summary: Facility Evaluation

raw_content:
Narrative:
On November 13, 2023, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an unannounced annual/required inspection to the facility. LPA met with Sterling Scott, Administrator. The facility is a one-story home with eight (8) bedrooms, three (3) full bathrooms. Currently there are seven (7) clients in placement. LPA obtained and reviewed the roster of clients, Personnel Report, Emergency Disaster Plan, and board minutes. Physical Plant LPA inspected the facility accompanied by Administrator, Scott. LPA inspected the building facility, the gym, and cafeteria located inside the campus LPA observed the following: the posted license, emergency disaster plan, client personal rights, and grievance procedure. The disinfectants, cleaning solutions, sharp objects are locked and inaccessible to clients. Each bedroom has two (2) single beds in good repair with clean sheets and linens and drawers and closet space for the client's clothing. There are extra linens, towels, and hygiene supplies in the cabinets. No room commonly used for other purposes is being used as a bedroom. The window screens are in good repair and free of dirt. There are lights in the rooms and throughout the facility. The faucets on each side of the facility deliver hot water (107 degrees and 115.8 degrees Fahrenheit) within temperature allowed under the regulation. There is a working telephone in the facility. There first aid kit was complete and readily available. The smoke/carbon monoxide detectors are in working order. All medications are centrally stored in the nurse station located in the administration building. All gym equipment is stable and secured and the facility maintains supplies of non-perishable foods for at least a week and fresh perishable foods for at least two days. All indoor and outdoor passageways are unobstructed. Operations The facility maintains a register of clients and is available upon licensing staff request. The client records are centrally stored at the staff office of the facility. The facility has written complaint procedures to file a complaint for the clients and/or their representatives. An exit interview was conducted, and a signed copy of LIC 809, LIC 809C, and LIC 809D were provided to the facility administrator. A deficiency citation was issued at the time of the inspection.


state: CA

facility_name: BOYS REPUBLIC GRAVES STRTP

summary: Facility Evaluation

raw_content:
Narrative:
On December 12, 2023, at 9: AM, Licensing Program Analysts (LPA) Gilbert Gutierrez and Juliet Robles conducted a continuation of the annual/required inspection at the Short Term Residential Therapeutic Program (STRTP) and met Administrator, Sterling Scott. The facility is licensed to serve 16 males, ages 13-17 and non-minor dependents. There are eight (8) clients placed in the facility currently. Client Records LPA reviewed five (5) client records. All client records are available to the licensing to review. Client records contain required information including, but not limited to, consent forms, removal/discipline/complaint procedures, medical assessment, personal property and valuables, education records, personal rights forms and medication administration records. One (1) client was interviewed. Staff Records LPA reviewed five (5 ) staff records. All staff subject to criminal records review have been fingerprinted and cleared. There is documentation of the required education and experience requirements and training. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill at least quarterly. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Needs and Services Plan for each client, medication records, and contact information for each client's responsible party and physician. Operations The facility maintains a register of clients and available upon licensing staff request. The client records are centrally stored at the staff of the facility. The board minutes meeting was available for review. The board of directors conducts meeting at least on a quarterly basis to review and discuss the STRTP's operation. The facility has written complaint procedures to file a complaint for the clients and/or their representatives. An exit interview was conducted, and a signed copy of LIC 809, LIC 809C,and LIC811s were provided to the facility administrator. No deficiency citations were issued at the time of the inspection.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Sterling Scott


summary: Facility Evaluation

raw_content:
Narrative:
On March 4, 2024, at 1: PM, Licensing Program Analyst (LPA) Gilbert Gutierrez made a case management inspection to the facility and met Administrator, Sterling Scott. The purpose of the case management was to follow up on a Special Incident Report (SIR) received by the Department on 03/04/24. The SIR indicated that 03/01/24, at around 10: PM, staff reference #1 (S1) informed all students that they were to go to put several items away, while support Staff reference #2 (S2) was in Hallway 1 speaking to the students. At 10: PM, while S2 was watching Hallway 1, he observed a student heading towards Hallway 2 bathroom that did not belong in that hallway, S1 to intervene. He quickly walked down hallway 2 to restroom the restroom where he observed clients (C1), (C2) and two other students inside. S1 immediately observed a cut on the bridge of C1's nose and a bruised upper lip on C2. C1 was assessed and transported to the hospital for medical attention. C1 also saw the facility nurse on 03/04/24. The proper medical procedures were followed throughout the incident. Staff will receive additional training to ensure that proper supervision and safety is being provided throughout their shift. Both students will continue to process this issue with their respective treatment team to find alternative ways for conflict resolution. LPA conducted interviews and reviewed the staff and client records. This incident needs further follow-up. An exit interview was conducted and copy of the LIC 809 and LIC 811 were provided to the administrator. No deficiency citation was issued at the time of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On April 3, 2024, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez made a case management inspection to the facility and met Administrator, Sterling Scott. The case management was a continuation of the follow-up conducted regarding Special Incident Report (SIR) received on 03/04/24. The SIR indicated that on 03/01/24 while the students were preparing for bedtime, two clients had a physical altercation inside the bathroom. On 03/04/24 and on 03/18/24, LPA conducted interviews. Based on the information gathered, there were two staff supervising 12 clients at the time of the incident. The clients inside the bathroom were doing personal hygiene before bedtime. Staff (S1) step into the office for a while to put away some items. The other staff (S2) was speaking to other clients in another hallway and also attending to the clients' requests for personal hygiene. S1 noticed a client from hallway 1, heading towards the bathroom in hallway 2. He followed the client quickly all the way to bathroom and noticed client (C1) with blood on the bridge of his nose. Ice was applied on C1's injury. C1 was assessed and determined he needed medical attention and was taken to the ER that night. Based on the information gathered, there was enough staff providing supervision to the clients at the time of the incident. The facility staff attended to the client's injury and provided the necessary medical attention. The incident needs no further follow-up currently. An exit interview was conducted and copy of the LIC 809 and LIC 811 were provided to Treatment Director, Garry Hodge. No deficiency citation was issued at the time of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On November 14, 2024, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an unannounced annual/required inspection to the facility. LPA met with Administrator, Sterling Scott and Treatment Director, Garry Hodge. The facility is a one-story building with eight (8) bedrooms, three (3) full bathrooms. Currently there are ten (10) clients in placement. Physical Plant LPA conducted the inspection accompanied by Administrator, Scott and Treatment Director, Hodge. LPA observed the following: the posted license, Ombudsman's information, Foster Youth Bill of Rights, grievance policy, grievance policy, Mental Health Program Approval, emergency disaster plan and facility sketch. There were extra linens, towels, and hygiene supplies in the cabinets. No room commonly used for other purposes is being used as a bedroom. There were lights in the rooms and throughout the facility. The faucets inside the bathrooms deliver hot water (105.6 degrees and 115.5 degrees Fahrenheit) within temperature allowed under the regulation. There was a working telephone in the facility. The first aid kit was complete and readily available. The smoke/carbon monoxide detectors were in working order. All medications were centrally stored in the nurse station located in the administration building. The facility maintains supplies of non-perishable foods for at least a week and fresh perishable foods for at least two days in the cafeteria. All indoor and outdoor passageways were unobstructed. An exit interview was conducted, and a copy of LIC 809 was provided to the administrator. No deficiency citations were issued at the time of the inspection.

visit_type: Annual

met_with: Sterling Scott, Garry Hodge


summary: Facility Evaluation

raw_content:
Narrative:
On November 21, 2024, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an unannounced annual/required inspection continuation to the facility. LPA met with Administrator, Jessica Ruiz and Administrator, Lori Kezos. There are 10 clients placed in the facility. Client Records LPA reviewed five (5) client records. All client records are available to the licensing to review. Client records contain required information including, but not limited to, consent forms, removal/discipline/complaint procedures, medical assessment, personal property and valuables, education records, and personal rights forms. Disaster Preparedness The facility has a disaster and mass casualty plan of action and conducts disaster drills at least quarterly. The facility maintains register of clients, Needs and Services Plan for each client, medication records, and contact information for each client's responsible party and physician. Operations The facility maintains a register of clients available upon licensing staff request. The board minutes meeting was available for review. The board of directors conducts meetings at least on a quarterly basis to review and discuss the STRTP's operation. The facility has written complaint procedures to file a complaint for the clients and/or their representatives. An exit interview was conducted, and a copy of the LIC 809 and LIC 811 were provided to the facility representative. A deficiency citation was issued at the time of the inspection.

