raw_content:
Narrative:
Other confidential interviews disclosed that the deliveries were thought to be food deliveries. An additional allegation alleging Staff did not prevent minors from engaging in inappropriate interactions with each other was received by CCL. Confidential interviews and record review confirm residents did engage in physical altercations. Confidential interviews reported varying accounts of how staff handled the physical altercations. Confidential interviews reported some staff would attempt to de-escalate the involved residents by using crisis communication, stepping in between the residents, and/or separating the residents involved. Additional confidential interviews reported some staff were hesitant and/or too fearful to get involved so they did not intervene. Confidential interviews and record review could not confirm or dispute the allegation. CCL received an additional allegation of minors do not have adequate meals. Record review revealed menus are created and food shopping is completed weekly. Confidential interviews reported conflicting reports of the facility not adhering to the posted menu due to residents not wanting what is on the menu. Confidential interviews reported residents are often required to make their own microwavable meals or provided with noodles to eat. Confidential interviews could not confirm, or dispute minors do not have adequate meals. An allegation alleging staff (unknown) refused to transport minor (Child #5 [C5]) to court ordered visitation. Confidential interviews and record review provided conflicting reports of how the facility handled transportation to court ordered visitations. Confidential interviews reported the facility is often short staffed and unable to take residents for visitations and the facility will often take residents on a different day stating they got mixed up with dates in order to make it appear as though attempts were made to adhere to court orders. Additional confidential interviews reported that all court ordered visitations are adhered to. Confidential interviews and record review were unable to confirm, or dispute staff refused to transport minor to court ordered visitation. CCL received an additional allegation staff (unknown) sleep while on shift. Confidential interviews provided conflicting reports of staff sleeping while on shift. Confidential interviews reported due to staff shortages staff was often asked to work long hours and were observed sleeping while on shift. Additional confidential interviews denied witnessing or knowledge of staff sleeping while on shift. Confidential interviews and record review could not confirm or dispute staff (unknown) sleep while on shift. ****** An additional allegation alleging staff (unknown) interfered with minors (Child #5 [C5]) right to file a complaint with licensing was received by CCL. Specifically, it was reported licensing gave C5 a business card for C5 to contact licensing which was confiscated so C5 could not contact licensing. Confidential interviews reported facility staff, specifically the Administrator, conduct room checks in the mornings and if business cards are found they are confiscated. Confidential interviews confirmed room checks for contraband are conducted in the mornings by administration. Confidential interviews provided conflicting statements of what items are confiscated when room checks are completed. Confidential interviews reported the only items confiscated are contraband while other interviews disclosed business cards for both licensing and county workers have been confiscated if they were visible during the room check. An allegation alleging facility has pests was received by CCL. Specifically, it was reported Child #5 (C5) was observed to have six bug bites on her body. Record review revealed earlier in the year the facility did undergo treatment for bed bugs and other insects. Record review revealed the facility replaced soft surfaces including mattresses, couches, and curtains. Confidential interviews revealed although the facility had been treated earlier in the year bugs and insects were still a routine problem in the facility. Confidential interviews and record review could not confirm or dispute where and when C5 was bitten. An allegation alleging the facility is malodorous was also received by CCL. Specifically, it was reported the facility smelled of mold and was causing congestion problems for residents. Confidential interviews reported the facility often had a heavy smell of bleach or other cleaning products. Confidential interviews reported the heavy cleaning solution smell was due to cleaning and to cover other smells in the facility and not mold. Confidential interviews could not confirm or dispute the allegation. CCL also received an allegation alleging staff (unknown) left minor (Child #1 [C1]) at the park unsupervised. Specifically it was reported C1 was taken to the park for a two-hour supervised outing with unknown staff, after an hour of being at the park unknown staff was called by the facility and was told to return, leaving C1 at the park. Confidential interviews provided conflicting reports of C1 being left at the park. Confidential interviews reported all of C1's outings are required to be supervised and at no time was C1 left at the park unsupervised. Conflicting confidential interviews reported staff would often drop residents off for supervised visits but would not stay with the residents. Record review was unable to provide evidence of C1's outing and/or C1 being left at the park. Confidential interviews could not confirm or dispute the allegation. ****** Based on record review and confidential interviews the allegations of Staff allowed drug dealer to come to the home and sell to the minors, Staff did not prevent minors from engaging in inappropriate interactions with each other, Minors do not have adequate meals, Staff (unknown) refused to transport minor (Child #5 [C5]) to court ordered visitation, Staff (unknown) sleep while on shift, Staff (unknown) interfered with minors (C5) right to file a complaint with licensing, Facility has pests, Facility is malodorous, and Staff (unknown) left minor (Child #1 [C1]) at the park unsupervised may or may not have occurred, however it is not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. A copy of the report and appeal rights were given to a facility representative. Original signature placed on file. addressed the issue of clients smoking on facility grounds by providing additional staff training. Based on confidential interviews and record review the allegation minors are allowed to smoke marijuana while in care is substantiated. The preponderance of evidence standard has been met. This is a violation of Interim Licensing Standards (ILS) standard 87087(c) Buildings and Grounds The licensee shall prohibit smoking in the facility and on the grounds of the facility. Resolved due to expiration of the STRTP license, as outlined in the September 2022 settlement agreement. A copy of the report and appeal rights were given to a facility representative. Original signature placed on file.

Investigation Findings:
13Community Care Licensing is delivering the finding(s) for the above stated allegationLPA conducted an inspection of the facility on March 14, 2022 at approximately 3:00 pm and no immediate deficiencies were observed. The investigation was conducted by LPA Strickland and included interviews with ADM, Staff #1 (S1), Staff #2 (S2) and Staff #3 (S3), four foster children Child #1 [C1], Child #3 [C3], Child #5 [C5], and Child #7 [C7]), Open Case Investigator (OCI) and ADM . In addition, county records and facility records were reviewed. On March 7, 2022, Community Care Licensing (CCL) received an allegation alleging staff allowed minors to use marijuana. Confidential interviews and record review provided consistent statements and accounts of residents being observed smoking in the facility bathroom, the residents' bedroom, and in the backyard of the facility on multiple occurrences. Confidential interviews reported if staff addressed the residents who were smoking, they did so by directing residents to smoke outside or to open the window. The facility has SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland 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 CCLD Regional Office, MAIN ST., SUITE This is an official report of an unannounced visit/investigation of a complaint received in our office on 03/07/2022 and conducted by Evaluator Nicole Strickland PUBLICCOMPLAINT CONTROL NUMBER: 19-CR- FACILITY NAME:ALPHA CONNECTION-NISQUALLY NEST, THEFACILITY NUMBER: ADMINISTRATOR:AMY OSBORNFACILITY TYPE: ADDRESS: CHIEF JOSEPH RDTELEPHONE: (760) 247- CITY:APPLE VALLEYSTATE: CAZIP CODE: CAPACITY:6CENSUS: DATE: 11/08/ UNANNOUNCEDTIME BEGAN: 02: PM MET WITH:Facility Representative TIME COMPLETED:03: PM 9Staff allowed drug dealer to come to the home and sell to the minors Staff did not prevent minors from engaging in inappropriate interactions with each other. Minors do not have adequate meals Staff refused to transport minor to court ordered visitation Staff sleep while on shift. Staff interfered with minors right to file a complaint with licensing Staff smoked cigarettes on premises of group home Facility is malodorous Staff left minor at the park unsupervised INVESTIGATION FINDINGS: 13Community Care Licensing is delivering the finding(s) for the above stated allegation(s). LPA conducted an inspection of the facility on March 14, 2022 at approximately 3:00 pm and no immediate deficiencies were observed. The investigation was conducted by LPA Strickland and included interviews with ADM, Staff #1 (S1), Staff #2 (S2) and Staff #3 (S3), four foster children Child #1 [C1], Child #3 [C3], Child #5 [C5], and Child #7 [C7]), Open Case Investigator (OCI) and ADM . In addition, county records and facility records were reviewed. On March 7, 2022, Community Care Licensing (CCL) received an allegation alleging Staff allowed drug dealer to come to the home and sell to the minors. Confidential interviews provided consistent statements of residents having deliveries of marijuana to the facility. Confidential interviews reported staff allowed these deliveries to keep the facility calm. Conflicting confidential interviews reported staff would turn the delivery drivers away. Confidential interviews could not confirm or dispute that staff allowed these deliveries. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland 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: 3 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-NISQUALLY NEST, THEFACILITY NUMBER: VISIT DATE: 11/08/2022

