summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
At 10:40am LPA arrived at the facility and was let in by Dean Pratt. He contacted Stacie to have her meet LPA at the staff file office at the other location ( E Autry Way, Anaheim). LPA and Stacie met at the staff office of the second facility and reviewed nine out of 16 staff files. LPA observed that three out of three Staff (S3, S4, and S5), please refer to Confidential Names List LIC 811, overnight personnel staff did not have training to be the facility manager. LPA asked Stacie if there were other personnel onsite during the overnight shifts, and Stacie indicated that there was no other staff that worked overnight on the same shift. LPA observed that only four out of nine staff (S1 through S9) had job shadowing documented in their files. Stacie stated that all staff do job shadowing training. LPA observed that nine out of nine staff (S1 through S9) did not have documentation of required training. **Continued on LIC809-C dated 4/16/16** **Continued from LIC809 dated 4/16/16** Based on files reviewed, overnight staff (S3, S4, and S5) did not have training to meet the requirements of a facility manager; a facility manager is required to be on the premises in the absence of the administrator. Per California Code of Regulations, Title 22, Division 6, Section 84065(i)(1)(D)(2)Staffing Records, a Type B deficiency is being cited today for not appropriately training staff to be a facility manager. In addition, based on files reviewed, the facility does not have documentation that staff are completing the necessary requirements as part of job shadowing, as well as the annual training requirement for staff S1- S9. Per California Code of Regulations, Title 22, Division 6, Section 84065(i)(1)(D)(2) and Section 84065(i)(5) are being cited for a Technical Violation. An exit interview was conducted with Stacie, and a plan of correction and appeal rights were discussed. A copy of this report, LIC811, LIC9102 and LIC9102-a, LIC809D, and appeal rights were given to Stacie for facility records.

Deficiencies:
84065(i): Deficient Practice Statement
1
2
3
4Based on observation, interview, and record review, the licensee did not comply with the section cited above in three out of 3 staff (S3, S4, and S5) which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/16/2025
Plan of Correction
1
2
3
4Per the facility representative, Pamala Smith-Bryant, the staff will complete all required trainings by 5/16/2025.

met_with: Stacie Torres, Director of Operations

title:
and (j).

This requirement is not met as evidenced by


state: CA

facility_name: OC TLC

summary: Facility Evaluation

raw_content:
Narrative:
On August 26, 2025, at 11: AM, Licensing Program Analyst (LPA) Jacqueline Garcia conducted a Case Management visit at the facility and met with Administrator, Pamela Smith Bryan. LPA Garcia conducted a walk through of the facility, and no physical plant deficiencies were observed. The purpose of todays visit was to discuss PIN 24-09-CR video cameras policy. LPA Garcia and Administrator, Pamela Smith Bryan discussed facility Addendum to Program Statement to address video camera policy. LPA Garcia conducted a walk through of all location of facility where camera's. LPA Garcia conducted a exit interview with Administrator, Pamela Smith Bryan and provided a copy of this report.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Pamela Smith Bryan-Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On July 9,2025 at 09: AM, Licensing Program Analysts (LPA's) Jacqueline Garcia and Gilbert Marquez conducted an announced pre-licensing inspection of the facility. LPA's met with Administrator Pamela Smith Bryan and CEO/CFO Sayeh Seyedathi. The facility is a three bedroom three bathroom two story home with an attached garage. The facility is a six bed ambulatory clients aged between 12-17 years old. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris. There is adequate indoor and outdoor activity space. Clients will have access to use facility telephone to make and receive confidential telephone calls. The facility smoke detectors and carbon monoxide detectors tested and were observed to be in working order; the fire extinguishers are properly charged and serviced on May 22, 2025. The facility has two first aid kits that has all of the required items. The applicant stated there were no weapons in the facility. Disinfectants and cleaning solutions will be stored and locked in storage closet in the garage. Sharp knives will be stored in a locked cabinet in the kitchen. Medication will be locked and stored in a cabinet in the staff office. The following required forms need to be posted in the facility: Personal Rights, LIC Emergency Disaster Plan, and Grievance Policy. *****Continue on Page 2. ****PAGE TWO CONTINUED: The facility is set up as follows: Upon entry to the facility to your right is the stairs leading to the second floor and a long hallway passing the stairs to the family/dinning room area and kitchen. Upon entry of the facility to your left is a open living room with couches, coffee table, fire place with a metal fence covering fireplace that flows into the dinning area and kitchen. The dinning room area contains a dining room table where it sits seven people. The kitchen is attached to dining area and contains dishwasher, fridge and other small appliances. Once you pass the kitchen family room/dinning area there is a sliding door leading to the backyard. The backyard has a patio table that sits seven people and also has outdoor activity for clients. Towards the back right of the facility is a staff office that will contain staff and client files, centrally stored medication and other facility logs. Next to the staff office is a restroom and a short hallways that leads to the garage. The water temperature measured 112 degrees. All shared living spaces have furniture in good condition. There are three client bedrooms that are designated for two clients per room with twin sized beds dresser and closet space for each client. The client bedrooms are located on the second floor of the facility. Bedroom #1 is located to the far right: it's designated for two clients, with two twin beds, two dressers and closet spaces. Bathroom #2 is located upstairs next to bedroom #1: Bedroom #2 is located upstairs on the right: it is designated for two clients, two twin beds, it has two dressers and closet space. Bedroom #3 is located upstairs on the left side: it is designated for two clients, two twin beds, two dressers and closet space and attached inside the bedroom is bathroom #3. ****Continue on Page 3. *****PAGE THREE CONTINUED: Each room has adequate clean linens, pillows, blankets, comforters, mattress pads, and mattresses pads. Each bedroom had adequate lighting. LPA's observed the following areas that need to be corrected: Seven days supplies of nonperishable food, two days supplies of perishable food, three day of emergency supply food, and back up Linen for all six beds. Based on the facility pre-licensing inspection, the facility will make the corrections and provide LPA's with verification of items purchased to complete pre licensing inspection. All special incident reports (SIR's) will be sent via e-mail to: cclpaccr@dss.ca.gov. The reporting requirements were reviewed with the Applicant. LPA's explained that once the license is approved, all employees shall have an approved criminal record clearance for CCL and be associated to this facility. LPA's conducted exit interview with Administrator Pamela Smith Bryan and CEO/CFO Sayeh Seyedathi. LPA's provided them with a copy of this report.

visit_type: Prelicensing


facility_name: OCTLC, INC.

summary: Complaint Investigation - Substantiated - 1 deficiency - 1 allegation

raw_content:
Narrative:
Confidential interviews revealed that facility staff monitor telephone calls of minors in care while in phase one of treatment. Confidential interviews revealed that a minor's mail is inspected and reviewed for contraband and illegal activity. Confidential interviews revealed that based on the level system of care, a minor may not move up a level and earn more privileges if the facility thinks that a minor has not met clinical and behavioral standards. Confidential interviews revealed that minors have a designated time to receive phone calls from parents, if parents call outside of those times, the facility will ask the parents to call back during designated times to speak to the minors. Confidential interviews revealed minors are not allowed to place or receive phone calls when they want to. Based on confidential interviews and record review, the preponderance of evidence standard has been met regarding the allegations that that facility staff do not allow minors to communicate freely on the telephone and facility staff do not treat minors fairly while in care, therefore the allegations are substantiated. This poses a potential Health, Safety or Personal Rights risk to the children in care. The facility will be cited for violating California Code of Regulations, Tittle 22, Section 84072(d) - Personal Rights. The licensee shall ensure that each child, regardless of whether the child is in foster care, is accorded the personal rights specified in Welfare and Institutions Code section 16001.9, as applicable. The facility will also be cited for violating California Code of Regulations, Tittle 22, Section 8000(b) -The licensee shall ensure compliance with all applicable law and regulation. An exit interview was conducted, and a copy of this report, along with appeal rights was provided to Pam Bryan.

