raw_content:
Narrative:
somewhere in the 400's but that they did not see anywhere for themselves that C1's blood sugar was that high. Another confidential interview stated that the relative gave C McDonalds on their visit which made C1 needing more insulin therefore, S2 went back home to get more insulin for C1. In regard to the allegation that licensee did not ensure caregivers were properly trained, it was specifically reported that S2 has not been properly trained and was providing care for C1 during the visit with C1's relative. Confidential interviews stated that they did not have training for children with diabetes at the time, however, they weren't around C1 during the visit with the relative for them to be providing care or to be considered a caregiver. Confidential interviews further explained that they were just providing transportation for the visit, LS was the one with C1 and the relative. Other confidential interviews stated that they were the one who provided care and were taught in the hospital how to check children's blood sugars and administer insulin. Based on confidential interviews and a review of pertinent documents, the allegations that licensee did not ensure C1's health care needs were met and licensee did not ensure caregivers were properly trained may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the allegations are unsubstantiated at this time An exit interview was conducted and a copy of this report was provided to staff member Steve Kibiku.

Investigation Findings:
13On December 4, Licensing Program Analyst (LPA) Maryjane Perez conducted an unannounced visit to Monica Small Family Home (SFH) and met with staff member Steve Kibiku to deliver the finding for the above stated allegations. On October 10, 2025, Community Care Licensing received complaint alleging that licensee did not ensure minor's health care needs were met and licensee did not ensure caregivers were properly trained. On October 22, 2025, LPA M. Perez conducted a health and safety inspection of the facility, and no hazards were observed. Lpa M. Perez also obtained pertinent documents and interviewed licensee (LS), staff 2 (S2), client 2 (C2) and attempted to interview client 1 (C1). Regarding the allegation that licensee did not ensure minors health care needs were met, it was specifically reported that C1 did not have insulin or snacks with them when C1 was visiting their relative and that C1's blood sugar levels were in the 400's. During confidential interviews it was reported that C1 had taken their insulin before going on their visit and that LS always has extra snacks in the car or packed for C1 when on outings. Confidential interviews further explained that the relative indicated that C1's blood sugar was UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: MaryJane Perez 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 RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: MONICA SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 12/04/2025

met_with: Staff 1- Steve Kibiku


state: CA

facility_name: MONTIEL SMALL FAMILY HOME

summary: Facility Evaluation

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Narrative:
On September 29, Licensing Program Analyst (LPA) Belinda Gilmer conducted an unannounced inspection at the facility at 8: AM. LPA met with Marta Montiel, Licensee. The purpose of the inspection was to conduct an Annual/Required inspection of this Small Family Home. Currently there are there are three (3) foster children and two (2) legal guardian. This is a six bedroom, three bathrooms one story single family home. During the inspection, LPA conducted a physical plant inspection, operational requirements interviewed (1) client the staff working with Licensee doesn't speak English and was not interviewed today. Physical Plant: The license is posted in a prominent, disinfectants, cleaning solutions are kept in the garage and sharps are kept on a high shelf in the kitchen over the refrigerator. The home has non-perishable foods for at least one week. Medications are centrally stored and locked box in the bathroom. All kitchen, food preparation, and storage areas are kept clean and free of rodents and other vermin. There are two carbon monoxide detectors in the home. The hot water temperature was tested and measured at 120 degrees. No more than 2 children share a bedroom. All beds are equipped with good springs and a clean mattress; and supplied with pillows which are clean and in good repair. Facility provides age-appropriate clothing items and hygiene products. Operations Licensee did not have a register of clients and the register at the time of this inspection. Licensee does not handle cash resources for clients. LPA issued provided Advisory Notes- Technical Violations (LIC 9102-TVs). 80076(a)(5) food service: Licensee had a menu but it wasn't dated, and she didn't have the items that were listed to be served today available during this inspection. 80071(a) (1) Register of Clients: Licensee did not have a registerer of clients during this inspection. An exit interview was conducted and a signed copy of this report was provided to the facility along with LIC 811 (Confidential Name/s) list). Appeal rights explained.

report_type: Facility Evaluation

visit_type: Annual

met_with: Marta Montiel


summary: Facility Evaluation

raw_content:
Narrative:
On 10/19/21 at 8: AM, Licensing Program Analyst (LPA) Belinda Gilmer conducted an unannounced inspection at the facility. LPA met with Licensee Marta Montiel the purpose of the inspection was to conduct a Annual Continuation. During this inspection, LPA reviewed one (1) staff file as there is only one staff working at this facility. Currently there are three (3) foster children and two (2) legal guardian in placement. This is a six (6) bedroom, three bathrooms one story single family home. During the inspection, LPA competed the operational requirements, interviewed (1) one staff that doesn't speak English using Interaction Voice Response Translator. Operations Licensee did not have a the clients register, clients ambulatory status not notes on the medical form, required forms wasn't complete, no record of cash resource weren't in the file at time of inspection, Licensee hasn't practice disaster drills and the emergency numbers including wasn't posted or located at the facility. Staffing: LPA Gilmer reviewed the one (1) staff personnel records. All individuals subject to criminal record review have been fingerprinted. There was no documentation in file of any training for staff. Children with Special Health Care Needs LPA reviewed the section of Children with Special Health Care Needs, no deficiencies were observed. Client Records: LPA reviewed the clients records the following forms were either not in the files or weren't completed: the client's medical assessment, there was no psychotropic medication log, no verification of doctor's order and or medication as prescribed in according to doctor's orders. LPA issued deficiency citations and provided Advisory Notes- Technical Violations (LIC 9102-TVs). An exit interview was conducted and a signed copy of this report was provided along with LIC 811 (Confidential Name/s list). Appeal rights explained.


summary: Facility Evaluation

raw_content:
Narrative:
On December 12, 2022, Licensing Program Analyst (LPA), Claudia Portillo conducted an unannounced visit at the small family home (SFH) above for the purpose of conducting an annual inspection. LPA met with the licensee of the home, Marta Montiel. There are four foster children in care and one child under limited conservatorship. A physical plant inspection was completed and included the following checks: small family home grounds are free of observable hazards. There is adequate indoor and outdoor activity space, including an outdoor patio. The smoke and carbon monoxide detectors are in working order. Knives and sharps are locked in the garage. LPA observed the Children's Personal Rights, license, and Emergency Plan LIC 610C posted in the facility. The medications are locked in the client's restroom and client's files are locked inside a file cabinet located in the living room area. LPA obtained and reviewed the following updated documentation: · LIC Personnel and client roster · Disaster Drills log · Plan of operation/Program Design The Small Family Home (SFH) program was in compliance with 2 applicable areas of the Compliance and Regulatory Enforcement (CARE) Tools, for Children's Residential licensees: physical plant and operations. LPA made recommendations to certain sections and will issue technical advisory's. LPA will conduct a case management at a later time to correct the capacity from three to six. Community care licensing (CCL) focuses its efforts on three priority areas: prevention, compliance, and enforcement. LPA will continue with the annual at a later date. A copy of this report was provided to the Administrator, Marta Montiel.

met_with: Marta Montiel, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On December 19, 2022 at Licensing Program Analyst (LPA) Claudia Portillo continued the Required 2 year Annual Inspection the agency above. Through the course of this inspection, LPA reviewed a sample of two (3) staff files and a review of the program designed. IIn addition, LPA reviewed the program designed and made contact with CSW to obtain guidance on clients NSP. LPA only complete one domain during today's inspection. LPA will resume the annual at a later date. Per Title Regulations, the licensee did not comply with sections Penal Code 11165.7(c )(1) : child abuse and neglect reporting act and Title 22 80066(b)(2) Personnel Records. During record review all three staff were missing the Mandated Reporter training and one staff was missing the test for tuberculosis. An exit interview was conducted, and a signed copy of this report was provided to the facility representative along with LIC 809, LIC 809D, and LIC 811, Appeal rights explained (Confidential Names list). A copy of this report was provided to the Administrator, Marta Montiel. .

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On 12/19/22, LPA Portillo met with the Administrator to obtain documentation on the capacity increase (from 3 to 6). Administrator provided copies of the following: Check for $25, letter to support change and LIC 200. LPA reviewed documentation for processing and will provide a copy of the license before 12/31/22.


summary: Facility Evaluation

raw_content:
Narrative:
On January 9, 2023, Licensing Program Analyst (LPA), Claudia Portillo conducted an unannounced visit at the small family home (SFH) above for the purpose of conducting an annual inspection. LPA met with the licensee of the home, Marta Montiel. There are four foster children in care who receive regional center services. For this review, four (4) placed LA County DCFS children were selected for the sample to assess the level of care and services they received. Additionally, LPA also conducted an interview with one staff member. No clients were interviewed due to their physical condition. Based on record review, the SFH is issued two citation and technical advisory/violations. An exit interview was conducted with licensee who agreed with the review findings and recommendations. LPA provided a signed copy of this report (LIC 809), Advisory Notes (LIC 9102) and LIC 811s (Confidential Names) was provided to the facility representative.


summary: Facility Evaluation

raw_content:
Narrative:
On October 25, 2023, Licensing Program Analyst (LPA), Claudia Portillo conducted an unannounced visit at the small family home (SFH) above for the purpose of conducting an annual inspection. LPA met with the licensee of the home, Marta Montiel. There are four clients in care (1 minor and 3 non-minor dependents (NMD) in care. A physical plant inspection was completed and included the following checks: small family home grounds are free of observable hazards. There is adequate indoor and outdoor activity space, including an outdoor patio. The smoke and carbon monoxide detectors are in working order. Knives, sharps and disinfectants are locked away and inaccessible to clients in care. LPA observed the Children's Personal Rights, license, and Emergency Plan LIC 610C posted in the facility. The medications are locked in client's restroom, staff and clients' files are securely locked in a cabinet located in the living room. Only authorized representatives have access to the files and medications. LPA obtained and reviewed the following updated documentation: · LIC Personnel and client roster · Disaster Drills log · Plan of operation/Program Design The Small Family Home (SFH) program was in compliance with 4 applicable areas of the Compliance and Regulatory Enforcement (CARE) Tools, for Children's Residential licensees: physical plant, operations, staff and client files. Community care licensing (CCL) focuses its efforts on three priority areas: prevention, compliance, and enforcement. LPA Portillo conducted one staff interview. An exit interview was conducted, and a signed copy of this report was provided to the facility representative along with LIC 809, LIC 809D, LIC 811(Confidential Names) and Technical Violations. Appeal rights explained . A copy of this report was provided to the Administrator, Marta Montiel.