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:


state: CA

facility_name: ALPHA CONNECTION-NISQUALLY NEST, THE

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Record review of the facilities communication log/running log revealed during the period for April 13, 2022 through May 1, 2022 staff noted 14 separate incidents were residents (Child #1 [C1], Child #3 [C3], Child #5 [C5], Child #8 [C8], and/or Child #9 [C9]) were observed to be smoking alone or with other residents. Information obtained from confidential interviews disclosed that staff would not always address clients who were smoking. Confidential interviews stated that when staff chose to address clients smoking on facility grounds, staff would direct clients to smoke outside or to open the window at the facility. The facility addressed the issue of clients smoking on grounds by providing additional staff trainings. An additional allegation alleging staff did not report an incident involving a minor was received by CCL. Record review was unable to provide evidence of the facility reporting Child #3 (C3) and Child #8 (C8) going AWOL on April 25, 2022. Record review revealed the facility submitted an incident report noting C3 and C8 were returned to the facility on April 27, 2022 after being AWOL for two days. A review of the facilities communication log/running log revealed on April 25, C3 and C8 left the facility at @ 6:45pm and were considered AWOL. Additional record review was unable to provide evidence that the 14 separate instances regarding the allegation of staff allowing minors to do drugs in the facility where (Child #1 [C1], Child #3 [C3], Child #5 [C5], Child #8 [C8], and/or Child #9 [C9]) were observed smoking in the facility were reported as required. Two additional allegations alleging staff called minors inappropriate names and staff (Administrator [ADM]), made inappropriate comments towards minors was also received by CCL. Specifically it was reported Child #5 (C5) was having an issue with school and when C5 addressed the issue with staff and ADM, ADM told C5 "tell someone who cares." Additional confidential interviews provided consistent statements of ADM referring to and calling at least three minors (Child #1 [C1]), Child #3 [C3] and C5) as sluts, hoes, and b*****s. Confidential interviews further reported when ADM would attempt to confiscate the minors contraband ADM was heard saying "give me the s**t, you nasty slut." An additional allegation was received by CCL alleging staff withheld minor's (Child #5 [C5]) allowance. Specific information as to which staff withheld the minor's allowance was not disclosed. Confidential interviews reported in March of 2022, C5 had C5's allowance withheld for talking with CPS, CWS, or licensing. Record review could not confirm C5 receiving C5's allowance for the week of March 9, 2022, April 6, 2022 and April 20, 2022. ****** simple reminders as staff including ADM would include inappropriate comments and inappropriate names when talking with minors. Based on record review and confidential interviews the allegations staff provided illegal drugs to minors, staff (Staff #4 [S4]) hit minor (Child #5 [C5]), staff (S4) restrained minor (C5), minors are forced out of the facility, and staff (Administrator [ADM]) harassed minor (C5), may or may not have occurred, however they are not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. A copy of the report and appeal rights were given to a facility representative. Original signature placed on file. illegal drugs but refused to disclose which staff. Additional confidential interviews confirmed the residents use of marijuana and/or methamphetamine however, denied knowledge of staff providing the illegal drugs to minors stating they are not sure how and where the residents obtained the illegal drugs. Two additional allegations alleging staff (Staff #4 [S4]) hit minor (Child #5 [C5]) and staff (S4) restrained minor (C5) were received by CCL. Specifically it was reported S4 hit C5 in the face and put her in a choke hold; unknown date of incident. Record review and confidential interviews could not confirm or dispute these allegations. Confidential interviews reported that the facility does not go hands on when there are issues at the facility. Conflicting confidential interviews reported the facility only restrains as a last resort. Confidential interviews reported C5 "went off" on S4 hitting and kicking and even spitting on S4 . Confidential interviews reported S4 was attempting to restrain C5 in order to protect S4 and hit C5 during the restraint. Record review revealed an incident between S4 and C5 occurred on 4/8/2022 where C5 hit S4, however there is no documentation that S4 attempted to restrain C5 during the incident. An additional allegation was received by CCL alleging minors are forced out of the facility. Specific information as to which staff force minors out of facility was not disclosed, however it was disclosed that minors are forced out in order for Child Protective Services (CPS), County Social Workers (CSW), or licensing not to have the opportunity to speak with minors. Confidential interviews provided conflicting statements regarding staff forcing minors out of the facility. Confidential interviews reported that once the facility is aware that CPS, CWS, or licensing is in the area staff contact administration and then are directed by administration to take residents on impromptu outings. Confidential interviews reported impromptu outings include going to get ice cream, going to IHop or to the store. Additional confidential interviews deny the allegation and report residents are only taken on approved outings. An additional allegation alleging Staff (Administrator [ADM]) harassed minor (C5). Specifically it was reported that ADM would purposely attempt to get a reaction from C5 by touching and moving C5's belongings. Confidential interviews could not confirm or dispute ADM harassing C5. Confidential interviews reported many of the residents would claim to feel harassed when staff are attempting to redirect them or providing residents with reminders to stick to the program. Conflicting confidential interviews reported that staff's, specifically ADM's redirection and/or reminders were more than just redirection or Based on confidential interviews and record review the allegations of Staff allowing minors to do drugs in the facility, Staff did not report an incident involving a minor, Staff called minors inappropriate names, Staff made inappropriate comments towards minors, and Staff withheld minor's allowance are substantiated. The preponderance of evidence standard has been met. This is a violation of Interim Licensing Standards (ILS) standard BUILDINGS AND GROUNDS 87087(c) The Licensee shall prohibit smoking in the facility and on the grounds of the facility; ILS standard REPORTING REQUIREMENTS 87061(b)(4) Any unusual absence or failure of a child to return or inform the facility that they are not returning for a specified period of time; two violations of ILS standard PERSONAL RIGHTS 87072(c)(10) To be accorded dignity in their personal relationships with staff and other persons and PERSONAL RIGHTS 87072(c)(18) To receive an allowance. Resolved due to expiration of the STRTP license, as outlined in the September 2022 settlement agreement. A copy of the report and appeal rights were given to a facility representative. Original signature placed on file.

Investigation Findings:
13Community Care Licensing is delivering the finding(s) for the above stated allegation(s). LPA conducted an inspection of the facility on May 3, 2022 at approximately 2:30pm and no immediate deficiencies were observed. The investigation was conducted by LPA Strickland and included interviews with four foster youth (Child #1 [C1], Child #3 [C3], Child #5 [C5], and Child #7 [C7]), three staff (Staff #1 [S1], Staff #2 [S2] and Staff #3 [S3]), Open Case Investigator (OCI), and ADM. In addition, county records and facility records were reviewed. On April 29, 2022, Community Care Licensing (CCL) received an allegation alleging staff allowing minors to do drugs in the facility. Specifically, it was reported when Open Case Investigations (OCI) investigator visited the facility OCI observed a strong smell of bleach and cleaning products. When OCI addressed the strong odor staff stated "Oh good, because some of these kids smoke weed" in the home. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-NISQUALLY NEST, THEFACILITY NUMBER: VISIT DATE: 11/08/2022

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:

report_type: Complaint Investigation

met_with: Facility Representative

complaint_status: unsubstantiated


raw_content:
Narrative:
Based on interviews and record reviews the allegations that C1 threatened C2, may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. A copy of the report and appeal rights was given to a facility representative. Original signature placed on file. Based on interviews and record reviews the allegation that C1 had access to dangerous objects is substantiated. This is a violation for California Code of Regulations (CCR) Title 22, Division 6, Section 80087(g) Buildings and Grounds. Resolved due to expiration of the STRTP license, as outlined in the September 2022 settlement agreement. A copy of the report and appeal rights were provided to the facility representative. Original signature placed on file.

Investigation Findings:
13Community Care Licensing is delivering the finding for the above stated allegation. LPA Jose Gonzalez conducted an inspection of the facility on May 12, 2022 at 12:37 pm and no immediate deficiencies were observed. Five of five children (C1, C2, C3, C4, C5), three staff and facility administrator were interviewed. It was reported to Community Care Licensing (CCL) that C1 had access to dangerous objects. Confidential staff interviews reported that C1 was in the kitchen with staff #1 (S1) assisting in cooking, when C1 threatened C2 with the knife. Confidential interviews reported that staff was contacted law enforcement for assistance and was able to get the knife away from C1. Confidential staff interviews reported that C1 was able to grab the knife due to the knife being accessible in the kitchen. Confidential interviews reported that C1 was given a 14-day due to C1's aggressive behaviors. The interviews that were provided to the LPA were consistent regarding the allegation that C1 had access to dangerous objects (knife). SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Darlene Almaraz 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 CCLD Regional Office, MAIN ST., SUITE This is an official report of an unannounced visit/investigation of a complaint received in our office on 05/05/2022 and conducted by Evaluator Darlene Almaraz PUBLICCOMPLAINT CONTROL NUMBER: 19-CR- FACILITY NAME:ALPHA CONNECTION-NISQUALLY NEST, THEFACILITY NUMBER: ADMINISTRATOR:AMY OSBORNFACILITY TYPE: ADDRESS: CHIEF JOSEPH RDTELEPHONE: (760) 247- CITY:APPLE VALLEYSTATE: CAZIP CODE: CAPACITY:6CENSUS: DATE: 12/02/ UNANNOUNCEDTIME BEGAN: 02: PM MET WITH:Facility RepresentativeTIME COMPLETED:02: PM 9Minor threatened another minor while in care. INVESTIGATION FINDINGS: 13Community Care Licensing is delivering the finding for the above stated allegation. LPA Jose Gonzalez conducted an inspection of the facility on May 12, 2022 at 12:37 pm and no immediate deficiencies were observed. Five of five children (C1, C2, C3, C4, C5), three staff and facility administrator were interviewed. It was reported to Community Care Licensing (CCL) that C1 threatened C2. Confidential interviews staff interviews reported that C1 had threatened C2 on several other occasions and had a history of making threats to C2. Information obtained from confidential interviews and record review revealed that staff would intervene and verbally redirect C1 from making threats to C2. According to record review a Child, Family and Team (CFT) was held to discuss C1's aggressive and "bully" behaviors. Confidential interviews reported that C1 was given a 14-day due to C1's aggressive behaviors. Other confidential interviews disclosed that staff did not always verbally intervene in the threatening gestures and remarks made to C2 by C1. LPA received inconsistent information regarding the allegation. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Darlene Almaraz 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: 3 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-NISQUALLY NEST, THEFACILITY NUMBER: VISIT DATE: 12/02/2022

