kit was accessible and is located in the kitchen and contained all required supplies. There is one fire extinguisher present in the home it is located near the home's front entrance. One fire extinguisher was observed to be properly charged and inspected by the fire department. There are no firearms or weapons in the home at the time of this inspection as stated by the applicant. There is no pool or accessible body of water at the home at the time of this inspection. The backyard where clients will have access to play is fenced. There is one video camera on the front door at the time of this inspection (Front Doorbell). The following corrections need to be made: Final revisions to program statement, including video camera policy. Complaint Hotline, Grievance Policy, House Rules, and Activity Calendar need to be posted. Corrections are due by close of business on January 6, 2026. Application will be forwarded to the Licensing Program Manager for Licensing upon receipt and confirmation of corrections made to the Program Statement and home corrections.

visit_type: Prelicensing


facility_name: CHERYL AND JESSE WHITE SFH

summary: Facility Evaluation

raw_content:
Narrative:
On May 23, 2024 at 9: AM, a Component II was conducted at the Monterey Park Children's Residential Program office with Cheryl and Jesse White Small Family Home. Present at the Component II from Cheryl and Jesse SFH was applicant Cheryl White, from the Department are Licensing Program Manager (LPM) Yan Yeung, Licensing Program Analysts (LPAs) Joe Martinez and Juliet Robles. During the meeting, LPA discussed their application and the pending items needed. Documents required to be submitted: For Jesse White: 1) LIC Health Screening and TB test For Licensee/Administrator 1) Program Statement Revisions- submitted -needed to review **Revise the age capacity 0-21/non minor dependents **Revise the Discipline and Phone calls **Sign In and Out Procedure **Label the facility sketch with the Exit and clients room 2) Adult Son (living at home) - TB test Here's the Program website that you can review the SFH tool: www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process Applicant was also advised to begin contacting placement agencies. An exit interview was conducted, and a signed copy of this report was provided to the Applicant.

met_with: Cheryl White


summary: Facility Evaluation

raw_content:
Narrative:
On July 12, 2024 at approximately 9: AM, Licensing Program Analyst (LPA) Juliet Robles conducted an announced pre-licensing inspection at the above address. Upon arrival, LPA met with Cheryl White, applicant. Together they toured the external and internal areas of the home. The following was observed at the time of inspection: Physical Plant This facility is a one story house located in a quiet residential community. The facility consists of four (4) bedrooms, two (2) bathrooms, kitchen, dining area, family room, laundry room and backyard. Overall, the facility is clean, sanitary and in excellent condition. Passageways are free from obstruction. Knives and sharps, disinfectants and cleaning solutions are kept locked and secured in the laundry room. Per applicant, there are no firearms on the premises. The facility has a centralized heat and air-conditioning unit. Temperatures throughout the home during the inspection were comfortable. Carbon monoxide and smoke alarms were tested and observed to be operational. The home has two fire extinguishers. The home has a working telephone that is available for client use. A fire inspection was conducted by the Rancho Cucamonga Fire Department on 05/06/24 and a fire clearance was granted for six ambulatory clients. Fixtures, Furniture, Equipment, and Supplies The home has toilets, wash basins, and one shower/bath for clients' use. Client bedroom #2 & #3 was observed to be clean, orderly, and contained a bunk bed and twin bed. LPA observed clean pillows, bed sheets and blankets. The client's bedroom has adequate closet and drawer space to accommodate client's clothing and personal belongings. Heath Related Services and Record Keeping Medications, the first aid kit will be centrally stored and locked in a cabinet by the hallway. The kit contains all required supplies. The client and staff files will be stored in a locked file cabinet in the applicant's bedroom. LPA also conducted Component III - Category Specific Orientation with the applicant. The following items were discussed and provided to the applicant: -Title 22 regulations on Small Family Homes - Continuing Requirements (General Licensing Requirements) - Buildings and Grounds requirements - Personnel Records (forms) - Client Records (forms) -Reporting Requirements - Other administrative forms LPA guided applicant to go to this website for additional information regarding the inspection and its CARE Tools and methods, please visit the CARE Tools web page or the Inspection Process Project web page.(www.cdss.ca.gov) Prior to today's visit, the applicant submitted the final Program Statement/Plan of Operation to LPA. The LPA will submit for final review and a new license will be mailed to the agency upon approval. No deficiencies were observed on this date. An exit interview was conducted a signed copy of this report was emailed to the applicant.


summary: Facility Evaluation

raw_content:
Narrative:
On February 20, 2025 at 10: AM, Licensing Program Analysts (LPAs) Juliet Robles and Caitlin Chambers conducted an unannounced inspection at the Small Family Home facility and met with the licensee, Cheryl White. The purpose of the inspection was about post licensing. Currently the facility has three (3) children in care. At 10:40AM, LPAs and licensee toured the internal and external areas of the home. The following was observed at the time of inspection: This facility is a one-story house located in a quiet residential community. The facility consists of four (4) bedrooms, two (2) bathrooms, kitchen, family room, dining area, laundry room and backyard. Overall, the facility is clean, sanitary and in excellent condition. Passageways are free from obstruction. Knives, sharps, disinfectants, and cleaning solutions are kept locked and secured in the laundry room. Per licensee, there are no firearms on the premises. The facility has a centralized heat and air-conditioning unit. Temperatures throughout the home during the inspection were comfortable. Carbon monoxide and smoke alarms were tested and observed to be operational. The home has two fire extinguishers: one in the kitchen and one outside. Medications, the first aid kit is centrally stored in a cabinet by the hallway. The first aid kit contains all required supplies. The home has toilets, wash basins, and one shower/bath for clients' use. The water temperature was tested at 112 degrees which is within regulatory guidelines. The following sleeping arrangements were noted: Bedroom #1 sleeps Client 1 and Client Bedroom #2 sleeps Client Bedroom #3 sleeps adult son Bedroom #4 - Master's Bedroom sleeps Licensee Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good condition. Each bedroom has sufficient drawer and closet space. There are two full bathrooms in the home, all in working order. The licensee is the main caretaker of the home. Client and staff files are stored under lock and key in the file cabinet in the licensee's bedroom. Emergency disaster drills are conducted every six months. LPA reviewed three (3) client records and one (1) staff record. LPA checked required criminal record and child abuse index check clearance or exemption for all adults in the home. The client's files contained: Admission Agreement, Medical Assessment, Consent Forms, Emergency Information, Appraisal Form, Immunization Record and Personal Rights. LPA interviewed the licensee. Clients were not available for interview at the time of inspection. LPA will attempt to interview clients at a later time. Based on the facility inspection and file reviews this date, there are no deficiencies found at this time. An exit interview was conducted and LPA provided a copy of the following reports: LIC 809, LIC 809C, LIC 811 to Ms. Cheryl White, Administrator/Licensee.


