raw_content:
Narrative:
The investigation included confidential interviews with, including but not limited to, facility staff members, S1 and C1 as well as review of medical records for C1, reports from California Highway Patrol Santa Maria, Lompoc Police Department report and facility file review. Information obtained revealed enough evidence to prove the alleged, as S1 admitted that S1 was distracted and unintentionally hit C1 with the vehicle as S1 was backing up while attempting to exit the parking lot at the School after dropping off facility clients on August 25, 2021. C1 was taken to the hospital to be treated for injuries. C1 sustained contusion and abrasions as a result. Records reviewed further revealed at the time of the incident, S1 was operating a vehicle in violation of a conditional exemption order for which S1 had previously been restricted from transporting clients. Based on information from record review and confidential interviews, the preponderance of the evidence standard has been met. The Department has determined substantiated finding for neglect/lack of supervision; thus, posing an immediate health, safety and personal rights risk of harm to children placed in care. The facility is issued a citation in accordance with the California Code of Regulations, Title 22, Chapter 1, Article 6, Responsibility for Providing Care and Supervision and Plan of Operation [See page LIC9099-D for cited deficiencies]. An exit interview was conducted, and appeal rights were discussed. A copy of this report, Confidential Names List and appeal rights were provided/emailed to Facility Administrator. (Continued on page LIC9099-D)

Investigation Findings:
13On March 29, 2022 at 6: PM, Licensing Program Analyst, Regina Martin conducted a follow-up complaint inspection to deliver findings on the above allegation. LPA met with Daniella Jimenez, Case Manager and together, discussed the investigative outcome. LPA Martin also spoke with Facility Administrator, Adrian Cooks via phone. On August 31, 2021, Community Care Licensing Division (CCLD) received complaint allegations concerning Staff member #1 (S1) who reportedly hit resident Client #1 (C1) with a vehicle while dropping minor off at school (see Confidential Names form LIC811, dated March 29, 2022). It was reported that C1 sustained injuries requiring medical attention. The allegation was referred to CCLD Investigations Bureau and investigated by Investigator Romelia Munoz. (Continued on page LIC9099-C) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Regina Martin 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 34-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, N. Continental Blvd. #290b El Segundo, CA Facility Name: Changing Faces, INC.FACILITY NUMBER: VISIT DATE: 03/29/2022

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

met_with: Daniella Jimenez, Case Manager


state: CA

facility_name: CHANGING FACES, INC.

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
continued from page 1 (9099) AGPA Woodard conducted the investigation into the above allegation and additional concerns. AGPA conducted interviews with 6 staff and 2 minors. The alleged victim was not interviewed due to initially declining not to be interviewed and later was on AWOL status. AGPA reviewed supportive documentation which showed minor was given OTC medication on 12/18/2021. Confidential interviews indicated the OTC ointment didn't work. Minor had a doctor's appointment on 12/29/2021. Minor's treatment was to continue using OTC Lotrimin, and a referral was given to discuss oral Terbinafine drug therapy. PRN documentation shows that the oral medication was given on 1/14/2022 and 1/15/2022. Minor was scheduled a follow-up doctor's appointment on 2/2/2022, however minor was AWOL for this appointment. Other issues investigated was the contractor/handyman is a felon and not associated to the facility. During the interview with the individual, he disclosed that he is never left alone with minors, and rarely at the facility performing maintenance when a minor is home. Based on Title Regulations, Criminal Record Clearance, a third-party repair person is exempt from the requirement to submit fingerprints. The issue where overnight staff fall asleep on shift was investigated. Staff and clients both denied this occurs, however there have been meetings to address the issue in the past, and that staff bring blankets and pillows from home. AGPA Woodard has determined the preponderance of evidence standard has not been met. Therefore, the allegation is found to be unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged personal rights violation occurred.

Investigation Findings:
13On April 9, 2022 at 11:20AM, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted a follow-up complaint inspection to deliver findings on the above allegation. Upon arrival, AGPA was greeted by Skyler Steward, Case Manager. On January 4, 2022, CCL received a complaint allegation concerning a minor has been requesting to see a doctor for athlete's foot for over two months. Minor asked for medication for it but is not given any. Medical supplies are very limited, and minor has not received any over the counter (OTC) treatment. Minor is showing signs of fungus on her big toe and pinky toe. Minor has not had any medical appointments set up to assess her foot. Other concerns addressed in the complaint were that the contractor/handyman is a felon and is not associated to this facility and overnight staff fall asleep. continue on 9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Tonya Barnes-Woodard 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 34-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, N. Continental Blvd. #290b El Segundo, CA Facility Name: Changing Faces, INC.FACILITY NUMBER: VISIT DATE: 04/09/2022

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

report_type: Complaint Investigation

met_with: Skyler Stewart

complaint_status: unsubstantiated


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
"All residents are wards of the court, and it is forbidden by law to publish any photographs of youth in our care...Appropriate photographs of resident may be taken in the home for scrapbook or photo album purposes only." Per California Code Regulation, Title 22, Division 6, Chapters 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), a deficiency was cited at the time of this inspection. See 9099D for details. Exit Interview conducted, and a copy of this report was left at the facility.

Investigation Findings:
13On October 27, 2022, at 3:30pm, Licensing Program Analyst (LPA) Enrique Hernandez made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation and deliver the findings. LPA spoke with Mandy Beyers Facility Manager and together, discussed the investigative finding. During the investigative process by Licensing program Analyst (LPA), Nancy O' Connell, all relevant parties have been accounted for. Supporting evidence includes: review of LIC 500, staff roster, and interviews from clients and staff. Supplemental evidence related to program policy and procedure was obtained directly from program staff during investigation. Interviews reflect confirmation that FM2 took a photo of residents with his personal cell phone during a social outing on or around January/February 2022. Further, evidence reflects those policies contained within the plan of operation strictly prohibit photography of youth and explicitly states, Continue on LIC9099-C SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Enrique M Hernandez 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 34-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, FACILITY NAME: CHANGING FACES, INC.FACILITY NUMBER: VISIT DATE: 10/27/2022

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

met_with: Facility Manager

complaint_status: SUBSTANTIATED


raw_content:
Investigation Findings:
13On March 16, 2023, at 10:25am Licensing Program Analyst (LPA) Nancy O'Connell and LPA Christine Wilson made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation and deliver the finding. LPA spoke with the Facility Manager and together, discussed the investigative finding. During the investigative process by Licensing program Analyst (LPA), Nancy O'Connell, all relevant parties have been accounted for. Supporting evidence includes: interviews with residents and staff attesting to continuous supervision within the facility and a lack of confirmed observation of residents harming other residents in care. Further, LPA attempted to conduct a confidential interview with the identified victim but was declined. During interviews with residents and staff, LPA was unable to obtain statements that would corroborate the occurrence of the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nancy O'Connell 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 1

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


raw_content:
Investigation Findings:
13On May23,32023 at 10:50 am, Licensing Program Analyst (LPA) Christine Wilson made an unannounced case management visit to Changing Faces, Inc. Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegation. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Wilson concluded the allegation: Staff do not prevent minors from using illegal drugs in the facility is unsubstantiated. Although there have been reports of illegal drug use at the facility, the type of illegal drug could not be verified, and a lack of supervision by facility staff could not be substantiated, even if illegal drug use were confirmed to be used at the facility. The allegation may have happened, but there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the finding is unsubstantiated. There are no deficiencies to be cited, at this time, regarding the above allegation. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Christine Wilson 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 1

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


raw_content:
Investigation Findings:
13On 06/16/2023 at 12:30pm Licensing Program Analyst (LPA) Christine WIlson made an unannounced complaint investigation t oChanging Faces Inc. Short Term Residential Therapeutic Program (STRTP) for the purpose of concluding the investigation on the above allegations. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Wilson concluded the above allegations, are unsubstatiated. In circumstantial evidence obtained, the above allegations may have happened, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the finding is unsubstantiated. There are no deficiencies to be cited, at this time, regarding the above allegations. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Christine Wilson 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 3