Investigation Findings:
13On June 23, 2021, at 2: PM, Licensing Program Analyst (LPA) Jesus Cervantes made an unannounced visit at the facility. LPA met with Pam Bryan, to issue the investigative findings of the allegations listed above. On August 31, 2020, Licensing Program Analyst (LPA) Jesus Cervantes, inspected the facility, and no deficiencies were noted. LPA Cervantes conducted interviews with eight of eight children (C1, C2, C3, C4, C5, C6, C7 and C8), and eight of eight staff (S1, S2, S3, S4, S5, S6, S8 and S9). During the investigation, LPA reviewed facility records and obtained copies of the following documents: Needs and Service Plan, LIC 500, client admission records, medication logs, and staff records On August 19, 2020, Community Care Licensing received allegations that facility staff do not allow minors to communicate freely on the telephone and facility staff do not treat minors fairly while in care. Confidential interviews and documents obtained revealed that the facility uses a level system of care for minors. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Jesus Cervantes 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: 5 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, THE CITY DR., Suite Orange, CA Facility Name: Octlc, INC.FACILITY NUMBER: 306004831

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

Deficiencies:
78000(b): 1
2
3
4
5
6
7

report_type: Complaint Investigation

met_with: Pam Bryan

complaint_status: SUBSTANTIATED

title:
-The licensee shall ensure compliance with all applicable law and regulation

This requirement is not met as evidenced by

description:
1
2
3
4
5
6
7


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Based on confidential interviews and record review, the allegation that that facility staff fail to communicate effectively with clients and parents may have occurred; however, it is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with appeal rights was provided to Pam Bryan

Investigation Findings:
13On June 23, 2021, at 2: PM, Licensing Program Analyst (LPA) Jesus Cervantes made an unannounced visit at the facility. LPA met with Pam Bryan, to issue the investigative findings of the allegation listed above. On August 31, 2020, Licensing Program Analyst (LPA) Jesus Cervantes, inspected the facility, and no deficiencies were noted. LPA Cervantes conducted interviews with eight of eight children (C1, C2, C3, C4, C5, C6, C7 and C8), and eight of eight staff (S1, S2, S3, S4, S5, S6, S8 and S9). During the investigation, LPA reviewed facility records and obtained copies of the following documents: Needs and Service Plan, LIC 500, client admission records, medication logs, and staff records. On August 19, 2020, Community Care Licensing received an allegation that facility staff fail to communicate effectively with clients and parents. Confidential interviews revealed that parents are not allowed to directly speak with the facility care staff. If parents of minors in care have questions about clinical care, parents can only receive information from the facility Chief Clinical Officer and not directly from the child's therapist or psychiatrist. Confidential interviews revealed that nonclinical questions are answered by the facility administrator. Parents are made aware of the communication guidelines and sign a written agreement understanding those guidelines. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Jesus Cervantes LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 3 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, THE CITY DR., Suite Orange, CA Facility Name: Octlc, INC.FACILITY NUMBER: VISIT DATE: 06/23/2021

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

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On October 19. 2022, at AM Licensing Program Analyst (LPA) Eduardo Barragan conducted an announced annual inspection. LPA Barragan met with Sayeh Seyedfathi, Administrator who provided LPA conducted a guided tour of the facility inside and out. The facility is a three bedroom four bathroom (for client use) in this two story home. The first floor consists of group therapy room, dining room, kitchen, laundry room, living room and a garage with a punching bag and gym equipment. LPA Barragan observed that there was plenty of food and nonperishable's. LPA Barragan observed just one bottle of ranch was expired and still remained in the fridge. (It was disposed of immediately .) A Technical Violation was administer for this. LPA Barragan noted that bedroom's one, two and three are well equipped to serve two clients each if needed. All beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. Each client had their own bed as well. Additionally, there is a staff office, and two administrator offices on the second story. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris and observable hazards. There is adequate indoor and outdoor activity space. Sports equipment/toys/books/games were observed for children's recreation time. All facility smoke detectors and carbon monoxide detectors are in appropriate working order; fire extinguisher is properly charged and serviced. The hot water temperature was measured in the kitchen and in all bathrooms and is currently 110.0 degrees, which is in ration. Per facility staff, no firearms or weapons are allowed in the facility. LPA observed the following items posted Personal Rights, Grievance Procedures, Visitation Policy, Facility sketch, Activity Schedule, Menu, Staff Schedule and Emergency Plan. Continued... Prior to inspection LPA reviewed personnel files to ensure they contained all required documentation per Title Regulations. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. All licensing fees have been paid and are current at this time. No Clients were able to be interviewed during this inspection due to them all being out on a school outing. Based on the facility inspection and file reviews this date no deficiencies found at this time. California Code of Regulations, (Title 22, Division 6, Chapter 1 regulation) A exit interview was conducted. A copy of the report was discussed and provided along with appeal rights to Sayeh Seyedfathi, Administrator.

visit_type: Annual

met_with: Sayeh Seyedfathi, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On February 20, 2025 at 11:30AM Licensing Program Analyst (LPA) Gilbert Marquez conducted an unannounced annual inspection. LPA Marquez met with Pamela Smith-Bryan, Administrator who provided LPA records of clients and staff at facility. A conducted guided tour of the facility inside and out was done by Sandra Enriquez. The facility is a three bedroom four bathroom (for client use) in this two story home. The first floor consists of group therapy room, dining room, kitchen, laundry room, living room and a garage with a punching bag and gym equipment. LPA Marquez observed that there was plenty of food and nonperishable's. LPA Marquez observed that kitchen refrigerator was well stocked, but there was some minor grime spots that would be cleaned with a towel, a Technical Assistance was noted for this. LPA Marquez noted that bedrooms one, two and three are well equipped to serve two clients each if needed. All beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. Each client had their own bed as well. Additionally, there is a staff office, and two administrator offices on the second story. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris and observable hazards. A rat poison pest box was found, and a Technical Violation was administered for this so that it may be properly made inaccessible. There is adequate indoor and outdoor activity space. Sports equipment/toys/books/games were observed for children's recreation time. All facility smoke detectors and carbon monoxide detectors are in appropriate working order; 3 of 3 fire extinguishers are properly charged and serviced. The hot water temperature was measured in the 2nd floor bathroom and was at 115.8F degrees and is in regulation. Per facility staff, no firearms or weapons are allowed in the facility. LPA observed the following items posted Personal Rights, Grievance Procedures, Visitation Policy, Facility sketch, Activity Schedule, Menu, Staff Schedule and Emergency Plan. Continued.... Prior to physical plant inspection, LPA reviewed five personnel files to ensure they contained all required documentation per Title Regulations. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. A Technical Violation was administered for fire drills only being done twice a year, and the Administrator said they would increase its frequency. A Technical Assistance was administered for staff not understanding what reasonable and prudent parent standards were, although frequent training was observed logged on site and done online as well on a variety of topics. Two clients and two staff were able to be interviewed during this inspection. Based on the facility inspection and file reviews this date no deficiencies found at this time. A exit interview was conducted. A copy of the report was discussed and provided along with appeal rights Pamela Smith-Bryan, Administrator.

met_with: Pamela Bryan, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On August 26, 2025, at 10: AM, Licensing Program Analyst (LPA) Jacqueline Garcia conducted a Case Management visit at the facility and met with Administrator, Pamela Smith Bryan. LPA Garcia conducted a walk through of the facility, and no physical plant deficiencies were observed. The purpose of todays visit was to discuss PIN 24-09-CR video cameras policy. LPA Garcia and Administrator, Pamela Smith Bryan discussed facility Addendum to Program Statement to address video camera policy. LPA Garcia conducted a walk through of all location of facility where camera's. LPA Garcia conducted a exit interview with Administrator, Pamela Smith Bryan and provided a copy of this report.


facility_name: ONE CARE

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with applicant Brian Sullivan for the purpose of conducting the Component II, face-to-face meeting. The following areas were discussed during the meeting: Licensee Duties and Responsibilities, Personnel Requirements, Needs and Services Plans, Buildings and Grounds, Fixture, Furniture, Equipment and Supplies, and Applicant Qualifications. The following specific issues were discussed: 1) Mr. Sullivan does not possess the necessary qualifications to serve as administrator. Therefore he will have to request and receive an exception or choose another administrator. 2) There is no first aid/CPR card included in the application. All persons providing direct care must have emergency first aid and CPR certification. 3) The LIC 503 that was included with the application is a photocopy. An original copy is needed. 4) An LIC 215 and LIC 503 is needed for the proposed Social Worker 5) Lines 1, 10 and 11 of the proposed budget need review 6) The facility sketch does not meet requirements 7) Facility personnel cannot demand that visits to clients be pre-scheduled 8) Homework time is too restrictive 9) Laundry and housekeeping service must be provided if clients refuse to do their own laundry or clean their room. 10) LPA and applicant discussed the blanket ban on mouthwash, aftershave and caffeinated beverages. These will apply on a case-by-case basis. 11) LPA and applicant discussed discipline policies and they will be amended 12) Applicant was informed that planned allowances do not meet DCFS standards,. 13) LPA suggested the addition of an additional overnight staff and a second facility manager(on call status may be used) The pre-licensing walk through was scheduled for 09/20/23 at 9: AM.