summary: Facility Evaluation

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Narrative:
On August 21, 2025 at 9: AM, Licensing Program Analyst (LPA) Juliet Robles made an unannounced visit to the Small Family Home (SFH) and met Jesse White SFH assistant administrator for the purpose of conducting a follow up case management inspection. The purpose of the visit is to confirm the usage of the camera and its location to submit a program statement addendum. LPA spoke with the Administrator, Cheryl White and stated that she cannot come to the facility due to an appointment at the doctor's office. The LPA and assistant administrator did a walk-through of the facility inside and outside. LPA observed that there are 8 cameras at the facility. 1) A video camera at the front door entrance, 2) living room facing the window, 3) part of living room facing the front door and hallway, 4) inside the family room facing the TV., 5) outside on the left side near the kitchen door facing the gate, 6) outside on the right side near the master bedroom window facing the playground, 7) outside left rear of the master bedroom facing the 2nd backyard and 8) outside on top of the roof or the eve of the home facing the street. Per assistant administrator, all video cameras both interior and exterior have their audio disabled. LPA advised the administrator to disable the camera until the approval letter is received. LPA requested the revise program statement to be submitted on or before August 26, 2025. LPA provided the facility a copy of PIN 24-09-CRP Video Cameras in Children's Residential Congregate Care Facilities. Based on the observation and information gathered, there is no deficiency cited at this time, no further follow up is needed. A copy of this report was given to the assistant administrator, Jesse White.

met_with: Jesse White


summary: Facility Evaluation

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Narrative:
On September 16, 2025 at 11: AM Licensing Program Analyst (LPA) Juliet Robles conducted an unannounced inspection at the Cheryl and Jesse White Small Family Home facility and met with the Cheryl White administrator. The purpose of the inspection was about an Annual/Required inspection. Currently the facility has two (2) children in care. This facility is license to provide services to six (6) ambulatory clients for developmentally disabled children aged 0 -17 years old. LPA and licensee toured the internal and external areas of the home. The following was observed at the time of inspection: There are eight (8) cameras at the facility, all video cameras both interior and exterior have their audio disabled. Physical Plant: This facility is a one-story house located in a quiet residential community. The facility consists of four (4) bedrooms, two (2) bathrooms, a large area with couch, TV, and pet dog kennel, kitchen, dining area, family room, laundry/storage area and two (2) backyards. Passageways are free from obstruction. Knives, sharps, disinfectants, and cleaning solutions are kept locked and secured in the laundry room. Per licensee, there are no firearms on the premises. The facility has a centralized heat and air-conditioning unit. Temperatures throughout the home during the inspection were comfortable. Carbon monoxide and smoke alarms were tested and observed to be operational. The home has a fire extinguisher in the kitchen. Medications, the first aid kit is centrally stored in a cabinet by the hallway. The first aid kit contains all required supplies. The home has toilets, wash basins, and one shower/bath for clients' use. The water temperature was tested at 107 degrees, which is within regulatory guidelines. The bathroom has protective nonslip material on rugs. There are fresh perishable and non-perishable foods in the home. The facility has a telephone service on the premises. The facility has an outdoor activity space which is free from hazards to life and health. Copy of facility license, facility sketch, emergency phone numbers, client activities, menu, personal rights and emergency disaster form were all prominently displayed in the home. The following sleeping arrangements were noted: Bedroom #1 sleeps Client 2- bunk bed, comforters, linens, pillows, drawer, closet Bedroom #2 sleeps Client 1- bunk bed and 1 twin bed, comforters, linens, pillow, drawer, closet Bedroom #3 sleeps adult son Bedroom #4 - Master's Bedroom sleeps Licensee The licensee is the main caretaker of the home. Client and staff files are stored in a locked file cabinet in the licensee's bedroom. Emergency disaster drills are conducted every six months. Client Files: Client files have a signed copy of the admission agreement, medical assessment, written consent, dental and medical history, a copy of the client's needs and services plan and any modifications. The original documentation signed by the client and the authorized representative acknowledging the receipt of information regarding the child's personal rights, an account of the client's cash resources, personal property and valuables. LPA reviewed two (2) client records at the facility. Clients were not available for interview at the time of inspection. Staff Files: The administrator and staff have a health screening with TB test, documentation of criminal record clearance, have a current First Aid and CPR certificate. The administrator and staff meet the initial and ongoing training requirements. LPA reviewed one (2) staff record at the facility. LPA interviewed one (1) staff member at the facility. Based on the facility inspection and file reviews this date, there are no deficiencies found at this time. A Technical Advisory was issued (see LIC 9102). An exit interview was conducted, and LPA provided a copy of the following reports: LIC 809, LIC 809C, LIC 811 and LIC 9102 to Ms. Cheryl White, Administrator/Licensee.


summary: Facility Evaluation

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Narrative:
On March 20, 2025 at 9:15 am, Licensing Program Analyst (LPA) Juliet Robles conducted an unannounced case management inspection to the Small Family Home facility and met Cheryl White, Licensee/Administrator. The purpose of the inspection is to provide a Technical Assistance (TA) with the reporting requirements and resources for training websites. On 03/16/26, LPA received a LIC 624, an Unusual Incident Report from the administrator, however the email address was sent to the wrong department. LPA discussed with the administrator the reporting requirements and to submit all Special Incident Report (SIR) to this email inbox ccllaeres@dss.ca.gov in a timely manner. The following topics, training and websites were discussed with the Administrator. · Reporting Requirements · Foster Care healthy sexual development · Reasonable & Prudent Parent Standard · Medication Guide · Personal Rights · Psychotropic Training An exit interview was conducted, and a copy of this report was provided to the facility administrator, Cheryl White.


facility_name: CHILDREN'S STATION, THE

summary: Facility Evaluation

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Narrative:
On 06/10/21, at 9:45 am, Licensing Program Analyst (LPA) Belinda Gilmer made an announced visit to this facility and met with Licensee, Edith Reynoso Silvia. The purpose of this visit was to conduct a required annual inspection. Licensee and LPA toured the entire home inside and out. Currently there are no children placed in the home. Licensee reported she is the only person living in the home. (see Confidential Name form (LIC 811) dated 6/10/21. The home is set up as follows: This is a two story single family home with six rooms 4 downstairs bedrooms are permitted by the City of Norwalk to be used as bedrooms, 3.5 bathrooms, a living room, dining-room, kitchen, Bedroom # 1 on the first floor is - vacate a twin beds, crib small refrigerator and closet space with mother's clothes in it). ( used to be her mother's bedroom) Bedroom # 2 - on the first floor vacate door with a direct exit to the outside (two twin bed, dresser and closet space). Bedroom # 3 - on the first floor vacate door with a direct exit to the outside dresser and closet space). Room # 4 - which was previous listed as a bedroom is currently being used as a storage area with a sofa, portable closet is being used as a storage room . Not permitted by the city to be used as a bedroom. Room # 5 - which was previous noted as a bedroom can't not be used as a bedroom per City of Norwalk inspector. The beds have been removed as required my the City of Norwalk. has one chair. Bedroom # 6 - occupied by licensee future son in law (twin bed and closet space) Licensee stated he has a full time live-in job and visits her on his off days. Bedroom # 7 - occupied by licensee. The gas stove, the smoke detector needs batteries; it was beeping. The carbon monoxide detector was tested and operable. Yet, LPA smelled gas during this visit. Licensee said she called the gas company in May because she also smelled something. When the gas company inspected her home they found potential explosive items in the trash can. However, the information licensee provided doesn't explain the gas smell that LPA smelled today. LPA will recommend Licensee contact the gas company again and have them reinspect the home and email LPA after the inspection. The home had a locked cabinet in the laundry area, disinfectants and cleaning solutions. The first aid kit is new and was sealed. The front and backyard were inspected LPA observed lots of plants. There were no pools and/or bodies of water on the premises. The licensee has current CPR and First Aid card that will expire on 12/03/22. Licensee has completed 8 hours of the 15 required hours of annual training. Licensee has 2 months to complete the additional 7 hours. Licensee is the only adults living in the home and she has obtained their criminal record and child abuse index check clearances. In accordance with California Code of Regulation, Title 22, Division 6, the following deficiencies were observed and will be cited. Exit interview was conducted and Licensee and a copy of this report was provided.

met_with: Edith Reynoso


summary: Facility Evaluation - 2 deficiencies

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Narrative:
On July 21, 2022 at 1: PM, Licensing Program Analysts (LPAs) Timika Martin and Jenny Mundo conducted an unannounced Plan of Correction inspection to the above facility. The purpose of the inspection is to verify if deficiencies cited on July 1, 2022, were corrected. LPA's met with Administrator, Edith Silva and informed her of the purpose for the inspection. At 1: PM LPA's conducted a tour of the facility along with the Administrator for verification of the plan of correction (POC). During today's inspection the LPAs reviewed each violation previously cited as follows: Limitations on Capacity and Ambulatory Status: The Licensee moved 3 clients from her Adult Residential Facility clients into the SFH licensed for children ages 0-17 (Corrected per Plan of Correction). Personal Rights: -The facility did not ensure cleanliness of the facility. The facility is in disarray with clutter and boxes throughout the home. The floors are not cleaned (Corrected per Plan of Correction). Buildings & Grounds: -The facility has an inoperable mini school bus in the driveway (Corrected per Plan of Correction). -The laundry room was disorganized with linens, clothes, laundry baskets and debris all over (Corrected per Plan of Correction). -The facility did not ensure cleanliness of the kitchen and dining room area. There was food located on the kitchen counters not properly stored, uncleaned dishes and boxes located in the living/dining room (Corrected per Plan of Correction). -There was a foul odor throughout the facility due to animal urine & feces not properly disposed. The facility has 12 cats/kittens and 1 dog roaming through the inside and outside of facility (Corrected per Plan of Correction). -The facility has flies/ fleas due to cat feces in the cat litter (Corrected per Plan of Correction). Furniture, Fixtures, Equipment, and Supplies: -Room #1 and room #2 both have one non-operable light bulb and bathroom #2 have a missing light (Corrected per Plan of Correction). -The beds did not have linens or pillows on the beds (Corrected per Plan of Correction). LPA's observed (9) out the (9) deficiencies cited to the facility on July 1, 2022 have been corrected as per plan of correction. Appeal rights were provided and discussed with the Administrator. An exit interview was conducted and copy of this report and Letters of Deficiency Citations Cleared were provided to the Administrator. .

Deficiencies:
80072: -
80087: -

met_with: Administrator, Edith Silva

title: Personal Rights

title: Buildings & Grounds


summary: Facility Evaluation

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Narrative:
On October 12, 2022 at 9:00AM, Licensing Program Analyst (LPA), Timika Martin conducted an unannounced inspection at the small family home (SFH) above for the purpose of conducting an annual inspection. LPA met with the licensee of the home, Edith Silva. The licensee stated that she does not currently have any clients living in the SFH and that the SFH has been vacant for approximately 2 years. The SFH is licensed to serve 4 developmentally disabled (medically fragile or special health care need children) ages 0-17; may be non-ambulatory. LPA toured the home with licensee and observed the following: This is a two-story single-family home with seven bedrooms (4 bedrooms downstairs and two bedrooms upstairs), 3.5 bathrooms, a living room, dining-room, kitchen and laundry room. Two out of the seven bedrooms are used for clients. There are two bedrooms upstairs, that are not for clients use. There is adequate indoor and outdoor activity space, including an outdoor yard. The smoke and carbon monoxide detectors are in working order. LPA observed the Emergency Contacts, Emergency Plan (evacuation), Regional Center poster and Covid-19 postings posted on the wall in the facility. LPA observed that the Personal Rights poster that was posted on the wall was not current. The facility is in disarray with clutter and boxes throughout the facility. In the dining and living room area, LPA observed serval boxes and bags which the licensee stated to be the adult clients from her Adult Residential Facility. Bedroom # 1 on the first floor is has a twin bed, crib small refrigerator and closet space with mother's belongings in it (used to be licensee mother's bedroom). Bedroom # 2 on the first floor contained two twin beds in each room with adequate drawer and closet space. LPA observed a pile of laundry on each twin bed. Bedroom # 3 on the first floor contained two twin beds in each room with adequate drawer and closet space. LPA observed a pile of laundry on one twin bed. Room # 4 is currently being used as a storage area with a portable closet. LPA observed the room to be cluttered and unorganized with boxes and clothing. Not permitted by the city to be used as a bedroom. Room # 5 previous noted as a bedroom can't not be used as a bedroom per City of Norwalk inspector. LPA observed this room to be a storage room, cluttered and unorganized with clothing, bedding, hangers and other miscellaneous items. Bedroom # 6 is occupied by licensee son. LPA observed this room to be unorganized filled with toys. Bedroom # 7 is occupied by licensee. LPA observed the bedroom to be cluttered and unorganized. LPA observed piles and boxes of papers around the room and other miscellaneous items. There were no pools and/or bodies of water on the premises. The licensee has current CPR and First Aid card that will expire on 12/03/22. Licensee has completed the required hours of annual training. Licensee is the only adult living in the home and she has obtained her criminal record and child abuse index check clearances. LPA reviewed licensee file and conducted an interview. No clients were interviewed due to none in placement. The following deficiency was observed and discussed: 80087(a) Buildings & Grounds (a)The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. An immediate civil penalty of $250 will be assessed for a repeat violation. LPA issued a Technical Assistance (see LIC 9102TA). Exit interview completed, the following deficiencies were cited, civil penalty was assessed and a copy of this report and appeal rights was left with the representative above.

met_with: Edith Silva


summary: Facility Evaluation

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Narrative:
On August 31, 2023, at 9:00AM, Licensing Program Analyst (LPA), Timika Martin and Angelina Garibaldo conducted an unannounced annual inspection at the small family home (SFH) above. LPAs met with the licensee of the home, Edith Silva. The licensee does not have any clients in placement. The SFH have been vacant for approximately 6 years. The SFH is licensed to serve 4 developmentally disabled (medically fragile or special health care need children) ages 0-17; may be non-ambulatory. LPAs toured the home with licensee and observed the following: This is a two-story single-family home with seven bedrooms (4 bedrooms downstairs and 2 bedrooms upstairs), 3.5 bathrooms, a living room, dining-room, kitchen, and laundry room. Two out of the six bedrooms are used for clients. There are two bedrooms upstairs, that are not for client use. There is adequate indoor and outdoor activity space, including an outdoor yard. The smoke and carbon monoxide detectors are in working order. LPAs observed the Emergency Contacts, Emergency Plan (evacuation), Regional Center poster and Covid-19 postings posted on the wall in the facility. LPA observed that the Personal Rights poster that was posted on the wall was not current. Bedroom # 1 on the first floor is has a twin bed, crib small refrigerator and closet space with mother's belongings in it (used to be licensee mother's bedroom). Bedroom # 2 on the first floor contained two twin beds in each room with adequate drawer and closet space. Bedroom # 3 on the first floor contained two twin beds in each room with adequate drawer and closet space. Room # 4 is currently being used as a storage area with a portable closet. Not permitted by the city to be used as a bedroom. Bedroom # 5 is occupied by licensee son. Bedroom # 6 is occupied by licensee. There were no pools and/or bodies of water on the premises. The licensee has current CPR and First Aid card that will expire on 5/02/25. Licensee has completed the required hours of annual training. Licensee is the only adult living in the home and she has obtained her criminal record and child abuse index check clearances. LPAs conducted an interview. No clients were interviewed due to none in placement. There were no deficiencies observed. Exit interview completed, and a copy of this report and appeal rights was left with the representative above.


summary: Facility Evaluation

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Narrative:
On August 21, 2024, at 10: AM, Licensing Program Analyst (LPA), Timika Martin conducted an unannounced annual inspection at the small family home (SFH) above. LPA met with the licensee of the home, Edith Silva. The licensee does not have any clients in placement. The SFH have been vacant for approximately 7 years. The SFH is licensed to serve 4 developmentally disabled (medically fragile or special health care need children) ages 0-17; may be non-ambulatory. LPAs toured the home with licensee and observed the following: This is a two-story single-family home with seven bedrooms (4 bedrooms downstairs and 2 bedrooms upstairs), 3.5 bathrooms, a living room, dining-room, kitchen, and laundry room. Two out of the six bedrooms are used for clients. There are two bedrooms upstairs, that are not for client use. There is adequate indoor and outdoor activity space, including an outdoor yard. The smoke and carbon monoxide detectors are in working order. LPA observed all of the required postings. Bedroom # 1 on the first floor is has a twin bed, crib small refrigerator and closet space with mother's belongings in it (used to be licensee mother's bedroom). Bedroom # 2 on the first floor contained two twin beds in each room with adequate drawer and closet space. Bedroom # 3 on the first floor contained two twin beds in each room with adequate drawer and closet space. Room # 4 is currently being used as a storage area with a portable closet. Not permitted by the city to be used as a bedroom.


summary: Facility Evaluation

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Narrative:
On August 19, 2025, at 10: AM, Licensing Program Analyst (LPA), Timika Martin conducted an unannounced annual inspection at the small family home (SFH) above. LPA met with the licensee of the home, Edith Silva. The licensee does not have any clients in placement. The SFH have been vacant for approximately 8 years. The SFH is licensed to serve 4 developmentally disabled (medically fragile or special health care need children) ages 0-17; may be non-ambulatory. LPAs toured the home with licensee and observed the following: This is a two-story single-family home with seven bedrooms (4 bedrooms downstairs and 2 bedrooms upstairs), 3.5 bathrooms, a living room, dining-room, kitchen, and laundry room. Two out of the six bedrooms are used for clients. There are two bedrooms upstairs, that are not for client use. There is adequate indoor and outdoor activity space, including an outdoor yard. The smoke and carbon monoxide detectors are in working order. LPA observed all of the required postings. Bedroom # 1 on the first floor is has a twin bed, crib small refrigerator and closet space with mother's belongings in it (used to be licensee mother's bedroom). Bedroom # 2 on the first floor contained two twin beds in each room with adequate drawer and closet space. Bedroom # 3 on the first floor contained two twin beds in each room with adequate drawer and closet space. Room # 4 is currently being used as a storage area with a portable closet. Not permitted by the city to be used as a bedroom.


summary: Facility Evaluation

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Narrative:
This is an amended report from June 30, 2022 and July 1, 2022. On 7/1/22 at 8: AM, Licensing Program Analysts (LPAs) Timika Martin and Jenny Mundo made an unannounced case management inspection to The Children's Station Small Family Home (SFH) and met with Administrator, Edith Silva. The purpose of the inspection was to follow up with the information gathered by Orange County, Harbor Regional Center and CCL Adult and Senior Care. The information indicated that Administrator, Edith Silva, relocated three (3) adult residents from her Adult Residential Facility (ARF) to the SFH without approval. At 8: AM LPAs toured the facility with Administrator and discussed the following observed deficiencies. 80010(a)(b) Limitations on Capacity and Ambulatory Status (a)A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including the capacity limitation. (b) Facilities or rooms approved for ambulatory clients only shall not be used by non-ambulatory clients. 80087(a) Buildings & Grounds (a)The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. 80087(a)(1) Buildings & Grounds (a)The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. (1) The licensee shall take measures to keep the facility free of flies and other insects. 80072 (a)(2)(3)Personal Rights (a)Except for children's residential facilities, each client shall have personal rights which include, but are not limited to, the following: (2)To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. (3)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including but not limited to: interference with the daily living functions, including eating, sleeping, or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. 83088 (a)(c)Fixtures, Furniture, Equipment, and Supplies (a) In addition to Section 80088, the following shall apply. (c) The licensee shall provide each child with an individual bed which is equipped with a clean, comfortable mattress, clean linens, blankets, and pillows, as needed, all in good repair. 80088 (d) Furniture, Fixtures, Equipment, and Supplies (d) The licensee shall provide lamps or lights as necessary in all rooms and other areas to ensure the comfort and safety of all persons in the facility. LPAs discussed the deficiencies observed with the Administrator. Deficiencies observed pose a Health and Safety risk to the clients in which they serve as the facility is not following keeping the facility clean, safe, sanitary and in good repair. Exit interview completed, the following deficiencies were cited, and a copy of this report was left with the representative above. At 8: AM LPAs toured the facility with Administrator. This is a two-story single-family home with six rooms 4 downstairs bedrooms, 3.5 bathrooms, a living room, dining-room, kitchen. The Administrator stated that she does not currently have any clients living in the facility and that the facility has been vacant for approximately 2 years. The Administrator stated that the she moved in 3 adult clients (ages 21,25,34) into the SFH because she is currently having construction done to one of her adult facilities (Xavier II). The licensee was advised she is not operating within the terms and conditions of her license. The Small Family Home is licensed to serve 4 developmentally disabled (medically fragile or special health care need children) ages 0-17; may be non-ambulatory. The Administrator stated that this SFH is listed as her emergency relocation for those clients. The licensee stated that the adult clients were move in the SFH the second week of June 2022 and were moved out on 6/30/22 into an Extended Stay Suites located in La Mirada. The Administrator also stated that the clients will be at the Extended Stay Suites for about 2-2 ½ months. The administrator stated that she informed Orange County CCL and Regional Center of the relocation and that they both approved the re-location both times. The administrator stated that she did not inform CCL Monterey Park and LA County of relocating the adult clients to the SFH. During the tour, LPA's observed a non-operable facility school bus located in the driveway that was uncleaned and covered in cobwebs. LPA's observed two cat litter boxes with feces inside of them, surrounded by flies/ fleas. LPA's observed several fruit trees and potted plants located in the front yard along with cats and kittens roaming/sitting in the yard. LPA's observed flies/fleas surrounding the front door. LPA's observed flies/fleas roaming inside of the SFH. There was a strong smell of urine & feces throughout the facility. The Administrator informed LPA's that the odor we were smelling was Febreze and cleaning solution. There were approximately 12-15 cats/kittens inside and outside of the home. The administrator stated that three cats belong to the clients and out the three cats they made babies. There was one dog roaming inside the home. The facility floor was not cleaned. The facility is in disarray with clutter and boxes throughout the facility. In the dining and living room area, LPA's observed serval boxes and bags which the Administrator stated to be the adult client's personal belongings. LPA's observed that the kitchen area was unkempt. LPA's observed frozen foods located on the kitchen counters and canned goods, juices, etc. on the kitchen counter and not properly stored. LPA's observed uncleaned dishes inside of the sink, on the kitchen counters and on the stove. LPA's observed the 4 bedrooms downstairs. One bedroom is used for storage, and three bedrooms are used for clients. The three bedrooms contained two twin beds in each room with adequate drawer and closet space. LPA's observed that each bed had a fitted sheet on the mattress and 3 out of the 6 beds contained pillows. The bedrooms were not equipped with clean linens, blankets, and pillows. In bedroom #1 and bedroom #2 both have one non-operable light bulb. In one bathroom there is a missing light/light bulb. LPA's observed that the laundry room was disorganized with linens, clothes, laundry baskets and debris all over. There are two bedrooms upstairs, that are not for clients use. Both rooms upstairs are in disarray with one bed each and clutter. During the tour of the facility, cats/and kittens were coming from underneath the couches and down that stairwells. In the back yard there is a sunroom where the cats/kittens, food, cages and play area is located. LPA's discussed with Administrator regarding surrendering her license approximately three times during the visit and she refused. Administrator stated that she plans on having clients and that DCFS would like to place children in her home. The following deficiencies were observed and discussed: 80010(a)(b) Limitations on Capacity and Ambulatory Status 80087(a) Buildings & Grounds 80087(a)(1) Buildings & Grounds 80072 (a)(2)(3) Personal Rights 83088 (a)(c) Fixtures, Furniture, Equipment, and Supplies 80088 (d) Furniture, Fixtures, Equipment, and Supplies LPAs discussed the deficiencies observed with the Administrator. Deficiencies observed pose a Health and Safety risk to the clients in which they serve as the facility is not following keeping the facility clean, safe, sanitary and in good repair. Exit interview completed, the following deficiencies were cited, and a copy of this report was left with the representative above.


summary: Facility Evaluation

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Narrative:
On 07/02/24 at 1: P.M., Licensing Program Analyst (LPA) Demetris Teal conducted an unannounced Pre licensing inspection at the above named facility.LPA met with Stephanie L. Childs-Administrator. This facility is a two (2) story home with five (5) bedrooms, three (3) bathrooms, one of the bedrooms is a staff office, kitchen, dining room, a living room, and a laundry area. There are no bodies of water on the premises. There are no firearms or ammunition in the facility. At 2: P.M., LPA conducted a walk-through of the entire facility. Physical Plant, Operations, Staffing and Client Records were reviewed and discussed with the administrator. The clients files will be maintained in locked file cabinets. Medication is located in a locked medicine box. The files and medicines will be in a locked room where only staff will have access. Washer and dryers are located in the hallway. Laundry and cleaning supplies will be in locked cabinets. During the inspection the administrator shared that they are currently approved with San Bernardino County and 1 child is currently placed. During the pre licensing a Component III was conducted on what to expect after licensing. Exit interview conducted. A copy of the 809 was left with the administrator.

met_with: STEPHANIE L. CHILDS-Admnistrator


summary: Facility Evaluation

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Narrative:
On October 02, 2025, at 10: A.M. Licensing Program Analyst (LPA) Demetris Teal conducted an unannounced case management inspection at Childs Small Family Home. LPA met with Stephanie Childs-Licensee. Purpose of the visit was to follow up on an incident report dated September 23, 2025. LPA discussed reporting requirements and the necessity to report unusual incidents. LPA printed and emailed Licensee the Component III information. LPA discussed incident involving allegations made by C1. Licensee denied alleged abuse. Licensee stated that C1 had threatened to tell her CSW and others that the Licensee had abused her prior to the reported allegations. Licensee said that when C1 cannot get her way, she will become irate and make statements including threats and verbal abuse towards Licensee. Licensee said that C1 told the CSW that she made up the allegations, in the presence of the Licensee. In other confidential interviews, it was revealed to the LPA that C1 had made up the allegations. LPA discussed allegations with CSW and CSW did not have any concerns. No personal rights violations have been found. The investigation is concluded No deficiencies noted at this time and no citations issued. An exit interview was conducted and a signed copy of this report along with 811 (Confidential Name List), was left with Licensee

met_with: Stephanie Childs


summary: Facility Evaluation

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Narrative:
On October 9th, 2025 at 10: AM, Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced post licensing inspection at the above address. LPA met Stephanie Childs, Licensee. LPA Ruacho conducted a physical plant inspection inside and outside the home with the Licensee. The following were observed at the time of inspection: This facility is a two (2) story home with five (5) bedrooms, three (3) bathrooms, one of the bedrooms is a staff office, there is a kitchen, dining room, a living room, and second family room and a laundry area. There are no bodies of water on the premises. There are eight (8) surveillance cameras on the premises, four (4) are located inside and four (4) are outside. The ones located inside are in common living spaces and do not violate personal rights of clients. There are no firearms or ammunition at the facility. The facility has a centralized heat and air-conditioning unit. Temperatures in all rooms are maintained at 74 degrees (F). The hot water temperature was measured at 109.7 degrees (F). Carbon monoxide and smoke detectors were observed in the home and in working order. The fire extinguishers are located on each floor of the home. All sharps are locked and inaccessible to client. Disinfectants and cleaning solutions are kept in a locked cabinet located in the garage. The facility has a working land line for client use. The applicant reports no firearms on the premises as well as no poisons and pesticides. The grounds are free from obstructions and hazards. All bedrooms have appropriate beds that are equipped with the good mattress, bedding, pillows, as well as blankets. Individual beds are observed to be in good repair, equipped with good springs, clean mattresses and pillows, as well as appropriate clean linens. The rooms have an ample amount of space for the clients and the closets have a lot of room for the clients' belongings. Bedrooms also have dressers. LPA observed bathrooms to be in good repair and working order. LPA also observed extra towels stored in the hallway closet. Medications will be centrally stored in the lockboxes in the downstairs office. Kitchen has a refrigerator, dishwasher, stove and adequate utensils and tableware to accommodate the number of clients. LPA observed the kitchen area to be clean and the refrigerator is clean. LPA observed snack fridge and cabinets in the kitchen. Licensee has a posted food menu in the office and an adequate amount of perishable and non-perishable foods. LPA reviewed one (1) client record and one (1) staff record. LPA checked required criminal record clearances, training, CPR certificate, and medical assessments for all adults in the home. The client's files contained: Admission Agreement, Consent Forms, and Emergency Information. Per California Code of Regulations (CCR) 83068.2(a) At the time of placement, the licensee or a designated person shall request for each child, a needs and services plan which describes the child's service needs. A citation was issued during today's inspection. Plan of correction was discussed and developed with the Licensee. An exit interview was conducted, and a copy of this report, along with the LIC TA, LIC 811, and appeal rights, was provided to the Licensee.

met_with: STEPHANIE L. CHILDS - Licensee


summary: Facility Evaluation

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Narrative:
On October 17, 2025, at 9:00AM Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced visit at the above facility. The purpose of the visit was to Amend the Post-Licensing document that was completed on October 9th, 2025. LPA met with the Licensee, Stephanie Childs. LPA met with the Licensee and the amendment was completed and signed. An exit interview was conducted. LPA provided the facility a signed copy the LIC 809. There were no deficiencies cited at the time of this inspection.


summary: Complaint Investigation - Unsubstantiated - 1 allegation

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Investigation Findings:
13On 12/04/2025 at 8: AM, Licensing Program Analyst (LPA) Noubar Yerkatyan conducted an unannounced visit to Childs Small Family Home (SFH) for the purpose of concluding the above complaint investigation. LPA met with Stephanie Childs, licensee and discussed the above complaint findings. Investigation consisted of the following: On 11/06/2025, LPA interviewed licensee; On 11/07/2025, LPA interviewed County Social Worker; On 11/20/2025, LPA interviewed C1; On 11/19/2025 and 11/20/2025, LPA interviewed C1's new caregiver; On 11/14/2025 and 11/20/2025, LPA interviewed Social Service Practitioner; On 11/05/2025 and 11/07/2025, LPA attempted to interview Reporting Party (see confidential names list dated 12/14/25). Interviews revealed the above allegation was false and did not occur. LPA was informed initially that the above allegation might have occurred, however other interviews revealed that the allegations were falsely reported. Due to the inconsistency of information obtained during the investigation, it cannot be determined whether the above allegation occurred. Based upon the interviews, the complaint findings are Unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegation occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tira Logan LICENSING EVALUATOR NAME: Noubar Yerkatyan LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Licensee


summary: Facility Evaluation

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Narrative:
On February 24, 2026, at 11: A.M., Licensing Program Analyst (LPA) Demetris Teal conducted an unannounced Annual Inspection at the above-named facility. LPA met with Licensee Stephanie Childs. The facility currently has a Small Family Home (SFH) license. The SFH is licensed to serve up to three (3) clients ages 3 to 17. The facility can serve ambulatory and non-ambulatory developmentally disabled clients, Regional Center clients, County placed clients and provide one on one care. There are currently no clients in placement. The LPA requested the following: Personnel Report LIC500, Client Roster, Clients and Staff Files. There are no clients in care. This facility is a two (2) story home with five (5) bedrooms, three (3) bathrooms, one of the bedrooms is a staff office. There is a kitchen, dining room, living room, and a laundry area. There are no bodies of water on the premises. There are no firearms or ammunition in the facility. At 1: P.M., LPA conducted a walk-through of the entire facility. continued on page 2.... .......page Physical Plant The license, personal rights, emergency disaster form, complaints poster, emergency phone numbers and food menu are posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are kept inaccessible and locked in a storage area. Sharps/knives are inaccessible and stored in a locked storage area. Facility has non-perishable food for at least one week and perishable food for at least two days. Medications are centrally stored in a locked room in the hallway. Smoke and carbon monoxide detectors were tested and in proper working order. Fire extinguisher was fully charged. Room temperatures are maintained at 76 degrees F. The hot water temperature was tested and measured at 120 degrees F. All sinks, showers and toilets are in working order. No more than 2 children share a bedroom. All beds are in good repair; equipped with good springs, clean mattresses and pillows. Overall, facility is clean, safe, sanitary and in good repair. Operations The facility administrator/licensee is responsible for communicating with emergency personnel. Client Records There are no clients in care Staff Records The administrator/licensee meets the required qualifications and/or experience. Documentation of the required education and experience requirements are maintained in the personnel file. There were were no citations issued. A copy of this report, LIC 811 and appeal rights were left with Licensee. Exit interview conducted.

met_with: Stephanie Childs-Licensee


facility_name: CHIU SMALL FAMILY HOME, THE

summary: Facility Evaluation

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Narrative:
On December 6, 2021, at 10:30AM, Licensing Program Analyst (LPA) Humberto Flores, conducted an unannounced Annual Inspection at Chiu Small Family Home (SMH) and met with Jean Chiu-Torres. The purpose of the inspection was to conduct an Annual Inspection. The facility it is a two-story home located in a gated community of a residential neighborhood. The facility has 5 bedrooms and 3 bathrooms. Currently there are two (2) ambulatory children in placement with special health care needs. Facility is licensed to serve two (2) ambulatory and two (2) non ambulatory children ages 0-17 years old. There are no bodies of water on premises. The following sleeping arrangements were noted: Bedroom #1 (First floor), it has 2 twin beds. Adopted daughter and Child Ref #1 (C1)(see Confidential Names form LIC811 dated 12/06/2021) sleep in it. Bedroom #2 (Second floor) it has a twin bed and sleeps 14 years old adopted son. Bedroom #3 (Second floor) it has a twin bed and sleeps Child Ref #2 (C2). cont.# Bedroom #4 (Second floor) it has a twin bed and sleeps 19 years old adopted son. Bedroom #5 (Second floor) Licensee and her husband. All bedrooms have adequate closet and drawer space. During the inspection a copy of the Register of Facility Clients and Personnel Report was provided upon request. The following topics were inspected: PHYSICAL PLANT: A tour of the facility was conducted inside and out, along with the Licensee. The License was placed in a prominent place, 1st floor living room of the facility. LPA Flores observed that the facility is clean, safe, sanitary and in good repair. The passageways are unobstructed. The disinfectants and cleaning solutions were stored away from the kitchen areas, food preparation areas to the children. The food is safe and of the quality and the quantity necessary to meet the needs of the clients. Each meal meets at least 1/3 of the recommended in the USDA Basic Food Group Plan-Daily Food Guide. Supplies of staples non-perishable foods for one week and perishable foods for two days are maintained in the facility. cont.# Medications are locked and accessible only to the Licensee and direct care staff. The temperature in the rooms that clients occupy are maintained between 68 and 85 degrees (F) and the hot water temperature was at 110 degrees (F). Emergency Intervention Plan: LPA Flores reviewed the Emergency Intervention Plan. CLIENT RECORDS: LPA Flores reviewed the 1 (1) client file records. The files contain: Admission Agreement, Medical Assessment, Consent Forms, Emergency Information, Appraisal & Needs Service Plan, Immunization Record and Personal Rights. The Safeguards For Cash Resources was missing for C1. Staff Records: A total of 1 employees' file was reviewed. The files contain the following documentation: Child Abuse Index Checks/Department of Justice (DOJ)/Federal Bureau of Investigation (FBI) criminal record clearances, criminal record statement and a health screening and tuberculosis and Certificate and Cardiopulmonary Resuscitation. # OPERATIONAL REQUIREMENTS: During the inspection review, LPA Flores observed the facility maintained an updated roster of the clients with pertinent information. The Licensee and direct care staff are the responsible and capable for communicating with emergency personnel if needed. No further inspection is needed. No citation was issued. A copy of this report and LIC 811 was provided to the SFH representative. Exit interview conducted.

met_with: Jean Chiu-Torres, Licensee


summary: Facility Evaluation

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Narrative:
On November 18, 2022 at 9: AM, Licensing Program Analyst (LPA) Timika Martin conducted an Annual inspection at the above facility. LPA met with the licensee Jean Chiu. At 9: AM, LPA conducted a complete tour of the inside and outside of the small family home (SFH). This two-story SFH has 5 bedrooms and 3 bathrooms. See Confidential Names Form (LIC 811) dated November 18, 2022. Currently, there are two ambulatory clients in placement with special health care needs. Facility is licensed to serve two (2) ambulatory and two (2) non ambulatory children ages 0-17 years old. There are no bodies of water on premises. The following sleeping arrangements were noted: Bedroom #1 (First floor), it has 2 twin beds, sleeps daughter and Child Ref #1 (C1) sleep in it. Bedroom #2 (Second floor) it has a twin bed and sleeps son. Bedroom #3 (Second floor) it has a twin bed and sleeps Child Ref #2 (C2) Bedroom #4 (Second floor) it has a twin bed and sleeps son. Bedroom #5 (Second floor) Licensee and her husband. All bedrooms have adequate closet and drawer space. All exits, and hallways were observed to be free and clear of hazards and obstruction. The carbon monoxide/smoke detectors throughout the facility upstairs and downstairs were checked to be operable and functioning. Water temperature was tested and was within regulatory guidelines. First aid kit was readily available, complete and stored in a laundry room cabinet. Medications were observed to be centrally locked in a locked area located in the upper and lower kitchen cabinet. Medications that needed refrigeration is stored in the garage refrigerator with a lock. Kitchen was inspected and food supplies both perishable and non-perishable were checked and found to be sufficient. Sharp knives and sharp utensils were made inaccessible. Per licensee there are no weapons in the facility. Cleaning solutions and toxins were locked in the garage, laundry room and kitchen cabinets, inaccessible to clients. Copy of facility license, facility sketch, emergency phone numbers, emergency disaster form were all prominently displayed in the home. LPA Martin reviewed the Emergency Intervention Plan. LPA reviewed two (2) client files and licensee's record. Licensee has current CPR and First Aid on file. Licensee is current with ongoing training hours. LPA checked required criminal record and child abuse index check clearance or exemption. The two clients are nonverbal; two clients takes food and medication through tube and C1 through a central line. The client's files contained: Admission Agreement, Medical Assessment, Consent Forms, Emergency Information, Individual Family Service Plan, Immunization Record and Personal Rights. The Safeguards for Cash Resources for C2 is no longer required per DCFS due to C2 being federally funded. Based on the facility inspection and file reviews this date, there are no deficiencies found at this time. An exit interview was conducted with the licensee. LPA provided a copy of the following reports: LIC 809, LIC 809C, LIC 811, were provided to Jean Chiu.

met_with: Jean Chiu-Torres


summary: Facility Evaluation

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Narrative:
On November 15, 2023 at 11: AM, Licensing Program Analyst (LPA) Timika Martin conducted an Annual inspection at the above facility. LPA met with the licensee Jean Chiu. At 9: AM, LPA conducted a complete tour of the inside and outside of the small family home (SFH). This two-story SFH has 5 bedrooms and 3 bathrooms. See Confidential Names Form (LIC 811) dated November 18, 2022. Currently, there are two ambulatory clients in placement with special health care needs. Facility is licensed to serve two (2) ambulatory and two (2) non ambulatory children ages 0-17 years old. There are no bodies of water on premises. The following sleeping arrangements were noted: Bedroom #1 (First floor), it has 2 twin beds, sleeps daughter and Child Ref #1 (C1) sleep in it. Bedroom #2 (Second floor) it has a twin bed and sleeps son. Bedroom #3 (Second floor) it has a twin bed and sleeps son. Bedroom #4 (Second floor) it has a twin bed and sleeps son. Bedroom #5 (Second floor) Licensee and her husband. All bedrooms have adequate closet and drawer space. All exits, and hallways were observed to be free and clear of hazards and obstruction. The carbon monoxide/smoke detectors throughout the facility upstairs and downstairs were checked to be operable and functioning. Water temperature was tested and was within regulatory guidelines. First aid kit was readily available, complete and stored in a laundry room cabinet. Medications were observed to be centrally locked in a locked area located in the upper and lower kitchen cabinet. Medications that needed refrigeration is stored in the garage refrigerator with a lock. Kitchen was inspected and food supplies both perishable and non-perishable were checked and found to be sufficient. Sharp knives and sharp utensils were made inaccessible. Per licensee there are no weapons in the facility. Cleaning solutions and toxins were locked in the garage, laundry room and kitchen cabinets, inaccessible to clients. Copy of facility license, facility sketch, emergency phone numbers, emergency disaster form were all prominently displayed in the home. LPA Martin reviewed the Emergency Intervention Plan. LPA reviewed two (2) client files and licensee's record. Licensee has current CPR and First Aid on file. Licensee is current with ongoing training hours. LPA checked required criminal record and child abuse index check clearance or exemption. C1 is nonverbal and takes food and medication through a central line. The client's files contained: Admission Agreement, Medical Assessment, Consent Forms, Emergency Information, Individual Family Service Plan, Immunization Record and Personal Rights. Based on the facility inspection and file reviews this date, there are no deficiencies found at this time. An exit interview was conducted with the licensee. LPA provided a copy of the following reports: LIC 809, LIC 809C, LIC 811, were provided to Jean Chiu.

met_with: Jean Chiu, Administrator


summary: Facility Evaluation

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Narrative:
On November 2, 2024 at 9: AM , Licensing Program Analyst (LPA) Olena Maico conducted an unannounced annual inspection visit at the above facility. LPA met with the licensee Jean Chiu-Torres. Currently there is one client in placement (See LIC 811 - List of Confidential Names). At 10: AM, LPA conducted a complete tour of the inside and outside of the small family home (SFH) along with the licensee. Outside facility is in good repair and no deficiencies noted. Outside patio has enough room for the clients to use if needed. This two story SFH has 5 bedrooms and 3 bathrooms. Currently, there are one ambulatory client in placement with special health care needs. Facility is licensed to serve two (2) ambulatory and two (2) non-ambulatory children ages 0-17 years old. License is posted in the living room area and visible to the LPA. There are no bodies of water on premises. There are two cameras on premises, one in the living room area and one in the family room area. Licensee was advised to update the Plan of Operations for the camera locations. The entrance to the house has wheelchair accessible ramp and the door opens to the living room area and that leads to the kitchen and upstairs. All the entrances are free and clear from hazard. Kitchen has all the necessary appliances and working stove and microwave. Knives are locked away in the drawer and inaccessible, and medications are centrally stored in the locked drawer and the ones required refrigerating in the locked box in the fridge. The following sleeping arrangements were noted: Bedroom #1 (First floor), it has 2 twin beds, sleeps daughter (13) and Child C1 (See LIC List of Confidential Names). Bedroom #2 (Second floor) it has two twin beds and sleeps son (7 years old). Bedroom #3 (Second floor) it has a twin bed and sleeps son (22). Son has a DOJ/FBI/CACI clearance in Guardian. Bedroom #4 (Second floor) it has a twin bed and sleeps son(17 years old). Bedroom #5 (Second floor) Licensee and her husband. All bedrooms have adequate closet and drawer space for the clients to store personal items. Bathrooms have enough personal hygiene items and toiletries. All exits, and hallways were observed to be free and clear of hazards and obstruction. The carbon monoxide/smoke detectors throughout the facility upstairs and downstairs were checked to be operable and functioning (connect to the alarm company). Water temperature was tested and was within regulatory guidelines ( F). First aid kit was readily available, complete and stored in a laundry room cabinet and expires 09/30/2025. Fire extinguishers located in the kitchen area and a second floor and are expiring October 2027. LPA Maico observed that the facility is clean, safe, sanitary and in good repair. The passageways are unobstructed. The disinfectants and cleaning solutions were stored away from the kitchen areas, food preparation areas and inaccessible to the children. The food is safe and of the quality and the quantity necessary to meet the needs of the clients. Each meal meets at least 1/3 of the recommended in the USDA Basic Food Group Plan-Daily Food Guide. Supplies of staples non-perishable foods for one week and perishable foods for two days are maintained in the facility. The client does not consume regular food, C1 feeds using G-tube and central line. Per licensee there are no weapons in the facility. During the inspection a copy of the Register of Facility Clients and Personnel Report LIC 500 was provided upon request. The following topics were inspected: Emergency Intervention Plan: LPA Maico reviewed the Emergency Intervention Plan. It has all the necessary items and was just updated 10/01/24. Licensee added phone number and email address to the form. Emergency drills are conducted monthly and topics are rotated. CLIENT RECORDS: LPA Maico reviewed the 1 client file records. The files contain: Admission Agreement, Medical Assessment, Consent Forms, Emergency Information, IPP plan from the regional center, Immunization Record and Personal Rights, Medication Administration Log. All forms need signatures are signed. Safeguard for cash resources is not attached due to the cash being managed through the trust management company. Staff Records: A total of 4 employees' file was reviewed. The files contain the following documentation: Child Abuse Index Checks/Department of Justice (DOJ)/Federal Bureau of Investigation (FBI) criminal record clearances, criminal record statement and a health screening and tuberculosis and CPR. All the training required is provided in the employee's records and training includes, but not limited to implicit bias, LGBTQ right training, cultural competency, Mandated reported training. The Licensee and direct care staff are the responsible and capable for communicating with emergency personnel if needed. No further inspection is needed. No citation was issued. A copy of this report and LIC 811 was provided to Jean Chiu. . Exit interview conducted.

met_with: Jean Chiu-Torres, RN, Administrator