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

met_with: Skyler Stewart - Case Manager - S13


raw_content:
Investigation Findings:
13On June 28, 2023 at 10:15am, Licensing Program Analyst (LPA) Nancy O'Connell made an unannounced inspection to the above-listed facility, for the purpose of concluding the investigation on the above allegation, and to deliver the finding. Based on confidential interviews with the relevant parties conducted during the investigation process, record review, and documents obtained, LPA Wilson concluded the allegation is unsubstantiated. Supporting evidence includes interviews with house residents and staff. Staff and clients did not provide a preponderance of evidence supporting any observance of staff, demonstrating lack of supervision. Further, it has been reported via the incident report, that minors may have been intoxicated and therefore, there are no witnesses that can corroborate the observance of lack of supervision leading to the allegation. Lastly, staff confirm that there were multiple attempts made to redirect youth to their rooms and staff stayed in direct supervision over youths who did not comply. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Per California Code Regulation, General Licensing Regulations there are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report was emailed to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nancy O'Connell 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 3

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

met_with: Sabrina Echevarria, Direct care staff.


summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On 11/02/ Licensing Program Analyst Connie Jones-Steward visited the facility to conlude the investigation of the above allegations. LPA has previously interviewed all relavent parties including staff and clients. Based on the interviews the allegations were resolved as unsubstantiated due to inconsistencies in the narratives given by those interviewed. There was lack of agreement as to whether the staff spoke disprespectfully to clients, handled them in a rough manner or allowed them to fight with each other. What was determined is that this is "no hand on" facility when it comes to interventions. If clients are physically fighting, staff is limited to trying to get between the clients, re-direct them and verbally de-escalate the situation. Unsubstantiated means that although an allegation could have happened, there is a lack of preponderance of evidence to prove that it did happen. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward 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 3

met_with: Maddie Hernandez, Case Manager


raw_content:
Investigation Findings:
13On 01/25/24 at 10:44AM Licensing Program Analyst (LPA) Jhane Haynes conducted an unannounced inspection to the above facility to deliver findings on the above allegation. LPA met with Jazmine Cooks Senior Program Manager(SPM) who granted access into the facility. During the investigation LPA Nancy O'Connell interviewed and accounted for all available relevant parties; and gathered pertinent information regarding the allegations. It was reported that staff denied the allegations, staff knock before entering client bedroom, staff seeks medical attention for clients as needed and staff intervene when clients engage in any form of altercations. Based on interviews and statements obtained, the complaint findings were found to be unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Jhane Haynes 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 1

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


raw_content:
Investigation Findings:
13On 01/25/24 at 10:44AM Licensing Program Analyst (LPA) Jhane Haynes made a follow up visit to the above facility to deliver findings on the above allegation and conclude the investigation. LPA met Jazmine Cooks Senior Program Manager(SPM) who granted access into the facility. During the investigation LPA Nancy O'Connell interviewed and accounted for all available relevant parties; and gathered pertinent information regarding the allegation. It was reported that the allegation was denied and staff knock before entering client bedrooms. Based on interviews and statements obtained, the complaint findings were found to be unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Jhane Haynes 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 1

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


raw_content:
Investigation Findings:
13On May 2, 2024 at 1:09 pm, Licensing Program Analyst (LPA) Christine Wilson made an unannounced inspection to the above listed facility) for the purpose of concluding the investigation on the above allegation. LPA WIlson was met by the Case Management Rehab Specialist, who allowed entry into the facility. Based on the confidential interviews conducted during the investigation process, record review, statements obtained. During the course of the investigation, it was revealed that staff did check clients rooms often, and staff did report the sexual misconduct to administration. There is not a preponderance of evidence to conclude a lack of supervision. LPA Wilson concluded the allegation: Lack of supervision resulting in minors engaging in inappropriate activity is unsubstantiated; meaning, the allegations may have happened, but there is not a preponderance of the evidence to prove that the alleged violation occurred. There are no deficiencies to be cited, at this time, regarding the above allegation. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Christine Wilson 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 1

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

visit_type: Case Management

met_with: Case Management Rehab Specialist


raw_content:
Narrative:
Page Based on information from record review and confidential interviews, the preponderance of the evidence standard has been met. The Department has determined substantiated finding for neglect/lack of supervision; thus, posing an immediate health, safety and personal rights risk of harm to children placed in care. The facility is issued a citation [See page LIC9099-D for cited deficiencies]. An exit interview was conducted, and appeal rights were discussed. A copy of this report, and appeal rights were provided/emailed to Facility Administrator.

Investigation Findings:
13On JUly 18, 2024 at 9: AM, Licensing Program Analyst (LPA) Christine Wilson, conducted a follow-up complaint inspection to deliver findings on the above allegation. LPA Wilson met with Facility Manager (FM2). LPA Wilson conducted confidential interviews with clients (C2, C3 and C4) and staff (S4). The investigation included confidential interviews with, including but not limited to, facility staff members, clients as well as review of documentation of records, such as Incident Reports, Suspected Child Abuse (SCAR) reports, disclosure notes, Daily and Communication Logs. Interviews and records reviewed revealed at the time and dates of the incident Supervision of clients (C1) and (C6) was lacking, which contributed to inappropriate sexual behavior taking place. Further visual of clients was not maintained due to the construction of a "fort," by client (C6) and assisted by staff (S1) and licensee holds a policy that forts are not allowed due to lack of visibiity that is created. Continued on LIC9099C SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Christine Wilson 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 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION WOODLAND HILLS S.Ro, Ventura Blvd., STE. Woodland Hills, CA Facility Name: Changing Faces, INC.FACILITY NUMBER: VISIT DATE: 07/18/2024

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

met_with: Facility Manager (FM2)


raw_content:
Narrative:
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility.

Investigation Findings:
13On 3/14/25 at 0945, Licensing Program Analyst (LPA) Nestor Gomez, made an unannounced complaint inspection to the above-listed facility, and met with Facility Manager, Vanessa Laron who granted access to the facility. The purpose of this visit is to conduct a follow-up complaint inspection and deliver findings. During the investigative process by Licensing program Analyst (LPA), Nancy O'Connell, all relevant parties have been accounted for. Supporting evidence includes: conflicting interviews with staff and clients, without clear evidence of a past history of beds or furniture being in disrepair. During the time of the initial inspection, LPA O'Connell obtained picture evidence reflecting that all beds in the four bedrooms were in good condition. Further, interviews and observations during the time of the initial inspection reflect that the facility have the required amounts of food available and accessible to clients in care. LPA O'Connell obtained evidence of fruit available on the counter, menu posted in the kitchen and the primary refrigerator and pantry filled with perishable/nonperishable food. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nestor Gomez 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 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION WOODLAND HILLS S.Ro, Ventura Blvd., STE. Woodland Hills, CA Facility Name: Changing Faces, INC.FACILITY NUMBER: VISIT DATE: 03/11/2025

met_with: Facility Manager - Vanessa Laron


raw_content:
Investigation Findings:
13On 3/14/25 at 09:45 am, Licensing Program Analyst (LPA) Nestor Gomez, made an unannounced complaint inspection to the above-listed facility, and met with Facility Manager, Vanessa Laron who granted access to the facility. The purpose of this visit is to conduct a follow-up complaint inspection and deliver the finding for the allegation listed on this complaint. During the investigative process by Licensing program Analyst (LPA), Nancy O'Connell, all relevant parties have been accounted for. Supporting evidence includes: interviews with staff/clients which do not support preferential treatment of youth in care. Specific youth identified to have received preferential care by facility staff could not be identified or located. Evidence obtained does not support any staff, presently or in the past, to have allowed clients to travel to or stay within their personal home. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nestor Gomez 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 1

