summary: Facility Evaluation

raw_content:
Narrative:
At 10:00am on 05/17/2023, Licensing Program Analyst (LPA) Karmen Balhotra made an unannounced Annual/Required inspection to the facility listed above. LPA met with Brittany Burns, Director of Residential Treatment, who helped facilitate the inspection. LPA conducted a Guardian check on 05/17/2023 and all employees have a clearance to work at the facility. There are no pool and or bodies of water on the property of the facility. There are no firearms at the facility. The facility has an active accreditation by the Joint Commission from May 14, 2022 and is active for 36 months. All appropriate signage is placed throughout the facility. LPA toured the facility, and the facility has a layout of; staff office, 10 bedrooms and 5 bathrooms, a laundry room, a kitchen, pantry, living room, dining room and family room where clients can have their free space. In addition to the facility, the property consists of another building which is their STRTP location, a school that is clients in placement attend, and administrative offices. Clients' placement providers are their local school district who need educational and or behavioral support. There are currently nine clients in placement at the facility. LPA was able to interview two clients and two staff members regarding the facilities operations. All sharps, cleaning supplies are locked in a cabinet in the laundry room and access for clients are granted if a staff member is present with them. All medications and appropriate documents are in the staff room and are securely locked. The licensee is being cited for 80088(e)(1) Fixture, Furniture, Equipment and Supplies as a Type A violation. A plan of correction was created with Director and will be fixed by the due date of 05/18/2023. At this time, the LPA will recommend licensure to the facility and the provisional license will dissolve. An exit interview was conducted, and a copy of this report was left with Director.

met_with: Brittney Burns


state: CA

facility_name: TLC CHILD AND FAMILY SERVICES-COAST HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli made an unannounced Annual/Required inspection to the facility. LPA met with Brittany Burns, Director of Residential Treatment, and Kayla Taylor, who helped facilitate the inspection. Chief Program Officer Liz Jimenez also assisted with the record review. LPA toured the facility, which has two residential buildings, including office, bedrooms, bathrooms, a laundry room, a kitchen, pantry, living room, dining room and family room where clients can have their free space. There are no pools or bodies of water on the premises. There are no firearms at the facility. Cleaning supplies are locked in a cabinet in the laundry room and access for clients are granted if a staff member is present with them. All medications and appropriate documents are in the staff room and are securely locked. In addition to the Group Home, the property has another building which is their Administrative Office and FFA and Adoptions location, and also school that clients attend. Clients' placement providers are though the school districts who need educational and or behavioral support. LPA interviewed three clients and three staff members regarding the facilities operations. No deficiencies were cited. An exit interview was conducted, and a copy of this report was left with Facility.

report_type: Facility Evaluation

visit_type: Annual

met_with: Brittany Burns, Kayla Taylor, and Liz Jimenez


summary: Facility Evaluation

raw_content:
Narrative:
On the above date Licensing Program Analyst (LPA) Brian Bertoli conducted an unannounced inspection at the facility and met with Administrator Brittany Burns regarding a Special Incident Report (SIR) that was submitted to Community Care Licensing. The incident took place on 04/15/2025 and the SIR was written to report an incident regarding youth overdosing on medication. LPA Bertoli discussed the incident with Administrator Burns. In the course of reviewing the incident, the Administrator stated that the youth was on a home visit and when the mother dropped her off at the facility, she let the youth take all of the medication with her, leading to the youth being able to ingest it (see LIC 812 dated 4/21/25). LPA issued an Advisory Note of California Code of Regulations, Title Division Six, regulation Health Related Services ... (k)(1) Medication shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. An exit interview was conducted and a copy of the report and appeal rights were provided to the facility.

visit_type: Case Management

met_with: Brittany Burns


summary: Facility Evaluation

raw_content:
Narrative:
On the above date Licensing Program Analyst (LPA) Brian Bertoli conducted an unannounced inspection at the facility and met with Administrator Brittany Burns regarding a Special Incident Report (SIR) that was submitted to Community Care Licensing. The incident took place on 03/03/2024 and the SIR was written to report an incident regarding staff giving youth the wrong medication. LPA Bertoli discussed the incident with Administrator Burns. In the course of reviewing the incident, the Administrator stated that staff had dispensed the wrong medication to the youth. Facility cited for violation of California Code of Regulations, Title Division Six, regulation Health Related Services ... (b) Clients shall be assisted as needed with self-administration of prescription and nonprescription medications. Based on records reviewed and interviews conducted on 03/14/2024, staff was found to have given the wrong medications to the youth. An exit interview was conducted and a copy of the report and appeal rights were provided to the facility.


facility_name: TOOR GROUP HOME

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
because LPA Carmona attempted and was unable to build rapport, qualify, and interview two of the three clients in care on 6/28/22 due to them being non-verbal. Two individuals have disclosed in their interviews that they have witnessed the minor pulling down their pants only to pee on the grass or while complaining of a smell or pain under their pants. Although the incidents did occur it was not due to lack of supervision but due to client's behaviors. The staff was able to redirect client and other clients in care when the incidents occurred. In addition, interviews conducted on 05/25/22, 06/28/22 and 07/07/22 were inconsistent and there were no witnesses who could testify in regard to staff behaviors. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are Unsubstantiated. An exit interview was conducted. A copy of this report and the Appeal Rights were discussed and provided via e-mail to the Administrator.

Investigation Findings:
13On 08/16/22 at 11:05 a.m. Licensing Program Analyst (LPA) Jacqueline Carmona conducted a complaint inspection to the above Group Home (GH) and met with Pushpinder Toor, Administrator for the purpose of delivering findings. During the investigation, LPA Carmona reviewed the agency's file at the licensing office, including the complaint history, criminal background check, incident reports and facility personnel report summary. LPA also reviewed the children's individualized personalized plan, the group home quarterly reports, children's face sheets, children's behavior support plan, medication logs, and the administrator training certificates. LPA Carmona conducted 8 confidential interviews between 05/25/22-07/14/22, an inspection of the facility was made inside and out, and no citations were issued. Based on interviews conducted during the investigation process the allegations cannot be substantiated UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Jacqueline Carmona LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, NATOMAS PARK DR., STE FACILITY NAME: TOOR GROUP HOMEFACILITY NUMBER: VISIT DATE: 08/16/2022

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

report_type: Complaint Investigation

met_with: Pushpinder Toor, Administrator

complaint_status: unsubstantiated


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Based on confidential interviews conducted during the investigation process it was confirmed the allegation above did occur. 5 confidential interviews confirmed that. clients were left outside in front of the facility without supervision for less than 3 minutes while waiting for the school transportation vehicle to take them to school. In addition, the staff member would remain inside the facility with the screen door closed while clients waited outside. Although there was a staff member present inside the facility, direct supervision was not provided to clients in care while they waited outside the facility. Based on LPA's observations and interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Tittle Regulations, Division 6, Chapter 5 are being cited on the attached LIC9099D. Exit interview conducted, copy of this report and the Appeal Rights were provided to the Pushpinder Toor, Administrator . Based on interviews conducted the allegations above cannot be substantiated because there were inconsistent statements throughout the investigation process. 8 confidential interviews confirmed clients are provided with an adequate amount of clothing. On 1/24/ LPA Carmona observed an adequate amount of clothing for all clients in care and reviewed the clients clothing inventory logs. Lastly, 7 confidential interviews corroborated that the staff do not yell at the clients in care; however, LPA Carmona was unable to interview 2 clients and qualify 1 client in care during the investigation process. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are Unsubstantiated. Exit interview conducted, copy of this report and the Appeal Rights were provided to Pushpinder Toor, Administrator.

Investigation Findings:
13On 3/14/ Licensing Program Analysts (LPA) Jacqueline Carmona and Tatyana Shulz conducted a complaint inspection to the above Group Home (GH) and met with Pushpinder Toor, Administrator for the purpose of delivering findings. During the investigation, LPA Carmona reviewed the agency's file at the licensing office, including the complaint history, criminal background check, incident reports, and facility personnel report summary. The minors clothing inventory, most recent IPP's, LIC500, LIC9020, Staff training logs, and Program Statement Section 3. LPA Carmona conducted 14 confidential interviews and attempted 2 confidential interviews from 1/16/24-3/07/24. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Jacqueline Carmona LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: TOOR GROUP HOMEFACILITY NUMBER: VISIT DATE: 03/14/2024


raw_content:
Narrative:
Based on evidence obtained and confidential interviews conducted during the investigation process the allegation above cannot be substantiated due to lack of evidence. 4 out of 5 confidential interviews state that due to the client's sensitive skin they suffer from rashes and nodules that will appear on different parts of their body. Due to the rupture of previous nodules in the armpit area, LPA observed the skin around the wound to be darker in color. LPA received hospital documentation highlighting the client's current skin condition and areas of concern. The client also has a history of self injurious behaviors (SIBs) which has lead to previous bruises on their person. Lastly, due to the client being nonverbal and the reporting party not being available for interview after 3 attempts, LPA was unable to gather any further details on the allegation. Although the allegation may have happened or may be valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted, copy of this report and the Appeal Rights were discussed and provided to the licensee.