met_with: Brian Sullivan


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with Mr. Sullivan to conduct the pre-licensing evaluation. The following was observed. This is a 4 bedroom, two bathroom single family home. It is located in a residential section of the City of Compton, CA. There are no bodies of water, no security bars on windows and no fireplaces in the home. There are no firearms or other weapons in the home. The home is equipped with fire alarms, smoke detectors and carbon monoxide detectors. There is a fully charged fire extinguisher in the kitchen area. There is locked storage space for knives, household and medications. There is a sofa in the living room area and a dining table with 4 chairs in the dining area. Kitchen and bathroom fixtures are clean and functioning well. All trash cans are covered. Hot water temperature was tested at 110. All bedrooms are single occupancy with beds, storage space and linens in good condition. All bedroom windows are operational and connected to an alarm system. The backyard is free of hazards with patio furniture in good condition.The following items need to be corrected prior to licensure: The lock on one of the Exit Doors was jammed. Therefore the door could not open. The applicant shall have the lock repaired, A thermometer is needed for the first aid kit. The horn in the facility van needs repair. Application review will continue when the above items and all items listed during the face-to-face meeting are corrected.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with the applicant to continue the pre-licensing inspection. The following were found to be corrected: The exit door is now operational. There is a thermometer for the first aid kit. The horn in the facility van is working The Department has received the approved fire clearance. Component III was scheduled for October 18, 2023 at 10: AM in the El Segundo Regional Office.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with applicant Brian Sullivan to conduct the Component III meeting. LPA Jones-Steward and Mr. Sullivan discussed the forms that are required to operate a licensed group home. LPA provided Mr. Sullivan with printed copies of the required documents. Mr. Sullivan will return with the corrections that were made to the group home program statement.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with Mr. Brian Sullivan to conduct the post-licensing evaluation. The following was observed. This is a 4 bedroom, two bathroom single family home. It is located in a residential section of the City of Compton, CA. There are no bodies of water, no security bars on windows and no fireplaces in the home. There are no firearms or other weapons in the home. There is currently one client in placement. The home is equipped with fire alarms, smoke detectors and carbon monoxide detectors. There are two fully charged fire extinguishers in the kitchen area. There is locked storage space for knives, household cleaners and medications. There is a complete 1st aid kit. There is a sofa in the living room area and a dining table with 4 chairs in the dining area. Kitchen and bathroom fixtures are clean and functioning well. All trash cans are covered. There is a food supply that meets Title 22 regulations. All bedrooms are single occupancy with full sized beds, the required storage space and linens in good condition. All bedroom windows are operational and connected to an alarm system. LPA reviewed 1 staff file and 1 client file. LPA also interviewed the one client. The facility was cited under Title 22 84070(b)(12)

met_with: Brian Sullivan, CEO


summary: Facility Evaluation

raw_content:
Narrative:
On May 23, 2025, Licensing Program Analyst (LPA) Andrea Aceves and Licensing Program Manager (LPM) Lakescia Smith arrived at the above location, for the purpose of conducting an Annual/Required Inspection. LPA and LPM met with Facility Manager, Brian Sullivan, who granted access to the facility and provided a tour of the entire interior and exterior physical plant. The facility is licensed to provide care and supervision to four (4) clients ages 12-17 years old, ambulatory only. Currently the census is (2). There are no bodies of water, no security bars on windows and no fireplaces in the home. This is a single-family home located in a residential neighborhood. There are four (4) bedrooms, two (2) bathrooms, one (1) living room, one (1) den/lounge room, kitchen/dining area, laundry area, an attached garage, and a backyard. The facility is set up as follows: Living room #1: located towards the front of the home. It's equipped with one sectional sofa, has recessed lighting, and board games. Report continued on LIC 809C (Page 1 of 3) Kitchen/Dining Area: equipped with a wood dining table with three (3) chairs and a bench. Equipped with gas operated four (4) burner stove, refrigerator/freezer, microwave, a lid covered trash can, disposable plates and cups, eating and cooking utensils. LPA and LPM informed staff maintain a supply of 7-day of non-perishable food supply and 2-day perishable food supply. LPA and LPM did not observe a weekly menu posted. Den room: equipped with one sofa and a wall mounted TV. Attached Garage: Is inaccessible to clients and mainly used for storage and is kept locked. Backyard: Clean and no hazards were observed. Bedrooms for client use: Each bedroom can accommodate 1 client. Bedroom #1 is vacant but had adequate drawers and closet space. Observed to have one (1) queen size bed, clean linens, blankets, pillows, sufficient lighting, and windows. Bedroom #2 has one client and has adequate drawers and closet space. Observed to have one (1) queen size bed, clean linens, blankets, pillows, sufficient lighting, and windows. Bedroom #3 has one client and has adequate drawers and closet space. Observed to have one (1) Cal King size bed, clean linens, blankets, pillows, sufficient lighting, and windows. Bedroom #4 is vacant and has adequate drawers and closet space. Observed to have one (1) Cal King size bed, clean linens, blankets, pillows, sufficient lighting, and windows. Bathroom # 1- located to the right and between laundry area and bedroom #2. No cleaning solutions under sink. Bathroom is clean and in good repair. . Bathroom # 2 - located in Bedroom #4. Bathroom is clean and in good repair. The hot water in bathroom #1 and #2 was tested and found to be between 105-120 degrees (F). Laundry Area: Stackable Washer and dryer located in the hallway and is operable. Vehicle: Staff utilize six (6) passenger Dodge Grand Caravan to transport clients. LPA observed the facility vehicle to have working seat belts, horn, and lights. Vehicle has current registration through February 02, 2026, and insurance with All State Northbrook Indemnity Company which expires on July 22, 2025. LPA observed the home to have one (1) fully charged fire extinguisher. Smoke and Carbon Monoxide combination detectors were tested and found to be in working order. The following posting requirements were observed and posted in public area: The Emergency Disaster Plan, Personal Rights, and the facility license. There is a working telephone readily accessible to clients. LPA received copy of the Staff Roster, however an updated roster was requested. LPA verified that all staff on the personnel roster have a criminal record clearance. LPA requested copy of client roster and staff will email a copy of current roster. Client resources: LPA advised staff to create and maintain a log on client issuance of monthly clothing allowance and weekly allowance. Staff should maintain a monthly inventory of client's clothes to verify clients have adequate clothing. LPA advised staff to create and post a monthly activity schedule, post grievance policy for clients and weekly food menu. The were no deficiencies cited at this time. Exit interview was completed and a copy of this report was provided to the Facility Manager, Brian Sullivan.

met_with: Brian Sullivan-


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On 08/25/25, Licensing Program Analyst (LPA) Andrea Aceves and Licensing Program Manager (LPM), arrived at One Care Group Home, for the purpose of conducting the Case Management - Annual Continuation. LPA and LPM met with the Facility Manager, Brian Sullivan and inquired about the current census. Thereafter, Facility Manager Marcus O'Keith arrived to the facility during the inspection. A copy of the Staff and Client Rosters were requested and received. LPA and LPM interviewed two (2) staff. No clients were present in the facility at time of inspection to complete interviews. LPA previously reviewed client files on initial inspection. Staff Records: The program currently has a total nine (9) staff on the roster. LPA reviewed a total of six (6) staff records. LPA obtained the LIC 500 to verify Staff to Client ratio. Two staff were interviewed. The following Type B deficiency is being cited for violating CCR 80066(a)-Personnel Records. See LIC 809D Exit interview was completed and a copy of this report and appeal rights were provided to Facility Manager, Marcus O'Keith.

Deficiencies:
80066(a): Personnel Records

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information


summary: Facility Evaluation

raw_content:
Narrative:
On 08/25/2025, Licensing Program Analyst (LPA) Andrea Aceves and Licensing Program Manager (LPM) Lakescia Smith, made an announced visit to One Care Group Home for the purpose of a Case Management- Incident Report. LPA and LPM met with Facility Manager Marcus O'Keith, to discuss an incident regarding unauthorized absence of a client. The department received an incident report dated 05/28/25. The incident report disclosed staff found an unknown female attempting to enter the facility through a client's bedroom window and found contraband on client's bed. The incident led for the client to leave the facility without permission. Per discussion with staff, the client did not return to the facility. Staff followed unauthorized absence protocols and sent an LIC624- Unusual Incident/Injury Report to El Segundo Regional Office. However, due to staff reporting incident to law enforcement, LPA provided staff with a copy of the Law Enforcement Report (LIC624LE) to complete when there's law enforcement involvement. No deficiencies cited at this time. Exit interview was conducted and a copy of this report was provided to Facility Manager, Marcus O'Keith.

met_with: Marcus O'Keith


facility_name: ONE CARE II GROUP HOME

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with administrator Veronica Tylor to conduct the pre-licensing evaluation. The following was observed. This is a 4 bedroom, two bathroom single family home. Three bedrooms and one bathroom are located downstairs. There is one bedroom and one bathroom upstairs. The home located in a residential section of the City of Compton, CA. There are no bodies of water, no security bars on windows and no fireplaces in the home. There are no firearms or other weapons in the home. There is a garage and a movie room that doubles as the interview room. There is an exercise room with exercise equipment . Fire & General Safety The home is equipped with smoke detectors and carbon monoxide detectors located in the bedrooms and hallways. There is a fully charged fire extinguisher in the kitchen. There are alarms on the exit doors Kitchen and Bathroom The kitchen stove and refrigerator are in good working order. The bathroom fixtures are clean and working properly. There is a dining room table that seats up to eight individuals. Storage Space There is designated locked storage space for knives, medications, household cleaners and client records. Bedrooms All bedrooms have one bed and adequate drawer and closet space for one client. There are blinds on the bedroom windows Misc: There is a complete first aid kit. The following is necessary before licensure: 1) Obtain fire clearance from the fire department 2) Post floor plans that clearly mark emergency exit route 3) Place "EXIT" signs over the exit doors. 4) Remove personal items from upstairs bedroom.

met_with: Veronica Tylor


summary: Facility Evaluation

raw_content:
Narrative:
On February 18, 2025, Licensing Program Analysts Connie Jones-Steward and Licensing Program Manager Lakescia Smith met with Veronica Tylor to conduct the Component II phase of the application process. The following issues were discussed during the meeting: LIC 404 was returned by post office. Please complete a new one to be resubmitted. The fire clearance has not been received. The licensing agency questioned the number of hours the applicant/administrator plans to spend at One Care, One Care II and Sullivan's Home, LLC. The movie room and exercise room are not indicated on the facility sketch. The number of clients per each bedroom is not indicated on the facility sketch. One bedroom must be designated for non-ambulatory. Articles of Organization signed by Veronica Tylor is needed. Complete pages 8, 9 and 12 of the program Update LIC 610C, remove Brian Sullivan as owner. Update LIC 500, indicate which hours Brian Sullivan and in which position. Submit updated LIC 508 for Veronica Tylor Complete updated LIC 200, identify age range and match to age range in program statement. Resubmit Section II of program statement.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with applicant Veronica Tylor to conduct the Component III meeting. LPA Jones-Steward and Ms. Tylor viewed the Component III Orientation and discussed the forms that are required to operate a licensed group home. LPA provided Ms. Tylor with hard copies the LIC forms.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with facility manager, Marcus O'Keith to conduct the Post-licensing inspection. The following was observed. The home located in a residential section of the City of Compton, CA. There are currently no clients in care. There are 4 bedrooms and two bathrooms. Three bedrooms and one bathroom are located downstairs. There is one bedroom and one bathroom upstairs. There are no bodies of water, no security bars on windows and no fireplaces in the home. There are no firearms or other weapons in the home. There is a detached garage and a detached movie room that doubles as the interview/visitation room. Bedrooms There are three bedrooms located on the first floor. 2 bedrooms have one full sized bed each. One bedroom has two full sized beds. Each bedroom has the required storage space.. Each bedroom has a working smoke detector, a working carbon monoxide detector and a functional window that leads to the outside. Each bed has the required linens. All windows are covered by blinds. The 4th bedroom is located upstairs and serves as a storage area/office space Fire & General Safety In addition to the smoke detectors in the bedrooms, there is also a smoke detector and carbon monoxide detector in the hallway. There is a fully charged fire extinguisher in the kitchen. The exit doors are clearly marked. Kitchen and Bathroom The kitchen stove and refrigerator are in good working order. The bathroom fixtures are clean and working properly. There is a dining room table that seats up to eight individuals. There are six dining room chairs. Storage Space There is designated locked storage space for knives, medications, household cleaners and client & staff records. Yard/Garage/Movie Room The detached garage, movie room and yard were inspected. No hazards were found. Misc: There is a complete first aid kit. The, facility license, floor plan, notice of personal rights, and emergency & disaster plan are posted as required. In the former workout area, there is a coach and a mounted flat screen TV. Licensee was advised to post the complaint procedure and place a complaint box. There were no deficiencies cited as a result of this inspection

met_with: Marcus O'Keith Facility Manager


facility_name: ONE CARE III GROUP HOME

summary: Facility Evaluation

raw_content:
Narrative:
On April 22, 2025, Licensing Program Analysts Connie Jones-Steward met with applicant Marcus O'Keith to conduct the Component II phase of the application process. The following issues were discussed during the meeting: LIC 404 was returned by post office. LIC 404 list two corporations and two bank accounts. Please submit a new LIC 404 listing a correct bank address, one corporation and one bank account, The fire clearance has not been received. Corrections are needed on the operating agreement. Another staff person must be listed on the LIC 308 as the designee. The applicant is to submit an organization chart that correctly represents the organization's chain of command. Add additional names or positions to the LIC 610C. Submit a legible copy of the building floor plan following the instructions on the LIC 9999. Also show number if clients per bedroom and location of all emergency shutoffs. Submit First Aid and CPR certificates for the administrator/applicant. LPA will resubmit fire clearance to add correct address. LPA requested that all updates and corrections be submitted by May 22, 2025. Pre-licensing visit was scheduled for May 8, 2025 at 2: PM.

met_with: Marcus O'Keith, applicant


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with applicant Marcus O'Keith to conduct the Component III meeting. LPA Jones-Steward and Mr. O'Keith viewed the Component III Orientation and discussed the forms that are required to operate a licensed group home. LPA provided Mr. O'Keithr with hard copies the LIC forms.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with applicant Marcus O'Keith to conduct the pre-licensing evaluation. The following was observed. This is a 3 bedroom, two bathroom single family home The home is located in a residential section of the City of Los Angeles, CA. There are no bodies of water, no security bars on windows and one decorative fireplaces in the home. There are no firearms or other weapons in the home. Fire & General Safety There are no security bars on windows. There are working smoke detectors and carbon monoxide detectors that are properly placed.. There is a fully charged fire extinguisher. There are no bodies of water on the premises. Per the applicant, there are no firearms on the premises. Kitchen, Living Room and Bathroom The hot water is at a safe temperature. There is a working stove, refrigerator and dishwasher. There is a dining room table with seating for four. In the living room there are two sofas. Storage Space There is locked storage space for client records, employee records, medications and hazardous items Bedrooms All bedrooms have 1 full size bed and adequate closet and drawer space. All bedrooms have operable windows. Yard Space The front and back yards are free of hazards. Postings: The following are posted: Floor plan, Emergency Disaster Plan, Notice of Personal Rights, Notice of Employee Rights. Misc: There is a first aid kit.& first aid manual. There is a washer & dryer combo in the home. The following items need correction prior to licensure: Obtain a fire clearance, Obtain a thermometer for the first aid kit Place poles in all bedroom closets Place coverings over all bedroom windows Obtain plates, bowls, glasses, cups and other dishes for client use. Set up space to be used as an office Place a fourth bed in the home Submit floor plan with room dimensions and windows demarcated. Add a smoke detector to the third bedroom. LPA Jones-Steward will return at a future date to verify corrections.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with applicant Marcus O'Keith to follow up on the pre-licensing corrections. LPA found the following to be corrected: Fire clearance has been granted Poles are placed in the bedroom closets. Bedroom windows have coverings There is a designated office/visitation area. The 4th bed has been added. There is a smoke detector in the third bedroom. There are adequate dishes, drinking utensils and eating utensils for the requested capacity. The following are still required: Thermometer for first aid kit A door for the third bedroom A floor plan that shows room dimensions and has windows demarcated. The following additional items are suggested for best practices: Obtain a complete set of cookware. Put address numbers in a visible location on outside of house. Once the required items have been completed, the application will be submitted for approval.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with administrator Marcus O'Keith to conduct the post-licensing evaluation. The following was observed. This is a 3 bedroom, two bathroom single family home. It is located in a residential section of the City of Los Angeles, CA. There are no bodies of water and no security bars on windows. The fireplace is for decorative purposes. There are no firearms or other weapons in the home. There are currently no placements and no staff currently working. The home is equipped with working smoke detectors and carbon monoxide detectors. There is a fully charged fire extinguisher in the kitchen area. There is locked storage space for knives, household cleaners and medications. There is a complete 1st aid kit. There are two sofas and an armchair in the living room area and a dining table with 4 chairs in the dining area. Kitchen and bathrooms are clean. Stove and refrigerator are working. All trash cans are covered. Hot water tested at 115 degrees. Yard area is free of hazards. Bedrooms number one and two have one full size bed each and the required storage space. Bedroom number 3 has one queen and one king bed. It has drawer space for two. There were no deficiencies cited on this date. Licensee was advised to post floor plans near each bedroom and obtain a portable closet for bedroom #3.

met_with: Marcus O'Keith, administrator


facility_name: OPERATION SAFEHOUSE, INC.

