summary: Facility Evaluation

raw_content:
Narrative:
On 9/05/2024, Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility and met with Lacy Weinberg Office Manager. The purpose of the visit was to conduct a Required Bi-Annual Inspection of the facility. The last Bi-Annual inspection for the facility was on 1/23/2023. LPA utilized the CARE Tool to complete the inspection. LPA conducted an inspection of the physical plant and checked for all necessary requirements. The facility was clean and organized and maintained an acceptable room temperature. The facility has five offices for social workers and three confidential interview/visitation rooms. LPA observed the proper postings including: facility license, complaint hotline, and emergency disaster plan. The restrooms for clients and staff were clean. Smoke alarms were in working order, fire extinguishers were current, and a first aid kit was fully stocked. Evacuation drills for the facility were completed quarterly. LPA observed client files were stored in locking file cabinets. The facility has no outstanding fees. The facility has 0 minor clients and Non-Minor Dependent clients. Clients live in apartments. No client resides more than two hours from the facility. The facility employs Social Worker/ Case Manager, and 1 of Supervisors/Program Manager. LPA reviewed Social Worker personnel files. Social work personnel had completed criminal record clearances and met minimum education and experience qualifications. All First Aid and CPR certifications were up to date for Social Worker personnel. LPA interviewed 1 social worker personnel. Social work personnel indicated they did not have more than 12 clients on their caseload. LPA reviewed 3 client files. All clients had signed Admission Agreements. Client files had current Needs and Service Plans, signed by the client and placing agency. Needs and Services Plan detailed adequate supportive services the facility offers to the clients. No citations were given on this date. A signed copy of this LIC-809 and LIC-809C report was provided to Lacy Weinberg Office Manager. An exit interview was conducted.

met_with: Lacy Weiberg- Office Manager


state: CA

summary: Facility Evaluation

raw_content:
Narrative:
On 4/07/26, Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility and met with Lacy Weinberg - Office Manager. The purpose of the visit was to conduct a Required Annual Inspection of the facility. The last Annual inspection for the facility was on 9/05/24. LPA utilized the CARE Tool to complete the Annual inspection. LPA conducted an inspection of the physical plant, and checked for all necessary requirements. The facility was clean and organized and maintained an acceptable room temperature. The facility has one office fora social workers and one confidential interview/visitation rooms. LPA observed the proper postings including: facility license, complaint hotline, and emergency disaster plan. The restrooms for clients and staff were clean. Smoke alarms were in working order, fire extinguishers were current, and a first aid kit was fully stocked, evacuation drill for the facility were completed quarterly. LPA observed client files were stored electronically with password protection. The facility has no outstanding fees. The facility has 0 minor clients and Non-Minor Dependent clients. Clients live in homes or remote site apartments. No client resides more than two hours from the facility. The facility employs Social Worker/Case Managers, and Supervisors/Program Manager. LPA reviewed Social Worker personnel files. Social work personnel had completed criminal record clearances and met minimum education and experience qualifications. Page 1 of All First Aid and CPR certifications were up to date for Social Worker personnel. LPA interviewed 0 social worker personnel, but interviewed the office manager. The Office Manager indicated the Social Worker does not have more than 12 clients on their caseload. LPA reviewed 3 client files. All clients had signed Admission Agreements. Two of three client files had current Needs and Service Plans, signed by the client and placing agency. Needs and Services Plan detailed adequate supportive services the facility offers to the clients. Facility is issued a citation per Title 22 regulation 86168.2 (a) (c) A signed copy of this LIC-809, LIC-809C, and LIC 809D, report was provided to Lacy Weinberg- Office Manager. An exit interview was conducted. Appeal rights were provided.

report_type: Facility Evaluation

visit_type: Annual

met_with: Lacy Weinberg- Office Manager


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
LPA informed Ms. Curran the allegation that the licensee failed to make payments on the nonminor dependent's apartment in a timely manner is substantiated since S1 admitted to the leasing agency and documented in C1's file that the late fees were Environmental Alternative's responsibility and not C1's. As a result of the information obtained and documentation reviewed, the complaint allegation is SUBSTANTIATED meaning that the allegation is valid because the preponderance of the evidence standard has been met. Facility was cited for violation of Title Division Six Section 86022(a)(4)(I) Plan of Operation. The plan of operation states that the monies received by the participants pay the expenses of rent, utilities, telephone, transportation, food...It further states that the participant's continued eligibility hinges on "paying bills on time". In addition, the plan of operation states that THP+FC/THPP staff...shall assist in payment of bills, conferring with the payee when necessary to insure payment has been made. There is no evidence that this was done as the leasing agency indicated that the utilities were either not paid or were paid late. Investigation showed that the agency was responsible for not paying C1's rent in a timely manner as the rent payment was late on at least two occasions, thus causing C1 to not be eligible for the month-to-month option upon the expiration of C1's lease. Subsequently, eviction proceedings for C1 were started as there is no documentation that the agency had other housing for C1 and C1 was unable to vacate in the allotted time. Exit interview conducted and documents provided to the facility for signature and return.

Investigation Findings:
13Licensing Program Analyst (LPA) Tamara Hill made an unannounced tele inspection to the facility on 5/20/21 at 10: AM and met with Deally Curran, Social Worker Supervisor to discuss the findings of the complaint. LPA informed Ms. Curran that the complaint investigation included initial tele inspection to the facility 1/15/21, interviews with C1 (see LIC811 dated 5/20/21), C1's lawyer, reporting party, and review of documentation provided by the facility as well as documents provided by C1's lawyer. Investigation shows that C1 solely signed a lease agreement on 2/14/2014. At the end of C1's lease in 2015, C1 was trying to get her apartment complex to move to a month to month rental agreement and when C1 went to the leasing office to discuss the details, C1 was told that "due to rent being paid late twice" and "late fees on utilities", they would not be renewing C1's lease nor would they move to a month-to-month agreement. The case notes written by S1, C1's case worker at that time, indicate that on 1/22/2015, S1 did go to the leasing office to discuss that the "late fee(s) on rent should not fall on [C1]'s record but on EA's behalf" but the leasing office would still not go month-to-month with C1. The leasing agency informed C1 to vacate the premises by 2/14/2015. There is no documentation that the agency had other housing for C1 and C1 was unable to vacate in the allotted time. This resulted in eviction proceedings to begin for C1 although C1 did vacate the premises prior to formal execution of the action. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Tamara Jensen-Hill 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, NATOMAS PARK DR., STE FACILITY NAME: ENVIRONMENTAL ALTERNATIVES THPP/THP+FC TRACYFACILITY NUMBER: VISIT DATE: 05/20/2021

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

report_type: Complaint Investigation

met_with: Deally Curran, Social Worker Supervisor

complaint_status: unsubstantiated


facility_name: ENVIRONMENTAL ALTERNATIVES THPP/THP+FC TRACY

summary: Facility Evaluation

raw_content:
Narrative:
On December 30, 2022 at 12: PM Licensing Program Analyst (LPA) Stephannie Verna arrived at the facility for the purpose of conducting an unannounced Case Management inspection related to a capacity decrease. LPA Verna met with Rocio Martinez, Social Worker Supervisor. LPA Verna conducted one interview and completed a facility inspection. LPA Verna reviewed control of property, deed, and lease agreements and other documents for clients in care, as well as the client register. LPA Verna will conduct a follow-up regarding this Case Management. No citations were issued during today's visit. The facility was issued a copy of this report and an exit interview was conducted with Rocio Martinez, Social Worker Supervisor.

visit_type: Case Management


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On May 10, 2023 at 11: AM, Licensing Program Analyst (LPA) Stephannie Verna arrived at the above facility for the purpose of completing an unannounced required Annual Inspection. LPA Verna met with Kyle Denton, Office Manager and Sydney Johnson, Office Manager. Environmental Alternatives is a Transitional Housing Placement Program (THPP) that supports Non-Minor Dependents (NMD) in creating and achieving independent living goals, and fostering independence. LPA Verna completed an inspection of the physical plant, the office and THPP office. LPA observed the facility sketch, disaster plan and facility license was posted in a prominent place in the office. The office had three levels. All three levels contained staff offices. The main level had visitation room, kitchen, bathroom and client file storage. The upper level had a bathroom. The lower level had a recreation area, bathroom, and storage closets/rooms. Carbon monoxide and smoke alarms were tested and in working condition. The water temperature was tested and measured at 108.3 degrees Fahrenheit. The fire extinguishers were charged and last inspected in May 2023. Files and cleaners were not left accessible to clients or others. The agency was observed to be clean, safe, and in good repair with the exception of one observation. LPA Verna observed the client restroom's on (the main floor) bathroom stall door did not close fully or lock and was not in good repair. continued on 809-c LPA completed the staff file review and reviewed a total of five staff files. The staff files contained the required documentation, with the exception of: While the agency does have written job descriptions and duties, they are not stored in the personnel records of five out of five employees (electronic). It was observed that LIC Personnel Records forms did not include all employee information such as date of hire and drivers license number, but the agency has documents on file including copies of drivers license's. LPA Verna reviewed of a total of five client files. From files and documents reviewed on today's date, it was observed that the client files contained the required documents with the exception of: Health and medical records were missing in five out of five client files, however three out of five client files documented the client declined to share health and medical information with the THPP. Also, there were five out of five client records which did not contain the LIC 602 or a medical assessment (health screening and TB test/results). Additionally, there was no record on file that the client refused to obtain a health screening and TB test/results. The facility stated that the clients have the right to refuse to share medical information, and they file documents the clients agree to share. Additionally, client files reviewed did contain completed Transitional Independent Living Plans (TILP), when provided by the placing county. LPA Verna conducted 3 staff interviews. The annual inspection was completed on today's date. The facility is being issued five Technical Advisories. Additionally, the facility is being issued one citation regarding deficiencies to Building and Grounds, CCR Title Regulation section 80087(a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. See LIC 809-D for citation and POC information. An exit interview was completed and a copy of this report and appeal rights were discussed and was provided to Kyle Denton, Office Manager and Sydney Johnson, Office Manager.