Investigation Findings:
13On September 11, 2025, at 1:55pm Licensing Program Analyst (LPA) Tatyana Shulz made an unannounced visit to deliver findings to the above Group Home (GH) and met with Pushpinder Toor, Administrator. Prior to the meeting LPA Shulz, conducted the 10-day inspection of the facility on 6/11/2025. No deficiencies were cited during that inspection. LPA Shulz requested, Current Staff and Client Roster, Doctor visits and medication list, Staff Schedule for May and June, Staff Contact Information, Client Face Sheets, Needs and Services plans for all clients in care, Individualized Behavior Support Plan (IBSP) for all clients in care and contact information for all involved parties. LPA Shulz conducted 5 interviews and attempted 3 interviews between 6/11/2025-9/08/2025. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Connie Goldie LICENSING EVALUATOR NAME: Tatyana Shulz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: TOOR GROUP HOMEFACILITY NUMBER: VISIT DATE: 09/11/2025


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts Dawn Eunice (LPA) and Yuvi Diaz (LPA) conducted the unannounced annual facility inspection. Upon arrival, there was no one at the home. LPA Eunice called the telephone number of record and spoke to Ms. Toor; she arrived to the facility about 1/2 hour afterwards. LPAs requested a staff and child roster. LPAs observed the menu, personal rights, exit signs, emergency disaster plan, and the license was posted. LPAs toured the facility inside and out. LPAs observed children's bedroom, living room, kitchen, food supply, bathrooms, back and front yards. The water temperature, smoke alarms, and fire extinguishers were checked as well. LPAs did not observe any buildings and grounds deficiencies. A review of Licensing Information System on November 3, 2021, indicates that all facility staff associated had DOJ, FBI, and child abuse index check clearances. LPAs will return to the facility at a later date to complete this annual inspection to include staff and client interviews as well as finish children file review. The facility was found to be clean, safe, sanitary and in good repair. There are not deficiencies cited this date.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts Dawn Eunice and Yuvi Diaz (LPAs) conducted an Annual Continuation Inspection on 11-9-2021. The original inspection occurred on 11-05-2021. At today's inspection there were 2 children present and 2 staff. During this time, a county social worker met with her client. At today's inspection LPAs reviewed board meeting minutes, staff and client rosters as well as the children's Independent Personal Plan's. LPAs conducted staff interviews and client interviews. This facility serves developmentally delayed children; one child was partially verbal, one child was non verbal. LPAs reviewed the CARES tool to re-visit information that may have been missed on 11-5-2021. This facility was found to be in substantial compliance with all mandates; it is clean, safe sanitary and in good repair. LPAs conducted exit interview, no deficiencies or advisory notes were given this date.


summary: Facility Evaluation

raw_content:
Narrative:
This report is created because LPA did not save the CARES tool during the 11-9-2021 continued annual inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On 11/28/ Licensing Program Analyst (LPA) Jacqueline Carmona arrived to the above facility with the purpose of conducting an unannounced annual required inspection. LPA Carmona met with Licensee (L) Pushpinder Toor and explained the reason for the visit. LPA Carmona asked (L) for the census and it was 2. The clients are both male from 15 - 18 years of age and are ambulatory. The Licensee was in the facility at the time of the inspection and both clients were in school. LPA Carmona conducted a walk through of the interior and exterior of the facility with (L). The facility is a one story home that consists of a living room, dinning area, kitchen, 2 full bathrooms, bedroom 1, bedroom 2, bedroom 3, bedroom 4, and a garage. Bedroom 1 has a full bathroom, a bed and 2 dressers. Bedroom 2 and bedroom 3 have one bed in each room and two dressers. LPA observed all clients provided adequate amounts of clothing and size of clothing. Bedroom 4 is used as the Licensees office where staff files and client files are stored. The kitchen has a pantry and a refrigerator which were fully stocked with two days of perishable food and seven day's worth of non-perishable food. All clients have a medication log and LPA observed all the medications locked and stored away in cabinet. All four bedrooms, living room, and dining room had furniture in good repair. The garage has a working washer and dryer. The bathrooms are clean, sanitary and functioning with warm water temperature of 110 degrees. The front and back yard are clear and free of debris. LPA checked all fire alarms and carbon monoxide alarms and they are fully functioning. The first aid kit was fully stocked, and readily available. The fire extinguishers were fully charged. There is adequate lighting throughout the home. LPA Carmona reviewed the client roster and LIC 500. LPA Carmona also reviewed staff files and all files had required documents, including CPR/ First Aid certificates, criminal record clearance, and training documents. LPA Carmona reviewed client files and all files had required documents. Clients are accorded dignity in personal relationships with staff and others. Continue to page Clients live in a safe, healthy, comfortable home and are treated with respect. Overall, the home was observed to be clean, safe, sanitary and in good repair. Clients attend school, extracurricular activities, cultural, and personal enrichment activities. The facility is up to date with their fees. Exit interview was conducted. No deficiencies cited during this inspection. A copy of this report will be emailed to the Licensee.

met_with: Pushpinder Toor, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Misty Valencia and Tine Thorn on 03/09/2023 at 9: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPAs Valencia and Thorn met with Pushpinder Toor, Administrator and inspected the facility inside and out. LPA reviewed three (3) clients records and three (3) staff personnel files on site at the facility. LPA reviewed three (3) clients psychotropic medications and medication records. LPA interviewed three (3) staff on site to discuss the facilities policies and procedures of operation. LPA interviewed three (3) clients currently prescribed psychotropic medication. LPA provided a copy of this licensing report to Pushpinder Toor, Administrator No deficiencies are being cited at this time. LPA conducted exit interview with Pushpinder Toor, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 11/30/23 at approximately 8:55 a.m. Licensing Program Analyst (LPA) Jacqueline Carmona made an unannounced annual inspection using the Compliance and Regulatory Enforcement (CARE) tool and met with Pushpinder Toor, Licensee. LPA Carmona conducted a walk through of the interior and exterior of the facility during the inspection today. The facility is a one story home that consists of a living room, dinning area, kitchen, 2 full bathrooms, bedroom 1, bedroom 2, bedroom 3, bedroom 4, and a garage. Bedroom 1 has a full bathroom a bed and 2 dressers. Bedroom 2 and bedroom 3 have one bed in each room and two dressers. Bedroom 4 has one bed and built in dresser. LPA observed all clients provided adequate amounts of clothing and size of clothing. The kitchen has a pantry and a refrigerator which were fully stocked with two days of perishable food and seven day's worth of non-perishable food. All clients have a medication log and LPA observed all the medications locked and stored away in cabinet. All four bedrooms, living room, and dining room had furniture in good repair. The garage has a working washer and dryer. The bathrooms are clean, sanitary and functioning with warm water temperature of 108 degrees. The front and back yard are clear and free of debris. LPA checked all fire alarms and carbon monoxide alarms and they are fully functioning. The first aid kit was fully stocked, and readily available. The fire extinguishers were fully charged. There is adequate lighting throughout the home. At the time of the inspection there are 4 clients placed in the group home and 6 staff. LPA Carmona reviewed the client roster and LIC 500. LPA Carmona also reviewed 5 staff files and all files had required documents, including CPR/ First Aid certificates, criminal record clearance, and training documents. LPA Carmona reviewed 4 client files and all files had required documents. LPA conducted 2 staff interviews and will return at a later time to conduct client interviews. Continue to page Clients live in a safe, healthy, comfortable home and are treated with respect. Overall, the home was observed to be clean, safe, sanitary and in good repair. Clients attend school, extracurricular activities, and personal enrichment activities. The facility is up to date with their fees. Exit interview was conducted. No deficiencies cited during this inspection. A copy of this report provided to the Licensee.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Michelle P. Kyane conducted a case management inspection on 04/23/2024 at 11am based on the number of relevant law enforcement contacts reported by the facility in 2022, pursuant to Health and Safety Code section 1538.7. During this inspection, 5 out of Direct Care Staff and 4 out of 4 youth files were reviewed. 2 out of Direct Care Staff and 0 out of 4 youth were interviewed. (See the Confidential Names List, LIC 811, dated 04/23/2024). The Plan of Operation including policies and procedures were reviewed. Minutes from the board of directors' meetings related to the facility's incidents involving contact with law enforcement were reviewed. Based on the analysis of the confidential interviews and youth file review including the needs and service plans, quarterly assessments, and emergency intervention plans, the licensee uses evidence-based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. LPA Michelle P. Kyane observed documentation of completed training on policies and procedures on when and how to involve law enforcement in response to an incident. Training records show staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance to their Emergency Intervention Plan when there is an immediate risk of serious harm to a youth or others. There are no deficiencies cited at this time. A copy of this report was discussed and provided to administrator Pushpinder K. Toor.