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:
Narrative:
appointment a few days later that facility staff was instructed to reduce the dosage back to only once per day as they had been doing so before the juvenile hall placement. Confidential interviews stated that facility staff immediately canceled the second dose of the medication once they were informed that it exceeded the prescribed dosage. While other confidential Information received by the Licensing Office stated that these allegations had occurred. There were no other known witnesses to these allegations. Based on interviews and confidential information obtained during the course of this investigation, the allegations that Staff did not dispense medication to youth according to doctor's orders, as well as mismanaged youth's medication, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Program Director, Amy Osborn to discuss the investigative findings for the above stated allegations. Licensing Program Analyst (LPA), Daniel Mena conducted an inspection to the Group Home (GH) on November 17, 2023, at 10:35am. No immediate hazards observed. LPA Mena interviewed Facility Administrator (FA), Facility Manager (FM), Medical Professional (DR), one of one foster children involved (C1), County Social Worker (CSW), as well as reviewed C1 and facility records. Community Care Licensing received information on November 08, 2023, alleging that Staff did not dispense medication to youth according to doctor's orders, as well as mismanaged youth's medication. Information obtained in confidential interviews did not corroborate the allegations with a preponderance of evidence. LPA obtained conflicting information during interviews. Confidential interviews denied allegations that staff had mismanaged and incorrectly dispensed medication for Child # 1 (C1). According to confidential information, C1's medication dosage was increased while C1 was placed in juvenile hall for several weeks. According to confidential interviews, when C1 was discharged from juvenile hall they were provided two medication bubble packs, one for morning dosage and one for evening dosage, and continued to administer medication this way. According to interviews, it was not until C1 had a medical UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-NISQUALLY NEST, THEFACILITY NUMBER: VISIT DATE: 12/22/2023

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

met_with: Amy Osborn


raw_content:
Narrative:
C3 had allegedly found on C2's phone. LPA Mena obtained conflicting information as to how C3 had gotten a hold of C2's cellphone, but all interviews denied that staff had allowed or provided C2's cellphone to C3. While other confidential Information received by the Licensing Office stated that these allegations had occurred. Based on interviews and confidential information obtained during the course of this investigation, the allegations that that due to a lack of care and supervision a client hit another client, as well as posted an inappropriate picture of another client while in care, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13icensing Program Analyst (LPA), Daniel Mena met with Administrator, Evonnda Hull to discuss the investigative findings for the above stated allegations. Licensing Program Analyst (LPA), Daniel Mena conducted an inspection to the Group Home (GH) on November 03, 2023, at 12:35am and on December 22, 2023, at 9:12am. No immediate hazards observed. LPA Mena interviewed Facility Manager (FM), Program Director (FD), five staff (S1, S2, S3, S4 & S5), three of three foster children involved (C1, C2 & C3), as well as reviewed client and facility records. Community Care Licensing received information on October 31, 2023, alleging that due to a lack of care and supervision a client hit another client, as well as posted an inappropriate picture of another client while in care. Information obtained in confidential interviews did not corroborate the allegations with a preponderance of evidence. LPA Mena obtained conflicting information during interviews. Confidential interviews denied allegations of a lack of care and supervision resulting in C3 being hit by C1 and C2 during a physical altercation. According to confidential interviews, C3 as well as C1 and C2 were all physical aggressors at different points of the altercation, and staff immediately intervened and eventually physically separated C3 away from C1 and C2. Confidential interviews also denied that staff had allowed C3 to get a hold of C2's cellphone resulting in C3 posting inappropriate pictures of C2 on the online that UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-NISQUALLY NEST, THEFACILITY NUMBER: VISIT DATE: 01/10/2024

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

met_with: Evonnda Hull


summary: Facility Evaluation

raw_content:
Narrative:
On September 23, 2021, Licensing Program Manager (LPM) Christina Barnes, and Licensing Program Analyst (LPA) Jose Gonzalez arrived at Alpha Connection- Nisqually Nest Short Term Residential Therapeutic Residential Program (STRTP). LPM and LPA, were met and granted access by and Facility Manager Elizabeth Lecona. The purpose of the visit is to conduct an annual inspection of the facility. At 9: AM, Program Director Amy Osborn, led the physical inspection of the facility with LPM Barnes and LPA Gonzalez. A physical plant inspection was completed and included the facility's, activity center, gaming room, kitchen area, refrigerator/freezers, food storage areas, client bedrooms, bathroom/showers and garage. Facility grounds are clean and free of debris and observable hazards. Sports equipment/toys/books/games/computers were observed for children's recreation time. There is adequate indoor and outdoor activity space. Facility smoke detectors and carbon monoxide detectors are in working order; fire extinguisher is properly charged and serviced. Licensee maintain an adequate supply of perishable and non-perishable foods and the menus were posted. All other required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsperson poster. Medications are locked and centrally stored inside staff's office. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. The hot water in the client's bathrooms was measured to be between 107 and 125 degrees. Per the Administrator, no firearms or weapons are allowed in the facility. The facility has a dining area, kitchen area, living room, open common area/formal living room, a clinician's office for therapeutic services, an entertainment room, and a room where the washer and dryer are located. All bedrooms have individual beds and drawer space for each client. The facility ensures that there is one client per bed with appropriate linens, pillows, comforters, and mattresses in good repair. Chemicals and/or poisons, sharp objects/knives are locked in a file cabinet in the staff office.**Cont809c** First Aid Kits are stored in a locked cabinet in the staff office. LPM and LPA reviewed the facility's disaster and mass casualty plan. The facility currently has two children sharing each bedroom. The facility must ensure that each client is aware of the bedroom sharing policy and document the advisement in the clients' files. Based on record review, the facility did provide a signed bedroom sharing document in their files. The facility is also required to ensure all client medications refusal are documented and signed by staff in the MARs medication log. LPA informed Administrator that all staff members need to complete the required 40 hour training as noted in ILS standards by October 2021. An exit interview was conducted and a copy of this report, LIC 809, and appeal rights were provided to Administrator.

report_type: Facility Evaluation

visit_type: Annual

met_with: Program Director Amy Osborn


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheraki Davis on 11/02/2021 at 2: PM. During the inspection, LPA met with Amy Osborn, Administrator and Lesly Rodas, Facility Director and inspected the facility. LPA reviewed two out of two child's psychotropic records on site at the facility at 2: PM. During the review of children's records, LPA observed one out of two children (C1) did not have a current JV 220 and JV 223. LPA reviewed two staff personnel files on site at the facility at 3: PM. LPA began two staff interviews at 3: PM. LPA interviewed one out of two children currently taking psychotropic medication beginning at 3: PM. One child refuse to interview. LPA conducted exit interview with Amy Osborn at 4: PM. LPA provided the Summary Report, LIC 9102, Appeal Rights to Amy Osborn, Administrator upon completion. One Advisory Notes- Technical Violation was issued (refer to LIC 9102) during the inspection.