Deficiencies:
80087(a): Deficient Practice Statement
1
2
3
4Based on observation and interviews, the licensee did not comply with the section cited above in one client restroom, where the restroom door was in need of repair and was observed to not close or lock, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/16/2023
Plan of Correction
1
2
3
4

title:
Building and Grounds
(a)	The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.

This requirement is not met as evidenced by


summary: Facility Evaluation

raw_content:
Narrative:
On 05/30/2025 at 12:45 p.m. Licensing Program Analyst (LPA) Elena Gonzalez-Soto arrived at the above agency and conducted an unannounced Annual Inspection. LPA met with Sydney Johnson, Office Manager who assisted with the inspection. LPA inspected and reviewed the following: Client Records: five files reviewed contained admission agreement, Identification & emergency information, Needs and Services Plan, and Transitional Independent Living Plan. Operations: reviewed Plan of Operation Certificate of Compliance: reviewed batch of five clients and signed, and reviewed list of all participants and living units. LPA obtained a copy of the facility's LIC 500. Further inspection is needed to complete required Annual Inspection. No citations were issued during today's inspection. An exit interview was conducted and a copy of this report was issued to

met_with: Sydney Johnson, Office Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 06/03/2025 at 10:45 a.m. Licensing Program Analyst (LPA) Elena Gonzalez-Soto arrived at the above agency and conducted an unannounced Annual Inspection continuation. LPA met with Sydney Johnson, Office Manager who assisted with the inspection. LPA inspected and reviewed the following: Physical Plant: license is posted in public, accessible area and records are maintained in secured area. Disaster Preparedness: Reviewed Emergency Disaster Plans for a batch of five clients, plans included emergency information and telephone numbers. Staff Records: five files reviewed contained: five criminal record clearances, five valid driver's licenses, LPA observed S1, S2, S3, and S4 did not have training related to the sexual and reproductive rights of children in foster care, all other required training has been completed. The facility is being issued a Technical Violation for California Code of Regulations, Title 22, Division Chapter 7, Article 06. Continuing Requirements, 86065 (f)(4) Personnel Requirements. An exit interview was conducted and a copy of this report was issued to Sydney Johnson, Office Manager.


facility_name: FAMILY CARE NETWORK, INC.

raw_content:
Investigation Findings:
13On 08/23/2024 at 11:30AM, Licensing Program Analyst (LPA) Jhane Haynes made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegations and deliver the findings. LPA spoke with TAYS Housing Manager(THM) and together discussed the investigative findings. During the investigation LPA Haynes interviewed and accounted for all relevant parties. Based on interviews gathered, guests are to leave by midnight. Safety checks were conducted by program and no unauthorized guests nor contraband was found. Parties involved denied drug use on property. Statements to corroborate the above allegations could not be obtained. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur therefore is UNSUBSTANTIATED. An exit interview was conducted, and a copy of this report was emailed to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Jhane Haynes LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Darci Rice TAYS Housing Manager(THM)


summary: Facility Evaluation

raw_content:
Narrative:
On March 15, 2022, at 11:20am Licensing Program Analysts (LPAs), Enrique Hernandez and Nancy O'Connell made an unannounced visit to the above facility for the purpose of a Required- Year visit. LPAs met with Brian Redin the Director of the administrative office of the THPP who provided a tour of the administrative offices. Director private room for the file reviews. LPA observed that the facility license was posted in public view, cabinets for THPP files were locked and kept in a secure area, Bill of Rights for clients were posted in visible area of building, Livescan is available on site. Licensee is operating within the conditions and limitations specified on the license. Annual fee is current. Due to time constraints, the LPAs will return to review staff and client files, in order to complete Annual required inspection. A copy of this report was discussed with the Director Due to technical difficulties, LPA will email Director a copy of this report.

met_with: Director


summary: Facility Evaluation

raw_content:
Narrative:
On 10/17/23 at 11:20AM, Licensing Program Analysts (LPA) Jhane Haynes and Christine Wilson made an unannounced visit to the above facility for the purpose of an Annual/Required visit. LPA Haynes and LPA Wilson met with the facility administrator (FA) Brian Redin who granted access into the office, provided a tour of the administrative office and private room for the file reviews. This is a one story office building located at Kendall Rd in San Luis Obispo, CA. It features the following: Lobby area containing three counseling rooms and a therapy room for clients. Hall leading to the first office sections that contains a board room for meetings, the offices for human resources/payroll, a break room with patio access and desks for volunteers/interns. There are two additional rooms for training and conferences. At the end of the hall, there is a facility room for maintenance staff that services the administrative office and off-site housing. Wrapping around the hall features an open concept room with desks available to rehab and wrap staff as well as cubicles for social workers. Client files are centrally stored in locked file cabinets in the shared workspace between foster care and transitional age youth staff. See 809-C LPAs observed: Records of C1,C2,C3,C4,C5 includes a personalized case plan, TB clearance, education if applicable and budgeting. Each participant's record contains copies of important documents including, but not limited to: A copy of the staff roster was provided and reveals that all staff have obtained a criminal record clearance with DOJ, FBI, and Child Abuse Response. LPA conducted staff interviews with FA and HM. See LIC811(confidential names) dated 10/17/2023. Due to time constraints, LPAs will return 10/18/2023 to review staff files and visit off-site locations. No deficiencies will be cited this day. An exit interview was conducted, and a copy of this report will be emailed to facility manager.

met_with: Brian Redfin Facility Administrator (FA)


summary: Facility Evaluation

raw_content:
Narrative:
On 10/18/2023 at 09: AM Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of continuing the Annual/Required visit initiated 10/17/23. LPA Haynes met with the Facility Administrator (FA) who provided access to facility and a private room to review staff files of FA, HM, SW and AC. See 811(Confidential Names). Staff files are stored electronically. Desiree Del Rio (HR) granted staff file access. LPA observed each staff file contained health screening, TB results, description of job duties, educational records, DOJ, FBI and CACI clearances as well as past required and upcoming trainings. Facility utilizes volunteers in terms of an internship. Based on staff interview, there are no volunteers employed at this time. LPA also conducted staff interviews with AC and SW. LPA Haynes and HM Darci Rice HM toured 2 off site apartments.(See 812 dated 10/18/23) Family Care Network has units in San Luis Obispo, Atascadero, Arroyo Grande, Santa Maria and Orcutt that are less two hours from administrative office. Per Title Division Chapter 7, one deficiency will be cited at this time. See 809-D for details. An exit interview was conducted and a copy of this report and appeal rights were emailed to facility administrator.

met_with: Darci Rice (HM)


summary: Facility Evaluation

raw_content:
Narrative:
On 04/08/24 at 01: PM Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of conducting a case management inspection for an incident received by the department on 04/04/24. Participant passed away due to overdose. LPA met with Facility Administrator(FA) Brian Redin who granted access to the facility. LPA conducted interview with FA and S1. LPA obtained contact information of P1's probation officer and parent. Further investigation is needed to determine whether a violation occurred. There are no deficiencies to be cited today. An exit interview was conducted and a copy of this report will be emailed to the facility administrator.

met_with: Brian Redin Facility Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 07/25/24 at 03:00PM Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of concluding a case management incident initiated 04/08/24. Death of client. LPA met with the Facility Administrator(FA) Brian Redin who granted access to the facility. The department determined no violation occurred. Client was enrolled in various services to support and address substance abuse. Apartment was searched by facility and police department for contraband, and none was found at the time of initial arrest. No deficiencies will be cited at this time. An exit interview was conducted and this report was emailed to the Facility Administrator.