met_with: PUSHPINDER K. TOOR


summary: Facility Evaluation

raw_content:
Narrative:
On 11/13/2024 at 9: AM Licensing Program Analysts (LPAs) Sarina Buchannan and Tatyana Shulz made an unannounced visit with the purpose of conducting an annual inspection to the above facility using the Compliance and Regulatory Enforcement (CARE) tool. LPAs met with Pindy Toor, Licensee, who assisted with the inspection. A walk through of the interior and exterior was completed. Physical Plant Room 1 is a client bedroom with a full sized bed, built in desk and cabinets, and an emergency exit door. Room 2 is a client bedroom with a full size bed, a dresser, and closet. Room 3 is a client bedroom with a full size bed bed, a dresser, and closet. Room 4 is a client bedroom with a full sized bed, a dresser, a television, and has a bathroom attached to it. Room 5 is the kitchen that has a menu listed on the refrigerator, sharps locked under the sink, and both the fridge and freezer are at the appropriate temperature. Room 6 is the family room with a sectional couch, a working telephone, games, and a television. There is two bathrooms, one is located in the hallway across from room 1 and the other is in room 4. The first bathroom had a working toilet, and running warm water with a temperature of 110 degrees. The second bathroom had a working toilet, and running warm water with a temperature of 110 degrees. The home has sufficient activities for the clients, including board games, coloring books, a television, and all furniture is in good repair. The backyard is gated with rose bushes, an arbor, and a personal sized trampoline. The backyard is clear of debris and clean. There is a garage with a washer and dryer in it and where staff and client files are kept locked. There is a Nissan Altima in good working condition, properly maintained, lights, tires, registration/insurance, working seat belts, and is available to transport clients if needed. Continued on (LIC 809-C) The following required documents were posted; License, Personal Rights, Facility Sketch, Client Sexual and Reproductive Rights, and Emergency Disaster plan. Disinfectants and cleaning solutions were locked and inaccessible to children in care. Refrigerator Temperature was at or below 45 degrees Fahrenheit. Nonperishable foods one week and fresh perishable foods two days minimum. Carbon monoxide and smoke detectors are in working order. First Aid Kit fully stocked. Medication centrally stored, locked/inaccessible to clients. Hot water is between 105-120 degrees Fahrenheit. Fire Extinguisher is up to date and in working order. Toilets wash basin, bath, and shower fixtures in good repair/no leaks/hot water temperature. Soap and paper towels are available to clients. Bedrooms had all required linens and furnishings. The facility is free of vermin. The following domains were also reviewed during today's inspection, Operations, Disaster Preparedness, Staffing, and Client Records. A total of 6 staff files and 4 client files were reviewed. No out of compliance issues were identified for these domains. LPA Buchannan also conducted 2 staff interviews and no concerns for follow up was noticed. LPA Buchannan attempted 1 client interview but the client was leaving for an outing and did not have time. A review of the Licensing Information System indicates the facility is up to date on their facility fees and all the staff were fingerprint cleared and associated to the facility. An exit interview was conducted and a copy of this report was provided to the Licensee, Pindy Toor, no deficiencies cited

met_with: Pindy Toor, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On December 16, 2024 at approximately 4:07 pm Licensing Program Analysts (LPAs), Tatyana Shulz and Orlando Areizaga made an unannounced inspection to conduct a case management to address the facility's request to change their staff to client ratio. LPAs met with Direct Support Staff, Baljit Toor who assisted with the inspection. Prior to the meeting LPA Shulz, requested the Needs & Service Plans for all clients in the home and a detailed description of the client's day to day schedule. LPA Shulz attempted 1 interview and conducted 4 interviews during this case management. The facility was originally approved to operate in a 1:2 ratio during the hours of 6 am.-9 am, 3 pm- 10 pm Monday- Friday and 7 am.-10 pm. Saturday-Sunday. The request is to change the ratio to 1:4 during all hours Monday-Sunday. Based on interviews conducted and documents acquired no Health and Safety concerns were noted for clients in care. There are staff available on call when needed and based on clients not requiring 1 on 1 supervision the ratio change has been approved. An exit interview was conducted, and a copy of this report was given to Direct Support Staff, Baljit Toor. This case management inspection is closed.

met_with: Baljit Toor-Direct Support Staff


summary: Facility Evaluation

raw_content:
Narrative:
On September 11, 2025 at 1:55pm Licensing Program Analyst (LPA) Tatyana Shulz made an unannounced visit at the above Group Home and met with Administrator, Pushpinder Toor. LPA conducted a tour of the inside and outside of the facility where LPA observed the following deficiency. A hornets nest under the gutter near the front door, back door and side of house. (See LIC TV) LPA Shulz requested work order be placed. This case management will remain open, until a follow up inspection is conducted to ensure the facility is in full compliance. An exit interview was conducted and a copy of this report will be left with Administrator, Pushpinder Toor.

met_with: Pushpinder Toor-Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On September 29, 2025 at approximately 1:39pm Licensing Program Analyst (LPA) Tatyana Shulz made an unannounced inspection to close a case management at the above Group Home. LPA was greeted by Baljit Toor, DSP who granted LPA access. Prior to the meeting LPA Shulz conducted a tour of the inside and outside of the facility where LPA observed the following deficiency. A hornets nest under the gutter near the front door, back door and side of house. LPA conducted a walk through of the facility and observed that the deficiency noted on the September 11, 2025 inspection has been fixed, the facility is in full compliance. This case management is now closed. An exit interview was conducted, and a copy of this report was left at the facility with Baljit Toor, DSP.

met_with: Baljit Toor- DSP


summary: Facility Evaluation

raw_content:
Narrative:
On November 14, 2025 at 10: AM Licensing Program Analyst (LPA) Tatyana Shulz made an unannounced visit with the purpose of conducting an annual inspection to the above facility using the Compliance and Regulatory Enforcement (CARE) tool. LPA met with Pushpinder Toor, Administrator, who assisted with the inspection. A walk through of the interior and exterior was completed. Physical Plant Rooms 1-4 are client bedrooms with a full sized bed, dresser and closet space. Room 4 also has a private bathroom. Room 5 is the kitchen with the menu displayed in the common area, sharps locked under the sink, and both the fridge and freezer are at the appropriate temperature. Room 6 is the family room with a sectional couch, a working telephone, and a television. There are two bathrooms, one is located in the hallway across from Room 1 and the other is in Room 4. The first bathroom has a working toilet, and running warm water with a temperature of 107 degrees. The second bathroom has a working toilet, and running warm water with a temperature of 108 degrees. The home has sufficient activities for the clients and all furniture is in good repair. The backyard is gated with rose bushes, an arbor, and a personal sized trampoline. The backyard is clear of debris and clean. There is a garage with a washer and dryer in it and where staff and client files are kept locked. There is a Toyota Camry in good working condition, properly maintained, lights, tires, registration/insurance, working seat belts, and is available to transport clients if needed. Continued on (LIC 809-C) The following required documents were posted; License, Personal Rights, Facility Sketch, and Emergency Disaster plan. Disinfectants and cleaning solutions were locked and inaccessible to children in care. Refrigerator Temperature was at or below 45 degrees Fahrenheit. Nonperishable foods one week and fresh perishable foods two days minimum. Carbon monoxide and smoke detectors are in working order. First Aid Kits are fully stocked. Medication centrally stored, locked/inaccessible to clients. Hot water is between 105-120 degrees Fahrenheit. Fire Extinguisher is up to date and in working order. Toilets, sinks, and shower fixtures are in good repair/no leaks/hot water temperature. Soap and paper towels are available to clients. Bedrooms had all required linens and furnishings. The facility is free of vermin. The following domains were also reviewed during today's inspection, Physical Plant, Operations, Disaster Preparedness, Staffing, and Client Records. A total of 5 staff files and 4 client files were reviewed. No out of compliance issues were identified for these domains. LPA Shulz also conducted 2 staff interviews and no concerns for follow up were noticed. LPA Shulz was unable to interview clients due to them being nonverbal. A review of the Licensing Information System indicates the facility is up to date on their facility fees and all the staff were fingerprint cleared and associated to the facility. An exit interview was conducted and a copy of this report was provided to the Administrator, Pushpinder Toor, no deficiencies cited.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Jean Stidman on 11/20/25 at 9:45am. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9(a)(2). During the inspection, LPA Stidman met with Pushpinder Toor, Administrator and inspected the facility inside and out. LPA reviewed five staff personnel files on site at the facility. LPA interviewed three staff on site to discuss the facilities policies and procedures of operation. LPA did not interview or review the files of four children currently prescribed psychotropic medication as three are non-minor dependents and one child has been in placement less than 30 days. During the inspection the LPA observed the following deficiency. LPA observed two out of five staff files are missing documentation of completion of course work per Title 22, Division 6, Chapter 5, Article 06, Regulation 84065(j)(3)(O). (see attached 809D) Plan of correction was discussed and appeal rights were provided. LPA provided a copy of this licensing report to Pushpinder Toor, Administrator. This inspection has been completed.


summary: Facility Evaluation

raw_content:
Narrative:
On 3/14/24 at approximately 10:00a.m. Licensing Program Analysts (LPAs), Jacqueline Carmona and Tatyana Shulz made an unannounced visit to conduct a case management regarding concerns of the facility not having adequate staffing. LPAs met with Pushpinder Toor, Administrator. The Group Home is a one story which consists of a living room, dining area, kitchen, 4 bedrooms and 2 full bathrooms. There have been recent concerns regarding the facilities staffing to ensure clients are taken out on community outings regularly and to ensure their supervision. Based on confidential interviews conducted and records reviewed it was confirmed the facility has been under ratio. The LIC9106 received by the Department on 3/09/20 states that between the hours of 6 a.m.-9 a.m. and 3 p.m.-10 p.m. the ratio should be 1 staff per 2 clients. The LIC500 dated 1/08/24 states that there is only 1 staff providing care and supervision Monday through Friday from 6 a.m.- 9 a.m. and it should be 2 staff supervising the clients due to the facility's census which is 4. There are 4 additional staff members listed on the LIC500, 2 are part time and 2 have no scheduled time on the form. An exit interview was conducted and a copy of this report and appeals rights was provided to the Administrator. This case management investigation is closed, and the facility has been cited for Lack of Supervision (See LIC 809D).


