raw_content:
Narrative:
Confidential interviews reveal there have not been any major injuries for Child #1 and staff are treating old wounds. Staff reported that daily body checks are conducted on the resident to see if any injuries. Staff deny that they would refuse to provide first aid to resident. Due to inconsistent statements LPA Phillips was not able to determine if the above said allegation occurred, therefore the allegation is found to be Unsubstantiated meaning that although the allegation may have happened or are valid there is not a preponderance of evidence to prove that the alleged incident occurred. Based on the observations made during today's inspection, no deficiencies were cited. Exit interview was conducted, and a copy of this report will be emailed to Administrator.

Investigation Findings:
13On 12/06/2022 @ 8: AM Licensing Program Analyst (LPA) ZenaPhillips conducted a follow up visit to ANGELES VISTA CHILDREN'S HOME and met with Brittney Jumper /Case Manager who provided the census. The purpose of the visit was to deliver findings for the complaint allegation listed above. During the course of the investigation five (5) confidential interviews were conducted, reviewed the following documentarty evidence:, Needs and Services Plan, medical appointments, medication log, SIR reports, staff and client files. It was reported to LPA that if resident is injured the nurse is called and if severe the resident will be transported to the hospital. First aid kit is available on site and injuries that go beyond first aid are reported on Special Inicident Report. 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: 12/06/2022

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

met_with: Brittney Jumper /Case Manager


state: CA

facility_name: ANGELES VISTA CHILDREN'S HOME

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
LPA received conflicting testimonies regarding the operational status of the facility phone. Witness interviews shared that the phone was not working during a specific visit. Witness interviews could not testify to why the phone was not working, for how long the phone was not working, or what the facility's response was. Staff testified that the facility phone was non-operational for a time, the facility's response was to try and fix the issue with the provider Spectrum, and then when the issue could not be fixed the facility just replaced the phone. LPA also observed the new phone to be in working order. Based on the available information LPA gathered from interviews, and observation evidence, the preponderance of the evidence standard has not been met; therefore, the allegation that the "Staff did not ensure telephone was working properly" is found to be unsubstantiated. Exit interview conducted. A copy of this report and appeal rights was given to Administrator.

Investigation Findings:
13On7/22/25 at 1: PM, Licensing Program Analyst (LPA) Reagan Cohen arrived at the above facility and met with Administrator Larrina Maloy for the purpose of delivering complaint findings regarding the above allegation. During the course of the investigation, LPA interviewed involved staff and witnesses. LPA was unable to interview clients due to them being non-verbal. Witness testimony alleged that during a visit, staff shared that the facility phone was not working at the moment and would hopefully be fixed soon. Staff interviews admitted that there was an issue with the phones for a short period of time from 3/29-4/1 2025. During that time, the facility's response was to call Spectrum, the phone provider. Spectrum tried to do some resets and reboots remotely, which did not work. Staff explained that neither they nor Spectrum could figure out the phone problem. Spectrum shared that they could not come out to service the phone until 4/3/25. The facility did not want to wait, so they just replaced the phone, which is now in working order. Staff state that they were not able to receive a work order from Spectrum because Spectrum never came out physically to work on the phone. During LPA's visit, LPA called and tested the new phone and observed it to be in working order. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Reagan Cohen LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: ANGELES VISTA CHILDREN'S HOMEFACILITY NUMBER: VISIT DATE: 07/22/2025

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

report_type: Complaint Investigation

met_with: Larrina Maloy Administrator

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On 10/07/2021 at 9: AM Licensing Program Analyst (LPA) Zena Phillips made an unannounced to Angeles Vista Children's Home to conduct Annual Inspection. LPA met with Linda Hudson/ who granted access to the facility. The entire physical plant was inspected. The Group Home is to provide care and supervision for six (6) children, ages 11-21 years Ambulatory Only. The Administrator confirmed that there are no guns or weapons on the premises. This is a 1-story three (3) bedrooms; 2 1/2 bathrooms. There is a fully furnished living room, dining room and Central Air conditioning unit. The outdoor perimeter front yard, side yard and backyard were inspected and found cleared of debris and hazards materials. LPA observed all windows, screens and blinds from the inside and outside of the facility were observed to be in good condition. The windows are double hung style with no bars on the windows in the event of an emergency evacuation. The passageways and porches are unobstructed. All posting requirements were met, (food menu, regulations, licenses, emergency disaster plan and personal rights). Posting are in the common area accessible to clients (clients are nonverbal). The cleaning supplies solutions, disinfectants are stored under the kitchen sink locked; sharp knives are also inaccessible in separate locked cabinet opposite of the kitchen sink. All the children prescribed medications are in locked rolling cabinet. LPA observed 5 hard wired connected and 3 battery operated combined Smoke detectors and Carbon Monoxide; tested to be operable. Report continues on LIC-809-C The garage has been converted in 2 offices; Administrator & Social Worker office and other portion used for extra supplies stacked neatly on metal shelving. One additional office for Staff is just behind laundry are to the left of rear exit of the house. The facility has a working telephone and clients can use the telephone unless restricted by court order. The staff accompanies clients to local recreational facilities based on the rules of the COVID-19. Clients are accorded dignity in personal relationships with staff and others The Facility operates within license conditions and limitations including capacity limitations. Facility has a current, written plan of operation. Facility personnel are instructed to report violations of personal rights. Licensee will report changes in the plan of operation affecting service to clients. Licensee will report client injuries requiring medical treatment. LPA will return to the facility at later date to complete Annual Inspection Clients records, Staff Records review, Staff interviews/ clients are nonverbal). There were no deficiencies cited at this time. Exit Interview was conducted and a copy of this report was left at the facility.

report_type: Facility Evaluation

visit_type: Annual

met_with: Linda Hudson/Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 10/08/2021 at 10: AM Licensing Program Analyst (LPA') Zena Phillips, made an announced visit to Angeles Vista Children's Home for Annual/Required licensing Inspection. LPA' met with Linda Hudson/ Administrator & Jasmine Hernandez/Case Manager who granted access to the facility. LPA reviewed the following during the inspection: Staff records review; the information regarding the Emergency Preparedness. LPA reviewed Criminal Records and confirmed that all current and former staff were also cleared. LPA reviewed The Administrator and Direct Care staff records. LPA reviewed the facility binder that included specific training: Specific Trainings include the following: Policies & Procedures; Health & Safety: Covid Training, Emergency Procedures: Medication;Trauma-Informed Care; Defensive Driving; Job Duties; and information about the Stakeholders. LPA was not able to interview residents all are are nonverbal. LPA observed the Board of Directors Meeting Notes and confirmed that meetings are held quarterly. LPA inspected facility vehicle and confirmed current registration and valid insurance in place. There were no deficiencies cited at this time. Exit Interview was conducted and a copy of this report was left at facility

visit_type: Case Management

met_with: Linda Hudson/Administrator & Jasmine Hernandez/ Case Manager


summary: Facility Evaluation

raw_content:
Narrative:
On March 8, 2022, at 8:55am Licensing Program Analysts (LPAs), Emelyn Sanchez P. and Olivia Rosas arrived at Angeles Vista Children's Home facility unannounced for the purpose of conducting a SB Psychotropic Medication Case Management- Medication Inspection Visit. LPAs Sanchez P., and Rosas met with Annielyn Dumas, Facility Administrator and Jasmine Hernandez, Facility Case Manager. LPAs Sanchez P. and Rosas reviewed two (2) client files and three (3) staff files. LPAs Sanchez P. and Rosas conducted no client interviews due to clients having an intellectually disability. LPAs Sanchez P. and Rosas conducted three (3) staff interviews. Currently there are six (6) clients residing in the above facility. This is one story building located in a residential area. The home is equipped with a kitchen, living room, dinning room, small office space, medication/laundry space, three bedrooms and two and a half bathrooms. There is a converted detached garage that is used as another office space and also used to store additional storage. Outdoor space is free of obstructions. LPAs Sanchez P. and Rosas observed the facility to be clean, safe, sanitary and in good repair. LPA Sanchez P. and Rosas observed adequate staffing in the facility to provide care and supervision to children in care. LPAs Sanchez P. and Rosas also observed medication to be centrally stored, locked and inaccessible to clients and unauthorized staff members. There were no deficiencies cited at this time. Exit interview was conducted, and a copy of this report was left at the facility.

met_with: Facility Administrator- Annielyn Dumas


summary: Facility Evaluation

raw_content:
Narrative:
On October 10, 2022 @ 1: PM Licensing Program Analyst (LPA) Zena Phillips made an announced visit for the purpose of conducting a Case Management visit inspection. LPA Phillips was greeted by Annielyn Dumas/ Administrator who granted access to the facility. The entire physical plant was inspected. The Group Home is to provide care and supervision for six (6) children, ages 6-17 years Non Ambulatory Only. The Administrator confirmed that there are no guns or weapons on the premises. This is a 1-story three (3) bedrooms; 2 1/2 bathrooms. The home is being inspected due to recent renovations. The facility has new paint in all three (3) bedrooms, new wood laminate flooring throughout living room, dinning room, kitchen and hallway. New upper cabinets in kitchen, with new quartz counter tops. The kitchen has new refrigerator and stainless sink. Two of the full bathrooms have new shower stalls, new sink, vanity with mirror, toilets and newly installed tile flooring. The half bathroom has new toilet bowl and vanity with mirror, and newly installed tile flooring. All windows have new white faux wood blinds that are cordless including the office area. Additional office for Staff is just behind laundry area to the left rear of the house. The facility has brand new washer in laundry room. The home is clean safe and sanitary and ready for residents.. There were no deficiencies cited at this time. Exit Interview was conducted and a copy of this report will be emailed to Annielyn Dumas / Administrator.