met_with: Brian Redin Facility Administrator(FA)


summary: Facility Evaluation

raw_content:
Narrative:
On 07/25/24 at 03:00PM Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of conducting a case management incident inspection for incident received by the department on 06/14/24. Resident's medicine was not refilled timely resulting in asthma attack. LPA met with the Facility Administrator(FA) Brian Redin who granted access to the facility. LPA conducted confidential interview with FA. LPA obtained client's contact information. Further investigation is needed to determine whether a violation occurred. No deficiencies will be cited at this time. An exit interview was conducted and this report was emailed to the Facility Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 07/25/24 at 03:00PM Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of conducting a case management incident inspection for incident received by the department on 04/26/24 involving resident, child and unauthorized adult. LPA met with Facility Administrator(FA) Brian Redin who granted access to the facility. LPA conducted confidential interview with FA. LPA obtained client and client's probation contact information and police report number. Further investigation is needed to determine whether a violation occurred. No deficiencies will be cited at this time. An exit interview was conducted and this report was emailed to the Facility Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/15/2025, at 12:30 pm, Licensing Program Analyst (LPA) Nestor Gomez arrived at the above facility, for the purpose of conducting an Annual Required Inspection. LPA Gomez met with Facility Administrator, Darci Rice who granted access to the office and provided a tour. Family Care Network, Inc. is located in a two-story office building. There is also a barn used for storage and a garden across from the office building. During the time of inspection, LPA Nestor conducted an inspection of the following areas: The Lobby area contains three (3) counseling rooms. There is a hallway leading to the first office sections that contains a board room for meetings, offices for human resources/payroll, break room with patio access and desks. There are two additional rooms for training and conferences. At the far end of the hallway, there is a facility room for maintenance staff that services the administrative office and off-site housing. The second floor is filled with cubicles and offices along the sides that are used for homeless housing resources. Wrapping around the hall features an open concept room with desks available to rehab and wrap staff as well as cubicles for social workers. Client files and Staff files are both digitally stored. Continue on 809-C (Page 1) Vehicles: LPA Nestor inspected two (2) facility vehicles in total. Chrysler Town & Country (Blue) with current registration that expires on 12/24/2025. Insured by Pennsylvania Manufactures Association Insurance company that expires 04/01/2026. Nissan Altima (Black) with current registration that expires on 08/20/2026. Insured by Pennsylvania Manufactures Association Insurance company that expires 04/01/2026. Vehicles are in good condition with no issues. Staff Interview: LPA Nestor conducted four (4) staff interviews with FA, S2, S4, S5. Client Interview: LPA Nestor did not conduct any client interviews because at the time of the inspection there were no clients at the facility. LPA Nestor will return to complete the inspection. There were no deficiencies observed or cited at this time. An exit interview was conducted, and a copy of this report was reviewed and provided to FA via email. End of Inspection (Page 2)

met_with: Facility Administrator - Darci Rice


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On 10/16/25, at 9:35 am, Licensing Program Analyst (LPA) Nestor Gomez returned to the above-mentioned facility to continue the annual inspection that was started on 10/15/25. LPA Gomez met with Facility Administrator (FA), Darci Rice, who granted access to the facility. The following was observed during the Inspection: Staff Records Review: LPA reviewed four (4) staff records for the FA, S2, S4 and S5. Clients Records Review: LPA reviewed client records for C1, C2, C3 and C4 which meet qualifications. Client Interview: LPA Nestor conducted client interviews with C3. Other clients were not available for interviews at the time of the inspection. LPA toured one (1) off site apartment. (See 812) Family Care Network has units in San Luis Obispo, Atascadero, Arroyo Grande, and Orcutt that are less two hours from administrative office. There were no deficiencies observed or cited at this time. Exit interview was conducted with the Facility Administrator and a copy of this report was emailed to the Facility Administrator.

Deficiencies:
86064(h): Administrator Qualifications and Duties

(h) The administrator shall complete training related to the sexual and reproductive rights of children in foster care that includes the following topics


summary: Facility Evaluation

raw_content:
Narrative:
On May 19, 2022, at 3:00pm Licensing Program Analyst (LPA) Nancy O'Connell, conducted an unannounced Case Management deficiencies inspection at Family Care Network located at the above address. Dana Nichols (Resource Family Services Manager), granted access into the facility. The purpose of the visit was to inquire about and deliver a deficiency citation regarding an incident that occurred on 4/29/22. The incident entails a resident residing in the Poinsettia THPP apartment testing positive for TB and reporting results to staff on 4/29/22, but staff did not report incident to the Department until 5/12/2022. Upon receipt of the SIR, LPA O'Connell called the licensee and spoke with Dana Nichols who admitted to submitting the report late. LPA discussed with the RF Services Manager the reason for the citation, to which RF Services Manager agreed. During the visit, LPA O'Connell requested the LIC500 and client roster for the THPP program. RF Services Manager communicated that one of the residents in the Poinsettia THPP apartment is not on the client roster, and is part of the Fostering Youth to Independence (FYI) program which is a county contracted program. Both LPA O'Connell and the RF Services Manager discussed the parameters of the program and RF Services Manager agreed to submit a copy of the program contract with the county to CCLD. There is a deficiency cited per Title Regulations on this date. Exit interview conducted and a copy of the report was left at the facility with the Manager. Cont on LIC809D.

met_with: Dana Nichols, RF Services Manager


facility_name: FD NALLS - NALLS FOUNDATION

raw_content:
Narrative:
Based on 5 confidential interviews, information provided in incident reports related to the complaint allegation, inconsistencies in statements and lack of corroboration, the allegation is determined to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted, and a copy of the report and appeal process was provided to the Program Administrator.

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

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

met_with: Program Director


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst, (LPA) Tana Kinder conducted a required inspection with the Program Manager on 9/24/201. LPA inspected the office space and observed a fully charged fire extinguisher, first aid kit, personal rights, a copy of the license and evacuation plan are posted in a prominent location. LPA observed a fully-wired sprinkler system. Personnel and client files are kept in a locked cabinet in a locked room. LPA reviewed 4 client files and 4 staff files. LPA used the CARE Tool to conduct the required inspection. An exit interview was conducted and a copy of the report was emailed to fdnallsfoundation@gmail.com.

met_with: Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Yuvi Diaz made an unannounced annual inspection on November 3, 2022, at 10:30AM LPA Diaz met with Tina Dollison, Program Manager who assisted annual with the inspection. LPA Diaz conducted a walk-through of the facility inside and out. Facility is in a three story building. Office is located on the second floor. Office has two large rooms, with working desks. LPA Diaz inspected and/or reviewed the following: I. Physical Plant: Posting of license, Personal Rights, Covid Poster, Facility Sketch, and Emergency Disaster Plan. Disinfectants/Cleaning solutions inaccessible, Working telephone. Carbon monoxide detectors and Smoke Detector were all in working condition. First Aid Kit fully stocked. II. Operations: Was reviewed. III. Disaster Preparedness: Disaster and mass casualty plan updated and available, IV. Staffing/Volunteers: LPA Diaz reviewed three staff files. Files has criminal record clearances.First Aid Certificate, Certified Administrators certificate valid and current Job title/qualification verified IV.Client Records: Number of Clients files reviewed two. All files had Needs and Services Plan, Agreement, Personal Rights, and Compatible Assessment. Report continues on LIC809-C The following items were reviewed for compliance in the regional office prior to the facility inspection: · Annual fees are to date. · Emergency Disaster Plan was posted · Personnel Roster, Facility Sketch, LIC 500, LIC 610C and LIC 308 · Waivers and Exceptions No deficiencies were cited. Two technical advisory's were noted. An exit interview was conducted with Tina Dollison, Program Manager. A copy of this report was emailed.

met_with: Tina Dollison, Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On September 29, 2023, at 10: AM, Licensing Program Analyst (LPA) Shalisa Stiger arrived at the above facility for the purpose of conducting an Annual Inspection. LPA Stiger arrived at Suite 240 and observed the door to be locked. LPA Stiger knocked and waited. LPA Stiger called the contact numbers on the facility profile and was unable to get in contact. With nothing further, LPA Stiger left the facility. LPA Stiger emailed the Administrator for business hours and to provide a copy of this report.