facility_name: TREETOPS CHILDREN'S HOME

summary: Facility Evaluation

raw_content:
Narrative:
On 1/31/2022 at 1: PM LPA Alyssa Ng made an unannounced inspection to conduct an annual required inspection. LPA met with Licensee Erika Juarez. The facility has a census of zero clients. The facility is clean, safe and sanitary and in good repair. All passageways are unobstructed. There are no pools or bodies of water. All disinfectants, cleaning solutions and poisons are located in a locked storage and are not accessible to the residents. Per Licensee Juarez there are no firearms in the facility. The inspected bedrooms were furnished accordingly. There are two bedrooms for clients and one staff room. The kitchen is clean and sanitary.The facility has sufficient two day perishable and seven day nonperishable food supply. The facility has Personal Rights and Emergency Disaster Plans are posted and in clear view. LPA Ng advised Licensee Juarez to get a lockbox for medication that may need to be refrigerated and locks for the pantry and fridge. The facility has not been vendorized and Licensee Juarez informed LPA Ng that Regional Center just accepted her program and will be conducting an inspection on February 15th 2022. No deficiencies were observed today. A copy of this report was left with Licensee Erika Juarez.

met_with: Erika Juarez


summary: Facility Evaluation

raw_content:
Narrative:
On 9/16/22 at 10: AM, Licensing Program Analyst (LPA) Alyssa Ng made a visit to the facility for a post-licensing inspection. LPA met with Administrator Erika Juarez and was informed of the purpose of the visit. Safety precautions were taken, including pre-visit screening, mask-wearing, and hand hygiene. At 11: PM, LPA Ng toured the facility inside and out. The home is single storied, and has two double occupancy bedroom and one staff bedroom. All client bedrooms were equipped with comfortable furnishings which included ample storage space for clients' belongings, desks and chairs, and twin sized beds. The twin beds have drawers underneath for addition storage. Each bedroom has a closet for extra storage space. Client bathroom was clean and furnished with hygiene supplies for each client. The water temperature measured 115 degrees F.The thermostat measured 70 degrees. The facility is clean, safe and sanitary. The kitchen was observed to be clean and free of hazards or chemicals. Sharps were located in a locked cabinet. The weekly menu was in the kitchen. LPA observed at least 2 days of perishable foods and 7 days of nonperishable foods. The smoke detectors are in working order. No bodies of water on the premises. All walkways were free from debris or hazards. Resident and staff files were inspected and observed to be complete. Facility has license, grievance procedures, LIC 610C, personal rights, and foster youth bill of rights posted. The CARE tool found no deficiencies. There are no citations. An exit interview was conducted and a copy of this report was provided to Administrator Erika Juarez, whose signature on this form confirms receipt.


summary: Facility Evaluation

raw_content:
Narrative:
On Tuesday January 17, 2023 at 1: PM Licensing Program Analyst (LPA) Alyssa Ng made an unannounced inspection to conduct an annual required inspection. LPA met with Erika Juarez, Administrator. The facility has a current census of 1 client. The facility is clean, safe and sanitary and in good repair. All passageways are unobstructed. There are 3 rooms and 2 bathrooms. Two of the bedrooms are double occupancy for clients and the other room is for staff. The garage is inaccessible to clients. There are no pools or bodies of water. All disinfectants, cleaning solutions and poisons are located in a locked closet and are not accessible to the residents. There are no firearms in the facility and all sharps are inaccessible to clients in care. The inspected bedrooms were furnished accordingly. The kitchen is clean and sanitary. The facility has sufficient two day perishable and seven day nonperishable food supply. Medications, client and staff binders are located in a locked cabinet. Thermostat and water temperature was 70 degrees F and 115 degrees F. Medication binder was inspected and complete. The facility has Personal Rights and Emergency Disaster Plans are posted and in clear view. LPA Ng reviewed one client file. A review of Guardian Background Check System printed on January 17, 2023 indicated that all facility staff have DOJ, FBI and child abuse index check clearances (CAIC). All client staff files and other documents were reviewed and were observed to be complete. LPA was not able to interview staff or client due to technical issues. LPA will come back at a later time to complete the inspection. No deficiencies were cited today. A copy of this report was given to Erika Juarez, Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 1/25/23 at 1: PM, Licensing Program Analyst (LPA) Alyssa Ng made an unannounced inspection to finish the annual required inspection. LPA met with Erika Juarez, Administrator. All staff files and other documents are in a centralized binder. Staff training hours meet the minimum requirements, A review of Guardian Background Check System indicate that all facility staff have DOJ, FBI and child abuse index check clearances (CAIC). LPA Ng interviewed 2 staff. No deficiencies were cited and a copy of this report has been left with the Erika Juarez, Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 1/5/24, Licensing Program Analyst (LPA) Mariah Hawkins made a visit to the facility for a required annual inspection. LPA met with Facility Manager Maria Juarez and informed of the purpose of the visit. During the inspection, LPA conducted a tour of the physical plant, inside and outside, interviews, and a review of facility records, including 5 personnel records and 2 resident records. Using the CARE Inspection Tool, no deficiencies were found. LPA observed the facility records to be complete and to be well-organized. The facility is clean, and no hazards were observed. The outdoor activity space is well-maintained, chemicals and medications are locked away, separate linens are provided to each resident, and the bathroom and kitchen spaces are maintained in sanitary condition. The kitchen is fully stocked with food within date. There are no citations. An exit interview was conducted, and a copy of this report was provided to Facility Manager Maria Juarez, whose signature on this form confirms receipt.

met_with: Facility Manager Maria Juarez


summary: Facility Evaluation

raw_content:
Narrative:
On 1/12/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a case management visit at the facility. LPA met with Facility Manager Maria Juarez and informed of the purpose of the visit. LPA visited to interview a resident. Staff informed LPA that the resident left for a home visit the night prior. LPA conducted an exit interview, and provided a copy of this report to Facility Manager Maria Juarez, whose signature on this report confirms receipt.


summary: Facility Evaluation

raw_content:
Narrative:
On March 18, 2025, at approximately 10: AM, Licensing Program Analyst (LPA) Jonathan Medina conducted an unannounced annual required inspection. LPA met with Facility Manager Maria Juarez and explained the purpose of the visit. The facility currently has one client in care. At approximately 10: AM, LPA Medina initiated the physical plant portion of the CARE Inspection Tool. The facility was observed to be clean, safe, sanitary, and in good repair. All passageways were unobstructed. The facility consists of three bedrooms and two bathrooms. Two of the bedrooms are designated for client use with double occupancy, while the third bedroom is assigned to staff. There were no pools or bodies of water on the premises. All disinfectants, cleaning solutions, and poisons were stored in a locked closet, making them inaccessible to residents. No firearms were present in the facility, and all sharp objects were secured and inaccessible to clients in care. The bedrooms were appropriately furnished, and the kitchen was clean and sanitary. The facility maintained a sufficient food supply, including a two-day supply of perishable food and a seven-day supply of non-perishable food. Medications, along with client and staff binders, were stored in a locked cabinet in the kitchen. At approximately 10: AM, LPA Medina checked the facility's thermostat and water temperature. The home was maintained at 70°F, and the water temperature was measured at 115°F. At approximately 10: AM, LPA observed the facility's first aid kit and confirmed it was complete. Continues on LIC 809-C. At approximately 11: AM, LPA Medina proceeded to review the staffing section of the CARE Inspection Tool. A total of five staff files were reviewed, and all were complete and in compliance with regulatory requirements. At approximately 12: PM, LPA reviewed the client's file, which was also found to be complete and in good order. At approximately 12: PM, LPA reviewed the facility's operations binder, which was complete and up to date. At approximately 1: PM, LPA Medina reviewed the facility's disaster preparedness and emergency intervention plan. It was confirmed that emergency drills are conducted quarterly and that all procedures are current and in compliance with regulations. At approximately 1: PM, LPA verified that the facility meets the standards for serving clients with special health care needs. The facility utilizes Thrive Behavioral Care to ensure compliance with regulations, conduct routine checks, and develop individualized goals for the client. At approximately 1: PM, LPA conducted a confidential interview with the facility manager. Due to the client being non-verbal, an interview could not be conducted. No deficiencies were observed during the inspection. An exit interview was conducted with Facility Manager Maria Juarez. A copy of this report was provided to Ms. Juarez, whose signature on this document confirms receipt.

met_with: Maria Juarez - Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 01/15/2026 at 10:20 a.m., Licensing Program Analyst (LPA) Brenda Rodriguez conducted an unannounced Annual Inspection and met with Maria Juarez, Facility Manager. LPA Rodriguez disclosed the purpose of the inspection and was granted entry into the facility by the Facility Manager. LPA Rodriguez used the CARE Inspection Tool. The facility currently has a census of two clients. LPA Rodriguez reviewed five (5) staff files and two (2) client files. LPA Rodriguez also reviewed the emergency disaster plan binder. LPA Rodriguez conducted one (1) confidential staff interview. During physical plant inspection, no deficiencies were found. LPA Rodriguez toured the facility inside and out. All client bedrooms were equipped with comfortable furnishings which included ample storage space for clients' belongings and full-sized beds. Each bedroom has drawers for extra storage space. Client bathroom was clean and furnished with hygiene supplies for each client. The facility is clean, safe and sanitary. The kitchen was observed to be clean and free of hazards or chemicals. No bodies of water on the premises. All walkways were free from debris or hazards. LPA toured the backyard and observed it to be free from hazards. The required Annual Inspection is complete. No deficiencies were cited. An exit interview was conducted at 1:20 p.m., and a copy of this report was given to Facility Manager Maria Juarez, whose signature on this form confirms receipt.