visit_type: Case Management

met_with: Amy Osborn, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On March 23, 2022, at 1:00pm an Informal Office Conference was held with the Alpha Connection Youth and Family Services Inc. (ACYFS) Corporation via Microsoft Teams. The following people were in attendance: Regional Manager (RM) LaCresha Cook, Licensing Program Managers (LPMs) Christina Barnes, Cheraki Davis, Licensing Program Analyst (LPA) Jose Gonzalez, Law Enforcement Contact Review Unit, (LPM) Angela King, Department of Health Care Services (DHCS) Jennifer Margedant, San Bernardino Behavioral Health Representatives Melissa Graham, Olivia Oliveros, and Diane Wolkenhauer, System of Care (SOC) Marjana Jackson and Dianna Wagner, San Bernardino County STRTP Coordinator Evelyn Martinez, San Bernardino County Children and Family Services (CFS) Amy Guisa, San Bernardino County investigation social workers Raquel Holguin and Norma Jimenez, Tulare County investigating social worker Emergency Response Lucia Rodriguez, Tulare County CWS Social Worker Brenda Bustos, Tehama County Angela Ackley, CFS manager, placement resource division Tracy Raymond, California Alliance for Child and Family Services Ric Weisgal, SSSP Fallon Greene. ACYFS Administrative staff, Chief Executive Officer Barron Wilson, Program Director/ Facility Administrator Amy Osborn, Facility Administrator Evonnda Hull, Clinician Lindsay Ruston, Clinician, Mark Daniels, and Dan Thorne. Nisqually Nest The following information was discussed: · Administrative oversight · Trauma Informed Care, Services and Approach · Head of Service Capacity · Law enforcement service calls *******CONTINUED on LIC C****** Absence Without Leave (AWOLS) · Clients have poor school attendance · Ongoing client substance abuse (alcohol and drugs) · Clients' lack of motivation towards the program · Lack of varied activities · Staff Supervision · Staff unable to manage defiant clients · Lack of detail in Special Incident Reports (SIRs), under-reporting (minimizing), and failure to report · Failure to follow program statement · Attempting to handle serious problems without involving law enforcement · Supervision of clients · Administrative Rounds · Lack of reporting to CCL, authorized representatives and San Bernardino Behavioral Health contract consultant · CSEC The Department recommended the licensee take full advantage of the System of Care support service recommendations, Law Enforcement Contact Review Unit advice for submitting law enforcement incident reports, San Bernardino Behavioral Health contract consultants' recommendations for the Head of Service and Department of Health Care Services request to update the facilities therapy sessions policy. RM Cook emphasized the importance of following the actual policies and procedures written in the program statement, corrective action and facility oversight. The facility was given until 04/8/2022 to submit the plan of corrections to Community Care Licensing (CCL) for approval. The licensee agrees to the following: 1. CCL is recommending an increase in staffing to ratios to increase the staff to client ratios. The licensee will submit a staff supervision plan. ******CONTINUED on LIC C ****** 1. The licensee will submit proof of daily administrative rounds completed by Administrator or administrative staff. Overnight rounds shall be included between the hours of 9pm and 6am to check on the well-being of clients and staff. The visits shall be at various hours, a minimum of 15 minutes, and shall be documented in the daily logbook. The visiting Administrator or administrative staff shall sign the logbook, state the time and date of arrival, time and date of departure, and any unusual observations. 2. Submit a plan on how the licensee will address the lack of staff involvement in preventing/dissuading clients engaging in CSEC behaviors. Plan will include how facility will encourage client involvement in preventing CSEC behaviors. 3. The licensee shall train staff to immediately contact law enforcement if staff believe that a crime has occurred or is in progress. Proof of training will be submitted. 4. The licensee will submit a plan on how incident reports are reviewed by administration, including the facility's plan of action/correction and how the facility will ensure the appropriate agencies are receiving the incident reports. 5. Within 24 hours of an incident, Administrator will submit an incident report to CCL, placement agencies, authorized representatives, and San Bernardino Behavioral Health contract consultant regarding SIRs with client-involved aggression/assaults, regardless of the location of the incident, when a client refuses to go to school, drug use, drug paraphernalia, and contraband found in placement. Provide full details describing the incident and the disposition including the facility's plan of action/correction. 6. The licensee shall submit a report of 2022 planned activities from January through March 31, 2022. The report needs to include the dates, times, and location of each activity, the names of clients who participated in each activity, and include the names of clients who did not participate and the reasons why. 7. The licensee will submit a plan to reduce AWOLs. 8. The licensee shall submit a plan to address smoking and drug use at the facility. An exit interview was conducted, a copy of this report was emailed to Barron Wilson. A copy of the signed report will be placed in the facility file.

met_with: Provisional License Informal Conference


summary: Facility Evaluation

raw_content:
Narrative:
On June 3, 2022 at 10: AM, Licensing Program Analyst (LPA) Leslie Covarrubias arrived unannounced at Alpha Connection- Nisqually Nest STRTP and met with Facility Manager, Pasami Savea. The purpose of this visit was to interview a client regarding an open investigation on the client's previous placement. The client refused to be interviewed. A copy of this report was given to Facility Manager, Pasami Savea. This report was emailed to Pasami Savea, Facility Manager for signature. Original signed reports will be placed in facility file.

met_with: Facility Manager, Pasami Savea


summary: Facility Evaluation

raw_content:
Narrative:
On June 10, 2022 at 11:31am, Licensing Program Analyst's (LPA's), Darlene Almaraz-Oseguera and Jose Gonzalez, conducted a collateral visit to the facility for the purpose of interviewing client #1 and client #2, client #3 (see Confidential Names form (LIC 811), dated June 17, 2022), regarding a prior placement. The interview is not related to this facility. Exit interview conducted and a copy of this report was provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Nicole Strickland arrived unannounced to Alpha Connection-Nisqually Nest and met with Administrator (ADM), Evonda Hull to deliver an amended report originally delivered March 14, 2022. A copy of this report along with the Amended report was provided to Administrator (ADM), Evonda Hull.

met_with: Administrator (ADM), Evonda Hull


summary: Facility Evaluation

raw_content:
Narrative:
On July 16, 2022, at 8:58 am, Licensing Program Analyst (LPA) Jose Gonzalez and Licensing Program Manager (LPM) Christina Barnes made an unannounced case management visit to Alpha Connections Nisqyually Nest (STRTP) regarding the STRTP staff/ client ratio. LPA and LPM conducted a health and safety inspection. During the health and safety inspection, LPA and LPM reviewed the facility log to determine compliance. LPA and LPM observed the facility log to be in compliance during the visit. LPA observed plastic utensils are being used by clients during mealtimes and staff stated clients are provided metal utensils upon request. There were no deficiencies observed during the visit. A copy of the report was discussed and provided to Alpha Connection Facility Manager (FM), Jasmin Morales.

met_with: Facility Manager (FM) Jasmin Morales


summary: Facility Evaluation

raw_content:
Narrative:
On August 17, 2022, at 9:57 am, Licensing Program Analyst (LPA) Jose Gonzalez and San Bernardino County Children Family Services (CFS) Amy Guisa made an unannounced case management visit to Alpha Connections Nisqyually Nest (STRTP) regarding the STRTP staff/ client ratio. LPA and CFS conducted a health and safety inspection. During the health and safety inspection, LPA and CFS observed the following chemicals underneath the kitchen sink, three light bulbs missing in the middle restroom, bedroom #1 missing light bulb and cover, bedroom #2 light bulb was out, window screen missing, bedroom #2 restroom no toilet paper, no paper towels, and no soap. All observations were corrected day of visit. LPA and CFS reviewed the medication log to determine compliance. LPA and CFS observed medication board change for client #1 (C1) dates August 9, 10, and 11, 2022. PD will provide additional information by end of business day regarding medication board change for C1. A copy of the report was discussed and provided to Alpha Connection Program Director (PD) Amy Osborn.


summary: Facility Evaluation

raw_content:
Narrative:
On August 18, 2022 at 3: PM, Associate Governmental Program Analyst (AGPA) Kim Robinson met with the Short Term Residential Therapeutic Program (STRTP) Administrator, Amy Osborn, to assess an Enhanced Civil Penalty (ECP). On July 13, 2022, the Department concluded a complaint investigation of allegations that a seventeen-year-old client (C1) suffered acute ethanol intoxication, resulting with emergency hospitalization. (See the Confidential Names List, LIC 811, dated August 18, 2022). The allegations were substantiated and the STRTP was cited under the Interim Licensing Standards, Section 87072(c) Personal Rights and 87065.2 (b)(1) Personnel Duties with a $500.00 immediate civil penalty assessment. The investigative evidence gathered shows Alpha Connection - Nisqually Nest (AC-NN) staff neglected to supervise and provide timely medical care of C1, allowing a situation that endangered the health of C1. Based on the analysis of the medical reports and interviews, the Department has determined that an enhanced civil penalty is warranted for STRTP staff neglecting to supervise and provide timely medical care to ensure the well-being of all minors in care as required in the Interim Licensing Standards. Section 11165.2 of the Penal Code defines neglect as negligent treatment or the maltreatment of a child by a person responsible for the child's welfare under circumstances indicating harm or threatened harm to the child's health or welfare. This section describes a number of more or less direct and (always) willful acts that constitute physical abuse. Pursuant to the Enhanced Civil Penalty law, Health and Safety (H&S) code section 1548 (f)(1)(A), the Department will be issuing an immediate civil penalty of $2,000.00. An exit interview was completed, and appeal rights discussed. A copy of this report, the Confidential Names List, Appeal Rights, and a Civil Penalty Assessment - Serious Bodily Injury/Physical Abuse (Form 421-D) were provided to the administrator.