met_with: Facility Location


summary: Facility Evaluation

raw_content:
Narrative:
On October 10, 2023, at 10: AM, Licensing Program Analyst (LPA) Shalisa Stiger made an unannounced annual inspection. LPA Stiger met with Tina Dollison, Program Manager who assisted with the annual inspection. LPA Stiger conducted a walk-through of the facility. The facility is in a three story commercial building. Office is located on the second floor and has two large rooms with working desks. LPA Stiger inspected and reviewed the following: I. Physical Plant: Posting of license, Personal Rights, Covid Poster, Facility Sketch, and Emergency Disaster Plan. Disinfectants/Cleaning solutions inaccessible, Working telephone. Fire extinguisher in working condition. Smoke Detector working for commercial building. LPA Stiger did not test smoke detector due to being a commercial building. First Aid Kit observed and fully stocked. II. Operations: Was reviewed. III. Disaster Preparedness: Disaster and mass casualty plan updated and available. IV. Staffing/Volunteers: LPA Stiger reviewed two (2) staff files including the Administrator file. Files have certifications, criminal record clearances. First Aid Certificate, Certified Administrators certificate valid and current Job title/qualification verified. IV.Client Records: Number of Clients files reviewed two (2) client files. All files had Needs and Services Plan, Agreement, Personal Rights, and Compatible Assessment. LPA Stiger reviewed the Discharge Plan and Policy located on Needs and Services document. Report continues on LIC809-C.. The following items were reviewed for compliance in the regional office prior to the facility inspection: Annual fees are to date, Emergency Disaster Plan was posted, Personnel Roster, Facility Sketch, LIC 500, LIC 610C and LIC 308, Waivers and Exceptions. No deficiencies were cited. An exit interview was conducted with Tina Dollison, Program Manager. A copy of this report was emailed.


facility_name: FIRST PLACE FOR YOUTH

summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Christopher Rollins conducted a follow-up complaint inspection with First Place for Youth and spoke with Emily Jensen Chief Impact and People Officer (CIPO). The purpose of the inspection was to deliver the findings for the above complaint allegations. During the course of investigating the allegations, LPA Rollins conducted confidential interviews with staff, clients, social workers and conducted client file review. Confidential interviews reveal conflicting stories about resident was threatened by another resident. Confidential interviews reveal conflicting stories about facility staff failing to provide a safe enviroment for particpant. Confidential Interviews reveal that there was a verbal altercation but there were conflicting reports that during the altercation there was threatening words exchange. Based on interviews and documentation there was not enough evidence to prove that facility staff failed to provide a safe enviroment,resident was threatened by another resident, and resident engaging in verbal altercation. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that facility staff failed to provide a safe enviroment, resident was threatened by another resident and residents engaging in verbal altercation, therefore the above allegations are unsubstantiated. Exit interview conducted with CIPO and report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: Christopher Rollins LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Emily Jensen- Chief Impact and People Officer


raw_content:
Narrative:
Based on interviews and documentation there was not enough evidence to prove that facility staff failed to provide a safe environment for participant, participant was threatened by another participant, staff did not accord participant privacy, facility staff spoke inappropriately to participant and facility staff did not ensure that a non minor parent provided proper care for participant child. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that facility staff failed to provide a safe environment for participant, participant was threatened by another participant, staff did not accord participant privacy, facility staff spoke inappropriately to participant and facility staff did not ensure that a non minor parent provided proper care for participant child, therefore the above allegations are unsubstantiated. Exit interview conducted with Administrator and report was left at the facility.

Investigation Findings:
13Licensing Program Analyst (LPA) Christopher Rollins conducted a follow-up complaint inspection with First Place for Youth and spoke with Lauren Grayman- Administrator. The purpose of the inspection was to deliver the findings for the above complaint allegations. During the course of investigating the allegations, LPA Rollins conducted confidential interviews with staff, clients, social workers and conducted client file review. Confidential interviews reveal conflicting stories about resident was threatened by another resident. Confidential interviews reveal conflicting stories about facility staff failed to provide a safe enviroment for particpant and particpant was threatened by another particpant. Confidential Interviews reveal conflicting stories about facility staff did not accord particpant privacy, facility staff spoke inapproprately to particpant and facility staff did not ensure that a non minor dependent parent provided proper care for the child. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: Christopher Rollins 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 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, TRAEGER AVE., SUITE FACILITY NAME: FIRST PLACE FOR YOUTHFACILITY NUMBER: VISIT DATE: 01/05/2022

met_with: Lauren Grayman-Administrator


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Alyssa Ng conducted a follow-up complaint inspection with First Place for Youth and spoke with Lauren Grayman- Administrator. The purpose of the inspection was to deliver the findings for the above complaint allegations. During investigation, incident reports and records were reviewed, and confidential interviews were conducted. Based on interviews and record review, LPA spoke to Administrator regarding apartment and let LPA know that the apartment was put on a treatment plan when roaches were first reported but client moved out. First Place For Youth gave up the lease due to client no longer being at the unit. The agency has investigated the complaint alleging apartment has roaches and mold. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. No citations were given due to the apartment being put on a pest control treatment plan when first notified about the incident. An exit interview was conducted, and a copy of the report was left with the Administrator. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Alyssa Ng 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 3

met_with: Lauren Grayman

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Investigation Findings:
13On 10-5-22 12:21PM, Licensing Program Analyst (LPA) George Karkazis conducted a follow up complaint investigation at First Place For Youth and met with Chloe Whittlesey, Program Manager. The purpose of the inspection was to deliver the findings of the above complaint allegation. During the investigation, LPA Karkazis conducted confidential interviews with staff and clients. During confidential interviews with LPA Karkazis, it was disclosed that there was an infestation of mice in one of the apartments. It was also disclosed that the facility immediately began addressing the problem by bringing in glue traps and hiring an exterminator. A verbal and written timeline of the service was provided to LPA Karkazis, to fix the mice infestation, and relocation of clients until the rodents were gone. It was also disclosed to LPA Karkazis that a few months ago it took First Place For Youth three weeks to address a bug infestation in their apartment. Photos of rat droppings were also obtained. Based on confidential interviews, photos, and records review, the preponderance of evidence standard has been met to determine that staff were not assisting to keep residents free of rodents. Therefore, the above allegation is substantiated. First Place For Youth has taken immediate steps to irradicate rodents and shall not be cited at this time. An exit interview was conducted, Appeal Rights were provided, and a copy of this report was left with Chloe Whittlesey, Program Manager. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Mendoza LICENSING EVALUATOR NAME: George Karkazis 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 3

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

met_with: Chloe Whittlese, Program Manager


raw_content:
Investigation Findings:
13On 11/08/2022 at 12:20PM, Licensing Program Analyst (LPA) Lisette Valenzuela conducted a visit to the above agency to deliver the findings on the listed allegation. LPA met with Dereassa Chambers, Program Manager. During the course the investigation, LPA conducted confidential interviews. According to confidential interviews, and record review, LPA Valenzuela concluded, the allegations that facility staff are not providing assistance to Non-Minor Dependent, had inconsistent support.Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated, and no Title 22 deficiencies were observed. Exit interview was conducted and a copy of this report was emailed to Dereassa Chambers, Program Manager, whose signature on this form confirms receipt of these documents. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Carolyn Flynn LICENSING EVALUATOR NAME: Lisette Valenzuela 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 3

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

met_with: Dereassa Chambers


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13At 11:45AM on December 1, 2022, Licensing Program Analysts (LPAs) Lisa Schlembach and Shikya Belfield conducted an unnanounced complaint inspection at the above-listed agency. The LPAs met with Administrator Lauren Grayman and DeReassa Chambers (County Program Manager - Santa Clara County) who assisted with the visit. Program Director Rachel Carlos made herself available via telephone for the duration of the visit. Based on confidential interviews, staff and client file reviews, and review of other agency documentation it was confirmed that the agency did not ensure that all participants had safe, healthy, and comfortable homes to live in. An exit interview was conducted with Lauren Grayman, and a copy of this report, along the associated deficiency page and appeal rights was emailed to Lauren Grayman and Rachel Carlos. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Carolyn Flynn LICENSING EVALUATOR NAME: Lisa Schlembach 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 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: FIRST PLACE FOR YOUTHFACILITY NUMBER: 015650108


raw_content:
Investigation Findings:
13On 10-4-23 10:29AM, Licensing Program Analyst (LPA) Karkazis conducted an unannounced inspection at First Place for Youth and met with Rachael Carlos, Regional Director of Programs, who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. Regarding the allegation that THP is not meeting participant's needs: Licensing Program Analyst (LPA) conducted confidential interviews with staff, clients, and conducted document research. During confidential interviews, inconsistent information was provided. Some interviewees stated that the facility was not doing anything to meet the client's needs while other interviewees were providing alternatives to meet the participant's needs. LPA conducted document research and found that all participants were safe and not in danger, and alternative living arrangements provided. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the THP is not meeting participant's needs. Therefore, the above allegation is UNSUBSTANTIATED. An exit interview was conducted and a copy of this report was given to Rachael Carlos, Regional Director of Programs. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: George Karkazis 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 3