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst, Veronica Whitaker conducted a case management inspection April 12, 2022 at 9: AM, based on the number of relevant law enforcement contacts reported by the facility pursuant to Health and Safety Code Section 1538.7. During this inspection, 10 out of Direct Care Staff and 5 out of 5 youth files were reviewed. 3 out of Direct Care Staff and 4 out of 5 youth were interviewed. (See the Confidential Names List LIC 811, dated 4/12/22. The Plan of Operation including policies and procedures were reviewed. Based on the analysis of the confidential interviews and youth file review including youth crisis intervention plans. The licensee uses Trauma informed and evidence based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing at the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. Interviews conducted with Direct Care Staff by LPA Veronica Whitaker confirmed completion of training on policies and procedures on when and how to involve law enforcement in response to an incident. Training records show staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance to their Emergency Intervention Plan when there is an immediate risk of serious harm to a child or others. There are no deficiencies cited at this time. A copy of this report was discussed and provided to Shawn Johnson, Director of Youth Services and Dana Darby, Associate Director.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Michael Almaraz, conducted an annual inspection at the Group Home. LPA met with the facility administrator Joseph "Shawn" Johnson. The facility was toured inside and out with facility administrator, Shawn Johnson. The home is a single-story residence with five bedrooms, three and half bathrooms and facility staff office with additional storage. Two clients, the administrator, two youth care staff and the associate director were present at the facility during the inspection. The home was approved for 17 male and female ambulatory clients age 11-17. The bedrooms were arranged so that there was one client to a room, and there was one client per bed. Client #1 was in bedroom #2 on the male's wing of the home and client #2 was in bedroom #4 on the female's wing of the home. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattress in good repair. Clients had adequate hygiene supplies stocked in the laundry room. Facility grounds were clean and free of debris and observable hazards. There was adequate indoor and outdoor activity space. Sports equipment/games/ books were observed for children's recreation time. All facility smoke detectors and carbon monoxide detectors were in appropriate working order, fire extinguishers were properly charged and serviced. Licensee maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. The hot water was measured to be F degrees. All hazardous items have been properly made inaccessible to areas where clients will have access. The kitchen had adequate cooking supplies and utensils. All required forms were posted including the Grievance Procedure, Personal Rights form, and the Foster Care Ombudsman poster. Medications are centrally stored in a lockbox located in a locked storage closet. The group home had cameras in common areas of the facility. Per facility administrator, there were no firearms or weapons in the facility. Administrator Shawn Johnson is present at the facility a minimum of 20 hours a week as verified by staff schedule and interviews. Appropriate staff/client ratios were verified during this inspection. (...) LPA discussed the following with Administrator: Incident reporting, including incidents related to Assembly Bill 388 law enforcement contacts as well as incidents involving emergency interventions. Based upon the facility records and interviews with staff and clients, Licensee appears to be meeting core services/supports requirements. Personnel files were reviewed to ensure they contained all required documentation per Title Regulations. Personnel files were maintained on-site in a locked cabinet in staff office. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index checks clearances and exemptions. A review of client records was also completed on this date. Client and staff interviews were conducted and there were no health and safety concerns. No deficiencies were noted in the areas during time of inspection. Facility appeared to be meeting the terms and conditions of the license.

met_with: Joseph DeShawn Johnson


summary: Facility Evaluation

raw_content:
Narrative:
Intentionally left blank as stated. Original report never given to provider.

met_with: Shawn Johnson- Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Latricia Rogers and Licensing Program Manager Angela King conducted a case management inspection Tuesday, September 12,2023 based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. During this inspection, 5 out of Direct Care Staff and 3 out of 3 youth files were reviewed. 2 out of Direct Care Staff and 2 out of 3 youth were interviewed. (See the Confidential Names List, LIC 811, dated September 12, 2023). The Plan of Operation including policies and procedures were reviewed. Based on the analysis of the confidential interviews and youth file review including the No Harm Contract, youth case plans, and crisis intervention plans, the licensee uses trauma-informed and evidence-based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. LPA Latricia Rogers observed documentation of completed training on policies and procedures on when and how to involve law enforcement in response to an incident. Training records show staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance to their Emergency Intervention Plan when there is an immediate risk of serious harm to a child or others. There are no deficiencies cited at this time. A copy of this report was discussed and provided to Shawn Johnson- Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On May 20, 2024, Licensing Program Analysts (LPAs), Cynthia Robinson and Cynthia Velasquez, conducted an annual inspection at the Group Home. LPAs met with the associate director Dana Darby. LPAs toured facility grounds. Group home is a single-story residence with five bedrooms, four and half bathrooms and facility staff office with additional storage. Additional administrative offices and school classroom were on grounds and toured. The home was approved for 17 male and female ambulatory clients aged 11-17. There are currently 2 clients in care. The bedrooms were arranged so that there was one individual bed per client. Beds were observed with appropriate clean linens, pillows, comforters, and mattress in good repair. Clients had adequate hygiene supplies stocked in the laundry room. Facility grounds were clean and free of debris and observable hazards. There was adequate indoor and outdoor activity space. Sports equipment/games/ books were observed for children's recreation time. Facility smoke detectors and carbon monoxide detectors were in appropriate working order, fire extinguishers were properly charged and serviced. Licensee maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. The hot water was measured to be 102. F degrees. All hazardous items have been properly made inaccessible to areas where clients will have access. The kitchen had adequate cooking supplies and utensils. All required forms were posted including the Grievance Procedure, Personal Rights form, and the Foster Care Ombudsman poster. Medications are centrally stored in a lockbox located in a locked storage closet. The group home has cameras in common areas of the facility. Per associate director, there were no firearms or weapons in the facility. Personnel files were reviewed to ensure they contained all required documentation per Title Regulations. Personnel files were maintained on-site in a locked cabinet in staff office. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index checks clearances and exemptions. A review of client records was also completed on this date and all appropriate forms were found. The following deficiencies are being noted and cited in accordance with Title Regulations Sections 84065(i)(6). See page LIC809D for citations. Client and staff interviews were conducted and there were no health and safety concerns. A copy of this report was reviewed and given to the facility representative, Dana Darby, associate director, along with a Confidential Names List (LIC811), LIC 809-D and appeals rights.

met_with: Dana Darby, Associate Director


summary: Facility Evaluation

raw_content:
Narrative:
On September 9, 2025, at 9: AM, Licensing Program Analyst (LPA) Jessica Peete conducted an unannounced case management visit at Operation Safe House Inc. LPA Peete met with the Director of Youth Services Shawn Johnson, to discuss the incident report submitted to Community Care Licensing on July 24, 2025, alleging a lack of supervision involving the clients identified on the Confidential Names List LIC 811. LPA Peete reviewed the incident report, supporting documentation, and interviewed facility staff (S1) and client 2 (C2). LPA made multiple attempts to interview client 1 (C1), but C1 did not respond to the interview request. Documentation indicated that video footage from the day of the incident was reviewed and showed S1 speaking with another client away from the supervision desk. This distraction allowed C2 to be in the girls' hallway and enter C1's bedroom. Statements about what took place between C1 and C2 in the room were inconsistent. However, both supporting documentation and confidential interviews confirmed that C2 was in C1's bedroom. Video footage also showed that S1 conducted a room check, but the check was not thorough. The documentation did not mention S1 seeing C2 in the room, even though the footage confirmed C2's presence and later exit from C1's bedroom after S1's room check. Based on the information obtained, the licensee is cited for violation of Title California Code of Regulations (CCR) Responsibility for Providing Care and Supervision 88078(a), which states (a) The licensee shall provide care and supervision as necessary to meet the client's needs. An exit interview was completed, and LPA provided this report, the Confidential Names List LIC 811, and appeal rights to the Director of Youth Services, Shawn Johnson.


summary: Facility Evaluation

raw_content:
Narrative:
On June 27, 2024, at 10: AM Licensing Program Analyst (LPA) Jessica Peete met with Operation Safehouse Group Home (GH) Administrative Director Norma Biegel, Human Resources Director Miriam Gomez, and Associate Director Dana Darby, to conduct a case management. According to information obtained by Community Care Licensing (CCL), staff 1 (S1) did not have a Criminal Clearance Background on file. S1 was hired on 05/12/2023, rehired 01/26/2024, and works at the facility with no fingerprint clearance on record. According to the Human Resource Director. Per the Human Resources Director statement S1's last day working at the facility will be 06/28/2024, and S1 will be disassociated. Based on facility document review and staff interview, the facility is being cited for violation of Title 22, Division Health and Safety Code, Chapter California Community Care Facilities Act, Article 02. Administration, section 1522(b)(D) Fingerprints and criminal records; exemptions; criminal record clearances: ...this section is applicable to criminal record clearances and exemptions for the following persons: (D) Any staff person, volunteer, or employee who has contact with the clients. S1 was allowed to work at the GH without a criminal clearance background, which poses an immediate Health, Safety, or Personal Rights risk to children in care. A civil penalty (LIC421BG) was issued for the facility, for allowing S1 to work before a criminal clearance background was filed. A copy of the report was discussed and provided, along with appeal rights and LIC 811, to Operation Safehouse Group Home (GH) Associate Director Dana Darby.