met_with: Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst, Daniel Mena and Licensing Program Manager, Natasha Dunlap conducted a teleconference meeting with Alpha Connection, Program Director, Amy Osborn, Clinician, Lindsay Baston and Consultant, Dan Thorne to discuss and review the probationary conditions that go into effect once Alpha Connections STRTP reverts back to a Group Home on January 01, 2023. On December 31, 2022, the STRTP applications for Alpha Connection Group Home For Children, License No. 366412000, Pine Ridge, Apple Valley, CA 92307; ACYFSAnoka Ranch, License No. 366401649, Anoka Road, Apple Valley, CA 92308; ACYFS-Shoshonee Place, License No. 366402331, Shoshonee Road, Apple Valley, CA 92307; and ACYFS Nisqually Nest, License No. 366403207, Chief Joseph Road, Apple Valley, CA 92308 (collectively the "facilities") are terminated and Alpha will transition/convert back to its group home licenses subject to a three (3) year probationary term with the following conditions: 1. Alpha shall operate each facility in substantial compliance with the regulations and statutes governing the operation of a group home. 2. During the period of Probation, the Department in its sole discretion may conduct unannounced site visits for the purpose of determining whether there is substantial compliance with the regulations and statutes governing the operation of the group home. 3. Alpha will submit an updated group home plan of operation and program statement for each group home to the Department within 30 days of the effective date of this Settlement Agreement and Mutual General Release including but not limited to: administrator pursuant to California Code of Regulations, Title 22, Regulation 84064. 2. No exceptions shall be made to these requirements during probation. 7. Alpha shall ensure that a qualified and certified administrator is present and available on premises of each facility, a minimum of 20 hours a week. In the administrator's absence, a designated substitute as defined in the California Code of Regulations, Title 22, Regulation 84064(d) shall be present and available on the premises of the facility. Alpha shall timely notify the Department of any change in administrator and the name, address, date of hire, background, qualifications, and certification of the new administrator. 8. Alpha shall develop a comprehensive training curriculum for all new and current staff who provide direct care services to children in care. The content of the training shall include, but not be limited to, the following: supervision of youth, reporting requirements to the Department and reporting requirements as a mandated child abuse reporter, personal rights, crisis prevention, and emergency intervention, including Alpha's runaway plan, and all applicable licensing laws and regulations. Training shall be mandatory for all employees. A detailed description of the in-service training and a record of all staff who attended the trainings shall be maintained and made available to the department upon request. a. Training to include (ii) Trauma Informed Interventions and Treatment Practices. Two (2) hours of instruction in the physical and psychosocial needs of the children, including behavior management, de-escalation techniques, and trauma-informed crisis management planning, including the use of emergency interventions. The training plan shall be designed to ensure the provision of trauma-informed services and be appropriate for the population and shall consider the training needs and skill level of staff b. All outstanding training, including but not limited to the training listed above, shall be completed by staff within 45 days of the group home transition. c. Additional staff hired after the transition to the group home must complete the trauma informed training within 45 days of hire and any additional training must be completed within the time frames outlined in the California Code of Regulations, Title 22, Regulation 84065. In the Matter of Alpha Connections Youth & Family Services, Inc. v. CDSS Case No. CVR Settlement Agreement and Mutual General Release 9. Alpha shall adhere to the reporting requirements as defined in California Code of Regulations, Title 22, Regulations 80061, 84061, in the regulations and statutes governing the operation of a group home. Alpha shall report to the Licensing office the following: any unusual incident, including, but not limited to, client death or injury which requires medical treatment, any suspected physical plant changes, and all unexplained absences. These incidents must be reported by the next working day, and a written report of the incident must be submitted within seven days following the occurrence of the incident. All unusual incident reports shall be complete, including addendums and follow-up information. 10. Alpha shall ensure compliance with California Code of Regulations, Title 22, Regulations 84068.1, 84068.2, 84068.3 and 84068.4 regarding Intake Procedure, Needs and Services Plans and Modifications, and Removal and/or Discharge Procedures. Prior to and during placement Alpha shall determine whether it can provide the services necessary to meet the child's needs and to effect discharge if it is determined that Alpha cannot provide the services necessary to meet the child's needs. Further, Alpha shall ensure that an appropriate assessment of a child's compatibility with other children in care is conducted during the intake process and is re-evaluated on a continuance basis when individual needs dictate. Alpha agrees that it shall not accept or retain, and will promptly discharge with written notice to the authorized representative, any child for whom it cannot adequately and safely provide care, any child who requires a higher level of care, and any child who would cause the Alpha to violate laws and regulations, or the conditions of Settlement Agreement and Mutual General Release. a. A description of trauma-informed and evidence-based intervention and de-escalation techniques that will be used to promote the safety of all individuals in the facility, including but not limited to children or nonminor dependents who have a propensity for behaviors that result in harm to self or others. b. A runaway plan that includes a continuum of non-physical interventions and strategies to de-escalate a situation where a child has indicated his /her intent to run away, that will be utilized by staff to prevent and Alpha to runaway behaviors. 4. Alpha shall ensure that all children are supervised 24 hours per day, 7 days per week, in accordance with its Program Statement and Plan of Operation and licensing regulations. 5. There shall be coverage by direct care staff as follows: a. During the hours of 7 am to 10 pm, there shall be one awake and on duty direct care staff for every three children, or fraction thereof, present, at a minimum b. During the hours of 10pm to 7am, there shall be one awake and on duty direct care staff for every six children, or fraction thereof, present, at a minimum. c. In addition to staff required in paragraph 1 or 2, when one or more children are present at the facility, at least one direct care staff shall be on call and capable of arriving at the facility within 30 minutes. d. If a child requires special care and supervision because of age, behavior or other factors, the number of awake and on-duty care staff shall be increased. 6. Any administrator employed by Alpha to operate the facility shall have, at minimum, the education and experience specified in California Code of Regulations, Title 22, Regulation 84064 and shall be certified as a group home 11. Alpha shall ensure the personal rights of all children in its care including the right to be provided safe, healthful, and comfortable accommodations to meet their needs, and shall be free from corporal or unusual punishment, pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other action of a punitive nature. 12. Alpha shall ensure that each child in care receives first aid and medical services, including arrangements and transportation. Further Alpha shall ensure that medications and any other toxic products are properly stored and kept in a safe and locked place that is not accessible to children in care or other persons other than employees responsible for the supervision of the centrally stored medication pursuant to California Code of Regulations, Title 22, Regulation sections 80075 and 84075. Employees of Alpha shall immediately document on the medication log any refusals of medication by a child in care and shall follow-up with proper notification to the child's physician. 13. Alpha's Board of Directors shall be active in ensuring accountability and ensuring that Alpha complies with all applicable regulations, by reviewing, on a quarterly basis Alpha's operation and documents as specified in Health and Safety code section 1520. 1(f), including a review of special incident reports and all licensing reports issued by the Department. 14. For the duration of the probationary period, Alpha shall provide all current and prospective parents or responsible parties of children in the facility with a copy of the settlement terms, as outlined in the Settlement Agreement and Mutual General Release. Proof of Acknowledgement shall be kept in the respective child's record and available for inspection by the Department. 15. Alpha will work collaboratively with the Department to comply and fully implement all Plan of Corrections and agreements. This Settlement Agreement and Mutual General Release supersedes any Compliance Plan or Corrective Action Plan that has previously been submitted by the Alpha to the Department. A copy of this report was provided and emailed for signatures.


summary: Facility Evaluation

raw_content:
Narrative:
On November 7, 2022, Licensing Program Analyst (LPA) Joon Choi and LPA Nicole Strickland, conducted an unannounced visit to the facility, to deliver an amended document initially delivered on September 8, 2022.

met_with: Evonda Hull, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst, Daniel Mena and Licensing Program Manager, Natasha Dunlap conducted a technical assistance meeting virtually via Teams with Alpha Connection Chief Executive Officer, Barron Wilson, Program Director, Amy Osborn, and Consultant, Dan Thorne to discuss and review the following pending Program Statement revisions: 3. PURPOSE, METHODS, AND GOALS Pg. Is highlighted placement agency wording correct because is s now a Group Home? Elaborate on the type of placements facility will take if regional, and plans to become vendorized. Pg. Are there case workers in private placements. Is working correct? Pg. Is there an assigned social worker in private placements? 5. SPECIAL SERVICES/PROGRAMS OFFERED Pg. How many hours per day is the training? Specify Pg. How many hours per class/training? 6. MEDICAL/DENTAL Pg. Medical Liaison (Who is this specifically) • LPA Mena did not see the procedures for handling and assisting children with self-administered medications. • LPA Mena did not see the procedure and staff positions(s) identified who are responsible for dispensing and destroying medications. 15. RUNAWAY PLAN Pg. Initially Define Acronym (AWOL) Pg. Define Acronyms (PO, CSW) · Did not observe mention of staff training Plan. · Did not specify actual time frames when determining when a child is absence without permission, depending on age ro developmental level etc. 16. CHILDREN'S COMPLAINT/GRIEVANCE PROCEDURES Pg. Under Filing Complaints- Where is that exactly is a copy of the complain-grievance policy posted/located? Living room? Kitchen area Pg. Under Procedure for External Complaint- Where is the information/procedure on how to file a complaint with licensing located and available to the client? • Child/authorized representative needs to understand the difference between a grievance & filing a formal complaint with Licensing against facility. 19. NUTRITION/SAMPLE MENU Pg.118 (CNIPS) define acronym. • Include procedure for which all staff (including new & substituting) are aware of dietary restrictions or allergies for all clients. 20. Clothing and Incidentals Pg.137/138 - What is the procedure that ensures that toiletries & personal hygiene products are always available and in stock. How often is shopping done? Who does the shopping? Etc. 22. STAFF QUALIFICATIONS • Attachment # Nicole Amy Squillace/Osborn. What is her title or position? • Attachment # Genesis Duran. What is her title or position? • Attachment # Guy Williams. What is her title or position? • Attachment # Evonda Hull. What is her title or position? 23. JOB DESCRIPTIONS Pg. 142 -Strtp? No longer a Short Term Residential Therapeutic Program Pg.142- GAAP What is this acronym? Pg.159- State's Interim Licensing Standards (Group Home Regulations?) Pg. CCL (define acronym for the reader) 24. INSERVICE TRAINING FOR STAFF Pg.164- "ACYFS complies with the staffing ratios required by the Interim Licensing Standards (ILS)" (Is this wording correct since it's now a GH?) Pg.165- ILS (is this correct since it is now a GH?) 28. FACILITY SKETCH • Did not see indication of number of children in each bedroom on facility sketch. Program Director, Osborn stated that corrections would be provided to Licensing Office by December 16, 2022. 8. ADMISSION/INTAKE Pg. Does highlighted portion need to be updated or corrected. Is this still accurate as a Group Home? 9. NEEDS AND SERVICES PLAN/ASSESSMENT Pg. Should highlighted portion read... and or parent/legal guardian since it is a GH? Pg. Is highlighted Social Worker statement accurate since it is now a GH? 11. VISITATION RULES & POLICY Pg. Where exactly do they take place in the home, supervision, ratios etc. How do you ensure that no contraband is provided by the visitor? Pg. How is transportation provided, are they searched for contraband upon return, who and when do they do it? · What types of visits are NOT permitted 12. HOUSE RULES AND POLICIES Pg. Entertainment Equipment - What are the times when they can be used? What about usage of facility's common use equipment? 13. DISCIPLINE POLICIES Pg. Make clear that withholding of allowances specifically, is not permitted as a form of discipline. 14. EMERGENCY INTERVENTION PLAN Pg. Typo Pg. Under Justification of restraints. Who would typically be the designee?