met_with: Annielyn Dumas/Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 10/26/2022 at 8: AM Licensing Program Analyst (LPA) Zena Phillips made an unannounced to Angeles Vista Children's Home to conduct Annual Inspection. LPA met with Vivian Okafor/Milieu Counselor who granted access to the facility. The entire physical plant was inspected. The Group Home is to provide care and supervision for six (6) children, ages 11-21 years Ambulatory Only. The Administrator confirmed that there are no guns or weapons on the premises. This is a 1-story three (3) bedrooms; 2 1/2 bathrooms. LPA observed clean linen on beds, adequate drawer storage and closet available for clothing. LPA observed the 2 1/2 bathrooms to be clean and sanitary with hot water within regulation temperature. There is a fully furnished living room, dining room with adequate seating for clients and Central Air conditioning unit. The outdoor perimeter front yard, side yard and backyard were inspected and found cleared of debris and hazards materials. LPA observed all windows, screens and blinds from the inside and outside of the facility were observed to be in good condition. The windows are double hung style with no bars on the windows in the event of an emergency evacuation. The passageways and porches are unobstructed. All posting requirements were met, (food menu, regulations, licenses, emergency disaster plan and personal rights). Posting are in the common area accessible to clients (clients are nonverbal). The cleaning supplies solutions, disinfectants are stored under the kitchen sink locked; sharp knives are also inaccessible in separate locked cabinet opposite of the kitchen sink. Report continues on LIC-809-C All the children prescribed medications are in locked rolling cabinet. LPA observed 5 hard wired connected and 3 battery operated combined Smoke detectors and Carbon Monoxide; tested by maintenance staff to be operable. The garage has been converted in 2 offices; Administrator & Social Worker office and other portion used for extra supplies stacked neatly on metal shelving. One additional office for Staff is just behind laundry are to the left of rear exit of the house. The facility has a working telephone and clients can use the telephone unless restricted by court order. Clients are accorded dignity in personal relationships with staff and others The Facility operates within license conditions and limitations including capacity limitations. Facility has a current, written plan of operation. Facility personnel are instructed to report violations of personal rights. Licensee will report changes in the plan of operation affecting service to clients. Licensee will report client injuries requiring medical treatment. LPA conducted four (4) Staff interviews, no Client interviews due to clients non verbal. LPA reviewed four (4) Staff files and four (4) Client records. LPA observed during this inspection facility to be clean, safe and sanitary. There were no deficiencies cited at this time. Exit Interview was conducted, and a copy of this report will be emailed to Annielyn Dumas.

met_with: Vivian Okafor/Milieu Counselor


summary: Facility Evaluation

raw_content:
Narrative:
On 11/03/2023 at 09: AM, (LPA) Licensing Program Analyst - Dennis Jarmin made an unannounced visit to Angeles Vista Children's Home to conduct the annual required inspection. LPA met with Danny Brown/DSP, who granted access to the facility. LPA then inspected the entire physical plant of the facility. The Group Home is licensed and provides care and supervision for six (6) children, ages 11-21 years Ambulatory only. There are no bodies of water on the premises and camera waiver is on file. State of California of license was posted. The Group Home Administrator confirmed that there are no guns or weapons stored on the premises. The facility is a one 1- story home with 3 bedrooms and 2 1/2 bathrooms. LPA observed the facility clean and sanitized with clean linens, appropriate drawer storage and closet available for clients clothing. The 2 1/2 bathrooms were observed clean and sanitary with the required hot water temperature within the regulation. The dining room and living room area had appropriate seatings, and furniture were in good repair condition. The facility has central air conditioning unit that provides suitable air temperature throughout the home with appropriate lighting. LPA observed all the windows in good condition including screens and blinds that are styled double hang with no bars in the event of an emergency evacuation. All passageway and porches were clear of obstruction and all required posting were met (meal plan, daily activities, required licenses and regulations, personal rights and emergency disaster plan) that are posted in the common area readily accessible to clients. LPA observed cleaning supplies solutions, bleaches and disinfectants are properly stored under the sink that is locked. Sharp knives were also observed locked and inaccessible on a separate cabinet opposite of the kitchen sink. Continue to Lic 809c The clients are all nonverbal and prescribed medications that are stored in a locked, RED medication rolling cart located pass the kitchen area. LPA observed 5 hard wired and 3 battery operated combined smoke detectors and Carbon Monoxide monitor, all system was tested by maintenance that have appropriate audible sounds and operable. The right side of the medication cart was the laundry area with no safety issues or concerns noted and an office for staff/administrator were on the rear exit of the home. The facility had outdoor area that are located in the front and back perimeter with no debris or hazardous materials noted. The facility has a working telephone and 2 mobile unit that clients can use unless prohibited by court order. The home accord clients with dignity in personal relationships with personnel and others. Overall, the licensee operates within the conditions and limitations of the license including capacity limitations. The facility has a current written plan of operation and all personnel are directed to report violations of Personal Rights. The Licensee reports any changes in operation that affects clients service and reports clients injuries that prompted medical service or treatment. LPA conducted Staff interviews, zero client interviews due to clients nonverbal conditions and reviewed 4 client records. LPA also reviewed the administrator file and 7 personnel files with no concerns noted. During this inspection, LPA observed the facility clean, sanitary, safe and free of hazards, and there are no deficiencies cited at this time. Exit interview was conducted, and a copy of the report will be emailed to Annielyn Dumas, Facility Administrator..

met_with: Annielyn Dumas


summary: Facility Evaluation

raw_content:
Narrative:
This is an amended report. On 09/27/2024 at 09: AM, (LPA) Licensing Program Analyst - Kim Dear made an unannounced visit to the Angeles Vista Children's Home to conduct an annual required inspection. LPA met with Kylia James, Direct Support Professional, (DSPII), who granted access into the facility. LPA was greeted by Rodtricia Brooks, DSPI whom stated the current census at this facility is 4. The Group Home is licensed and provides care and supervision for six children, ages 6-17 years of age, ambulatory only. The State of California license was posted. The kitchen has new refrigerator and stainless sink. Two of the full bathrooms have new shower stalls, new sink, vanity with mirror, toilets and newly installed tile flooring. The half bathroom has new toilet bowl and vanity with mirror, and newly installed tile flooring. The Group Home Administrator confirmed that there are no guns or weapons stored on the premises. The facility is a one story home with 3 bedrooms and 2 1/2 bathrooms. LPA observed the facility clean and sanitized with clean linens, appropriate drawer storage and closet available for clients clothing. The bathrooms were observed to be clean and sanitary with the required hot water temperature, ( F) within the regulation. The dining room and living room area had appropriate seating, furniture cushioning and springs are in good condition. The facility has central air conditioning through out housing and lighting is appropriate. Wood laminate flooring is throughout the living room, dinning room, kitchen and hallways. LPA observed windows throughout the facility to be in good condition including screens. Passageways and porches were clear of obstruction and all required posting were met (meal plan, daily activities, required licenses and regulations, personal rights and emergency disaster plan. LPA observed cleaning supplies/ solutions, bleaches and disinfectants are properly stored under the sink, in cabinets as well as in outdoor storage unit that is locked. Sharp knives were also observed locked and inaccessible to clients. Washer and dryer appliances are available on service porch of the kitchen area. Kitchen has a double sided sink. (See 809C) All of the clients prescribed medications are in locked rolling cabinet. LPA observed a total of (6) smoke detectors/ carbon monoxide units were push tested tested by maintenance staff to be operable. The garage has been converted in 2 offices; Administrator & Social Worker office and other portion used for extra supplies stacked neatly on metal shelving. An additional office for Staff is located behind the laundry set up, to the left of rear exit door of the house. There are no bodies of water on the premises. Facilities camera waiver is on file, however current licensee is unaware if the equipment is functioning/ recording or not. The facility has a working telephone and clients can use the telephone unless restricted by court order. Clients are accorded dignity in personal relationships with staff and others. The Facility operates within license conditions and capacity limitations. LPA conducted five (5) Staff interviews, no client interviews were conducted due to client's non- verbal abilities. LPA reviewed four (4) staff files and four (4) client records. LPA observed facility to be clean, safe and sanitary. Facility will be cited for non- compliance of personnel currently working at the facility without clearance, as well as health clearance violations and the lack of staff training in which poses a health and safety risk for children in care. Facility cited for violation of the California Code of Regulations, Title 22, Division Six, regulation(s). An immediate civil penalty has been issued for sections: 80019 (e)(3). Criminal Record Clearance, 80054(b).Civil Penalty, 84061(e), Reporting Requirements, and 84065(h), Personnel Records. An exit Interview was conducted with the facility administrator, Lorrena Maloy and a copy of this report was provided.

met_with: Lorrena Maloy


summary: Facility Evaluation

raw_content:
Narrative:
On 10/01/2024 at 09: AM, (LPA) Licensing Program Analyst - Kim Dear made an unannounced visit to Angeles Vista Children's Home to conduct the annual inspection continuation. LPA met with Linda Hudson, whom granted access into the facility. LPA then completed file inspections and CARES Tool input. The Group Home is licensed and provides care and supervision for six (6) children, ages 11-21 years Ambulatory only. There are no bodies of water on the premises and camera waiver is on file. State of California of license was posted. Based on CARES Tool completion, facility will be cited and has technical A and B advisories. LPA observed facility to be clean, safe and sanitary. Facility will be cited for non- compliance of personnel currently working at the facility without clearance, as well as health clearance violations and the lack of staff training in which poses a health and safety risk for children in care. . An exit Interview was conducted with the facility administrator, a copy of Appeal Rights were provided and a copy of this report was given to facility..