met_with: Administrative Director, Norma Biegel, Human Resources Director, Miriam Gomez, Associate Director,Dana Darby


summary: Facility Evaluation

raw_content:
Narrative:
On April 15, 2026, at 10: AM Licensing Program Analysts (LPA), Julian Lucas conducted an annual random inspection at Operation Safe Inc. Group Home (GH). LPA met with the Director, Shawn Johnson. LPA inspected the facility grounds. LPA observed the group home to be a single-story residence with five bedrooms, four and one half bathrooms with temperature readings of 109. Degrees Fahrenheit. The facility includes a staff office. The group home additionally has administrative offices and one school classroom behind facility. There are currently seven clients in care. LPA observed the bedrooms which were arranged for one individual bed per client. Beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. Each client has a dresser for belongings and there were separate dressers and a closet space for each client. There was a laundry room with one washer and one dryer and an adequate supply of detergent. LPA inspected the facility grounds, which were clean and free of debris and safety hazards. There was an adequate indoor and outdoor activity space. The recreation room had games, books, and art supplies. Facility smoke detectors and carbon monoxide detectors were in appropriate working order; fire extinguishers were properly charged and serviced. The kitchen had an adequate supply of perishable and non-perishable foods with the posted menu. The hot water was measured to be 109. Degrees Fahrenheit. The kitchen had adequate cooking supplies and utensils. All required forms were posted including the Grievance Procedure, Personal Rights form, and the Foster Care Ombudsman poster. Sharps were kept in the staff office. Medications are centrally stored in a lockbox located in a locked storage closet. The group home has cameras in common areas of the facility. LPA reviewed four staff files and four client files. Client and staff interviews were conducted and there were no health and safety concerns. An exit interview was conducted, and a copy of this report and LIC 811 was provided to the Director, Shawn Johnson.

met_with: Shawn Johnson, Director


summary: Facility Evaluation

raw_content:
Narrative:
On June 16, 2022, at 10: AM Licensing Program Analyst (LPA), Michael Almaraz, conducted an annual inspection at the Group Home. LPA met with the facility administrator Joseph "Shawn" Johnson. The facility was toured inside and out with facility administrator, Shawn Johnson. The home is a single-story facility with 10 bedrooms, four restrooms, laundry room, two counseling offices and facility staff office with additional storage. Four clients, the administrator, two staff and the associate director were present at the facility during the inspection. The facility was approved for 20 male and female ambulatory clients age 11-17. The bedrooms were arranged so that there was one client to a room, and there was one client per bed. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattress in good repair. Clients had adequate hygiene supplies stocked in the laundry room. Facility grounds were clean and free of debris and observable hazards. There was adequate indoor and outdoor activity space. Sports equipment/games/ books were observed for children's recreation time. All facility smoke detectors and carbon monoxide detectors were in appropriate working order, fire extinguishers were properly charged and serviced. Licensee maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. The hot water was measured to be F degrees. All hazardous items have been properly made inaccessible to areas where clients will have access. The kitchen had adequate cooking supplies and utensils. All required forms were posted including the Grievance Procedure, Personal Rights form, and the Foster Care Ombudsman poster. Medications are centrally stored in a lockbox located in the staff office. The group home had cameras in common areas of the facility. Per facility administrator, there were no firearms or weapons in the facility. Administrator Shawn Johnson is present at the facility a minimum of 20 hours a week as verified by staff schedule and interviews. Appropriate staff/client ratios were verified during this inspection. LPA discussed the following with Administrator: Incident reporting, including incidents related to Assembly Bill 388 law enforcement contacts as well as incidents involving emergency interventions. Based upon the facility records and interviews with clients, Licensee appears to be meeting core services/supports requirements. During LPA inspection a review of client records and physical plant were conducted. Client interviews were also conducted and there were no health and safety concerns. LPA will return at a later date to complete the annual inspection. No deficiencies were noted in these areas during the time of inspection

met_with: Shawn Johnson


summary: Facility Evaluation

raw_content:
Narrative:
On June 22, 2022, at 12: PM Licensing Program Analyst (LPA), Michael Almaraz, conducted an annual inspection continuation at the Group Home. LPA met with the facility administrator Joseph "Shawn" Johnson. The facility was toured inside and out with facility administrator, Shawn Johnson. The home is a single-story facility with 10 bedrooms, four restrooms, laundry room, two counseling offices and facility staff office with additional storage. Four clients, the administrator, one staff and the associate director were present at the facility during the inspection. The facility was approved for 20 male and female ambulatory clients age 11-17. The bedrooms were arranged so that there was one client to a room, and there was one client per bed. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattress in good repair. Clients had adequate hygiene supplies stocked in the laundry room. Facility grounds were clean and free of debris and observable hazards. There was adequate indoor and outdoor activity space. Sports equipment/games/ books were observed for children's recreation time. All facility smoke detectors and carbon monoxide detectors were in appropriate working order, fire extinguishers were properly charged and serviced. Licensee maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. The hot water was measured to be F degrees. All hazardous items have been properly made inaccessible to areas where clients will have access. The kitchen had adequate cooking supplies and utensils. All required forms were posted including the Grievance Procedure, Personal Rights form, and the Foster Care Ombudsman poster. Medications are centrally stored in a lockbox located in the staff office. The group home had cameras in common areas of the facility. Per facility administrator, there were no firearms or weapons in the facility. Administrator Shawn Johnson is present at the facility a minimum of 20 hours a week as verified by staff schedule and interviews. Appropriate staff/client ratios were verified during this inspection. LPA discussed the following with Administrator: Incident reporting, including incidents related to Assembly Bill 388 law enforcement contacts as well as incidents involving emergency interventions. Based upon the facility records and interviews with clients, Licensee appears to be meeting core services/supports requirements. During LPA inspection a review of staffing records, operational requirements, disaster preparedness, emergency intervention plan and clients with special health care needs were conducted. Staff interviews were conducted. LPA noted deficiencies in staffing records and emergency preparedness during the time of inspection LPA explained and provided a copy of the LIC 809, LIC D and LIC 811 to Shawn Johnson.


summary: Facility Evaluation

raw_content:
Narrative:
On March 14, 2024,Licensing Program Analyst (LPA) Cynthia Velasquez and Licensing Program Manager ( LPM) Cheraki Davis conducted an Annual/Random inspection with Associate Director Catalina Garcia. LPA began the physical plant inspection at 9:15 a.m. The facility was inspected inside and outside with facility staff. The facility consists of 10 bedrooms; six girls' and four boys' bedrooms with two beds and sufficient drawer/closet space. There were two restrooms and five showers, laundry facility, two client interview/counseling offices, and a facility staff office. There were two staff available in the facility, one Associate Director and one Youth Care Staff. The bedrooms were arranged with two beds per room. The beds were sanitary, with comforters, pillows, and mattress covers. Personal hygiene kits are available for children. As there were no clients enrolled at this time, as their census is zero, at times, they range from three to six clients but are approved for a census of 20. Their ages range from 11 years to 17 years of age. The bathrooms were observed to be clean, with separate shower areas. There were toiletries, towels, and sanitary napkins available and in kept in stock. A personnel roster was provided and upon review complied through Guardian. Emergency Disaster Plan was reviewed and is updated as necessary to include earthquake, Fires, and Flooding procedures. The facility maintains cleansers, laundry soap, and all chemical based products locked in a closet/storage area. The kitchen area has adequate food, perishable and non-perishable items as well as two freezers and two refrigerators of food available. Sharp items are locked in a drawer away from children's reach. There are smoke/carbon monoxide detectors in large areas and are operable. Fire extinguishers were checked for recent inspection and were fully charged. There are no weapons or firearms on the premises. There is a tote for client medications which has a lock located in the facility staff office. License is posted for public view at several areas of the facility, Personal Rights, Program/Mission Statement, and General Rules of the facility. Disaster Preparedness, and Operational Requirements have been met. There are no pools or other bodies of water on the property. There is adequate indoor and outdoor activity space, all exits and walkways are free from obstruction. Due to time constraints LPA will return to complete the inspection at a later date. Based on observations made during the inspection there were no deficiencies cited. An exit interview was conducted, and a copy of this report and appeal rights were provided to the Associate Director, Catalina Garcia.

met_with: Catalina Garcia


summary: Facility Evaluation

raw_content:
Narrative:
On March 25, 2024, at 9:45 am, Licensing Program Analyst Cynthia Velasquez met with Joseph Johnson, Administrator for a Case Management - Annual Continuation of Operation Safehouse, Inc, Thousand Palms' staff files. Based on observations of staff files, there were no deficiencies in staff case files and Annual Inspection has been completed. An exit interview was conducted and Administrator was given a copy of this report, and personal rights.

met_with: Joseph Johnson, Aministrator


summary: Facility Evaluation

raw_content:
Narrative:
On July 16, 2024, at 9: AM, Licensing Program Analyst (LPA) Jessica Peete met with Operation Safe House Group Home Case Manager Kiamy Zaldivar to discuss deficiencies regarding the facilities fire clearance. The Department was informed 07/11/2024 by the Riverside County Office of the Fire Marshal that the facilities fire panel is non-operational resulting in the authorized fire authority revoking the fire clearance. Per the Administrator's statement, the licensee is aware of the issue and is in contact with the monitoring company to schedule repairs to the panel. Based on document review and staff interview, the facility is being cited for violation of Title 22, California Code of Regulations 80020(a) Fire Clearance (a) All facilities shall secure and maintain a fire clearance approved by the city or county fire department, the district providing fire protection services, or the State Fire Marshal. An exit interview was conducted and Plans of Correction were reviewed and developed with the licensee. A copy of this report and the appeals rights were discussed and left with Case Manager, Kiamy Zaldivar.