met_with: Maria Juarez, Facility Manager


facility_name: TRICIA'S HOME

summary: Facility Evaluation

raw_content:
Narrative:
On December 14, 2021 at 9:30 am Licensing Program Analysts (LPA) Isabel Mendoza and Cheyenne McCambridge made an unannounced annual/required visit. LPA met with Administrator, Rochelle Rivera. The facility currently has 4 clients in care. All clients were at school during todays inspection. At 9: AM LPA's did a walk thru the facility was clean, safe, sanitary, and in good repair. The facility consists of four bedrooms, three for clients and one staff bedroom. LPA's observed the facilities fireplace was not properly fenced. Bedroom #3 possibly has a leak issue because the right side of the bedroom's ceiling was wet and there was a small area that was lifted and appeared to have water/air inside. During inspection, the Administrator contacted their repair person and he will be coming out today. The Administrator will contact LPA Mendoza and give LPA an update on the roof/ceiling issue. All bedrooms were inspected and furnished accordingly along with two bathrooms.The kitchen is clean and sanitary. LPA Mendoza inspected the freezer and found several raw food items that were not properly sealed. LPA Mendoza requested the Administrator to throw them out. The facility has sufficient two day perishable and seven day nonperishable food supply. Medications are located in locked cabinet in the garage, currently no clients are on medications. All passageways are unobstructed. There is an outdoor space for the clients, and no hazards or broken items. There are no pools or bodies of water. All disinfectants, cleaning solutions and poisons are located in garage and are not accessible to the residents. At 10: AM LPA's reviewed all four client files, and files were complete. All clients are all over the age of 18, and the facility is currently working with Golden Gate Regional Center (GGRC) and will be converting to an Adult facility once they get okay from GGRC and will follow-up submit all items to CCL. The facility submitted there application to GGRC and CCL about 2 years ago and have been in contact with numerous people at GGRC and currently working with Kevin Abad, LPA Mendoza will reach out to Abad to get an update on the facilities adult application. LPA reminded the facility to follow up with CCL on the adult application as well. LPA will also reach out to Adult Program to confirm receipt of application submitted. The Administrator agreed and will contact LPA with an update by end of next week. LPA Mendoza is requesting the facility to submit age exceptions for all 4 clients in care. The facility will submit support letters from each authorized representative and a letter from the facility no later than Wednesday, 12/21/21. At 11: AM LPA's received all four staff files. All files were reviewed and had all required training and documents. LPA's interviewed the Administrator. During inspection, LPA obtained copy of Rochelle Rivera's updated Administrator certificate. LPA requested the facility to submit the following items no later than Friday 12/17/21, an updated LIC 500 (staff schedule) and LIC 610 (Emergency Disaster Plan). Exit interview conducted. No deficiencies cited during todays inspection. The facility received three Advisory Notes- Technical violations and a copy of the report was left with the facility.

met_with: Administrator Rochelle Rivera


facility_name: TRINITY EL MONTE

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis conducted a virtual Component II session with Trinity Youth Services on September 13, 2022 at 11:00am by way of Microsoft Teams. Present at the Component II from Trinity Youth Services were Gilbert Quinbar, Director of Residential Services; Cher Ofstedahl, CEO; and Jennifer Artiga, Program Director. During the meeting the following items were discussed: 1. Staff Associations 2. Group Home Program Statement revisions 3. Emergency Disaster Plan 4. Emergency Intervention Plan 5. LIC 400 6. Application 7. Neighborhood Complaint Policy 8. Bank Verification Form LPA asked questions regarding the provider's Program Statement to assess their understanding of the regulations in place for a Group Home. LPA advised the provider that all revisions/corrections need to be submitted directly to him for review. The Pre-Licensing inspection will take place on Wednesday, September 14, 2022. LPA discussed the upcoming Pre-Licensing inspection in general and what it involved. LPA advised the provider that their program statement will also be reviewed by his manager, LPM Yan Yeung. Exit Interview conducted


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis went to Trinity Youth Services on September 14, 2022 at 11:00am for the purposes of an announced Pre-licensing inspection. The Department has received application materials from the provider to become licensed as a group home licensee at the site. LPA met with Jennifer Artiga, Program Director and Jaime Acosta, Direct Care Supervisor, and together they toured the facility inside and outside. The facility is located in a residential neighborhood and consists of three individual dorms for placement purposes (Luna, Sol, and Estrella). The rooms have twin beds, desk, and closet space. There is also a separate telephone room in each dorm for the clients' use. Sharp knives and cleaning supplies are kept locked in areas inaccessible to children. Overall, the facility appeared clean, safe, and sanitary. LPA observed fully charged fire extinguishers throughout the facility. Exit signs were also visible throughout the facility as well. The outdoor areas were observed to be free of debris and hazards. LPA observed the kitchen area to be clean and the refrigerators were well stocked with ample food supply. LPA also observed adequate perishable and nonperishable food items at the facility. There is no swimming pool or other bodies of water on the premises. The Program Director stated that there weren't any firearms or other weapons on the premises. The facility has locked file cabinets for the client files. Smoke alarms were operable throughout the facility. There is adequate space for indoor and outdoor activities. Medications will be kept locked in the Team Administrator's office. The facility also has nurse staff and clinicians. During the tour of the facility, LPA observed copies of the Emergency Plan, Inspection Report, Disaster Plan Policy and Procedures, Foster Care Ombudsman information, and food and nutrition menus. The facility will provide educational services at the facility for each client. LPA observed two classrooms on the premises. Each classroom has seating capacity for twelve students each. The classrooms were set up in a "classroom style" setting and the environment is situated for classroom learning. LPA met the lead teacher who advised LPA that she's currently working on the curriculum and other educational components as they await their first students. LPA also met the facility's bilingual instructional paraprofessionals. LPA found no Title 22 deficiencies on this date. Exit interview conducted LPA Davis discussed warm weather conditions and precautions with the provider and provided them with the Department's website address (www.ccld.ca.gov). LPA also conducted a Component III at the facility with Jennifer Artiga, Program Director. During the Component III meeting, the following forms were given and/or discussed: LIC Preplacement of Appraisal Information LIC Appraisal/Needs and Services Plan LIC Physician's Report for Community Care Facilities LIC Identification and Emergency Information LIC Personal Rights LIC Record of Client's Safeguarded Cash Resources LIC Consent for Emergency Medical Treatment LIC Centrally Stored Medication and Destruction Record LIC Client/Resident Personal Property and Valuables LIC Unusual Incident/Injury Report LIC Admission Agreement Guide The provider was also briefed about community passes, room searches/strip searches, community sensitivity, and client education.

visit_type: Prelicensing


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis went to Trinity Youth Services on March 29, 2023 at 11:45am for the purposes of an unannounced Post Licensing inspection. LPA met with Jaime Acosta, Direct Care Supervisor, and discussed the purpose of today's inspection. The group home is located in a residential neighborhood and currently has seven youth in placement. LPA observed the facility's kitchen to be clean and well stocked with several food items (perishable and nonperishable). Sharp knives, chemicals, cleaning supplies, and medications are kept locked in areas inaccessible to clients. LPA observed the bathrooms to be in good repair and working order. Each bedroom contained twin beds, dressers, and closet space. Exit signs were visible throughout the facility. The First Aid Kit was fully stocked with bandages, scissors, band-aids, tweezers, and a thermometer. There is adequate seating in the dining area and the living room. There are separate phone booths/areas for the clients' use. LPA observed fully charged fire extinguisher inside the facility. There are two separate classrooms on the premises for the clients' daily educational activities. There is no swimming pool or other bodies of water on the premises. The Direct Care Supervisor stated that there weren't any firearms or other weapons on the premises. The facility currently has four vans for client transportation needs. The last fire drill occurred on March 15, 2023 at 10:40pm. LPA observed the following posted on a bulletin board: personal rights information, emergency disaster plan, fire department inspection report, ombudsman information, and the facility license. Smoke alarms were operable throughout the facility. There is adequate space for indoor and outdoor activities. The facility also has available case managers and clinicians. LPA observed a computer area, game area, lounge area, and a laundry room. . The outdoor areas were observed to be free of debris and hazards. LPA reviewed files and found the reviewed files to be in order. LPA obtained an updated LIC500 (Personnel Report) and a client roster. Licensee will scan/email LPA a copy of their most recent Board of Director's meeting minutes. LPA found no Title 22/ILS deficiencies on this date. Exit interview done

met_with: Jaime Acosta, Direct Care Supervisor


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis went to Trinity Youth Services on September 07, 2023 at 12:35pm for the purposes of an unannounced Required Annual inspection. LPA met with Jaime Acosta, Direct Care Supervisor, and discussed the purpose of today's inspection. The group home is located in a residential neighborhood and currently has twelve youth in placement. LPA observed the facility's kitchen to be clean and well stocked with several food items (perishable and nonperishable). Exit signs were posted and visible throughout the facility. Sharp knives, chemicals, cleaning supplies, and medications are kept locked in areas inaccessible to clients. Each bedroom contained twin beds, dressers, and closet space. The First Aid Kit was fully stocked with bandages, scissors, band-aids, tweezers, and a thermometer. LPA observed a private room for the clients to make and receive telephone calls. There is adequate seating in the dining area and the living room. LPA observed fully charged fire extinguishers throughout the facility. LPA also observed the bathrooms to be in good repair and working order. There are two separate classrooms on the premises for the clients' daily educational activities. There is no swimming pool or other bodies of water on the premises. The Direct Care Supervisor stated that there weren't any firearms or other weapons on the premises. The facility currently has five vans for client transportation needs. The last fire drill occurred on August 16, 2023 at 8:31pm. LPA observed the following posted on a bulletin board: facility license, personal rights information, accreditation information, ombudsman information, Mental Health Program Approval, foster youth rights information, and the emergency disaster plan. There is adequate space for indoor and outdoor activities. LPA observed an outdoor basketball court for the clients' use. Smoke alarms were operable throughout the facility. LPA observed a computer area, game area, lounge area, and a laundry room. The outdoor areas were observed to be free of debris and hazards. LPA reviewed four client and four staff files and found the reviewed files to be in order. Staff and client interviews were conducted during today's inspection. LPA obtained an updated LIC500 (Personnel Report) and a client roster. Licensee will scan/email LPA a copy of their most recent Board of Director's meeting minutes. LPA found no Title 22/ILS deficiencies on this date. Exit interview done LPA discussed the warm weather conditions and precautions with licensee and provided licensee with the department's website address (www.ccld.ca.gov).


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis went to Trinity Youth Services on August 09, 2024 at 1:38pm for the purposes of an unannounced Required Annual inspection. LPA met with Jaime Acosta, Direct Care Supervisor, and discussed the purpose of today's inspection. The group home is located in a residential neighborhood and currently has eleven youth in placement. LPA observed the facility's kitchen to be clean and well stocked with several food items (perishable and nonperishable). LPA also observed separate walk-in freezer and refrigerator rooms, respectively. Exit signs were posted and visible throughout the facility. Sharp knives, chemicals, cleaning supplies, and medications are kept locked in areas inaccessible to clients. The First Aid Kit was fully stocked with bandages, scissors, band-aids, tweezers, and a thermometer. The bedrooms contained twin beds, dressers, and closet space. There were three separate telephone rooms set aside for the clients to make and receive private telephone calls. There is adequate seating in the dining area and the living room. LPA observed fully charged fire extinguishers throughout the facility. There is no swimming pool or other bodies of water on the premises. The Direct Care Supervisor stated that there weren't any firearms or other weapons on the premises. The last fire drill occurred on July 17, 2024 at 8:10am. There is adequate space for indoor and outdoor activities. LPA observed an outdoor basketball court for the clients' use as well as volleyball and soccer. Smoke alarms were operable throughout the facility. LPA observed a computer area, game area, lounge area, and a laundry room. LPA observed the following posted on a bulletin board: facility license, personal rights information, accreditation information, ombudsman information, Mental Health Program Approval, foster youth rights information, and the emergency disaster plan. The outdoor areas were observed to be free of debris and hazards. LPA reviewed five client files and found the reviewed files to be in order. Staff and client interviews were conducted during today's inspection. LPA obtained an updated LIC500 (Personnel Report) and a client roster. LPA also obtained a copy of the licensee's most recent Board of Director's meeting minutes. LPA found no Title 22/ILS deficiencies on this date. Exit interview done LPA discussed the warm weather conditions and precautions with licensee and provided licensee with the department's website address (www.ccld.ca.gov).


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis went to Trinity Youth Services on November 22, 2024 at 1:42pm for the purposes of an unannounced case management inspection. LPA met with Jaime Acosta, Direct Care Supervisor, and together they toured the facility. The group home is located in a residential neighborhood and currently has eleven youth in placement. The facility appeared clean and well maintained. LPA did not observe any pools or other bodies of water at the facility. The outdoor areas were clear of sharp objects and free of debris and hazards. LPA observed an outdoor basketball court and a soccer area for the youth, The client rooms contained twin beds, dressers, and closet space. The facility keeps their sharp knives, cleaning supplies, and medications in areas inaccessible to clients. The last fire drill was held on November 13, 2024 at 5:52pm. LPA observed a computer area, game area, and a lounge area. The facility has three separate telephone rooms set aside for the clients to make and receive private telephone calls. LPA randomly reviewed two client files (refer to Confidential Names form (LIC 811) dated November 22, 2024) and found the reviewed files to be in order. LPA obtained a client roster and a current copy of the facility's staff roster (LIC500). The Direct Care Supervisor stated that there weren't any firearms or other weapons on the premises. LPA was able to speak with one client during the inspection. The client was observed to be neat and well groomed. LPA found no Title 22 deficiencies on this date. Exit interview done LPA discussed the cold weather conditions and precautions with licensee and provided licensee with the department's website address (www.ccld.ca.gov).


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis went to Trinity Youth Services on March 03, 2025 at 2:15pm for the purposes of an unannounced case management inspection. LPA met with Jaime Acosta, Direct Care Supervisor (DCS), and together they toured the facility. The group home is located in a residential neighborhood and currently has two youth in placement. The facility appeared well maintained. The outdoor areas were clear of sharp objects, debris, and hazards. LPA observed an outdoor basketball court and a soccer area for the youth. The last fire drill was held on February 19, 2025 at 8:55pm. The client bedrooms contained twin beds, dressers, and closet space. LPA did not observe any pools or other bodies of water at the facility. The smoke alarms were operable in the bedrooms. Exit signs were visible throughout the facility. LPA also observed menus, Emergency Disaster Plan, Personal Rights information, Foster Care Ombudsman information, facility license, and accreditation certificate posted on a bulletin board in the hallway. The facility has five SUVs for client transportation needs. LPA reviewed both client files (refer to Confidential Names form (LIC 811) dated March 03, 2025) and found the reviewed files to be in order. LPA spoke with both clients at the facility through the facility's interpreter (Hany Shaker). Both clients indicated that things were going well and that staff treats them nice. The clients also stated that they were getting plenty to eat. Both clients were observed to be neat and well groomed. DCS stated that their client population is low. Two clients aged out of the facility based on ORR policies and three transferred to another facility based on their desire to be placed in a larger facility. DCS said that ORR has advised them that things are "wait and see" at the moment as they await further instructions regarding placing new clients given that the population is low at the border. LPA found no Title 22/ILS deficiencies on this date. Exit interview done


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis went to Trinity Youth Services on July 16, 2025 at 11:54am for the purposes of an unannounced Required Annual inspection. LPA met with Jaime Acosta, Direct Care Supervisor, and discussed the pending inspection. The group home is located in a residential neighborhood and consists of three individual dorms for placement purposes (Luna, Sol, and Estrella). Currently, there are eight clients in placement at the facility. All eight clients are placed in Luna. Zero clients are placed in Sol and Estrella, respectively. The bedrooms contain twin beds, dressers, and closet space. There is a separate telephone room in each dorm for the clients' use. LPA observed the facility's kitchen to be clean and well stocked with several food items (perishable and nonperishable). LPA also observed separate walk-in freezer and refrigerator rooms as well. The outdoor areas were observed to be free of debris and hazards. LPA observed an outdoor basketball court for the clients' use as well as a soccer field. There is adequate seating in the dining area and the living room. LPA observed fully charged fire extinguishers and exit signs throughout the facility. Sharp knives, chemicals, and cleaning supplies are kept locked in areas inaccessible to clients. Medications are stored and kept in a cabinet in the Team Administration office. The facility has several fully stocked First Aid Kits on the premises. There is no swimming pool or other bodies of water on the premises. The Direct Care Supervisor stated that there weren't any firearms or other weapons on the premises. The last fire drill occurred on July 16, 2025 at 8:10am. LPA observed a computer area, game area, lounge area, and a laundry room. LPA observed the following posted on a bulletin board: facility license, inspection report, Foster Care Ombudsman information, Personal Rights information, Accreditation information, Foster Youth Rights information, and the Emergency Disaster Plan. LPA reviewed five client files and three staff files. The reviewed files were found to be in order. Staff and client interviews were conducted during today's inspection. LPA obtained an updated LIC500 (Personnel Report) and a client roster. LPA also obtained a copy of the licensee's most recent Board of Director's meeting minutes dated March 14, 2025.. LPA found no Title 22/ILS deficiencies on this date. Exit interview done LPA discussed the warm weather conditions and precautions with licensee and provided licensee with the department's website address (www.ccld.ca.gov).

met_with: Jaime Acosta, Direct Care Supervisor,


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis went to Trinity Youth Services on October 17, 2025 at 3:00pm for the purposes of an unannounced case management inspection. LPA met with Jaime Acosta, Direct Care Supervisor, and discussed the purpose of today's inspection. The group home is located in a residential neighborhood and currently has twenty youth in placement. LPA randomly reviewed two client files (refer to Confidential Names form (LIC 811) dated October 17, 2025) and found the reviewed files to be in order. LPA obtained a client roster and a current copy of the facility's staff roster (LIC500). LPA spoke with two clients during the inspection. Both clients indicated that things were going well. LPA utilized the services of a staff interpreter during his interview with the clients. Both clients were observed to be neat and well groomed. LPA found no Title 22 deficiencies on this date. Exit interview done


facility_name: TRINITY II

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

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

visit_type: Complaint Investigation

met_with: Edgardo Joven, House Manager


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
Based on LPA's observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation (Staff did not properly report an incident) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, CCR 80061(b)), is being cited on the attached LIC 9099D. Staff sent an Incident Report to CCL six days after the incident happened, but did not call to report the incident within 24 hours. Deficiencies are being cited based on LPA's observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22, see LIC 9099D. An exit interview was conducted, and appeal rights were reviewed and developed with the House Manager. A copy of this report was left with the House Manager, Edgardo Joven.