met_with: Linda Hudson


summary: Facility Evaluation

raw_content:
Narrative:
This is an amended report from October 14, 2024. On 10/14/2024 at 01: PM, (LPA) Licensing Program Analyst - Kim Dear made an unannounced visit the Angeles Vista Children's Home to deliver licensing report issued on 09/27/24. LPA met with Chidinma Ehiemere, Direct Support Person, (DSP), whom granted access into the facility. A copy of the report was provided to the DSPi Staff.

met_with: Chidinma Elmeini


summary: Facility Evaluation

raw_content:
Narrative:
On 01/17/25, at 12:40, Licensing Program Analyst, (LPA), Kim Dear, (LPA), Charmetha White, and Licensing Program Manager, (LPM) Enrique Hernandez made an unannounced visit to the Angeles Vista Children's group home for the purpose of conducing a Plan of Correction (POC) inspection. LPA's and LPM met with Armando Velasquez, House Manager. Said visit was conducted to ensure that the POC's had been implemented reflecting the correction of previous deficiencies cited at the 09/27/24 site visit. A review of employee files together with House Manager on this site visit indicates that the following cited deficiencies were pending correction: Staff Files: PERSONNEL RECORDS: Staff files pending correction TRAINING RECORDS: Staff files pending correction. ONGOING TRAINING RECORDS: Staff files pending correction. ADMINISTRATOR QUALIFICATIONS: No request received to CCLD office. LPA's and LPM have found the facility to have areas of staff files not corrected. LPM as authorized a (30) thirty day extension for corrections to be met. The other deficiencies were corrected, and Civil Penalties have been received. No Additional deficiencies were observed or cited Per California Code of Regulations, Title Regulations, Division 6, Chapters 1 & 5. Exit interview was conducted, and a copy of this report was left at the facility.

met_with: Armando Velasquez


summary: Facility Evaluation

raw_content:
Narrative:
On October 29, 2025, Licensing Program Analyst (LPA) C. White arrived at Angeles Vista Children's Home for the purpose of conducting an Annual Required Inspection. LPA met with House Manager, Armando Velasquez, and together a tour of the entire facility was conducted. The facility is licensed to provide care and supervision to six (6) developmentally disabled children, ages 6-17 years old, non-ambulatory and ambulatory. The program accepts placement from the Regional Center and DCFS. The current census is 4 (four). All currently placed children are non-verbal. The facility is set up as follows: This is a single-story home located in a residential neighborhood. The home includes 3 bedrooms, 2 ½ bathrooms, a living room, dining room, kitchen, laundry area, staffing offices, a detached converted garage, and a backyard. Living room: has two (2) sofas, a mounted flat screen TV, and a covered non-operational fireplace. Dining room: has a wooden table with six (6) chairs. There is a locked file cabinet that contains client medication and client files. Kitchen: is equipped with a five (5) burner gas stove/oven (all burners were operational at the time of the inspection), refrigerator/freezer, and a microwave above the stove. The facility maintains an adequate supply of perishable and non-perishable food. The kitchen trash bin has a lid cover. Sharps were observed to be in a locked lower cabinet to the left of the stove. The kitchen also has a locked deep freezer, toaster, and dishwasher. Disinfectants and cleaning supplies are stored under the sink in a locked cabinet. Report continued on LIC 809C (Page 1 of 3) Laundry area: is located between the kitchen and staffing office, near the back door. It is equipped with one (1) washer and one (1) dryer. Laundry detergent and other cleaning supplies are kept in locked cabinets. Staffing Office: has a desk, chair, a computer, and storage lockers for the staff. Detached Converted Garage: one side was observed to be used for storage, extra hygiene supplies, disinfectants, and emergency food supplies. There is also a deep freezer to store food overflow. The other side was observed to be used for 2 (two) staffing offices: the Administrator and House Manager. The rooms have desks, chairs, computers, a printer, and storage cabinets that contain staff files. Backyard: has a covered sitting area with ample seating. (3) Bedrooms: Bedrooms #1 and #3 are equipped with two (2) twin beds, a dresser, adequate closet space, windows, and working ceiling lights. Bedroom #2 is equipped with one (1) bed, a dresser, adequate closet space, windows, and a working ceiling light. (2) Bathrooms: Bathroom #1: is a ½ bathroom located at the front of the hallway and is equipped with a toilet and sink. Bathroom #2 is located at the back of the hallway, and Bathroom #3 is located in bedroom #3. Bathrooms #2 and #3 are full bathrooms, and both are equipped with a toilet, sink, and shower. Hygiene and grooming supplies are kept in locked cabinets inside of bathroom #2 and #3. All bathrooms were operational at the time of the inspection. Additionally, the hot water was tested and was found to be between 105-120 degrees (F). Vehicle: The facility shares a vehicle with Valley Ridge Group Home for emergency purposes, and all clients are bused to school. The facility has adequate hygiene and grooming. The smoke alarms and carbon monoxide detectors were tested and found to be in working order. The first aid kit was checked and found to be complete. There is a working telephone readily accessible to clients in the home at all times. The facility has central air conditioning. Report continued on LIC 809C (Page 2 of 3) Overall, the facility appeared clean, safe and sanitary. The front and back yards are free of debris and hazardous material. Passageways, stairways, inclines, ramps and open porches are unobstructed. There were no security bars on the windows. No bodies of water on the premises and no weapons in the facility. Children in care are supervised and protected at all times. Children are accorded dignity in personal relationships with staff and others. Children attend school, extracurricular, cultural and personal enrichment activities. Facility met posting requirements. Facility operates within license capacity and limitations. LPA will return at a later date to review client and staff files. LPA verified that all Staff listed on the LIC 500, obtained and dated 10/01/2025, are cleared and associated with the facility. LPA informed House Manager, Armando Velasquez, that the facility would be cited. The following deficiency is being cited for violating of California Code of Regulations Title 22, Division Regulation 80023(a) Disaster and Mass Casualty Plan. (see page D) (Page 3 of 3).

met_with: Armando Velasquez - House Manager


summary: Facility Evaluation

raw_content:
Narrative:
On December 16, 2025, Licensing Program Analyst (LPA) C. White conducted an unannounced Plan of Correction (POC) visit to the above facility for the purpose of clearing a POC. LPA met with Administrator, Larrina Maloy. The POC was originally cited on October 29, 2025 during the Annual Inspection. The deficiency cited was as follows: Type B - The facility did not have a disaster and mass casualty plan binder available for review at the time of the inspection. Section 80023(a). Original POC Date: 11/19/2025 (cleared: 12/16/2025; POC letter: 12/16/2025). The Licensee developed a binder which LPA reviewed on 12/16/2025, and observed included an updated LIC 610C, Emergency Disaster Plan; LIC 9020, Client Roster; LIC 625, Appraisal/NSP's for each client; Facility Sketch; and Plans/Procedures for emergency disasters. There are no deficiencies cited at this time. An exit interview was conducted and a copy of this report and POC letter was provided to the Administrator.

met_with: Larrina Maloy - Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 4/18/ LPA Reagan Cohen arrived at Angeles Vista Children's Home for the purpose of an unannounced case management deficiency inspection and met with Administrator Larrina Maloy. While reviewing the staff schedule and roster LPA noticed that staff (Kafilat Azeez, Edward Cox, Chidinma Ehiemere, Joan Gambie, Hilarion Ihezuoh, Minkailu Kabia, Basil Lwokolo, Stanley Okoro, Peter Olowa, Veronica Ortega, Becky Ovie, & Aisha Sidibeh) were listed on the schedule but were missing clearance on guardian. Administrator admitted that the staff has worked at he facility without being cleared. Administrator stated that previously there was an error and multiple staff had to be re-finger printed even though they had clearance specifically for Angeles Vista. LPA informed Administrator that the facility would be cited. The following deficiency is being cited for violating of California Code of Regulations Title 22, Division Regulation 80019 (e) (2) criminal record clearance. (see page D) Exit interview completed, appeal rights issued, and a copy of this report was given to the Administrator.

met_with: Administrator Larrina Maloy


facility_name: ANGELFIELD SERVICES

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPA) Alyssa Ng and Licensing Program Manager (LPM) Helga Wong met with applicant Mary Jane Cagadas via Microsoft Team Meeting to conduct a component II of the orientation process. The following items were discussed: - Physical Plant and the use of the facility - Facility will provide care for DD clients, Level 4I with Regional Center -Administrator will be working at the facility minium 20 hours weekly -Training for staff including topics on Medication, DSP 1 & 2, and Emergency Intervention -Reviewing and understanding of Title 22 regulations and Health and Safety Codes -Personal Rights -Supportive Services Component III and Pre-Licensing inspection will be scheduled by LPA Alyssa Ng when she received fire clearance. An exit interview was conducted and a copy of this report was given to applicant Cagadas.

met_with: Mary Jane Cagadas


summary: Facility Evaluation

raw_content:
Narrative:
On 7/20/22 at 1: PM, Licensing Program Analyst Alyssa Ng met with applicant Mary Jane Cagadas via Microsoft Teams Meeting. The purpose of this meeting was to discuss the facilities Program Statement and Plan of Operation. The following items were discussed: - Goal/Purpose of the Group Home -Training for staff (CPI, DSP, etc.) -Intake/Admission Process for future clients -Needs & Service Plan & how to incorporate the goals into the clients lives -Planned Social Activities -Emergency Intervention Procedures (COVID plan, ON-Call staff, Fire, etc.) -AWOL/Runaway Procedure -Incident Reports -Special Services offered -Fingerprinting/Guardian process -Behavior management -Visitation Procedure/Policy Component III and Pre-Licensing date is set for August 8th at 10: AM. LPA advised Mary Jane to have forms available (Staff, Client, Medication) when LPA conducts the Pre-Licensing visit. An exit interview was conducted and a copy of this report was sent to Applicant Mary Jane Cagadas.


summary: Facility Evaluation

raw_content:
Narrative:
On September 21, 2022 at 9:45am, Licensing Program Analyst (LPA) Monica Pavia conducted an announced pre-licensing inspection of the facility. LPA met and toured the facility with Mary Jane Cagadas, Licensee. This Group Home is a one story facility located in a residential area. The facility consists of 3 client bedrooms and 2 client bathrooms, living and dining areas, kitchen, and laundry room. There are two locked sheds in the backyard and it was discussed with the Licensee that Community Care Licensing (CCL) would need access at all times. The facility is clean, safe, sanitary, and in good repair. All passageways are unobstructed and all doors open freely. There is no pool on the premises. Fire arms are not allowed on the facility premises. At the time of visit, the following was observed: Fire extinguishers are throughout the house. Smoke detectors are throughout the house and operational. Carbon monoxide detectors are located in the hallway, outside of the client bedrooms. Each bedroom has a bed, clean linens, and adequate drawer/cabinet space. Facility has a fire clearance. First aid kit was observed. Hot water temperature measured at 108 degrees Fahrenheit. Staff and client files will be locked in the filing cabinet in the dining room. Medications will be centrally stored and locked in the filing cabinet in the dining room. Disinfectants and other toxic materials will be locked in the laundry room. Extra bedding and towels are kept unlocked, in the hallway closet. Sharp knives are kept locked in a tool box in the kitchen. Site location has a live in staff bedroom and bathroom that is kept locked, and meets prelicensing requirements. Site location has ring cameras at the front door and on the outside perimeter of the house. Per Licensee, they belong to the homeowner and are not hooked up. Licensee will provide a sworn affidavit from homeowner stating the ring cameras are not in use and will not be activated as long as this site location is a Community Care Licensing facility. Licensee agrees to meet current County safety COVID guidelines. Items to complete prior to licensure/placement. Send photos once complete. - remove or hang pictures that are currently in client bedroom closets - replace missing electric plate in dining room - lock toxins in laundry room and staff bathroom - child lock on mini-fridge in dining room (secure lock if meds are inside) - swing outside to be set up This facility will be ready for licensure once above is completed, Licensee submits Nonprofit Articles of Incorporation and Licensing Program Manager (LPM) has reviewed the application file. Component II: LPA Pavia discussed with the following, with Administrator: - Administrator on site required hours - discipline policies & house rules - facility emergency intervention plan

visit_type: Prelicensing


summary: Facility Evaluation

raw_content:
Narrative:
On 10/24/23, Licensing Program Analyst (LPA) Mariah Hawkins conducted a required annual inspection. LPA met with Administrator Mary Jane Cagadas and informed of the purpose of the visit. The facility has had no placements (clients), as the vendorization is still pending with Regional Center. Administrator agreed to update LPA when the vendor certificate is acquired. LPA inspected the facility site and grounds and reviewed facility records with Administrator. LPA observed the facility to be clean and organized, kitchen and bathroom spaces to be maintained in sanitary condition, and bedrooms to be tidy and ready for clients. Using the CARE Inspection Tool, no deficiencies were found. An exit interview was conducted, and a copy of this report was left with Administrator Mary Jane Cagadas, whose signature on this form confirms receipt.

met_with: Administrator Mary Jane Cagadas


summary: Facility Evaluation

raw_content:
Narrative:
On 10/07/24, Licensing Program Analysts (LPAs) Celeste Aparicio and Jonathan Medina conducted a unannounced required annual inspection. LPAs met with Administrator Mary Jane Cagadas and informed of the purpose of the visit. During the inspection the resident in care was present in the facility due to being on a Fall break from school. The resident was engaged in daily activities during the inspection. Administrator indicated that the resident is nonverbal. LPAs observed resident to be dressed in clean, well-fitting clothes, and to be closely supervised by present personnel. Facility Administrator indicated that the present personnel helping with the resident in care were the Administrators parents who would be residing at the facility for a six month period. The CARE Inspection Tool was used to conduct the inspection. At the start of the inspection LPAs conducted a walk through of the facility, inside and out. LPAs observed centrally stored medications maintained in a locked cabinet, three client bedrooms, two bathrooms , living room, kitchen, dining area, washroom, and garage that had been converted into a staff office/ bedroom. LPA's observed at least one-week supply of nonperishable and a two-day supply of perishable food. In the backyard LPA's observed two sheds. The larger shed was used as a storage space as the other smaller shed was used for gardening materials. Both sheds were locked. The facility is maintained at 77 degrees. Hot water temperature measures at 112 degrees. LPA observed the facility to be clean, organized, and to be maintained in sanitary condition. During the walk through LPA's observed two cleaning materials left out in unlocked spaces. LPAs asked licensee to keep these materials in locked cabinets, the facility Administrator placed these cleaning materials in the appropriate locations. LPAs reviewed one client file and three staff files. After documentation review and interview with Administrator, LPA advised the facility converting into a Small Family Home to better satisfy facility licensing standards. LPAs identified areas in which the licensee could improve documentation regarding staff training logs, disaster preparedness, licensing forms, and complaint procedures. LPA is issuing six technical assistance advisory notes and one Technical Violation relating to the discussed topics. Additionally, LPA is issuing a citation Health and Safety Code, Section 1565(c) regarding the two uncleared personnel present at the facility. An exit interview was conducted, appeal rights provided, and a copy of this report was left with Administrator Mary Jane Cagadas, whose signature on this form confirms receipt.

met_with: Mary Jane


summary: Facility Evaluation

raw_content:
Narrative:
On October 15, 2025 at 2pm, Licensing Program Analyst (LPA) Celeste Aparicio conducted an unannounced case management inspection. The purpose of the inspection is to amend report from October 7, 2025.

met_with: Administrator , Mary Jane Cagadas


summary: Facility Evaluation

raw_content:
Narrative:
On October 30, 2025 at 10:50am, Licensing Program Analyst (LPA) Celeste Aparicio conducted an unannounced visit to the facility for the purpose of conducting Angelfield Services Annual inspection. LPA Aparicio met with facility Administrator, Mary Jane Cagadas who helped facilitate the inspection. At the beginning of the visit, there were zero (0) clients and two (2) staff members present in the facility. By the conclusion of the inspection, there were 3 clients and 4 staff members present. During the inspection, LPA Aparicio utilized the CARE Tool to complete a comprehensive walkthrough of the facility, review four (4) client files, and examine the Centrally Stored Medication and Medication Administration Records (MARs). The walkthrough revealed that the facility was clean, organized, safe, sanitary, and in good repair. The home is a single-story residence consisting of three (3) client bedrooms, each arranged for double occupancy with single beds, and two (2) bathrooms. Two of the clients share a bedroom. The facility administrator resides in a separate bedroom located in the converted garage area of the home. The property also features a spacious backyard with artificial turf and two large storage sheds, both used for facility storage purposes. During the review of client files, LPA found no documentation showing that the health, safety, and compatibility of the two clients sharing a bedroom had been assessed. There was also no documentation showing that the licensee talked with the children about their sexual orientation and gender identity. Additionally, LPA observed no standard appraisal forms upon intake for each client in care. {See LIC809-C for continued report} LPA is issuing citation of California Code of Regulations (CCR),Title 22, Division 6, Chapter Section 84087(e)Building and Grounds and 84068.1(b)(1)(C) Intake Procedures. LPA also identified three areas in which technical assistances could be beneficial. Reference related LIC9102. The annual inspection is not complete at this time. A continuation visit will be conducted at a later date to complete this inspection. An exit interview was conducted, appeal rights were discussed, and a copy of this report was provided to Administrator, Mary Jane Cagadas whose signature on this form confirms receipt.


summary: Facility Evaluation - 2 deficiencies

raw_content:
Narrative:
On November 4, 2025 at 10:06am, Licensing Program Analyst (LPA) Celeste Aparicio conducted an unannounced visit to the facility for the purpose of completing the Angelfield Services Annual inspection. LPA Aparicio met with facility Administrator, Mary Jane Cagadas who helped facilitate the inspection. At the beginning of the visit, there was (1) client and (1) staff member present in the facility. By the conclusion of the inspection, there were (3) clients and (4) staff members present. LPA observed the clients in care to be well groomed, fed, and comfortable in the facility. During the inspection, LPA Aparicio utilized the CARE Tool to complete a comprehensive review of the facility's Disaster Preparedness, Operations, Emergency Intervention protocol, and (5) staff files. During the review of the facility's operations, LPA observed that the facility did not have documentation to support that board members are active. In addition, the facility could not show board minutes to LPA upon request. Regarding operations, LPA observed that the facility has not developed, maintained and implemented written complaint procedures by which children or their authorized representatives are permitted to file complaints. Additionally upon the review of facility operations, LPA Aparicio learned that the corporation of the facility is on suspended status. At this time further investigation into the status of the corporation is needed. LPA will follow up with facility at a later date. Upon the review of the Disaster Preparedness, LPA observed that emergency drills were not being conducted on a quarterly basis and the facility did not have all of the following readily available in case of an emergency: roster of individuals served by facility, copies of Needs and Services Plans, medication lists for individuals severed, or contact information for the responsible party and physician. {See LIC809-C for continued report}. During the review of (5) staff files, LPA observed that (5) staff had no documentation of training received of the facility's approved Emergency Intervention Plan(EIP) regarding CPI Nonviolent Crisis Intervention training. LPA only observed ProACT certifications for EIP which have not been approved by the department at this time. Additionally upon the review of staff training files, LPA did not observe any staff to have received training regarding the reasonable and prudent parent standard. Based on documentation review of the LIC Personnel Report and interview with the Administrator it was found that the facility has no designated facility manager. {Reference related LIC9102 and LIC809-D pages}. Based on LPA observations, LPA is issuing (6) Technical Violations, (2) Technical Assistances and (7) Citations for the regulation sections stated below. The Technical Violations include: CCR Sections 84072.2(a)(3), 80066(a)(8),84066(b)(1), 84066(b)(6),84065(i)(2), and 84065(k). The Technical Assistances include: CCR Sections 80071(a)(1)(D) and 84065(i)(3)(X) Citation sections of California Code of Regulations (CCR),Title 22, Division 6, Chapter 5, Section 84063(a)Accountability, 84072.2(a)Complaint Procedures, 84365(d)(1)(C)Emergency Intervention Staff Training, 84065(b)(1)Personnel Requirements, and 84065(d)Personnel Requirements. Citations of Health and Safety Code (HSC) Sections 1565(c) and 1565(e) Other Provisions. The annual inspection is not complete at this time. A continuation visit will be conducted at a later date to complete one more section in the CARE Tool and conduct staff/client interviews. An exit interview was conducted, appeal rights were discussed, and a copy of this report was provided to Administrator, Mary Jane Cagadas whose signature on this form confirms receipt.

Deficiencies:
84063(a): Accountability

(a) The board of directors shall be active in ensuring accountability, and shall perform, at a minimum, the following duties
84065(d): Personnel Requirements

(d) The licensee shall designate at least one facility manager to be present at the facility at all times when children are present


summary: Facility Evaluation

raw_content:
Narrative:
On November 18, 2025, Licensing Program Analysts (LPAs) Celeste Aparicio and Kaitlyn Wong conducted an unannounced visit to the facility to complete the annual inspection. LPAs met with Facility Manager Alliana Villanueva, who assisted with the inspection. At the time of the visit, there were three clients and two staff members present. Using the CARE Inspection Tool, LPAs completed the Special Health Care Needs (SHCN) section. No items requiring correction were observed. LPAs interviewed two on-site staff members regarding the facility's operational policies and procedures. LPAs also interviewed one child and attempted to interview two additional children; however, one child is nonverbal and the other declined to participate. The annual inspection is now complete. An exit interview was conducted, and a copy of this report was provided to Facility Manager Alliana Villanueva, whose signature acknowledges receipt.

met_with: Facility Manager, Alliana Villanueva


summary: Facility Evaluation

raw_content:
Narrative:
On 12/4/25 at 2:40PM, Licensing Program Analyst (LPA) Celeste Aparicio made a Case Management visit to the facility to review and discuss plans of corrections (POCs). LPA Aparicio met with facility Administrator, Mary Jane Cagadas who helped facilitate the inspection. During the inspection, there were three (3) clients and four (4) staff members present in the facility. The visit pertained to several POCs that remain incomplete. Two POCs issued on 10/07/25 (See LIC Case Management Deficiencies dated 10/07/2025) were reviewed; one was previously cleared on 10/08/25. The second POC, related to Section 80061(b)(1)(E) Reporting Requirements, was granted an extension to 12/01/25. As of today, the Department has not received the required documentation for this POC. During the Annual Inspection on 10/30/25 (See LIC Annual dated 10/30/2025), two additional POCs were issued for Sections 84087(e) Buildings and Grounds and 84070(b)(14) Children's Records, both due 11/30/25. No extensions were requested, and the Department has not received the required submissions. [Report continued on LIC809-C] During the continuation of the Annual Inspection on 11/04/25 (See LIC Case Management - Annual Continuation dated 10/30/2025), a POC for Health and Safety Code 1565(c) was issued with a due date of 11/25/25. Although documentation was submitted, it did not meet the agreed-upon requirements. LPA clarified the needed materials on 12/02/25 and requested resubmission by the end of business on 12/04/25; these materials have not been received yet. As of 12/4/25, the Department has not received verification demonstrating completion of POCs for Sections 80061(b)(1)(E), 84087(e), and 84070(b)(14). LPA is assessing a civil penalty for late POC, pursuant to California Code of Regulations, Title 22, Section 80054, of $100 per day beginning the POC due date for each POC not completed. The civil penalty comes to $800.00 for POCs issued on 10/30/25 plus civil penalty comes to $300.00 for POC issued on 10/07/25 totalling $1,100. LPA advises that this is an accruing penalty and the POCs should be submitted by the end of tomorrow (12/5/25) to avoid additional penalty. Additionally during the inspection LPA requested to review and obtain copies of the licensee's bylaws and/or articles of incorporation in relation to the clearance of a POC issued on 11/04/25 for California Code of Regulations (CCR), Title 22, Division 6, Section 84063(a) Accountability. The LPA explained that the licensee is expected to operate in accordance with its bylaws and/or articles of incorporation as they relate to organizational accountability and operational procedures. Licensee also advised Licensee reads Facts you Need to Know Group Home Board of Directors booklet. An exit interview was conducted, appeal rights were provided, an additional copy of the 10/31/23 report was provided, and a copy of this report was provided to Administrator, Mary Jane Cagadas, whose signature on this form confirms receipt.

met_with: Administrator, Mary Jane Cagadas


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On Monday, January 5, 2026 at 10AM, a noncompliance conference was held to discuss compliance concerns at the facility. Licensee was informed of the purpose of the meeting. The specific areas of concern were discussed, and a corrective action plan was developed in consultation with Licensee. In attendance representing Licensee: - Mary Jane Cagadas, Licensee & Administrator - Olga Regal, Assistant/ Facility Manager In attendance representing the Department: - Helga Wong, Regional Manager - Isabel Diego, Licensing Program Manager - Carolyn Flynn, Licensing Program Manager - Celeste Aparicio, Licensing Program Analyst The Administrator has agreed to adhere to the following conditions until the noncompliance period concludes: 1. For 24 months following this noncompliance conference, the facility shall be subject to increased Department monitoring, which may include additional inspections, record reviews, and interviews. (Continued LIC809-C, page 2) 2. Within 60 days of this conference (Due: 03/30/26), the facility shall maintain good standing with the California Secretary of State and submit proof of active status to the Department. 3. Within 60 days of this conference (Due: 03/30/26), the Licensee shall submit a written plan with proof of documentation which includes that all staff must be fully fingerprint cleared on Guardian prior to working in the facility. As of 1/5/26 18 individuals are still showing "In Process" on Guardian. 4. Within 60 days of this conference (Due: 03/30/26), the Licensee shall submit a comprehensive training plan, which includes topics on Reporting Requirements and topics included in section 84065 (i)(3)(A-Z) Personnel Requirements. Licensee must ensure all training courses that are completed by staff shall have records of the course title and subject matter, learning objectives and activities, number of hours per training session, qualifications of the trainer, and a training evaluation in each personnel file. This training plan will ensure staff meet the on boarding and annual training requirement and documentation will be readily available upon CCL request. 5. Within 60 days of this conference ( Due: 03/30/26), the Licensee shall revise and update the Plan of Operation and Program Statement regarding the emergency intervention plan specifically to reflect the use of Pro-Act for Department review to ensure full compliance with Title 22 requirements prior to implementation. Also, update their training plan, per the above condition, and include a section regarding the camera usage, per PIN 24-09-CRP. 6. The Administrator Mary Jane Cagadas is the assigned administrator for the facility and must ensure they are designated as the administrator for only one facility at this time. Once the facility has returned to full compliance, the Administrator may request to serve as the administrator for a second facility; however, prior approval from Community Care Licensing (CCL) will be required. 7. The facility shall maintain accurate, complete, and readily available client records, including client registers, Standard Appraisals, compatibility determinations, and intake documentation must be readily available upon CCL request. (Continued LIC809-C, page 3) 8. Within 60 days of this conference (Due: 03/30/26), the facility shall ensure they conduct and document quarterly emergency drills and maintain required emergency information and this information must be readily available upon CCL request. 9. Within 60 days of this conference (Due: 03/30/26), the facility shall designate a qualified facility manager according to section 84065(d) Personnel Requirements, who is present or on duty as required and responsible for daily operations. 10. The facility shall maintain complete personnel files for each staff member. This includes having a copy of their job descriptions, duty statements, performance evaluations, and all documentation of all required training. Per Personal Records and Personal Records requirements at all times must be readily available upon CCL request. 11. On a quarterly basis the administrator shall conduct training to all staff on ensuring safe storage of hazardous materials and cleaning supplies are safely stored away. This training must be completed by 03/30/26 at all times must be readily available upon CCL request. 12. Technical Support Program (TSP) services were discussed and offered. Licensee has agreed to receive TSP services. LPA Aparicio will put in referral 01/06/26. Licensing will be following up with Contra Costa County Fire Protection District regarding the facility's fire clearance and floor plan with garage arrangement. The meeting adjourned at : AM. A copy of this report was provided to Mary Jane Cagadas, Licensee & Administrator whose signature confirms receipt.

Deficiencies:
94066: Angelfield Servicesfacility Number: 075650160 Visit Date: 01/05/2026 Narrative 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 328. Within 60 days of this conference (Due: 03/30/26), the facility shall ensure they conduct and document quarterly emergency drills and maintain required emergency information and this information must be readily available upon CCL request.
9. Within 60 days of this conference (Due: 03/30/26), the facility shall designate a qualified facility manager according to section 84065(d) Personnel Requirements, who is present or on duty as required and responsible for daily operations.
10.

title: Facility Name


summary: Facility Evaluation

raw_content:
Narrative:
On January 15, 2026, Licensing Program Analyst (LPA) Celeste Aparicio made an unannounced visit to the facility for the purpose of conducting a case management inspection. LPA Aparicio met with Facility Manager, Nazarene Lagadan. It was determined that on September 28, 2025, an incident occurred involving staff and C1 (Reference: LIC 811 dated 1/15/26). During the incident, C1 became escalated and engaged in physically aggressive behavior. Staff utilized a physical restraint to prevent harm to C1 and others. The incident report submitted to the licensing department was incomplete and did not include: the facility's plan for the child following the incident (including any updates to the child's needs and services plan); a clear description of the manual restraints used and the duration of the restraint; or C1's verbal response, physical condition, and any injuries observed at the conclusion of the restraint. LPA is issuing three technical violations for California Code of Regulations Title 22, Section Reporting Requirements for the specified sections below. (Reference LIC9102 attached to report dated 1/15/26). 84061(h)(4) Reporting Requirements 84061 (h)(6)(C) Reporting Requirements 84061 (h)(6)(H) Reporting Requirements An exit interview was conducted, appeal rights were discussed, and a copy of this report was provided to the facility.

met_with: Facility Manager, Nazarene Lagadan


summary: Facility Evaluation

raw_content:
Narrative:
*This is an amended report from the original report date of October 7, 2025.LPA amending report to assess civil penalties LIC421BG. See below.* On October 7,2025 at 2:00pm, Licensing Program Analyst (LPA) Celeste Aparicio conducted a case management inspection and met with Administrator, Mary Jane Cagadas. LPA disclosed the purpose of the inspection and was granted entry to the facility by the Direct Care Staff. 4 clients and 5 staff were present in the facility during this inspection. At 2:05pm, LPA Aparicio reviewed the Guardian Employee Roster and observed S1 and S2 (See LIC811 ) to be 'In Process' status on Guardian while working at the facility during this inspection. LPA Aparicio discussed with the facility Administrator , Mary Jane Cagadas that all staff needed to be fully cleared on Guardian before employees could work with the clients in care. The facility administrator explained that they were unaware that staff were not fully cleared on the Guardian portal and asked LPA for assistance in navigating Guardian for their employees. LPA discussed the resources available and provided the resources to the facility Administrator. LPA is issuing citation of California Code of Regulations (CCR), Title 22, Section 80019 (e)(2) Criminal Record Clearance. (See attached LIC809-D page.) Additionally, as mandated in Section 80019, LPA is assessing an immediate civil penalty of $100 for a maximum of 5 days in violation, in which ( S1 ) and (S2 ) worked on site, for a total of $1000. LPA had to print and complete the LIC 421BG and provide a copy to Administrator Mary Jane. During a review of the facility communication log, LPA observed that a client C1 (See LIC811) ran away from the facility on 9/7/25, 9/18/25, and 9/20/25. LPA spoke to the facility Administrator about these incidents and learned that these incidents had not been reported to the Licensing Department. During this interview LPA learned that the facility Administrator was not aware that behavioral or runaway incidents needed to be reported to the Licensing Department. LPA is issuing citation of California Code of Regulations Title 22, Section 80061(b)(1)(E) Reporting Requirements. (See attached LIC809-D page.) An exit interview was conducted, appeal rights were discussed, a copy of the LIC421BG was left, and a copy of this report was provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 12/23/25, Licensing Program Analyst (LPA) Celeste Aparicio conducted a visit to the facility, during which the deficiencies listed below were identified. LPA met with Facility Manager Nazarene Lagadan, who facilitated the inspection. LPA observed that there were two residents and two staff present. One of the residents, C1 (Reference LIC 811 dated 12/23/25), has aged out of the children's residential age range. The facility is licensed to serve youth up to seventeen years of age. In August 2025, the facility Administrator was advised that an age-exception request must be submitted for any resident turning eighteen years of age or older in order to remain in compliance. As of the date of this observation, no age-exception request on behalf of C1 has been received by the Department. LPA is issuing a citation of CCR, Title 22, Section Limitations on Capacity and Ambulatory Status. (Reference LIC 809-D dated 12/23/25). An exit interview was conducted, appeal rights were discussed, and a copy of this report was provided to Facility Manager, Nazarene Lagadan whose signature confirms the receipt of this report.


summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On January 15, 2026, Licensing Program Analyst (LPA) Celeste Aparicio conducted an unannounced complaint inspection and met with Facility Manager, Nazarene Lagadan. LPA explained the purpose of the visit and was granted entry. The purpose of the inspection was to deliver findings related to the complaint investigation. Regarding the allegation that a staff member caused injury to a minor in care, LPA conducted confidential interviews and reviewed available documentation. Evidence showed that on September 28, 2025, an incident occurred involving C1 (Refer to LIC 811 dated 1/15/26), during which C1 became escalated. Staff implemented a restraint to prevent (C1) from harming self and others. Due to inconsistent interview statements and records review, LPA was unable to determine whether staff caused an injury to the minor as a result of the restraint. Although the allegation may have happened or is valid, based on LPA's observations, interviews, and record review, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. Therefore, the allegation is found to be unsubstantiated. An exit interview was conducted, appeal rights were discussed, and a copy of this report was provided to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Celeste Aparicio LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2


summary: Facility Evaluation

raw_content:
Narrative:
On March 11, 2026, at approximately 11: AM, a Licensing Program Analyst (LPA) Celeste Aparicio conducted a case management visit at the facility to follow up on a reported incident. The Department received information that a teenage client may have assisted in bathing two younger clients while staff were present and supervising. Staff reportedly allowed this after the teenage client requested to assist, in an effort to prevent escalation. At the time of the visit, one (1) client and two (2) staff were present in the facility. During the inspection, the LPA interviewed two (2) staff members and reviewed available client Needs and Services Plans (NSPs) and behavioral documentation related to the reported incident. The LPA observed that hygiene assistance documentation was missing from the NSP of one involved client. NSPs for the other involved clients were not available at the time of the visit because the clients were recently placed and the facility's behavior consultant is currently developing their NSPs. Based on staff interviews and the documentation available at the time of the inspection, the LPA was unable to confirm that the reported incident occurred. [Report continued on LIC809-C] The LPA issued Technical Violations for the following sections of California Code of Regulations (CCR), Title 22: Section 80061(b)(1)(E) - Reporting Requirements: The facility did not report the behavior as an unusual incident to the Department. Facility has a scheduled incident report training with the departments Technical Support Program (TSP) on March 23, 2026. Section 84078(b) - Responsibility for Providing Care and Supervision: Staff are responsible for providing care and supervision. Personal care services must be provided by staff only and in accordance with each client's Needs and Services Plan. Section 84068.2(b)(4) - Needs and Services Plan: Client personal care and grooming needs must be documented in the NSP. (Reference related LIC 9102 forms dated March 11, 2026.) An exit interview was conducted with facility staff. Appeal rights were discussed, and a copy of this report was provided to the facility.


raw_content:
Investigation Findings:
13On February 19, 2026, Licensing Program Analyst (LPA) Celeste Aparicio conducted an unannounced complaint inspection and met with Administrator, Mary Jane Cagadas. The purpose of the inspection was to deliver findings related to the complaint investigation. During the inspection there were two clients and two staff present in the facility. Regarding the allegation staff slapped child and staff placed cat urine on a child, LPA conducted confidential interviews and reviewed available documentation. Following the review of documentation and interviews, it was found the allegations could not be confirmed due to the inability to obtain statements from all involved parties. Although the allegation may have happened or is valid, based on LPA's observations, interviews, and record review, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. Therefore, the allegation is found to be unsubstantiated. An exit interview was conducted, appeal rights were discussed, and a copy of this report was provided to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Celeste Aparicio LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On March 30, 2026, at approximately 1:45pm, a Licensing Program Analyst (LPA) Celeste Aparicio conducted a case management visit at the facility to follow up on a review of documentation. At the time of the visit, four(4) client and three(3) staff were present in the facility. The facility appeared clean and in good condition, and clients were observed to be well cared for and content. LPA conducted a comprehensive review of the facility's records. Based on this review, it was determined that the facility did not maintain a Psychotropic Medication Administration Record (PMAR) for the month of November 2025 for one client and one of the client's prescribed medications. As a result, LPA Aparicio issued a California Code of Regulations (CCR) Title 22, Section 84070(b)(16) Children's Records. (Reference LIC 809-D dated 3/30/26). An exit interview was conducted, appeal rights were discussed, and a copy of this report was provided to the facility.