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


raw_content:
Investigation Findings:
13On 12-8-23 10:38AM, Licensing Program Analyst (LPA) George Karkazis conducted an unannounced inspection at First Place For Youth, and met with De Reassa Chambers, Clinical Program Manager, who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. The complaint alleged that staff did not keep the apartment free of cockroaches. LPA conducted confidential interviews, document research and obtained photos of cockroaches in the apartment. A written timeline of services was provided to LPA Karkazis. Based on the information obtained, there is a preponderance of evidence to prove the above allegation is SUBSTANTIATED. First Place For Youth has since relocated the client and shall not be cited at this time. An exit interview was conducted, Appeal Rights were provided, and a copy of this report was left with De Reassa Chambers, Clinical Program Manager. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lidia Tinoco LICENSING EVALUATOR NAME: George Karkazis 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO RO, TRAEGER AVE., SUITE This is an official report of an unannounced visit/investigation of a complaint received in our office on 09/26/2023 and conducted by Evaluator George Karkazis PUBLICCOMPLAINT CONTROL NUMBER: 14-CR- FACILITY NAME:FIRST PLACE FOR YOUTHFACILITY NUMBER: ADMINISTRATOR:LAUREN GRAYMANFACILITY TYPE: ADDRESS:426 17TH STREET, #100TELEPHONE: (510) 272- CITY:OAKLANDSTATE: CAZIP CODE: CAPACITY:250CENSUS: 60DATE: 12/08/ UNANNOUNCEDTIME BEGAN: 10: AM MET WITH:De Reassa Chambers, Clinical Program ManagerTIME COMPLETED:12: PM 9Staff entered the minors apartment without prior consent. INVESTIGATION FINDINGS: 13On 12-8-23 10:38AM, Licensing Program Analyst (LPA) George Karkazis conducted an unannounced inspection at First Place for Youth, and met with De Reassa Chambers, Clinical Program Manager, who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. The complaint alleged that staff entered the minor's apartment without consent. LPA Karkazis conducted confidential interviews and document research which provided inconsistent information. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation occurred. Therefore, the allegation is UNSUBSTANTIATED. An exit interview was conducted and a copy of this report was given to De Reassa Chambers, Clinical Program Manager. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lidia Tinoco LICENSING EVALUATOR NAME: George Karkazis 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: 2 of 2

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


raw_content:
Investigation Findings:
13On 03/21/2024 at 2:22PM, Licensing Program Analysts (LPA) George Karkazis and LPA Jasmine Cardeno conducted a visit to First Place for Youth (Concord) to deliver the findings on the listed allegation. LPA Karkazis and LPA Cardeno met with Liz Gomez, County Program Manager During the course of the investigation, LPA Karkazis conducted confidential interviews and reviewed records. According to confidential interviews and records review, LPA Karkazis concluded that the allegation, "Staff did not ensure the apartment was free of cockroaches," had inconsistent support. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegation is UNSUBSTANTIATED. An exit interview was conducted and a copy of this report was printed and given to Liz Gomez, County Program Manager whose signature on this form confirms receipt of these documents. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: George Karkazis LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Liz Gomez, County Program Manager


raw_content:
Investigation Findings:
13On 12-18-24 10:26AM, Licensing Program Analyst (LPA) George Karkazis conducted an unannounced inspection at First Place for Youth (FPFY) and met with De'Reassa Chambers, Clinical Program Manager, who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. The complaint alleged that staff allowed minor to have possession of weapons. LPA Karkazis conducted confidential interviews, reviewed documentation, and it was confirmed that a client in care had weapons. LPA obtained a photo of the weapons in possession of the minor. Confidential interviews disclosed that the client was instructed to remove the weapons and first to keep them in their vehicle. They then later were asked to be stored away from the premises. Based on the information obtained, there is a preponderance of evidence to prove the above allegation staff allowed minor to have possession of weapons is SUBSTANTIATED. The facility is being cited for Title Interim Licensing Standards AB Nonminor Dependents, THPP Article 06. 86272(a) PERSONAL RIGHTS. An exit interview was conducted, appeal rights provided, and a copy of this report was given to De'Reassa Chambers, Clinical Program Manager. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: George Karkazis 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 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO RO, TRAEGER AVE., SUITE FACILITY NAME: FIRST PLACE FOR YOUTHFACILITY NUMBER: 015650108

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


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Christopher Rollins made an unannounced required Annual inspection to First Place For Youth Administrative office. LPA met with Lauren Grayman Administrator. The Transitional Housing Placement Plus Foster Care program (THP-FC) services non-minors dependents. At 01: PM, LPA did a walk through inspection with Administrator of the office. The office has sufficient space for confidential meetings, all participant files and staff files are located in a locked cabinet in a secure location. The agency has their license posted in their office. The office is in compliance with Community Care Licensing (CCL) regulations. LPA spoke with Administrator about the residential units. Administrator stated that all residential units have all working toilets, sinks and tubs. Administrator stated that all disinfectants and cleaning supplies are locked up and inaccessible. Administrator notified LPA that the program provides all participants with household essentials and that there are no weapons or firearms stored in the apartment units. At 02: PM, LPA reviewed 9 participants files with Administrator. LPA observed all Participants files to be complete and found no deficiencies. All documents are complete and up to date. At 2: PM LPA observed 7 staff files to be complete, all documentation is up to date and all staff training were up to date/current. During inspection, LPA receive a updated copy of the LIC Personnel Report to maintain their file current. LPA also spoke with Administrator about updating the Program Administrator documents. A review of Licensing Information System on September 28, 2021 indicates that all facility staff associated to the facility had DOJ, FBI and child abuse index check clearances. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted and a copy of the report was left at the facility.

met_with: Lauren Grayman- Administrator


summary: Facility Evaluation

raw_content:
Narrative:
A virtual office meeting was conducted on January 28, 2022 on Microsoft Team regarding a death of a client (C1). Present in this meeting are: CCL: Helga Wong LPM, Nelson Martinez RM, and Alyssa Ng LPA THPP: Jamie Kugelberg and Rachel Carlos In the meeting the following were discussed: - Information on the death of C1 - Client's background and case history - Incident reports - Needs and Services - Client's achievement and challenges LPA Ng requested the following from the THPP: - C1's last 6 months records -C1's roommate recent records - Incident reports related to C At this time client's cause of death is unknown and still under investigation.

met_with: Jamie Kugelberg


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
Licensing Program Analyst (LPA) Lisette Valenzuela and Licensing Program Manager (LPM) Isabel Mendoza made an unannounced required Annual inspection to First Place For Youth Administrative office. LPA Valenzuela and met with Lauren Grayman Administrator. The Transitional Housing Placement Plus Foster Care program (THP-FC) services non-minors dependents. At 10: AM LPA Valenzuela and LPM Mendoza arrived to facility and the administrator was not present. At 10: AM Lauren Grayman, Administrator arrived to the facility. At 11: AM, LPA did a walk-through inspection with Administrator of the office. Facility has access to password protected electronic files, which staff members have access to them. The office has sufficient space for confidential meetings, all participant files and staff files are located in a locked cabinet in a secure location. The agency has their license posted in their office. LPA spoke with Administrator about the residential units. Administrator stated that all residential units have all working toilets, sinks and tubs. At 11: AM ,LPA Valenzuela and LPM Mendoza reviewed 10 participants files (P1- P10) (Please refer to LIC 811 for confidential names, dated 05/24/22) with Administrator. During participant file reviews LPA and LPM was not able to locate medical assessment for all 10 participants. The Administrator stated that the facility staff request copies from the participants. However the participant do not always release that information. During inspection, the Administrator showed LPA and LPM their intake and staff case notes which showed that this was being completed, however the medical assessments were not performed by a licensed physician. In addition the facility did not have the clients ambulatory status on file. At 12: PM LPA Valenzuela and LPM Mendoza reviewed 10 staff files which were complete. However LPA and LPM discovered that several staff members were not fingerprint cleared. It was later learned that they provided staff files that did not work for the above licensed facility. The facility keeps staff files for the whole region, and not just of the licensed facility, which made it difficult for LPA Valenzuela and LPM Mendoza to conduct an adequate staff file review. LPA Valenzuela and LPM Mendoza advised facility going forward to provide staff files for the above licensed facility only. LPA Valenzuela and LPM Mendoza reviewed an additional 5 staff files, which all staff were fingerprint cleared and all staff files were complete. Please note HR employee was out today, 05/24/22. LPA was unable to obtain an updated LIC 500. LPA requested the facility to submit a copy to LPM Mendoza via mail no later than Friday 5/27/22. The facility is currently in the process of changing administrators and will submit all required correct documents to CCL once they confirm who they will designate. LPA was not able to interview staff due to the time consumption of the Staff and Participant file reviews. Facility cited for violation of California Code of Regulations, Title Division Six, regulation 86069(a) and 86069(b)(4): Participant Medical Assessments. In addition, Two Technical Violations were issued. An exit interview was conducted and a copy of the report was emailed to the Administrator.