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:

complaint_status: SUBSTANTIATED


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Christopher Rollins made an unannounced annual inspection to Trinity II facility. LPA met with Terri Ingram Administrator . LPA reviewed files with Administrator. The facility is licensed for 6 residents (all can be ambulatory) ages 13-18 and currently 4 clients reside in facility. The facility consists of 3 bedrooms (3 double occupancy rooms for clients) and 2 bathrooms (1 for clients and 1 for staff). No more than two clients to a room. At 2: PM, LPA Rollins and Administrator toured the facility inside and out. The kitchen is clean. The hot water in the bathroom and kitchen measured at 107.4 degrees F which is currently between 105 - 120 degrees. The facility has plenty of nonperishable and perishable food supply. Medication, cleaning supplies and knives are locked away. Medication logs are up to date and current. There are enough folks, spoons, plates and cups. All passageways are unobstructed. All smoke detectors are update and working. The home is clean, safe, and sanitary. There are no firearms on the property. The fire extinguisher has been checked and is up to date. There are no bodies of water on the property. LPA observed first aid kit to be fully stocked. The home is maintained at a comfortable temperature. Personal rights, floor plan, food menu and Emergency disaster forms were posted and in clear view. At 03: PM, LPA Rollins observe four client files with Administrator. LPA Rollins observed all four client files to be complete and found no deficiencies. The documentation in the clients file are complete and up to date. At 4: PM, LPA observed all 9 staff files with Administrator. LPA observed all nine staff files to be complete, all correct documentation and all staff were up to date with there 20 hours of annual training for the year. At 5: PM LPA Rollins conducted staff interviews and observe clients interaction with staff. During inspection, LPA receive a updated copy of the LIC Personnel Report to maintain their file current. A review of Licensing Information System on September 16, 2021 indicates that all facility staff associated to the program has DOJ, FBI and child abuse index check clearances. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted and a copy of the report was left at the facility.

met_with: Terri Ingram-Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On Friday 02/25/2022, Licensing Program Analysts (LPA) Alyssa Ng made an unannounced inspection to conduct an annual required inspection. LPA met with House Manager Edgardo Joven. Later on, Maria Golitzen, Assistant Administrator arrived. The facility has a census of four clients. There was only one resident in care. The other clients were at school. LPA was unable to interview youth because youth is non-verbal. However, client appeared to be in good spirit. LPA also interviewed two staff. The CARE Inspection Tool was used to conduct the inspection. The facility and grounds are clean, tidy, and free of obstructions. There are no hazards on the premises and no firearms, per Administrator. Bedrooms are double-occupancy, and beds have clean linens and mattress pads. There is enough storage for residents' personal belongings. Food is of good quality, within date, and stored properly. First aid kit was observed to be complete. Room temperature was maintained at a comfortable temperature within permitted range. LPA conducted confidential staff interviews. Resident present during visit is nonverbal but was observed to be content, engaged in activities, supervised by staff, clean, and dressed in well-fitting clothing. Resident and staff records were observed to be complete and the facility in compliance, with only the following exceptions: Hot water in the resident bathrooms measured outside of permitted range ( F to F). At 11:44AM, it measured 135. F and 130.2, and the hot water setting was lowered. At 1:12PM, it measured 97. F, and the setting was adjusted again. At 2:00PM, it measured F. Staff made multiple attempts, including adjusting the setting 3+ times and testing multiple sinks, but at the end of the visit, both bathrooms measured 105. F, which is the permitted range. LPA recommended to keep checking the temperature daily. There are no citations today. An exit interview was conducted, and a copy of this report was left with Assistant Administrator Maria Golitzen, whose signature on this form confirms receipt.

met_with: Edgardo Joven


summary: Facility Evaluation

raw_content:
Narrative:
On 2-1-23 10: AM, Licensing Program Analysts (LPA)George Karkazis conducted an unannounced Annual/Random inspection at listed facility. LPA met with Maria Golitzen, Facility Manager, and toured the facility inside and out. Safety precautions were taken including screening call and mask wearing. The Group Home is licensed to serve six clients. Present during the inspection were three staff and one client. At 10:25AM, LPA Karkazis reviewed client and staff files. All staff and client files were complete and in good order. At 12:15PM, LPA Karkazis toured the facility. LPA Karkazis observed three bedrooms and two bathrooms. LPA observed facility license, personal rights, facility sketch, meal menu, and other forms posted on the walls throughout the facility. LPA Karkazis tested the water temperature and found it to be 111 degrees which is in range. The thermostat read 70 degrees which is within range. Sharps were locked and chemicals were safely stored. There were two days of perishable foods and seven days non-perishable foods present. The medication was also stored and locked in the kitchen cabinet. LPA Karkazis observed one broken window in bedroom #2 and one broken window in the dining room. Both broken windows were safely covered. The facility is clean and orderly. LPA Karkazis interviewed three staff and one client. At 12:45PM Karkazis toured the backyard. There were no open bodies of water. The backyard was in good repair and clean. continued on LIC 809-C continued from LIC A citation was issued, at this time the facility is in violation of California Code of Regulations, Title 22, Division Buildings and Grounds 80087(a). An exit interview was conducted, appeal rights discussed and a copy of this report was given to Maria Golitzen, Facility Manager.

met_with: Maria Golitzen, Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 2-7-24 10:22AM, Licensing Program Analyst George Karkazis conducted an unannounced Annual/Random inspection at listed facility. LPA met with Maria Golitzen, Assistant Administrator and toured the facility inside and out. The Group Home is licensed to serve 6 clients. Present during the inspection were 3 staff and 1 client. The rest of the clients are nonverbal. At 10:35AM, LPA Karkazis reviewed client and staff files. All client and staff files were complete and in good order. At 12:11PM, LPA Karkazis toured the facility. LPA Karkazis observed 3 bedrooms and 2 bathrooms. LPA observed facility license, personal rights, facility sketch, meal menu, and other forms posted on the walls throughout the facility. LPA Karkazis tested the water temperature and found it to be 109 degrees which is in range. The thermostat read 70 degrees which is within range. Sharps were locked and chemicals were safely stored. There were two days of perishable foods and seven days non-perishable foods present. The medication was also stored and locked in the upper kitchen cabinet. The facility is in good repair and clean. LPA Karkazis interviewed 3 staff and 1 client. At 1:01PM LPA Karkazis toured the backyard. There were no open bodies of water. The backyard was in good repair and clean. At this time there were no deficiencies. An exit interview was conducted, appeal rights discussed and a copy of this report was given to Maria Golitzen, Assistant Administrator.

met_with: Maria Golitzen, Assistant Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 2-21-25 9:30AM, Licensing Program Analysts George Karkazis conducted an unannounced Annual/Random inspection at listed facility. LPA met with Maria Golitzen, Administrator Assistant and toured the facility inside and out. The Group Home is licensed to serve 6 clients. Present during the inspection were 3 staff and 1 client. At 10:00AM LPA Karkazis reviewed client and staff files. All staff and client files were, complete and in good order. At 11:38AM, LPA Karkazis toured the facility. LPA Karkazis observed 3 bedrooms and 2 bathrooms. LPA observed facility license, personal rights, facility sketch, meal menu, and other forms posted on the walls throughout the facility. LPA Karkazis tested the water temperature and found it to be 112 degrees which is in range. The thermostat read 68 which is within range. Sharps were locked and chemicals were safely stored. There were two days of perishable foods and seven days non-perishable foods present. The medication was also stored and locked in the kitchen, in an upper cabinet. The facility is in good repair and clean. LPA Karkazis interviewed 3 staff and no clients. The client that was present was non-verbal At 12:01PM LPA Karkazis toured the backyard. There were no open bodies of water. The backyard was in good repair and clean. At this time there were no deficiencies. An exit interview was conducted, appeal rights discussed and a copy of this report was given to Maria Golitzen, Administrator Assistant.

met_with: Maria Golitzen, Administrator Assistant


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPA's) Alyssa Ng and Lisa Schlembach on 09/14/2022 at 12: PM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA's met with Maria Golitzen, Facility Manager and inspected the facility inside and out. LPA reviewed 1 child record and 3 staff personnel files on site at the facility. There were two staff members and 0 clients present at the time of the inspection. The current census is four clients, all clients are currently at school. At 2: PM, three clients came back from school. LPA reviewed 1 of child's psychotropic medications and medication records. It was learned during that three out of the four clients are 18 and over. LPA Ng advised Maria Golitzen, Facility Manager that the facility is licensed for clients 6-17 and will need to do age exceptions for all three clients. The three clients in the home are 18, 19, and 19. A technical assistance was given. LPA interviewed 3 of staff on site to discuss the facilities policies and procedures of operation. LPA interviewed 1 client who is currently prescribed psychotropic medication. During the inspection the LPAs observed 2 deficiencies (see attached 809D), plan of corrections were discussed and appeal rights were provided. LPA provided a copy of this licensing report to Maria Golitzen, Facility Manager.