met_with: Barron Wilson


summary: Facility Evaluation

raw_content:
Narrative:
On February 14, 2023, Licensing Program Analyst (LPA) Daniel Mena arrived at Alpha Connection- Group Home (GH). LPA Mena was granted access by Administrator, Evonda Hull. The purpose of the visit is to conduct an annual inspection of the facility. Administrator led the physical inspection of the facility with LPA Mena. A physical plant inspection was completed and included the facility's visitor's room, living room, bonus room, kitchen area, dinning area, refrigerator/freezers, food storage areas, 3 client bedrooms, and 2 bathroom/showers. Facility grounds are clean and free of debris and observable hazards. Sports equipment/toys/books/games/computers were observed for children's recreation time. There is adequate indoor and outdoor activity space. Facility smoke detectors and carbon monoxide detectors are in working order; fire extinguisher is properly charged and serviced. Licensee maintain an adequate supply of perishable and non-perishable foods and the menus were posted. All other required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsperson poster. Medications are locked and centrally stored inside staff's office. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. Hot water temperature was measured. Administrator stated that water was adjusted at time of visit. Per the Administrator, no firearms or weapons are allowed in the facility. The facility has a dining area, kitchen area, living room, open common area/formal living room, an office, and a room where the washer and dryer are located. All bedrooms have individual beds and drawer space for each client. The facility ensures that there is one client per bed with appropriate linens, pillows, comforters, and mattresses in good repair. CONTINUES on LIC 809C Chemicals and/or poisons, sharp objects/knives are locked in a file cabinet in the staff office. First Aid Kits are stored in a locked cabinet in the staff office. LPA reviewed the facility's disaster plan. The facility currently has two children sharing each bedroom. The facility must ensure that each client is aware of the bedroom sharing policy and document the advisement in the clients' files. Based on record review, the facility did provide a signed bedroom sharing document in their files. LPA Reviewed client's medication and medication logs. See attached LIC 809D for cited deficiency. An exit interview was conducted and a copy of this report were provided to Administrator.

met_with: Evonda Hull


summary: Facility Evaluation

raw_content:
Narrative:
LPA Mena conducted an unannounced Case Management visit on this date. LPA Mena met with Administrator, Evonnda Hull and Facility Manager, Nicole Tracy. While at the facility, LPA Mena reviewed Client Records (C1, C2 & C3) and will obtain copies of pertinent documentation to ensure the facility is meeting the needs of clients in care. In addition, LPA Mena conducted interviews with staff (S1 & S2) and one Client (C1) who were present on facility grounds during visit. An exit interview was conducted and a copy of this report was provide.


summary: Facility Evaluation

raw_content:
Narrative:
LPA Mena conducted an unannounced Case Management visit on this date. LPA Mena met with Administrator, Evonnda Hull. While at the facility, LPA Mena reviewed Client's Records (C1) and will obtain copies of pertinent documentation to ensure the facility is meeting the needs of client in care. In addition, LPA Mena conducted interviews with staff (S1) and Child #1 (C1) who were present on facility grounds during visit. An exit interview was conducted and a copy of this report was provide.


summary: Facility Evaluation

raw_content:
Narrative:
On March 12, 2024, Licensing Program Analyst (LPA) Daniel Mena arrived at Alpha Connection- Group Home (GH). LPA Mena was granted access by Facility Director, Morgan Tyler. The purpose of the visit is to conduct an annual inspection of the facility. Program Administrator, Evonnda Hull led the physical inspection of the facility with LPA Mena. A physical plant inspection was completed and included living room, bonus room, kitchen/dinning area, refrigerator/freezers, food storage areas, 3 client bedrooms, and 2 bathroom/showers. Facility grounds are clean and free of debris and observable hazards. Sports equipment/toys/books/games/computers were observed for children's recreation time. There is adequate indoor and outdoor activity space. Facility smoke detectors and carbon monoxide detectors are in working order; fire extinguisher is properly charged and serviced. Licensee maintain an adequate supply of perishable and non-perishable foods and the menus were posted. All other required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsperson poster. Medications are locked and centrally stored inside staff's office. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. Hot water temperature was measured. Administrator stated that water was adjusted at time of visit. Per the Administrator, no firearms or weapons are allowed in the facility. The facility has a dining area, kitchen area, living room, open common area/formal living room, an office, and a room where the washer and dryer are located. All bedrooms have individual beds and drawer space for each client. The facility ensures that there is one client per bed with appropriate linens, pillows, comforters, and mattresses in good repair. CONTINUES on LIC 809C Chemicals and/or poisons, sharp objects/knives are locked in a file cabinet in the staff office. First Aid Kits are stored in a locked cabinet in the staff office. LPA reviewed the facility's disaster plan. The facility currently has two children sharing each bedroom. The facility must ensure that each client is aware of the bedroom sharing policy and document the advisement in the clients' files. Based on record review, the facility did provide a signed bedroom sharing document in their files. LPA Reviewed client medication and medication logs. There were no deficiencies/corrections observed on this date. An exit interview was conducted and a copy of this report were provided to Administrator.

met_with: Evonnda Huill


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Sarah Lo on 05/08/24 at 09: AM. The case management inspection is conducted pursuant to Health and Safety Code Section 1538.9(a)(2). During the inspection, LPA met with Evonnda Hull, Administrator and inspected the facility inside and out. LPA reviewed (1) children's records on site at the facility. LPA reviewed (5) staff personnel files on site at the facility. LPA reviewed (1) child's psychotropic medications and medication records. LPA interviewed (1) child that is currently prescribed psychotropic medication at their assigned school after the facility visit. No deficiencies are being cited at this time. LPA provided a copy of this licensing reporting and conducted an exit interview with Evonnda Hull, Administrator.

met_with: Evonnda Hull, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On September 20, 2024, Licensing Program Analyst (LPA) Daniel Mena arrived at Alpha Connection- Group Home (GH). LPA Mena was granted access by Facility Staff, Akenese Matavao. The purpose of the visit is to conduct an annual inspection of the facility. Program Administrator, Evonnda Hull led the physical inspection of the facility with LPA Mena. A physical plant inspection was completed and included living room, bonus room, kitchen/dinning area, refrigerator/freezers, food storage areas, 3 client bedrooms, and 2 bathroom/showers. Facility grounds are clean and free of debris and observable hazards. Sports equipment/toys/books/games/computers were observed for children's recreation time. There is adequate indoor and outdoor activity space. Facility smoke detectors and carbon monoxide detectors are in working order; fire extinguisher is properly charged and serviced. Licensee maintain an adequate supply of perishable and non-perishable foods and the menus were posted. All other required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsperson poster. Medications are locked and centrally stored inside staff's office. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. Hot water temperature was measured. Administrator stated that water was adjusted at time of visit. Per the Administrator, no firearms or weapons are allowed in the facility. CONTINUES on LIC 809C The facility has a dining area, kitchen area, living room, open common area/formal living room, an office, and a room where the washer and dryer are located. All bedrooms have individual beds and drawer space for each client. The facility ensures that there is one client per bed with appropriate linens, pillows, comforters, and mattresses in good repair. Chemicals and/or poisons, sharp objects/knives are locked in a file cabinet in the staff office. First Aid Kits are stored in a locked cabinet in the staff office. LPA reviewed the facility's disaster plan. The facility currently has two children sharing each bedroom. The facility must ensure that each client is aware of the bedroom sharing policy and document the advisement in the clients' files. Based on record review, the facility did provide a signed bedroom sharing document in their files. LPA Reviewed client medication and medication logs. There were no deficiencies/corrections observed on this date. An exit interview was conducted and a copy of this report were provided to Administrator.


