summary: Facility Evaluation

raw_content:
Narrative:
On June 28, 2023, at 9: AM, Licensing Program Analyst (LPA), Val Wilson, arrived at the Group Home (GH) and met with Youth Homelessness Prevention Center(YHPC), Shelter Manager, Nike Hanson. LPA notified the shelter manger of the reason for the subsequent annual/random continuation visit and the LPA was greeted and granted access. The annual was initiated on June 20, 2023, and continued on June 21, 2023. Remaining care tool section for completions is client file review. There were three staff present and three clients present at the time of today's inspection. Administrator, Darryl Evey, joined via phone during the exit. During the visit, LPA inspected the client electronic and paper records. The facility utilizes an electronic file application for the client records called Apricot: A Social Solutions Program. The files are separate and filed by name and/or record identification number. LPA reviewed five out of five client files [client 1 (C1), client 2 (C2), client 3 (C3), client 4 (C4), and client 5 (C5)] side by side with the shelter manager pulling up each document for LPA review. C1 was here for 21 days and has been discharged. C2 was here for 13 days and has been discharged. C3 has been here for 12 days. C4 has been here for six days. C5 has been here for two days. Currently, the client removal plan is in the Apricot system where it is reviewed and signed. The client planned discharge (currently called smart goals) is reviewed, developed, and signed by hand during the case management intake and placed in a case management binder. However, the YHPC written policies and procedures governing a client's removal and/or planned discharge are not included. The YHPC will be merging the two documents, adding the policies and procedures, and this document will then be found in Apricot once completed. Additionally, the written policies and procedures governing a client's removal and/or planned discharge from the youth homelessness prevention center were not posted during inspection, but were posted prior to LPA leaving the YHPC today. Emergency service needs are located in Apricot under Services and also in the case management binder under each clients tab. ****** (Continued) The licensee has not provided C1, C2, C3, C4 or C5 with a Telecommunications Device Notification form (LIC 9158, 11/04), notifying the youth that they are entitled to obtain services and equipment from the telephone company. Needs assessment of the client conducted within 72 hours of admission to the YHPC are located in Apricot under Services and also in the case management binder under each clients tab. YHPC clients that have a county social worker have the assessment during the child family team meeting (CFTM). The other clients need assessments are evaluated and memorialized by the YHPC. C1 does not have the clients needs assessment CFTM in their record. The YHPC informed the LPA they will email the county social worker for a copy, which was received prior to LPA exit. C2, C3, and C4 needs assessment was conducted and documented by the YHPC. C5 was admitted 42 hours ago and the CFTM is scheduled prior to 72 hours. Reunification with family, a suitable family member, or other government and local organization is identified during needs assessment. Clients with county social workers would have this identified in their CFTM. The licensee did not document the bedroom sharing arrangement for C4 and C5, who currently share a room, which ensures the health and safety, client compatibility when considering care in an age and developmentally appropriate manner, and gives regard to the client's sexual orientation and gender identity. Based on observation, interview, and record review, the licensee is cited under Title 22, Division Chapter 5, Article 07. Physical Environment, section 84087(e) Buildings and Grounds, for two out of five client records [C4 and C5] and Interim Licensing Standards, YHPC, Article 06. Continuing Requirements, section 84568(f) Admission Procedures, for five out of five client records [C1, C2, C3, C4 or C5], which poses/posed a potential health, safety or personal rights risk to persons in care. Additionally, there are technical violations issued for 84570(b)(10) Youth Records and 84568(e) Admission Procedures. A copy of this report, LIC 809, 809D, Technical Violations, appeal rights, and LIC Confidential Names were provided to YHPC designee.


state: CA

facility_name: MY PLACE

summary: Facility Evaluation

raw_content:
Narrative:
On August 15, 2023, at 2:00 p.m., Licensing Program Analyst (LPA) Val Wilson, LPA Nicole Strickland, Licensing Program Manager (LPM) Jennifer Smith and Regional Manager (RM) LaCresha Cook met with Family Assistance Program (FAP) Chief Executive Officer (CEO) and My Place Administrator Darryl Evey, Chief Operating Officer (COO) Ken Weekes, My Place Shelter Manager Fatima Herrera, Our House Shelter Manager Joe Mendoza, Our House Social Worker Julie Ann Ferreira, Board Member John Perring-Mulligan, Board Member Kierre Coghill, CDSS System of Care (SOC) Provider Policy Implementation Unit Manager Alicia Bernstein, SOC Policy Analyst Chris Meyer, SOC Health Program Specialist I Hong Luu, SOC Policy Analyst Gina Jones, Child Trafficking Research and Policy Unit Analyst Leland Turner, Catalyst Center Senior Program Advisor Misty Berard and Kelsie Tatum Martinez, San Bernardino County Children and Family Services (SBCCFS) Shelter Coordinator Amy Mierzwi, SBCCFS Deputy Director Nancy Satterwhite, SBCCFS Assistant Director Jonathan Byers, SBCCFS PRD Tracy Raymond and SBCCFS PRD Ana del Nogal; Department of Behavioral Health (DBH) San Bernardino County Dianne Wolkenhauer, PhD, Department of Health Care Services Staff Services Manager Dave Gutierrez and Central Placement Unit Supervisor Christina Lopez via Microsoft Teams for a virtual informal office conference. The purpose of the meeting was to discuss the following issues and concerns with the Licensee for both Our House and My Place facilities: Administrator qualifications and duties, lack of administrative oversight, staff training, plan of correction, lack of trauma informed care, personal rights, and lack of supervision concerning the Our House facility. The three areas of concern applicable to the My Place facility are lack of administrative oversight, Administrator qualifications and duties and Plan of correction. Administrator qualifications and duties - LPM Smith advised there are concerns regarding the Administrator's lack of knowledge regarding specific incidents that have occur in the facility, lack of knowledge of the clients in care and the needs and services of the clients in care, and Administrator referring (Continued on page 2) Pg 2 (Continued from page 1) Community Care Licensing (CCL) representatives to the Facility Manager, Joe Mendoza for information. The concerns cover the period of February 2022, when the Administrator of Our House was Darryl Evey until present. CEO stated that they are in the process of having facility administrators present at the facilities for 40 hours per week. They are also in the process of hiring a Director that will be overseeing the Administrators. Lack of oversight- LPM Smith advised there are concerns that the Administrator is not familiar with the regulations and there is a breakdown in communication amongst the staff. RM Cook stated there should be oversight by the Administrator and Board of Directors for all facility operations. CEO stated reports are emailed to CEO and he works on the outcome. Each month there is a board meeting and they go over special incident reports and Licensing reports. They also have a leadership meeting each week to go over pending issues. SBCCFS PRD Tracy Raymond shared improvements observed with Our House since the implementation of new youth and shelter protocols that San Bernardino county provides assist with, including CFTMs being initiated immediately, internal meetings every other week with FAP. The addition of Social Worker Julie Ann who comes from a trauma informed focus has been a strong positive influence over the last year. There are also supportive actions like peer advocates meeting with the youth to assist youth to adjust to being in a shelter. Tracy reported that Our House accepts placement for a broad spectrum of youth that are difficult to place and STRTP's are no longer willing to work with. If FAP calls the county emergency hotline, San Bernardino county representatives report to the facility and remove youth as necessary from placement to assist with de-escalation of emergency situations and crisis intervention. Tracy stated San Bernardino county is improving their practice and are helping FAP improve in their operations, working together as a partnership. Staff training- RM Cook advised there are concerns regarding a lack of staff training being reported from information gathered during complaint investigations and the annual inspections. CEO stated they began documenting the ongoing training a year ago when CCL brought this to their attention. Staff training is done every other Thursday, debriefing is done during staff meetings, along with scheduling staff, and outside agency training is provided. The process to onboard is four months and staff turnover averages at four months, leaving continued staffing issues as a primary struggle. As an incentive, the benefit of a half-paid day off has been implemented and additionally there are more outdoor activities which help the staff's mental health. (Continued to page 3) Pg 4 (Continued from page 3) https://www.cdss.ca.gov/Portals/9/ACIN/2019/I-28_19.pdf?ver=2019-07-23-145815-020, ACIN I-28-19 (July 22, 2019) Harm Reduction Series - Social Worker, ACIN I-50-19 (July 29, 2019) Harm Reduction Series - Probation Officer, ACIN I-36-21 (June 22, 2021) Harm Reduction Series - Law Enforcement, ACIN I- 31-22 (April 8, 2022), Harm Reduction Series - Caregiver and ACIN I-59-18 (September 14, 2018) Introduction to the Harm Reduction Strategies Series Regarding Commercially Sexually Exploited Children. Personal rights and Lack of supervision- LPM Smith discussed several substantiated complaints regarding personal rights and lack of supervision from 2022 to present. LPM Smith summarized deficiencies cited. LPM Smith informed the Licensee of the Technical Support Program (TSP), stating it is a branch that can work with FAP in various areas they may need support in regarding facility operations. A referral can be made but it is voluntary. CEO stated their intention was never to work with foster youth, but there was a need and CFS asked the facility for support. CEO stated foster youth are much more difficult than the runaways and respond differently to the support, and support with crisis intervention would be appreciated. LPM Smith advised FAP to identify any areas they may need support to CCL and CCL will submit a TSP referral. Tracy Raymond stated the harm reduction training and resources provided by the Child Trafficking Research and Policy Unit is super informative for harm reduction and collaboration. Tracy also stated that San Bernardino county understands the responsibility they have in this situation and will continue to partner with the facility to help with compliance issues. CEO stated that he was not in agreement with CCL findings. RM Cook advised that FAP has the right to appeal and there are times the appeal is heard and findings are overturned. SBCCFS Deputy Director Nancy Satterwhite stated the county has looked at ways to collaborate and how to "team" placement combinations for youth in care. Peer family advocates are connected with the youth and it has been beneficial. San Bernardino county will also be hosting a mandated reporter training at Our House and looking at the contracts with the County for extra supports services that can be implemented. The CEO reported feeling better about the interaction with DCFS and how they are removing the clients to help the Program succeed along with the new contract that includes a new crisis intervention protocol. RM Cook reminded that regulatory enforcement and compliance is provided to protect the health and safety of youth in care and CCL hopes that the Licensee will take advantage of the assistance, collaboration, and all resources offered and provided by CCL and each department represented in the meeting. (Continued to page 5) Pg 3 (Continued from page 2) Representative from the Catalyst Center, Misty Berard shared they are available for support and shared the following links: mberard@catalyst-center.org; kmartinez@catalyst-center.org; https://catalyst-center.teachable.com/courses; https://catalystcenter.learnupon.com/store Plan of correction (POC)- LPM Smith advised that Joe from Our House and Fatima of My Place submit plan of corrections in a timely manner. There are concerns with the plan of correction from Nike of My Place and Devin of Our House not being submitted on time and verbally stating the plan of correction will be late. LPA Valerie Wilson has reminded them that the request for an extension for the plan of correction needs to be submitted and approved by CCL prior to the due date. LPM Smith advised if plan of correction is not received by the due date and there has not been an extension approved by CCL for the plan of correction due date the facility can be assessed civil penalties. CEO stated that Fatima's Administrator qualifications were turned in to CCL for My Place. Fatima will ensure that the plan of corrections are done properly. The current Administrator for Our House, Devin, will be separating employment from Our House at the end of the month and a new Administrator will be hired at Our House. The Board has done some interviews to fill the Administrator position. CEO complained that previous administrator packets took longs periods of time to approve and possibly Joe Mendoza can be designated during CCL's review of the administrator packet. RM Cook stated that the turnaround time for administrator qualifications review should be less than two weeks if the statement of qualification, and the correct documents are all provided in a timely manner to the LPA, and the candidate meets regulation requirements. If additional information is needed from the facility the turnaround time may be longer. Lack of trauma informed care- RM Cook advised that there have been substantiated complaints and case managements involving violations of personal rights that imply a lack of trauma informed care being provided by the facility staff. CEO stated their staff receive a lot of harm reduction and trauma informed care trainings. SOC Alicia Bernstein provided an overview of trauma informed care and provide resources. Child Trafficking Research and Policy Unit Analyst Leland Turner discussed harm reduction and provided resources and links for support. leeland.turner@dss.ca.gov (Continued to page 4) Pg 5 (Continued from page 4) The licensee is being requested to submit a Plan of Action for each of the focus areas above including the following: - How will the Board of Directors ensure appropriate administrative oversight is implemented? - Submit an updated LIC 500 for the hours that will be worked by the Administrator and facility staff -How will the Board review complaints, what information will be included in board meeting minutes, and how will the Board address issue client health and safety issues as they arise? - How will the facility ensure staff training is completed. - How will the facility ensure staff have knowledge of the program statement? - How will the facility ensure staff know how to implement appropriate crisis intervention? - How will the facility ensure the plan of corrections are completed and submitted to CCL by the due date? - How will the facility ensure trauma informed care is being provided? - How will the facility ensure the personal rights of clients are not being violated by staff? - How will the facility ensure that staff are adequately supervising the clients? The Plan of Action response will be submitted to CCL by August 29, 2023. If more time is needed to submit the plan of action or there are any questions, please contact LPA Valerie Wilson at valerie.wilson@dss.ca.gov or (951) 897-9155. A copy of this report was emailed to CEO Darryl Evey for electronic signature. The signed report will be placed in the facility file.