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


raw_content:
Narrative:
Regarding the allegation that "Staff are being told not to follow reporting requirements",during the investigation, records review and interview evidence revealed that staff are trained and instructed to conduct proper reporting procedures. Other interviews claimed that staff are discouraged from implementing proper reporting procedures. LPA received multiple conflicting reports when asked about the allegations. LPA was able to obtain a copy of every requested report and was able to verify its submission to CRP. Based on the available information LPA gathered from interviews and observation, the preponderance of the evidence standard has not been met, therefore the allegation of "Staff are not following proper reporting requirements" has been found to be unsubstantiated. Regarding the allegation that "Staff face retaliation from management", During the investigation, staff interviews revealed that staff were retaliated against by management including cutting hours and even firing employees to retaliate against employees who spoke up against management practices. Other interviews disclosed that the staff are not retaliated against by management, and employees were let go due to not being good fits with the company or failing to obtain a criminal records clearance. LPA received multiple conflicting reports from staff when asked about the allegations. Based on the available information LPA gathered from interviews and observation, the preponderance of the evidence standard has not been met, therefore the allegation of "Retaliation from management" has been found to be unsubstantiated. An exit interview was conducted, during which LPA provided the Administrator with a copy of this report and a copy of their appeal rights. Facility is being cited for "staff having an altercation with a minor in care" based on LIS STRTP Personal Rights Section 87072 (c) (15): "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: To be accorded dignity in their personal relationships with staff and other persons." Regarding the allegation that "Staff are working without criminal clearance", LPA interviewed involved staff and clients. Interview evidence and record review revealed that the facility is allowing "staff to work without the proper criminal clearance." Interview, observation, and records evidence reveal that ate one time three staff members did not have the proper criminal record clearance yet were allowed to provide care, services, and supervision to the clients and have access to the facility. One staff (S1) was allowed to have access to the facility, to clean, drop off items, and access records, with out a criminal record clearance. Another staff (S2) was allowed to regularly provide rehab services to clients without the proper criminal record clearance. Staff (S3) was allowed to provide direct care and supervision to clients without a criminal records clearance. Based on the available information LPA gathered from interviews and records review, three staff members were found to be in violation, the preponderance of the evidence standard has been met, therefore the allegation of "Staff are working without the proper criminal clearance" is found to be substantiated. The Facility is being cited for violating Title 22, Division Chapter Article 03. Application Procedures Criminal Clearance (e) (2): "All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility: Obtain a California clearance or a criminal record exemption as required by the Department" An exit interview was conducted, during which LPA provided the Administrator with a copy of this report.

Investigation Findings:
13Licensing Program Analyst (LPA) Reagan Cohen investigated the above allegations and created this report. LPA Nestor Gomez arrived at Changing Faces for the purpose of delivering complaint findings regarding the above allegations. LPA Cohen interviewed involved staff and clients. Regarding the allegation that "Staff did not prevent inappropriate interaction between children in care", interview evidence and record review revealed that while an allegation was made, a facility internal investigation and a conversation with the client's Social Worker could not substantiate the claim. The client who made the allegation later recanted their story and admited it to be false. Based on the available information LPA gathered from interviews and observation, the preponderance of the evidence standard has not been met, therefore the allegation of "Staff did not prevent inappropriate interaction between children in care" is found to be unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nestor Gomez 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 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION WOODLAND HILLS S.Ro, Ventura Blvd., STE. Woodland Hills, CA Facility Name: Changing Faces, INC.FACILITY NUMBER: VISIT DATE: 03/14/2025


raw_content:
Investigation Findings:
13On 8/28/2025, at 9:08 am, Licensing Program Analyst (LPA) Nestor Gomez made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation(s) and deliver the findings. LPA spoke with Ashley Del Rio - Case Manager and together, discussed the investigative findings. During the investigative process by Licensing program Analyst (LPA), Nestor Gomez, all relevant parties have been accounted for. The validity of the allegations could not be determined. The parties interviewed either confirmed or denied the allegations. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nestor Gomez 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 1

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

met_with: Ashley Del Rio - Case Manager


raw_content:
Narrative:
Based on the statements and documents obtained, the allegation is determined to be unsubstantiated as the evidence obtained was not sufficient to substantiate the allegation. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. There are no deficiencies cited at this time. Exit interview completed. A copy of this report was emailed to Facility Manager and Facility Administrator.

Investigation Findings:
13On 10/24/2025, at 11: AM, Licensing Program Analyst (LPA), Andrew Upshaw conducted a subsequent complaint inspection to deliver findings concerning the above-mentioned allegation. LPA Upshaw met with Vanessa Laron, Facility Manager, to discuss the investigative outcome. On 08/12/2025, Community Care Licensing Division (CCLD) received a complaint alleging that clients are bringing methamphetamine into the facility, and that facility staff are not intervening. The allegation was referred to CCLD Investigations Branch, and the investigation was conducted by Investigator Douglas Real. Confidential interviews were conducted with multiple clients and facility staff. During confidential interviews all parties interviewed indicated that they do not have knowledge of any clients bringing methamphetamine into the facility. It was indicated during confidential interviews that there is a no drugs and alcohol policy in the facility and that staff conduct room searches and have clients shake out their clothes to ensure they do not have contraband when clients return from unauthorized absences. (Continued on page 9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Andrew Upshaw 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 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290b El Segundo, CA Facility Name: Changing Faces, INC.FACILITY NUMBER: VISIT DATE: 10/24/2025

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

met_with: Vanessa Laron, Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On November 2, 2021 at 09:45am Licensing Program Analysts (LPA) Enrique Hernandez conducted an unannounced inspection, at the above-said facility, for the purpose of conducting an Annual Required Inspection. LPA met with Rosalie Romero Program Manager (PM) who granted access into the facility and provided a tour of the entire facility, inside and out. This is a four bedroom, two and a half bathroom, single story family residence that includes a living room, dining area, kitchen, laundry area, staff offices and a detached garage converted to group therapy room and visitation room. LPA toured the entire facility with the PM and observed the following: Bedroom #1 is occupied by two female clients, it has two twin size beds, adequate closet and drawer space. Bedroom #2 is occupied by two female clients, it has two twin size beds, adequate closet and drawer space and a half bathroom (toilet). Bedroom #3 is vacant, it has two twin size beds, adequate closet and drawer space and a private bathroom. Bedroom #4 is occupied by two female clients, it has two twin size beds, adequate closet and drawer space and a private bathroom with a bathtub. LPA observed adequate non-perishable foods for one week and perishable food for two days. In between meal snacks is available in the facility. Facility is clean, safe, sanitary, and in good repair. Passageways, inclines, and Porsches are unobstructed. Rules, regulations, licenses, emergency disaster plan and personal rights are posted at the facility. Menu is posted in the kitchen. Hazardous and cleaning solutions, disinfectants, poisons, medication and sharp knives are inaccessible to the clients. Continued on LIC809-C Meds have a double locked and accessible only to employees supervising stored medications. Home has working smoke alarms, carbon monoxide detector and fire extinguishers at the time of this inspection. Client Bedrooms are inspected and found to be in compliance. Bathrooms were toured and found to have regulation temperature hot water. The facility has a working telephone/landline. There is no bodies of water on the premises. Licensing staff requested copies of, and received the following documents: Staff / Client roster, Monthly Fire Drill records within the last year, Board of Director Meeting Minutes, The licensee will email the Operations and Safety Manual and national accreditation certificate LPA will return to continue the annual/ required inspection to review personnel and client's files to ensure it meets regulatory requirements. LPA also will conduct interviews with clients and staff at a later date. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 4.0, there are no deficiencies to be cited at this time. Exit interview was conducted and a copy of this report was left with the Program Manager whose signature on this form confirm receipt of this document.