summary: Facility Evaluation

raw_content:
Narrative:
On September 26, 2024, Licensing Program Analyst (LPA), Claudia Portillo conducted an unannounced visit at the small family home (SFH) above for the purpose of conducting an annual inspection. LPA met with the licensee of the home, Marta Montiel. There are two clients in care (1 minor and 1 non-minor dependents (NMD) in care. LPA conducted a physical plant inspection of the entire home (inside and out). LPA observed the Children's Personal Rights, license, and Emergency Plan LIC 610C posted in the facility. The medications are locked in client's restroom, staff and clients' files are securely locked in a cabinet located in the living room. Only authorized representatives have access to the files and medications. The rooms approved for ambulatory clients are not used by nonambulatory clients. LPA obtained and reviewed the following updated documentation: · LIC Personnel and client roster · Disaster Drills logs The Small Family Home (SFH) program followed 4 applicable areas of the Compliance and Regulatory Enforcement (CARE) Tools, for Children's Residential licensees: physical plant, operations, staff, and client files. Community care licensing (CCL) focuses its efforts on three priority areas: prevention, compliance, and enforcement. LPA Portillo reviewed 2 staff and 2 client files. Clients are non-verbal. An exit interview was conducted, and a signed copy of this report was provided to the facility representative along with LIC 809, LIC 809D, LIC 811(Confidential Names) and Technical Advisory/violations, and appeal rights explained. A copy of this report was provided to the Administrator, Marta Montiel.


summary: Facility Evaluation

raw_content:
Narrative:
On June 12, 2025 at 11:00 am, Licensing Program Analyst (LPA) Charmaine Linley met with applicant Bertrand Moore for Component II Orientation via Microsoft Teams Meetings. The following questions were discussed and answered: Mr. Moore confirmed the facility will not accept children with special health care needs, if a new Health Screening Report/TB test can be submitted, and clarifying the grievance/complaint procedures, and the discipline/personal rights procedure. LPA sent a copy of the LIC 184, LIC 281, Care Tools Pre-licensing form, and CRP PIN 24-09, to assist with the revisions needed to the application via email. A copy of this report was provided to the applicant via email along with the signed Orientation form indicating Component II has been completed. A copy of this report will be placed in the facility file.

met_with: Bertrand Moore


summary: Facility Evaluation

raw_content:
Narrative:
On the date listed above, Licensing Program Analyst (LPA) Charmaine Linley conducted Component III Small Family Homes via Microsoft TEAMS with Applicant, Bertrand Moore. A copy of the handout was emailed prior to Component III and the Pre-Licensing Inspection is scheduled for October 29, 2025, at 10:30 am. A copy of this report was emailed to Bertrand Moore for a signature and a copy of the signed report will be placed in the facility file.


summary: Facility Evaluation

raw_content:
Narrative:
On November 13, 2025, at 11:14 am, Licensing Program Analysts (LPAs) Charmaine Linley and Gilbert Marquez arrived at the facility to conduct a pre-licensing inspection of the facility. LPAs met with Applicant, Bertrand Moore, who led a tour of the facility. The facility was toured inside and outside with the Applicant. Currently, there are no clients in placement. The facility is located in a rural residential neighborhood and is located on a half-acre of land. At this inspection, there is no grass in the front or backyard and there are no outside furniture items. The facility is a single-story building with four bedrooms and three bathrooms which are set up as follows: Bedroom #1 (Master) has a California bed and sleeps the Applicant. Bedroom #2 (Clients) has two single beds and will sleep two clients. Bedroom #3 (Clients) has two single beds and will sleep two clients. Bedroom #4 (Clients) has two single beds and will sleep two clients. The facility also consists of a living room, kitchen, dining area, a laundry room located in the hallway between the garage and bedroom #4, a two car garage, and the backyard. There is a properly fenced and secured fire place in the living room. There is no pool at the home at the time of this inspection. The Client's bedrooms were arranged so that no more than two client's will be in a room. No room commonly *** used for other purposes is used as a bedroom and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There were seven smoke/carbon monoxide detectors in every bedroom, kitchen, living room and hallway. The combo detectors were checked and in properly functioning order. The home's central air conditioning module was located on the outside perimeter of the house next to the back porch. The home's tankless water heater was located in the garage. The home appliances were in working order at the time of this inspection. The Client and Staff files will be locked in a locked file cabinet located in the Applicant's bedroom that has a lock on the outside of the door. There was adequate food storage space. LPA observed a supply of food for a minimum of three meals. A trash can for storage of solid waste had a tight-fitting lid and was present in the kitchen. The sharp knives will be locked in the kitchen cupboard, next to the pantry, inaccessible to clients. The medications will be located in a locked cabinet in the kitchen next to the sink. The hot water in the kitchen was measured and registered at 118 degrees at 11:24 am, which is within the regulatory requirements. The hot water in the bathroom located in the hallway was measured and registered at 111 degrees, at 11:40 am, which is within the regulatory requirements. The home's First Aid kit was accessible and is located in the cupboard under the kitchen island did not contain the thermometer and tweezers, as required. There was one fire extinguisher present in the home located in the dining room near the hallway. It was observed to be properly charged and full. There are no firearms or weapons in the home as stated by the applicant. The backyard where clients will have access to play is fenced. The home has proposed that they will have eight security cameras located on the outside porch, one located in the hallway between bedroom #1 and #2, one located in the corner of the kitchen, one located in the garage, one located on each side of the house between the fence and side yard, one located on the outside perimeter of the home in the backyard next to the back porch, and one located outside of the garage by the driveway, however, there were no video cameras present for this inspection. The following corrections need to be made to the home: Tweezers and a thermometer, along with a copy of the First Aid Manual. Bathrooms will need paper towels. *** A washer and dryer that will be located in the hallway between the garage and bedroom #4. The following forms need to be posted: Activity schedule, grievance/complaint procedure, and LIC 610. Cleaning supplies will be purchased and locked in the locked cabinet underneath the kitchen sink. Applicant will have all the corrections by November 20, 2025 and will send photos to LPA Linley. An exit interview was conducted, and a copy of the report was provided to Bertrand Moore. A copy of this report will be placed in the facility file. Licensing Program Manager will review the application and this report and once approved, the Facility License will be printed out and emailed to the applicant.

visit_type: Prelicensing


summary: Facility Evaluation

raw_content:
Narrative:
On April 13, 2026, at 12:09 pm, Licensing Program Analyst (LPA) Val Wilson arrived at Moore Love Small Family Home (SFH) to complete the home health and safety inspection and provide a report. The initial inspection, on March 25, 2026, at 10:15 am, was not completed due to Licensee time constraint. LPA met with Licensee, Bertrand Moore, Jr., to continue the inspection of the home and case management. There are no clients in placement. On March 25, 2026, LPA observed the following: • Client bedroom #1 had staff 1's (S1's) personal belongings and S1 explained that they lived in Client bedroom #1. • Client bedrooms (#2 and #3) each had two beds. Client bedrooms (#2 and #3) were arranged with both boxspring mattresses placed directly on the ground and both beds pushed together as one bed. • Licensee was not able to provide court authorization or provide evidence an emergency court authorization was sought. Licensee stated that this was the document received and they would reach out to the authorized representative to see if there was a current order. Based on confidential interviews, observation, and record review, the facility is sighted for Title 22 Fixtures, Furniture, Equipment, and Supplies(c) which poses a potential Health, Safety, and Personal Rights risk to clients in care. Based on confidential interviews, observation, and record review, the facility is sighted for Title 22 Health Related Services(g) which poses a potential Health, Safety, and Personal Rights risk to clients in care. Based on confidential interviews, observation, and record review, a Technical Assistance Advisory Notes (TA) will be issued for Limitations on Capacity and Ambulatory Status (a) which poses a potential Health, Safety, and Personal Rights risk to clients in care An exit interview was conducted and appeal rights were reviewed with Licensee. A copy of this report, LIC 811, 809D, 809G and appeal right were provided to the Licensee.