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst Veronica Whitaker conducted a case management inspection October 1, 2024, at 9: AM based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. During this inspection, 5 out of Direct Care Staff and 2 out of 2 youth files were reviewed. 2 out of Direct Care Staff and 1 out of 2 youth were interviewed. (See the Confidential Names List, LIC 811, dated October 1, 2024. The Plan of Operation including policies and procedures were reviewed. Minutes from the board of directors' meetings related to the facility's incidents involving contact with law enforcement were reviewed. Based on the analysis of the confidential interviews and youth file review including the needs and service assessments, youth case plans, quarterly assessments, and crisis intervention plans, the licensee uses trauma-informed and evidence-based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. LPA Veronica Whitaker observed documentation of completed training on policies and procedures on when and how to involve law enforcement in response to an incident. Training records show staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance to their Emergency Intervention Plan when there is an immediate risk of serious harm to a child or others. There are no deficiencies cited at this time. A copy of this report was discussed and provided to Evonnda Hull, Administrator.


summary: Facility Evaluation

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Narrative:
On July 11, 2025, Licensing Program Analyst (LPA) Daniel Mena arrived at Alpha Connection- Group Home (GH). LPA Mena was granted access by Facility Director, Morgan Tyler. The purpose of the visit is to conduct an annual inspection of the facility. Program Administrator, Evonnda Hull, led the physical inspection of the facility with LPA Mena. A physical plant inspection was completed and included living room, bonus room, kitchen/dinning area, refrigerator/freezers, food storage areas, 3 client bedrooms, and 2 bathroom/showers. Facility grounds are clean and free of debris and observable hazards. Sports equipment/toys/books/games/computers were observed for children's recreation time. There is adequate indoor and outdoor activity space. Facility smoke detectors and carbon monoxide detectors are in working order; fire extinguisher is properly charged and serviced. Licensee maintain an adequate supply of perishable and non-perishable foods and the menus were posted. All other required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsperson poster. Medications are locked and centrally stored inside staff's office. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. Hot water temperature was measured and found to be at Per the Administrator, no firearms or weapons are allowed in the facility. CONTINUES on LIC 809C The facility has a dining area, kitchen area, living room, open common area/formal living room, an office, and a room where the washer and dryer are located. All bedrooms have individual beds and drawer space for each client. The facility ensures that there is one client per bed with appropriate linens, pillows, comforters, and mattresses in good repair. Chemicals and/or poisons, sharp objects/knives are locked in a file cabinet in the staff office. First Aid Kits are stored in a locked cabinet in the staff office. LPA reviewed the facility's disaster plan. The facility currently has three children in care. The facility must ensure that each client is aware of the bedroom sharing policy and document the advisement in the clients' files. Based on record review, the facility did provide a signed bedroom sharing document in their files. LPA Reviewed client medication and medication logs. There were no deficiencies/corrections observed on this date. An exit interview was conducted and a copy of this report were provided to Administrator.


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst Veronica Whitaker conducted a case management inspection September 23, 2025, at 9: AM, based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. During this inspection, 5 out of Direct Care Staff and 3 out of 3 youth files were reviewed. 2 out of Direct Care Staff and 0 out of 3 youth were interviewed. (See the Confidential Names List, LIC 811, September 23, 2025). The Plan of Operation, including policies and procedures, were reviewed. Minutes from the board of directors' meetings related to the facility's incidents involving contact with law enforcement were reviewed. Based on the analysis of the confidential interviews and youth file review including the needs and service assessments, youth case plans, quarterly assessments, and crisis intervention plans, the licensee uses trauma-informed and evidence-based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline.


summary: Facility Evaluation

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Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Jacqueline Garcia on October 15, 2025 at 10: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA met with Evonnda Hull, Administrator and inspected the facility inside and out. LPA reviewed 1 child records and 5 staff personnel files on site at the facility. LPA reviewed 1 of 1 child's psychotropic medications and medication records. LPA interviewed 2 staff on site to discuss the facilities policies and procedures of operation. LPA will return to continue child interview at a later time due to client not being present at this time. During the inspection no deficiencies were cited. LPA conducted an exit interview with Administrator, Evonnda Hull and a copy of this report, LIC 811 dated 10/15/25 were reviewed and provided to Administrator, Evonnda Hull.

met_with: Evonnda Hull-Administrator


summary: Facility Evaluation

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Narrative:
On November 25, 2025, at 11: AM, Licensing Program Analyst (LPA) Daniel Mena met with Alpha Connections Group Home for Children (GH) Facility Director, Morgan Tyler and Program Administrator, Evonnda Hull regarding a case management inspection. The purpose of the inspection is to review facility compliance with the probationary conditions set forth by the Settlement Agreement and Mutual General Release that went into effect on January 1, 2023. While at the facility LPA conducted a records review and conducted staff and client interviews. An annual/required facility inspection was conducted by LPA Mena on July 11, 2025, during which the facility was found to be in compliance with California Code of Regulations, Title 22, Division 6, Chapter 5. A copy of this report was provided to Administrator.


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA), Jose Gonzalez and Licensing Program Manager (LPM) Christina Barnes conducted a safety inspection. During the safety inspection with facility manager (FM) Misty Hutchings, LPA, and LPM observed a cogitate butt by the back-door entrance and bedroom #3 had a cigarette smoke odor.

met_with: Program Director (PD), Amy Osborn


summary: Facility Evaluation

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On April 11, Licensing Program Analyst (LPA), Jose Gonzalez and Licensing Program Manager (LPM) Christina Barnes met with Chief Executive Officer (CEO), Barron Wilson to deliver the finding of a case management. On February 18, Licensing Program Analyst (LPA), Jose Gonzalez and Licensing Program Manager (LPM) Christina Barnes conducted a safety inspection at ALPHA CONNECTION-NISQUALLY NEST, THE 366403207. During the safety inspection LPA, and LPM obtained a copy of a video dated 11/29/2021 in which the Program Director (PD), Amy Osborn, and two clients are having a verbal interaction. LPA and LPM observed that PD was confronting client #1 (C1) in a non-trauma informed approach, for smoking a cigarette in C1's bedroom. PD also threatened to cancel C1's family visit due to C1 smoking a cigarette in the bedroom. LPA and LPM also observed that PD sprayed C1 with air freshener from a can that she was holding. During the video review, LPA and LPM observed that PD's further interaction with C1 was also in a non-trauma informed approach. The facility will be cited for the deficiencies under ILS 87072 (11) Personal Rights. An exit interview was conducted and a copy of this report, was provided to Chief Executive Officer Barron Wilson.


summary: Facility Evaluation - 1 deficiency

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Narrative:
On May 3, 2022 at 4:32pm Licensing Program Analyst (LPA), Nicole Strickland, met with Alpha Connection - Nisqually Nest to deliver a case management deficiencies report. LPA Strickland was at the facility speaking with Administrator Amy Osborne in the staff office. At 3:26pm LPA and Administrator opened the door to the staff office to exit when LPA and Administrator observed the smell of Marijuana. Administrator and LPA walked toward the living room where Staff #1 (S1)was siting with Child #1. Administrator and LPA asked S1 what the smell was to which S1 stated she didn't know. LPA then observed the back door of the facility to be open and Staff #2 (S2) came into the living room from the hallway. Administrator asked S2 about the smell. S2 responded that Child #2 and Child #3 were in the room and had been smoking marijuana. Administrator headed back to room #2 where the door to the room was observed to be closed. Administrator knocked on the door and asked permission to come in. Administrator entered the room and after approximately 30 seconds exited the room with a white cap approximately 1 and 1/2 inches in diameter with marijuana residue and half smoked blunt (marijuana rolled in the form of a cigar). Administrator proceeded to dispose of the contraband and reentered the room and confiscated a container that also had marijuana residue in it. The facility is being cited for violation of Interim Licensing Standards (ILS) standard 87065.2 (b)(1) Personnel Duties (b) Direct care staff shall perform the following duties: (1) supervision, protection, and care of children at all times, individually and in groups. A copy of the report was discussed and provided along with appeal rights to Alpha Connection - Nisqually Nest Administrator (ADM), Amy Osborne.