report_type: Facility Evaluation

visit_type: Annual

met_with: Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 12/28/23 at 02:27PM Licensing Program Analyst (LPA) Jhane Haynes arrived at the above facility, for the purpose of conducting Annual/Random inspection. LPA met with Associate Professional Clinical Counselor (APCC) Aysia Reiwaldt who granted access into the facility. Together LPA and APCC toured the facility. It is a one-story home in a residential area licensed to care for children ages 12-17, ambulatory only. LPA observed the following during facility tour: Living Room equipped with adequate seating for clients; couch, couch chairs, TV, and fireplace inaccessible to clients. Dining Area is equipped with a table, adequate seating for clients, staff desk. Board behind staff desk has required postings: facility and administrative license, personal rights. Kitchen is equipped with functional refrigerator, stove, oven, and microwave. There are snacks for in-between meals. Refrigerator operating temperature does not exceed 45 degrees and freezer at 0 degrees. There are perishables for two days and non-perishables for up to a week located in pantry. There is adequate dinnerware for clients. Menu is posted on fridge. Fire extinguisher placed on wall near pantry. Sharps are secured in a locked container in secured pantry. Hallway leading to bedroom 3 and 4 contains TV, bookcase and closet facility uses as a "ticket store" as client incentives. Bedroom #1 is equipped with two twin beds, two dressers and closet. It rooms C6. Bedroom #2 is equipped with two twin beds, two dressers and closet. Bedroom also features ensuite half bathroom. It rooms C4 and C7. Bedroom #3 is equipped with two twin beds, two dressers and closet. It rooms C5 and C1. Bedroom #4 is equipped with two twin beds, two dressers and closet. It rooms C2 and C3. See LIC809-C Bathroom #1 is located between bedroom 1 and 2 contained functioning sink, toilet, tub and separate shower. There is a cabinet with extra linen storage. Staff Office is equipped with desk and chairs. It contains first aid kit, locked file cabinets and cameras and door to med room. Emergency first aid and food supplies are kept, and cleaning supplies and extra hygiene products are secured. Med Room is equipped with secured cabinets where client medications, small refrigerator and log are stored. Key to med room is secured in staff office. Laundry contains two washers and dryers, refrigerator, and freezer for extra food storage. It also has a couch, TV, and half bathroom with function toilet and sink as well as door for to therapy cottage. A fire extinguisher is located adjacent to appliances. Therapy Cottage is used by clients for activities or therapy sessions. There's chairs and desk for zoom. Exterior contains large, locked storage container that extra supplies not limited to clothing, paper and cleaning supplied are stored. A gazebo with chairs were found, picnic table and storage shed of youth belongings that are away from care and excess items. Pathways were free and clear of any obstructions. Due to time constraints, LPA will return to continue annual inspection. No deficiencies will be cited at this time. An exit interview was conducted, and a copy of this report was left the facility manager.

met_with: Aysia Reiwaldt Associate Professional Clinical Counselo(APCC)


summary: Facility Evaluation

raw_content:
Narrative:
On 12/28/23 at 11: Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of continuing facility annual inspection. LPA met with Facility Manager(FM) Rosalie Romero who granted access to the facility and provided a desk for file review. LPA reviewed files of FA, FM, S1,S2,C2,C3,C5 and C7. LIC811 for names. Client files contained all required documents not limited to needs and service plans, admissions agreement, cash resources and medical assessments. Staff files included current training, personnel records, education background and health screening. File of S2 was observed to be missing required health screening. All client files are maintained and contained required documents. SPM stated it was completed and will be obtained by doctor the following week. Staff associated to facility have obtained criminal record clearance from DOJ, FBI and CACI. During visit, Senior Program Manager (SPM) Jazmine Cooks took over to relieve FM's shift. Due to technical issues, LPA will return at another date to complete review. Per Title Division Chapter 1 one deficiency will be cited today. See LIC809-D for details. An exit interview was conducted and copy of this report was left with facility administrator.

met_with: Jazmine Cooks Senior Program Manager(SPM)


summary: Facility Evaluation

raw_content:
Narrative:
On 01/25/24 at 10: AM Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of continuing annual inspection after previous technical issues. LPA met with Jazmine Cooks Senior Program Manager(SPM) who granted access to the facility. LPA reviewed the disaster preparedness plan and conducted interviews with FM, S1, S2, S3. No clients were in the home at the time of the visit to complete interviews. Disaster preparedness plan observed to be in compliance. This concludes the annual inspection. There are no deficiencies to be cited at this time. An exit interview was conducted, and a copy of this report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 07/26/24 at 12:50PM Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of conducting a case management inspection following an incident report received by the department on 07/05/24. Former staff contacting client within facility. LPA met with the Senior Program Manager(SPM) Jazmine Cooks who granted access to the facility. LPA conducted interview with S1, S2 and S3. LPA also obtained incident report supporting documents. Further investigation is needed to determine whether a violation occurred. No deficiencies will be cited at this time. An exit interview was conducted, and this report was emailed to the Senior Program Manager.


summary: Facility Evaluation

raw_content:
Narrative:
On 5/16/25, at 9:00 am, Licensing Program Analyst (LPA) Nestor Gomez conducted an unannounced case management follow up for an incident report received on 5/10/25 for the above mentioned facility. LPA was met by Direct Care Staff (S6) Jazmin Lemus who granted access into the facility. LPA requested the LIC 500 and client roster. LPA conducted an interview with C1. Further investigation or interviews are required on the above incident. Exit interview was conducted with the S4, Amanda Stillwell and a copy of this report will be emailed to S4.

met_with: Jazmin Lemus - Direct Care staff


summary: Facility Evaluation

raw_content:
Narrative:
On 11/3/25 at 10:00am Licensing Program Analyst (LPA) Nancy O'Connell arrived at the above facility, for the purpose of conducting Annual/Random inspection. LPA met with Vanessa Laron, residential counselor, who granted access into the facility. The facility is a one-story home in a residential area licensed to care for children ages 12-17, ambulatory only. LPA observed the following: Living Room equipped with adequate seating for clients; couch, couch chairs, TV, and fireplace inaccessible to clients. Dining Area is equipped with a table, adequate seating for clients, staff desk. Board behind staff desk has required postings: facility and administrative license. Kitchen is equipped with functional refrigerator, stove, oven, and microwave. There are snacks for in-between meals. Refrigerator operating temperature does not exceed 45 degrees and freezer at 0 degrees. There are perishables for two days and non-perishables for up to a week located in pantry. There is adequate dinnerware for clients. Fire extinguisher placed on wall near pantry. Sharps are secured in a locked container in the staff office. Hallway contains TV, bookcase and closet facility uses as a "ticket store" as client incentives. Bedroom #1 is equipped with two twin beds, two dressers and closet. Bedroom #2 is equipped with two twin beds, two dressers and closet. Bedroom also features ensuite half bathroom. Bedroom #3 is equipped with two twin beds, two dressers and closet. Bedroom #4 is equipped with two twin beds, two dressers and closet. continued on LIC809C Bathroom #1 is located between bedroom 1 and 2 contained functioning sink, toilet, tub and separate shower. There is a cabinet with extra linen storage. Staff Office is equipped with desk and chairs. It contains first aid kit, locked file cabinets and cameras and door to med room. Emergency first aid and food supplies are kept, and cleaning supplies and extra hygiene products are secured. Med Room is equipped with secured cabinets where client medications, small refrigerator and log are stored. Key to med room is secured in staff office. Laundry contains two washers and dryers, refrigerator, and freezer for extra food storage. It also has a couch, TV, and half bathroom with function toilet and sink as well as door for to therapy cottage. A fire extinguisher is located adjacent to appliances. Therapy Cottage is used by clients for activities or therapy sessions. There's chairs and desk for zoom. Exterior contains large, locked storage container that extra supplies not limited to clothing, paper and cleaning supplied are stored. A gazebo with chairs were found, picnic table and storage shed of youth belongings that are away from care and excess items. Client/Staff Interviews: LPA conducted a confidential interview with: FC1, FC3, FC4, and RS1. During the time of inspection, LPA completed the Care Tool for STRTPs and completed the Physical Plant. Per California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulation, and STRTP Interim Licensing Standards (ILS) Version 5, there are no deficiencies cited during this inspection. An exit interview was conducted, and staff was informed that the annual inspection would be completed on another day. A copy of this report was sent to the administrator via email.

met_with: Vanessa Laron, Residential Counselor (RS1)


summary: Facility Evaluation

raw_content:
Narrative:
On 11/10/25 at 10:00AM Licensing Program Analyst (LPA) Nancy O'Connell made an unannounced visit to the above-listed facility for the purpose of conducting a Case Management - Annual Continuation inspection. LPA was met Amanda Stillwell, Case Manager. LPA met with CM and informed them that the purpose of the visit is to complete the Annual Inspection. LPA inquired about the current census, requested the Register of Clients, and a staff roster. LPA requested to review selected staff and staff files. See LIC811, dated 11/10/25, for names. Client/Staff File reviews: LPA conducted file reviews for: C1, C2, C3, C4, C5, FA, CM, S1, S2, and S3. During the time of inspection, LPA reviewed the Care Tool for STRTPs and completed the following sections: Operations, Disaster Preparedness, Emergency Intervention, Client Records, Staff Records, and Core Therapeutic Services. Per California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulation, and STRTP Interim Licensing Standards (ILS) Version 5, there are no deficiencies cited during this inspection. An exit interview was conducted, and staff was informed that the annual inspection was complete. A copy of this report was sent to the administrator via email.

met_with: Amanda Stillwell, Case Manager (CM)


raw_content:
Narrative:
Due to a lack of evidence obtained during the investigation, LPA Gray determined that the allegations are Unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that a violation occurred. There are no deficiencies cited at this time. An exit interview was conducted, and a copy of this report was emailed to the Facility Manager and the Administrator.

Investigation Findings:
13On 10/24/2025 at 11: AM Licensing Program Analyst (LPA) Andrew Upshaw made an unannounced visit to conclude the investigation. Prior to entering the facility LPA Upshaw conducted a health and safety risk assessment. During the investigation, LPA Gray interviewed all relevant parties available and gathered pertinent information in reference to the allegation. Based on confidential interviews and documentary evidence, there is no evidence to determine that facility staff did not provide adequate supervision resulting in minors being assaulted by another minor in care. Documented evidence determined that Client 1 (C1) was assaulted. C1 did not provide any names of information in reference to reported allegations. Records determined that the facility developed a Safety Plan to monitor C1's symptoms, to protect them from being allegedly bullied. Crisis interventions were utilized to de-escalate, intervene, redirect clients and prevent clients from being verbally and physically assaulted. -Continued on 9099-C- UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Andrew Upshaw 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 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290b El Segundo, CA Facility Name: Changing Faces, INC.FACILITY NUMBER: VISIT DATE: 10/24/2025

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


summary: Facility Evaluation

raw_content:
Narrative:
On 7/30/2025, at 2:00 pm Licensing Program Analyst (LPA) Nestor Gomez made an unannounced inspection to the above-mentioned facility, for the purpose of following up on a Case Management inspection regarding an incident report that was received on 5/10/2025. LPA met with Facility Manager (FM), Vanessa Laron, who granted access to the facility. No further investigation or interviews are required on the above incident. PER California Code Regulation 80072 (a)(3), there are one (1) deficiency to be cited at this time. See 809-D. Exit interview was conducted and a copy of this report will be emailed the Facility Administrator, (FA), Adrian Cooks.

met_with: Vanessa Laron - Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On August 25, 2021 at 8:30 am Licensing Program Analyst (LPA) Enrique Hernandez made an unannounced inspection to the above said facility for the purpose of conducting a Case Management Inspection to address concerns regarding reporting requirements. LPA met with Program Manager Rosalie Ramiro, who granted access to the facility and together discussed the reporting requirements. On 8/10/2021 the Department received multiple incident reports dated back from June 2021. The facility was under the impression that only law enforcement incidents need it to be submitted. LPA received an email from the licensee Stephanie Cooks on 8/11/2021 with a plan of correction regarding that Special Incidents Reports sent on a timely manner. LPA have informed the facility administrator on 2/4/2021 and on 4/29/2021 the importance of submitting unusual incident reports and not just incidents that law enforcement was involved PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 3.1, The following deficiency is to be cited Exit interview conducted, and a copy of this report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 08/30/2021, Licensing Program Analyst (LPA) Enrique Hernandez conducted a Case Management - Incident inspection at the above facility in response to two Special Incident Reports that were submitted to Community Care Licensing (CCL), in order to investigate a possible violation. LPA met with the Facility Administrator Adrian Cook and Breanna McCormick (Sr. Program Manager/ Administrator) who granted access at the facility Agape STRTP. LPA discussed the incidents with Adrian Cook and Breanna McCormick. One incident, which occurred on 07/11/2021, involved a client (C1), who was not given the medication by staff (S1); the other incident, which occurred on 08/23/2021, involved client (C2), who was given the medication by staff (S2). [See LIC Confidential Names List form (LIC811), dated 08/30/2021, for names]. LPA interviewed the Facility Administrator (FA), who confirmed that client's medication was administered to clients (C1 and C2). Adrian Cook said training will be provided to properly administer the medications, so this doesn't happen again. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 3.1, The following deficiency is cited (See 809-D) Exit interview was conducted and a copy of this report was left at the home with the Licensee whose signature on this form confirm receipt of this document.

met_with: Administrator


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On June 7, 2022 at 8:00 am Licensing Program Analysts (LPAs), Emelyn Sanchez P. and Olivia Rosas arrived at Changing Faces, INC. unannounced for the purpose of conducting a SB Psychotropic Medication Case Management- Medication Inspection Visit. LPAs Sanchez P. and Rosas met with Adrian Cooks, Administrator. LPAs Sanchez P. and Rosas reviewed three (3) client files and three (3) staff files. LPAs Sanchez P. and Rosas conducted three (3) staff interviews and one (1) client interview. Currently there are six (6) clients residing in the above facility. During the review of client records, LPAs Sanchez P. and Rosas reviewed 3 files and observed 2 out of 3 client files did not contain the proper authorization for the use of psychotropic medications. The facility did not have current JV 220 and JV223 for Client#1 (C1), and Client#3 (C3) that authorizes the use of psychotropic medication. This is a single story facility located in a residential area and equipped with four (4) bedrooms, (2) two and a half bathrooms, living room, dining area, kitchen, laundry space, one (1) staff office and a detached garage converted to group therapy room and visitation room. There are no bodies of water on the premises. Common areas area clean and in good repair. Rooms are fully furnished with two beds, and closet space. Outdoor space is free of obstructions. Report continues on LIC809-C LPAs Sanchez P. and Rosas observed the facility to be clean, safe, sanitary and in good repair. LPAs Sanchez P. and Rosas observed adequate staffing in the facility to provide care and supervision to children in care. LPAs Sanchez P. and Rosas also observed medication to be stored in the Staff Office triple locked and inaccessible to clients and unauthorized staff members. One deficiency was observed (refer to LIC 809D) and cited from the California Code of Regulations, Title 22, and Health & Safety Codes during the inspection. Exit interview was conducted, and a copy of this report was left at the facility.

Deficiencies:
87070: Based on the review of clients records1
2
3
4
5
6
7Facility will ensure client files contain proper authorization for the use of psychotropic medications such as the JV220 and JV223. Facility will obtain current and updated JV220 and JV223 forms from clients authorized representatives.
8
9
10
11
12
13
14the facility did not ensure that client file contained the proper authorization for the use of psychotropic medications.

met_with: Adrian Cooks, Administrator

title: (b)(11) Children's Records. A copy of the current court order, or written authorization of the child's parent or guardian, for each psychotropic medication, as defined in Section 87001(p)(8). This requirement is not met as evidenced by


summary: Facility Evaluation

raw_content:
Narrative:
On 1/18/23 at 4:10pm, Licensing Program Analyst (LPA) Nancy O'Connell, made an unannounced inspection to the above-listed facility, in order to conduct a case management-incident inspection. LPA met with the Facility Administrator (FA), who granted access to the facility and provided a tour of the facility, inside and out. On 1/17/23, the Department received a Serious Incident Report from the facility DATED 1/13/23, reporting that a resident engaged in self harm and drank cleaning solution ("Windex") while in the facility, which resulted in a hospitalization. LPA spoke with staff and inquired about details of the incident and asked about reason why chemical was accessible to resident, and staff responded-" I assume they took it when we took it out to do chores." LPA observed cleaning supply cabinet and observed cleaning supplies. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 4, a deficiency will be cited at this time. Exit Interview conducted, and a copy of this report was sent to the facility.

met_with: Skyler Stewert, Case Manager


summary: Facility Evaluation

raw_content:
Narrative:
On May 23, 2023 at 10:50 am, Licensing Program Analyst (LPA) Christine Wilson made an unannounced visit to the above listed facility, in order to conduct a case management deficiency.LPA Wilson was met by (S1) who allowed entry to the facility. Report was reviewed with staff S2. During the course of the complaint investigation (Complaint Control# 34-CR-20230317111939), it was discovered that an incident report 79877148, on 03/15/23 for the youth (C2) was not reported to Community Care Licensing (CCL). On 05/10/23, LPA Wilson spoke to staff (S6) via telephone, and requested that the Incident Report be sent to CCL A (1) deficiency Type B has been determined at this time. The following deficiency has been cited. (See LIC 809D) An exit interview was conducted and Plans of Correction was developed and reviewed with the licensee. A copy of this report and appeals rights were discussed and left with licensee. (S1) whose signature on this form confirm receipt of these documents.

met_with: Staff #2 (S2)


summary: Facility Evaluation

raw_content:
Narrative:
On September 1, 2023 at 1:09 pm, Licensing Program Analyst (LPA) Christine Wilson made an unannounced visit to the above listed facility, in order to conduct a case management inspection. LPA Wilson was met by (S1) Case Manager who allowed entry to the facility. During the course of the complaint investigation (Complaint Control# 34-CR-20230321140006), deficiencies were observed that did not fall into one of the allegations. This complaint investigation revealed a lack of supervision by staff (S2), who drove four (4) clients to a liquor store to cash a check, which resulted in clients stealing and consuming alcohol. Choosing to bring clients to a liquor store is not something staff should do. The following deficiency has been cited. (See LIC 809D) An exit interview was conducted, a copy of this report was left with the licensee, and appeals rights were discussed.

met_with: Case Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 07/26/24 at 12:50PM Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of conducting a case management inspection following an incident report received on 07/22/24. Staff over administered client medication. LPA met with Senior Program Manager(SPM) Jazmine Cooks who granted access to the facility. LPA spoke with FA, reviewed the medication log, and obtained medication training log. LPA observed a violation of the Interim Licensing Standards(ILS) was found and the facility will be cited. Per ILS Article Sec 87075, one deficiency will be cited today. See LIC809-D for details. An exit interview was conducted, and a copy of this report and appeal rights was emailed to the Senior Program Manager.


raw_content:
Investigation Findings:
13On 1-12-26, at 11:05am, Licensing Program Analyst (LPA) Nancy O'Connell made an unannounced inspection to the above facility for the purpose of concluding a follow-up investigation on the above allegation and deliver the findings. LPA spoke with Vanessa Laron, Facility Manager (FM) and together, discussed the investigative finding. During the investigative process by Licensing program Analyst (LPA), Nancy O'Connell, all relevant parties have been accounted for. During the investigative process, LPA obtained information regarding medication distribution procedures, supervision policies, and interpersonal interactions between staff and clients. Statements obtained did not support clear evidence that staff do not monitor and store medications correctly, and that staff do not supervise youth in care according to facility policies. Further, evidence did not support clear findings that staff do not provide a safe and respectful envirnment to children in care. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and an electronic copy of this report was provided to the facility administrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nancy O'Connell 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 1

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

met_with: Vanessa Laron, Facility Manger (FM)


summary: Facility Evaluation

raw_content:
Narrative:
On 4-13-26 at 10:00am, Licensing Program Analyst (LPA) Nancy O'Connell, and Licensing Program Manager (LPM) Enrique Hernandez made an unannounced inspection to the above-listed facility, and met with Vanessa Laron, Facility Manager (FM). The purpose of this inspection is to conduct a Case Management-Incident inspection regarding a report that was submitted to the Department on 4-8-26. On 4-8-26, the Department received a Serious Incident Report (SIR) from the facility, indicating that a serious incident took place while staff and C1 were out in the community on 4-6-26. The report reports that on 4-6-26, C1 requested clothing items from staff and was denied access to personal clothing items. As a result, C1 became escalated and left the facility without authorization. During the time of the inspection LPA conducted confidential interviews with FM, CM, C5, and C7. [See Confidential Names form (LIC811), dated 4-13-26, for names]. LPA obtained the following reports for C1: Needs and Services Plans, Emergency Intervention Policies, Personnel report, and the current client roster. Based on LPAs observations and interviews, and review of documented evidence, further investigation is needed. No deficiencies are cited today. Exit Interview conducted, and a copy of this report was sent to the facility administrator.


facility_name: CHARIS YOUTH CENTER- KOINONIA HOUSE

raw_content:
Investigation Findings:
13Licensing Program Analyst, (LPA) Robyn Word conducted a follow-up complaint investigation for the above allegations. LPA met with Geoffrey Frey- Assistant Facility Manager on 6/19/2021 at 12:44PM. During the complaint investigation, LPA conducted a site inspection and reviewed staff and residents' files. Copies of pertinent documentation including: training records, needs and services plans, and case notes were obtained on 2/9/2021. During the investigation LPA Word conducted interviews with staff, FC1, FC2,FC3 and Program Manager (see LIC 811 dated 6/19/2021 for confidential names list). Due to inconsistent statements the LPA was unable to determine if FC2 accidentally bumped into FC1, or if FC2 purposely grabbed FC1 private area. The staff stated that if FC2 had wondering behaviors and would walk in and out of the resident's room, and when redirected she would immediately walk out. Staff stated that it wasn't a malicious thing, it was more so of FC2 forgetting her whereabouts. As a result of the investigation and information obtained, the complaint finding is UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted, and a copy of the 9099 and appeal rights were left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Daniel Allmon LICENSING EVALUATOR NAME: Robyn Word 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 2

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


raw_content:
Investigation Findings:
13Licensing Program Analyst, (LPA) Robyn Word conducted a follow-up complaint investigation for the above allegations. LPA met with Geoffrey Frey- Assistant Facility Manager on 6/19/2021 at 1:44PM. During the complaint investigation, LPA conducted a site inspection and reviewed staff and residents' files. Copies of pertinent documentation including: training records, needs and services plans, inventory sheets, incident reports and case notes were obtained on 3/30/2021. During the investigation LPA Word conducted interviews with staff, FC1, FC2,FC3 and Program Manager (see LIC 811 dated 6/19/2021 for confidential names list). Due to inconsistent statements the LPA was unable to determine if FC1 was prevented from participating in her therapy group due to not filling out an inventory sheet. Staff, and residents stated that the house manager never refused therapy to any of the residents and would always encourage the residents to attend therapy. The house manager stated that she has never denied FC1 access to therapy. As a result of the investigation and information obtained, the complaint finding is UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted, and a copy of the 9099 and appeal rights were left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Daniel Allmon LICENSING EVALUATOR NAME: Robyn Word 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 2

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


raw_content:
Narrative:
As a result of the investigation and information obtained, the complaint finding is UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted, and a copy of the 9099 and appeal rights were given to the Director on 9/21/2021.

Investigation Findings:
13Licensing Program Analyst (LPA) Robyn Word conducted a follow-up complaint investigation. LPA met with Alisa Wood Program Director/Clinical Head of Service at 12:00PM. During the complaint investigation, LPA conducted a site inspection and reviewed staff and residents' files. Copies of pertinent documentation including: Training Records, Program Statements, Grocery Receipts, and Menus were obtained on 6/19/2021. During the investigation LPA Word conducted interviews with Reporting Party, Staff, Program Director, FC1, and FC2 (see LIC 811 dated 9/21/2021 for confidential names list). Due to inconsistent statements, and review of documentation the LPA was unable to determine if youth are not receiving appropriate lunches while at school. The School Staff, and Residential Director stated that during summer break the school was receiving nutritional school lunches provided by the community food bank. The Director stated that the facility was also providing supplemental meals to the school as well, and the licensed residential facility never received any meals from the food bank. FC1, and FC2 stated that the lunches were standard: sandwiches, chips, juices and fruits and would change based on the day of the week. (Please see continuation page) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Daniel Allmon LICENSING EVALUATOR NAME: Robyn Word 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, COHASSET RD., SUITE FACILITY NAME: CHARIS YOUTH CENTER- KOINONIA HOUSEFACILITY NUMBER: VISIT DATE: 09/21/2021


raw_content:
Narrative:
The Administrator stated that due to COVID-19 there were challenges in ensuring that each staff completed their full pro act training in a timely manner. The Administrator provided training records for all staff at the facility that included: de-escalation training, trauma informed training, nonverbal ques training, and assertive communication training. As a result of the investigation and information obtained, the complaint finding is UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted, and a copy of the 9099 and appeal rights were given to the Director on 9/21/2021.

Investigation Findings:
13Licensing Program Analyst (LPA) Robyn Word conducted a follow-up complaint investigation. LPA met with Alisa Wood Program Director/Clinical Head of Service at 12:00PM. During the complaint investigation, LPA conducted a site inspection and reviewed staff and residents' files. Copies of pertinent documentation including: Needs and Services, CFT meeting records, incident reports, and 14-day notice was obtained on 6/19/2021, and 9/21/2021. During the investigation LPA Word conducted interviews with Reporting Party, Staff, Program Director, FC1, and FC2 (see LIC 811 dated 9/21/2021 for confidential names list). Statements in interviews revealed that the staff would try to assist FC1 with cleaning up after herself, and FC1 would decline their help, and not allow the staff in her bedroom. The facility provided additional therapy services to FC1, and placed FC1 in a room by herself. FC1 behaviors became triggering for the other residents and a 14-day notice was placed on FC1 as of 9/15/2021. (Please see continuation page) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Daniel Allmon LICENSING EVALUATOR NAME: Robyn Word 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, COHASSET RD., SUITE FACILITY NAME: CHARIS YOUTH CENTER- KOINONIA HOUSEFACILITY NUMBER: VISIT DATE: 09/21/2021


facility_name: CHARIS YOUTH CENTER- NIKAO HOUSE

raw_content:
Narrative:
As a result of the investigation and information obtained, the complaint finding is UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted, and a copy of the 9099 and appeal rights were given to the Director on 9/21/2021.

Investigation Findings:
13Licensing Program Analyst (LPA) Robyn Word conducted a follow-up complaint investigation. LPA met with Alisa Wood Program Director/Clinical Head of Service at 12:00PM. During the complaint investigation, LPA conducted a site inspection and reviewed staff and residents' files. Copies of pertinent documentation including: Training Records, Program Statements, Grocery Receipts, and Menus were obtained on 6/19/2021. During the investigation LPA Word conducted interviews with Reporting Party, Staff, Program Director, FC1, and FC2 (see LIC 811 dated 9/21/2021 for confidential names list). Due to inconsistent statements, and review of documentation the LPA was unable to determine if youth are not receiving appropriate lunches while at school. The School Staff, and Residential Director stated that during summer break the school was receiving nutritional school lunches provided by the community food bank. The Director stated that the facility was also providing supplemental meals to the school as well, and the licensed residential facility never received any meals from the food bank. FC1, and FC2 stated that the lunches were standard: sandwiches, chips, juices and fruits and would change based on the day of the week. (Please see continuation page) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Daniel Allmon LICENSING EVALUATOR NAME: Robyn Word 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, COHASSET RD., SUITE FACILITY NAME: CHARIS YOUTH CENTER- NIKAO HOUSEFACILITY NUMBER: VISIT DATE: 09/21/2021


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst, Kate Mensah conducted a Case Management Inspection on October 20, 2021, at 10: AM, based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code Section 1538.7. 4 out of Direct Care Staff and 6 out of 6 youth files as identified on the LIC Confidential Names dated October 20, 2021, were reviewed. 2 out of the Direct Care Staff and 6 out of 6 youth were also interviewed. The Plan of Operation including policies and procedures were reviewed. A copy of this report was discussed and provided to Jonathan Stockdale, Administrator.

met_with: Heather Madison, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Robyn Word conducted a case management visit to follow up on an incident that occurred 11/15/2021 involving resident FC1 and staff K. Woo (see confidential names list dated 11/18/2021) the incident report stated that law enforcement was called due to there being a report that staff KW was mistreating FC1. The incident report stated that Deputy Mackey spoke with staff K. Woo, witnessed the youth in question sitting and enjoying a movie calmly with his peers, and left stating that he did not see any reason to write a report or take the complaint further. LPA Word conducted an interview with staff K. Woo, the house manager, FC1 therapist, FC2, and staff MF, resident FC1 was discharged on 11/17/2021. At this time the incident needs further investigation.

met_with: William Butz- House Manager


facility_name: CHARIS YOUTH CENTER-PETRA HOUSE

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Robyn Word conducted a virtual follow-up complaint investigation. LPA Word emailed complaint finding for the above allegation to Alica Wood-Program Director/Clinical Head of Service at 1:30PM. During the complaint investigation, LPA conducted a virtual site inspection and reviewed staff and residents' files. Copies of pertinent documentation including: training records, needs and services plans, and case notes were obtained on 1/22/2021. During the investigation LPA Word conducted interviews with staff, FC1, FC2,FC3 and Program Manager (see LIC 811 dated 5/14/2021 for confidential names list). Due to inconsistent statements the LPA was unable to determine if the Staff physically assaulted FC1 while in care, or if the staff spoke inappropriately towards FC1 while in care. Residents and staff stated that FC1 was the one that physically assaulted staff. Residents also stated that they have never witnessed the staff speak inappropriately towards FC1. As a result of the investigation and information obtained, the complaint finding is UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted, and a copy of the 9099 and appeal rights were emailed to the Director on 5/14/2021. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Daniel Allmon LICENSING EVALUATOR NAME: Robyn Word 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 2

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

met_with: Alisa Wood-Program Director/Clinical Head of Service


raw_content:
Investigation Findings:
13Licensing Program Analyst, (LPA) Robyn Word conducted a follow-up complaint investigation for the above allegations. LPA met with Geoffrey Frey- Assistant Facility Manager on 6/19/2021 at 12:44PM. During the complaint investigation, LPA conducted a site inspection and reviewed staff and residents' files. Copies of pertinent documentation including: training records, needs and services plans, incident reports and case notes were obtained on 3/5/2021. During the investigation LPA Word conducted interviews with staff, FC1, FC2,FC3 and Program Manager (see LIC 811 dated 6/19/2021 for confidential names list). Due to inconsistent statements the LPA was unable to determine if the above allegations did occur. Staff and residents stated that they have never heard any staff make inappropriate comments to FC1, and that FC1 was never denied a home visit, and due to COVID-19 some visits would have to be on grounds, staff and residents also stated that they have never witnessed a staff smoking with the residents. Residents stated that there are cameras on grounds and the staff never suggested that they smoke. As a result of the investigation and information obtained, the complaint finding is UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted, and a copy of the 9099 and appeal rights were left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Daniel Allmon LICENSING EVALUATOR NAME: Robyn Word 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 2

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


raw_content:
Narrative:
As a result of the investigation and information obtained, the complaint finding is UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted, and a copy of the 9099 and appeal rights were given to the Director on 9/21/2021.