met_with: Licensee, Bertrand Moore, Jr


summary: Facility Evaluation

raw_content:
Narrative:
On April 15, 2026 at 9:35 am, Licensing Program Analyst (LPA) Gilbert Marquez arrived at the facility to conduct a post-licensing inspection of the facility. LPA met with Licensee Bertrand Moore. Currently, there are no clients in care. The facility is a single-story building that is located on a half-acre of land in a rural residential neighborhood. The facility was toured inside and outside with the Licensee and included the following checks: living room, kitchen, dining area, a laundry room located in the hallway between the garage and bedroom #4, and a two car garage. There are four bedrooms and three bathrooms which are set up as follows: Bedroom #1 will sleep two clients, has two single beds, and drawers Bedroom #2 will sleep two clients, has two single beds, and drawers Bedroom #3 is the Master bedroom and has a California bed and sleeps the Licensee Bedroom #4 will sleep two clients, has two single beds, drawers and a TV Bathroom #1 has a sink, toilet and shower Bathroom #2 is attached to the Master Bedroom and has a sink, toilet, and shower Bathroom #3 is attached to bedroom #4, and has a sink, toilet and shower **Continued on LIC809C** **Continued from LIC809** The clients' bedrooms are arranged so that no more than two clients will be in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate closet space for the client's belongings. All the required linens are on every bed. There are seven smoke/carbon monoxide detectors in every bedroom, kitchen, living room and hallway. The combo detectors were checked and in properly functioning order. There is a properly fenced and secured fireplace in the living room. The home appliances were in working order at the time of this inspection. There is adequate food storage space. Licensee maintains an adequate supply of perishable and non-perishable foods to prepare the items on the posted menu. LPA observed a minimum seven-day non-perishable and two-day perishable supply of food. A trash can for storage of solid waste had a tight-fitting lid and was present in the kitchen. The sharp knives are not present at the time of inspection, but will be locked in the Master bedroom, and inaccessible to clients. The medications will be located in a locked cabinet in the kitchen next to the sink. Cleaning supplies are locked in the cabinet underneath the kitchen sink. The hot water in the kitchen was measured and registered at 119.1 degrees Fahrenheit, and bathroom #3 hot water was measured and registered at 119.4 degrees Fahrenheit, which both are within the regulatory requirements of 105 to 120 degrees Fahrenheit. The home's First Aid kit was accessible and is located in the cupboard under the kitchen island and has all the required supplies. There is one fire extinguisher present in the home located in the dining room near the hallway. It was observed to be properly charged and full. The facility does not have any security cameras on site at this time. All required forms are posted including Grievance Procedures, Personal Rights, and the Emergency Disaster Plan. At the time of this inspection, there is no grass in the front or backyard, and there are no outside furniture items. Licensee has four collapsing camping chairs for use outside. The home's central air conditioning module is located on the outside perimeter of the house next to the back porch. The home's tankless water heater is located in the garage. Facility grounds are clean and free of debris. There is adequate indoor and outdoor activity space. **Continued on LIC809C page 2** **Continued from LIC809C** LPA asked to see the fire drill log or the emergency disaster drill log. Licensee stated that he did not have a log printed out and had not done a disaster drill recently. The Client and Staff files will be locked in a locked file cabinet located in the Licensee's bedroom that has a lock on the outside of the door. There are no firearms or weapons in the home as stated by the Licensee. Based on LPA observation, record review, and interview, a type B deficiency is given today regarding the absence of a disaster drill log at the time of inspection. This is not in compliance with California Code of Regulations, Title 22, Division 6, Chapter 1, Section 80023(d)Disaster and Mass Casualty Plan. Please see LIC D for full text and to review the plan of correction. LPA conducted an interview with Licensee Bertrand Moore. An exit interview was conducted with the Licensee Bertrand Moore to explain this report, the LIC809D page, and a plan of correction for the one deficiency. The appeal rights were discussed. A copy of the Facility Evaluation Report, along with LIC809D page, the Confidential Names List LIC811, and the appeal rights were given to Licensee, and additionally will be kept in the facility file.

met_with: Bertrand Moore, Licensee


facility_name: MORALES SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward visited the foster home to conduct the annual required inspection. The following was observed. This is a six bedroom, two bathroom home located in a residential area of the City of Compton. There is one foster care clients and four legal wards. All clients are non-verbal. Licensees also have current first aid/CPR training. They each have 3 hours of current caregiver training and are scheduled to enroll in more classes is September There are no bodies of water, no fireplaces and no fire arms in the home. All medications, knives and household cleaners are safely stored. Smoke detectors and carbon monoxide detectors are working and properly placed. The yard area is free of visible safety hazards. Bedrooms #1, 2, and 3 have exit doors Bedrooms #4, 5, and 6 have working security bars. The security bar release in bedrooms #4 and #6 are blocked by furniture All bedrooms have adequate beds and storage space. Bathroom and kitchen equipment is in good working condition. There is ample food in the home. All adults in the home have the required Criminal Background Clearances. The licensees were cited under 80087(c) Buildings and Grounds, Furniture was blocking the security bar releases. However the deficiency was corrected prior to close of inspection, The licensees were also cited under 80068.3(a) Modifications to Needs and Services Plan; The Needs and Services Plan for one client was not current

met_with: Milton & Bertha Hernandez


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward visited the Morales Small Family Home to conduct the Required Year Inspection. The following was observed. This is a six bedroom, two bathroom home located in a residential area of the City of Compton. There is one foster care client and four legal wards. All clients are non-verbal. Licensees also have current first aid/CPR training. Both licensees have several hours of current foster parent training, There are no bodies of water, no fireplaces and no fire arms in the home. All medications, knives and household cleaners are safely stored. Smoke detectors and carbon monoxide detectors are working and properly placed. There is a fully charged fire extinguisher. The yard area is free of visible safety hazards. The following were posted as required: License, Menu, Floor Plan and Notice of Personal Rights. Bedrooms #1, 2, and 3 have exit doors Bedrooms #4, 5, and 6 have working security bars on windows. The security bar releases are not blocked by furniture. All bedrooms have adequate beds with linens in good condition and the required storage space. Bedrooms were found to be at a comfortable temperature. The home has air conditioning and working wall heaters. Bathroom and kitchen equipment is in good working condition. Food supply exceeds the Title 22 requirements for fresh and non-perishable food. All adults in the home have the required Criminal Background Clearances. There were no deficiencies cited as a result of this inspection.

met_with: Milton and Bertha Morales


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Reagan Cohen and Licensing Program Manager Lakescia Smith made an unannounced visit to the Morales Small Family Home for the purpose of a case management other visit. LPA and LPM attempted to conduct an annual required inspection, but the visit type is not available. Therefore LPA will return at a later date to conduct the annual required inspection. Currently there are no foster children in care and LPA and LPM verified legal guardianship of Child 1. LPA and LPM advise the caregiver to contact licensing if the wish to surrender their license. LPA and LPM discussed the facility personnel report summary dated 08/23/24, which shows two adult individuals without a complete clearance. LPA and LPM will verify in /guardian whether a clearance was completed and follow up with the caregivers. LPA and LPM advised caregiver of their outstanding fees. LPA and LPM provided PIN # to check and pay fees online. Per Mr. Morales they "never received a fee" or notice of payment due. Exit Interview completed.

met_with: Mr. and Mrs. Morales


facility_name: MORAN FAMILY CARE AND SUPPORT

summary: Facility Evaluation

raw_content:
Narrative:
On May 29, 2025, Licensing Program Analysts (LPAs) Charmaine Linley and Rachel Vanegas, met with applicant Karina Moran and staff member Matias Moran for Component II Orientation via Microsoft Teams Meetings. LPA Vanegas translated the meeting in Spanish for Ms. Moran. LPAs went over revisions needed for the application prior to licensure. The following areas were covered: the facility will need bond surety coverage for holding clients money in the home and the facility will have video cameras inside of the facility. The following questions were discussed and answered: medication procedures for how the facility will handle clients coming in with medication, daily schedule can include school times blocked out on the schedule, and Matias Moran stated he was recently cleared and associated in Guardian. LPA Vanegas provided the phone number to Guardian to ensure Matias is cleared and associated in Guardian. Ms. Moran confirmed a fire inspection has not been scheduled and LPA Linley stated they will contact the Fire Department. LPA sent a copy of the LIC 184, LIC 281, Care Tools Pre-licensing form, and CRP PIN 24-09, to assist with the revisions needed to the application via email. A copy of this report was provided to the applicant along with the signed Orientation form indicating Component II has been completed via email. A copy of this report will be placed in the facility file. This Report is Incorrect Type of Visit - Office, Not POC

met_with: Karina Moran


summary: Facility Evaluation

raw_content:
Narrative:
On September 8, 2025, at 11:00 am, Licensing Program Analysts (LPAs) Charmaine Linley and Rachel Vanegas arrived to conduct a pre-licensing inspection of the facility. LPA met with Applicant, Karina Moran, who led a tour of the facility. The facility was toured inside and outside with the Applicant. Currently, there are no clients in placement. The facility will have the capacity to accept six clients ages 6-17 years old. The facility is a two-story building with four bedrooms and four bathrooms which are set up as follows: Bedroom #1 (Clients) is on the first floor, has two-tiered bunk beds with the appropriate railing and has two single beds that will sleep only one client in each bed. Bedroom #2 (Clients) is on the second floor, has two-tiered bunk beds with the appropriate railing and has two single bed that will sleep only one client in each bed. Bedroom #3 (Clients) is on the second floor, has two-tiered bunk beds with the appropriate railing and has two single beds that will sleep only one client in each bed. Bedroom #4 (Master) is on the second floor has one queen sized bed and sleeps the Licensee. The facility also consists of a family room, living room, playroom, kitchen, dining room, a laundry room located in the garage, a two car garage, and the backyard. There is a properly fenced and secure fire place in the living room. There is a swimming pool in the backyard. It is properly secured with a latched gate that opens away from the swimming pool. *** The Client's bedrooms were arranged so that no more than two client's will be in a room. No room commonly used for other purposes is used as a bedroom and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There were nine smoke/carbon monoxide detectors in every bedroom, playroom, garage and hallway. The combo detectors were checked and in properly functioning order. The home's central air conditioning module was located on the outside of the home. The home's water heater was located in the hallway on the first floor in a closet next to the garage. The home appliances were in working order at the time of this inspection. The Client and Staff files will be locked in a cabinet located in the playroom. There was adequate food storage space. LPAs observed a three day supply of non-perishable food. A trash can for storage of solid waste had a tight-fitting lid and was present in the kitchen. The sharp knives are in a locked drawer in the kitchen that is inaccessible to clients. The medications will be located in a locked box in a locked cabinet in the playroom. The hot water in the kitchen was measured and registered at 111 degrees at 11:27 am, which is within the regulatory requirements. The home's First Aid kit was accessible and is located in the dining room and contained all required supplies. There were three fire extinguishers present in the home located in the dining room on the wall, one by the front door on the wall, and one upstairs next to the linen storage area. They were observed to be properly charged and inspected by the fire department. There are no firearms or weapons in the home as stated by the applicant. The backyard where clients will have access to play is fenced. The home has six video cameras installed above the playroom, above the window in the family room, in the corner of the dining room, above the door in the kitchen, above the corner window of the living room, and over the window in the hallway of the second floor. *** The following corrections need to be made to the home: Drawers storage space need to be provided for each client in each of the bedrooms to store their belongings, the following forms need to be posted: Activity Calendar, Menu, Grievance Procedure, there needs be a locked cabinet in the playroom with how the clients records will be stored, employee files with required clearances, training, CPR/1st Aid card, and storage for the medication and clients allowance. Photos of these corrections will be sent via email to LPA by end of business day on September 15, 2025. Applicant was asked to notify their assigned LPA when the first client is placed at the facility. Licensing Program Manager will review the application and this report and once approved, the Facility License will be printed out and emailed to the applicant. An exit interview was conducted, and a copy of the report was provided to Karina Moran. A copy of this report will be placed in the facility file.