Deficiencies:
86069(a): Deficient Practice Statement
1
2
3
4Based on all participant files review and interview with administrator, the licensee did not comply with the section cited above in 10 out of 10 participant files. Which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/30/2022
Plan of Correction
1
2
3
4

title:
Participant Medical Assessments

(a) Prior to or within 30 calendar days following the acceptance of a participant, the licensee shall obtain a written medical assessment of the participant, as specified in Section 80069(b), which enables the licensee to determine his/her ability to provide necessary health related services to the participant. The assessment shall be used in developing the Needs and Services Plan.

This requirement is not met as evidenced by


summary: Facility Evaluation

raw_content:
Narrative:
On 11/15/22 at 3:45PM, Licensing Program Analyst (LPA) Mariah Hawkins made a health check visit to the THPP office and met with Regional Director Rachel Carlos and Clinical Manager Jameson Wolf and informed of the purpose of the visit. The purpose of the visit was to follow-up on the death of a participant. Relevant information and documentation was obtained at visit. An exit interview was conducted, and a copy of this report was provided to Regional Director Rachel Carlos and Clinical Manager Jameson Wolf, whose signature on this form confirms receipt.

met_with: Regional Director Rachel Carlos; Clinical Manager Jameson Wolf


summary: Facility Evaluation

raw_content:
Narrative:
**Due to technical laptop issues, this form is superseded by the latter LIC809 form also dated 12/1/2022.** At 11:50AM on December 1, 2022, Licensing Program Analysts (LPAs) Lisa Schlembach and Shikya Belfield conducted an unannounced visit of the above listed agency. The LPAs met with Program Administrator Lauren Grayman and DeReassa Chambers (County Program Manager - Santa Clara County) who assisted with the visit. LPA Schlembach explained that the purpose of the visit was to conduct a case management regarding deficiencies observed by LPA Schlembach during the course of a complaint investigation dated 06/27/2022. Based on confidential interviews, reviewing staff, client, and agency files, LPA Schlembach confirmed the following: 1. The agency did not report incidents to the Department, as required. This is a violation THPP ILS, Section 86261(a)(4), which states, "The licensee or THPP staff shall report to the licensing agency and the person or agency responsible for placing a nonminor dependent, such as a social worker or probation officer, when any of the following events occur... Any unusual incident that involves a nonminor dependent and threatens the physical or emotional health or safety of the nonminor dependent or anyone in the THPP." 2. The agency did operate in accordance with the terms specified in the Plan of Operation. This is a violation of THPP ILS Section 80022(k), which states, "The facility shall operate in accordance with the terms specified in the Plan of Operation. *Continued on LIC809-C* **Due to technical laptop issues, this form is superseded by the latter LIC809 form also dated 12/1/2022.** Specifically from FPFY's Plan of Operation: · Complaints of noise, cleanliness or other site specific concerns will result in a warning letter. · Violations of the visitor policy will result in increased visits from program staff. Repeat violations will result in a final warning and either relocation or exit from the program. · Duplicating apartment keys for non-participants or any behavior that threatens the safety of the youth or others will result in the youth being relocated as soon as possible and the convening of a team decision meeting with the youth, MFP staff, and county workers to determine youth's continued eligibility for the program. · FPFY staff provide round-the-clock support to participants. MFP maintains round-the-clock on-call support for program participants at all times. On-call staff respond by telephone and in-person if needed to address complaints and emergencies. On-call staff are supported by a program supervisor, administrator or agency executive at all times. · A Safety Plan is used when a client has expressed that his/her safety is threatened by an EXTERNAL source. · All social work staff receive annual in-service training equivalent to at least 20 hours. First Place for Youth provides 24 hours of initial orientation training to each staff person including Child Abuse Reporting, Rights of Participants, Characteristics of Transition Age Foster Youth, Strengths based and Trauma Informed Assessment and Intervention, Motivational Interviewing, Assessment, Crisis Response and De-escalation; Skill Building; and Documentation. First Place for Youth provides a minimum of twenty hours of in-service training per FTE annually. An exit interview was conducted with Lauren Grayman, and a signed copies of the following forms was emailed to Lauren Grayman and Rachel Carlos: LIC809 - Facility Evaluation Report, LIC809-C - Facility Evaluation Report Continued, and LIC809-D - Facility Evaluation Report Deficiencies.

met_with: Luaren Grayman


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) George Karkazis made an unannounced required Annual inspection to First Place for Youth. LPA met with Jameson Wolf, County Program Manager. The Transitional Housing Placement Plus Foster Care program (THP-FC) services non-minors dependents. Safety precautions were taken including screening call and mask wearing. The facility is licensed for 250 participants. Present were three staff members and no clients At 1:30PM, LPA did a walk through inspection with Jameson Wolf . The office has sufficient space for confidential meetings, all client files and staff files are located in a locked cabinet in the Human Resources Office. The agency has their license posted in their office. The office is in compliance with Community Care Licensing (CCL) regulations. LPA spoke with Jameson Wolf about the residential units. Jameson Wolf stated that all residential units have at least one toilet, sink and tub in working order. Jameson Wolf stated that all disinfectants and cleaning supplies are locked up and inaccessible. Jameson Wolf notified LPA that the program provides all participants with household essentials and that there are no weapons or firearms stored in the housing units. At 1:57PM, LPA reviewed five client files and five staff files with Jameson Wolf. LPA observed five client files to be complete and found no deficiencies. All documents are complete and up to date. LPA observed five staff files to be complete, all documentation is up to date and all staff training were up to date/current. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted and a copy of the report was given to Jameson Wolf, County Program Manager

met_with: Jameson Wolf, County Program Manager,


summary: Facility Evaluation

raw_content:
Narrative:
On September 29, 2025 a Case Management visit was conducted by Licensing Program Analyst (LPA) Omar Sawyer and LPA Vaishali Singh-Sood. The purpose of this inspection is to re-deliver an amended report from March 3, 2025. The purpose of that inspection was to conduct a Case Management visit to obtain more information regarding a serious incident. LPA Sawyer and LPA Singh-Sood met with Nicole Harrington, Regional Director of Programs. ***On 3-3-25 12:00PM, Licensing Program Analyst (LPA) George Karkazis conducted an unannounced inspection at First Place for Youth and met with Nicole Harrington, Regional Director of Programs. On 3-2-25 at approximately 3:24PM, LPA received a voicemail from First Place for Youth's Nicole Harrington, Regional Director of Programs. The purpose of the inspection was to obtain additional information regarding a serious incident. Nicole Harrington has already submitted an incident report. An Oakland Police report has been requested. At this time the investigation is not complete, further interviews and document research are required. An exit interview was conducted, and a copy of this report was given to Nicole Harrington, Regional Director of Programs. On September 29, 2025 - No deficiencies were cited. Exit interview was conducted with Nicole Harrington, Regional Director of Programs, regarding the amended report, whose signature confirms receipt and a copy of the amended report was left at the facility office.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPA) George Karkazis and Will Ea made an unannounced required Annual inspection to First Place for Youth. LPA met with Nicole Harrington, Regional Director of Programs. The Transitional Housing Placement Plus Foster Care program (THP-FC) services non-minors dependents. The facility is licensed for 250 participants. Present were two staff members and no clients At 12:15PM, LPA did a walk through inspection with Nicole Harrington . The office has sufficient space for confidential meetings, all client files and staff files are located in a locked cabinet in the Human Resources Office. The agency has their license posted in their office. The office is in compliance with Community Care Licensing (CCL) regulations. LPA spoke with Nicole Harrington about the residential units. Nicole Harrington stated that all residential units have at least one toilet, sink and tub in working order. Nicole Harrington stated that all disinfectants and cleaning supplies are locked up and inaccessible. Nicole Harrington notified LPA that the program provides all participants with household essentials and that there are no weapons or firearms stored in the housing units. At 10:15AM, LPA reviewed five client files and five staff files with Nicole Harrington. LPA observed five client files. C2 did not have a health and education summary, nor a TILP. LPA observed five staff files to be complete, all documentation is up to date and all staff training were up to date/current. . The facility is receiving two citations for Non-Minor Dependent Records ILS 86270(a)(2)(B) and ILS 86270(a)(2)(D). Appeal right were provided, Exit interview conducted and a copy of the report was given to Nicole Harrington, Regional Director of Programs.


summary: Facility Evaluation

raw_content:
Narrative:
On September 29, 2025 a Case Management visit was conducted by Licensing Program Analyst (LPA) Omar Sawyer and LPA Vaishali Singh-Sood. The purpose of this inspection is to re-deliver an amended report from August 7, 2025. The purpose of that inspection was to complete and close a Case Management report regarding a serious incident, which occurred 03/02/25. LPA Sawyer and LPA Singh-Sood met with Nicole Harrington, Regional Director of Programs. The investigation was conducted fully by the licensing agency's Investigations Branch (IB). Investigator(s) conducted confidential interviews and record reviews. At this time the investigation is complete, and no further interviews or document research are required. No deficiencies were cited. Exit interview was conducted with Nicole Harrington, Regional Director of Programs, whose signature confirms receipt and a copy of the report was left at the facility office.


summary: Facility Evaluation

raw_content:
Narrative:
Control #: 2467-FN Licensing Program Analyst (LPA) Omar Sawyer and LPA Shikya Belfield made an unannounced case management inspection at the above agency on 12/04/2025 at 10: AM. LPA Sawyer and LPA Belfield met with James Dixon, County Program Manager. The purpose of the inspection was to obtain more information from the Transitional Housing Placement Program (THPP) regarding an Incident Report that was submitted to Community Care Licensing (CCL) by the THPP. According to the incident report there was a violent domestic dispute with Participant 1 ( see lic811 dated 12/4/25), where participant was injured and law enforcement was involved. LPA Sawyer requested a Current Housing Placement map for current Participants in the THPP specifically. LPA Sawyer conducted confidential interviews and requested copies of the safety plan that was created as a result of the incident. Confirmation of the safety of the participant was confirmed and this case management is complete. An exit interview was conducted with James Dixon, County Program Manager. A copy of this report was printed and left with James Dixon, whose signature confirms receipt.

met_with: James Dixon, County Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
** Due to technical laptop errors, this form supersedes the previous LIC809 form, also dated 12/1/2022.** At 11:50AM on December 1, 2022, Licensing Program Analysts (LPAs) Lisa Schlembach and Shikya Belfield conducted an unannounced visit of the above listed agency. The LPAs met with Program Administrator Lauren Grayman and DeReassa Chambers (County Program Manager - Santa Clara County) who assisted with the visit. LPA Schlembach explained that the purpose of the visit was to conduct a case management regarding deficiencies observed by LPA Schlembach during the course of a complaint investigation dated 06/27/2022. Based on confidential interviews, reviewing staff, client, and agency files, LPA Schlembach confirmed the following: 1. The agency did not report incidents to the Department, as required. This is a violation THPP ILS, Section 86261(a)(4), which states, "The licensee or THPP staff shall report to the licensing agency and the person or agency responsible for placing a nonminor dependent, such as a social worker or probation officer, when any of the following events occur... Any unusual incident that involves a nonminor dependent and threatens the physical or emotional health or safety of the nonminor dependent or anyone in the THPP." 2. The agency did operate in accordance with the terms specified in the Plan of Operation. This is a violation of THPP ILS Section 80022(k), which states, "The facility shall operate in accordance with the terms specified in the Plan of Operation. *Continued on LIC809-C* **Due to technical laptop issues, this form supersedes the former LIC809 form also dated 12/1/2022.** Specifically from FPFY's Plan of Operation: · Complaints of noise, cleanliness or other site specific concerns will result in a warning letter. · Violations of the visitor policy will result in increased visits from program staff. Repeat violations will result in a final warning and either relocation or exit from the program. · Duplicating apartment keys for non-participants or any behavior that threatens the safety of the youth or others will result in the youth being relocated as soon as possible and the convening of a team decision meeting with the youth, MFP staff, and county workers to determine youth's continued eligibility for the program. · FPFY staff provide round-the-clock support to participants. MFP maintains round-the-clock on-call support for program participants at all times. On-call staff respond by telephone and in-person if needed to address complaints and emergencies. On-call staff are supported by a program supervisor, administrator or agency executive at all times. · A Safety Plan is used when a client has expressed that his/her safety is threatened by an EXTERNAL source. · All social work staff receive annual in-service training equivalent to at least 20 hours. First Place for Youth provides 24 hours of initial orientation training to each staff person including Child Abuse Reporting, Rights of Participants, Characteristics of Transition Age Foster Youth, Strengths based and Trauma Informed Assessment and Intervention, Motivational Interviewing, Assessment, Crisis Response and De-escalation; Skill Building; and Documentation. First Place for Youth provides a minimum of twenty hours of in-service training per FTE annually. An exit interview was conducted with Lauren Grayman, and a signed copies of the following forms was emailed to Lauren Grayman and Rachel Carlos: LIC809 - Facility Evaluation Report, LIC809-C - Facility Evaluation Report Continued, and LIC809-D - Facility Evaluation Report Deficiencies.


summary: Facility Evaluation

raw_content:
Narrative:
On 12-18-24 10:26AM, Licensing Program Analyst (LPA) George Karkazis conducted an unannounced inspection at First Place for Youth (FPFY) and met with De'Reassa Chambers, Clinical Program Manager who helped with the inspection. The purpose of the inspection was to conduct a Case Management Inspection. During the complaint investigation dated 9-13-24 #14-CR20240913110932, LPA conducted confidential interviews and document research which revealed in the FPFY program statement that if a client is in possession of weapons (legal, illegal, or simulated) to any FPFY activity, will be exited from the program. Upon discovery of the client's weapons, FPFY issued a housing violation. The client maintained placement and was not exited from the program. The facility is being cited for Title 22, Division 6, Chapter 7, Article 03, 86022(e) Plan of Operation Type B. An exit interview was conducted, appeal rights provided, and a copy of this report was given to De'Reassa Chambers, Clinical Program Manager.


raw_content:
Narrative:
LPA obtained SIR's #835286 and #837766, training log for unscheduled visits, NMD1 notice of lease violation, photos of alcohol bottles in NMD1 apartment, and NMD1 signed program agreement including substance abuse policy. Based on the interviews conducted and documentary evidence, the information gathered did not produce corroborating evidence to support the above said allegation. LPA Edison was not able to determine if the above said allegation occurred, therefore the allegation is determined to be unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. Based on the observations made during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Regional Director of Programs.

Investigation Findings:
13On March 2, 2023 at 2:09pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to First Place for Youth and spoke with Lamont Walker, Regional Director of Programs. The purpose of this visit was to deliver the findings for the above complaint allegation. During the investigation, a total of one (1) witness, three (3) Non-Minor Dependents, and three (3) staff were interviewed. Confidential interviews and inconsistent statements made by staff, witnesses, and Non-Minor Dependent #1 (NMD1) did not substantiate the allegation, Youth is not given privacy. Statements made by S1 and NMD1 did not confirm that NMD1 was not dressed when S1 entered NMD1's bedroom. Confidential interviews revealed upon inspection of NMD1's unit, multiple alcohol bottles were observed by S1 and the smell of marijuana in the unit. Additional confidential staff interviews also revealed NMD1 violated the program agreement on illegal activities/drug use/ alcohol use. Documentary evidence revealed S1 training on conducting unscheduled visits to participant units and notice of NMD1's notice of lease violation. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Daphne Edison 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 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: FIRST PLACE FOR YOUTHFACILITY NUMBER: VISIT DATE: 03/02/2023

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

met_with: Lamont Walker-Regional Director of Programs


summary: Facility Evaluation

raw_content:
Narrative:
On July 30, 2021 at 11:20am Licensing Program Analyst (LPA), Emelyn Sanchez P. made an unannounced visit to the First Place for Youth THPP+FC, for the purpose of conducting an Annual/Required Inspection Visit. LPA, Sanchez P met with Facility Administrator, Jamie Kugelberg who granted access and provided a tour of the Administrative Office which is located at the above said address on the 6th floor of an executive suite that is shared amongst other companies. The facility is licensed to provide transitional housing placement plus foster care (THP+FC) to Non-Minor Dependents only. The office is set up as follows: This is a 13 room office with a lobby area, one small conference room, one large conference room, lunch/break room and printing area. The lobby area has two desks along the wall with three operating computers and chairs. There is also one round table with a sofa and two sofa chairs and small table. The receptionist desks are located to the left when entering the office space. The small conference/classroom area has a table with more then 10 chairs for seating. The large conference room has a large table with 9 chairs and a desk/cabinet with an operating computer to the left when entering the room. The lunch/break room area has a small table with three chairs, microwave, and refrigerator/freeze for staff to use. Clients are not allowed inside the break room without a staff member. In the assigned office space for the Regional Director are the staff files locked in a small cabinet. All client files are kept locked in cabinets in the office room assigned to the Youth Advocates. This office is used by clients, office personnel, and social workers. The facility was inspected and the following was observed: The licensee operates within capacity limitations. A review of all staff clearances conducted on 7/30/2021 indicate that all individuals who require background checks have received criminal record clearances and child abuse index clearances or exemptions. All posting requirements were met. Report Cont. on LIC 809-C. LPA will return to the facility at later date to complete the Annual Inspection (i.e Staff/Client Records review and conduct Staff/Client interviews) No deficiencies observed at the time of the visit. Exit Interview was conducted and a copy of this report was left at the facility.

met_with: Facility Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On August 19, 2021 at 8:00am Licensing Program Analyst (LPA), Emelyn Sanchez P. made an announced visit to the First Place for Youth THPP+FC, for the purpose of conducting a Case Management- Annual Continuation Inspection Visit. LPA, Sanchez P. met with Facility Administrator, Jamie Kugelberg who granted access into the Administrative Office which is located at the above said address on the 6th floor of an executive suite that is shared amongst other companies. The facility is licensed to provide transitional housing placement plus foster care (THP+FC) to Non-Minor Dependents only. LPA Sanchez P. reviewed ten (10) Staff records and ten (10) Client records. LPA Sanchez P. conducted nine (9) staff interviews with Staff #1, Staff #2, Staff #3, Staff #4, Staff #5, Staff #6, Staff #8, Staff #9, and Staff #10. LPA Sanchez P. also conducted eight (8) client interviews with Client #2, Client #3, Client #4, Client #5, Client #6, Client #7, Client #9, and Client #10. No deficiencies observed at the time of the visit. Exit Interview was conducted and a copy of this report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On June 9, 2022 at 9:31am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to First Place for Youth THPP+FC, for the purpose of conducting a two (2) year Required Inspection. LPA Edison met with Lamont Walker, Regional Director of Programs who granted access and provided a tour of the Administrative Office which is located at the above said address on the 6th floor of an executive suite that is shared with other companies. The facility is licensed to provide transitional housing placement plus foster care (THP+FC) to two-hundred and fifty (250) Non-Minor Dependents only. The census on the date of this visit is one hundred thirty-three (133). The office is set up as follows: This is a thirteen (13) room office with a lobby area, one small conference room, one (1) large conference room, lunch/break room and printing area. The lobby area has two (2) desks along the wall with three (3) operable computers. There is also one (1) round table with a sofa, two (2) chairs, a and small table. The receptionist desks are located to the left when entering the office space. The small conference/classroom area has a table with ten (10) or more chairs for seating. The large conference room has a large table with nine (9) chairs and a desk/cabinet with an operable computer to the left upon entrance to the room. The lunch/break room area has a small table with three (3) chairs, microwave, and refrigerator/freezer for staff use. Clients are not permitted inside of the break room unless accompanied by a staff member. Staff files are kept locked in a small cabinet in the office occupied by the Regional Director of Programs. Client files are kept locked in cabinets in the office occupied by the Youth Advocates. The Youth Advocate office is also used by clients, office personnel, and social workers. Continued on LIC 809-C During this visit, LPA reviewed three (3) staff records and conducted two (2) staff interviews. Caregiver(s)/adults working/residing in the facility have DOJ/FBI criminal record clearances and Child Abuse Index Checks. Emergency Mass Disaster Casualty Plan was available for review. LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. Direct care staff have valid CPR and First Aid training. All posting requirements were met. During this visit, LPA reviewed three (3) client records. Client records contained copies of Needs and Service Plans and Medical Authorizations signed by each child and their authorized representative. Children are accorded dignity in personal relationships with staff and others. Off Site Living Units Inspected: 1. El Segundo Blvd. #4, Compton, CA 90222 2. Denker Ave. #B , Gardena, CA The facility was inspected, and the following was observed: The licensee operates within capacity limitations. There were no firearms or other weapons observed inside of the living units. No bodies of water on living unit premises. Overall, the offsite living units are safe, sanitary, and in good repair for the safety and wellbeing of clients, employees, and visitors. Smoke detectors and carbon monoxide detectors tested audible and are in operable condition in the living units. There is a fully charged regulation fire extinguisher in the units. Hot water was tested and is in a safe temperature range. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit Interview was conducted, and a copy of this report will be emailed to the Regional Director of Programs.


summary: Facility Evaluation

raw_content:
Narrative:
On August 18, 2022 at 1:16pm, Licensing Program Analyst (LPA), Daphne Edison made an unannounced visit to First Place for Youth for the purpose of conducting a Case Management for Special Incident #823167, Non-Minor Dependent (NMD) Death. LPA met with Lamont Walker, Regional Director of Programs and discussed the incident. A Special Incident Report was submitted to Community Care Licensing (CCL) on August 12, 2022 for the incident which occurred on August 5, 2022, when Non-Minor Dependent #1 (NMD1) (see Confidential Names List, LIC 811 dated 8/18/2022) was involved in a fatal automobile accident in the state of Idaho. During this visit, confidential interviews were conducted with Staff #1. Additional staff interviews will be conducted on a later date. Staff interview conducted on this day revealed that NMD1 had driven alone to the state of Idaho where NMD1 was involved in a fatal automobile accident. Staff interviews also revealed that upon being notified of the death of NMD1, the facility staff immediately notified Community Care Licensing (CCL) of the death of NMD1. Additionally, LPA Edison learned that NMD1's placement with First Place for Youth was closed effective August 5, 2022 per the date of NMD's death . Based on the information gathered at this time, the facility took proper action regarding the incident in question and no violation will be cited on this day regarding this case management incident. Exit interview was conducted, and a copy of this report will be emailed to the Regional Director of Programs.


summary: Facility Evaluation

raw_content:
Narrative:
On February 14, 2023 at 8:40am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to First Place for Youth THP+FC for the purpose of conducting a Case Management for Special Incident Report #841202. LPA met with Lamont Walker, Regional Director of Programs and discussed the incident. During this visit, confidential interviews were conducted. Additional interviews will be conducted at a later date. LPA discussed CCL Reporting Requirements with licensee. LPA requested and was provided a copy of the current LIC 500 and the participant list. This case management needs further investigation. Based on the observations made during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Regional Director of Programs.


summary: Facility Evaluation

raw_content:
Narrative:
On September 29, 2023, Licensing Program Analyst (LPA) C. White made an unannounced visit to First Place for Youth THP+FC for the purpose of conducting a Case Management Visit in regard to Special Incident Report #919788 dated 09/25/2023; received by CCL on 09/26/2023. LPA met with Clinical Program Manager, Mariya Libman and discussed the incident. Per the report the incident occurred on 09/24/2023. During this visit, a confidential interview was conducted. Additional interviews will be conducted at a later date. LPA requested and was provided the following: a copy of the current LIC 500, the current participant list, contact information for Client #1 and Client #2. This case management needs further investigation. Based on the information gathered during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report was emailed to the Clinical Program Manager.

met_with: Mariya Libman - Clinical Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 7/31/2024, at 11: AM, Licensing Program Analyst (LPA) Regina Martin attempted an unannounced Case Management - Incident inspection at First Place For Youth. LPA Martin later spoke with Administrator via telephone in response to Special Incident Report (SIR #: 1054175) submitted to Community Care Licensing (CCL) on 6/25/2024. LPA Martin informed the incident has been referred to CCL Investigations Branch, Investigator Edward Hector. Upon completion of the investigation, the investigation findings will be delivered and discussed. LPA Martin requested the following documents to be emailed including Client Roster, Personnel Report (Schedule) LIC500, and Needs and Services and Transitional Independent Living Plan for subject participant. Please submit requested documents to LPA Regina Martin at regina.martin@dss.ca.gov The incident requires further investigation. There are no deficiencies cited per California Code of Regulations, at this time. A copy of this report was emailed to Administrator for signature.


summary: Facility Evaluation

raw_content:
Narrative:
On August 15, 2024, (LPA), Licensing Program Analyst Kim Dear made a unannounced visit to the First Place For Youth organization to conduct a Annual Inspection. LPA was met by Brandy Sperry, the Office Administrator whom granted access into the facility, Ms. Sperry then contacted LaMont Walker,LPA began the inspection of the physical plant areas of the facility. The facility provides care and supervision for non- minor dependants. The facilities current census, consists of (143), one- hundred and forty- three clients, non- ambulatory only. The facility location is on the (6th.),sixth floor, suite 200. This location has (15) office rooms and a mid- sized conference room. The office spaces has a desk set up with chairs aligning the office walls. The individual office set- ups displayed a computer and desk personalized with artifacts of its occupants. The conference room housed an abundance of seating chairs neatly stack top one another and a cherry- wood finished table with seating chairs for (12), twelve individuals sat in the center of the room. All required certifications, fire clearance, License of Operational type documents were displayed in frames about the hall way wall. Fifteen staff files and (5) client files were reviewed (15). Two staff were present for interviews, however no clients were available for interviewing at the time of this inspection. Mr. Walker provided the current LIC500 and client rosters via email. Both documents containing almost identical information as to the LIS printout. During this inspection, the LPA found the facility to be clean, sanitary, organized and free from hazard(s). No deficiencies could be visually found nor identified after completion of the CARES Tool, therefore no citations will be issued at this time. The exit interview was conducted, and a copy of this inspection report will be emailed to the Regional Director, LaMont Walker.

met_with: LaMont Walker