report_type: Facility Evaluation

met_with: Darryl Evey, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On December 12, 2023, at 2:00pm Licensing Program Analysts (LPAs), Val Wilson and Jason Dalton, met with My Place Group Home (YHPC), Administrator, Fatima Herrera, regarding a case management for a special incident report (SIR) dated November 12, 2023. The SIR was regarding Client 1 (C1) and Client 2 (C2) reporting Staff 1 (S1) had relations with C1. During this visit, the LPA's interviewed the Administrator. Additional information is needed at this time. If the LPA receives information that there were any violations to Title 22, the LPA will return at a later date to cite deficiencies. LPAs requested all documentation from S1's file and facility files regarding this SIR. Exit interview conducted and a copy of this report, LIC 811, and appeal rights was provided to Fatima Herrera.

visit_type: Case Management

met_with: Fatima Hererra


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst arrived to My Place CA-18W, Apple Valley CA 92307 and met with Shelter Manager, Nike Hanson to deliver an amended document initially delivered to the facility on March 12, 2024.

met_with: Shelter Manager, Nike Hanson


summary: Facility Evaluation

raw_content:
Narrative:
Pg 2 (Continued from page 1) ***created in error***

met_with: Sylvia Steinhart


summary: Facility Evaluation

raw_content:
Narrative:
On July 8, 2021 at 09: AM, Licensing Program Analyst's (LPA's) Anastasia Flores and Bobatunde Aborchie arrived and met with (RHYS) Run Away Homeless Youth Shelter, Facility Manager, Shelly Thomas. LPA's disclosed the purpose of the inspection and was granted entry into the facility by the Youth Advocate, Larieya Boyd. There was one staff and five clients present at the time of inspection. At 10: AM, the facility was toured inside and out with Ms. Boyd and Ms. Thomas. The home is a two-story residence with three bedrooms and four bathrooms. Downstairs: Dining room equipped with large table and 8 chairs There is a client bathroom downstairs next to family room, with a toilet and sink in operable working order. At 10: AM, hot water temperature was measured at 115.5 degrees and met the regulation requirement between 105 and 120 degrees. Family room was equipped with couches, coffee table, and a fireplace that was properly screened. Living room was equipped with adequate lighting, large sofa, coffee table, television and games. Open kitchen area is used for meal prepping. LPA observed pots, pans, lids, dishware, eating utensils, cooking utensils, cups, mugs and all the large kitchen appliances. All sharp knives are locked in a box and stored in staff office. There was an emergency supply of perishable foods located in the pantry. The trash can in the kitchen was observed to have no lid and LPAs advised the staff to have a lid placed on for health reasons. Staff informed LPAs that a client had broken the lid and it will be replaced immediately. First aid kit and locked box to keep medications and knives was observed in closet of staff office. There is a small refrigerator in the office to store refrigerated medications. There was also a bathroom located in the office, with operable shower, sink and toilet. Locked supply closet with cleaning supplies, brooms near the front door. Laundry room with washer and dryer are located downstairs. The door from laundry room to the garage is kept locked at all times and is used for storage. LPAs observed piles of donated clothes in the garage and it was noted to have the clothes put away or removed to trash as to not create such a clutter. Posted items included Personal Rights, Clients Grievance Procedures and Foster Care Ombudsman Poster. () Five of five client files were reviewed during the inspection. Staff files are kept at the human resources office down the street and will be reviewed at a later time. A review of administrative records indicate that the facility has paid their current licensing fees. There was no updated staff roster posted. Based on the facility inspection and file reviews this date, there was two deficiencies cited at this time; Title 22, Division 6, Chapter 1; Article 07. Section; 80088 (b) Furniture, fixtures, equipment and supplies; there were four window screens missing. A technical violation LIC TV was issued for the clean up of the clothes in the garage, damaged doors and holes in walls. An exit interview was conducted and a copy of this report, 809D and LIC 9102 and appeal rights was provided to the Shelly Thomas. Upstairs: Bedroom #1 designated for 2 clients. 2 twin size beds equipped with mattress pads and comforter. There is a closet available for client use. There was no screen on the window and the screen was sitting behind the bedroom door with a hole. Bedroom #2 designated for 2 clients. 2 twin size beds equipped with mattress pads and comforter, full dresser and closet available for client use. There was no screen on the window. Bedroom #3 designated for 2 clients. 2 twin size beds equipped with mattress pads and comforter, 2 full dressers and closet. The window was open with no screen on the window. There is a hallway restroom designated for male client use, with operable sink, toilet and shower. At 10: AM the hot water temperature was measured at 114.6 degrees and met the regulation requirement. There was an open Windex bottle under the sink, it was immediately removed and placed in the locked cabinet. LPA observed extra supplies of towels, comforters and linens. Intake/Therapy office equipped with desk, chairs, white boards, office supplies, operational supplies. Inside the staff office there is another bathroom utilized by female clients, the main lights are currently not working and need to be replaced. Smoke detectors in each bedroom were observed and carbon monoxide detector located upstairs, downstairs and in common areas are in working order. Posted items included Personal Rights, Clients Grievance Procedures and Foster Care Ombudsman Poster. Outdoor: Front yard is safe and free of hazards, there was trash observed on the side of house and was immediately removed by Ms. Thomas. Backyard is safe and free of hazards. There were table and chairs in a covered patio available for client use. LPAs observed a broken basketball court, informed by Ms. Thomas that it was broken due to the wind. It was discussed with facility representatives to have it removed for safety of clients. There was no pool or other bodies of water. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. LPAs observed four window screens missing, one in bedroom 1, bedroom 2, bedroom 3 and one in the upstairs female client's bathroom. There were window screens observed that need to be properly adjusted to the windows, one on the front outside window and one on the back-upstairs window intake/therapy office. There were two-bedroom doors with holes #1, #3 and one wall upstairs damaged that needed to be repaired. The pile of clothes in the garage are going to be cleaned up today per Ms. Thomas. There is adequate shelf and closet space for client's belongings. There are no guns or weapons in the facility as stated by Shelly Thomas. ()