met_with: Maria Golitzen


summary: Facility Evaluation

raw_content:
Narrative:
On 03/20/2026 at 9: AM, Licensing Program Analysts (LPAs) Amee Li and Simran Nayyar visited the above listed facility to conduct an unannounced Annual/Random inspection for Children's Residential facility Trinity II (#15650114). At the time of the inspection, there are four clients in care and three clients were present. One client was at school. All clients are above the age of 18 and ambulatory. LPAs met with Edgardo Joven, Caretaker, who assisted LPAs with the physical plant inspection. After the physical plant inspection, LPAs observed on the facility license that the facility was now an Adult Residential Facility (ARF) under the name Trinity Adult Residential Care, Inc. (#019201574). Staff requested for LPAs to wait for Assistant Administrator to arrive to discuss facility closure. At 10: AM, LPAs met with Maria Golitzen, Administrator Assistant to discuss the closure of the Children's Residential facility. Staff called Licensee Terri Ingram to assist via phone. Closure letter and closure plan had been received previously, but the text message that was sent to inform of the facility's ARF licensure had not been received by the Department. LPAs requested for the text message to be forwarded to them and Licensee forwarded it immediately. Please refer to LIC812 attached to the report for text message details. During the visit, LPAs collected the forfeited Children's Residential facility license. At this time, no deficiencies were cited. An exit interview was conducted, and a copy of this report was left with Maria Golitzen, Administrator Assistant whose signature below confirms receipt.


raw_content:
Narrative:
An additional confidential witness stated that S1 refused to take C1 on the outing because C1 did not speak to S1 and because S1 didn't feel safe with C1. LPA was not informed during interviews or provided documentation that C1 had acted out aggressively toward S1. Based on confidential interviews the preponderance of evidence standard has been met and the Department has determined S1 did not allow C1 to go on an outing with S1 and other clients (C2, C3). Therefore, the allegation is substantiated. The facility is being cited for violation of Title Regulations 84072 (d)(18) Personal Rights. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Karen Carmona.

Investigation Findings:
13On February 6, 2025, at 1: PM Licensing Program Analyst (LPA) Michael Almaraz met with Trinity Youth Services Yucaipa Independence House Case Manager, Karen Carmona, to issue the finding for the above allegation involving client #1 (C1) listed on the confidential names list (LIC 811) dated February 6, 2025. On December 4, 2024, at 12: PM LPA inspected the facility, and no deficiencies were noted. During LPA's investigation LPA reviewed six clients' files (C1, C2, C3, C4, C5, C6) and reviewed the facility file. Furthermore, LPA Almaraz conducted interviews with three staff, and five of six clients. One (C4) of six clients was unavailable for interview. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Michael Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: TRINITY YOUTH SERVICES YUCAIPA INDEPENDENCE HOUSEFACILITY NUMBER: VISIT DATE: 02/06/2025

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

met_with: Karen Carmona


raw_content:
Narrative:
yelled racial slurs to the clients as they drove by. It was reported that the facility does not have enough staff working. Lastly, it was reported that staff is providing alcohol and lottery tickets to the clients. Confidential interviews revealed conflicting statements. LPA was unable to interview all individuals, although multiple attempts were made, thus, confidential interviews could not confirm or deny the allegations. Based on confidential interviews and records reviewed the allegations that staff speaks to minors in an inappropriate manner, staff does not provide transportation to minors in care, facility does not have enough staff to meet minor's needs, staff is providing clients with contraband, which may have occurred, however, they are not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report, LIC 811, and appeal rights were provided to Saul Vera. A copy of this report will be placed in the facility file.

Investigation Findings:
13On March 20, 2025, at 11:00 am, Licensing Program Analyst (LPA) Charmaine Linley conducted an unannounced complaint inspection at the above facility. LPA Linley met with Saul Vera, Lead Case Manager. The purpose of the inspection was to deliver the findings of the complaint investigation. LPA Michael Almaraz conducted an inspection of the facility on July 16, 2024, at 2:41 pm, and no deficiencies were found. LPA Linley interviewed two Clients (C1-2), five Staff (S1-5), and LPA was unable to interview five Clients (C3-7) and three Staff (S6-8), despite multiple attempts to contact them. During the investigation, LPA reviewed the facility documents. On July 11, 2024, Community Care Licensing (CCL) received allegations that staff speaks to minors in an inappropriate manner, staff does not provide transportation to minors in care, facility does not have enough staff to meet minor's needs, staff is providing clients with contraband. It was reported that staff drove by the clients while they were walking back to the facility from an outing, did not pick up the clients, and S UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley 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 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: TRINITY YOUTH SERVICES YUCAIPA INDEPENDENCE HOUSEFACILITY NUMBER: VISIT DATE: 03/20/2025

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

met_with: Saul Vera


raw_content:
Narrative:
Confidential interviews confirmed hearing S1 calling C3, C6 and C7 stupid for leaving early on the outing. Additionally, confidential interviews confirmed that while driving back to the facility, S1 made a comment to C4 and C5 regarding C3, C6 and C7 stating that walking back to the facility was a dumb idea. Based on confidential interviews, the preponderance of evidence standard has been met and the allegation that S1 does not treat C3, C6 and C7 with respect is substantiated. The facility is being cited for violations of Title 22, Division 6, Chapter 5, Section 84072(d)(1) - Personal Rights (d) The licensee shall ensure that each child, regardless of whether the child is in foster care, is accorded the personal rights specified in Welfare and Institutions Code section 16001.9, and below, as applicable: (1) To live in a safe, healthy, and comfortable home where they are treated with respect. If the child is an Indian child, to live in a home that upholds the prevailing social and cultural standards of the child's Indian community, including, but not limited to, family, social, and political ties. An exit interview was conducted, appeal rights were explained, and a copy of this report and LIC 811 was provided to Trinity Youth Services Independence House Group Home (GH), Katherine Lopez, Facility Manager.

Investigation Findings:
13On April 11, 2025 at 02: PM, Licensing Program Analyst (LPA) Sarah Lo met with Katherine Lopez, Facility Manager, to deliver the findings for the above complaint allegation at Trinity Youth Services Independence House Group Home (GH). On 01/24/2024, LPA Michael Almaraz inspected the facility's physical plant, and no immediate health and safety hazards were observed. The investigation included interviews with one staff (S1), Facility Administrator (AD) and three clients (C4, C5, C6). LPA was unable to located five clients (C1, C2, C3, C7, C8) an interview. On June 06, 2024, Community Care Licensing received an allegation stating that staff (S1) does not treat minors (C3, C6, C7) with respect. Specifically, it was reported that S1 called C3, C6 and C7 stupid for leaving the outing early and had to walk back to the facility in the rain. (continued on LIC 9099c) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Sarah Lo 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 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: TRINITY YOUTH SERVICES YUCAIPA INDEPENDENCE HOUSEFACILITY NUMBER: VISIT DATE: 04/11/2025

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

met_with: Katherine Lopez, Facility Manager


raw_content:
Narrative:
An additional confidential witness informed LPA that S1 was directed to take C1 to the game but on the day of S1 refused to. S1 admitted to refusing to transport C1 to C1's soccer game. Based on confidential interviews the preponderance of evidence standard has been met and the Department has determined S1 refused to transport C1 to a school activity. Therefore, the allegation is substantiated. The facility is being cited for violation of Title Regulations 84074(c)(3) Transportation. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Saul Vera.

Investigation Findings:
13On April 17, 2025, at 1: PM Licensing Program Analyst (LPA) Michael Almaraz met with Trinity Youth Services Yucaipa Independence House Lead Case Manager, Saul Vera, to issue the finding for the above allegation involving client #1 (C1) listed on the confidential names list (LIC 811) dated April 17, 2025. On December 4, 2024, at 1: PM LPA inspected the facility, and no deficiencies were noted. During LPA's investigation LPA reviewed six clients' files (C1, C2, C3, C4, C5, C6) and reviewed the facility file. Furthermore, LPA Almaraz conducted interviews with three staff, and five of six clients. One of six clients (C4) was unavailable for interview. On December 2, 2024, the Department received a complaint that facility staff did not ensure that minor was transported to a school activity as needed. It was specifically reported that staff #1 (S1) refused to transport C1 to a school soccer game. Confidential witnesses informed LPA that on November 29, 2024, C1 had a school soccer game but S1 refused to take C1. Furthermore, it was disclosed to LPA C1 had informed facility staff prior to the game that C1 would be needing a ride. (continued on page 2...) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Michael Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: TRINITY YOUTH SERVICES YUCAIPA INDEPENDENCE HOUSEFACILITY NUMBER: VISIT DATE: 04/17/2025

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


facility_name: TRINITY YOUTH SERVICES YUCAIPA INDEPENDENCE HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
On May 10, 2023, at 11: AM Licensing Program Analyst (LPA) Michael Almaraz and Licensing Program Manager (LPM), Abdoulaye Traore, met with facility Director of Residential Services Gil Quinbar, Campus Director Teresa Valles, and Assistant Campus Director Jason Mayo, via Microsoft Teams to conduct a Component II Interview. LPA and LPM went over revisions needed for the Application and Program Statement. Via EMAIL LPA provided Gil Quinbar a copy of this LIC 809, a LIC 184 and a Department letter of the revisions needed for the application. Signed LIC 809 will be placed in the facility file.

met_with: Gil Quinbar