met_with: Kiamy Zaldivar, Case Manager


facility_name: OPTIMUM RESIDENTIAL CARE

summary: Facility Evaluation

raw_content:
Narrative:
On July 17, 2025, at 1: PM, Licensing Program Analyst (LPA) Jacob Salem and Licensing Program Manager (LPM) Dawn Segura met with Applicant Gregory Carinci, Social Services Community Liason Shelly Gonchoroff, and Administrator Taylor Pearce at the Community Care Licensing San Diego office for a Component II orientation. LPA went over application revisions and discussed the application process prior to licensure. LPA confirmed that they have received fire clearance, and that a pre-licnesing visit will be scheduled once criminal background clearances are received and applicant's revisions are approved by the Department. A signed copy of this report was provided to applicant Carinci.

met_with: Gregory Carinci, Applicant


summary: Facility Evaluation

raw_content:
Narrative:
On September 30, 2025, at 9: AM, Licensing Program Analyst (LPA) Jacob Salem met with Applicant Gregory Carinci, Administrator Taylor Pearce, and Social Services Community Liason Shelly Gonchoroff for the purpose of conducting a pre-licensing inspection for a Group Home. Applicant Carinci is applying for a license for six ambulatory clients age 7-17. The home is a one story residence located on a residential street. LPA Salem toured the home inside and out and inspected the facility's physical plant, including personal rights postings, health related services, buildings and grounds, food services, telephones, indoor and outdoor activity space, and furniture, fixtures, equipment and supplies. The home is clean, in good repair, and free from observable risks to clients' health, safety, and personal rights. The home contains a four client bedrooms, two client bathrooms, kitchen, an open living room area , garage and locked storage closet where client files will be kept, backyard and patio, and closet with locked medication cabinet. The license will be posted in the front hallway upon licensure. The client bedrooms will be set up as follows: bedroom 1 sleeps one client, bedroom 2 sleeps one client, bedroom 3 sleeps two clients, and bedroom 4 sleeps two clients. The home has a cental smoke and carbon monoxide detection system. The facility has demonstrated compliance with Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was provided to Applicant Carinci.


summary: Facility Evaluation

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Narrative:
On the above date, Licensing Program Analyst (LPA) Latricia Rogers conducted a annual inspection. LPA was met at the facility by Daniel Delgado, Administrator and Shane Parr, Superintendant of Operations. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris and observable hazards. There is a shed located in the facility back yard. The shed is used to store old files and is kept locked with no access to clients. There is also a underground basement with stairs located in the back yard. The door to the basement is locked and inaccessible to clients. There is adequate indoor and outdoor activity space. Sports equipment/toys/books/games were observed for clients recreation time. All facility smoke detectors and carbon monoxide detectors are in appropriate working order; fire extinguisher is properly charged and serviced. There was no food supply available in the facility as facility has been closed and without client placements since March 2019. All required forms are posted including the Grievance Procedures, Visitation Policies, and Personal Rights form. No Medications were reviewed as there are no current client placements in the facility since March 2019. Licensee has provisions for contraceptives to be held in individually locked containers by clients. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. The hot water in the client's bathroom was measured 110.0 degrees and in the kitchen measured 105.0 degrees. Facility has cameras in living room, dining room and kitchen areas of the facility. Per facility staff, no firearms or weapons are allowed in the facility. Facility appears to be meeting the terms and conditions of their license. Administrator, Daniel Delgado is present at the facility a minimum of 20 hours a week, as verified by staff schedule and interviews. Appropriate staff/client ratios were verified during this inspection. The facility employs 1 facility managers and 6 direct care staff to begin when clients are placed at the facility. Licensee has obtained National Accreditation through Teen Challenge USA. The Accreditation is valid through April 2023. Licensing fee payments have been paid and there is currently a balance of 0. LPA discussed the following with the Administrator: Incident reporting, including incidents related to Assembly Bill 388 law enforcement contacts as well as incidents involving emergency interventions. LPA discussed procedures for Child and Family Team (CFT) meetings, including an overview of required Core Services and Supports. Based upon interviews with staff, the Licensee appears to be meeting CFT and Core Services/Supports requirements. Personnel files were reviewed to ensure they contained all required documentation per Title Regulations. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. Staff #3 did not have TB test. A technical violation was issued to the facilty with plan of correction and due date. Staff interviews were conducted and revealed no issues.

met_with: Daniel Delgado- Administrator


facility_name: OUR HOUSE

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Narrative:
Based on LPA's observation the preponderance of evidence standard has been met and the Department has determined the allegation that the facility is unsanitary has been met. The facility is being cited for Title 22, Division 6, Chapter 1, Article 07, Physical Environment section; 80087(a) Buildings and Grounds which poses an immediate health, safety and personal rights risk to children in care. An exit interview was completed and a copy of this report, LIC 811 and appeal rights were provided to facility representative.

Investigation Findings:
13On September 3, 2021 at 11: AM, Licensing Program Analyst (LPA) Anastasia Flores met with Our House Group Home (GH), Youth Advocate, Flor Diaz to deliver the findings of the above allegation. On July 28, 2021 at 11:51AM a safety inspection was conducted and no immediate safety or health concerns were observed. Interviews were conducted with staff #1 and facility manager (FM). On July 19, 2021 this agency received allegation that the Group home (GH) had vomit on the floor of the bedroom closet, mold on the bathroom walls and stray cats coming in and out of the GH windows. On 07/28/21, LPA Flores and Wilson observed three pop up child size tents in the backyard carport area. Interview with S1 informed LPA's that the tents are used for shelter for the stray cats that have been coming around the GH. Interview with S1 denied that the stray cats are allowed to come into the GH. LPA's observed the carpet in Client #1 (C1) room torn, patched together under the corner of bed, flooring missing in the closet with a large reddish-orange oval shape stain in the left corner. LPA's observed broken tile in client's bathroom and an overflowing uncovered trashcan. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Christina Barnes LICENSING EVALUATOR NAME: Anastasia Flores LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: OUR HOUSEFACILITY NUMBER: 366428048

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

met_with: Flor Diaz


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Narrative:
information received by Licensing Office stated that this allegation had occurred, and that S1 had inappropriately touched C1's private area, as well as forced C1 to touch them in a sexual manner during S1's work shift. There were no other known witnesses to this allegation. Based on confidential information obtained during the course of this investigation, the allegation that Staff member sexually abused group home minor, more specifically that Staff # 1 (S1) had inappropriately touched Child # 1's (C1) private parts, as well as forced C1 to touch their private parts, may have occurred, however is not supported or proven by evidence. Therefore, the above allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Assistant Manager, Joseph Mendoza to discuss the investigative findings for the above stated allegation. Licensing Program Analyst, Cheraki Davis conducted an inspection to the facility on November 17, 2021 at 10:26am. Special Investigator (SI), Marlon Williams interviewed three staff (S1, S2, S3), three foster children (C1, C2 & C3), County Investigator (C1), as well as reviewed police, client and facility records. Community Care Licensing received information on November 08, 2021 alleging that Staff member sexually abused group home minor, more specifically that Staff # 1 (S1) had inappropriately touched Child # 1's (C1) private parts, as well as forced C1 to touch their private parts. Information obtained in confidential interviews did not corroborate the allegation with a preponderance of evidence. Confidential interviews denied that C1 had ever been inappropriately touched by S1, or that C1 had been forced to touch S1 in a sexual manner. Confidential information obtained during interviews also stated that C1 had a documented history of making false statements. While other confidential UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: OUR HOUSEFACILITY NUMBER: VISIT DATE: 04/07/2022

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

met_with: Joseph Mendoza


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Narrative:
clients do sometimes try and bring in contraband, including marijuana, it will be confiscated by staff if found. While other confidential information received by Licensing Office stated that these allegations had occurred, and that a staff provided Child # 1 with contraband, as well as smoked marijuana with child #1. Based on confidential information obtained during the course of this investigation, the allegations that a staff member provided group home Child # (C1) with cigarettes and drugs, as well as smoked marijuana with C1, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Assistant Manager, Joseph Mendoza to discuss the investigative findings for the above stated allegations. Licensing Program Analysts (LPAs), Anastasia Flores and Daniel Mena conducted an inspection to the Group Home (GH) on June 25, 2021 at 10:24am and on February 25, 2022 at 12:38pm. No immediate hazards noted. LPAs Flores and Mena interviewed five staff (S1, S2, S3, S4 & S5), three foster children (C1, C2 & C3), County Social Worker (CSW), as well as reviewed client and facility records. Community Care Licensing received information on June 15, 2021 alleging that a staff member provided group home Child # (C1) with cigarettes and drugs, as well as smoked marijuana with C1. Information obtained in confidential interviews did not corroborate the allegations with a preponderance of evidence. Confidential interviews denied that any staff sell or provide, cigarettes, marijuana or any other prohibited contraband to minors in care. Confidential interviews also denied that any staff smoke with, encourage or permit clients to smoke marijuana at the facility. According to confidential interviews, although UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: OUR HOUSEFACILITY NUMBER: VISIT DATE: 05/06/2022

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


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Narrative:
provided C1 marijuana several months prior (exact date unknown). Confidential interviews and record review could not confirm, or dispute staff provided marijuana to C1. Confidential interviews reported C1 did smoke while residing at the facility however, what C1 smoked and how C1 obtained the substance was unable to be confirmed. Other confidential interviews denied observing staff giving C1 marijuana while in care. Based on record review and confidential interviews the allegation of staff (unknown) provided marijuana to (Child #1 [C1]), may or may not have occurred, however it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights to Our House Shelter Manager, Fatima Herrera..