facility_name: MORE THAN A HOUSE SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On May 28, 2024 at 1: PM, Licensing Program Analyst (LPA) Charmetha White conducted a Component II, Face-to-Face meeting with More Than A House Small Family Home Licensee, Carmyn Wyrick. The purpose of the meeting was to discuss the pending Small Family Home application and Program Statement review. The following concerns were discussed: Program Statement: • Treatment • Education • Transportation • Discipline · Emergency Intervention Plan · AWOL/Run Away Plan · Telephone Policy · Mail • Recreation • Protection • Religious Services Report continued on LIC C • Personal Hygiene Items • Personal Allowance/Paid Jobs • Medical/Dental • Record and Reporting FOLLOW - UP: A Pre-Licensing Inspection will be conducted on 06/04/2024 at 10: AM. An exit interview was conducted, and a copy of this report was given to the Applicant.

met_with: Applicant - Carmyn Wyrick


summary: Facility Evaluation

raw_content:
Narrative:
On June 4, 2024, at 9: AM, Licensing Program Analyst (LPA) C. White arrived at More Than A House Small Family Home for the purpose of conducting a Pre-Licensing Inspection. LPA was met by Applicant, Carmyn Wyrick, who granted access to the home and together a tour of the interior and exterior home was conducted. Currently living in the home is the Applicant. The residence is set up as follows: This is a single-story 3-bedroom, 2 bathroom home located in a residential area. The home consists of a living room, dining area, Office area, kitchen, laundry room, backyard, and a detached garage. Living room: is equipped with a sectional sofa, mounted TV, mounted storage cabinet. Dining area: is equipped with a wooden table and eight (8) chairs. Office area: Desk, chair, computer, and locked storage cabinet for client and staff files. Kitchen: is equipped with a refrigerator/freezer, a five (5) burner gas stove/oven (all burners were operational at the time of this inspection), a microwave, and a pantry. Sharps and knives are kept in locked kitchen drawers. Cleaning supplies and laundry detergent are kept in a locked kitchen closet next to the refrigerator. Laundry room: is located off the kitchen and is equipped with a washer, dryer, and storage shelves. Backyard: is equipped with two (2) tuff shed used to store tools. Detached garage: LPA observed the garage to be used for extra storage. Bedroom #1: will be used as the client's room. The room is equipped with a queen size bed, dresser, a mounted TV, a night stand, lamp, and has two (2) windows. The room contains a working ceiling light/fan and a closet. Report continued on LIC 809C. (Page 1 of 3) Bedroom #2: will be used as the client's room. The room is equipped with a queen size bed, two (2) dressers, a mounted TV, a nightstand, lamp, and has two (2) windows. The room contains a working ceiling light/fan and a closet. Bedroom #3: is occupied by the Applicant. The room is equipped a king size bed, a crib, two (2) dressers, two (2) nightstands, working lights, two (2) walk-in closets, and an en suite. Bathroom #1: is located along the hallway near bedroom #1. The bathroom is equipped with a toilet, a sink, and a combination shower/tub. Bathroom #2: is located inside bedroom #2. The bathroom is equipped with a toilet, double sinks, a stand-alone shower, a tub, and a two (2) windows. The hot water was tested and found to be with 105-120 degrees (F). LPA observed the home to have a fully charged fire extinguisher, a complete First Aid Kit, and a combination lock box to store refrigerated medications. The homes hallway cabinets store extra linen and hygiene products. The smoke and carbon monoxide detectors were tested and found to be in working order. Extra disinfectants and cleaning solutions are kept locked... The home has a working telephone readily accessible to children in care. LPA observed the applicant to have a dog. LPA observed the applicant to have current up to date veterinarian record. LPA observed the home to be clean, safe, and sanitary. Passageways, stairways, inclines, ramps and open porches are unobstructed. The front and backyard were clean and free of debris. There are no bodies of water located on the premises. There are no firearms or dangerous weapons in the home. Vehicle: Applicant will transport children in 2022, BMW 750i. LPA observed the vehicle to have working seat belts, horn, and lights. Applicant has current registration through September 2024 and insurance with Progressive Express Insurance which expires on 09/17/2024. Report continued on LIC 809C. (Page 2 of 3) LPA reminded Applicant to ensure the following when children are in placement: Children are accorded personal rights. Children are to be supported and encouraged to participate in extracurricular activities. Children are allowed and encouraged to contact the licensing agency, in confidence, without threats or punishment for making complaints. Children are accorded dignity in personal relationships with others in the home. LPA observed the Disaster Plan and Discipline policies posted... During the visit, LPA reiterated the importance of submitting Special Incident Reports, Law Enforcement contacts, and to report all changes within the home to Community Care Licensing and any other appropriate agency. Applicant acknowledges abuse reporting requirements. Criminal Record Clearance Status: Per Guardian the Applicant is associated to the facility and listed as eligible. Prior to licensure the following is still required: Component III will be scheduled for June 12, 2024. An exit interview was conducted. A copy of this report was left with the Applicant. (Page 3 of 3).

met_with: Carmyn Wyrick - Applicant


summary: Facility Evaluation

raw_content:
Narrative:
On June 12, 2024, 10: AM, Licensing Program Analyst (LPA) C. White conducted a Component III office meeting at the El Segundo Children's Residential Regional Office for More Than A House (SFH). Attending Component III was Applicant, Carmyn Wyrick. The purpose of this meeting was to discuss the forms that are required to be maintained, available, and posted at the facility for inspections per Title Division Chapter 1 (General Regulations) and Title 22, Division 6, Chapter 4 (Small Family Homes). LPA went over the following: · Child's Records: General regulation section code 80070 & Small Family Home regulation 83070 · Personnel records: General regulation section code 80066 · Reporting Requirements: General regulation section code 80061 & Small Family Home regulation 83061 · Intake: General regulation section code 80068 & Small Family Home regulation 83068.1 · Compatibility: *Useful documentation Small Family Home regulation 83068.2* · Supervision: General regulation section code 80078 & Small Family Home regulation 83078 · Removal/Discharge · Complaint Procedures · Food: General regulation section code 80076 & Small Family Home regulation 83070 · Hygiene (toiletry) · Prudent Parenting: Small Family Home regulation LPA C. White will submit the application for review and final approval of licensure. A Copy of this report was provided to the applicant.


summary: Facility Evaluation

raw_content:
Narrative:
On July 17, 2024, at 10: AM, Licensing Program Analyst (LPA) Kim Denise Dear and Licensing Program Manager (LPM), Bernice Karnsrithong arrived at the More Than A House, small family home for the purpose of conducting a case management inspection. The LPA was met by licensee, Carmyn Marie Wyrick, who granted the LPA and LPM access to the home and initiated scheduled tour of the interior and exterior of the small family home the licensee. During the visit, LPA Dear and LPM Karnsrithong observed the following: The Floorplan: This is a single-story 3-bedroom, 2-bathroom home. The home consists of a living room, dining area, office area, kitchen, laundry room, backyard, and a detached garage. The Fire Department has approved a capacity of 3 for this facility. Bathroom #1: Located along the hallway in between bedrooms (1) and (2) within the hallway for client use. The bathroom is equipped with a toilet, a sink, and a combination shower/tub. The testing of the running water was conducted during the Health and Safety segment of the inspection. Temperatures were found to be with 103-120 degrees (F). Bedroom #1: For client's space, is equipped with a queen size bed, one(1) dressers, a mounted TV, (2) night stands, lamp, two (2) windows as well as a ceiling light/fan and a closet. Bedroom #2: For client's use, is equipped with a closet, (2) twin sized beds, (2) dresser drawers, a mounted TV, (1) one night stand, with lamp, and has two (2) windows as well as a ceiling fan/ light. (Page 1 of 2) Bedroom #3: is occupied by the licensee. The room is equipped a king size bed, a crib, two (2) dresser drawers, two (2) nightstands, working lights, and two (2) walk-in closets. Bathroom #2 (master bathroom): To be use by the only. Client's toiletries/ supplies are stored here. *The small family home is of sufficient size to accommodate the capacity of three (3) clients: children ages three (3) to seventeen (17). There were no deficiencies cited. Exit interview was conducted with the licensee and a copy of this report was provided. (Page 2 of 2)