Deficiencies:
87065.2: (1) supervision, protection, and care of children at all times, individually and in groups.

met_with: Administrator Amy Osborne


summary: Facility Evaluation

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Narrative:
On July 13, 2022, at 5:00 pm Licensing Program Analyst (LPA), Nicole Strickland, met with Alpha Connection - Nisqually Nest, Administrator (ADM), Evonda Hull to deliver a case management deficiencies report. According to information obtained by Community Care Licensing (CCL) there were at least two separate incidents where Child #4 (C4) was jumped/beat up by other residents in the facility. Confidential interviews revealed during one occasion Staff # 1 (S1) observed Child #7 (C7) choking C4 and hitting C4 in the head with a skateboard causing C4 to sustain a knot on C4's head and bruises on C4's neck, arm and thigh. Confidential interviews reported during an interview with C4, on March 2, 2022, Investigations Branch, Special Investigator (SI) observed C4 to have bruising on the side of C4's face. Confidential interviews reported C4 was sitting on C4's bed when Child #2 (C2), Child #6 (C6) and Child #5 (C5) entered the bedroom and "jumped C4, stealing C4's necklace." Confidential Interviews reported during the struggle C4 was hit in the face with the necklace. Confidential interviews reported staff attempted to pull C2, C6, and C5 off of C4 and then provided C4 with ointment. Record review was unable to provide evidence that either of these qualifying events were reported to Community Care Licensing and/or the residents authorized representatives. The facility is being cited for violation of California Code of Regulations (CCR) regulation 80061(b)(1)(E) REPORTING REQUIREMENTS: (b)(1)(E) Any unusual incident or client absence which threatens the physical or emotional health or safety of any client. Confidential interviews and record review revealed an Serious Incident Report (SIR) for incident dated 3/22/22 written for Child #7 (C7) which notes C7 continued to verbally threaten the other resident (not named) stating C7 was going to "kill (Child #6 [C6])." The report notes C7 was so enraged that C7 ran to C7's room, retrieved a pointed comb and threatened to stab the other resident. The report further notes ACYFS staff quickly intervened and created a barrier to prevent C7 from using the comb to cause physical harm, C7 became frustrated that C7 could not get to the other resident, so C7 started to push ACYFS staff threatening to fight them if they did not let C7 go. Confidential interviews revealed when C7 attempted to stab Child # 6 (C6), Staff #4 (S4) "bear hugged" C7 in order to prevent anyone from being injured. Record review revealed the incident was reported to Community Care Licensing and noted that Law Enforcement was contacted, however the SIR does not include information regarding C7 being placed in a manual restraint. The facility is being cited for violation of California Code of Regulations (CCR) regulation 80061(b)(3) REPORTING REQUIREMENTS 80061(b)(3) Each time the child has been placed in a manual restraint, to be reported as required in section 87095.61. A copy of the report was discussed and provided along with appeal rights to Alpha Connection - Nisqually Nest, Administrator (ADM), Evonda Hull.


facility_name: ALPHA CONNECTION-SHOSHONEE PLACE, THE

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Narrative:
clients in this facility. Community Care licensing also received an allegation that minors are unable to sleep while in care. Confidential interviews reported that sometimes at night it's loud. Confidential interviews reported that there are no music playing or loud talking going on at night that prevents clients (C1-C6) from sleeping. Confidential interviews reported that sometimes at night can be noisy but it hasn't been noisy in about two months. Other confidential interviews reported that clients are able to sleep during the night. Based on confidential interviews and information obtained, the allegations that conduct inimical-staff provided drugs and alcohol to minors (C1-C11) while in care, sexual abuse-staff sexually abused the minors (C1-C11) while in care, firearms are present in the facility, staff encouraged the minors (C1-C11) to fight one another while in care, staff did not safeguard the minor's (C5 & C9) personal belongings, minors (C1-C11) are unable to sleep while in care may have occurred, however; is not supported by evidence. Therefore, the allegations are unsubstantiated. A copy of this report and appeal rights were provided to Emanuel Wiley, STRTP Facility Director. witnessing any staff smoking with clients. Confidential interviews reported that S1 denied the allegation. In addition, confidential interviews reported that staff denied witnessing S1 smoking marijuana or providing marijuana to the clients. Confidential interviews reported that staff denied they provided drugs or alcohol to any of the clients at the facility. There were no videos or photographs of the incidents. Community Care Licensing also received an allegation that staff sexually abused the minors (C1-C11) while in care. Confidential interviews reported that clients had sex with S2 but laughed afterwards. Confidential interviews reported that clients bragged they had sex with S2. Confidential interviews denied having a sexual relationship with any of the clients at the facility. Other confidential interviews reported that no one witnessed any inappropriate behavior between clients (C1-C11) and staff. Additionally, a confidential interview denied sexual intercourse with any staff. There were no videos or photographs of the incidents. Community Care Licensing also received an allegation that firearms are present in the facility. Confidential interviews reported that C1 posed with a firearm on social media. Law Enforcement determined the firearm was not real and was an air soft gun. Confidential interviews reported that no firearms were confiscated or on the premises. Confidential interviews reported that clients (C1-C6) haven't had not seen any firearms in the facility. Other confidential interviews reported that clients haven't heard any conversations about firearms between staff and clients (C1-C6). Other information received stated that firearms are present at the facility. Community Care Licensing also received an allegation that staff encouraged the minors (C1-C7) to fight one another while in care. Confidential interviews reported that S3 paid the clients to fight each other as a form of discipline. Other confidential interviews reported that all the clients get along with each other and did not witness staff encouraging clients to fight. Confidential interviews reported that staff doesn't force clients to fight other clients. Confidential interviews reported that some of the clients attempt to have other clients fight each other while other confidential information stated that the allegation was true. Community Care Licensing also received an allegation that staff did not safeguard the minor's personal belongings. Confidential interviews reported that a client (unknown) used C9's scooter. When staff located the scooter, it was returned to C9 damaged/broken. Other confidential interviews reported that staff denied damaging the scooter. Confidential interviews reported that C5 have had some personal items taken by other clients (unknown) and the clients doesn't tell the truth about taking the items. Confidential interviews reported that clients (C1-C4 & C6) haven't had any of their personal belongings taken from staff or from other

Investigation Findings:
13On October 05, 2021 at 4:26pm, Licensing Program Analyst (LPA), Cheraki Davis met with Emanuel Wiley, Short Term Residential Therapeutic Program (STRTP) Facility Director to deliver the finding for the above complaint allegations. The investigation was conducted by Special Investigator Charlotte Jackson of the Community Care Licensing (CCL) Investigations Bureau. Investigation included interviews with Contra Costa County Social Worker, Program Director, Facility Managers, clients (C1-C11), staff, and one adult. Law Enforcement Contact Reports, Appraisal/Needs and Services Plans, Emergency Response Referral Information, and incident reports were reviewed. On May 26, 2021, Community Care Licensing received an allegation which stated staff (unknown) provided drugs and alcohol to minors (C1-C11) while in care. It was reported that staff (unknown) regularly bought drugs and engaged in drug and alcohol use with clients (C1-C11). Confidential interview reported that S1 provided clients with marijuana, took them to buy marijuana, and smoked marijuana with clients at the facility. Other confidential interviews reported that clients denied staff provided them with drugs or alcohol and UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Cheraki Davis LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-SHOSHONEE PLACE, THEFACILITY NUMBER: VISIT DATE: 10/05/2021

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

met_with: Emanuel Wiley


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Additional confidential witness statements indicate that several clients allowance are locked up in the staff office and that the facility staff transport the clients to the store and purchase the items for the clients at the store. CSW also stated that the facility had informed her that they were not going to give C1 his allowance money to hold on his person but instead were going to purchase items that C1 had requested from the store. CSW went on to add that C1 would go AWOL with his money and would return to the home with alcohol, marijuana, and other substances. Based on confidential interviews, the allegation that alleged client #1 (C1) that alleged the clients are not given allowance and that the clients are not provided educational rights., may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Program Director (PD), Amy Osborn. Additional confidential witness statements indicate that C1 was without clothing for approximately two months. Confidential witness statements revealed that C1 had written a list of C1's missing clothing and submitted it to the FM and S1 to fax to the cooperate office. Additional confidential witness statements indicate that C1's missing clothing list was submitted to the corporate office on two different dates. Confidential witness statements revealed that the facility staff were waiting for CEO's approval to release the funds to purchase C1's clothing. During LPA inspection of C1's bedroom C1 had the following items two pair of basketball shorts, a pair of sweats, four pairs of underwear, red pajama pants, and three to four pairs of socks. Additional confidential witness statements indicate that FM and S1 had contacted Program Director, Amy Osborn regarding the funds to purchase C1's clothing. CSW stated that the STRTP facility had informed her that the facility was going to replace C1's clothing. Based on confidential interviews and LPA's observations, and physical inspection at the facility, the facility did not ensure that client #1 (C1) had adequate clothing is Substantiated because the preponderance of evidence standard has been met for the allegation. This poses a potential health, safety, or personal rights risk to clients in care. The facility is being cited under Short-Term Residential Therapeutic Program Interim Licensing Standards (ILS) Chapter 7. Version 3.5 87072(d) Personal Rights (d) The licensee shall ensure that each child, regardless of whether the child is in foster care, is accorded the personal rights specified in Welfare and Institutions Code (WIC) section 16001.9, ...16001.9 (a)(3) To receive...adequate clothing. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Program Director (PD), Amy Osborn.

Investigation Findings:
13On December 21, 2021 at 8:53AM, Licensing Program Analyst (LPA) Jose Gonzalez met with Alpha Connection Shoshonee Program Director (PD), Amy Osborn, to deliver the findings for the above stated allegations. LPA conducted a safety inspection at the facility at 12:09pm on August 13, 2021 and no safety hazards were observed. LPA also reviewed six of six client's records. During the investigation, interviews were conducted with six of six clients (C1, C2, C3, C4, C5, C6), Facility Manager (FM), Staff #1 (S1), and County Social Worker (CSW). The Department received a complaint on August 5, 2021, that alleged the facility did not provide client #1 (C1) adequate clothing. Confidential witnesses stated that C1 did not have enough clothing. Additional confidential witness statements indicate that C1's clothes were taken by C6. Confidential witness statements also revealed that C1 was borrowing clothes from the other clients. **R- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-SHOSHONEE PLACE, THEFACILITY NUMBER: 366402331

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: