raw_content:
Narrative:
Confidential interviews reported that the facility staff are checking on the minors and providing supervision for the minors in care. The Department also received an allegation that facility staff #1 (S1) is sleeping during work shifts. Confidential interviews reported that the minors C1- C5 are asleep and were not aware of S1 sleeping during the night shift. Confidential interviews indicated that the facility staff is not sleeping during work shifts. Confidential interviews reported that S1 and the other facility staff conduct headcounts every 10 minutes. Confidential interviews revealed that the minors (C1-C5) hadn't observed S1 sleeping at the home. Confidential interviews disclosed that S1 works the night shift at this home and another home. Other confidential interviews reported that S1 is sleeping during his designated time of working at the home. Based on inconsistent confidential interviews, the allegations that facility staff are not providing supervision to the minors (C1-C6) in care and that facility staff #1 (S1) are sleeping during work shifts may have occurred, however, are not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Program Director (PD), Amy Osborn.

Investigation Findings:
13On August 5, 2022, at 11: 28 am, Licensing Program Analysts (LPA's) Jose Gonzalez and Joon Choi met with Program Director (PD), Amy Osborn, to deliver the findings for the above-stated allegations. LPA conducted a safety inspection at the facility at 10:31 am on March 18, 2022, and no immediate health and safety hazards were observed. LPA also reviewed six out of six clients' records. During the investigation, interviews were conducted with five clients (C1, C2, C3, C4, & C5), the Assistant Executive Director (AED), and Staff #1 (S1). LPA attempted to interview C6 but was unsuccessful due to C6 refusing to be interviewed. The Department received an allegation on March 18, 2022, that facility staff are not providing supervision to the minors (C1-C5) in care. Confidential interviews disclosed that the minors do not feel safe at home because other minors threaten them when the facility staff is not monitoring their interactions. Additional confidential interviews indicated that the minors felt uncomfortable around other minors that would assault them when facility staff were performing other tasks. Other confidential interviews revealed that the facility staff intervened immediately when the residents argued or fought.R- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION GROUP HOME FOR CHILDRENFACILITY NUMBER: VISIT DATE: 08/05/2022

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

met_with: Program Director (PD), Amy Osborn


state: CA

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
information during interviews. Confidential interviews denied allegations that anyone from this or any other Alpha Connections Group Home had ever assaulted C1 or any other client. Confidential interviews also denied that any clients had ever been paid by staff to physically assault, threaten, or intimidate C1 or any other clients. According to confidential information received in interview, C1 had a history of making false statements. While other confidential Information Received by Licensing Office stated that these allegations had occurred. LPA Mena spoke to County Social Worker who stated that they had no concerns regarding these allegations and C1's safety around other peers during the time that they were placed at this facility. Based on interviews and confidential information obtained during the course of this investigation, the allegations that Child # 1 (C1) was physically assaulted by minors at the group home, and staff paying other minors to physically assault and intimidate C1, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Program Director, Elysia Moore to discuss the investigative findings for the above stated allegations. Licensing Program Analysts (LPAs), Jose Gonzalez and Daniel Mena conducted an inspection to the Short Term Residential Therapeutic Program (STRTP) on March 18, 2022 at 9:24am and on September 08, 2022 at 11:30am. No immediate hazards observed. LPAs Gonzalez and Mena interviewed four staff (S1, S2, S3 & S4), County Social Worker (CSW), five of six foster children (C2, C3, C4, C5 & C6), as well as reviewed client and facility records. LPA Mena was unable to interview Child # 1 (C1) due to them currently being on AWOL (Absence without official leave) status and their current whereabouts being unknown. Community Care Licensing received information on March 08, 2022 alleging that Child # 1 (C1) was physically assaulted by minors at the group home, and staff paying other minors to physically assault C1. Information obtained in confidential interviews did not corroborate the allegations with a preponderance of evidence. LPAs obtained conflicting UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION GROUP HOME FOR CHILDRENFACILITY NUMBER: VISIT DATE: 09/14/2022

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

report_type: Complaint Investigation

met_with: Elysia Moore

complaint_status: unsubstantiated


raw_content:
Narrative:
Confidential interviews denied allegations of a lack of supervision resulting in C1 trespassing onto neighbor's private property. According to confidential interviews, Staff # 1 (S1) and Staff # 2 (S2) were present the day of the incident and immediately verbally intervened as soon as they observed C1 leaving facility. According to confidential information, S1 and S2 were involved and engaging with C1 during the entire duration of the incident and were speaking and counseling C1, in an attempt to get C1 to come back to facility. According to confidential interviews, C1 was refusing to listen to staff and appeared to be "delusional" and was subsequently placed on a 5150 hold once police was called and arrived on scene. While other confidential information received by Licensing Office stated that the allegation had occurred, and that staff did not appear to do enough in order to prevent C1 from going into neighbor's garage and physically engaging with neighbor. According to confidential information, neighbor had to hold C1 at gunpoint until police arrival after C1 had gotten a hold of a hammer inside the garage. Additional confidential interviews disclosed that they did not witness the incident because they were not on facility grounds during the time of the incident. Based on interviews and confidential information obtained during the course of this investigation, the allegation that Staff did not provide adequate supervision to minor in care, more specifically that staff was unable to prevent Child #1 from leaving facility and trespassing into neighbor's private property, may have occurred, however is not supported or proven by evidence. Therefore, the above allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Program Director, Elysia Moore to discuss the investigative findings for the above stated allegation. Licensing Program Analysts (LPAs), Jose Gonzalez and Daniel Mena conducted an inspection to the Short Term Residential Therapeutic Program (STRTP) on July 21, 2022 at 11:40am and on September 08, 2022 at 10:50am. No immediate hazards observed. LPAs Gonzalez and Mena interviewed two of two staff involved (S1 & S2), Facility Director (S3), five foster children (C1, C C3, C4 & C6), as well as reviewed client and facility records. Community Care Licensing received information on July 20, 2022 alleging that Staff did not provide adequate supervision to minor in care, more specifically that staff was unable to prevent Child #1 from leaving facility and trespassing into neighbor's private property. Information obtained in confidential interviews did not corroborate the allegations with a preponderance of evidence. LPAs obtained conflicting information during interviews. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION GROUP HOME FOR CHILDRENFACILITY NUMBER: VISIT DATE: 09/14/2022

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


raw_content:
Narrative:
interviews. Confidential interviews denied allegation that anyone from this or any other Alpha Connections Group Home had ever physically abused C1 or any other client. Confidential interviews also denied that C1 had injured themselves at facility and that staff did not seek medical care for C1's injury. According to confidential interviews, C1 had injured themselves in a fight a few weeks prior to placement at this facility, and that once facility staff became aware of injury, C1 was taken to urgent care to seek medical treatment. While other confidential Information Received by Licensing Office stated that these allegations had occurred, and that although C1 was taken to urgent care for injury, staff did not immediately follow-up with a specialist for C1's nasal fracture. Based on interviews and confidential information obtained during the course of this investigation, the allegations that Facility Staff physically abused Child # 1 (C1), that C1 had sustained injuries while in care, and that Facility Staff did not seek medical attention for C1's injury, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analysts (LPAs), Daniel Mena and Jessica Peete met with Facility Director, Morgan Tyler to discuss the investigative findings for the above stated allegations. Licensing Program Analysts (LPAs), Jose Gonzalez and Daniel Mena conducted an inspection to the Short Term Residential Therapeutic Program (STRTP) on June 17, 2022 at 10:25am and on September 08, 2022 at 11:20am. No immediate hazards observed. LPAs Gonzalez and Mena interviewed five staff (S2, S3, S4, S5 & S6), County Social Worker (CSW1), five of five foster children (C1, C2, C3, C4 & C5), as well as reviewed client and facility records. Community Care Licensing received information on June 13, 2022 alleging that Facility Staff physically abused Child # 1 (C1) and that C1 had sustained injuries while in care. Allegation also claimed that Facility Staff did not seek medical attention for Child#1's injury. Information obtained in confidential interviews did not corroborate the allegations with a preponderance of evidence. LPAs obtained conflicting information during UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION GROUP HOME FOR CHILDRENFACILITY NUMBER: VISIT DATE: 09/21/2022

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

met_with: Morgan Tyler


raw_content:
Narrative:
Connections Group Home had ever physically abused or spit on C1 or any other client. Confidential interviews also denied that any staff had ever confiscated any of C1's belongings, other than prohibited contraband, such as vape pens or alcohol during health and safety checks. While other confidential Information Received by Licensing Office stated that these allegations had occurred, and that facility staff had spat on and was physically aggressive towards C1 because they had refused to get out of bed. Confidential information received by Licensing Office also stated that C1 had personal belongings, such as clothing and electronic devices taken by clients and staff during AWOLs (absence without official leave). Based on interviews and confidential information obtained during the course of this investigation, the allegations that Facility Staff physically abused, spit on, as well as confiscated Child # 1's (C1) belongings, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analysts (LPAs), Daniel Mena and Jessica Peete met with Facility Director, Morgan Tyler to discuss the investigative findings for the above stated allegations. Licensing Program Analysts (LPAs), Jose Gonzalez and Daniel Mena conducted an inspection to the Short Term Residential Therapeutic Program (STRTP) on July 08, 2022 at 12:17pm and on September 08, 2022 at 11:00am. No immediate hazards observed. LPAs Gonzalez and Mena interviewed five staff (S2, S3, S4, S5 & S6), County Social Worker (CSW1), six of six foster children (C1, C2, C3, C4, C5 & C6), as well as reviewed client and facility records. Community Care Licensing received information on July 07, 2022 alleging that Facility Staff physically abused, spit on, as well as confiscated Child # 1's (C1) belongings. Information obtained in confidential interviews did not corroborate the allegations with a preponderance of evidence. LPAs obtained conflicting information during interviews. Confidential interviews denied allegations that anyone from this or any other Alpha UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION GROUP HOME FOR CHILDRENFACILITY NUMBER: VISIT DATE: 09/21/2022

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


raw_content:
Narrative:
Other confidential interviews suggest the allegation was not true. Confidential interviews were also conducted with facility staff. All confidential interviews with staff suggest that the allegation did not occur. LPA received inconsistent information regarding the allegation. The Department also received an allegation that staff (S5) instructed other minors to physically assault minors while in care. Confidential interviews were conducted with FC1, FC2, FC3, FC4, FC5 and FC6, and OC1, OC2, OC3, OC4 and OC5. Confidential interviews disclosed that after S1 took a minor's video game system, one or more minor's in care, locked the staff member in a client's room. Confidential interviews disclosed that S1 called S5 for assistance. Confidential interviews disclosed that S5 brought clients from another facility to exercise physical discipline on the minors of the primary facility. Other confidential interviews disclosed that this incident didn't happen. Confidential interviews disclosed that S5 was near the facility at the time of the incident performing regular duties such as distributing allowances and supplies. Confidential interviews were also conducted with facility staff. These interviews suggest that no such incident, as described in this allegation occurred. LPA received inconsistent statements regarding the allegation. The Department also received an allegation that staff (S1, S2), did not ensure that minor attended school. Confidential interviews were conducted with FC1, FC1, FC3, FC4, FC5 and FC6. Confidential interviews disclosed that some clients refused to attend school sometimes, and that other times, staff were late in taking them to school. Confidential interviews were also conducted with facility staff. These interviews disclosed that staff always prompt the clients for school, and that the only times clients miss school, is when they refuse. Based on inconsistent confidential interviews, the allegations that facility staff inappropriately handled a minor in care, instructed other minors to physically assault minors while in care, and did not ensure that minor attended school, may have occurred, however, are not supported or proven by evidence. There the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Facility Director Morgan Tyler.

Investigation Findings:
13On 09/29/2022 at 08: AM, Licensing Program Analysts (LPA) Joon Choi and Michael Almaraz, met with Alpha Connection Group Home for Children Short Term Residential Therapeutic Program (STRTP) Facility Director Morgan Tyler, to deliver the findings for the above allegations. LPA conducted a safety inspection of the facility on 8/23/2022. No immediate safety issues or deficiencies were observed. The investigation included interviews with County Social Worker (CSW), clients (FC1, FC2, FC3, FC4, FC5 and FC6), other clients (OC1, OC2, OC3, OC4 and OC5) and staff (S1, S2, S3, S4, S5). Facility records and client files were reviewed. On 8/17/2022, Community Care Licensing received an allegation that staff (S1) inappropriately handled a minor in care. Confidential interviews were conducted with FC1, FC2, FC3, FC4, FC5 and FC6. Confidential interviews disclosed that S1 attempted to confiscate a video game system from a minor in care. Confidential interviews disclosed that the minor(s) were against this and confronted staff. Some confidential interviews suggest that staff may have inappropriately handled a client. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Joon R Choi LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION GROUP HOME FOR CHILDRENFACILITY NUMBER: VISIT DATE: 09/29/2022

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

met_with: Morgan Tyler, Facility Director


raw_content:
Narrative:
allegations that alcohol was accessible to children and that facility staff allowed minors to smoke at the facility during a family visitation. Confidential interviews also denied a lack of supervision and stated that clients are not allowed to smoke, vape or consume alcohol at the facility. According to confidential interviews, when clients do manage to sneak or smuggle in alcohol or drugs without staff's knowledge, contraband will be confiscated by staff when found. Confidential interviews stated that staff does search clients belongings when returning from AWOLs, as well as do perimeter checks around the facility for hidden contraband. While other confidential Information Received by Licensing Office stated that these allegations had occurred, and that facility staff had allowed or "ignored" clients from vaping/smoking in the front yard area and possessing alcohol during a family visitation. Based on interviews and confidential information obtained during the course of this investigation, the allegations that there is alcohol accessible to minors, as well as that Facility Staff does not provide adequate supervision and allows minors to smoke at the facility, more specifically that clients were observed to have been vaping/smoking in the front yard area as well as in the possession of alcohol during a family visitation, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Facility Director, Morgan Tyler to discuss the investigative findings for the above stated allegations. Licensing Program Analyst (LPA), Daniel Mena conducted an inspection to the Short Term Residential Therapeutic Program (STRTP) on September 21, 2022 at 1:38pm. No immediate hazards observed. LPA Mena interviewed four staff (S1, S2, S3 & S4) two foster children (C1 & C2), as well as reviewed client and facility records. LPA Mena was unable to interview Child # 3 due to them currently being on AWOL (absence without official leave) status. Community Care Licensing received information on September 15, 2022 alleging that there is alcohol accessible to minors, as well as that Facility Staff does not provide adequate supervision and allows minors to smoke at the facility, more specifically that clients were observed to have been vaping/smoking in the front yard area as well as in the possession of alcohol during a family visitation. Information obtained in confidential interviews did not corroborate the allegations with a preponderance of evidence. LPA obtained conflicting information during interviews. Confidential interviews denied UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION GROUP HOME FOR CHILDRENFACILITY NUMBER: VISIT DATE: 09/30/2022

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


raw_content:
Narrative:
status, and not under the care and supervision of facility staff. Confidential interviews also denied allegation staff does not ensure that C1 goes to school on time or that they are picked up in a timely manner. According to confidential information, C1 is sometimes late to school in the mornings because they refuse to get out of bed, or because C1 and other clients often take convincing and encouragement by staff in order to get them to go. Confidential interviews also denied that C1 is picked up late and stated that C1 often wanders after school or AWOLs from school before facility staff arrives. While other confidential information received by Licensing Office stated that these allegations had occurred. LPA Mena spoke to C1's County Social Worker who stated that they currently had no concerns regarding C1's level of care at the facility. Based on interviews and confidential information obtained during the course of this investigation, the allegations that Foster Child # 1's (C1) hygiene needs are not being met, that C1 sustained unexplained burn injuries while in care, and that facility did not ensure that C1 is taken to and from school in a timely manner, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Group Home (GH) Facility Manager, Ajee-aonna Glover to discuss the investigative findings for the above stated allegations. LPA Mena conducted an inspection to the GH on May 17, 2023 at 9: AM. No immediate hazards observed. LPA Mena interviewed four foster children (C1, C2, C3 & C4), three staff members (S1, S2 & S3), Program Director (PD), County Social Worker (CSW), as well as reviewed facility and client information. Community Care Licensing received information on May 12, 2023, alleging that Foster Child # 1's (C1) hygiene needs are not being met, that C1 sustained unexplained burn injuries while in care, and that facility did not ensure that C1 is taken to and from school in a timely manner. Information obtained in confidential interviews did not corroborate the allegations with a preponderance of evidence. LPA Mena obtained conflicting information during interviews. Confidential interviews denied allegations that C1's hygiene needs are not being met. According to confidential interviews, C1 refuses to bathe and change clothing on a daily basis. Confidential interviews stated that C1 is strongly encouraged to bathe, but that staff cannot physically force C1 to bathe or change their clothing. LPA Mena observed an adequate amount of clothing and personal hygiene products available for C1. According to confidential interviews, cigarette burn marks observed on C1 were all self-inflicted while on AWOL (absence without official lave) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION GROUP HOME FOR CHILDRENFACILITY NUMBER: VISIT DATE: 05/23/2023

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

met_with: Ajee-aonna Glover


facility_name: ALPHA CONNECTION GROUP HOME FOR CHILDREN

summary: Facility Evaluation

raw_content:
Narrative:
On June 28, 2021 at 1:50pm, an unannounced Post-Licensing Inspection was conducted by Licensing Program Analysts (LPA) Kendal Zirbes and Jose Gonzalez. During the inspection, LPA's met with facility manager, Manny Wiley who provided access to the facility. LPA and Facility Manager, inspected the facility inside and out. The facility was licensed as a Short Term Residential Therapeutic Program (STRTP) on October 2, 2020. The facility in the process of receiving a Mental Health Certification with San Bernardino County. The facility is a one-story house with three bedrooms, three bathrooms, a living room, visitation room, kitchen, dining room, garage, therapy office and staff office. A physical plant inspection was completed and included the following checks: facility grounds are clean and free of debris and observable hazards. There is adequate indoor and outdoor activity space. Sports equipment/books/games were observed for youth's recreation time. All facility smoke detectors and carbon monoxide detectors are in appropriate working order. The facility maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. The facility had all required documents posted throughout the facility. Medications are locked and centrally stored in a locked filing cabinet within the locked staff office. Six individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. At 3:00pm, the hot water was measured by Facility Manager, Manny Wiley. At the time of this inspection the hot water temperature was 105 degrees. The facility has a fully equipped first aid kit and first aid manual. The facility is not equipped with cameras. At the time of this inspection, there were no bodies of water on the facility ground. Per facility staff, no firearms or weapons are allowed in the facility and smoking is prohibited. The facility vehicle was observed to be in safe operating condition and the registration was up to date. Youth files were maintained in a locked filing cabinet within the staff office. Staff/client ratios were verified during this inspection and they were in accordance with the regulations. Five youth files were reviewed on this date as well as a sample of six personnel files. Files were reviewed to ensure they contained all required documentation. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. Report continued on page Licensee has obtained National Accreditation through CARF. The Accreditation is valid through August 31, 2021. Licensing fee payments have been paid. A copy of this report was reviewed with the Program Manager. A copy of this report was emailed to the facility

report_type: Facility Evaluation

met_with: Program Director, Amy Osborn


summary: Facility Evaluation

raw_content:
Narrative:
On September 30, 2021, Licensing Program Manager (LPM) Christina Barnes, and Licensing Program Analyst (LPA) Jose Gonzalez arrived at Alpha Connection- Alpha Home for Children Residential Therapeutic Residential Program (STRTP). LPM and LPA, were met and granted access by and Program Director Amy Osborn. The purpose of the visit is to conduct an annual inspection of the facility. At 9: AM, Program Director Amy Osborn, led the physical inspection of the facility with LPM Barnes and LPA Gonzalez. A physical plant inspection was completed and included the facility's, activity center, gaming room, kitchen area, refrigerator/freezers, food storage areas, client bedrooms, bathroom/showers and garage. Facility grounds are clean and free of debris and observable hazards. Sports equipment/toys/books/games/computers were observed for children's recreation time. There is adequate indoor and outdoor activity space. Facility smoke detectors and carbon monoxide detectors are in working order; fire extinguisher is properly charged and serviced. Licensee maintain an adequate supply of perishable and non-perishable foods and the menus were posted. All other required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsperson poster. Medications are locked and centrally stored inside staff's office. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. The hot water in the client's bathrooms was measured to be between 111 and 125 degrees. Per the Program Director, no firearms or weapons are allowed in the facility. The facility has a dining area, kitchen area, living room, open common area/formal living room, a clinician's office for therapeutic services, an entertainment room, and a room where the washer and dryer are located. All bedrooms have individual beds and drawer space for each client. The facility ensures that there is one client per bed with appropriate linens, pillows, comforters, and mattresses in good repair. *******CONTINUED on 809C******* Chemicals and/or poisons, sharp objects/knives are locked in a file cabinet in the staff office. First Aid Kits are stored in a locked cabinet in the staff office. LPM and LPA reviewed the facility's disaster and mass casualty plan. The facility currently has two children sharing each bedroom. The facility must ensure that each client is aware of the bedroom sharing policy and document the advisement in the clients' files. Based on record review, the facility did provide a signed bedroom sharing document in their files. LPA informed Program Director that all staff members need to complete the required 40 hour training as noted in ILS standards by October 2021. An exit interview was conducted and a copy of this report, LIC 809, and appeal rights were provided to Program Director.

visit_type: Annual

met_with: Program Director Amy Osborn


summary: Facility Evaluation

raw_content:
Narrative:
On July 28, 2022, at 8: AM Licensing Program Analyst (LPA), Jose Gonzalez and Licensing Program Manager (LPM) Christina Barnes met with Program Director (PD), Amy Osborn for a case management to interview client (C1). At 9: AM, a safety inspection was conducted of the facility and no immediate health and safety hazards were observed. LPA and LPM were unable to interview client due to client not being at the facility. The client was absent without leave and has not returned. An exit interview was conducted and a copy of this report, was provided to Amy Osborn.

visit_type: Case Management

met_with: Program Director (PD)


summary: Facility Evaluation

raw_content:
Narrative:
On August 17, 2022, at 12:51 pm, Licensing Program Analyst (LPA) Jose Gonzalez and San Bernardino County Children Family Services (CFS) Amy Guisa made an unannounced case management visit to Alpha Connections Alpha (STRTP) regarding the STRTP staff/ client ratio. LPA and CFS conducted a health and safety inspection. During the health and safety inspection, LPA and CFS observed butter knifes in the kitchen drawer. LPA and CFS observed one staff and no clients present during the visit. A copy of the report was discussed and provided to Alpha Connection Program Director (PD) Amy Osborn.

met_with: Program Director (PD) Amy Osborn.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst, Daniel Mena and Licensing Program Manager, Natasha Dunlap conducted a teleconference meeting with Alpha Connection, Program Director, Amy Osborn, Clinician, Lindsay Baston and Consultant, Dan Thorne to discuss and review the probationary conditions that go into effect once Alpha Connections STRTP reverts back to a Group Home on January 01, 2023. On December 31, 2022, the STRTP applications for Alpha Connection Group Home For Children, License No. 366412000, Pine Ridge, Apple Valley, CA 92307; ACYFSAnoka Ranch, License No. 366401649, Anoka Road, Apple Valley, CA 92308; ACYFS-Shoshonee Place, License No. 366402331, Shoshonee Road, Apple Valley, CA 92307; and ACYFS Nisqually Nest, License No. 366403207, Chief Joseph Road, Apple Valley, CA 92308 (collectively the "facilities") are terminated and Alpha will transition/convert back to its group home licenses subject to a three (3) year probationary term with the following conditions: 1. Alpha shall operate each facility in substantial compliance with the regulations and statutes governing the operation of a group home. 2. During the period of Probation, the Department in its sole discretion may conduct unannounced site visits for the purpose of determining whether there is substantial compliance with the regulations and statutes governing the operation of the group home. 3. Alpha will submit an updated group home plan of operation and program statement for each group home to the Department within 30 days of the effective date of this Settlement Agreement and Mutual General Release including but not limited to: 11. Alpha shall ensure the personal rights of all children in its care including the right to be provided safe, healthful, and comfortable accommodations to meet their needs, and shall be free from corporal or unusual punishment, pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other action of a punitive nature. 12. Alpha shall ensure that each child in care receives first aid and medical services, including arrangements and transportation. Further Alpha shall ensure that medications and any other toxic products are properly stored and kept in a safe and locked place that is not accessible to children in care or other persons other than employees responsible for the supervision of the centrally stored medication pursuant to California Code of Regulations, Title 22, Regulation sections 80075 and 84075. Employees of Alpha shall immediately document on the medication log any refusals of medication by a child in care and shall follow-up with proper notification to the child's physician. 13. Alpha's Board of Directors shall be active in ensuring accountability and ensuring that Alpha complies with all applicable regulations, by reviewing, on a quarterly basis Alpha's operation and documents as specified in Health and Safety code section 1520. 1(f), including a review of special incident reports and all licensing reports issued by the Department. 14. For the duration of the probationary period, Alpha shall provide all current and prospective parents or responsible parties of children in the facility with a copy of the settlement terms, as outlined in the Settlement Agreement and Mutual General Release. Proof of Acknowledgement shall be kept in the respective child's record and available for inspection by the Department. 15. Alpha will work collaboratively with the Department to comply and fully implement all Plan of Corrections and agreements. This Settlement Agreement and Mutual General Release supersedes any Compliance Plan or Corrective Action Plan that has previously been submitted by the Alpha to the Department. A copy of this report was provided and emailed for signatures. administrator pursuant to California Code of Regulations, Title 22, Regulation 84064. 2. No exceptions shall be made to these requirements during probation. 7. Alpha shall ensure that a qualified and certified administrator is present and available on premises of each facility, a minimum of 20 hours a week. In the administrator's absence, a designated substitute as defined in the California Code of Regulations, Title 22, Regulation 84064(d) shall be present and available on the premises of the facility. Alpha shall timely notify the Department of any change in administrator and the name, address, date of hire, background, qualifications, and certification of the new administrator. 8. Alpha shall develop a comprehensive training curriculum for all new and current staff who provide direct care services to children in care. The content of the training shall include, but not be limited to, the following: supervision of youth, reporting requirements to the Department and reporting requirements as a mandated child abuse reporter, personal rights, crisis prevention, and emergency intervention, including Alpha's runaway plan, and all applicable licensing laws and regulations. Training shall be mandatory for all employees. A detailed description of the in-service training and a record of all staff who attended the trainings shall be maintained and made available to the department upon request. a. Training to include (ii) Trauma Informed Interventions and Treatment Practices. Two (2) hours of instruction in the physical and psychosocial needs of the children, including behavior management, de-escalation techniques, and trauma-informed crisis management planning, including the use of emergency interventions. The training plan shall be designed to ensure the provision of trauma-informed services and be appropriate for the population and shall consider the training needs and skill level of staff b. All outstanding training, including but not limited to the training listed above, shall be completed by staff within 45 days of the group home transition. c. Additional staff hired after the transition to the group home must complete the trauma informed training within 45 days of hire and any additional training must be completed within the time frames outlined in the California Code of Regulations, Title 22, Regulation 84065. In the Matter of Alpha Connections Youth & Family Services, Inc. v. CDSS Case No. CVR Settlement Agreement and Mutual General Release 9. Alpha shall adhere to the reporting requirements as defined in California Code of Regulations, Title 22, Regulations 80061, 84061, in the regulations and statutes governing the operation of a group home. Alpha shall report to the Licensing office the following: any unusual incident, including, but not limited to, client death or injury which requires medical treatment, any suspected physical plant changes, and all unexplained absences. These incidents must be reported by the next working day, and a written report of the incident must be submitted within seven days following the occurrence of the incident. All unusual incident reports shall be complete, including addendums and follow-up information. 10. Alpha shall ensure compliance with California Code of Regulations, Title 22, Regulations 84068.1, 84068.2, 84068.3 and 84068.4 regarding Intake Procedure, Needs and Services Plans and Modifications, and Removal and/or Discharge Procedures. Prior to and during placement Alpha shall determine whether it can provide the services necessary to meet the child's needs and to effect discharge if it is determined that Alpha cannot provide the services necessary to meet the child's needs. Further, Alpha shall ensure that an appropriate assessment of a child's compatibility with other children in care is conducted during the intake process and is re-evaluated on a continuance basis when individual needs dictate. Alpha agrees that it shall not accept or retain, and will promptly discharge with written notice to the authorized representative, any child for whom it cannot adequately and safely provide care, any child who requires a higher level of care, and any child who would cause the Alpha to violate laws and regulations, or the conditions of Settlement Agreement and Mutual General Release. a. A description of trauma-informed and evidence-based intervention and de-escalation techniques that will be used to promote the safety of all individuals in the facility, including but not limited to children or nonminor dependents who have a propensity for behaviors that result in harm to self or others. b. A runaway plan that includes a continuum of non-physical interventions and strategies to de-escalate a situation where a child has indicated his /her intent to run away, that will be utilized by staff to prevent and Alpha to runaway behaviors. 4. Alpha shall ensure that all children are supervised 24 hours per day, 7 days per week, in accordance with its Program Statement and Plan of Operation and licensing regulations. 5. There shall be coverage by direct care staff as follows: a. During the hours of 7 am to 10 pm, there shall be one awake and on duty direct care staff for every three children, or fraction thereof, present, at a minimum b. During the hours of 10pm to 7am, there shall be one awake and on duty direct care staff for every six children, or fraction thereof, present, at a minimum. c. In addition to staff required in paragraph 1 or 2, when one or more children are present at the facility, at least one direct care staff shall be on call and capable of arriving at the facility within 30 minutes. d. If a child requires special care and supervision because of age, behavior or other factors, the number of awake and on-duty care staff shall be increased. 6. Any administrator employed by Alpha to operate the facility shall have, at minimum, the education and experience specified in California Code of Regulations, Title 22, Regulation 84064 and shall be certified as a group home

met_with: Amy Osborn


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst, Daniel Mena and Licensing Program Manager, Natasha Dunlap conducted a technical assistance meeting virtually via Teams with Alpha Connection Chief Executive Officer, Barron Wilson, Program Director, Amy Osborn, and Consultant, Dan Thorne to discuss and review the following pending Program Statement revisions: 3. PURPOSE, METHODS, AND GOALS Pg. Is highlighted placement agency wording correct because is s now a Group Home? Elaborate on the type of placements facility will take if regional, and plans to become vendorized. Pg. Are there case workers in private placements. Is working correct? Pg. Is there an assigned social worker in private placements? 5. SPECIAL SERVICES/PROGRAMS OFFERED Pg. How many hours per day is the training? Specify Pg. How many hours per class/training? 6. MEDICAL/DENTAL Pg. Medical Liaison (Who is this specifically) • LPA Mena did not see the procedures for handling and assisting children with self-administered medications. • LPA Mena did not see the procedure and staff positions(s) identified who are responsible for dispensing and destroying medications. • Attachment # Guy Williams. What is her title or position? • Attachment # Evonda Hull. What is her title or position? 23. JOB DESCRIPTIONS Pg. 142 -Strtp? No longer a Short Term Residential Therapeutic Program Pg.142- GAAP What is this acronym? Pg.159- State's Interim Licensing Standards (Group Home Regulations?) Pg. CCL (define acronym for the reader) 24. INSERVICE TRAINING FOR STAFF Pg.164- "ACYFS complies with the staffing ratios required by the Interim Licensing Standards (ILS)" (Is this wording correct since it's now a GH?) Pg.165- ILS (is this correct since it is now a GH?) 28. FACILITY SKETCH • Did not see indication of number of children in each bedroom on facility sketch. Program Director, Osborn stated that corrections would be provided to Licensing Office by December 16, 2022. 8. ADMISSION/INTAKE Pg. Does highlighted portion need to be updated or corrected. Is this still accurate as a Group Home? 9. NEEDS AND SERVICES PLAN/ASSESSMENT Pg. Should highlighted portion read... and or parent/legal guardian since it is a GH? Pg. Is highlighted Social Worker statement accurate since it is now a GH? 11. VISITATION RULES & POLICY Pg. Where exactly do they take place in the home, supervision, ratios etc. How do you ensure that no contraband is provided by the visitor? Pg. How is transportation provided, are they searched for contraband upon return, who and when do they do it? · What types of visits are NOT permitted 12. HOUSE RULES AND POLICIES Pg. Entertainment Equipment - What are the times when they can be used? What about usage of facility's common use equipment? 13. DISCIPLINE POLICIES Pg. Make clear that withholding of allowances specifically, is not permitted as a form of discipline. 14. EMERGENCY INTERVENTION PLAN Pg. Typo Pg. Under Justification of restraints. Who would typically be the designee? 15. RUNAWAY PLAN Pg. Initially Define Acronym (AWOL) Pg. Define Acronyms (PO, CSW) · Did not observe mention of staff training Plan. · Did not specify actual time frames when determining when a child is absence without permission, depending on age ro developmental level etc. 16. CHILDREN'S COMPLAINT/GRIEVANCE PROCEDURES Pg. Under Filing Complaints- Where is that exactly is a copy of the complain-grievance policy posted/located? Living room? Kitchen area Pg. Under Procedure for External Complaint- Where is the information/procedure on how to file a complaint with licensing located and available to the client? • Child/authorized representative needs to understand the difference between a grievance & filing a formal complaint with Licensing against facility. 19. NUTRITION/SAMPLE MENU Pg.118 (CNIPS) define acronym. • Include procedure for which all staff (including new & substituting) are aware of dietary restrictions or allergies for all clients. 20. Clothing and Incidentals Pg.137/138 - What is the procedure that ensures that toiletries & personal hygiene products are always available and in stock. How often is shopping done? Who does the shopping? Etc. 22. STAFF QUALIFICATIONS • Attachment # Nicole Amy Squillace/Osborn. What is her title or position? • Attachment # Genesis Duran. What is her title or position?

met_with: Barron Wilson


summary: Facility Evaluation

raw_content:
Narrative:
On February 22, 2023, Licensing Program Analyst (LPA) Daniel Mena arrived at Alpha Connection- Group Home (GH). LPA Mena was granted access by Administrator, Evonda Hull and Administrator, Guy Williams. The purpose of the visit is to conduct an annual inspection of the facility. Administrator led the physical inspection of the facility with LPA Mena. There are currently no children in placement. A physical plant inspection was completed and included the facility's visitor's room, living room, kitchen area, dinning area, office, refrigerator/freezers, food storage areas, 3 client bedrooms, front and backyard areas, and 4 bathroom/showers. Facility grounds are clean and free of debris and observable hazards. Sports equipment/toys/books/games/computers were observed for children's recreation time. There is adequate indoor and outdoor activity space. Facility smoke detectors and carbon monoxide detectors are in working order; fire extinguisher is properly charged and serviced. Licensee is to maintain an adequate supply of perishable and non-perishable foods and the menus are to be posted. All other required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsperson poster. Medications are to be locked and centrally stored inside staff's office. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. Hot water temperature was measured. Per the Administrator, no firearms or weapons are allowed in the facility. The facility has a visitor's room, living room, kitchen area, dinning area, office, laundry room, food storage areas, 3 client bedrooms, and 4 bathroom/showers. All bedrooms have individual beds and drawer space for each client. The facility ensures that there is one client per bed with appropriate linens, pillows, comforters, and mattresses in good repair. CONTINUES on LIC 809C Chemicals and/or poisons, sharp objects/knives are locked in a file cabinet in the staff office. First Aid Kits are stored in a locked cabinet in the staff office. LPA reviewed the facility's disaster plan. The facility currently has no children. The facility must ensure that each client is aware of the bedroom sharing policy and document the advisement in the clients' files. Based on record review, the facility did provide a signed bedroom sharing document in their files. There were no deficiencies/corrections observed on this date. An exit interview was conducted and a copy of this report were provided to Administrator.

met_with: Evonda Hull


summary: Facility Evaluation

raw_content:
Narrative:
LPA Mena conducted an unannounced Case Management visit on this date. LPA Mena met with Program Director, Amy Osborn and Administrator, Guy Williams. While at the facility, LPA Mena discussed and reviewed Client Records (C1, C2, C3, C4, C5 & C6) and will obtain copies of pertinent documentation to ensure the facility is meeting the needs of clients in care. In addition, LPA Mena conducted interviews with staff (S1, S2 & PD) and three Clients (C1, C2 & C3) who were present on facility grounds during visit. An exit interview was conducted and a copy of this report was provide.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Sarah Lo and Leslie Covarrubias on 02/08/2024 at 10: AM. The case management inspection is conducted pursuant to Health and Safety Code Section 1538.9(a)(2). During the inspection, LPAs met with Amy Osborn, Program Director, and inspected the facility inside and out. LPA reviewed five children's records on site at the facility. LPA reviewed five staff personnel files on site at the facility. LPA reviewed five child's psychotropic medications and medication records. LPA interviewed five children that are currently prescribed psychotropic medication at their assigned school after the facility visit. No deficiencies are being cited at this time. LPAs provided a copy of this licensing reporting and conducted an exit interview with Amy Osborn, Program Director.

met_with: Amy Osborn, Program Director


summary: Facility Evaluation

raw_content:
Narrative:
On February 27, 2024, Licensing Program Analyst (LPA) Daniel Mena arrived at Alpha Connection- Group Home (GH). LPA Mena was granted access by Facility Administrators, Guy Williams and Evonnda Hull. The purpose of the visit is to conduct an annual inspection of the facility. Program Director, Amy Osborn, led the physical inspection of the facility with LPA Mena. A physical plant inspection was completed and included the facility's visitor's room, common area, kitchen area, refrigerator/freezers, food storage areas, client bedrooms, bathroom/showers and garage. Facility grounds are clean and free of debris and observable hazards. Sports equipment/toys/books/games/computers were observed for children's recreation time. There is adequate indoor and outdoor activity space. Facility smoke detectors and carbon monoxide detectors are in working order; fire extinguisher is properly charged and serviced. Licensee maintain an adequate supply of perishable and non-perishable foods and the menus were posted. All other required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsperson poster. Medications are locked and centrally stored inside staff's office. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. Hot water temperature was measured. Facility Manager stated that water was adjusted at time of visit Per the Administrator, no firearms or weapons are allowed in the facility. The facility has a dining area, kitchen area, living room, open common area/formal living room, an office, and a room where the washer and dryer are located. All bedrooms have individual beds and drawer space for each client. The facility ensures that there is one client per bed with appropriate linens, pillows, comforters, and mattresses in good repair. CONTINUES on LIC 809C Chemicals and/or poisons, sharp objects/knives are locked in a file cabinet in the staff office. First Aid Kits are stored in a locked cabinet in the staff office. LPA reviewed the facility's disaster plan. The facility currently has two children sharing each bedroom. The facility must ensure that each client is aware of the bedroom sharing policy and document the advisement in the clients' files. Based on record review, the facility did provide a signed bedroom sharing document in their files. LPA Reviewed client's medication and medication logs. There were no deficiencies/corrections observed on this date. An exit interview was conducted and a copy of this report were provided to Program Director.


summary: Facility Evaluation

raw_content:
Narrative:
On September 27, 2024, Licensing Program Analyst (LPA) Daniel Mena arrived at Alpha Connection- Group Home (GH). LPA Mena was granted access by Facility Manager, Ajee-Aonna Glover. The purpose of the visit is to conduct an annual required inspection of the facility. Program Director, Amy Osborn, led the physical inspection of the facility with LPA Mena. A physical plant inspection was completed and included the facility's visitor's room, common area, kitchen area, refrigerator/freezers, food storage areas, client bedrooms, bathroom/showers and garage. Facility grounds are clean and free of debris and observable hazards. Sports equipment/toys/books/games/computers were observed for children's recreation time. There is adequate indoor and outdoor activity space. Facility smoke detectors and carbon monoxide detectors are in working order; fire extinguisher is properly charged and serviced. Licensee maintain an adequate supply of perishable and non-perishable foods and the menus were posted. All other required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsperson poster. Medications are locked and centrally stored inside staff's office. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. Hot water temperature was measured. Facility Manager stated that water was adjusted at time of visit Per the Administrator, no firearms or weapons are allowed in the facility. CONTINUES on LIC 809C The facility has a dining area, kitchen area, living room, open common area/formal living room, an office, and a room where the washer and dryer are located. All bedrooms have individual beds and drawer space for each client. The facility ensures that there is one client per bed with appropriate linens, pillows, comforters, and mattresses in good repair. Chemicals and/or poisons, sharp objects/knives are locked in a file cabinet in the staff office. First Aid Kits are stored in a locked cabinet in the staff office. LPA reviewed the facility's disaster plan. The facility currently has two children sharing each bedroom. The facility must ensure that each client is aware of the bedroom sharing policy and document the advisement in the clients' files. Based on record review, the facility did provide a signed bedroom sharing document in their files. LPA Reviewed client's medication and medication logs. There were no deficiencies/corrections observed on this date. An exit interview was conducted and a copy of this report were provided to Program Director.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Rachel Vanegas and Carissa Aviles on August 22, 2025 at 10:30am. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPAs Vanegas and Aviles met with Administrator - Guy Williams and inspected the facility inside and out. LPAs reviewed three of three child's records and five of five staff personnel files on site at the facility. LPAs reviewed three of three child's psychotropic medications and medication records. LPAs interviewed two of five staff on site to discuss the facilities policies and procedures of operation. LPAs interviewed zero of three children currently prescribed psychotropic medication. LPAs provided a copy of this licensing report to Administrator - Guy Williams. No deficiencies are being cited at this time. LPAs conducted and exit interview with Administrator - Guy Williams.

met_with: Administrator - Guy Williams


summary: Facility Evaluation

raw_content:
Narrative:
On November 13, 2025, Licensing Program Analyst (LPAs) Daniel Mena & Matthew Dorantes arrived at Alpha Connection- Group Home (GH). LPA Mena was granted access by Facility Manager, Alyssa Clements. The purpose of the visit is to conduct an annual required inspection of the facility. Program Director, Amy Osborn, led the physical inspection of the facility with LPA Mena & Dorantes. A physical plant inspection was completed and included the facility's visitor's room, common area, kitchen area, refrigerator/freezers, food storage areas, client bedrooms, bathroom/showers and garage. Facility grounds are clean and free of debris and observable hazards. Sports equipment/toys/books/games/computers were observed for children's recreation time. There is adequate indoor and outdoor activity space. Facility smoke detectors and carbon monoxide detectors are in working order; fire extinguisher is properly charged and serviced. Licensee maintain an adequate supply of perishable and non-perishable foods and the menus were posted. All other required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsperson poster. Medications are locked and centrally stored inside staff's office. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. Hot water temperature was measured. No firearms or weapons are allowed in the facility. CONTINUES on LIC 809C The facility has a dining area, kitchen area, living room, open common area/formal living room, an office, and a room where the washer and dryer are located. All bedrooms have individual beds and drawer space for each client. The facility ensures that there is one client per bed with appropriate linens, pillows, comforters, and mattresses in good repair. Chemicals and/or poisons, sharp objects/knives are locked in a file cabinet in the staff office. First Aid Kits are stored in a locked cabinet in the staff office. LPA reviewed the facility's disaster plan. The facility currently has four children in care, two children currently share a bedroom. The facility must ensure that each client is aware of the bedroom sharing policy and document the advisement in the clients' files. Based on record review, the facility did provide a signed bedroom sharing document in their files. LPA Reviewed client's medication and medication logs. There were no deficiencies/corrections observed on this date. An exit interview was conducted and a copy of this report were provided to Program Director.


summary: Facility Evaluation

raw_content:
Narrative:
On November 13, 2025, at 12:00PM, Licensing Program Analysts (LPAs) Daniel Mena and Matthew Dorantes met with Alpha Connections Group Home for Children (GH) Program Director, Amy Osborn regarding a case management inspection. The purpose of the inspection is to review facility compliance with the probationary conditions set forth by the Settlement Agreement and Mutual General Release that went into effect on January 1, 2023. While at the facility LPAs conducted a records review and conducted staff interviews. An annual/required facility inspection was conducted by LPAs Mena and Dorantes on November 13, 2025, during which the facility was found to be in compliance with California Code of Regulations, Title 22, Division 6, Chapter 5. A copy of this report was provided to Program Director, Amy Osborn.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Cheraki Davis on 10/26/2021 at 1: PM. During the inspection, LPA met with Evonnda Hull, Administrator and Emanuel Wiley, Facility Manager and inspected the facility. LPA reviewed two out of two child's psychotropic records on site at the facility at 1: PM. During the review of children's records, LPA observed one out of two children (C1) did not have a current JV 220 and JV 223. LPA reviewed two staff personnel files on site at the facility at 2: PM. LPA began two staff interviews at 3: PM. LPA interviewed one out of two children currently taking psychotropic medication at 3: PM. One child refuse to interview. LPA conducted exit interview with Evonnda Hull at 4: PM. LPA provided the Summary Report, LIC 809D, Appeal Rights, to Evonnda Hull, Administrator upon completion. 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. ****This is an amended report of a report that was originally issued on 10/26/2021****

met_with: Evonnda Hull


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA), Jose Gonzalez and Licensing Program Manager (LPM) Christina Barnes conducted a safety inspection. During the record review with Assistant Executive Director (AED), Christian Wilson, LPA, and LPM observed client #1 (C1) file that the bedroom sharing agreement was missing, in client #2 (C2) and client #3 (C3) bedroom sharing agreement have not been updated (09/09/2021), clients #4 (C4), #5 (C5), and #6 (C6) bedroom sharing agreement were not signed. Deficiencies will be cited.


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On June 3, 2022, Licensing Program Analyst (LPA's) Jose Gonzalez and Darlene Oseguera made an unannounced case management inspection. LPA's met with Alpha Connection Anoka Facility Administrator (FA), Evonnda Hull to discuss information received by Community Care Licensing. On March 16, 2022, the Department received information regarding a staff member sleeping on the overnight shift and a picture of the staff (S1), slumped to the side asleep on a couch located in the Alpha Connection Short Term Residential Therapeutic Program (STRTP). Confidential interviews also revealed that staff and clients have observed S1 asleep on the overnight shift at various Alpha Connection facilities during S1's assigned work hours. Based on confidential interviews, LPA's observation, and evidence gathered S1 was observed and photographed slumped to the side asleep on a couch located in the Alpha Connection STRTP. The facility is being cited for violation of Short Term Residential Therapeutic Program Interim Licensing Standards, Version 4, Section 87065.2(b)(1) Personnel Duties. The licensee did not ensure clients were supervised and protected at all times. This poses an immediate health, safety, or personal rights risk to the children placed in care. An exit interview was conducted. A copy of this report and appeal rights were provided to Facility Administrator (FA),

Deficiencies:
87065.2: (1) supervision, protection, and care of children at all times, individually and in groups.

title: (b)(1) Personnel Duties (b) Direct care staff shall perform the following duties


summary: Facility Evaluation

raw_content:
Narrative:
On June 17, 2022 at 10:46 am, Licensing Program Analyst's (LPA's), Jose Gonzalez and Darlene Almaraz-Oseguera conducted a safety inspection at the facility. During the safety inspection with direct support staff (S1) Billie Jo Lemon, and both LPAs observed a cigarette butt on the floor of bedroom #2. LPA's and S1 observed a cigar filter, ashes inside and on top the sink inside bedroom #2-bathroom floor. The Deficiencies will be cited. 87087(c) Buildings and Grounds The licensee shall prohibit smoking in the facility and on the grounds of the facility. Based on LPA's and Billie Jo Lemon observations a cigarette butt on the floor of bedroom #2. LPA's and Billie Jo Lemon observed a cigar filter, ashes in and on the sink inside bedroom #2-bathroom floor. This poses a potential Health, Safety, or Personal Rights risk to children in care.


summary: Facility Evaluation

raw_content:
Narrative:
On July 16, 2022, at 09:00am, Licensing Program Analyst (LPA) Joon Choi and Licensing Program Manager (LPM) Cheraki Davis made an unannounced case management visit to Alpha Connections Group Home for Children (STRTP) regarding the STRTP staff/client ratio. LPA Choi and LPM Davis were met by Direct Care Staff Maria Macias, Facilty Manager (FM) Karen Reyes and Facility Director (FD) Morgan Tyler who arrived later. LPA Choi and LPM Davis conducted a health and safety inspection of the facility. During the health and safety inspection, LPA Choi did not observe any immediate deficiencies. LPA Choi observed two staff and six clients present during the visit. LPA Choi and LPM Davis reviewed the facility log to determine compliance. LPA Choi and LPM Davis observed the following during the review of the facility log. At 9:30, LPA Choi and LPM Davis observed the facility's LIC 500 staff roster, was not current, as it did not list S1 and S2's (S2 was an overnight shift staff, reported to have worked last night) work schedules. During confidential interviews with the facility's clients, it was reported that the clients were able to use regular silverware utensils. However, during confidential interviews, it was reported that a new client recently harmed another client with a silverware fork and that after this incident, it was reported that the facility staff implemented the use of plastic utensils. LPA Choi reviewed one client file. The facility is being cited for violating Interim Licensing Standards (ILS) 87066(b)(3). Based on record review, LPA observed S1 and S2's time schedule was not noted on the facility's LIC 500, Personnel Report that was posted in the staff's office. A copy of the report was discussed and provided with appeal rights, to Alpha Connection Facility Director Morgan Tyler.

met_with: Karen Reyes, Facility Manager


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
conflicting information during interviews. Confidential interviews denied allegations of AD having made threats against C1 as they intervened during an incident in which C1 had become upset and was engaged in property destruction. According to confidential interviews, AD was not heard by any other client of staff present of having made threats against C1 during this incident. While other confidential Information received by Licensing Office stated that this allegation had occurred and that AD threatened to "make a few calls" and have C1 removed from the GH due to his behavior. There are no other known witnesses to this allegation. Based on interviews and confidential information obtained during the course of this investigation, the allegation that Staff threaten client in care, may have occurred, however is not supported or proven by evidence. Therefore, the above allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Group Home (GH) Administrator, Guy Williams to discuss the investigative findings for the above stated allegation. LPA Matthew Dorantes conducted an inspection to the GH on January 28, 2026, and LPA Mena on March 03, 2026. No immediate hazards were observed. LPA Mena interviewed four of four foster children in care [Child # 1 (C1), Child # 2 (C2), Child # 3 (C3) & Child # 4 (C4)], four staff members [Staff # 1 (S1), Staff # 2 (S2), Staff # 3 (S3) & Staff # 4 (S4)], Facility Administrator (AD), Program Director (PD), as well as reviewed facility and client information. Community Care Licensing received information on January 22, 2026, alleging that Staff threaten client in care. Information obtained in confidential interviews did not corroborate the allegation with a preponderance of evidence. LPA Mena obtained Continues on next page UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Nicole Strickland LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION GROUP HOME FOR CHILDRENFACILITY NUMBER: VISIT DATE: 03/04/2026

met_with: Guy Williams


facility_name: AMANA HOME

summary: Facility Evaluation

raw_content:
Narrative:
On 4/11/25, Licensing Program Analysts (LPAs) Mariah Hawkins and Will Ea conducted an announced prelicensing inspection. LPAs met with Directors Kaycee Makalintal, Nemia Atendido, Cherry Agravante, Jasmin Nelson, and Claire Ascalon. During the inspection, LPAs toured the facility site and reviewed licensing procedures. LPAs observed the facility to be a single-story house in a residential neighborhood. The facility and grounds were maintained in safe condition. Kitchen and bathrooms are in sanitary condition. There are four single-occupancy bedrooms and two bathrooms. Bedrooms have personal storage and clean linens, including spare linens. Hot water measured within permitted range. Sharps and chemicals are locked away where they will be inaccessible to clients. There is locking storage for medications and confidential client records. Grievance procedures, facility sketch with emergency exits shown, and personal rights are posted in the facility. Using the CARE inspection tool, no deficiencies were observed and no corrections were needed. An exit interview was conducted, and a copy of this report was provided to Directors.

visit_type: Prelicensing

met_with: Directors Kaycee Makalintal, Nemia Apeneieo, Cherry Agravante, Jasmin Nelson, and Clair Ascalon


summary: Facility Evaluation

raw_content:
Narrative:
On 12/12/25, Licensing Program Analysts (LPAs) Kimberly Hall and Brian Bertoli made a visit to the facility for a post-licensing inspection. LPAs met with Licensee, Cherry Agravante and Patrick Orea, Facility Manager and informed them of the purpose of the visit. There was one client in care (non-verbal, not interviewed). LPAs reviewed one child record and observed it to be complete. 3 staff files were observed to be complete. 3 staff were interviewed. LPAs discussed facility operations with Licensee Cherry Agravante and Administrator Kaycee Makalintal (who was on the phone via video). LPAs toured the facility site and observed the facility to be maintained in safe condition, furniture was observed to be in good condition, dangerous items such as chemicals, medications, or sharp objects were observed to be stored where only accessible to staff, and the bathrooms and kitchen were clean and sanitary. Technical advisories was issued for: 1565(a)(7)(A) - Documentation of emergency power 84070(b)(16) - Individual log for each psychotropic drug No deficiencies were observed during today's inspection. An exit interview was conducted, appeal rights discussed, and a copy of this report was left with Administrator.

met_with: Cherry Agravante, Patrick Orea


facility_name: ANESTA

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Kellie McKinley conducted an announced Pre-licensing inspection on 4/16/2024 at 9: AM at the above location, as required for the Group Home (GH) licensure. LPA met with Jamie Murray - Partner. During the pre-licensing visit, LPA conducted a Health and Safety inspection using the CARE tool. LPA observed the facility was clean inside and safe. The outside of the facility has a pool in the back yard that is fully enclosed with a five-foot fence and locking gates. There is a pool house with pump inside. The facilities sits on about 3-4 acres of property, which also is fenced and enclosed. LPA observed that there are two floors to the facility; the upstairs room will be utilized as the staff office for storing inaccessible medications and chemicals, in addition to any other item required to be inaccessible to clients. LPA observed 4 of client bedrooms, equipped with appropriate furniture, bedding, and supplies for clients. Sufficient storage space for client's personal belongings was observed in each room. The facility is requesting to be licensed for 4 clients. Staff will include eight to ten staff hired and ready for the first clients ranging in age from 13 to 17 years old. LPA observed a medication Lock box in the kitchen, which was empty, but locked, and accessible only to designated staff. The kitchen area was equipped with an adequate amount of utensils, dining supplies, and cups for client. No food was observed as there are no clients, and no pending placements at this time. Facility will verify required food on hand at time of client placement. LPA observed a staff office space that is locked and inaccessible to clients, where client records will be locked in file cabinets. The facility has a detached garage space which houses extra beds, frames, freezer for extra food storage and supplies which is inaccessible to the clients at all times. LPA observed a wood stove fireplace in the living room, and confirmed with the Licensees that they were purchasing a barrier to place around the wood stove. continued on 809_C page The smoke detectors were tested and found to be functional during the inspection and there were functioning carbon monoxide detectors on each floor of the facility. Number of fire extinguishers were present with a recent inspection date of January 2024. A fully equipped first aid kit was ordered and will be placed in the kitchen area. LPA reviewed the First aid kits content list while at the facility. The Foster Youth Bill of Rights was posted in a conspicuous location. There are 2 bathrooms in the facility that are accessible to client use. The water temperature was tested and found to be 120 degrees. The facility is ready for licensure as an Group Home and LPA recommends that the facility be licensed. A signed copy of this report was provided to Jamie Murray and Jeff Curtis.

met_with: Jamie Murray- Partner


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Kellie McKinley conducted an unannounced Post-licensing inspection on 7/11/24 at 8: AM at the above location, as required for the Group Home licensure. LPA met with Amaya Chase- DSP and Cory Ranberg- administrator. During the post-licensing visit, LPA conducted a Health and Safety inspection using the CARE tool. LPA observed the facility was clean inside and safe. The outside of the facility is fenced in the backyard, and spacious, clean and well maintained for outdoor activities. LPA observed that there are two floors to the facility. LPA observed three client bedrooms, equipped with appropriate furniture, bedding, and supplies for clients. Sufficient storage space for client's personal belongings was observed in each room. The facility is licensed for 4 clients and 1 client is currently in placement. An LIC 500 was received and the facility has 15 staff members not including the administrators. Staff to client ratio is 3-4/1 currently. During sleeping hours ratio is 2-1 for night staff. LPA observed the medication stored and locked in an locked office in a locked filing cabinet. The kitchen area was equipped with an adequate number of utensils, dining supplies, and cups for clients. LPA observed 2 days of perishable food and 7 days of non-perishable food on site. LPA observed a staff office space that is locked and inaccessible to clients, where client records are locked in file cabinets in a locked office. Facility has a garage used for maintenance supplies and is locked and made inaccessible to clients. The laundry room does have a door, but all cleaning supplies and chemicals are locked up high in cabinets. The smoke detectors were tested and found to be functional during the inspection and there were functioning carbon monoxide detectors on each floor of the facility. Three fire extinguishers were present with a recent inspection date of 1/14/2024. A fully equipped first aid kit was in the office area. Report continued on 809- C LPA observed the following items posted:- Personal Rights, Emergency Disaster, Exit signs, Foster Care Bill of Rights, Facility Sketch with emergency exit routes identified. There are two bathrooms in the facility that are accessible to client use. The water temperature was tested and found to be within regulatory temperature. LPA conducted 2 of staff interviews and 0 of clients interviews. Client interviews could not be conducted as client is not verbally understandable to LPA. LPA reviewed 3 of staff files and 1 client files. This facility meets Interim Licensing Standards mandates and is clean safe, sanitary and in good repair. LPA recommends the facility obtains permanent license with management approval. A signed copy of this report was provided to Cory Ranberg and Jamie Murray. End of report.

met_with: Facility manager


summary: Facility Evaluation

raw_content:
Narrative:
On 5/15/25, Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility and met with Nicole Eccles- Facility Manager. The purpose of the visit was to conduct a Required Annual Inspection of the facility. The last Annual inspection for the facility was on 7/11/24 for a post Licensing inspection.. LPA utilized the CARE Tool to complete the Annual inspection. The facility is licensed to provide treatment services for ambulatory children ages 8 to 17 years. The facility currently has one clients, all Regional Center placements. One client(s) was/were present during the inspection, yet left soon after for a scheduled appointment . The facility is licensed for a maximum capacity of 4. Staff to client ratio is 4:1. LPA conducted an inspection of the physical plant, and checked for all necessary requirements. The facility had no noticeable odor and maintained an acceptable room temperature. There are a total of four bedrooms available for clients, with each client having their own bedroom. LPA observed the client bedrooms, living rooms, kitchen, two bathrooms, the backyard, the garage, and the staff office to be clean and organized. LPA observed each client bedroom to have a closet, a dresser, and a clean mattress. Sheets, blankets, and pillows were in good condition. Every bedroom was decorated with the client's personal items. LPA observed a locked staff office where files and medications are stored. Client files were stored electronically with password protection. LPA observed the proper postings including: facility license, complaint hotline, menu, and continued on C page emergency disaster plan. Smoke alarms were in working order, fire extinguishers were current, and a first aid kit was fully stocked. The facility has no outstanding fees. LPA observed 3 days of perishable food and 7 days of non-perishable food in the kitchen and in the additional refrigerator in the garage. Disinfectants and cleaning solutions were inaccessible. LPA reviewed one client files. One client is currently taking parent approved medications and had current parental consent on file. Psychotropic medication logs for clients were written on separate Psychotropic Medication Administration Records. Clients were current on CHDP physical exams and dental exams. The client's Needs and Services Plan/Individual Program Plan, were complete and up to date. LPA reviewed 4 staff files. Staff files had completed criminal record clearances and all required initial and annual training. First Aid and CPR certifications were up to date for all staff. Administrators Certificate was valid. LPA interviewed 3 staff on site. LPA interviewed 0 clients, as client left to attend a scheduled appointment. No citations were given on this date.

met_with: Nicole Eccles- Facilty Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 4/15/26, Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility and met with Tawney Newbury- Facility Manager and Cory Ranberg- Administrator. The purpose of the visit was to conduct a Required Annual Inspection of the facility. The last Annual inspection for the facility was on 5/15/2025. LPA utilized the CARE Tool to complete the Annual inspection. The facility is licensed to provide treatment services for ambulatory children ages 7-17 years. The facility currently has 2 clients, all Regional Center placements. 2 client(s) were present during the inspection, but later went to school. The facility is licensed for a maximum capacity of 6. Staff to client ratio is 5:2 due to the level Regional Center designation. LPA conducted an inspection of the physical plant, and checked for all necessary requirements. The facility had no noticeable odor and maintained an acceptable room temperature. There are a total of four bedrooms available for clients, with each client having their own bedroom. LPA observed the client bedrooms, living rooms, kitchen, two bathrooms, the backyard, the garage, and the staff office to be clean and organized. LPA observed each client bedroom to have a closet, a dresser, and a clean mattress. Sheets, blankets, and pillows were in good condition. Every bedroom was decorated with the Page 1 of 2 client's personal items. LPA observed a locked staff office where files and medications are stored. Client files were stored in binder in a locked cabinet in a locked office. protection. LPA observed the proper postings including: facility license, complaint hotline, menu, and emergency disaster plan. Smoke alarms were in working order, fire extinguishers were current, and a first aid kit was fully stocked. The facility has no outstanding fees. LPA observed 2 days of perishable food and 7 days of non-perishable food in the kitchen and in the additional refrigerator in the garage. Disinfectants and cleaning solutions were inaccessible. LPA 2 client files. 1 of clients were taking prescribed psychotropic medications and had current parental consent on file. Psychotropic medication logs for clients were written on separate Psychotropic Medication Administration Records. Clients were current on CHDP physical exams and dental exams. The client's Needs and Services Plan/Individual Program Plan, were complete and up to date. LPA reviewed 5 staff files. Staff files had completed criminal record clearances and all required initial and annual training. First Aid and CPR certifications were up to date for all staff. Administrators Certificate was valid. LPA interviewed 2 staff on site. LPA interviewed 1 client, as the other client had to go to school and was not available for an interview. No citations were given on this date. An exit interview was conducted.

met_with: Tawney Newbury- Facility Manager Cory Ranberg- Administrator


facility_name: ANGELES VISTA CHILDREN'S HOME

raw_content:
Narrative:
Staff #1 stated there was a commotion in Child 1 & Child 2's shared room and upon entering room Staff 2 saw Child 2 on top of Child 1 in Child 1's bed. Staff 2 immediately intervened and called Staff 3 for additional support. Staff 2 attended to Child 1 getting Child 1 prepared to see medical doctor. Child 1 was taken to doctor for treatment and police were called out to assess Child 1 and Child 2. Multiple staff were interviewed, and they all expressed that they did not have any concerns with physical abuse or neglect for any of the clients residing in the home. LPA Phillips could not confirm with residents reason for altercation as residents are non verbal. Additionally, staff stated that Child 1 was moved to another room within the facility immediately following the incident. Also Staff stated additional monitoring of Child 1 and Child 2 has followed the incident. Based on the interview statements and documentation that were obtained, the preponderance of evidence standard has not been met, therefore the above allegations are found to be unsubstantiated. Exit interview was conducted, and a copy of this report will be emailed to the Annielyn Dumas/ Administratorqw

Investigation Findings:
13On January 6, 2022 at 12: PM Licensing Program Analyst (LPA), Zena Phillips conducted a follow-up complaint investigation visit to Angeles Vista Children's Home and met with Annieyln Dumas /Administrator. The purpose of the visit was to deliver findings for the above complaint allegation. Youth sustained unexplained injuries while in care During the investigation process by Licensing Program Analyst (LPA), Zena Phillips, all relevant parties have been accounted for. Based on the interviews conducted, the above allegation is found to be unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove or disprove that a violation occurred. Supporting evidence include the following: Staff #1 stated that Child 1 sustained injuries from Child UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips 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 FACILITY NAME: ANGELES VISTA CHILDREN'S HOMEFACILITY NUMBER: VISIT DATE: 01/06/2022

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

met_with: Annielyn Dumas/ Administrator


raw_content:
Narrative:
LPA Phillips observed cleaning solutions , hand sanitizer and cleaning schedule for maintenance staff. Additionally Staff 1, Staff 2 and Staff 3 all reported wearing mask during shift, temperature checks and reporting all COVID to proper authorities. All staff interviewed report cleaning hands and reporting illness of residents and self as required by facility and health department. LPA Phillips reviewed special incident reports and found incidents reported to department as required. After review of staff interview , facility reports and LPA Phillips observation the allegations were found to be Unsubstantiated meaning that although the allegations may have happened or are valid there is not a preponderance of evidence to prove that the alleged incident occurred. No deficiencies cited at the time of this investigation. Exit interview was conducted, and copy of the report was left with facility administrator

Investigation Findings:
13On March 16, 2022 @ 12: PM Licensing Program Analyst (LPA), Zena Phillips conducted a follow-up complaint investigation visit to Angeles Vista Children's Home and met with Jermaine Trottie Administrator. The purpose of the visit was to deliver findings for the above complaint allegations. During the investigation process by Licensing Program Analyst (LPA), Zena Phillips, all relevant parties have been accounted for. Based on the interviews conducted, the above allegations are found to be unsubstantiated, meaning that although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove or disprove that a violation occurred. LPA Phillips observed cleaning solutions and automatic dispenser with thermometer installed at front entrance. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips 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 FACILITY NAME: ANGELES VISTA CHILDREN'S HOMEFACILITY NUMBER: VISIT DATE: 03/16/2022

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

met_with: Jermaine Trottie/ GH Administrator


raw_content:
Narrative:
LPA Phillips observed very light redness with faint purplish color around left eye and below eye area of Child #1. Staff # 1, Staff #2, & Staff # 3 all stated that Child #1 has self harming episodes about one to two times per month and they try and protect Child #1 from greater harm. Evidence revealed that self harming is a behavioral pattern and confirmed by Child # Social Worker and NSP review. Additionally staff did close monitoring of Child #1 during self harming episode and administered first aid after Child # 1 was calm. The Department has determined, based on the preponderance of the evidence obtained during this investigation, that the allegation above is unsubstantiated. No deficiencies cites at this time. Exit interview was conducted and a copy of report will be emailed to Administrator Annielyn Dumas.

Investigation Findings:
13On April 21, 2022, @ 1: PM Licensing Program Analyst (LPA), Zena Phillips and LPA Kuliema Calloway conducted a joint follow-up complaint investigation visit to Angeles Vista Children's Home and met with Annielyn Dumas Administrator who granted access to the facility. The purpose of the visit was to deliver findings for the above complaint allegation. During the investigation process by LPA Phillips confidential interviews were conducted with relevant parties, reviewed Special Incident Reports, medical appointment notice, and Needs and Service Plan of Child #1 in care. LPA Phillips attempted interview with Child #1 but unable to conduct interview due to Child #1 is non verbal. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips 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 FACILITY NAME: ANGELES VISTA CHILDREN'S HOMEFACILITY NUMBER: VISIT DATE: 04/21/2022

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

met_with: Annielyn Dumas /Administrator


raw_content:
Narrative:
Confidential interviews revealed that Child #1 self harms as part of Child #1's behavior. It was reported to LPA Phillips that staff are taught to redirect client and hold Child #1 hands during attempts to self harm. Staff stated they are doing their best to provide one on one care. It was reported to LPA Phillips if available staff sit with Child #1 but still need to assist with other residents as needed. It was reported to LPA Phillips that funding is needed to provide one on one staff care to Child #1. It was reported to LPA Phillips funding request has been made by and will notify facility. Staff #1, Staff #2 and Staff #3 all state they make sure Child #1 is eating and try to make sure foods that Child #1 likes is prepared. Also Staff #1 said Child #1 like spicy foods and tries to prepare spicy food that Child #1 likes such as fries, chicken tenders and tater tots. LPA Phillips was provided a daily food log listing all food and amounts consumed by Child #1. It was reported to LPA Phillips that the facility is making every effort to meet the needs of Child #1 but admit Child #1 requires a higher level of care. During the confidential interviews it was reported to LPA Phillips that Child #1 is hard to place and lack of funding to being a minor. Due to inconsistent statements LPA Phillips was not able to determine if the above said allegations occurred, therefore the allegations were found to be Unsubstantiated meaning that although the allegations may have happened or are valid there is not a preponderance of evidence to prove that the alleged incidents occurred. No deficiencies cited at the time of this investigation. Exit interview was conducted, and copy of the report will be left with facility administrator.

Investigation Findings:
13On 11/29/2022 @ 8: AM Licensing Program Analyst (LPA), Zena Phillips conducted a follow-up complaint investigation visit to ANGELES VISTA CHILDREN'S HOME and met with Valerie Onyeachonam/Direct Care Staff who granted acess to the facility. The purpose of the visit was to deliver findings for the complaint allegations. During the investigation of the allegations: Staff did not prevent minor from self harming. Facility not providing one on one supervision to minor. Facility did not ensure minor was fed. Minors needs are not being met. LPA Phillips conducted five (5) confidential interviews and reviewed the following documentarty evidence:, Needs and Services Plan, medical appointments, medication log, staff and client files, facility menu and client log of food consumed. LPA observed nurse at facility for client assessment clean and dress wounds. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips 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 FACILITY NAME: ANGELES VISTA CHILDREN'S HOMEFACILITY NUMBER: VISIT DATE: 11/29/2022

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

met_with: Valerie Onyeachonam/Direct Care Staff