met_with: Jessica Ruiz, Lori Kezos


summary: Facility Evaluation

raw_content:
Narrative:
On November 6, 2025, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an unannounced annual/required inspection at the facility. LPA met with Administrator, Sterling Scott, Associate Director, Jessica Ruiz. The facility is a one-story home with eight (8) bedrooms, three (3) full bathrooms. Currently there are ten clients in placement. LPA obtained and reviewed the LIC 500 (Personnel Report) LIC Administrative Organization, Emergency Disaster Plan, and board minutes. Physical Plant LPA inspected the facility accompanied by Administrator, Scott and Associate Director Ruiz. Program Supervisor, Sean Stuart toured the LPA in the cottage. LPA observed the following: the posted license, emergency disaster plan, Ombudsman's client personal rights, and grievance procedure, CARF Accreditation, and Mental Health Program Approval (MHPA). The disinfectants, cleaning solutions, sharp objects are locked and inaccessible to clients. Each bedroom has two (2) single beds in good repair with clean sheets and linens and drawers and closet space for the client's clothing. There are extra linens, towels, and hygiene supplies in the cabinets. No room commonly used for other purposes is being used as a bedroom. There are lights in the rooms and throughout the facility. The bathroom faucets deliver hot water within range allowed by the regulations. (107 degrees and 106.7 degrees Fahrenheit). There is a working telephone in the facility. The first aid kit was complete and readily available. The smoke/carbon monoxide detectors are in working order. All medications are centrally stored in the nurse station located in the administration building. LPA with Associate Director Ruiz toured the recreation building/gym, all gym equipment is stable and in good condition. LPA also toured the cafeteria. The facility maintains supplies of non-perishable foods for at least a week and fresh perishable foods for at least two days. All indoor and outdoor passageways are unobstructed. An exit interview was conducted, and a copy of the LIC 809 was provided to the facility representative. A deficiency citation was issued at the time of the inspection.

met_with: Sterling Scott, Jessica Ruiz


facility_name: BOYS REPUBLIC ILP STRTP

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
The facility staff provides constant supervision to C1 and keeps all the residents safe. C1 when interviewed indicated feeling safe at the facility, however C1 refused to answer any additional questions during the interview. CSW indicted having no safety or supervision concerns with the facility. CSW stated the facility reports all incidents to CSW. CSW stated CSW and PO are C1's authorized representatives. LPA reviewed C1's NSP which indicated C1's representatives are CSW and PO. LPA reviewed incident reports which indicate the altercation with another client was reported to CSW, PO and C1's mother. C1 and the other client did not sustain any injuries. Based on the interviews and records reviewed the allegations is/are found unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the allegations. Appeals rights were provided and discussed with the facility representative mention above. There were no deficiencies cited.

Investigation Findings:
13On August 29, 2023, at 8: AM Licensing Program Analyst Larry Cabral (LPA) conducted a follow-up inspection for the purpose of providing findings for the above complaint allegations. LPA Cabral met with the STRTP Administrator Lori Kezos. During the investigation, LPA Cabral interviewed one facility staff (S1) and one client (C1) on 6/2/23 (see Confidential Names Form LIC 811 dated August 29, 2023). LPA Cabral interview one county social worker (CSW) on 6/2/23 and one probation officer (PO) on 6/2/23. LPA reviewed C1's needs and services plan (NSP) and incident reports. On 5/31/23 the Department received a complaint alleging staff did not provide a safe environment to client in care and staff hides information from client's authorized representative. The facility staff denied the allegations stating staff reports all incidents to C1's CSW, PO and C1's mother. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Larry Cabral 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 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION LA & TRI-COASTAL CR, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BOYS REPUBLIC ILP STRTPFACILITY NUMBER: VISIT DATE: 08/29/2023

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

report_type: Complaint Investigation

met_with: Lori Kezos, Administrator

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On 12/13/22 at 9: AM, Licensing Program Manager (LPM) Jean Herring, and Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an announced pre-licensing inspection and Component lll at the above facility address. The purpose of the inspection was to license above facility separate from Boys Republic as the licensed facility, after it was assigned a different address by the City of San Bernardino. LPA met Associate Director, Sterling Scott, Treatment Director, Garry Hodge and Director, Serafin Blau, who gave a tour of the facility. Executive Officer, Chris Burns was present during the Component lll discussion. The inspection is considered a relocation. Licensee submitted an application for a license for two separate facilities under one license. Per licensee, the City of San Bernardino already changed the address of both facilities to have the same address. Both facilities are structured the same. Both are one-story home that has 3 bedrooms and 1 bathroom. There are currently six (4) clients in placement in each facility. The following was observed at the time of the inspection. The staff schedule, Emergency Disaster Plan and Foster Youth Rights. Foster Ombudsman phone number and menu. The facility has a staff office, clinician offices, a living room/dayroom equipped with sofas and a TV, a laundry room Seven of the bedrooms have two (2) single beds inside and two bedrooms have one single bed . All the beds have clean mattresses equipped with clean linens and beddings. All the bedrooms have drawers and closet space for the clients' use. The facility has working telephone. There were working smoke/carbon monoxide detectors in the hallways, living room, and in each bedroom. The water temperature in the bathroom sinks was tested (117.6 degrees Fahrenheit within the temperature allowed by Title Regulations. The centralized heating and air were working. All cleaning solutions were observed locked in cabinets. All medications are centrally stored locked in the Nurse Office located Administration Building. The residents in placefoods are being prepared in the cafeteria, where the clients and staff eat. There were adequate foods both perishable and non perishable in the facility. The facility is ready to accept clients after the facility is licensed. The facility provides recreation to the clients where they can lift weights and play pool and table tennis. There is a pool which is also part of their recreation. At around 1: PM, LPM and LPA conducted Component lll with the licensee. The following was discussed: LIC 200: Line 1, The licensee name should be Boys Republic. New LIC 200 with corrections was submitted during the inspection visit. The need for a board resolution designating the administrator. The need for a waiver(s) The licensee will submit the required board resolution by 12/15/22. An exit interview was conducted and copies of the reports were provided to Mr. Hodge.

visit_type: Prelicensing

met_with: Sterling Scott, Garry Hodge, Serafin Blau


summary: Facility Evaluation

raw_content:
Narrative:
On March 1, 2023 at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez made a case management inspection to the facility and met Lori Kezos, Administrator. The purpose of the case management was to follow-up on a Special Incident Report (SIR) received by the Department 0n 02/03/23. The SIR indicated that 01/27/23 client (C1) went inside the staff office and took staff (S1) see LIC 811 ( Confidential Names List) pens and purse. He was told to return the items, but he refused and left the office. C1 returned to the office and decided to take items belonging to staff. S2 and S3. It was noted that S1 and S2 tried to physically get back their personal belongings. They struggled to get their belongings from C1. On 01/28/23, S2 noticed C1 with a bruise on his triceps. On 02/02/23, Administrator Kezos made a follow-up conversation with C1 and confirmed that the bruise came from S1. S1 was suspended and S2 and S3 were written-up. They will be retrained on boundaries and appropriate interactions. Per Administrator Kezos, C1 does not want to talk about how it happened. it was not clear if C1's bruise was caused by S1's hand accidentally pressed on C1's arm while trying to get her purse or the strap of her purse. S1 was still on probation at the time of the incident and was terminated on 02/06/23. S2 was written up while S3 was not after further follow-up it was determined that he was not involved in the incident. S3 was able to get his backpack from C1 without incident. LPA obtained a copy of proof of S1's termination and S2's write up and the retraining of staff last 02/06/23 regarding staff and student boundaries. Based on the information gathered, S1 and S2 acted inappropriately in handling the situation and were disciplined. The facility took appropriate steps/actions regarding the incident. This incident needs no further follow-up currently. A copy of the report and LIC 811 was provided to the administrator. No deficiency citation issued at the time of the inspection.

met_with: Lori Kezos


summary: Facility Evaluation

raw_content:
Narrative:
On March 24, 2023 at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez arrived at the facility to conduct a post-licensing inspection. LPA met with Administrator, Jessica Ruiz and Treatment Director, Garry Hodge who accompanied this LPA to the site of the facility. At the facility LPA met with Administrator, Jayson Moore who gave the tour of whole facility. The facility has 6 clients currently. Physical Plant The inspection of the facility started at around 9: AM. LPA together with Administrator, Lori Kezos toured the facility. The ILP has 2 cottages and each facility has 3 bedrooms and 2 bathrooms. The following was observed at the time of the inspection. The posted license, Emergency Disaster Plan and Youth Personal Rights, and Foster Ombudsman phone number. Seven out of nine bedrooms have two (2) single beds inside and two bedrooms have one single beds . All the beds have clean mattresses equipped with clean linens and beddings. All the bedrooms have drawers and closet space for the clients. There were working smoke/carbon monoxide detectors in the hallways, living room, and in each bedroom. All cleaning supplies were locked inside the cabinets. There were adequate hygiene supplies for the clients. The centralized heating and air were working. All cleaning solutions were observed locked in cabinets. All medications are centrally stored locked in the Nurse Office located Administration Building. There was adequate perishable and non-perishable foods in the facility cafeteria. The first aid kit was complete. There were extra linens, extra towels and hygiene supplies in the facility. All passageways are unobstructed. The water temperature in the bathroom sinks were tested and observed went over the temperature allowed by Title Regulations however, the maintenance person was able to lower cthe temperature to 117.8 before LPA left the facility. An exit interview was conducted and a copy of the LIC 809 and LIC 809D were provided to the facility representative. A deficiency citation is issued at the time of the inspection.