met_with: Carmyn Marie Wyrick


summary: Facility Evaluation

raw_content:
Narrative:
On August 30, 2024, at 10: AM, Licensing Program Analyst (LPA), Cheri Wilkerson and Licensing Program Manager (LPM), JoAunne Griffin arrived at the above facility for the purpose of conducting a Post-Licensing Inspection. LPA and LPM met with Licensee, Carmyn Wyrick. A health and safety assessment was conducted. The home is located in a residential area and is set up as follows: This is a single-story three bedroom and two-bathroom home. The home also consists of a living room, dining area, office, kitchen, laundry room, backyard, and a detached garage. Living room: is equipped with a sectional sofa, mounted TV, mounted storage cabinet. Dining area: is equipped with a wooden table and eight chairs. Office area: is equipped with a desk, chair, computer, and locked storage cabinet for client and staff files. Kitchen: is equipped with a refrigerator/freezer, a five-burner gas stove/oven (all burners were operational at the time of this inspection), a microwave, and a pantry. Sharps and knives are kept in locked kitchen drawers. Cleaning supplies and laundry detergent are kept in a locked kitchen closet next to the refrigerator. Laundry room: is located off the kitchen and is equipped with a washer, dryer, and storage shelves. Backyard: is equipped with two tuff sheds used to store tools. Detached garage: LPA observed the garage to be used for extra storage. Pg Bedroom 1: Vacant. The room is equipped with a queen size bed, dresser, a mounted TV, a nightstand, lamp, and has two windows. The room contains a working ceiling light/fan and a closet. Bedroom 2: Vacant. The room is equipped with a queen size bed, two dressers, a mounted TV, a nightstand, lamp, and has two windows. The room contains a working ceiling light/fan and a closet. Bedroom 3: is occupied by the Licensee. The room is equipped a king size bed, a crib, two dressers, two nightstands, working lights, two walk-in closets, and on-suite. Bathroom 1: is in the hallway. The bathroom is equipped with a toilet, a sink, and a combination shower/tub. Bathroom 2: is located inside bedroom 2. The bathroom is equipped with a toilet, double sinks, a stand-alone shower, a tub, and two windows. The hot water was tested and found to be with 105-120 degrees (F). LPA observed the home to have a fully charged fire extinguisher, a complete First Aid Kit, and a combination lock box to store refrigerated medications. The homes hallway cabinets store extra linen and hygiene products. The smoke and carbon monoxide detectors were tested and found to be in working order. The home has a working telephone readily accessible to children in care. The hot water was tested and found to be within a safe temperature. LPA observed the Licensee to have a dog with current veterinarian record. LPA observed the home to be clean, safe, and sanitary. Passageways, stairways, inclines, ramps, and open porches are unobstructed. The front and backyard were clean and free of debris. There are no bodies of water located on the premises. There are no firearms or dangerous weapons in the home. LPA reminded Licensee to ensure the following when children are in placement: Children are accorded personal rights. Children are to be supported and encouraged to participate in extracurricular activities. Children are allowed and encouraged to contact the licensing agency, in confidence, without threats or punishment for making complaints. Children are accorded dignity in personal relationships with others in the home. LPA observed the Disaster Plan and Discipline policies posted. Pg. During the visit, LPA reiterated the importance of submitting Special Incident Reports, Law Enforcement contacts, and to report all changes within the home to Community Care Licensing and any other appropriate agency. Criminal Record Clearance Status: Per Guardian the Licensee is associated to the facility and listed as eligible. There were no deficiencies at this time. An exit interview was conducted, and a copy of this report will be emailed to Carmyn Wyrick. Pg 3.

met_with: Carmyn Wrick


summary: Facility Evaluation

raw_content:
Narrative:
On June 13, 2025 at 9:15am, Licensing Program Analyst (LPA), Lanice White and Licensing Program Manager (LPM), Kevin Sauk arrived at the above facility for the purpose of conducting an Annual/Required Inspection. LPA and LPM met with Facility Administrator (FA), Carmyn Wyrick, who granted access into the home. A health and safety assessment was conducted. Currently residing in this home are the Facility Administrator (FA), client (C1), and two dogs. The home is located in a residential area and is set up as follows: This is a single-story three bedroom and two-bathroom home. The home also consists of a living room, dining area, office, kitchen, laundry room, backyard, and a detached garage. Living room: is equipped with a sectional sofa, mounted TV, mounted storage cabinet. Dining area: is equipped with a wooden table and five chairs. Office area: located in the living room, is equipped with a desk, chair, computer, and locked storage cabinet for client and staff files. Kitchen: is equipped with a refrigerator/freezer, a five-burner gas stove/oven (all burners were operational at the time of this inspection), a microwave, and a pantry. Sharps and knives are kept in locked kitchen drawers. Cleaning supplies and laundry detergent are kept in a locked kitchen closet next to the refrigerator. Laundry room: is located off the kitchen and is equipped with a washer, dryer, and storage shelves. Backyard: is equipped with two tuff sheds used to store tools. Detached garage: LPA observed the garage to be used for extra storage and home gym. (Continued on 809-C page 2) Bedroom 1: Sleeps client (C1). The room is equipped with a queen size bed, dresser, a mounted TV, a nightstand, lamp, and has two windows. The room contains a working ceiling light/fan and a closet. Bedroom 2: Vacant. The room is equipped with two twin size beds, two dressers, a mounted TV, a nightstand, lamp, and has two windows. The room contains a working ceiling light/fan and a closet. Bedroom 3: is occupied by the Licensee. The room is equipped a king size bed, a crib, two dressers, two nightstands, working lights, two walk-in closets, and on-suite. The two dogs have received all required vaccinations and sleep in the living room or in Bedroom#3. Bathroom 1: is in the hallway. The bathroom is equipped with a toilet, a sink, and a combination shower/tub. Bathroom 2: is located inside bedroom 2. The bathroom is equipped with a toilet, double sinks, a stand-alone shower, a tub, and two windows. Cameras: Camera #1 is located near the front porch, #2 is in the driveway /East side of home, #3 back door, #4 back yard, #5 westside of home, #6 exterior front yard, #7 front door bell, # Living room, # Hallway, #10 dining room, # Work desk area, #12, Laundry area, and #13 kitchen area. LPA advised licensee that all cameras to mounted and fixed. LPA observed the home to have a fully charged fire extinguisher, a complete First Aid Kit, and a combination lock box to store refrigerated medications. The homes hallway cabinets store extra linen and hygiene products. The smoke and carbon monoxide detectors were tested and found to be in working order. The home has a working telephone readily accessible to children in care. The hot water was tested and found to be within a safe temperature. The hot water was tested and found to be with 100 degrees (F). LPA observed the home to be clean, safe, and sanitary. Passageways, stairways, inclines, ramps, and open porches are unobstructed. The front and backyard were clean and free of debris. There are no bodies of water located on the premises. There are no firearms or dangerous weapons in the home. (Continued on LIC809-C, page 3) Client Records: LPA reviewed one client (C1) records for children Staff Records: LPA reviewed three staff (FA, S1, S2) records . LPA reviewed training LPA obtained the Facility Profile and Personnel Report and confirmed that the Licensee have required criminal record clearances. DOJ, FBI and Child Abuse Response, which meet qualification. Staff Interview: LPA conducted a confidential interview with staff (FA and S1). Client Interviews: One client (C1) interview was conducted. Two deficiencies were cited at the time of inspection. (See LIC809-D) LPA Lanice White and LPM Kevin Sauk concluded the Annual/Required Inspection. An exit interview was conducted, and a copy of this report was emailed to the Facility Administrator (FA).

met_with: Carmyn Wrick - Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On April 30, 2026 at 12:45pm Licensing Program Analyst (LPA) Erika Butler-Williams and Licensing Program Analyst (LPA) Donald Martin arrived at the above facility for the purpose of conducting a Case Management Investigation. LPA's met with, Carmyn Wyrick and was allowed into the facility. On April 21, 2026 the department received and incident report dated 4/20/2026 stating that C1 engaged in property destruction and self harm, which prompted S2 to contact law enforcement. S1 is proactive in aiding C1 with her explosive behaviors and has made an effort to remove items in the home that could potentially be an instrument for C1's self harming behaviors. The department has received several incident reports (4) in the last month that also prompted the visit. The incident reports are consistent with a child getting adjusted to a new environment and the care givers appear to be providing the necessary care and supervision for all clients in care. LPA inspected the home and reviewed the files of the clients. The home is clean and in order. After interviews with staff and the client, LPA has determined that the Case Management investigation is Unsubstantiated. There were no deficiencies cited at the time of the visit.

met_with: Carmyn Wyrick-Caregiver


summary: Facility Evaluation

raw_content:
Narrative:
. On May, 14, 2026 at 2: PM Licensing Program Analyst (LPA) Erika Butler-Williams and Licensing Program Analyst (LPA) Donald Martin arrived at the above facility for the purpose of conducting a Case Management Visit. LPA's met with, Carmyn Wyrick and was allowed into the facility. LPA's discussed with the licensee if the client's placed at the home are placed by Regional Center. The licensee is emailing LPA a copy of the documents that were sent by Department of Children and Family Services. LPA needs to have further discussion with management. LPA discussed with the licensee an option to open a Therapeutic Shelter Home. No deficiencies cited.

met_with: Carmyn Wyrick


facility_name: MOSS SMALL FAMILY HOME

summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Investigation Findings:
SubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:

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

report_type: Complaint Investigation

met_with: Kandra Moss, Licensee

complaint_status: SUBSTANTIATED


summary: Facility Evaluation

raw_content:
Narrative:
On March 8, 2023 at 9:30am, Licensing Program Analyst (LPA) Monica Pavia conducted an announced pre-licensing inspection of the home. LPA met and toured the home with Licensee, Kandra Moss. This Small Family Home (SFH) is a two story home located in a residential area. The home consists of 2 client bedrooms and 2 client bathrooms, living and dining areas, and kitchen. The home is clean, safe, sanitary, and in good repair. All passageways are unobstructed and all doors open freely. There is no pool on the premises. Fire arms are not allowed on the home premises. At the time of visit, the following was observed: Fire extinguishers are throughout the house. Smoke detectors/carbon monoxide detectors are throughout the house and operational. Each bedroom has a bed, clean linens, and adequate drawer/cabinet space. First aid kit was observed. Hot water temperature measured at 105 degrees Fahrenheit. Staff and client records will be stored and locked on site. Medications will be centrally stored and locked on site. Disinfectants and other toxic materials will be locked in the garage. Extra bedding and towels are kept in the hallway cabinet. Knives and sharps will be kept locked in the kitchen. LPA will submit application to Licensing Program Manager (LPM) for approval. Component II: LPA Pavia discussed with the following, with Licensee: - home core services and support - home emergency intervention plan

met_with: Kandra Moss


summary: Facility Evaluation

raw_content:
Narrative:
Visit was attempted on 01/05/24 at 1: PM. LPA will return at a later date to conduct post licensing. See LIC 812 pertaining to attempted visit.


summary: Facility Evaluation

raw_content:
Narrative:
On 02/21/2024 at 11: AM, Licensing Program Analyst (LPA) Brenda Rodriguez met with Licensee Kandra Moss for a post-licensing inspection. LPA Rodriguez used the CARE Inspection Tool. There are no clients placed yet, as Licensee is still working with Regional Center to become vendorized. LPA Rodriguez conducted the physical plant inspection. Facility is a two story house. LPA Rodriguez went upstairs and there are four bedrooms and two bathrooms. LPA Rodriguez went down stairs where the kitchen, dining room, living room, and a third bathroom is located. The facility is free of obstructions and hazards. LPA Rodriguez reviewed the facilities operations plan, disaster preparedness plan, and emergency intervention plan. Licensee has all the essential forms that are needed when a client is placed in the facility. Licensee agrees to notify LPA Rodriguez when Licensee has their first placement. LPA Rodriguez conducted one staff interview. An exit interview was conducted, and a copy of this report was emailed to Licensee Kandra Moss, whose signature on this form confirms receipt.


summary: Facility Evaluation

raw_content:
Narrative:
On 06/25/2024 at 10:31am, Licensing Program Analysts Kristin Pierotti and Jasmine Cardeno conducted an unannounced Annual Inspection at listed facility. LPA met with Kandra Moss, Licensee, and toured the facility inside and out. The Small Family Home is licensed to serve three clients. Present during the inspection were 1 staff and 0 clients. At 10:45am LPA Pierotti and Cardeno reviewed 1 client file and 4 staff files. At 11:02am, LPA Pierotti and Cardeno toured the facility. LPA Pierotti and Cardeno observed 4 bedrooms and 3 bathrooms. LPA's observed facility license, personal rights, facility sketch, meal menu, and other forms posted on the walls throughout the facility. LPA Pierotti tested the water temperature and found it to be 107.8 degrees which is in range. The thermostat read 73 which is within range. Chemicals were locked and safely stored. There were two days of perishable foods and seven days non-perishable foods present. The medication was also stored and locked in medical box in fridge. The facility is in good repair and clean. LPA Pierotti and Cardeno interviewed 1 staff and 0 clients because client was at school. At 11:30am LPA Pierotti and Cardeno toured the backyard. There were no open bodies of water. The backyard was in good repair and clean. At this time LPAs observed locks on the fridge and some food cabinets. LPAs instructed licensee to remove locks and contact client's physician to obtain records as to why the locks are necessary for the client's over-eating behaviors. Licensee will follow up with an email to request an exception for locks. At this time LPAs observed an unlocked used injections container and had a conversation with licensee regarding proper storage. Licensee immediately placed the container in a locked cabinet. During a staff file review, prudent parenting training was missing. LPA will send training information to Licensee. At this time LPAs delivered two Technical Violations and one Technical Assistance. An exit interview was conducted and a copy of this report was given to Kandra Moss, Licensee.


summary: Facility Evaluation

raw_content:
Narrative:
On 04/17/25 at 10:25am, Licensing Program Analyst (LPA) Kristin Pierotti conducted a required annual inspection. LPA met with Kandra Moss, Licensee and informed of the purpose of the visit. The Small Family Home is licensed to provide care for 3 developmentally disabled clients, ambulatory only. LPA used the CARE Inspection Tool and conducted a tour of the facility site, review of 2 personnel records and 1 resident records, and confidential interviews with 1 staff member and 0 residents. LPA observed the facility to be in good condition, clean and well organized. Kitchen and bathrooms are sanitary. The facility currently has 1 resident and each resident has their own bedroom with individual beds and plenty of storage for personal items. The rooms and common spaces are nicely decorated and furnished. Medications, sharps, and chemicals are stored where inaccessible to the residents. LPA observed personnel and resident records to be complete and had all necessary documents. Staff have full background clearances and valid first aid training certifications. Residents' records contain current emergency contact information and complete care plans. Upon reviewing the residents' medication records, LPA observed that for the month of April there are not separate logs for each psychotropic medication. LPA observed there to be separate logs for months prior. LPA is providing technical assistance for Psychotropic Medication Administration Records. Based on interviews, LPA observed staff to be knowledgeable of facility policies, mandated reporting, and client needs. No citations were issued at today's visit. One technical violation advisory was issued. An exit interview was conducted, appeal rights were provided, and a copy of this report was left with Licensee, whose signature confirms receipt.


summary: Facility Evaluation

raw_content:
Narrative:
On 06/11/25, Licensing Program Analyst (LPAs) Cole Oliver and Celeste Aparicio made a visit to the facility regarding the facility closure. LPA met with the facility Administrator and informed the Administrator on the purpose of the visit. LPAs conducted a walk through of the facility. LPA's observed there to be no clients in care and facility to be empty due to the facility's closure. Closure letter, closure plan, and forfeited license has been received by the Department. An exit interview was conducted, and a copy of this report was left with facility Administrator, whose signature on this form confirms receipt.

met_with: Kandra Moss, Administrator


facility_name: MOUNTAIN VIEW HOME

summary: Facility Evaluation

raw_content:
Narrative:
On September 30, Licensing Program Analyst (LPA) Cynthia Ramos met with applicant Elizabeth Gonzalez for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the LIC 184, Letter of Application Revision, and additional correspondence to assist with the revisions needed to the application. A copy of this report was provided to applicant Elizabeth Gonzalez.

met_with: Applicant-Elizabeth Gonzalez


facility_name: MULELE SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On 01/08/2026, Licensing Program Manager (LPM) Abdoulaye Traore and Licensing Program Analyst (LPA) Maya Chavez conducted an in office Component II meeting with Mulele Small Family Home (SFH) applicants, Irene and Johnes Mulele. LPM and LPA went over revisions needed for the application prior to licensure. LPA provided a copy of the LIC809, LIC184 and Letter of Application Revisions to applicants. A copy of this report was provided to applicants Irene and Johnes Mulele.

met_with: Applicant- Irene Mulele


summary: Facility Evaluation

raw_content:
Narrative:
On March 4, 2026, Licensing Program Analyst (LPA) Maya Chavez arrived at Mulele Small Family Home (SFH) for a pre-licensing inspection for an initial license. LPA met with applicant Irene Wangui Mulele and spouse, Johnes Makau Mulele who led a tour of the entire home inside and outside. The applicant is applying to serve three clients: two infants/children ages 0-5 and one child age 6-17. There are currently no clients placed in the home. The home is a two-story building with six bedrooms and four and a half bathrooms. The downstairs consisted of an office space, living and dining room, kitchen, family room, laundry room, client's bed room #6 with bathroom, and a half bathroom. Fire extinguisher #1 was located in the dining room and was operable. There was one carbon monoxide detector and four smoke detectors downstairs all of which were tested and operable. The kitchen has numerous locked cabinets/drawers to secure any knives/sharp objects, cleaning supplies, medications, etc. The kitchen had a telephone service, trash can with lid, and there is plenty of perishable and non-perishable foods in the refrigerator and two freezers. There was a dining table that had adequate seating. The living room had a screened fire place, couches, and TV. Client's bedroom #6 was located downstairs with a full bathroom. The client's bedroom had a full sized bed with adequate bedding, a secured crib, plenty of closet space/drawers, and extra linens. Attached to the client's bedroom is one full bathroom. There are several cabinets and closets throughout the downstairs as well as upstairs for storage. In the office there is a locked cabinet for client's cash resources, client's files, and employee's files. The half bathroom is located next to the office. There is an exit door in the office which leads to the court yard. There is an exit door going to the back yard located between kitchen and family area and another exit door leading through the laundry room into the garage which then has a door leading the outside of the house. In the center of the downstairs floor is the stairway leading upstairs. The upstairs consisted of client's bedroom #2, bedrooms #1, #3, #4, and #5, three full bathrooms, closets, and loft area with exercise equipment. Bedroom #1 is the master bedroom which had a full bathroom and is for licensee's use only no clients will stay in there. Bedroom #3 is for the licensee's adult son, again no clients will stay in there. Bed rooms #4 and #5 have a shared jack and jill bathroom which are currently not occupied but will not be for client's use. Fire extinguisher #2 is located upstairs at the top of the staircase and was operable. There was one carbon monoxide detector and six smoke detectors upstairs all of which were tested and operable. The client's bedroom #2 has a queen sized bed with adequate bedding and plenty of closet space/drawers. The client's full sized bathroom is located next to the client's bedroom. Bedrooms were arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no client's bedroom serves as a passageway to another room. All hazardous items have been properly made inaccessible to areas where children will have access. The backyard where children will have access to play was completely fenced, had a gate with a latch and will remain unlocked at all times. There were no pools or other bodies of water and no weapons/firearms as stated by applicant. All appliances were in working order, there were trash cans for storage of solid waste with tight fitting lids. There was one garage which stored three cars. The two cars used to transport client's were checked and had up to date registration and emergency kits. Applicants stated that all cars are in good repair and in working condition, LPA observed cars to be in good repair. Based on this inspection, the home is appropriate for a capacity of three ambulatory clients. The request of License will be forwarded to Licensing Program Manager for final approval. Exit interview was conducted and a copy of this report was discussed and provided to Irene Mulele, applicant.


facility_name: MY FUTURE IS BRIGHT

summary: Facility Evaluation

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Narrative:
On September 4th, 2025, at 11:00am, Licensing Program Analyst (LPA) Johanna Aracena conducted an in-office meeting at the Monterey Park Regional Office with Kim Durley, Administrator for My Future is Bright Small Family Home. The purpose of the meeting is to conduct component II for the licensing of My Future is Bright Small Family Home. The component II meeting consisted of LPA Aracena addressing the following corrections/revisions: · LIC200, LIC215, LIC402, LIC308, LIC420, LIC501, LIC503, LIC508D, LIC610C were completed correctly · LIC400: Affidavit regarding client's cash resources- Applicant does not want to handle cash. Re-submit form stating she will safeguard cash for the clients. · LIC999-Facility Sketch must be re-submitted with all details of the home. The sketch must show doors, closets, bathroom, etc. Sleeping arrangements to be shown as well as dimensions of the rooms. ·Fire inspection will be conducted if licensee will care for non-ambulatory children or if the home will be a specialized small family home. · Childcare, before or after care for clients when the licensee will not be available. · Trainings- Licensee/staff training in providing family home care and supervision appropriate to the type of children to be served. · Staffing plan, qualifications, and duties (if applicable). · Plan for in-service training/education of clients and staff. Staff education if required by regulations governing the specific facility categories. The applicant will have a total of two (2) weeks to complete the revisions and re-submit them to LPA Aracena by September 19th, 2025. Corrections in the program should be highlighted showing the changes.

met_with: Kim Durley- Applicant


summary: Facility Evaluation

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Narrative:
On January 16, 2026, Licensing Program Analyst (LPA) Johanna Aracena conducted a follow up pre-licensing inspection at the above named facility. LPA met with the applicant Kim Durley and conducted a toured of the home. During the walk through, LPA Aracena observed two (2) roll away beds in the second bedroom for the use of the clients. The applicant was informed of no roll away bed are accepted as regular beds for the clients. LPA Aracena tested the water and it was still over 120 degrees. LPA asked the applicant to lower the temperature to 115 degrees. The carbon monoxide detector was in working condition and it was operable. The applicant has a lockbox for sharps (knifes and scissors) and another lockbox for medication. Both lockboxes will be in a second locked cabinet that only the applicant/staff will have access to. The applicant obtained a thermometer which makes the first aid kit complete. The applicant decided she will only accept ambulatory clients. A follow up inspection will be held on Monday, February 2, 2026 at 10am.

met_with: Applicant


summary: Facility Evaluation

raw_content:
Narrative:
On March 4, 2026, Licensing Program Analyst (LPA) Johanna Aracena conducted a follow up pre-licensing inspection at the above named facility. LPA met with the applicant Kim Durley and conducted a toured of the home. During the walk through of the home LPA Aracena the applicant changed the two roll away beds for two twin size bed. This inspection concludes the pre-licensing inspection. Exit interviewed was conducted and a copy of this report was provided to the applicant.


summary: Facility Evaluation

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Narrative:
On March, 25, 2026, Licensing Program Analyst (LPA) Johanna Aracena,conducted an announced visit to the above named facility and conducted component III and signed the applicant's certificate. The applicant has to re-do her fingerprinting in order to get licensed. No citations, exit interview conducted and a copy of this report was provided to the applicant


summary: Facility Evaluation

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Narrative:
On May 13, Licensing Program Analyst (LPA) Maryjane Perez met with applicants Irene Ndegwa and Stanley Nderitu this date for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the LIC 184, Letter of Application Revision, and additional correspondence to assist with the revisions needed for the application. A copy of this report was provided to applicants Irene Ndegwa and Stanley Nderitu.

met_with: Applicants Irene Ndegwa and Stanley Nderitu


summary: Facility Evaluation

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Narrative:
On October 16, 2025, Licensing Program Analyst (LPA) Maryjane Perez arrived at Ndegwa Small Family Home (SFH) for a pre-licensing inspection for an initial license. LPA met with applicants Irene Ndegwa and Stanley Nderitu who led a tour of the entire home inside and outside. The applicants are applying to serve two ambulatory clients ages 0-17 years old. Currently there are no clients placed in the home. The home is a one story building with three bedrooms and two bathrooms. There was a entry way that had a living room area with couches, TV, books/toys, and a dining table with adequate seating. The hallway to the kitchen had all required postings such as visitation policy, facility sketch, disaster plan, and personal rights. There was a kitchen that had a locked cabinet for storing medications, knives/ sharp objects and fire extinguisher #1. There was a stocked refrigerator and pantry with perishable and non-perishable foods. The refrigerator also stored a locked box for clients medications. There was a locked kitchen sink cabinet that stored cleaning supplies. The kitchen also had counter space with additional seating. There was a desk area with a working computer and extra stationary. As well as a properly screened fireplace. The hallway leading to the bedrooms had fire extinguisher #2 that was operable, a first aid kit with all required elements and a cabinet for storing extra hygiene items. The hallway also had a locked cabinet for storing client files, employee records, and a lock box for client cash resources. Bedroom #1 was the master bedroom for applicants and had a king size bed, a crib that was occupied by applicants biological son, bathroom #1 that was fully functioning and a glass door leading to the backyard, the bedroom was locked at all times. Bedroom #2 was utilized for two ambulatory clients and had two twin size beds, all required bedding, dresser/ closet space, and lighting. The client bedroom is currently vacant. Bathroom #2 was fully functioning with a shower/ bath tub, toilet , sink and water temperature measuring 111.5 degrees Fahrenheit. Bedroom #3 was utilized for applicants two biological children and had two twin size beds, dresser/closet space and lighting. The garage was locked at all times and stored a washing machine and dryer with a locked cabinet storing laundry detergents/ cleaning essentials. There was a desk area with another computer for applicants use. The garage also had extra household items stored such as toilet paper and paper towels, an extra deep freezer for frozen goods, a locked tool box, and fire extinguisher #3. The applicant understands that clients must be supervised when in the garage. The backyard was free of hazards, had a grass area where children can play, chickens in a chicken coop, and a storage shed that stored gardening tools and extra holiday decorations. The backyard was completely fenced and had a side gate with a latch. Bedrooms were arranged so that no more than two children share a room, and there is one child per bed. No room that is commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. The smoke detectors and carbon monoxide detectors were checked and are working properly. All hazardous items have been properly made inaccessible to areas where children will have access. There were no pools or other bodies of water and no weapons/firearms as stated by applicant. There was no land- line telephone service but all appliances were in working order, and all trash cans for storage of solid waste had tight fitting lids. Based on this inspection of the home, the facility will need the following corrections: Applicants to obtain a land line telephone service. After corrections are completed, the applicants will notify LPA so another inspection can be completed and the request for licensure can be forwarded to Licensing Program Manager for final approval. Component III orientation was also completed this day of October 16, 2025. An exit interview was conducted. A copy of this report and one technical advisory were provided to applicants Irene Ndegwa and Stanley Nderitu.

met_with: Applicants- Irene Ndegwa and Stanley Nderitu


summary: Facility Evaluation

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Narrative:
On November 27, 2024 at 9:30AM, Licensing Program Analyst (LPA) Adaleyci Caballero met with Applicants Nelly and Danson Kagoiya via Microsoft Teams Meeting for a Component II of the application process. LPA Caballero went over revisions needed for the application prior to license. The revisions are due no later than December 11, 2024. LPA Caballero sent a copy of the LIC Notice of Incomplete Application to assist with the revisions needed to the application. A copy of this report was provided to applicants via email. Original signed copy of this report will be placed in the facility file.

met_with: Applicants-Nelly and Danson Kagoiya


summary: Facility Evaluation

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Narrative:
On January 22, 2025 at 9:40AM, Licensing Program Analyst (LPA) Adaleyci Caballero completed a pre-licensing inspection of Nelly and Danson Kagoiya Small Family Home (SFH). LPA met with Applicant Nelly Kagoiya and Danson Mugura who led a tour of the home. The facility was toured both inside and out with the applicant. There are no clients in placement. The home is a two story building with five bedrooms, three full bathrooms and one half bathroom which are set up as follows: Bedroom #1- It consisted of one single bed. The bed had linen, comforters, and pillows. Bedroom will be used as a guest room. Bedroom #2- It consisted of two single beds. The beds had linen, comforters, and pillows. It will sleep two clients. Bedroom #3- It consisted of two single beds. The beds had linen, comforters, and pillows. It will sleep two clients. Bedroom #4- It consisted of two single beds. The beds had linen, comforters, and pillows. It sleeps two biological children. Bedroom #5- (applicants) It consisted of a single bed. A living room, family room, kitchen, dining area, loft, laundry room, three car garage, and a backyard. The garage will be utilized for storage. The clients' bedrooms were arranged so that no more than two clients will be in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the clients' belongings. There was a smoke detector in every bedroom. The seven smoke detectors were checked and working properly. The two carbon monoxide detectors were checked and working properly. The home's central air conditioning module was in the backyard. The water heater is located in the garage. The appliances were in working order. Client and staff files will be locked inside a cabinet in the kitchen. There was adequate food storage space and a supply of three days of perishable food and seven days of non-perishable food. The home had a trash can for storage of solid waste with a tight-fitting lid. The sharp knives, chemicals, and cleaning supplies were locked in a cabinet and drawers in the kitchen. Medications will be locked in a cabinet in the kitchen inaccessible to clients in care. The hot water was at a temperature of 113.7 degrees Fahrenheit. The First Aid Kit was accessible and placed in the a kitchen drawer. There were two fire extinguishers present in the home located in the kitchen and the upstairs hallway. They were observed to be properly charged and inspected by the fire department. There are no firearms in the home. There is no pool or other bodies of water at the home. The backyard is fully fenced and free of debris. The home has three cameras on the outside premises of the home. Corrections to be made: Telephone service Program Statement update on cameras. Component III was conducted. An exit interview was conducted, and a copy of this report was provided to applicants Nelly Kagoiya and Danson Muguru. Application will be forwarded to Licensing Program Manager Jennifer Smith for licensure.

met_with: Licensee-Nelly Kagoiya and Danson Mugura


summary: Facility Evaluation

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Narrative:
On July 09, 2025 at 10:40AM, Licensing Program Analysts (LPAs) Rachel Vanegas and Carissa Aviles completed a post-licensing inspection of Nelly and Danson Kagoiya Small Family Home (SFH). LPAs met with the Licensees, Nelly Kagoiya and Danson Mugru who led a tour of the home. The facility was toured both inside and out with the Licensees. The home is a two story building with five bedrooms, three full bathrooms and one half bathroom which are set up as follows: Bedroom #1- Contains one single bed. The bedroom is utilized as a guestroom and client's in care do not have access to the bedroom. Bedroom #2- Contains two single beds. There are two dressers and a closet for clients to store personal belongings. Both beds are currently vacant. Bedroom #3- Contains two single beds. There are two dressers and a closet for clients to store personal belongings. One bed is utilized by one client in care. The other bed is currently vacant. Bedroom #4- Contains two single beds. It sleeps two biological children. Bedroom #5- Contains one single bed. It sleeps the licensees. There is a living room, family room, kitchen, dining area, loft, laundry room, three car garage, and a backyard. The clients' bedrooms were arranged so that no more than two clients will be in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. **Continued on the next page** There was a smoke detector in every bedroom. The smoke detectors were checked and working properly at the time of this inspection. The carbon monoxide detectors were checked and working properly at the time of this inspection. The home's central air conditioning module was in the backyard. The water heater is located in the garage. The hot water was measured in the kitchen and registered at 120. F. The appliances were in working order at the time of this inspection. Client and staff files are securely stored in a locked cabinet in the kitchen. Medications are locked in a cabinet in the kitchen inaccessible to clients in care. There are no firearms or weapons in the home at the time of this inspection as reported by both Licensees. The First Aid Kit was accessible and placed on the kitchen cabinet, it contained all of the necessary items. There were two fire extinguishers present in the home located in the kitchen and the upstairs hallway. They were observed to be properly charged and inspected by the fire department. LPAs observed two days supply of perishable and seven days supply of non-perishable foods in the kitchen refrigerator and pantry. There was a trash can with a tight fitting lid located in the kitchen. There is no pool or other bodies of water at the home during this inspection. The backyard is fully fenced and free of debris. The home has three cameras on the outside premises of the home. LPAs reviewed one client file for Client 1 (C1) during this inspection. LPAs observed required documents including signed placement agreements, Health and Education Passports, Authorization of Medical Care Forms signed by the Authorized Representative, Signed Needs and Services Plan, Health Screening including Tuberculosis Risk Assessment Documentation, Signed Personal Rights Form (613B), etc. LPAs reviewed two staff files for Staff 1 (S1) and Staff 2 (S2). LPAs observed required documents including current cardiopulmonary resuscitation (CPR) cards, drivers license, background clearance forms, job duties, etc. Based on observation and record review, there are no violations or citations issued at the time of this inspection. An exit interview was conducted and a copy of this report and appeal rights were reviewed and provided to the Licensees - Nelly Kagoiya and Danson Mugru.


facility_name: NELLY DUARTI SMALL FAMILY HOME

summary: Facility Evaluation

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Narrative:
On October 23, 2025, Licensing Program Analyst (LPA) Maryjane Perez met with applicants Nelly and Henry Duarti this date for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the LIC 184, Letter of Application Revision, and additional correspondence to assist with the revisions needed to the application. A copy of this report was provided to applicants Nelly and Henry Duarti.

met_with: Applicants- Nelly and Henry Duarti


summary: Facility Evaluation

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Narrative:
On December 12, 2025, Licensing Program Analyst (LPA) Maryjane Perez arrived at Nelly Duarti Small Family Home (SFH) for a pre-licensing inspection for an initial license. LPA met with applicants Nelly and Henry Duarti who led a tour of the entire home inside and outside. The applicants are applying to serve one bedridden client ages 6-17 years old. Currently there are no clients placed in the home. The home is a two-story building with seven bedrooms and five bathrooms. The downstairs consisted of an entry way with a storage closet for storing extra shoes, coats, and luggage. There was a door leading to the activity area where there was a couch, table and cabinets that stored extra office supplies, a locked cabinet for clients cash resources, clients files, and employee files. There was another locked cabinet for storing medications and a bulletin board with all required postings such as emergency disaster plan, personal rights, visitation policy, and facility sketch. Fire extinguisher #1 was also in this area and was operable but there was a trash can that was missing a lid. There was a door leading to the small garage that stored extra household items such as holiday decorations. There was also an exit door that led to the outside front of the home. Laundry room #1 was accessible to clients and stored extra wipes, gloves, diapers, pads, etc. Bathroom #1 had dual sinks, a walk in shower, a toilet and a locked sink cabinet that stored laundry detergents/ cleaning compounds. Bedroom #1 was also downstairs and was utilized for applicants two legal guardians. The room had one full size bed and one hospital bed, dresser space and lighting. Bedroom #2 was utilized for one bed ridden client and had a full size bed with rails, dresser/ closet space, a sliding door exit leading to the backyard with a ramp. The room also had an electric hoyer lift for bedridden client use and had a trash can that was missing a lid. The kitchen had a telephone service a first aid kit that was missing a thermometer and tweezers. Applicant understands that the first aid kit should have all required elements. Fire extinguisher #2 was also in the kitchen and was operable. There was several locked cabinets for storing knives/ sharp objects, tools, and cleaning compounds. The refrigerator and pantry were fully stocked with perishable and non-perishable foods. There was a dining tablethat had adequate seating. There was bathroom #2 that had a toilet and sink with hot water temperature measuring 117.1 degrees Fahrenheit. The living room had a screened fire place, couches, and TV. The upstairs consisted of a loft area with couches, TV, desks, a workout bicycle/treadmill and several books. There was also a trash can that was missing a lid and fire extinguisher #3 that was operable. Bedroom #3 was utilized for applicants biological daughter and had a full size bed, dresser and closet space. Bedroom #4 was utilized for applicants adopted son and had a bunk bed with one full size bed and one twin size bed. Bedroom #5 was utilized for applicant biological daughter and was fully furnished with a full size bed. Bedroom #6 was utilized for applicants other biological daughter and had bathroom #3 that was fully functioning. Bathroom #4 stored laundry detergents in a locked sink cabinet and had a toilet, sink, and trash can that was missing a lid. Laundry room #2 was also upstairs that was accessible to clients but had a locked cabinet for detergents/ cleaning supplies. Bedroom #7 was the master bedroom for applicants and was fully furnished with a king size bed, office space and bathroom #5 that was fully functioning. Bedrooms were arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. The smoke detectors and carbon monoxide detectors were checked and are working properly. All hazardous items have been properly made inaccessible to areas where children will have access. The backyard where children will have access to play was completely fenced, had a gate with a latch, a storage shed that stored extra household items and an outdoor fire place that was missing a screen around it. There were no pools or other bodies of water and no weapons/firearms as stated by applicants. There was a telephone service and all appliances were in working order there were trash cans for storage of solid waste but four trash cans were missing tight fitting lids. There were two garages the big one stored extra house hold items, an extra refrigerator that had a locked medication box for clients and a deep freezer that stored extra frozen goods. The garage was locked at all times. Based on this inspection, the facility will need the following corrections: Applicants to obtain four trash cans to have lids Applicants to obtain thermometer for first aid kit Applicants to obtain tweezers for first aid kit Applicants to obtain a screen for open-faced outdoor fireplace After corrections are completed, the applicants will notify LPA so that another inspection can be completed. Component III orientation was also completed this day of December 12, 2025. Exit interview was conducted and a copy of this report was discussed and provided to applicants Nelly and Henry Duarti.

met_with: Applicants- Nelly Duarti and Henry Duarti


facility_name: NELLY SMALL FAMILY HOME

summary: Facility Evaluation

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Narrative:
On November 18, 2022, at 8:50 am, Licensing Program Analyst (LPA) Linda Haynes met with applicant Nelly Peete on this date for a Component II. LPA requested the following additional documentation from applicant a resume and a copy of college transcripts. A pre-licensing visit has been scheduled with applicant for December 8, 2022. Exit interviewed conducted. A copy of this report was given and explained to applicant Nelly Peete.

met_with: Nelly Peete


summary: Facility Evaluation

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Narrative:
On December 8, 2022 at 12:54PM, Licensing Program Analyst (LPA) Linda Haynes and Licensing Program Manager (LPM) Cheraki Davis began a pre-licensing inspection for Nelly Small Family Home license. LPA and LPM met with applicant Nelly Pete who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there are no clients placed in the home. The applicant is applying to serve two clients ages 3 to 17. The home is a two story building with five bedrooms and three bathrooms which are set up as follows: · Bedroom #1 (Master) has one bed, will sleep the licensee, and has a master bathroom. · Bedroom #2 (Mothers room) had one queen bed; will sleep the Mother. · Bedroom #3 (Client's) was vacant, had two twin-sized beds. It will sleep two clients. · Bedroom #4 (daughters) had one queen size bed, will sleep the daughter. · Bedroom #5 (Guest) has one queen bed is vacant and will be used as a guest room · A great room/living room, kitchen, dining area, three bathrooms, an attached two car garage, a laundry room, storage closet, and the backyard. The Client's bedroom was arranged so that no more than two clients will share the room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There was a smoke detector in every bedroom and a carbon monoxide / smoke detector located in the hallway. The five smoke detectors and the carbon monoxide / smoke detector were checked, and they were working properly. The home's central air conditioning module was on the patio. The home's tankless water heater was located inside the garage. Inside the facility there was a fireplace with a gate in the front.. The home has an installed sprinkler system. The appliances were in working order. : The client's files will be locked inside a cabinet in the locked laundry room. There was adequate food storage space and a supply of two days of perishable foods and a week of non-perishable foods. A proper storage of all food was discussed. A trash can for storage of solid waste had a tight-fitting lid and was located in the garage. The hot water in the Master Bathroom measured to be 113.1 degrees Fahrenheit. The water temperature of the client bathroom was observed to be 115.1 degrees Fahrenheit. The water temperature in bathroom number 3 measured to be 114.2 degrees Fahrenheit. The home's First Aid kit was accessible the first aid kit and located in the pantry. A fire extinguisher was present in the home and located in the pantry. It was observed to be properly charged but needs to be inspected by the fire department. Applicant stated there were no weapons/firearms in the home. LPA and LPM observed there was no swimming pool. The backyard where clients will have access to play was completely fenced. The following deficiencies were observed: The client's beds need a mattress cover on them. The kitchen cabinet that contains the knives needs to have a lock on it The kitchen cabinet that stores the cleaning supplies needs to have a lock on it The required forms needed prior to operation, were not posted at the time of this inspection. The First Aid Kit needs more band aids and adhesive tape. The fire extinguisher needs to be checked by the fire department. The closet in the clients room needs to be cleaned out so that the clients may use it The request for a license will be forwarded to Licensing Program Manager for final approval once the Plan of Corrections are cleared. Applicant will email LPA within two weeks with proof of corrections. An exit interview was conducted. A copy of this report was provided to Nelly Pete.

met_with: Nelly Pete