Investigation Findings:
13On September 21, 2021 at 11:35am Licensing Program Analyst (LPA), Nicole Strickland, met with Our House Shelter Manager, Fatima Herrera. to deliver the finding for the above stated allegation. LPA conducted an inspection of the facility on June 8, 2022, at approximately 12:50pm and no immediate deficiencies were observed. The investigation was conducted by Special Investigator Brittany Hudec and LPA Strickland and included interviews with eight foster youth (Child #1 [C1], Child #2 [C2], Child #3 [C3], Child #4 [C4], Child #5 [C5], Child #6 [C6], Child #7 [C7], Child #8 [C8]), five staff (Staff #1 [S1], Staff #2 [S2], Staff #3 [S3], Staff #4 [S4], Staff #5 [S5]), Administrator (ADM), Program Manager (PMgr), Shelter Manager (SMgr) and a San Bernardino County Social Worker (CSW). In addition, county records and facility records were reviewed. On June 2, 2022, Community Care Licensing (CCL) received an allegation alleging that staff provided marijuana to minor (Child #1 [C1]). Specifically, it was reported staff (unknown only partial name given) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: OUR HOUSEFACILITY NUMBER: VISIT DATE: 09/21/2022

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


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Narrative:
temporarily went out at the facility during which time C1 and C2 had a physical altercation resulting in C1 sustaining injuries. Record review and Confidential interviews provided conflicting accounts of the altercation. Record review noted on 6/2/ C1 and C2 were involved in two physical altercations which during the second altercation C2 hit C1 with a metal water bottle. Record review also noted staff encouraged C2 to move to another bedroom to deescalate the situation. Additional Record review and confidential interviews reported a glass bottle was used during the altercation causing the injuries to C1. Confidential interviews also reported the facility protocol during incidents involving physical altercations is for staff to verbally redirect the minors involved, monitor the situation and call 911. Confidential interviews reported staff did attempt to redirect the residents during both altercations however during the second altercation it was another resident (Child #3 [C3]) who intervened ending the altercation at which time staff separated the residents and then called 911. Confidential interviews could not confirm or dispute the allegations of lack of supervision resulted in minor causing injuries to another minor while in care and lack of supervision resulted in minors engaging in physical altercation while in care. Based on record review and confidential interviews the allegations of Minor (C2) causing injuries to another minor (C1) while in care and lack of supervision resulted in minors (C1 and C2) engaging in physical altercation while in care, may or may not have occurred, however they are not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights was provided to Our House Shelter Manager, Fatima Herrera.

Investigation Findings:
13On November 4, 2022 at 3:50pm Licensing Program Analyst (LPA), Nicole Strickland, met Our House Shelter Manager, Fatima Herrera, to deliver the findings for the above stated allegations. LPA conducted an inspection of the facility on June 13, 2022 at approximately 3:20pm and no immediate deficiencies were observed. The investigation was conducted by Special Investigator Georgina Tallagua and LPA Strickland and included interviews with Shelter Manager (SMgr), two former residents (Child #2, [C2] and Child #3 [C3]), and two staff (Staff #1 [S1] and Staff #2 [S2]). One confidential witness was unable to be interviewed due to current whereabouts being unknown. In addition, county records and facility records were reviewed. On June 8, 2022, Community Care Licensing (CCL) received two allegations alleging lack of supervision resulted in Minor (C2) causing injuries to another minor (C1) while in care and lack of supervision resulted in minors (C1 and C2) engaging in physical altercation while in care. Specifically it was reported the power UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: OUR HOUSEFACILITY NUMBER: VISIT DATE: 11/04/2022

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

met_with: Fatima Herrera


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Narrative:
activity and Staff (S1) allowed minor (C1) to visit with unauthorized adult (Adult #1 [A1]). Specifically, it was reported S1 allowed C1 to leave the facility to meet with A1 who was known to participate in CSEC activities. Confidential interviews provided conflicting statements regarding the allegations. Confidential interviews reported that residents would often leave the facility without permission (AWOLing) and return to the facility prior to resident being considered AWOL according to facilities AWOL protocol of two hours which is when authorities would be notified. Confidential interviews reported staff would attempt to discourage this behavior by reminding residents of consequences of leaving without permission and the safety concerns staff had for the residents. Conflicting confidential interviews reported S1 allowed C1 to leave with A1 as long as C1 brought S1 food when C1 returned without considering C AWOL. Confidential interviews and record review could not confirm or dispute these allegations. Community Care Licensing (CCL) received an additional allegation alleging Staff (Staff #1 [S1]) assisted minors (Child #1 [C1] and other youth [youth's names unknown]) with purchasing illegal substances. Specifically, it was reported S1 had taken C1 and other youth at the facility to purchase illegal drugs and alcohol. Confidential interviews reported conflicting statements regarding the allegation. Confidential interviews and record review revealed S1 had been disciplined for taking residents on unapproved outings. Confidential interviews could not confirm or dispute these outings were to purchase illegal drugs and alcohol. Based on record review and confidential interviews the allegations alleging Staff (Staff #1 [S1]) did not prevent minor (Child #1 [C1]) from engaging in Commercial Sexual Exploitation of Children (CSEC) activity, Staff (S1) allowed minor (C1) to visit with unauthorized adult (Adult #1 [A1]), and Staff (S1) assisted minors (C1 and other youth [youth's names unknown]) with purchasing illegal substances, may or may not have occurred, however they are not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights to Our House Administrator, Devin Baze.

Investigation Findings:
13On January 27, 2023 at 2:27pm Licensing Program Analyst (LPA), Nicole Strickland, met with Our House Administrator, Devin Baze to deliver the findings for the above stated allegations. LPA conducted an inspection of the facility on March 14, 2022 at approximately 10:30 am and immediate safety hazards and deficiencies were addressed and corrected. The investigation was conducted by LPA Strickland and included interviews with four current and former staff (Staff #1 [S1], Staff #2 [S2], Staff #3 [S3], and Staff #4 [S4]), three former foster youth (Child #1 [C1], Child #2 [C2], Child #4 [C4]), and one Court Appointed Special Advocate (CASA) worker. One confidential witness did not respond to LPA's request for an interview and therefore was not interviewed. In addition, county records and facility records were reviewed. On March 4, 2022, Community Care Licensing (CCL) received two allegations alleging Staff (Staff #1 [S1]) did not prevent minor (Child #1 [C1]) from engaging in Commercial Sexual Exploitation of Children (CSEC) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: OUR HOUSEFACILITY NUMBER: VISIT DATE: 01/27/2023

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

met_with: Devin Baze


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Narrative:
The interviews that were provided to the LPA were not consistent and did not provide any specific details regarding C1 having access to drugs while placed at this facility. Based on interviews and record reviews the allegation that C1 had access to drugs while placed at this facility, may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Erik Juarez.

Investigation Findings:
13On February 28, 2023 at 11:25am , Licensing Program Analyst's (LPA's) Darlene Almaraz-Oseguera and Emina Preciado conducted an unannounced inspection to the facility to deliver the findings of the above allegations. LPA met with Erik Juarez. LPA Linda Haynes conducted an inspection of the facility on March 09, 2022 at 12:45 pm and no immediate deficiencies were observed. Two of three clients (C1, C2, C3), four staff and facility administrator were interviewed. It was reported to Community Care Licensing (CCL) that C1 had access to drugs while placed at this facility. Confidential staff interviews reported that C1 was in placement at this facility for three weeks. Confidential interviews reported that throughout C1's placement at this facility, C1 left the facility without permission and C1 was involved in numerous incidents. Confidential staff interviews reported that C1 had returned from an absent without leave (AWOL) and possibly under the influence. Confidential interviews reported that while at the facility C1 did not have any access to drugs other than the medication that was prescribed to C1. LPA attempted to interview C1 but was unsuccessful after several attempts. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Darlene Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: OUR HOUSEFACILITY NUMBER: VISIT DATE: 02/28/2023

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

met_with: Erik Juarez