met_with: Jessica Ruiz, Garry Hodge, Lori Kezos


summary: Facility Evaluation

raw_content:
Narrative:
On May 4, 2023 at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an inspection at the facility. The inspection was a continuation of the post-licensing inspection. LPA met with Administrator, Sterling Scott. Licensee provided a copy of the LIC 500, client roster, board minutes meeting, Emergency Disaster Plan, and Activity Report. Client Records All client records reviewed are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to, consent forms, court orders, needs and services plan, removal/discipline/complaint procedures; medical assessment; safeguards for cash resources, personal property and valuables; education records; personal rights forms. Staff Records LPA reviewed five personnel records. The personnel records contain required information including, but not limited to, employee's full name, driver's license, date of employment, home address and phone number, documentation of the educational background, training and/or relevant experience, health screening and tuberculosis test documents. Documentation of successful completion of training is maintained in the personnel record for each staff. The administrator has a valid Administrator's certificate. Personnel records are maintained on the licensee, administrator and each employee. All individuals subject to criminal record review have been fingerprinted. Disaster Preparedness Plan Facility maintains a current disaster and mass casualty plan. Facility maintains register of clients, medication records, and contact information for each client's responsible party and physician. The facility conducts emergency drills once a month. · Emergency Intervention Plan The facility has emergency intervention plan. The staff records contain proof of training. An exit interview was conducted and a copy of the LIC 809, LIC 809C, LIC 9102 and LIC 811s were provided to the facility representative. No deficiency citations issued at the time of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On November 13, 2023, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an unannounced annual/required inspection to the facility. LPA met with Sterling Scott, Administrator. Independent Living Program ( ILP) Administrator, Lori Kezos arrived shortly. The ILP consisted of two (2) one- story buildings (Combs and Boone Cottages) located inside Boys Republic campus. Currently, there are eight (8) clients in placement. LPA obtained and reviewed the roster of clients, Personnel Report, Emergency Disaster Plan, and board minutes. Physical Plant LPA inspected the facility accompanied by Administrator Scott. LPA inspected the building facility, the gym, and cafeteria located inside the campus. LPA observed the following: the posted license, emergency disaster plan, client personal rights, and Ombudsman's flyer and number. The disinfectants, cleaning solutions, sharp objects are locked and inaccessible to clients. The facility maintains supplies of non-perishable foods for at least a week and fresh perishable foods for at least two days. Each bedroom has two (2) single beds in good repair with clean sheets and linens and drawers and closet space for the client's clothing. There are extra linens, towels, and hygiene supplies in the cabinets. No room commonly used for other purposes is being used as a bedroom. The window screens are in good repair and free of dirt. There are lights in the rooms and throughout the facility. The facility has a centralized medication storage inside the nurse office. There is a working telephone in the facility. The first aid kit was complete and readily available. The smoke/carbon monoxide detectors in the facility are in working order. The faucets in both cottages deliver hot water, however, the temperature at Combs Cottage was 140 degrees Fahrenheit while at Boone Cottage it was 117 degrees Fahrenheit. All medications are centrally stored in the nurse station located in the administration building. All gym equipment is stable and secured and the facility maintains supplies of non-perishable foods for at least a week and fresh perishable foods for at least two days. All indoor and outdoor passageways are unobstructed. Operations The facility maintains a register of clients and available upon licensing staff request. The client records are centrally stored on the staff of the facility. The facility has written complaint procedures to file a complaint for the clients and/or their representatives. An exit interview was conducted, and a signed copy of LIC 809, LIC 809C, LIC 809D were provided to the facility representative. A deficiency citation was issued at the time of the inspection.

met_with: Sterling Scott, Lori Kezoa


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On December 12, 2023, at 9: AM, Licensing Program Analysts (LPA) Gilbert Gutierrez and Juliet Robles conducted a continuation of the annual/required inspection at the Short Term Residential Therapeutic Program (STRTP) and met Administrator, Sterling Scott. The facility is licensed to serve 12 males, ages 13-17 and non-minor dependents. There are four (4) clients placed in the facility currently. Client Records LPA reviewed five (5) client records. All client records are available to the licensing to review. Client records contain required information including, but not limited to, consent forms, removal/discipline/complaint procedures, medical assessment, personal property and valuables, education records, personal rights forms and medication administration records. Two (2) clients were interviewed. Staff Records LPA reviewed five (5 ) staff records. Staff records contain documentation of the required education and experience requirements and training. A staff subject to criminal records review was found not associated to the facility at the time of the inspection. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill at least quarterly. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Needs and Services Plan for each client, medication records, and contact information for each client's responsible party and physician. Operations The facility maintains a register of clients available upon licensing staff request. The client records are centrally stored in the administration building. The board minutes meeting was available for review. The board of directors conducts meetings at least on a quarterly basis to review and discuss the STRTP's operation. The facility has written complaint procedures to file a complaint for the clients and/or their representatives. An exit interview was conducted, and a signed copy of LIC 809, LIC 809C, LIC 809D, LIC 421 and LIC811s was provided to the facility representative. A deficiency citation and a civil penalty was issued at the time of the inspection.

Deficiencies:
80019(f): Deficient Practice Statement
1
2
3
4Based on record review, the licensee did not comply with the section cited above  which poses an immediate health, safety or personal rights risk to persons in care. Staff ref #6, see LIC 811 (Confidential Names List) was not associated and cleared at the time of the inspection.
POC Due Date: 12/13/2023
Plan of Correction
1
2
3
4

title:
or

This requirement is not met as evidenced by


summary: Facility Evaluation

raw_content:
Narrative:
On June 11, 2024, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez made a case management inspection to the facility and met Administrator, Sterling Scott. The case management was a follow-up regarding the Special Incident Report (SIR) received on 06/03/24. The SIR indicated that on 06/02/24 at around 8: PM, client (C1) was in the living room watching TV and being supervised by staff (S1). C1 asked S1 to move from his seat so that he can lay down on the couch. S1 told C1 he could move to a different seat because he was sitting there at the time. C1 then laid on the couch and started putting his feet on S1's laptop which was placed on his lap. S1 continued to counsel C1 to stop. The third time that C1 put his foot on the laptop, S1 kicked his left leg to prevent him from putting his leg on the laptop. C1 reported the incident to S2 who was in the kitchen at the time cleaning after dinner. S2 checked C1's leg and noticed slight redness but no swelling or noticeable injuries. S1 was sent home for the evening by his supervisor and another staff came to work overnight. C1 was assessed and no medical attention needed. C1 also refused any medical attention. LPA conducted interviews and gathered the following information: S1 just lifted his leg to block C1 from putting his foot down on his laptop and denied kicking C1. C1 confirmed the incident while C2 who was watching TV at the time refused to talk. S2 only heard C1 asking S1 to move to another couch and did not hear S1's response. She did not hear any loud noise coming from the living room while she was in the kitchen. LPA also gathered information that both clients did not like the report that S1 made previously regarding their behavior. Therefore, based on the above information, the incident cannot be substantiated at this time. The incident needs no further follow-up currently. An exit interview was conducted and copy of the LIC 809 and LIC 811 were provided to the facility representative. No deficiency citation was issued at the time of the inspection.

met_with: Lori Kezos, Chris Colflesh


summary: Facility Evaluation

raw_content:
Narrative:
On October 10, 2024, at 9:25 a.m., Licensing Program Analyst (LPA), Christopher J. Williams made an unannounced visit to the above facility for the purpose of a case management inspection. The purpose of the inspection is to follow-up on a Special Incident Report (SIR) received by the Department on 10/02/2024 (See LIC811 - Confidential Names List dated 10/10/2024). The SIR indicated that on October 01, 2024, at approximately 3:15 p.m., S1 was conducting room safety checks, when he observed an unauthorized female (U. F.) person located in C1's bedroom alone. During this time C1 was in the living room area watching television. S1 contacted S2 immediately to inform her of the incident. S2 came to C1's bedroom and asked the U. F. how she arrived at Boys Republic in which the U. F. stated that she walked. S2 instructed the U. F. that she needed to leave the premises because she was trespassing. Per the SIR, the U. F. exited the facility without given her name. The SIR also stated that staff noticed that the window screen to C1's bedroom had been removed, suggesting that the U. F. entered through the window. S3 and the S4 did a perimeter search of the campus as well as the exits and could not locate the unauthorized female visitor. ... LPA interviewed 3 staff (S1, S2 and S3), attempted to interview S4, however she was on vacation and not currently available. LPA attempted to interview C1, however client refused to be interviewed by LPA. LPA was informed by the S1 that during the approximate time of the incident staff were in the office across the hallway from C1's room completing a training class via Microsoft Teams and that's why he (S1) started his safety checks with C1's room because it was the room nearest to the office. S3 stated to LPA that the next day after the incident on 10/02/2024, he instructed the "Night Staff" to keep up with timely safety checks, including the window screens to the resident's rooms on campus, ensuring that the screens have not been tampered with. LPA inspected the new window screen located outside of C1's bedroom and confirmed that it was in place nor damaged, and not tampered with. Based on the information obtained by LPA concerning the unauthorized female visitor, there is no evidence that the incident is a result of negligence, lack of supervision, health, safety, or personal rights violations. Exit interview was conducted and completed by LPA. A signed copy of this report along with the LIC811 - (Confidential Names List) was provided to the facility representative. No deficiencies cited at the time of time of inspection. No further follow-up is needed.

met_with: Chris Colflesh, Unit Supervisor


summary: Facility Evaluation

raw_content:
Narrative:
On October 10, 2024, at 9:25 a.m., Licensing Program Analyst (LPA), Christopher J. Williams made an unannounced visit to the above facility for the purpose of a case management inspection. The purpose of the inspection is to follow-up on a Special Incident Report (SIR) received by the Department on 10/02/2024 (See LIC811 - Confidential Names List dated 10/10/2024). The SIR indicated that on October 01, 2024, at approximately 3:15 p.m., S1 was conducting room safety checks, when he observed an unauthorized female (U. F.) person located in C1's bedroom alone. During this time C1 was in the living room area watching television. S1 contacted S2 immediately to inform her of the incident. S2 came to C1's bedroom and asked the U. F. how she arrived at Boys Republic in which the U. F. stated that she walked. S2 instructed the U. F. that she needed to leave the premises because she was trespassing. Per the SIR, the U. F. exited the facility without given her name. The SIR also stated that staff noticed that the window screen to C1's bedroom had been removed, suggesting that the U. F. entered through the window. S3 and the S4 did a perimeter search of the campus as well as the exits and could not locate the unauthorized female visitor. ... Continued.... LPA interviewed 3 staff (S1, S2 and S3), attempted to interview S4, however she was on vacation and not currently available. LPA attempted to interview C1, however client refused to be interviewed by LPA. LPA was informed by the S1 that during the approximate time of the incident staff were in the office across the hallway from C1's room completing a training class via Microsoft Teams and that's why he (S1) started his safety checks with C1's room because it was the room nearest to the office. S3 stated to LPA that the next day after the incident on 10/02/2024, he instructed the "Night Staff" to keep up with timely safety checks, including the window screens to the resident's rooms on campus, ensuring that the screens have not been tampered with. LPA inspected the new window screen located outside of C1's bedroom and confirmed that it was in place nor damaged, and not tampered with. Based on the information obtained by LPA concerning the unauthorized female visitor, there is no evidence that the incident is a result of negligence, lack of supervision, health, safety, or personal rights violations. Exit interview was conducted and completed by LPA. A signed copy of this report along with the LIC811 - (Confidential Names List) was provided to the facility representative. No deficiencies cited at the time of time of inspection. No further follow-up is needed.

met_with: Chris Colflesh, Supervisor


summary: Facility Evaluation

raw_content:
Narrative:
On November 21, 2024, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an unannounced annual/required inspection to the facility. LPA met with Administrator, Lori Kezos of the Independent Living Program ( ILP). The ILP consisted of two (2) one- story buildings (Combs and Boone Cottages) located inside Boys Republic campus. Currently, there are six clients in placement. LPA obtained and reviewed the clients' roster, Emergency Disaster Plan, and board minutes. Physical Plant The ILP consisted of two one- story buildings (Combs and Boone Cottages) located inside Boys Republic campus. LPA observed the following: the posted license, clients' personal rights, and Ombudsman's flyer and number, Facility Menu, Mental Health Program Approval (MHPA), Emergency Disaster Plan, Fire Department's latest inspection dated 10/02/24. The disinfectants, cleaning solutions, sharp objects were locked and inaccessible to clients. The facility maintains supplies of non-perishable foods for at least a week and fresh perishable foods for at least two days. A maximum of two single beds in good repair with clean sheets and linens. There were extra linens, towels, and hygiene supplies in the cabinets. No room commonly used for other purposes is being used as a bedroom. The window screens were in good repair and free of dirt. There were lights in the rooms and throughout the facility. The first aid kit was complete and readily available. The faucets inside the bathrooms deliver hot water (112.4 degrees and 120 degrees Fahrenheit) within temperature allowed under the regulation. All medications were centrally stored in the nurse station located in the administration building. The gym equipment was stable and secured. The facility maintains supplies of non-perishable foods for at least a week and fresh perishable foods for at least two days. All indoor and outdoor passageways were unobstructed. Continued... Client Records LPA reviewed two client records. All client records are available to licensing for review. Client records contain required information including, but not limited to, consent forms, removal/discipline/complaint procedures, medical assessment, personal property and valuables, education records, personal rights forms and signed needs and services plan (NSP).. Disaster Preparedness Plan The facility has a disaster and mass casualty plan of action and conducts disaster drills at least quarterly. The facility maintains register of clients, Needs and Services Plan for each client, medication records, and contact information for each client's responsible party and physician. Operations The facility maintains a register of clients available upon licensing staff request. The client records are centrally stored on the staff of the facility. The board minutes meeting was available for review. The board of directors conducts meetings at least on a quarterly basis to review and discuss the STRTP's operation. The facility has written complaint procedures to file a complaint for the clients and/or their representatives. An exit interview was conducted, and a signed copy of LIC 809, LIC 809C,and LIC811 were provided to the facility administrator. No deficiency citations were issued at the time of the inspection

met_with: Lori Kezos, Jessica Ruiz


summary: Facility Evaluation

raw_content:
Narrative:
On November 6, 2025, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an unannounced annual/required inspection at the facility. LPA met with Administrator, Sterling Scott, Associate Director, Jessica Ruiz. The facility has nine clients in placement currently. Physical Plant LPA inspected the facility accompanied by Administrator Scott. LPA inspected the building facility, the gym, and cafeteria located inside the campus. LPA observed the following: the posted license, emergency disaster plan, client personal rights, and Ombudsman's flyer and number. The disinfectants, cleaning solutions, sharp objects are locked and inaccessible to clients. The facility maintains supplies of non-perishable foods for at least a week and fresh perishable foods for at least two days. Each bedroom has two (2) single beds in good repair with clean sheets and linens and drawers and closet space for the client's clothing. There are extra linens, towels, and hygiene supplies in the cabinets. No room commonly used for other purposes is being used as a bedroom. The window screens are in good repair and free of dirt. There are lights in the rooms and throughout the facility. The facility has a centralized medication storage inside the nurse office. There is a working telephone in the facility. The first aid kit was complete and readily available. The smoke/carbon monoxide detectors in the facility are in working order. The faucets in both cottages deliver hot water, however, the temperature at Combs Cottage was 140 degrees Fahrenheit while at Boone Cottage it was 117 degrees Fahrenheit. All medications are centrally stored in the nurse station located in the administration building. All gym equipment is stable and secured and the facility maintains supplies of non-perishable foods for at least a week and fresh perishable foods for at least two days. All indoor and outdoor passageways are unobstructed. An exit interview was conducted and a copy of the LIC 809 was provided to the facility representative. No deficiency citation issued at the time of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On January 12, 2023 at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez made a case management inspection to the facility and met Sterling Scott, Administrator. The purpose of the case management was to follow-up on a Special Incident Report (SIR) received by the Department regarding medication error. Per the SIR, On 12/17/22 at 9: PM client (C1) requested his medication from staff (S1) see LIC 811 (Confidential Names List). While providing the medication, S1 made a mistake of giving C1 the medication that was already discontinued as of 12/01/22. S1 was aware that the medication was discontinued. C1 showed no adverse effects or any other abnormal signs or symptoms after taking the medication. The nurse supervisor was contacted and was informed of the, incident and also C1's authorized representative. At 10: AM, LPA reviewed S1's records and obtained copy of S1's refresher training on Medication Dispensing and facility staff training on Reporting Guidelines. Section 80075(b)(5)(B) provides that once ordered by the physician the medication is given according to the physician's directions. A deficiency citation is issued to the facility per above section. An exit interview was conducted and a copy of this report, LIC 809D and LIC 811 were provided to Administrator, Sterling Scott.

met_with: Sterling Scott.


facility_name: BOYS REPUBLIC LAWS STRTP

summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
On 12/08/2023, the Department received a complaint alleging that Boys Republic staff did not safeguard a client's property, a cellular phone. The facility unit supervisor (S4) disclosed that they accidentally lost a client's phone after the focused client requested to access his cellular phone to obtain a contact number on or about 11/16/23. S4 disclosed initially, that it was reported by another staff that she returned the phone to the Program Office (PO) that same day, however, circumstances surrounding the event could no longer be verified that the phone was returned to the PO after the client obtained his contact number. The staff who picked up the phone for the client on 11/16/2023 stated that at first, she believed she returned the phone to the PO, but after speaking with another worker at the PO, she now believes that she left the phone on the counter at the cottage and that is when the phone was reportedly went missing. Staff interviews provided consistent information that the phone went missing and they attempted to locate the phone, but their attempts were unsuccessful. Other confidential interviews with the focused client corroborated the incident and its timeline when his phone was determined lost/missing after he requested to access his cellular phone on or about 11/22/23 (second time). The focused client disclosed that the facility has offered to replace his cellular phone but has declined the offer at this time. Based on the information gathered during interviews and documentary evidence produce corroborating evidence to support the allegation that the staff workers did not properly safeguard the clients cellular phone. The preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated per California Code of Regulations Title Division Six Chapter Five. Facility cited for violation California Code of Regulations Title Division Six, ILS 80026(b). Safeguards for Cash Resources, Personal Property, and Valuables of Residents. LPA Vargas conducted an exit interview, explain appeal rights.

Investigation Findings:
13On 12/18/2023 at 10: AM, Licensing Program Analyst (LPA) Joseph Vargas conducted a follow-up inspection for the purpose of providing findings for the above complaint. LPA met with Mr. Hodge. During the course of the investigation, LPA conducted telephonic interfviews and in-person visits three faciluity staff workers, one client on 12/11/2023, one individual idetified as other on 12/14/2023, and County Probation Officer on 12/11/2023. Reference Confidential Names List LIC811 dated 12/18/2023. During the inspection LPA requested for review and obtained copy of the staff and client facility roster reports, special incident reports, clients' Needs and Service Plan, and placement history, including a review of the county report associated with this complaint investigation. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Joseph Vargas 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 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION LA & TRI-COASTAL CR, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BOYS REPUBLIC LAWS STRTPFACILITY NUMBER: VISIT DATE: 12/18/2023

met_with: Mr. Hodge, Treatment Director, and Assistant Supervisor J.P. Ferrett

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
On 06/21/2024, the Department received a complaint alleging that staff working at the facility do not prevent client(s) from having access to Marijuana. The Facility Supervisor (FS) denied the allegation and stated that Marijuana and other types of contraband are not permitted. FS disclosed that all staff workers at the facility don't allow clients to have any smoking products, including vape pens. FS disclosed that they had one incident on 06/21/2024 that involved a client, and the age of the client appears to match the report that involved Marijuana vape pens. FS disclosed that the contraband was confiscated, and a Special Incident Report dated 06/21/2024 was submitted to the appropriate county and state agencies for review. In confidential interviews with clients, and staff working at the facility provided consistent statements and denied the allegation that the staff does not prevent clients from having access to Marijuana and other contraband. One individual identified as "other" in the report could not be located/contacted therefore no statement was obtained. Based on the information gathered during interviews and documentary evidence, it cannot be determined whether the allegation occurred that staff working at the facility do not prevent client(s) from having access to Marijuana and other types of contraband. Therefore, the above allegation is determined unsubstantiated at this time. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged abuse occurred. The resolution to this complaint was discussed with the facility representative and copies of all licensing reports were provided after the inspection. An exit interview was conducted and the Appeal rights were given and explained. No deficiencies were cited at this time.

Investigation Findings:
13On 07/29/2024 at 1: PM, Licensing Program Analyst (LPA) Joseph Vargas conducted a follow-up inspection for the purpose of providing findings for the above complaint. LPA met with Mr. Garza, Facility Supervisor. During the course of the investigation, LPA conducted telephonic interviews and in-person visits with two clients, one staff workers on 06/25/2024, one staff worker on 6/27/2024, two staff workers and two clients on 07/22/2024. Reference Confidential Names List LIC811 dated 07/29/2024. During the inspection LPA requested for review and obtained copy of the staff and client facility roster reports, special incident reports, including a review of history of complaints. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Joseph Vargas 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 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION LA & TRI-COASTAL CR, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BOYS REPUBLIC LAWS STRTPFACILITY NUMBER: VISIT DATE: 07/29/2024

met_with: Mr. Garza, Facility Supervisor


summary: Facility Evaluation

raw_content:
Narrative:
On 12/13/22 at 9: AM, Licensing Program Manager (LPM) Jean Herring, and Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an announced pre-licensing inspection and Component lll at the above facility address. The purpose of the inspection was to license above facility separate from Boys Republic as the licensed facility, after it was assigned a different address by the City of San Bernardino. LPA met Associate Director Sterling Scott, Treatment Director, Garry Hodge and Director, Serafin Blau, who gave a tour of the facility. Executive Officer Chris Burns arrived shortly. The inspection is considered a relocation. The facility is a two-story home that has 3 bedrooms downstairs and 5 bedrooms upstairs. The facility has 1 bathroom in each floor. There are no clients in placement. The facility was not used as residential facility since 2020 . The following was observed at the time of the inspection. The Emergency Disaster Plan and Foster Youth Bill of Rights and Mental Health Patient's Rights, Foster Ombudsman phone number. The facility has a staff office, a living room/dayroom with sofas and a TV, and a laundry room. All the bedrooms have two (2) single beds inside. All the beds have clean mattresses equipped with clean linens and beddings. All the bedrooms have drawers and closet space for the clients' use. The facility has working telephone. There were working smoke/carbon monoxide detectors, emergency exits on the second floor of the building. There is also emergency exits in the building. The water temperature in the bathroom sinks was tested (119.3 degrees Fahrenheit) within the temperature allowed by Title Regulations. The centralized heating and air were working. All cleaning solutions were observed locked in cabinets. All medications are centrally stored locked in the Nurse Office located Administration Building. The foods are being prepared in the cafeteria, where the clients and staff eat. There were adequate foods both perishable and non- perishable in the cafeteria.The facility provides recreation to the client where they can lift weights and play pool and table tennis. There is a pool which is also part of their recreation. The facility is under refinishing touches and will be ready for placement by Friday 12/16/22. At around 1: PM, LPM and LPA conducted Component lll with the licensee. The following was discussed: LIC 200: Line 1, The licensee name should be Boys Republic. New LIC 200 with corrections was submitted during the inspection visit. The need for a board resolution designating the administrator. The need for a waiver(s) The licensee will submit the required board resolution by 12/15/22. An exit interview was conducted and copies of the reports were provided to Mr. Hodge.

met_with: Sterling Scott, Garry Hodge, and Serafin Blau


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Gilbert Gutierrez made a case management visit to the facility on March 1, 2023 and met Sterling Scott, Administrator. The purpose of the case management was regarding licensee's search protocols to look for contrabands in the facility. Currently, licensee uses the services of a company that conducts searches in the facility premises using sniffing dogs.. The following was discussed at the meeting: The need for searches to be on case by case basis only To cease any blanket policy regarding searches The need for search policies to be trauma informed The need for documentation of the search in the client's records/file. Search policies should not violate the client's personal rights An exit interview was conducted and a copy of the report and LIC 9102 was provided to the facility representative.

met_with: Sterling Scott


summary: Facility Evaluation

raw_content:
Narrative:
On March 28, 2023 at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez arrived at the facility to conduct a post-licensing inspection. LPA met with Associate Director, Sterling Scott who accompanied this LPA to the site of the facility. There were nine clients placed in the facility. Physical Plant The inspection started at around 9: AM. The facility is a two-story building that has 8 bedrooms. The facility has one bathroom in each floor for the clients. The following was observed at the time of the inspection. The posted license, Emergency Disaster Plan, Grievance and Personal Rights. The facility has a staff office, a living room/dayroom with sofas and a TV, and a laundry room. All the bedrooms have two single beds inside except for one bedroom located in the second floor. All the beds have clean mattresses with clean linens and beddings. There were drawers and closets for the clients. The smoke/carbon monoxide detectors were tested and working. The water temperature was tested (118.2 degrees Fahrenheit) and found within the temperature allowed by Title Regulations. All cleaning solutions were observed locked in cabinets. The first aid kit is complete. All medications are centrally stored locked in the Nurse Office located Administration Building. There were adequate perishable foods for at least 2 days and non-perishable foods for at least 7 days in the cafeteria. All passageways are unobstructed. An exit interview was conducted, and a copy of the report was provided to the facility representative. No deficiency citation issued at the time of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On April 12, 2023 at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an inspection at the facility. The inspection was a continuation of the post-licensing inspection conducted last 03/28/23.. LPA met with Administrator, Jessica Ruiz. There were six clients placed in the facility. Licensee provided a copy of the LIC 500, client roster, board minutes meeting, Emergency Disaster Plan, and Activity Report. Client Records All client records reviewed are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to, consent forms, court orders, needs and services plan, removal/discipline/complaint procedures; medical assessment; safeguards for cash resources, personal property and valuables; education records; personal rights forms; and medication administration records. Staff Records LPA reviewed two personnel records. The personnel records contain required information including, but not limited to, employee's full name, driver's license, date of employment, home address and phone number, documentation of the educational background, training and/or relevant experience, health screening and tuberculosis test documents. Documentation of successful completion of training is maintained in the personnel record for each staff. The administrator has a valid Administrator's certificate. Personnel records are maintained on the licensee, administrator and each employee. All individuals subject to criminal record review have been fingerprinted. Disaster Preparedness Plan Facility maintains a current disaster and mass casualty plan. Facility maintains register of clients, medication records, and contact information for each client's responsible party and physician. The facility conducts emergency drills at least once quarterly. · Emergency Intervention Plan The facility has emergency intervention plan. The staff records contain proof of training. An exit interview was conducted and a copy of the LIC 809, LIC 809C LIC TV and LIC 811 were provided to the facility representative. No deficiency citations issued at the time of the inspection.

met_with: Jessica Ruiz


summary: Facility Evaluation

raw_content:
Narrative:
On November 28, 2023, at 12: PM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an unannounced annual/required inspection to the facility. LPA met with Jessica Ruiz, Administrator, who accompanied this LPA to the site of the facility. There are 12 clients placed in the facility. Physical Plant The inspection started at around 1: PM. The facility is a two-story building that has 8 bedrooms. The facility has one (1) full bathroom on each floor. The following was observed at the time of the inspection. The posted license, Emergency Disaster Plan, Foster Care Ombudsman's information and Youth's Personal Rights. The facility has a staff office and therapist offices, a living room/dayroom, and a laundry room. There is only a maximum of two (2) beds in each bedroom. All bedrooms have drawers and closet spaces for the clients. The smoke/carbon monoxide detectors were tested and working. The water temperature was tested (105 degrees Fahrenheit) using a digital thermometer. All cleaning solutions were observed locked in cabinets. There was extra linens and hygiene supplies in the cabinets and storage room. There was a first aid kit in the facility. All medications are centrally stored locked in the Nurse Office located in the Administration Building. There was adequate perishable foods for at least 2 days and non-perishable foods for at least 7 days in the cafeteria. All passageways are unobstructed. An exit interview was conducted, and a copy of the report was provided to the facility representative. A deficiency citation was issued at the time of the inspection.

met_with: Jessica Ruiz, Sterling Scott


summary: Facility Evaluation

raw_content:
Narrative:
On December 12, 2023, at 9: AM, Licensing Program Analysts (LPA) Gilbert Gutierrez and Juliet Robles conducted a continuation of the annual/required inspection at the Short Term Residential Therapeutic Program (STRTP) and met Administrator, Sterling Scott. The facility is licensed to serve 16 males, ages 13-17 and non-minor dependents. There are 14 clients placed in the facility currently. Client Records LPAs reviewed five (5) client records. All client records are available to the licensing to review. Client records contain required information including, but not limited to, consent forms, removal/discipline/complaint procedures, medical assessment, personal property and valuables, education records, personal rights forms and medication administration records. LPAs interviewed one (1) client. Staff Records LPAs reviewed five (5 ) staff records. All staff subject to criminal records review have been fingerprinted and cleared. There is documentation of the required education and experience requirements and training. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill at least quarterly. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Needs and Services Plan for each client, medication records, and contact information for each client's responsible party and physician. Operations The facility maintains a register of clients available upon licensing staff request. The client records are centrally stored on the staff of the facility. The board minutes meeting was available for review. The board of directors conducts meetings at least on a quarterly basis to review and discuss the STRTP's operation. The facility has written complaint procedures to file a complaint for the clients and/or their representatives. An exit interview was conducted, and a signed copy of LIC 809, LIC 809C and LIC811s were provided to the facility representative. No deficiency citations were issued at the time of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On April 18, 2024, at 9: AM Licensing Program Analyst (LPA) Gilbert Gutierrez made a case management inspection to the facility and met Administrator, Jessica Ruiz. The purpose of the case management was to follow up on a Special Incident Report (SIR) received by the Department on 04/06/24. The SIR indicated that allegedly staff (S1) pushed client (C1) back after the latter pushed the staff causing him to become off balanced. S1 wrestled with C1 but then disengaged with no further action. The incident allegedly happened a month ago. No specific date and time reported. On 04/18/24, LPA interviewed C1 and several staff including S1. C1 and S1 denied the incident happened. After the alleged incident was reported C1 feels safe around S1. During records review, LPA was provided reports that S1 documented previously regarding C1's behavior. One of the reports was regarding a contraband that C1 dropped which S1 retrieved. During interviews, LPA received information that C1 was mad at S1 for finding a contraband on him. S1 was targeted due to these reports. Based on the information gathered, the alleged incident did not happen and therefore needs no further follow-up currently. An exit interview was conducted and copy of the LIC 809 and LIC 811 were provided to the administrator. No deficiency citations issued at the time of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On November 21, 2024, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an unannounced annual/required inspection to the facility. LPA met with Administrator, Jessica Ruiz who accompanied this LPA to the site of the facility. There are 11 clients placed in the facility. Physical Plant The facility is a two-story building that has 8 bedrooms. The facility has one full bathroom on each floor. The following was observed at the time of the inspection. The posted facility license, Foster Care Ombudsman's information and Youth's Personal Rights, facility menu, client's sexual reproductive rights, grievance procedure, Emergency Disaster Plan, Mental Health Program Approval (MHPA), Fire Department's Inspection dated 10/02/24. The facility has a staff office and therapist offices, a living room/dayroom, and a laundry room. A maximum of two beds in each bedroom. There were extra linens, towels, and hygiene supplies in the cabinets. No room commonly used for other purposes is being used as a bedroom. There were lights in the rooms and throughout the facility. The faucets inside the bathrooms deliver hot water (110 degrees and 105.4 degrees Fahrenheit) within temperature allowed under the regulation. There was a working telephone in the facility. The first aid kit was complete and readily available. All medications are centrally stored locked in the nurse office located in the administration building. There were adequate perishable foods for at least 2 days and non-perishable foods for at least 7 days in the cafeteria. All passageways are unobstructed. Client Records LPA reviewed five (5) client records. All client records are available to licensing to review. Client records contain required information including, but not limited to, consent forms, removal/discipline/complaint procedures, medical assessment, personal property and valuables, education records, personal rights forms, and Needs and Services Plan (NSP). Disaster Preparedness Plan The facility has a disaster and mass casualty plan of action and conducts disaster drills at least quarterly. The facility maintains register of clients, Needs and Services Plan for each client, medication records, and contact information for each client's responsible party and physician. Operations The facility maintains a register of clients available upon licensing staff request. The client records are centrally stored in the administration building. The board minutes meeting was available for review. The board of directors conducts meetings at least on a quarterly basis to review and discuss the STRTP's operation. The facility has written complaint procedures to file a complaint for the clients and/or their representatives. An exit interview was conducted, and a copy of the report was provided to the administrator. No deficiency citations issued at the time of the inspection.

met_with: Jessica Ruiz, Lori Kezos


summary: Facility Evaluation

raw_content:
Narrative:
On December 9, 2024, at 10:00am, a meeting was held at Boys Republic main campus attended by Community Care Licensing (CCL) Licensing Program Manager (LPM) Jean Herring (via phone) and Licensing Program Analyst (LPA) Gilbert Gutierrez. Los Angeles County Probation, Child Welfare Placement Permanency & Quality Assurance, Director Lisa Campbell-Motton, Director, Pamela Pease, DPO ll, Lori Tchakerian, and Supervisor, Belarmina Ortiz, San Bernardino County Probation, PO Dominique Bright, and Supervisor, Karen Lopez. Boys Republic Executive Director, Chris Burns, and Associate Director, Sterling Scott, Administrator, Jessica Ruiz, Administrator, Jason Moore, Clinical Director, Federico Escobedo, and Intake Director, Ray Esparza. The following was discussed at the meeting: · The incident regarding a client overdose · Notification of all county probation departments of overdose incidents · Installation of cameras behind the cottages A copy of the report was provided to Executive Director, Burns.

met_with: Chris Burns, Sterling Scott


summary: Facility Evaluation

raw_content:
Narrative:
On November 6, 2025, at 9:15, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an unannounced annual/required inspection at the facility. LPA met with Administrator, Jessica Ruiz who accompanied this LPA to the site of the facility. There are 8 clients placed in the facility. LPA obtained and reviewed the LIC 500 (Personnel Report) LIC Administrative Organization, Emergency Disaster Plan, and board minutes. Physical Plant The facility is a two-story building that has 8 bedrooms. The facility has one (1) full bathroom on each floor. The following was observed at the time of the inspection. The posted license, Emergency Disaster Plan, Foster Care Ombudsman's information and Youth's Personal Rights, Grievance Procedure forms, CARF Accreditation and Mental Health Program Approval. The facility has a staff office and therapist offices, a living room/dayroom, and a laundry room. There is only a maximum of two (2) beds in each bedroom. All bedrooms have drawers and closet spaces for the clients. The smoke/carbon monoxide detectors were tested and working. The water temperature was tested (112 degrees Fahrenheit) using a digital thermometer. All cleaning solutions were observed locked in cabinets. There was extra linens and hygiene supplies in the cabinets and storage room. There was a first aid kit in the facility. All medications are centrally stored locked in the Nurse Office located in the Administration Building. There was adequate perishable foods for at least 2 days and non-perishable foods for at least 7 days in the cafeteria. All passageways are unobstructed. An exit interview was conducted, and a copy of the report was provided to the facility representative. A deficiency citation was issued at the time of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On 3/18/2026 at 8:44AM Licensing Program Analyst (LPA) Amber Hunter conducted an unannounced case management inspection at the above-named Short Term Residential Therapeutic Program (STRTP). LPA met with Jessica Ruiz, Administrator. The purpose of this inspection was to follow up on an unusual incident dated 3/4/26 involving C1 and C2. On 3/4/26, the Department received an incident report, which states that C2 went into room 4 and was followed by C1. Staff (S1) went into room 4 and found both students out of breath. Both students claimed that they were horse-playing, but C2's lip was bleeding, and he had several red marks on his face. On 3/5/26 it was later disclosed by C1 to a Case Worker that staff (S2) had encouraged C2 to fight C1 with the incentive that C2 would be offered a meal if he fought C1. C1 also stated to the Case Worker that S2 had said something's to him that were degrading his mother. During today's inspection, LPA reviewed clients and staff records. Copies of pertinent documents were obtained. LPA also interviewed 3 staff members and 5 clients. Further follow-up is required. A signed copy of this report was provided to the STRTP representative along with LIC 811 (confidential names' list).


summary: Facility Evaluation

raw_content:
Narrative:
On April 2, 2026 at 8:41,am Licensing Program Analyst (LPA) Amber Hunter conducted an unannounced case management inspection at the above-named Short Term Residential Therapeutic Program (STRTP) LPA met with Sterling Scott, Associate Director. The purpose of this inspection was to follow up on an unusual incident dated 3/4/26 involving foster children. On March 4, 2026, the Department received an incident report reporting that two clients were involved in a physical altercation. When staff entered, the clients had already separated and claimed they were horse playing, but one client had a bleeding lip and visible red marks on his face. On March 6, 2026, an incident report addendum reported that on March 5, one of the involved clients told a facility case worker that a staff member had encouraged the fight by offering food as an incentive and made degrading remarks about the client's mother. During the course of the investigation LPA Hunter conducted confidential interviews with 5 clients and 3 staff on 3/18/26. On 3/24/ LPA interviewed 2 staff, 3 case workers, and a nurse. LPA reviewed and obtained documents including but not limited to staff training and certificates, special incident reports (SIR's), Needs and Services Plans (NSP's), rosters, staff written statements, and night shift log. Based on interviews, statements, and documentation, the claim that staff member S2 encouraged a client to fight another and made degrading remarks about the client's mother could not be proven. Evidence shows S2 warned another staff member ahead of time about a possible fight, documented incidents appropriately, and has no prior history of similar allegations despite long-term employment since 2001. Continued on 809C No further action is required. A signed copy of this report was provided to the STRTP representative along with LIC 811 (confidential names' list).


summary: Facility Evaluation

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Narrative:
On April 15, 2026 at 8:43AM, Licensing Program Analyst (LPA) Amber Hunter conducted an unannounced case management inspection at the above-named Short Term Residential Therapeutic Program (STRTP). LPA met with Erin Barilla, Human Resources. The purpose of this inspection was to follow up on an unusual incident dated 4/8/2026 involving C1. On 4/10/2026, the Department received an incident report, which states that on April 8,2026 the Unit Supervisor was notified by C1's facility Caseworker that C1 was upset due to a facility Caseworker pushing him out of a chair and not allowing him to use the office phone. During today's inspection, LPA reviewed client and staff records. Copies of pertinent documents were obtained. LPA interviewed 1 client and conducted a walk thru of the cottage. During the inspection LPA Hunter observed in room 4 on the ceiling an old vent where the paint was coming off, has hard sharp edges, and holes along the bottom exposing sharp metal. Further follow-up is required. A signed copy of this report was provided to the STRTP representative along with LIC 811 (confidential names' list).

met_with: Erin Barilla


summary: Facility Evaluation

raw_content:
Narrative:
On April 16, 2026 at 1: PM, Licensing Program Analyst (LPA) Amber Hunter conducted an unannounced case management inspection at the above-named Short Term Residential Therapeutic Program (STRTP). LPA met with Jessica Ruiz, facility Administrator. The purpose of this inspection was to follow up on an unusual incident dated 4/8/2026 involving C1. On 4/10/2026, the Department received an incident report, which states that on April 8,2026 the Unit Supervisor was notified by C1's facility Caseworker that C1 was upset due to a facility Caseworker pushing him out of a chair and not allowing him to use the office phone. During today's inspection, LPA interviewed 3 staff members and 6 clients. Further follow-up is required. A signed copy of this report was provided to the STRTP representative along with LIC 811 (confidential names' list).


facility_name: BOYS REPUBLIC MCCORMICK STRTP

summary: Facility Evaluation

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Narrative:
On 12/13/22 at 9: AM, Licensing Program Manager (LPM) Jean Herring, and Licensing Program (LPA) Gilbert Gutierrez conducted an announced pre-licensing inspection and Component lll at the above facility address. The purpose of the inspection was to license above facility separate from Boys Republic as the licensed facility, after it was assigned a different address by the City of San Bernardino. LPA met Associate Director, Sterling Scott, Treatment Director, Garry Hodge and Director, Serafin Blau, who gave a tour of the facility. Executive Officer, Chris Burns was present during the Component lll discussion. This inspection is considered a relocation. The facility is a two-story building that has 3 bedrooms downstairs and 4 bedrooms upstairs. Licensee will put a wall in two big bedrooms to convert the rooms in two separate bedrooms to meet the regulation requiring only two clients in each bedroom. The facility has 1 bathroom in each floor. The following was observed at the time of the inspection. The Emergency Disaster Plan and Foster Youth Bill of Rights and Mental Health Patient's Rights, Foster Ombudsman phone number. The facility has a staff office, a living room/dayroom with sofas and a TV, and a laundry room. All the bedrooms have two (2) single beds inside. All the beds have clean mattresses equipped with clean linens and beddings. All the bedrooms have drawers and closet space for the clients' use. The facility has working telephone. There were working smoke/carbon monoxide detectors, and fire alarm system in the facility. There is also emergency exits in the building. The water temperature in the bathroom sinks was tested (111.2 degrees Fahrenheit) within the temperature allowed by Title Regulations. The centralized heating and air were working. All cleaning solutions were observed locked in cabinets. All medications are centrally stored locked in the Nurse Office located Administration Building. The foods are being prepared in the cafeteria, the clients and staff eat. There were adequate foods both perishable and non- perishable in the cafeteria. The facility is ready to accept clients after the facility is licensed. The facility provides recreation to the clients where they can lift weights and play pool and table tennis. There is a pool which is also part of their recreation. The following was discussed: LIC 200: Line 1, The licensee name should be Boys Republic. New LIC 200 with corrections was submitted during the inspection visit. The need for a board resolution designating the administrator. The need for a waiver(s) The licensee will submit the required board resolution by 12/15/22. An exit interview was conducted and copies of the reports were provided to Mr. Hodge.

met_with: Sterling Scott, Garry Hodge, Serafin Blau


summary: Facility Evaluation

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Narrative:
On March 24, 2023 at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted a pOn March 24, 2023 at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted a post-licensing inspection. LPA met with Administrator, Jessica Ruiz and Treatment Director, Garry Hodge who accompanied this LPA to the site of the facility. At the Administrator, Jayson Moore gave the tour of whole facility. The facility has 8 clients currently. Physical Plant The inspection started at around 10: AM. The facility is a two-story building that has 9 bedrooms. The facility has one bathroom in each floor. The following was observed at the time of the inspection. The posted license, Emergency Disaster Plan, Foster Ombudsman phone number. The facility has a staff office, a living room/dayroom with sofas and a TV, and a laundry room. All the bedrooms have two single beds inside except for one bedroom located in the second floor. All the beds have clean mattresses with clean linens and beddings. All the bedrooms have drawers and closets for the clients. The smoke/carbon monoxide detectors were tested and working. The water temperature was tested using a digital thermometer and observed (114.7 degrees Fahrenheit) within the temperature allowed by Title Regulations. The centralized heating and air were working. All cleaning solutions were observed locked in cabinets. All medications are centrally stored locked in the Nurse Office located Administration Building. There were adequate perishable foods for at least 2 days and non-perishable foods for at least 7 days in the cafeteria. All passageways are unobstructed. An exit interview was conducted, and a copy of the report was provided to the facility representative. No deficiency citation issued at the time of the inspection.

met_with: Jessica Sanchez, Garry Hodge, Jayson Moore


summary: Facility Evaluation

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Narrative:
On April 26, 2023 at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an inspection at the facility. The inspection was a continuation of the post-licensing inspection.. LPA met with Administrator, Jayson Moore. Licensee provided a copy of the LIC 500, client roster, Emergency Disaster Plan, and Activity Report. Client Records All client records reviewed are available to the licensing agency to inspect, audit and upon demand. Client records contain required information including, but not limited to, consent forms, court orders, needs and services plan however, one of the client's NSPs was not signed by the authorized representative. Also the records contain removal/discipline/complaint procedures; medical assessment; safeguards for cash resources, personal property and valuables; education records; personal rights forms. Staff Records LPA reviewed five personnel records. The personnel records contain required information including, but not limited to, employee's full name, driver's license, date of employment, home address and phone number, training and/or relevant experience, health screening and tuberculosis test documents. Documentation of successful completion of training is maintained in the personnel record for each staff. The administrator has a valid Administrator's certificate however the proof of education was not on file.. Personnel records are maintained on the licensee, administrator and each employee. All individuals subject to criminal record review have been fingerprinted. Disaster Preparedness Plan Facility maintains a current disaster and mass casualty plan. Facility maintains register of clients, medication records, and contact information for each client's responsible party and physician. The facility conducts emergency drills once a month. · Emergency Intervention Plan The facility has emergency intervention plan. The staff records contain proof of training. An exit interview was conducted and a copy of the LIC 809, LIC 809C, LIC 9102 and LIC 811s were provided to the facility representative. A deficiency citation issued at the time of the inspection.

met_with: Jayson Moore


summary: Facility Evaluation

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Narrative:
On December 12, 2023, at 9: AM, Licensing Program Analysts (LPAs) Gilbert Gutierrez and Juliet Robles conducted an unannounced annual/required inspection to the facility. LPA met Jason Moore, Administrator, who gave the tour of the facility. There are six (6) clients placed in the facility currently. Physical Plant The inspection started at around 9: AM. The facility is a two-story building with 9 bedrooms. The facility has one (1) full bathroom on each floor. The following was observed at the time of the inspection. The posted license, Emergency Disaster Plan, Foster Care Ombudsman's information and Youth's Personal Rights, Complaint and Grievance Procedure, and Mental Health Program Approval. The facility has a staff office and therapist offices, a living room/dayroom, and a laundry room. There is only a maximum of two (2) beds in each bedroom. All bedrooms have drawers and closet spaces for the clients. The fire alarm was tested and working. The water temperature was tested (118) degrees Fahrenheit) using a digital thermometer. All cleaning solutions were observed locked in cabinets. There was extra linens and hygiene supplies in the cabinets and storage room. There was a first aid kit in the facility. All medications are centrally stored locked in the Nurse Office located in the Administration Building. There was adequate perishable food for at least 2 days and non-perishable foods for at least 7 days in the cafeteria. All passageways are unobstructed. An exit interview was conducted, and a copy of LIC 809 was provided to the facility representative. No deficiency citations were issued at the time of the inspection.

met_with: Jason Moore, Sterling Scott


summary: Facility Evaluation

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Narrative:
On December 14, 2023, at 9: AM, Licensing Program Analysts (LPA) Gilbert Gutierrez and Juliet Robles conducted a continuation of the annual/required inspection at the Short Term Residential Therapeutic Program (STRTP) and met Administrator, Jason Moore. The facility is licensed to serve 16 males, ages 13-17 and non-minor dependents. There are seven (7) clients placed in the facility currently. Client Records LPA reviewed six (6) client records. All client records are available to the licensing to review. Client records contain required information including, but not limited to, consent forms, removal/discipline/complaint procedures, medical assessment, personal property and valuables, education records, personal rights forms and medication administration records. Staff Records LPA reviewed six (6') staff records. All staff subject to criminal records review have been fingerprinted and cleared. There is documentation of the required education and experience requirements and training. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill at least quarterly. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Needs and Services Plan for each client, medication records, and contact information for each client's responsible party and physician. Operations The facility maintains a register of clients and available upon licensing staff request. The client records are centrally stored at the staff of the facility. The board minutes meeting was available for review. The board of directors conducts meeting at least on a quarterly basis to review and discuss the STRTP's operation. The facility has written complaint procedures to file a complaint for the clients and/or their representatives. An exit interview was conducted, and a signed copy of LIC 809, LIC 809C,and LIC811s were provided to the facility administrator. No deficiency citations were issued at the time of the inspection.

met_with: Jason Moore


summary: Facility Evaluation

raw_content:
Narrative:
On November 14, 2024, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an unannounced annual/required inspection to the facility. LPA met Administrator, Sterling Scott and Treatment Director, Garry Hodge. There are ten (10) clients placed in the facility currently. Physical Plant LPA conducted the inspection accompanied by Administrator, Scott and Treatment Director, Hodge. The facility is a two-story building with 9 bedrooms. The facility has one (1) full bathroom on each floor. The following was observed at the time of the inspection. The posted license, Emergency Disaster Plan, Foster Care Ombudsman's information and Youth's Personal Rights, Complaint and Grievance Procedure, and Mental Health Program Approval. The facility has a staff office and therapist offices, a living room/dayroom, and a laundry room. A maximum of two (2) beds in each bedroom. All bedrooms have cabinet spaces for the clients clothing. The water temperature in each bathroom was tested (113.5- and 115.4-degrees Fahrenheit) and within the temperature allowed by regulation. All cleaning solutions were observed locked in cabinets. There was extra linens and hygiene supplies in the cabinets and storage room. There was a first aid kit in the facility. All medications were centrally stored locked in the Nurse Office located in the Administration Building. There were adequate perishable foods for at least 2 days and non-perishable foods for at least 7 days in the cafeteria. All indoor and outdoor passageways were unobstructed. An exit interview was conducted, and a copy of LIC 809 was provided to the facility representative. No deficiency citations were issued at the time of the inspection.

met_with: Sterling Scott, Garry Hodge


summary: Facility Evaluation

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Narrative:
On November 21, 2024, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an unannounced annual/required inspection continuation to the facility and met with Administrator, Jessica Ruiz and Administrator, Lori Kezos. Client Records LPA reviewed five (5) client records. All client records are available to the licensing to review. Client records contain required information including, but not limited to, consent forms, removal/discipline/complaint procedures, medical assessment, personal property and valuables, education records, and personal rights forms. Disaster Preparedness The facility has a disaster and mass casualty plan of action and conducts disaster drills at least quarterly. The facility maintains register of clients, Needs and Services Plan for each client, medication records, and contact information for each client's responsible party and physician. Operations The facility maintains a register of clients available upon licensing staff request. The board minutes meeting was available for review. The board of directors conducts meetings at least on a quarterly basis to review and discuss the STRTP's operation. The facility has written complaint procedures to file a complaint for the clients and/or their representatives. An exit interview was conducted, and a copy of the report was provided to the administrator. No deficiency citations issued at the time of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On November 6, 2025, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an unannounced annual/required inspection at the facility. LPA met Associate Directors, Sterling Scott and Jessica Ruiz, who accompanied this LPA to the facility. There are nine (9) clients placed in the facility currently. Physical Plant The facility is a two-story building with 9 bedrooms. The facility has one (1) full bathroom on each floor. The following was observed at the time of the inspection. The posted license, Emergency Disaster Plan, Foster Care Ombudsman's information and Youth's Personal Rights, Complaint and Grievance Procedure, and Mental Health Program Approval and CARF Accreditation. The facility has a staff office and therapist offices, a living room/dayroom, and a laundry room. There is only a maximum of two (2) beds in each bedroom. All bedrooms have drawers and closet spaces for the clients. The fire alarm was tested and working. The water temperature was tested (108.7 degrees Fahrenheit) using a digital thermometer. All cleaning solutions were observed locked in cabinets. There were extra linens and hygiene supplies in the cabinets and storage room. There was a first aid kit in the facility. All medications are centrally stored locked in the Nurse Office located in the Administration Building. There was adequate perishable food for at least 2 days and non-perishable foods for at least 7 days in the cafeteria. All passageways are unobstructed. An exit interview was conducted, and a copy of LIC 809 was provided to the facility representative. A deficiency citation was issued at the time of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On October 8, 2025, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez made a case management inspection to the facility and met Associate Director, Jessica Ruiz. The case management was to follow up the Special Incident Report (SIR) received by the Department. The SIR indicated that on 09/24/25 while staff was monitoring the downstairs hallway, she observed client #1 (C1) exit the back door of the cottage. Staff went to the back door of the cottage seconds later and observed another client #2 (C2) standing at the doorway and C1 at the bottom of the patio stairway. C1 went inside and told staff he injured his left shoulder. C1 told another staff member that he slipped, fell, and reported that he felt his left shoulder popped out of place. C1 was evaluated by the facility nurse and immediately transported to the emergency room (ER). C1 told another staff member that his injury was a result of horseplay with C1. At the time of this case management follow-up, LPA gathered the information that the night the incident happened; the clients were doing chores. Staff observed C1 went to the back door without permission and followed C1 immediately. C1 went to the back door of the cottage knowing that C2 was there getting supplies. When staff arrived, she observed C2 standing and C1 at the bottom of the stairway. C1 told staff he hurt his shoulder. He was taken to the ER, provided a shoulder sling, and went to school the following day. C2 confirmed that during their horse play, C1 threw a punch at him and missed. C1 slipped and fell, landing on his arm. He confirmed a staff member was present. LPA learned that C1 ran away from the facility last 09/29/25 and did not return. He was discharged as of 09/29/25. Based on the information gathered, the incident needs no further follow-up currently. An exit interview was conducted and a copy of LIC 809 and LIC 811 were provided to the Associate Director. No deficiency citation was issued at the time of the inspection.


facility_name: BOYS REPUBLIC MONROVIA RESIDENCE

summary: Facility Evaluation

raw_content:
Narrative:
On November 28, 2023, at 8: A.M, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted an announced pre-licensing inspection to the above address and met Administrator, Lance Parks and Supervisor, Steve Tavera. This site will be a Short Term Residential Therapeutic Program (STRTP) facility. The facility will provide services to six (6) clients. At around 8: A.M, LPA with Administrator and Supervisor toured the facility. The facility is a one story house with four (4) bedrooms and two (2) full and two (2) half bathrooms and attached garage. At the time of the inspection, the following was observed: a staff office and therapist office, family room, living room, dining room/kitchen area. There is a working telephone, copy, fax, printer all in one machine and computer(s) filing cabinets with lock, tables, chairs inside the staff office. In this office is where confidential records, the first aid kit and personal hygiene, and office supplies will be stored. Each bedroom has working lights, adequate drawers, closet spaces, two (2) single beds with clean beddings and linens. There is extra linens and towels in the cabinets located in the hallway. The carbon and smoke detectors located in the bedrooms, hallways, living rooms and kitchen are in working order. There is a refrigerator, a freezer, dishwasher, microwave, oven, clean plates, and utensils in the kitchen. There are perishable and non-perishable foods in the facility. The garage will be the workout/exercise area and laundry area of the clients. The temperature inside the home was 68 degrees Fahrenheit at the time of the inspection. The following documents will be resubmitted: - Orientation Certification (Copy) - Board resolution (Copy) - ACCREDITATION (Copy) Cont. - Application (LIC 200) - Board Resolution - Administrative Organization (LIC 309) - Board of Director's Statement for new members - Surety Bond (LIC 402) - Monthly Operating Statement (LIC 401) - Supplemental Financial Information (LIC 401a) - Proof of education (Transcript/Diploma/license) - Personnel record (LIC 501) for the agency social worker/therapist. The required documents will be resubmitted by 12/01/23. After the required documents are received the facility will be issued a license. An exit interview was conducted and a copy of the LIC 809, LIC 809C were provided to the administrator.

met_with: Lance Parks