visit_type: Annual

met_with: Shelly Thomas


summary: Facility Evaluation

raw_content:
Narrative:
On October 16, 2023 at 1:50 pm Licensing Program Analyst (LPA), Nicole Strickland, met with My Place Group Home Youth Homelessness Prevention Center, Administrator Fatima Herrera via telephone and Shelter manager Judith MendozA in person, to deliver a case management deficiencies report. Information obtained by Community Care Licensing (CCL) revealed there have been several requests for youth and facility records requested by CCL's Special Investigator (SI) Wilfredo Vasquez. The dates of these requests include September 22, 2023, October 4, 2023, and October 11, 2023. These requests were made to house manager Estephanie Fajardo, Shelter Manager Mendoza, and Director Steinhart by SI Vasquez. The facilities lack of response to the provide the requested documents is a violation of Interim Licensing Standards (ILS) standard 84544(d). Based on confidential interview and record review there is a preponderance of evidence the facility has not ensured requested documents were made available to SI. The facility is being cited for violation of Youth Homeless Prevention Center Interim Licensing Standard (ILS) 84544(d) INSPECTION AUTHORITY OF LICENSING AGENCY (d) The licensing agency shall have the authority to inspect, audit, and copy youth or youth homelessness prevention center records upon demand during normal business hours. Records may be removed if necessary for copying. Removal of records shall be subject to the requirements specified in Section 84570(e) and California Code of Regulations, Title 22 and Section 80066(c), which posed a potential health, safety and personal rights risk to children in care. A copy of the report was discussed and provided along with appeal rights to My Place Group Home Youth Homelessness Prevention Center, Shelter Manager Judith Mendoza.

met_with: Shelter Manager Mendoza


summary: Facility Evaluation

raw_content:
Narrative:
Facility Evaluation Report (LIC 809) created in error.

met_with: Shelter Manager, Nike Hanson,


summary: Facility Evaluation

raw_content:
Narrative:
On December 20, 2024, at 4: PM, Licensing Program Analyst (LPA), Val Wilson, met with My Place Group Home Youth Homelessness Prevention Center, Lead Facility Manager, Estephanie Fajardo, and via phone, Administrator, Nike Hanson, to deliver a case management deficiencies report. According to information obtained by Community Care Licensing (CCL), during the review of an incident that occurred on or around on Sunday, November 12, 2023, confidential interviews stated around 10:30AM, My Place received an allegation via a phone call that S1 allegedly was involved in a personal rights violation regarding C1. An initial report to CCL was not made within the next business day. CCL received a Special Incident Report (SIR) of this allegation on November 18, 2023, at 11: PM. On Wednesday, December 27, 2023, at 4: PM, CCL received a Law Enforcement SIR. Based on confidential interview and record review, the facility is being cited for violation of Interim Licensing Standards, YHPC, Article 06. Continuing Requirements, 84561(d) Reporting Requirements. A copy of the reports (LIC 809, LIC 809D, LIC 811) and appeal rights were reviewed, discussed, and provided to the facility representative.

met_with: Estephanie Fajardo and via phone, Nike Hanson


summary: Facility Evaluation

raw_content:
Narrative:
On October 23, 2024, at 10: AM, Licensing Program Analyst (LPA) Valerie Wilson arrived at My Place Youth Homelessness Prevention Center (YHPC) for pre-licensing inspection. LPA was greeted by Administrator, Nike Hanson and Lead Facility Manger, Estephanie Fajardo. The Director of Youth Shelters, Sylvia Steinhart arrived during the inspection. LPA was provided a tour of the home, both inside and out. The home is a single story building with four bedrooms, three full bathrooms, and attached garage. Administrator denies there are firearms or weapons in the facility. LPA completed a health and safety inspection and observed the following: *entry way of the home is equipped with an entry table with log guest sign in book. All required forms are posted; evacuation and disaster plan, personal rights, visitation policies, Ombudsman poster, fire clearance approval, and complaint hotline. All facility smoke detectors and carbon monoxide detectors are hard-wired in and are in appropriate working order *living room 1 has a television, gaming system, videos, sofa, and a fireplaces that is inaccessible to youth. living room 2 has a blackboard chalk wall, board games, art supplies, and a locked cabinet for stored hygiene products. *dining room has a table and six chairs, a standing popcorn machine, a covered waste bin, and a 5 gallon water dispenser for hot and cold water. The kitchen has a refrigerator/freezer, a covered waste bin, a microwave, a stove/oven, multiple cupboards (filled with plates, pots, pans, serving ware, and silverware), and sink. There is a freezer temperature is 0 degrees Fahrenheit and the attached refrigerator is 40 degrees Fahrenheit. *laundry room has a washer and dryer. There is a locked cupboard for disinfectants, cleaning solutions, poisons, and other items that could pose a danger if readily available to youth. ***Continued on page 2*** **Continued from page 1*** The complaint procedures and forms are accessible to the youth and public in a hanging wall file by the laundry room near the staff office, and a locked mailbox for the youth to anonymously provide a complaint is below the grievance forms. The administrator has the key to check the box and follow the procedure. *bathroom 2 is a youth bathroom with a sink, toilet, and shower. *garage is locked and contains a deep freezer located in the garage that is 0 degrees Fahrenheit. Youth files will be locked in a cabinet in the locked garage in addition to the electronic Apricot youth files. An emergency power portable backup generator is in the locked garage with the manufacturer's operating instructions, and this is documented on the disaster plan. *bedroom 1 is utilized as a staff office and contains nonperishable emergency supplies, storage and preservation of medication to be kept in a locked closet in a locked safe, including the storage of medications that require refrigeration, along with the documentation for centrally stored medication. A cordless phone is kept on a charging station in the staff office and is accessible for youth to use privately in the home. First aid supplies are maintained in the staff office and in the facility vehicle. Staff files will be kept in a locked cabinet in the staff office that remains locked. Should youth entrust personal property to the licensee, items will be locked in the closet. The written disaster and mass casualty plan of action is located in the staff office with the emergency provisions. A binder to contain the fire drills is maintained in the staff office. There are three desks, a file cabinet, and a Wi-Fi router. *bathroom 1 is a staff bathroom and has a bathtub, shower, sink, and toilet. Water temperatures were measured 105.9 degrees Fahrenheit. *bathroom 3 is a youth bathroom with a sink, toilet and shower/tub. Water temperatures were measured 106.1 degrees Fahrenheit. There is a linen closet that has the towels and other linens stored. *bedroom 2, 3 and 4 are youth bedrooms and arranged so that no more than two youth share a room, and there was one youth per bed. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. ***Continued on page 3*** **Continued from page 2*** There was adequate drawer and closet space for youth belongings; 2 chests of drawers in each room. All beds contained a mattress, mattress pad, sheets, comforter, and pillows. *Yards- front yard had a cement walkway, driveway, and U-shaped drive with an awning that have rolling gates that exit to the street. The main water shut off is next to the front yard gate. The backyard can be entered from inside the home through a sliding door or a gate from the side yard. Gas and electrical shut off are on the side of the house and clearly marked. There is a ping pong table, kick boxing stand, punching bag, beanbag toss game, and various outdoor balls and games. There are bushes and trees located along the gated backyard. The side yard is dirt and separated by the garage and a fence. Facility grounds are clean and free of debris and observable hazards. There is adequate indoor and outdoor activity space. Based on LPA's observations, updates are required for a definitive plan of operation/program statement. At this time the physical plant of this facility is within the YHPC home regulations. LPA will review plan of operation/program statement revisions which will be provided no later than October 25, 2024. LPA will then submit the application forward to the Licensing Program Manager for review. After a final file review, the facility will be submitted for licensure. During the meeting component II and component III were discussed. LPA discussed Post Licensing visits that Community Care Licensing (CCL) may provide, solutions to problematic areas, overview of Title 22, YHPC regulations, personal fingerprint requirements, abuse reporting requirements, and licensing fees. LPA communicated about LPA responsibility; Special Incident reporting requirements and AB388 reporting. The license will expire one year from effective date. Facility will be licensed for a capacity of 6 youth and only accepts ambulatory youth. Exit interview conducted a copy of this report was provided to Nike Hanson and Sylvia Steinhart.

visit_type: Prelicensing

met_with: Nike Hanson


summary: Facility Evaluation

raw_content:
Narrative:
On February 19, 2025, at 9: AM, Licensing Program Analyst (LPA) Valerie Wilson arrived at My Place Youth Homelessness Prevention Center (YHPC) for post-licensing inspection. LPA was greeted by Administrator (ADM), Nike Hanson. Facility is licensed for a capacity of 6 youth and only accepts ambulatory youth. During the inspection there was Client 1 (C1) and the ADM at the facility; both ADM and C1 were interviewed. LPA was provided a tour of the home, both inside and out. The home is a single story building with four bedrooms, three full bathrooms, and attached garage. Administrator denies there are firearms or weapons in the facility. LPA completed a health and safety inspection and observed the following: *entry way of the home is equipped with an entry table with log guest sign in book. All required forms are posted; evacuation and disaster plan, personal rights, visitation policies, Ombudsman poster, fire clearance approval, and complaint hotline. All facility smoke detectors and carbon monoxide detectors are hard-wired in and are in appropriate working order *living room 1 has a television, gaming system, videos, sofa, and a fireplaces that is inaccessible to youth. Living room 2 has a blackboard chalk wall, board games, art supplies, and a locked cabinet for stored hygiene products. *dining room has a table and six chairs, a standing popcorn machine, a covered waste bin, a covered recyclable bin, and a 5-gallon water dispenser for hot and cold water. The kitchen has a refrigerator/freezer, a covered waste bin, a microwave, a stove/oven, multiple cupboards (filled with plates, pots, pans, serving ware, and silverware), and sink. There is a freezer temperature is 0 degrees Fahrenheit and the attached refrigerator is 34 degrees Fahrenheit. *laundry room has a washer and dryer. There is a locked cupboard for disinfectants, cleaning solutions, poisons, and other items that could pose a danger if readily available to youth. ***Continued on page 2*** **Continued from page 1*** The complaint procedures and forms are accessible to the youth and public in a hanging wall file by the laundry room near the staff office, and a locked mailbox for the youth to anonymously provide a complaint is below the grievance forms. The administrator has the key to check the box and follow the procedure. *bathroom 2 is a youth bathroom with a sink, toilet, and shower. *garage is locked and contains a deep freezer located in the garage that is 0 degrees Fahrenheit. Youth files are locked in a cabinet in the locked garage in addition to the electronic Cap60 youth files. An emergency power portable backup generator is in the locked garage with the manufacturer's operating instructions, and this is documented on the disaster plan. *bedroom 1 is utilized as a staff office and contains nonperishable emergency supplies, storage and preservation of medication to be kept in a locked closet in a locked safe, including the storage of medications that require refrigeration, along with the documentation for centrally stored medication. A cordless phone is kept on a charging station in the staff office and is accessible for youth to use privately in the home. First aid supplies are maintained in the staff office and in the facility vehicle. Staff files are kept in a locked cabinet in the staff office that remains locked. Should youth entrust personal property to the licensee, items will be locked in the closet. The written disaster and mass casualty plan of action is located in the staff office with the emergency provisions. A binder to contain the fire drills is maintained in the staff office. There are three desks, a file cabinet, and a Wi-Fi router. *bathroom 1 is a staff bathroom and has a bathtub, shower, sink, and toilet. Bathroom 3 is a youth bathroom with a sink, toilet and shower/tub. Water temperatures were measured 111.7 degrees Fahrenheit. There is a linen closet that has the towels and other linens stored. *bedroom 2, 3 and 4 are youth bedrooms and arranged so that no more than two youth share a room, and there was one youth per bed. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. ***Continued on page 3*** **Continued from page 2*** There was adequate drawer and closet space for youth belongings; 2 chests of drawers in each room. All beds contained a mattress, mattress pad, sheets, comforter, and pillows. *Yards- front yard had a cement walkway, driveway, and U-shaped drive with an awning that have rolling gates that exit to the street. The main water shut off is next to the front yard gate. The backyard can be entered from inside the home through a sliding door or a gate from the side yard. Gas and electrical shut off are on the side of the house and clearly marked. There is a ping pong table, kick boxing stand, punching bag, beanbag toss game, and various outdoor balls and games. There are bushes and trees located along the gated backyard. The side yard is dirt and separated by the garage and a fence. Facility grounds are clean and free of debris and observable hazards. There is adequate indoor and outdoor activity space. LPA conducted file review for C1, ADM, Staff 2, Staff 3, Staff 4, and Staff 5. LPA reviewed the December 17, 2024, board meeting minutes. Minutes did not reflect the board's discussion of the documents specified in Health and Safety Code Section 1520.1(f) or reflect the discussion of specified documents and the facility's operation. Based on observation, interview, and record review, the licensee did not comply with Title 22, Division 6, Chapter 5, Article 06. Continuing Requirements 84063(a)(9) Operational Requirements, which poses/posed a potential health, safety or personal rights risk to persons in care, resulting in a Type B violation. Exit interview conducted with the ADM. A copy of this report, 809D, LIC 811, and appeal rights was explained and provided to Nike Hanson.


summary: Facility Evaluation

raw_content:
Narrative:
**This is an amended report of the report issued on 10/16/25 to reflect the annual inspection was announced due to the temporary closure of the facility.** On October 16, 2025, at 10: AM, Licensing Program Analysts (LPAs) Raina Perez-Diaz and Matthew Dorantes, arrived at My Place Youth Homelessness Prevention Center (YHPC) for an annual announced required inspection. LPA was greeted by Administrator (ADM), Samantha Fuentes. Facility is licensed for a capacity of 6 youth and only accepts ambulatory youth. During the inspection there were zero clients in care at the facility. LPA was provided a tour of the home, both inside and out. The home is a single story building with four bedrooms, three full bathrooms, and attached garage. Administrator denies there are firearms or weapons in the facility. LPA completed a health and safety inspection and observed the following: The entry way of the home is equipped with an entry table with log guest sign in book. All required forms are posted; evacuation and disaster plan, personal rights, visitation policies, Ombudsman poster, fire clearance approval, and complaint hotline. All facility smoke detectors and carbon monoxide detectors are hard-wired in and are in appropriate working order. The living room 1 has a television, gaming system, videos, sofa, and a fireplace that is inaccessible to youth. Living room 2 has a blackboard chalk wall, board games, art supplies, and a locked cabinet for stored hygiene products. The dining room has a table and six chairs, a standing popcorn machine, a covered waste bin, a covered recyclable bin, and a 5-gallon water dispenser for hot and cold water. The kitchen has a refrigerator/freezer, a covered waste bin, a microwave, a stove/oven, multiple cupboards (filled with plates, pots, pans, serving ware, and silverware), and sink. **Continued on page 2** The laundry room has a washer and dryer. There is a locked cupboard for disinfectants, cleaning solutions, poisons, and other items that could pose a danger if readily available to youth. The complaint procedures and forms are accessible to the youth and public in a hanging wall file by the laundry room near the staff office, and a locked mailbox for the youth to anonymously provide a complaint is below the grievance forms. The administrator has the key to check the box and follow the procedure. The bathroom #2 is a youth bathroom with a sink, toilet, and shower. The garage is locked and contains a deep freezer. Youth files are locked in a cabinet in the locked garage. Bedroom #1 is utilized as a staff office and contains nonperishable emergency supplies, storage and preservation of medication to be kept in a locked closet in a locked safe, including the storage of medications that require refrigeration, along with the documentation for centrally stored medication. A cordless phone is kept on a charging station in the staff office and is accessible for youth to use privately in the home. First aid supplies are maintained in the staff office. Staff files are kept in a locked cabinet in the staff office that remains locked. Should youth entrust personal property to the licensee, items will be locked in the closet. The written disaster and mass casualty plan of action is located in the staff office with the emergency provisions. A binder to contain the fire drills is maintained in the staff office. The facility last held an emergency practice drill on January 2, 2025. Due to the current closure in April of 2025, no drills have taken place. ADM reported the facility conducts emergency drills every three months.. Due to the current facility status no violation was given. ADM is aware once the facility reopens an emergency drill needs to be conducted. ADM understood. There are three desks, a file cabinet, and a Wi-Fi router also in the office. Bathroom 1 is a staff bathroom and has a bathtub, shower, sink, and toilet. Bathroom 3 is a youth bathroom with a sink, toilet and shower/tub. Water temperatures were measured 117.5 degrees Fahrenheit. There is a linen closet that has the towels and other linens stored. Bedroom 2, 3 and 4 are youth bedrooms and arranged so that no more than two youth share a room, and there was one youth per bed. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. **Continue on LIC 812-C** There was adequate drawer and closet space for youth belongings; 2 chests of drawers in each room. All beds contained a mattress, mattress pad, sheets, comforter, and pillows. The yards- front yard had a cement walkway, driveway, and U-shaped drive with an awning that have rolling gates that exit to the street. The main water shut off is next to the front yard gate. The backyard can be entered from inside the home through a sliding door or a gate from the side yard. Gas and electrical shut off are on the side of the house and clearly marked. There is a ping pong table, kick boxing stand, punching bag, beanbag toss game, and various outdoor balls and games. There are bushes and trees located along the gated backyard. The side yard is dirt and separated by the garage and a fence. Facility grounds are clean and free of debris and observable hazards. There is adequate indoor and outdoor activity space. Based on the facility inspection, the current census being zero, and the facility's temporary closure, LPA did not review any staff or client files or conduct interviews at the time of this inspections and there are no deficiencies cited at this time. LPA informed the Licensee to notify the Department at the time of receiving a client in care. The Department will return to conduct staff and client file reviews and ensure the facility has conducted an emergency drill. Though this item needs to be corrected the Director and ADM was advised due to the temporary closure of the facility no violation will be given; however, should the facility situation change they were advised corrections will need to be completed right away. An exit interview was conducted, a copy of this report and appeal rights was provided to Director of Youth Shelters, Sylvia Steinhart.


facility_name: NOAH'S ANCHORAGE YMCA

summary: Facility Evaluation

raw_content:
Narrative:
On December 14, Licensing Program Analyst (LPA) Enrique Hernandez conducted a Case Management Annual/Required inspection, at Noah's Anchorage Youth Shelter LPA met with Amy Buckner Facility Administrator (FA). This is a five bedroom, two and half bath, two story family residence that includes a living room, dining area, kitchen, laundry area, a therapy room and a staff office. No clients are residing in the home during the time of the inspection. There was no swimming pool or bodies of water on the premises. FA states there are no guns or weapons in the home. During the time of the inspection LPA observed the following: Bedroom #1(downstairs) is occupied by one client. it has two twin size beds, adequate closet and drawer space. Bedroom #2(downstairs) is Vacant. It has two twin size beds, adequate closet and drawer space. Bedroom #3(upstairs) is being used as the facility administrator's office. There are two desk three monitors and keyboard on each desk. Bedroom #4(upstairs) is occupied by one client. It has two twin size beds, adequate closet and drawer space. Bedroom #5(upstairs) is Vacant. It has two twin size beds, adequate closet and drawer space [see LIC Confidential Names List form (LIC811), dated 12/15/2021, for names]. LPA observed non-perishable foods enough for one week and perishable food for two days. Nutritious snacks are available in the facility. Facility is clean, safe, sanitary and in good repair. Passageways, stairways, inclines, ramps, and open porches are unobstructed. Rules, regulations, licenses, emergency disaster plan and personal rights are posted at the facility. Continue on LIC 809-C Menu is posted in the kitchen. Hazardous and cleaning solutions, disinfectants, poisons, medication and sharp knives are inaccessible to the clients. Meds are locked and accessible only to employees supervising stored medications. Home has working smoke alarms, one carbon monoxide detector and working fire extinguishers at the time of this visit. Client Bedrooms are inspected and found to be in compliance. The facility has a working telephone. There is no bodies of water on the premises. Children in care are supervised & protected at all times. Facility personnel are instructed to report violations of personal rights. Children are accorded dignity in personal relationships with staff and others. Children live in a safe, healthy, comfortable facility and are treated with respect. Children can contact the licensing agency or Foster Care Ombudsperson in confidence without threats or punishment for making complaints. Children are encouraged to attend school, extracurricular, cultural, and personal enrichment activities. Facility reports client injuries requiring medical treatment. The first aid kit is complete with scissors, tweezers, thermometer, gauzes, antiseptic and 1st Aid Manual. Fire extinguishers are available and fully charged. Cleaning solution/toxins are inaccessible. There are extra linens, and hygiene supplies available. The yard and surrounding areas are free and clear of debris. Carbon monoxide detector, and all smoke detectors are fully functional. The facility is observed in overall good repair and working order. Per California Code of Regulations, Title Regulations, Division 6, Chapters 1 & 5,there are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report was left with the Facility Administrator (FA).

met_with: Facility Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On December 14, Licensing Program Analyst (LPA) Enrique Hernandez conducted a Case Management Annual/Required inspection, at Noah's Anchorage Youth Shelter LPA met with Amy Buckner Facility Administrator (FA). This is a five bedroom, two and half bath, two story family residence that includes a living room, dining area, kitchen, laundry area, a therapy room and a staff office. No clients are residing in the home during the time of the inspection. There was no swimming pool or bodies of water on the premises. FA states there are no guns or weapons in the home. During the time of the inspection LPA observed the following: Bedroom #1(downstairs) is occupied by one client. it has two twin size beds, adequate closet and drawer space. Bedroom #2(downstairs) is Vacant. It has two twin size beds, adequate closet and drawer space. Bedroom #3(upstairs) is being used as the facility administrator's office. There are two desk three monitors and keyboard on each desk. Bedroom #4(upstairs) is occupied by one client. It has two twin size beds, adequate closet and drawer space. Bedroom #5(upstairs) is Vacant. It has two twin size beds, adequate closet and drawer space [see LIC Confidential Names List form (LIC811), dated 12/15/2021, for names]. LPA observed non-perishable foods enough for one week and perishable food for two days. Nutritious snacks are available in the facility. Facility is clean, safe, sanitary and in good repair. Passageways, stairways, inclines, ramps, and open porches are unobstructed. Rules, regulations, licenses, emergency disaster plan and personal rights are posted at the facility. Continue on LIC 809-C Menu is posted in the kitchen. Hazardous and cleaning solutions, disinfectants, poisons, medication and sharp knives are inaccessible to the clients. Meds are locked and accessible only to employees supervising stored medications. Home has working smoke alarms, one carbon monoxide detector and working fire extinguishers at the time of this visit. Client Bedrooms are inspected and found to be in compliance. The facility has a working telephone. There is no bodies of water on the premises. Children in care are supervised & protected at all times. Facility personnel are instructed to report violations of personal rights. Children are accorded dignity in personal relationships with staff and others. Children live in a safe, healthy, comfortable facility and are treated with respect. Children can contact the licensing agency or Foster Care Ombudsperson in confidence without threats or punishment for making complaints. Children are encouraged to attend school, extracurricular, cultural, and personal enrichment activities. Facility reports client injuries requiring medical treatment. The first aid kit is complete with scissors, tweezers, thermometer, gauzes, antiseptic and 1st Aid Manual. Fire extinguishers are available and fully charged. Cleaning solution/toxins are inaccessible. There are extra linens, and hygiene supplies available. The yard and surrounding areas are free and clear of debris. Carbon monoxide detector, and all smoke detectors are fully functional. The facility is observed in overall good repair and working order. Per California Code of Regulations, Title Regulations, Division 6, Chapters 1 & 5, there are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report was left with the Facility Administrator (FA).


summary: Facility Evaluation

raw_content:
Narrative:
On December 15, 2021, at 11:30 am, Licensing Program Analyst (LPA) Enrique Hernandez conducted a Case Management other - Incident inspection at the above facility, and met with Facility Administrator (FA) Amy Buckner, who granted access into the facility in response to a CBCB Possible Match Investigation pertaining to a Child Abuse Central Index (CACI) Possible Match on Staff #1 (S1). [see LIC Confidential Names List form (LIC811), dated 12/15/2021, for names]. LPA interviewed FA who stated that S1 applied on 07/12/2021 to work on the facility, but was never cleared and never came to work at the facility. FA disassociate Staff #1 from the facility on 12/15/2021. FA provided additional emails that she had with guardian. At this time, the Department has made no determination on whether a violation has occurred. Per California Code of Regulations, Title Regulations, Division 6, Chapters 1 & 5, there are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report was left with the Facility Administrator (FA).


summary: Facility Evaluation

raw_content:
Narrative:
On 10/12/2023, Licensing Program Analyst (LPA) Bernice Karnsrithong arrived at the facility for the purpose of conducting an annual inspection. LPA met with Karen Arellano, Lead Residential Caseworker who granted tour and access to the facility. The facility is licensed to provide care and supervision to run away and homeless youth for up to ninety (90) days for children ages twelve (12) to seventeen (17) years old, ambulatory only. During the visit there were no clients present in the facility. The facility is located in a residential area. The facility is a two (2) story home. The first floor has the staff office and two (2) client bedrooms, one (1) client bathroom, staff bathroom, kitchen/dining area, living room and garage. First floor has access to the garage which has been converted into client's study area, laundry room and storage. The garage area has storage for soap, laundry and cleaning supplies. There is also a refrigerator in the garage that is being utilized to store extra perishable food items. The kitchen is equipped with a stove, sink, and kitchen utensils. All sharp items are locked and inaccessible to clients. Menus are posted in the kitchen. There are snacks and fruits readily available for the clients to eat in kitchen counter. There is sufficient perishable and non-perishable food items in the facility. There is a fire extinguisher located next to the kitchen/dining area. The living room has a couch and television. Clients' rights are posted in the first floor hallway. There is a private room being utilized for private meetings, phone calls and intake located on the first floor. The staff office has locked cabinets used to store disinfectants, toiletries, and client medications. Staff files are stored in the staff office room. During the visit, LPA Karnsrithong conducted four (4) staff record reviews and two (2) staff interviews. There were no deficiencies cited at this time. Exit interview was conducted and a copy of this report will be provided to the facility. Client record review and interviews will be completed on a later date.

met_with: Karen Arellano


summary: Facility Evaluation

raw_content:
Narrative:
On 10/13/2023, Licensing Program Analyst (LPA) Bernice Karnsrithong arrived at the facility for the purpose of conducting an annual inspection. LPA Karnsrithong met with Vanessa Loza, Program Director who granted tour and access to the facility. During the visit, no clients were present in the facility. There is a total of four (4) fire extinguishers throughout the facility. There are four (4) working fire/carbon monoxide alarms in the facility. A disaster/evacuation plan is posted in the facility. Staff conducts emergency drills once a month. There is an Automated External Defibrillator machine located in the staff office to be used in case of an emergency. All staff have updated First Aid/CPR certification. First aid kit is supplied with scissors, tweezers, thermometer, gauzes, antiseptic, bandages and other medical supplies and is available to use in case of an emergency. All staff are trained with care and supervision, child abuse reporting, medical care administration, trauma informed care and other required trainings for congregate care staff. Facility personnel are instructed to report violations of personal rights and child abuse. Children are accorded with their personal rights and needs. Children live in a safe, healthy, comfortable facility and are treated with respect. Staff coordinate and connect clients with appropriate resources and referrals to local government agencies and organizations to help youth secure a suitable placement. There are a total of four (4) client bedrooms in the facility; two (2) bedrooms are located on the first floor and two (2) bedrooms are located on the second floor. Each bedroom has two (2) twin sized beds, pillows, sturdy mattresses and clean linens. Each bedroom has sufficient storage and adequate lighting. There is a desk and chair for youth to use inside the bedroom. There are (2) full sized bathrooms clients can use in the facility. Both bathrooms are equipped with a working toilet, shower and sink. Faucets used by clients for personal use have hot water. All bathrooms were observed to be clean and in good working condition. (Page 1 of 2) There is sufficient supplies of toiletries and hygiene products for the clients. The outdoor space has recently been remodeled. The outdoor space is fenced in and was observed to be free of flies and other insects. All outdoor and indoor passageways were observed to be free of debris and obstruction. All window screens were observed to be clean and in good condition during the visit. There were no deficiencies cited at this time. LPA Karnsrithong concluded the required annual inspection for the facility. Exit interview was conducted with the Program Director and a copy of this report was provided to the facility. (Page 2 of 2)

met_with: Vanessa Loza


summary: Facility Evaluation

raw_content:
Narrative:
On 1/28/25, Licensing Program Analyst (LPA)Nancy O'Connell conducted an Annual/Required inspection, at Noah's Anchorage Youth Shelter. LPA met with Vanessa Loza, Facility Administrator (FA). This is a four bedroom, two and half bath, two story family residence that includes a living room, dining area, kitchen, laundry area, a therapy room, two staff offices and a private room used for confidential phones calls/therapy sessions. No clients are residing in the home during the time of the inspection. There is no swimming pool or body of water on the premises. There are no guns or weapons in the home. Required postings are visible in the main hallway. There are 4 fire extinguishers observed and fully charged. Carbon monoxide/fire alarms were tested and found to be operational during inspection. LPA confirmed criminal record clearances for all staff listed on the LIC500. LPA confirmed that a change of administrator was completed within the last year and that all required documents have been reviewed and approved with the Department. During the time of the inspection LPA observed the following: Bedroom #1(downstairs) has two twin size beds, adequate closet and drawer space, a desk and closet. Bedroom #2(downstairs) has two twin size beds, adequate closet/drawer space and a closet. Bedroom #3(upstairs) has two twin size beds, adequate closet/drawer space and a closet Bedroom #4(upstairs) has two twin size beds, adequate closet/drawer space and a closet Continued on LIC809C Staff office (upstairs) is being utilized as a staff office and has two desks, two computers, file cabinets. It is used as the administrators office as well as a meeting room with clients/families. Living room (downstairs): enough seating for five individuals, tv, movies, games Kitchen: refrigerator, stove, microwave, available snacks on the counter, locked/secured trashdrawer, locked knife drawer was observed adjacent to the stove and contained an inventory sheet with knife count. Refrigerator was stocked with fresh food, and kept at required temp. Pantry closet ((located in hallway): this closet was stocked with non-perishable items. Bathroom (downstairs): contained a standing shower, sink, toilet, hand-wash items. Temperature was found to be within required limits. Half bathroom (downstairs): located in main hallway: used primarily for staff but can be used for clients when needed. There is a door that leads outside of the facility located next to this bathroom. Garage (attached): there is a garage that is utilized as a multipurpose/activity room. There are large couches, long tables for gathering, a laundry area, three computer stations, a closet filled with arts/crafts tools, and locked cabinets that hold detergent products. There is a door that leads to the back yard. Backyard: there are two gates that allow for entrance to the backyard, but one is kept locked for safety, while the other gate located near the main entrance of the facility is always kept unlocked. There are multiple tables available for leisure, a BBQ that is kept secure while not in use, and areas used for gardening. Front yard: the front of the facility is gated, and has a ramp leading to the front entrance. LPA conducted 2 file reviews for S1 and S, [see LIC Confidential Names List form (LIC811), dated 1/28/25, for names]. Children in care are supervised & protected at all times. Facility personnel are instructed to report violations of personal rights. Children are accorded dignity in personal relationships with staff and others. Children live in a safe, healthy, comfortable facility and are treated with respect. Children are encouraged to attend school, extracurricular, cultural, and personal enrichment activities. Due to time constraints, LPA will return to complete the Annual Review. Per California Code of Regulations, Title Regulations, Division 6, Chapters 1 & 5, there are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report was emailed to the FA.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/2/25 9:15AM Licensing Program Analyst (LPA) Nancy O'Connell made an unannounced visit to the above-listed facility for the purpose of conducting a Case Management - Annual Continuation inspection. LPA was met by Vanessa Loza, Facility Administrator (FA). LPA was informed that there are 3 clients in care at this time. LPA met with FA and informed them that the purpose of the visit is to complete the Annual Inspection. LPA inquired about the current census, requested the Register of Clients, and a staff roster. LPA requested to conduct interviews and reviews of selected staff files. See LIC811, dated 10/2/25, for names. Client/Staff Interviews: LPA conducted a confidential interview with: RS1, RS2, and C1. C2, and C3 declined to be interviewed. Client/Staff File reviews: LPA conducted file reviews for: RS1, RS2, C1, and C2. During the time of inspection, LPA completed the following sections of the Care Tool: Staff records, and client records. Records are maintained in paper charts and electronically. Per California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulation, there are no deficiencies cited during this inspection. An exit interview was conducted, and staff was informed that the annual inspection was complete. A copy of this report was sent to the administrator via email.


summary: Facility Evaluation

raw_content:
Narrative:
On 1-22-26 at 12:00pm Licensing Program Analyst (LPA) Nancy O'Connell made an unannounced visit inspection to Noah's Anchorage YMCA for the purpose of conducting a Case Management inspection. LPA met with Vanessa Loza, Facility Administrator (FA), who granted access to the facility. On 12-17-25, Community Care Licensing Division (CCLD) received a Serious Incident Report (SIR). The SIR communicated that on 12-12-25, an incident involving two youth (C1 and C2) resulted in C1 alleging that C2 touched her inappropriately during the evening of 12-12-25. The incident was reported to occur while both youth were sitting together on the couch in the facility living room. LPA interviewed facility staff who reported that the incident was addressed upon C1's disclosure, and C2 was discharged immediately from the facility as a result of the report. During the course of this investigation, LPA O'Connell reviewed facility footage related to the time of incident and did not observe any physical or inappropriate contact between youth. LPA observed that facility staff were present and available within the facility office during the time of incident and checked in on the youth shortly after the alleged incident. Further, during the time of inspection, LPA reviewed facility supervision policies and interviewed staff about policies, and found that staff adhered to the established supervision policies and procedures which require staff to check in on youth as needed. Based on California Code of Regulations, there is no evidence of a violation. There were no deficiencies cited during today's inspection. This case management incident is closed. Exit interview was conducted and a copy of this report was emailed to the administrator of the facility.


facility_name: OUR PLACE YOUTH SHELTER

summary: Facility Evaluation

raw_content:
Narrative:
On February 26, 2024 at 11:00AM, Licensing Program Analyst (LPA) Adaleyci Caballero met with applicant Fatima Herrera via Microsoft Teams Meeting for a Component II of the application process. Lpa a. Caballero went over revisions needed for the application prior to license. Lpa a. Caballero provided Administrator with a copy of the LIC 184-Notice of Incomplete Application and additional correspondence to assist with the revisions needed to the application. A copy of this report was provided to applicant via email. Original signed copy of this report will be placed in the facility file.

met_with: Administrator-Fatima Herrera


summary: Facility Evaluation

raw_content:
Narrative:
On May 29, 2024, at 12:50PM, Licensing Program Analysts (LPAs) Adaleyci Caballero and Rachel Vanegas arrived at Our Place Youth Homelessness Prevention Center-Group Home for a scheduled pre-licensing inspection. LPAs were met at the facility by Administrator Fatima Herrera, Director of Youth Shelters Sylvia Steinhart, and Shelter Manager Nike Hanson. This facility is applying for a license to operate a Homeless Center with a capacity of six clients. The facility was toured both inside and out with the applicants. The home is set up as follows: · Bedroom #1- It consisted of a single bed. The bed had linen, comforters, and pillows. It will sleep one client. · Bedroom #2- It consisted of two single beds. The beds had linen, comforters, and pillows. It will sleep two clients. · Bedroom #3- It consisted of a single bed. The bed had linen, comforters, and pillows. It will sleep one client. · Bedroom #4- It consisted of two single beds. The bed had linen, comforters, and pillows. It will sleep two clients. The backyard where clients will have access to play is completely fenced and free of weed and dirt residue. There is no pool or other bodies of water. LPAs observed safe, clean, and age-appropriate educational supplies and games for the age group of clients to be cared for inside facility. LPAs did not observe outdoor activity equipment for clients to be cared for. Prior to licensure the following items are needed: 1. First Aid kit with thermometer with all required items. 2. Adequate outdoor equipment for the clients to serve. A Component III Orientation needs to be scheduled when the corrections are completed. Based on the inspection of the home on this date, the facility did not appear to be in compliance with the Community Care Licensing Division Title Laws and Regulations. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. Applicants were made aware that clients of opposite sex, over the age of 5, require separate bedrooms. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawers and closet space for clients' belongings. Facility is composed of a staff office with a desk, storage closet, and bathroom for staff use. There is a living room area for client activities and a family room with a television for screen time. There is also an intake room for admission purposes and CFS meetings and a room designated for donations in the west side part of the facility. Lastly, a laundry room. All hazardous items will be stored in the staff office. The medications and confidential files will be locked and stored in the staff office. Cleaners/chemicals will be locked and stored in the staff office inaccessible to clients in care. Sharp objects were observed locked in staff office. First Aid kit at the facility was missing a thermometer. There are no guns or weapons as stated by Administrator Fatima Herrera. The hot water was at a temperature of 116.2 degrees Fahrenheit. Proper storage of all food was observed. The kitchen had a trash can with lid for waste. The Facility Sketch, Emergency Disaster Plan, Personal Rights, and Visitation policies were posted at this time. The garage was separated from the house with an external door and will be utilized for storage only.


summary: Facility Evaluation

raw_content:
Narrative:
On this date, Licensing Program Analyst (LPA) Adaleyci Caballero met with Administrator Fatima Herrera to discuss revisions of the Program Statement. Original signed document will be placed in the facility file.


summary: Facility Evaluation

raw_content:
Narrative:
On this date, Licensing Program Analyst (LPA) Adaleyci Caballero met with Administrator Fatima Herrera to discuss revisions of the application Program Statement. Original signed document will be placed in the facility file.


summary: Facility Evaluation

raw_content:
Narrative:
On August 26, 2024, at 3:00PM, Licensing Program Analysts (LPAs) Adaleyci Caballero and Valerie Wilson and Licensing Program Manager (LPM) Jennifer Smith met with Applicant Fatima Herrera and Director of Youth Shelters Sylvia Steinhart via Microsoft Teams Meeting for a review of Our Place Program Statement. LPM went over revisions needed for the Program Statement prior to licensure and the revisions are due no later than September 10, 2024. The following corrections need to be made: Forms: LIC 500 does not show 24-hour coverage for Sunday. LIC 400 - Affidavit for Client Cash Resources needs to be completed. LIC 9106 - Group Home Program Statement page 5 needs to be signed by administrator, page 10 need to correct ratio from 1:1 to 6 to 1:6 and page 12 needs to be signed by administrator. Program Statement - Part III Program Narrative: Section 3: Purpose Methods and Goals How will results or outcomes be measured? Section 4: Planned Activities/ Use of Community Resources Open Arms Drop-In Center states youth will volunteer, this cannot be mandatory that they volunteer. This section needs to be revised. Section 6: Medical/Dental Identify what position(s) will be responsible for dispensing medications. Section 7: Transportation Describe arrangements for transporting children to and from school. Section 8: Admission/ Intake Add information from ILS 84568(c) to this section. page 21 - States clients accepted through Children Family Services or Probation, YHPC's cannot accept this type of placement. page 23 - Fourth box states if coming from CFS........needs to be corrected. page 24 - 3.a. if investigation finds evidence of abuse, management will make a report. This statement needs to be amended the report should be made if there is a disclosure or possibility and should not have to wait for investigation.. page 34 - Third paragraph last sentence - separate by commas not clear. page 40 - Cannot have blanket search policy, what is tum? page 42 - What is discharge CY? page 43 - Is this part of the policy on page 42, has a new signature area? Section 11: Visitation Rules and Policy Page 54 - Add visiting hours, or document if visiting can occur at any time of day and night. Section 12: House Rules page 57 - C. Personal Hygiene - tattoos must be covered, you cannot have a blanket statement. page 60 - III b. Incomplete sentence correction needed. Section 14: Expand on the techniques of group and individual management, methods for de-escalating volatile situations, alternate methods for of handling aggressive and assaultive behavior, techniques for returning the child to the planned activity following the emergency intervention and include the name and qualifications of the individual who designed the emergency intervention plan. Section 17: Handling Children's Funds, Allowances, and Salaries Add that the personal funds will be locked and kept on grounds. Section 19: Nutrition/ Sample Menu Are there any alternative meals if the clients do not want what is being served? Section 21: Staff Schedule The weekly schedule (groups and activities) July 2024 is in this section, this is not the correct area, where should this go? - Per Sylvia Steinhart this page was moved to the planned activities section. Section 22: Staff Qualifications Add resume and job application for administrator, not included. Section Job Descriptions Job description minimum qualifications do not include licenses/certificates required by the profession, needs to be added. Section 24: Inservice Training for Staff Page In House Service Training - states as per Title 22 all staff requires 10 hours initial and 30 hours formal training, this is not in Title 22. Page 107- heading states Training Topics as per 87065.1 - this is not the correct section. 87065.1 refers specialized in-home health care. The annual training curricula needs to be added. Section 25: Administration Names and positions of paid staff who are board members or related to board members needs to be added or a statement that this is not applicable. Section 28: Facility Sketch The number of children per bedroom on the facility sketch needs to be added. A copy of this report was provided to applicant Fatima Herrera via email. Original signed copy of this report will be placed in the facility file.


summary: Facility Evaluation

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Narrative:
On January 10, 2025, at 10:50AM, Licensing Program Analyst (LPA) Val Wilson arrived at Our Place Youth Shelter Youth Homelessness Prevention Center-Group Home for an unannounced post-licensing inspection; first admission was received on October 22, 2024. LPA was granted access to the facility by facility manager (FM), Madisson Reynolds. LPA explained the purpose of the inspection, provided the entrance checklist, and then met with the Administrator, Fatima Herrera. LPA was provided a workspace in the staff office. The facility currently has one client [client 1 (C1)] admitted. The facility was toured both inside and out with ADM at 11:00AM. During the inspection, C1, ADM and FM were present and interviewed. The home is set up with four bedrooms, consisting of: · Bedroom #1- a dresser, closet, single bed with bed had linen, comforters, and pillows. It will sleep one client. · Bedroom #2- two dressers, two single beds with bed had linen, comforters, and pillows. It will sleep two clients. · Bedroom #3- a dresser, closet, single bed with bed had linen, comforters, and pillows. It will sleep one client. · Bedroom #4- two dressers, two single beds with bed had linen, comforters, and pillows. It will sleep two clients. The living room area has sofas, chairs, cordless telephone, Wi-Fi router, video game console, television, board games and an arts and craft center. There is also an intake room utilized for admission purposes and/or private phone calls, meetings, or visits; emergency provisions are stored in the closet. The laundry room has a washer and dryer. There is a room designated for donations in the west side part of the facility. There are 10 smoke detectors/alarms, three carbon monoxide detectors/alarms, and five fire extinguishers. There are two client full-bathrooms with a sink and tub/showers. ***Continued on page 2 **Continued from page 1** On the east side of the home is the staff office with a desk, storage closet, and bathroom for staff use. All medications, sharp objects, and hazardous items are stored in the staff office storage closet, inaccessible to clients in care. The confidential employee files, client files, and medications are locked in the staff office. Cleaners/chemicals are locked and stored in the staff office. There were two complete First Aid kits at the facility. There are no guns or weapons as stated by Administrator, Fatima Herrera. The hot water was at a temperature of 106.6 degrees Fahrenheit in bathroom #3 and 107.1 degrees Fahrenheit in the kitchen. Proper storage of all food was observed. LPA observed a two day supply of non perishable and a seven day supply of perishable foods; menu is posted. The kitchen had a trash can with lid for waste. The Facility Sketch, Emergency Disaster Plan, Personal Rights, Visitation policies, daily activities schedule, monthly outings schedule, and Grievance forms/box were posted in the living room entrance. The garage was separated from the house with an external door and will be utilized for storage only. The emergency generator is stored in a central location by Family Assistance Program and will be brought to the facility as needed. The backyard is completely fenced and free of weed and dirt residue. There is no pool or other bodies of water. There is a basketball court and two covered areas for outdoor activities. LPA observed safe, clean, and age-appropriate educational supplies and games for the age group of clients cared for inside facility. LPA reviewed five staff files and one client file. LPA and ADM reviewed and discussed the updates needed to the program statement to be consistent with the Community Care Licensing approved youth homelessness prevention center program statement recently approved within Family Assistance Program. ADM will provide the updates no later than February 10, 2025. Based on the inspection of the home on this date, the facility is operating within the limitations of Community Care Licensing and is appropriate for a capacity of 6 children, ages 12-17 years, ambulatory only. Exit interview conducted and a copy of this report and appeal rights was discussed and provided to the administrator.

met_with: Fatima Herrera


summary: Facility Evaluation

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Narrative:
On September 25, 2025, at 09: AM, Licensing Program Analyst (LPA) Raina Perez-Diaz arrived at Our Place Youth Shelter Youth Homelessness Prevention Center-Group Home for an announced required annual inspection. Due to the facility status of being inactive, LPA scheduled the inspection. LPA was granted access to the facility by Director of Youth Shelters (DYS), Sylvia Steinhart, who led a tour of the home. The facility currently has no clients in care and is temporarily closed. The location currently has a for sale sign and an application with the department to open another type of facility under a different license. This facility was toured both inside and out with DYS at 11: AM. The home is set up with four bedrooms, consisting of: · Bedroom #1- a dresser, closet, single bed with bed had linen, comforters, and pillows. It will sleep one client. · Bedroom #2- two dressers, two single beds with bed had linen, comforters, and pillows. It will sleep two clients. · Bedroom #3- a dresser, closet, single bed with bed had linen, comforters, and pillows. It will sleep one client. · Bedroom #4- two dressers, two single beds with bed had linen, comforters, and pillows. It will sleep two clients. The living room area has sofas, chairs, cordless telephone, Wi-Fi router, television, board games and an arts and craft center. There is also an intake room utilized for admission purposes and/or private phone calls, meetings, or visits; emergency provisions are stored in the closet. The laundry room has a washer and dryer. There is a room designated for donations in the west side part of the facility. ***Continued on Lic-809-C*** There are 10 smoke detectors/alarms, three carbon monoxide detectors/alarms, all wired to each other were tested and in working condition. Additionally, the facility had five fire extinguishers. They were observed to be properly charged and inspected by the fire department. There are two client full-bathrooms with a sink and tub/showers. On the east side of the home is the staff office with a desk, storage closet, and bathroom for staff use. All future medications, sharp objects, and hazardous items are/will be stored in the staff office storage closet, inaccessible to clients in care. Any confidential employee files and client files are locked in the staff office. Cleaners/chemicals are locked and stored in the staff office. There were two complete First Aid kits at the facility, which contains all required items. There are no guns or weapons as stated by DYS. The hot water was at a temperature of 115.6 degrees Fahrenheit which is within regulations. LPA observed a seven day supply of non-perishable and no supply of perishable foods; However, a menu is posted. Due to the facility being closed since June 2025, DYS was reminded once a client is in care the facility is required to obtain and maintain a two day supply of perishable foods. DYS understood. The kitchen had a trash can with lid for waste. The Facility Sketch, Emergency Disaster Plan, Personal Rights, Visitation policies, daily activities schedule, monthly outings schedule, and Grievance forms/box were posted in the living room entrance. The garage is separate from the house with an external door and will be utilized for storage only. The facility outside grounds were also inspected and it was observed to be clean and well maintained, emergency exits were free from obstruction. There is no pool or other bodies of water. There is a basketball court and two covered areas for outdoor activities. LPA observed safe, clean, and age-appropriate educational supplies and games for the age group of clients cared for inside facility. Based on the facility inspection, the current census being zero, and the facility's temporary closure, LPA did not review any staff or client files or conduct interviews at the time of this inspections and there are no deficiencies cited at this time. LPA informed the Licensee to notify the Department at the time of receiving a client in care. The Department will return to conduct staff and client file reviews and ensure the facility has the required amount of perishable food. Though items need to be corrected the Director was advised due to the pending closure of the facility license and no violation was given for the lack of perishable food; however, should the facility situation change they were advised corrections will need to be completed right away. An exit interview was conducted, a copy of this report and appeal rights was provided to Director of Youth Shelters, Sylvia Steinhart.


facility_name: OUR STAY

summary: Complaint Investigation - Unsubstantiated - 1 allegation

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Narrative:
confidential interviews could not confirm or deny the allegation. Thus, confidential interviews did not corroborate the allegation with a preponderance of evidence. Based on confidential interviews and records reviewed the allegation that staff did not prevent C2 from engaging in inappropriate behaviors with C1, which may have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted and appeal rights explained. Due to printer difficulties, a copy of this report, LIC 811, and appeal rights were emailed to the Facility Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On May 19, 2025, at 4:40 pm, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Ashley Yeager, Youth Care Advocate, to discuss the investigative finding for the allegation noted above. LPA Valerie Wilson conducted an inspection of the facility on June 17, 2024, at 3:30 pm, and no deficiencies were observed. LPA Wilson interviewed one Client (C2). LPA Linley interviewed three Staff (S1, S3, S4), one Client (C3), and LPA was unable to interview two Clients (C1, C4), and two Staff (S2, S5), despite multiple attempts to contact them. LPA reviewed the facility documents during the investigation. On June 17, 2024, Community Care Licensing (CCL) received an allegation that staff did not prevent a minor from engaging in inappropriate behaviors with another minor. It was reported that another client tried to kiss C1 and put their hands down C1's pants and C1 pushed them away. It was reported this occurred when staff left the room. LPA was unable to interview all individuals, although multiple attempts were made, thus, UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: OUR STAYFACILITY NUMBER: VISIT DATE: 05/19/2025

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

report_type: Complaint Investigation

met_with: Ashley Yeager

complaint_status: unsubstantiated


summary: Facility Evaluation

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Narrative:
On October 17, 2023 at 12:00PM, Licensing Program Analyst (LPA) Adaleyci Caballero and Licensing Program Manager (LPM) Abdoulaye Traore met with applicant Fatima Herrera via Microsoft Teams Meeting for a Component II of the application process. Lpa a. Caballero went over revisions needed for the application prior to license. Lpa a. Caballero gave a copy of the LIC 184, Notice of Incomplete Application, and additional correspondence to assist with the revisions needed to the application. A copy of this report was provided to applicant via email. Original signed copy of this report will be placed in the facility file.


summary: Facility Evaluation

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Narrative:
On December 18, 2023, Licensing Program Analyst (LPA) Adaleyci Caballero and Licensing Program Manager (LPM) Abdoulaye Traore arrived at Our Stay Youth Homelessness Prevention Center-Group Home for a scheduled pre-licensing inspection. LPA and LPM were met at the facility by Administrator Fatima Herrera, Director of Youth Shelters Sylvia Steinhart, and Shelter Manager Joseph Mendoza This facility is applying for a license to operate a Homeless Center with a capacity of six clients. The facility was toured both inside and out with the applicants. The home is set up as follows: · Bedroom #1- It consisted of two single beds. The beds were missing linen, comforters, and pillows. It will sleep two clients. · Bedroom #2- It consisted of two single beds. The beds were missing linen, comforters, and pillows. It will sleep two clients. · Bedroom #3- It consisted of two single beds. The beds were missing linen, comforters, and pillows. It will sleep two clients. · Bedroom #4- It consisted of a single bed, a dresser, and a desk. This room is being converted to an office. The bed and dresser will be removed according to the applicants. The bedroom was missing supplies. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. Applicants were made aware that clients of opposite sex, over the age of 5, require separate bedrooms. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawers and closet space for client's belongings, however all beds were missing sheets. Prior to licensure the following items are needed: 1. Hot water heater must be maintained within the regulation range of 105-120 degrees. 2. All client beds need to have linen, comforters, sheets, and pillows. 3. Fire alarm system is not synchronizing and were not working properly. 4. First Aid kits with all required items. 5. Food supplies for the clients to serve. 6. A Trash can with lid in kitchen area. 7. Adequate cleaning supplies 8. Bedroom 4 needs to be free of one bed, a dresser to be converted a locked staff office. 9. Games, educational supplies, and any adequate equipment for the clients to serve. 10. Hygiene supplies for the clients to serve. 11. The Facility Sketch, Emergency Disaster Plan (LIC 610), Personal Rights, Grievance procedures, Visitation policies need to be posted. 12. Backyard free of debris. 3. A Component III Orientation needs to be scheduled when the corrections are completed. Based on the inspection of the home on this date, the facility did not appear to be in compliance with the Community Care Licensing Division Title Laws and Regulations. All hazardous items will be stored in bedroom 4 to be converted into staff office. The medications and confidential files will be locked and stored in the staff office. Cleansers/chemicals will be locked and stored in the staff office's closet. No Sharp objects were observed during the inspection. There was no First Aid kit at the facility. There are no guns or weapons as stated by Administrator Fatima Herrera. The hot water temperature was not in the proper temperature. Applicants understand that the water temperature must be maintained within the regulation range of 105-120 degrees Fahrenheit. Proper storage of all food was discussed, however there was no food in the refrigerator. The kitchen did not have a trash with lid for waste. The Facility Sketch, Emergency Disaster Plan, Personal Rights, Visitation policies were not posted at this time. The garage was separated from the house with an external door and will be utilized for storage only. The backyard where clients will have access to play is completely fenced, however there was weed and dirt residue around the house. There is no pool or other bodies of water. LPM and LPA did not observe any safe, clean, and age-appropriate educational supplies and games for the age group of clients to be cared for both inside and outside the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On January 31, 2024 at 10:30AM Licensing Program Analyst (LPA) Adaleyci Caballero and Licensing Program Manager (LPM) Abdoulaye Traore arrived at Our Stay Youth Homelessness Prevention Center-Group Home for a scheduled corrections visit from a pre-licensing inspection dated December 18, 2023. LPA and LPM were met at the facility by Administrator Fatima Herrera, Director of Youth Shelters Sylvia Steinhart, and Shelter Manager Joseph Mendoza. This facility is applying for a license to operate a Homeless Center with a capacity of six clients. The facility was toured both inside and out with the applicants. The home is set up as follows: · Bedroom #1- It consisted of two single beds. The beds had linen, comforters, and pillows. The room was furnished with two beds and a dresser. It will sleep two clients. · Bedroom #2- It consisted of two single beds. The beds had linen, comforters, and pillows. The room was furnished with two beds and a dresser. It will sleep two clients. · Bedroom #3- It consisted of two single beds. The beds had linen, comforters, and pillows. The room was furnished with two beds and a dresser. It will sleep two clients. · Bedroom #4- This room is an office space for staff and the closet will be used for storage of chemicals, medications and sharp objects. Bedrooms were arranged so that no more than two clients share a room, and there is one client per bed. Applicants were made aware that clients of opposite sex, over the age of five, require separate bedrooms. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawer and closet space for client's belongings. All hazardous items will be stored in bedroom 4 to be converted into staff office. The medications and confidential files will be locked and stored in the staff office. Cleansers/chemicals will be locked and stored in the staff office's closet. First Aid kit at the facility is located in the staff office. There are no guns or weapons as stated by Administrator Fatima Herrera. The hot water temperature was observed to be at appropriate temperature. Applicants understand that the water temperature must be maintained within the regulation range of 105-120 degrees Fahrenheit. The kitchen trash was observed to have a lid. The Facility Sketch, Emergency Disaster Plan, Personal Rights, Visitation policies were observed posted. The garage was separated from the house with an external door and will be utilized for storage only. The backyard where clients will have access to play is completely fenced and free of weeds and dirt residue around the house. There is no pool or other bodies of water. LPM and LPA observed safe, clean, and age-appropriate educational supplies and games for the age group of clients to be cared for both inside and outside the facility. Corrections made: 1. Hot water was observed at 116.0 degrees Fahrenheit. 2. All client beds had linen, comforters, sheets, and pillows. 3. Fire alarm system was synchronized and working properly. 4. First Aid kits with all required items were located in staff office. 5. Food supplies for the clients to serve. 6. A Trash can with lid in kitchen area. 7. Adequate cleaning supplies located in staff office. 8. Bedroom 4 was converted to a locked staff office. 9. Games, educational supplies, and adequate equipment for the clients to serve were observed. 10. Hygiene supplies for the clients to serve. 11. The Facility Sketch, Emergency Disaster Plan (LIC 610), Personal Rights, Grievance procedures, Visitation policies were observed posted. 12. Backyard clean and free of debris. Based on this inspection, the home is appropriate for a capacity of 6 ambulatory clients. All corrections were made, and all requirements are met at this time. The request of License will be forwarded to Licensing Program Manager Abdoulaye Traore for final approval. Component III orientation was conducted by LPM A. Traore during the visit. Exit interview conducted and a copy of this report was discussed and provided to Administrator Fatima Herrera. Due to technical difficulties, the copy of this report was provided to Administrator Fatima Herrera via email.