Investigation Findings:
13Licensing Program Analyst (LPA) Robyn Word conducted a follow-up complaint investigation. LPA met with Alisa Wood Program Director/Clinical Head of Service at 12:00PM. During the complaint investigation, LPA conducted a site inspection and reviewed staff and residents' files. Copies of pertinent documentation including: Training Records, Program Statements, Grocery Receipts, and Menus were obtained on 6/19/2021. During the investigation LPA Word conducted interviews with Reporting Party, Staff, Program Director, FC1, and FC2 (see LIC 811 dated 9/21/2021 for confidential names list). Due to inconsistent statements, and review of documentation the LPA was unable to determine if youth are not receiving appropriate lunches while at school. The School Staff, and Residential Director stated that during summer break the school was receiving nutritional school lunches provided by the community food bank. The Director stated that the facility was also providing supplemental meals to the school as well, and the licensed residential facility never received any meals from the food bank. FC1, and FC2 stated that the lunches were standard: sandwiches, chips, juices and fruits and would change based on the day of the week. (Please see continuation page) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Daniel Allmon LICENSING EVALUATOR NAME: Robyn Word 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, COHASSET RD., SUITE FACILITY NAME: CHARIS YOUTH CENTER-PETRA HOUSEFACILITY NUMBER: VISIT DATE: 09/21/2021


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Robyn Word conducted a follow-up complaint investigation. LPA met with Alisa Wood Program Director/Clinical Head of Service at 12:00PM. During the complaint investigation, LPA conducted a site inspection and reviewed staff and residents' files. Copies of pertinent documentation including: Needs and Services, Incident reports, Program statements, Menus, and Grocery receipts were obtained on 6/19/2021, and 9/21/2021. During the investigation LPA Word conducted interviews with Reporting Party, Staff, Program Director, FC1, and FC2 (see LIC 811 dated 9/21/2021 for confidential names list). Statements in interviews revealed that FC1 mail was provided to her the next day. The Director, and residents stated that after a specified meal if a client is still hungry they are provided additional food choices, The Director stated that the facility is not mandated to serve wheat bread to the clients, As a result of the investigation and information obtained, the complaint finding is UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted, and a copy of the 9099 and appeal rights were given to the Director on 9/21/2021. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Daniel Allmon LICENSING EVALUATOR NAME: Robyn Word 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 2

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


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPAs) Robyn Word, and Kellie McKinley conducted an unannounced Annual/Required Inspection on 8/4/2021 at the facility office located at West Main Street Grass Valley, CA 95945 beginning at 10: AM. LPAs met with Heather Madison, Operations Manager, and explained the purpose of the inspection. The facility is licensed for 6 clients and currently serves 4 clients. The facility serves severely emotional disturbed residents between the ages 14-16. All staff and resident files are kept in a locked cabinet at this location. The LPAs reviewed two resident files, and four staff files. The LPAs also reviewed the programs operations file. All required documentation were present. No deficiencies were noted in client, or staff files. LPAs were unable to finish the Annual Inspection and will return on another date and time to conduct the physical plant inspection. No citations were issued on today's date. Exit interview conducted, Due to technical difficulties, and a power outage a copy of the 809 will be emailed to the Operations Manager.

met_with: Heather Madison- Operations Manager


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Robyn Word conducted an unannounced Annual continuation inspection at the facility. LPA Word, and LPA Kellie McKinley reviewed residents and staff files on 8/4/2021. On today's date LPA Word met with Administrator Jonathan Stockdale and inspected the facility. The facility is licensed to serve 6 clients, between the ages of 14-22. There are currently 3 residents. There are 3 bedrooms and 3 bathrooms, The staff office is located downstairs. LPA observed the facility to be clean, safe and sanitary. The walkways were free of obstruction throughout the house and backyard. The outside area consists of: A raised patio area that includes a sitting area, and plants. Documentation was posted which included, personal rights, emergency exit plan, disaster plan, Covid19 protocol, and grievance procedure. Employee and client's files are kept at the office located at West Main Street Grass Valley, CA 95945. A fully stocked first aid kit is kept in the medication locked cabinet, and facility van. Each client had a hygiene kit kept in a locked cabinet. Blinds on the bedroom windows were in good repair. Medication disbursement is logged. Bubble packs are not in use. There are three fire extinguishers that are fully charged, with current tags. The facility vehicle is a van with current tags that will expire in April of 2022. The tire tread was in a safe range. The kitchen was stocked with enough perishable/non-perishable food for 3 clients. The August menu was placed on the refrigerator. The kitchen was stocked with plates, utensils and drinking cups for 3 clients, sharp kitchen utensils are locked in the medication cabinet. The water temperature in the kitchen faucet was 98 degrees. Each client's bedroom had a firm mattress, with a bed cover, sheets, blanket and pillows. There are additional linen in the hall closet, along with additional bath towels and face cloths. Laundry supplies were stored in a locked cabinet. No deficiencies noted at today's evaluation. Exit interview conducted and a copy of the report was provided to the Administrator.

met_with: Administrator Jonathan Stockdale


facility_name: CHATEAU #1

raw_content:
Investigation Findings:
13On June 4, 2025, at 12:30 pm, Licensing Program Analyst (LPA) Nestor Gomez made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation and deliver the findings. LPA spoke with Martin Usher and together, discussed the investigative findings. During the investigative process by Licensing program Analyst (LPA), Nestor Gomez, all relevant parties have been accounted for. Supporting evidence includes: conflicting interviews with staff and client, pest control invoices (1/8/25 & 2.14.25), letter of termination for S4, Guardian clearance for S4 and a guardian report dated for 3/5/2025. LPA obersved the cameras to be approprately placed within the facility property. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nestor Gomez 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 1

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

met_with: Martin Usher - Facility Manager


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
The evidence confirms there were locks on the residents' windows, which prevented the residents from evacuating in case of an emergency. A deficiency was cited at the facility regarding Personal Rights a citation in accordance with Program Interim Licensing Standards, Chapter 5, the Facility cited for violation of California Code of Regulations, Title Division Six, regulation ILS Personal Rights - Chapter Section 80072(a)(7) Not to be locked in any room, building, or facility premises by day or night. The exit interview was conducted with , and a copy of this report was provided to the facility. (refer to LIC9099D for details).

Investigation Findings:
13On September 3, 2025, Licensing Program Analyst (LPA) Justine Armstrong conducted an unannounced visit to Chateau #1 to conclude the investigation of the above allegation and deliver the findings. LPA met with Fazeela Shaikh, who granted access to the facility, and together, they discussed the investigation During the investigation process, all relevant parties have been accounted for. It was reported that the Licensee did not ensure that the facility adhered to emergency safety protocols. S1 admitted to having locks on the window. S1 clarified that the locks were removed the same day as the audit walk through. S1 confirmed being cited for having locks on the window, and the citation was cleared following an audit walk-through conducted on June 13, 2025. After conducting various confidential interviews and reviewing documents, the preponderance of evidence standard has been met; therefore, the allegation is found to be substantiated. (Continued on LIC9099C) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Enrique M Hernandez LICENSING EVALUATOR NAME: Justine Armstrong 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 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: CHATEAU #1FACILITY NUMBER: VISIT DATE: 09/03/2025

met_with: Fazeela Shaikh