Deficiencies:
84070: (16) A separate log for each psychotropic medication prescribed to the child...

met_with: Facility Manager, Olga Regal

title: Children's Records (b) The following information regarding the child shall be obtained and maintained in the child's record


raw_content:
Investigation Findings:
13On February 19, 2026, Licensing Program Analyst (LPA) Celeste Aparicio conducted an unannounced complaint inspection and met with Administrator, Mary Jane Cagadas. The purpose of the inspection was to deliver findings related to the complaint investigation. During the inspection there were two clients and two staff present in the facility. Regarding the allegation staff administered unauthorized medication to a minor without proper consent, LPA conducted confidential interviews and reviewed available documentation. After the review of documentation and interviews with relevant parties, it was found that the allegation could not be confirmed due to inconsistent statements and documentation obtained. Although the allegation may have happened or is valid, based on LPA's observations, interviews, and record review, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. Therefore, the allegation is found to be unsubstantiated. An exit interview was conducted, appeal rights were discussed, and a copy of this report was provided to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Celeste Aparicio LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


raw_content:
Investigation Findings:
13On March 11, 2026, Licensing Program Analyst (LPA) Celeste Aparicio conducted an unannounced complaint inspection and met with Administrator, Mary Jane Cagadas. The purpose of the inspection was to deliver findings related to the complaint investigation. During the inspection there was one client and two staff present in the facility. Regarding the allegation lack of supervision resulting in inappropriate interactions between clients and staff pushed youth in care, LPA conducted confidential interviews and reviewed available documentation. Following the review of documentation and interviews, it was found the allegations could not be confirmed due to the inability to obtain statements from all involved parties. Although the allegation may have happened or is valid, based on LPA's observations, interviews, and record review, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. Therefore, the allegation is found to be unsubstantiated. An exit interview was conducted and a copy of this report was provided to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Celeste Aparicio LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


summary: Facility Evaluation

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Narrative:
On April 14, 2026, Licensing Program Analyst (LPA) Celeste Aparicio conducted a case management visit. The LPA met with Direct Support Professional, Alliana Villanueva and informed them of the purpose of the visit. This inspection was conducted to ensure the facility is in compliance with the conditions outlined during the January Noncompliance Conference (NCC) held on January 5, 2026 (refer to LIC Office Visit dated January 5, 2026). During the inspection, the LPA reviewed staff files, client files, the emergency preparedness binder, and the facility's Plan of Operation (POO) and Program Statement (PS). A walkthrough of the facility, both inside and outside, was also conducted. The facility was observed to be clean, sanitary, and in good repair. The LPA verified that the facility is in good standing with the California Secretary of State. Proof of active status was submitted to the Department on March 20, 2026. On the same date, the licensee submitted documentation confirming that all staff were fingerprint cleared through Guardian. As of March 2, 2026, twenty-one (21) staff members had an eligibility determination of "complete." At the time of today's inspection, twenty-three (23) staff members were fully cleared in Guardian. The LPA reviewed ten (10) staff files and found them to be complete. Files included appropriate training documentation, such as course titles and subject matter, learning objectives and activities, number of training hours per session, trainer qualifications, and training evaluations in each personnel file. On March 20, 2026, the licensee submitted a comprehensive training plan that includes reporting requirements, onboarding training, and annual training requirements. Documentation was readily available upon Community Care Licensing (CCL) request.[See LIC809-C, Page 2] [Page 2]On March 20, 2026, the licensee submitted a revised and updated Plan of Operation and Program Statement related to the emergency intervention plan. During the inspection, the LPA reviewed these documents and identified outstanding revisions and details that still need to be incorporated. The LPA will work with the licensee to ensure all necessary updates are completed, including details regarding the facility's emergency intervention procedures and camera usage. The documents remain under review, and additional feedback will be provided. At the time of inspection, it was determined that Administrator S1 (See LIC811 attached to report) is currently listed as the administrator of a newly licensed Adult Residential Facility (ARF). The LPA spoke with the Facility Manager by phone regarding this matter. The Facility Manager indicated there had been a misunderstanding of NCC Term #6. Following clarification, the licensee confirmed that Administrator S1 will be removed as the administrator of the ARF to comply with NCC terms. Based on the current LIC 500, S1 appears to be working the number of hours necessary to manage and administer this facility. The licensee will follow up with the LPA to confirm that S1 is no longer listed as the administrator of another facility in accordance with NCC requirements. The LPA reviewed five (5) client files and found them to be complete, including Standard Appraisals, compatibility determinations, and intake documentation, all of which were readily available upon request. During the review, the LPA noted that some compatibility assessments require additional detail, particularly regarding the rationale for shared bedroom placements. The LPA provided feedback to the licensee, who is currently working with the Technical Support Program (TSP) to address these items. The LPA reviewed the facility's emergency drill binder and verified that the following drills were conducted: Fire drill (AM and PM shifts) on January 19, Earthquake drill (overnight shift) on March 1, Shelter-in-place drill (AM shift) on March 15, The LPA reviewed the LIC 500, LIC 308, and staff files to confirm that the facility has a designated and qualified Facility Manager as of January 4, 2026. Staff files were also reviewed to ensure inclusion of job descriptions, duty statements, performance evaluations, and all required training documentation. [See LIC809-C, Page 3] [Page 3] On March 20, 2026, the licensee submitted training materials via email regarding the safe storage of hazardous materials and cleaning supplies. The LPA reviewed the training sign-in sheets and verified that all staff completed the training on February 15, 2026; February 16, 2026; and March 20, The facility has been receiving Technical Support Program (TSP) services since January 2026 to assist with incident reporting, record keeping, client compatibility, and care and supervision. No deficiencies were observed, and no citations were issued during today's visit. An exit interview was conducted with the facility manager, and a copy of this report was left at the facility.

met_with: Direct Support Professional, Alliana Villanueva and Facility Manager, Olga Regal


facility_name: APOLLO GROUP HOME

summary: Complaint Investigation - Substantiated - 1 allegation

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Narrative:
Based on today's visit, Children's Residential Title Community Care Regulations, Section 80022(k)); Plan of Operation; deficiency was cited. However, due to the staff being forthcoming about the injury, the injury not intentionally being caused to the client in care, and the Administrator still deciding to terminate the staff, there will not be a plan of correction, as the staff has already been terminated. An exit interview was conducted at 11: AM, and a copy of the report was mailed to Ms. Ayala.

Investigation Findings:
13On 6/23/2023, at 10: AM, Licensing Program Analyst (LPA) Vaishali SIngh-Sood conducted an unannounced visit to the facility. The purpose of this visit was to deliver the findings on the listed allegations. LPA met with Juanita Ayala, Caregiver. At the time of the visit, there were four youth and four staff in the facility. Over the course of the investigation, confidential interviews, a file review, and evidence were obtained regarding the aforementioned allegation. Based on the staff involved admitting he had been playing with the client in which he unintentionally caused injury, there is a preponderance of evidence. As a result of the injury/bruising, the Administrator immediately terminated the staff. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Vaishali Singh-Sood 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 26-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. First Street, Ste. FACILITY NAME: APOLLO GROUP HOMEFACILITY NUMBER: 435202522

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

met_with: Eleanor Asia Rall

complaint_status: SUBSTANTIATED


summary: Facility Evaluation

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Narrative:
On August 6, 2021, at 9: AM Licensing Program Analyst (LPA) Sam Raissi conducted an unannounced inspection to the facility for the purpose of conducting an Annual/Required inspection. LPA Raissi met with Administrator, Juanita P. Ayala of Apollo Group Home and both toured the facility, inside and out. The Group Home is licensed to serve six clients, ages 6-17 years. Currently in placement are six clients. All six of the clients were present during the inspection. LPA Raissi observed at the time of this inspection, the facility to be clean, safe, and sanitary. All fire alarms, and carbon monoxide detectors were in good working condition, and the fire extinguisher is current. This LPA reviewed the staff and client files, medication logs, and they had the necessary forms. The following documents are posted in the facility: facility license, emergency disaster plan, facility sketch, menu, activity calendar and personal rights. The hot water temperature was at (Kitchen Sink - 105.1, Hall Bathroom 105.3, and Bedroom Bathroom 105.3 degrees). A review of Licensing Information System on August 4, 2021 indicates that all facility staff are associated to the facility had DOJ, FBI, and child abuse index check clearances. According to the Administrator, there are no weapons, and/or bodies of water at the facility which meets title 22 regulations. There are currently no exceptions on file, and there have not been any deficiencies cited in the past year. There were no deficiencies noted at today's inspection. The agency listed above this report was issued Advisory Notes -Technical Assistance (LIC 9102TA). Exit interview conducted and a copy of the report was left with the Administrator.

met_with: Juanita P. Ayala


summary: Facility Evaluation

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Narrative:
On August 31, 2022, at 10: AM Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced inspection to the facility for the purpose of conducting an Annual/Required inspection. LPA Singh-Sood met with Administrator, Jaclyn Tan of Apollo Group Home and both toured the facility, inside and out. The Group Home is licensed to serve six clients, ages 6-17 years. Currently in placement are six clients. All six of the clients were present during the inspection. LPA Singh-Sood observed at the time of this inspection, the facility to be clean, safe, and sanitary. All fire alarms, and carbon monoxide detectors were in good working condition, and the fire extinguisher is current. This LPA reviewed the staff and client files, medication logs, and they had the necessary forms. The following documents are posted in the facility: facility license, emergency disaster plan, facility sketch, menu, activity calendar and personal rights. The hot water temperature was at (Kitchen Sink - 107.1, Hall Bathroom 109.3, and Bedroom Bathroom 108.3 degrees). A review of Licensing Information System on August 31, 2022 indicates that all facility staff are associated to the facility had DOJ, FBI, and child abuse index check clearances. According to the Administrator, there are no weapons, and/or bodies of water at the facility which meets title 22 regulations. There are currently no exceptions on file, and there have not been any deficiencies cited in the past year. There were no deficiencies noted at today's inspection. The agency listed above this report was issued Advisory Notes -Technical Assistance (LIC 9102TA). Exit interview conducted and a copy of the report was left with the Administrator at 4: PM.

met_with: Jaclyn Tan


summary: Facility Evaluation

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Narrative:
On August 23, 2023, at 9: AM Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced inspection to the facility for the purpose of conducting an Annual/Required inspection. LPA Singh-Sood met with Lead Staff, Zandy Aycardo of Apollo Group Home and both toured the facility, inside and out. The Group Home is licensed to serve six clients, ages 6-17 years. Currently in placement are five clients. Only one of the client was present during the inspection, but all the clients are non-verbal. LPA Singh-Sood observed at the time of this inspection, the facility to be clean, safe, and sanitary. All fire alarms, and carbon monoxide detectors were in good working condition, and the fire extinguisher is current and was serviced on February 2023. This LPA reviewed the staff and client files, medication logs, and they had the necessary forms. The following documents are posted in the facility: facility license, emergency disaster plan, facility sketch, menu, activity calendar and personal rights. The hot water temperature was at (Kitchen Sink - 111.3, Hall Bathroom 112.4, and Bedroom Bathroom 111.1 degrees). A review of Guardian/LIS on August 23, 2023 indicates that all facility staff are associated to the facility had DOJ, FBI, and child abuse index check clearances. According to the Administrator, there are no weapons, and/or bodies of water at the facility which meets title 22 regulations. There are currently no exceptions on file, and there have not been any deficiencies cited in the past year. There were no deficiencies noted at today's inspection. The agency listed above this report was issued Advisory Notes -Technical Assistance (LIC 9102TA). Exit interview conducted and a copy of the report was left with the Administrator at 3: PM.

met_with: Zandy Aycardo


summary: Facility Evaluation

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Narrative:
On August 29, 2024, at 10: AM Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced inspection to the facility for the purpose of conducting an Annual/Required inspection. LPA Singh-Sood met with Administrator, Juanita Ayala, of Apollo Group Home and both toured the facility, inside and out. The Group Home is licensed to serve six clients, ages 6-17 years. Currently in placement are six clients. During the inspection, only one client was present, but all the clients are non-verbal. LPA Singh-Sood observed at the time of this inspection, the facility to be clean, safe, and sanitary. All fire alarms, and carbon monoxide detectors were in good working condition, and the fire extinguisher is current and was serviced on March 20, 2024. This LPA reviewed the staff and client files, medication logs, P&I, and the facility had the necessary forms. The following documents are posted in the facility: facility license, emergency disaster plan, facility sketch, menu, activity calendar and personal rights. The hot water temperature was at (Kitchen Sink - 113, Hall Bathroom 114, and Bedroom Bathroom 112.2 degrees). A review of Guardian/LIS on August 29, 2024 indicates that all facility staff are associated to the facility had DOJ, FBI, and child abuse index check clearances. According to the Administrator, there are no weapons, and/or bodies of water at the facility which meets title 22 regulations. There are currently no exceptions on file, and there have not been any deficiencies cited in the past year. On August 20, 2024, San Andreas Regional Center did a quarterly inspection for the facility. There were no deficiencies noted at today's inspection. Exit interview conducted and a copy of the report was provided to Ms. Ayala at 3: PM.

met_with: Juanita Ayala


summary: Facility Evaluation

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Narrative:
On September, 25 2025, at 09: AM Licensing Program Analyst (LPA) Omar Sawyer and LPA, Shikya Belfield conducted an unannounced inspection of the above facility for the purpose of conducting an Annual/Required inspection. LPA Sawyer and LPA Belfield met with Administrator, Juanita Ayala, of Apollo Group Home and toured the facility, inside and grounds. The Group Home is licensed to serve six clients, ages 6-17 years. Currently in placement are four clients. No clients were present during this inspection. All clients are non-verbal. LPA Sawyer observed at the time of this inspection, the facility to be clean and in safe condition. All fire alarms, and carbon monoxide detectors were in good working condition, and the fire extinguisher is current and was serviced on March 12, 2025. Based on the review of Staff files, five out of nine Staff files reviewed did not have Criminal Record Clearance. Facility is being cited for violation of California Code of Regulations, Title 22, Division 6, Section 80019(e)(2), as described on the following page LIC809D. The following documents are posted in the facility: facility license, emergency disaster plan, facility sketch, menu, activity calendar and personal rights. The hot water temperature was at (Kitchen Sink - 104, Hall Bathroom 103, and Bedroom Bathroom 104 degrees Fahrenheit). Based on LPA observations there are no bodies of water at the facility. At this time the inspection is incomplete and will be concluded at a later date. An exit interview was conducted and a copy of the report was provided to Administrator, Juanita Ayala, whose signature confirms receipt.

met_with: Juanita Ayala, Administrator


summary: Facility Evaluation

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Narrative:
On September, 26 2025, at 10: AM Licensing Program Analyst (LPA) Omar Sawyer and LPA, Shikya Belfield conducted an unannounced inspection of the above facility for the purpose of conducting an Annual/Required inspection continuation. LPA Sawyer and LPA Belfield met with Administrator, Juanita Ayala, of Apollo Group Home. The Group Home is licensed to serve six clients, ages 6-17 years. Currently in placement are four clients. No clients were present during this inspection. All clients are non-verbal. LPA Sawyer requested the Four Client files, P&I reports, and consultant logs for review. Based on a review of of clients P&I reports, LPA asked Adminstrator questions regarding the transactions on the accounts of two clients. LPA obtained copies of these files for further review. There were no Violations of California Code of Regulations, Title 22, Division Six cited during this inspection. An exit interview was conducted and a copy of this report was left with Administrator Juanita Ayala whose signature confirms receipt.


facility_name: AR & EM HOME CARE, INC

summary: Facility Evaluation

raw_content:
Narrative:
On August 19, 2025, at 9:05 am, Licensing Program Analysts (LPAs) Charmaine Linley, Stefanie Mutialu, and Gilbert Marquez arrived at the facility to conduct a pre-licensing inspection of the facility. The facility was inspected inside and out with Marie Noel, Facility Administrator, Monica Daniel, Chief Financial Officer, and Roxanne Spencer, Chief Executive Officer. The home is a single-story residence with a swimming pool in the backyard. There are no camera located inside or outside of the facility. The facility consists of one living room, one family room, two restrooms, one dining room and one kitchen. The garage is located next to the kitchen and leads to the driveway. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris. There is adequate indoor and outdoor activity space. The living room is furnished with one couch, one love seat, and one chair with enough seating for four people. The living rooms has board games and arts and crafts activities available for the client's use. The family room is equipped with two desks, two computers and locked file cabinet and two telephones that were tested and were observed to be in working order. The kitchen is equipped with operable appliances, kitchen utensils, pot, pans and dishes. The facility had a two day supply of perishable food and a seven day supply of non-perishable food. The hot water in the kitchen was measured at 117 degrees, which is within regulatory requirements. The kitchen's appliances were tested and were observed to be in working order. The facility's smoke detectors were tested and observed to be in working order. There are six smoke *** detectors, one in the dining room, one in the hallway, and one in each individual bedroom. There are two carbon monoxide detectors that are located in the hallway and in the dining room. The carbon monoxide detectors were tested and observed to be in working order. Fire extinguishers are properly charged and serviced. There are a total of four fire extinguishers located in the laundry room, garage, under the kitchen sink, and in the hallway. The facility has a fully equipped first aid kit and first aid manual stored on top of the file cabinet in the family room. There are no guns or weapons in the facility as stated by the Administrator. Medications are locked and centrally stored in a medication cabinet in the family room. Disinfectants and cleaning solutions were stored locked in a locked cabinet in the garage. Sharp knives were made inaccessible and stored in a locked drawer in the kitchen. The staff and client files will be maintained in a locked file cabinet in the family room. The following required posted items were observed accessible to clients: Fire Clearance, Grievance Procedures, Personal Rights, Visitation policies, Emergency Disaster Plan and current menu. The bedrooms are set up as follows: Bedroom #1 will be occupied by one resident; has one twin bed, all required linen, mattress is in good condition. Bedroom #2 will be occupied by one resident; has one twin bed, all required linen, mattress is in good condition. Bedroom #3 will be occupied by one resident; has one twin bed, all required linen, mattress is in good condition. Bedroom #4 will be occupied by one resident; has one twin bed, all required linen, mattress is in good condition. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. The bathrooms were clean and in good repair. The facility outside grounds were also inspected and it was observed to be clean and well maintained. *** Emergency exits were free from obstruction. There is an in-ground swimming pool located in the backyard of the facility which is made inaccessible with a fence and two pool gates that swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate. The fence is constructed so that the fence does not obscure the pool from view. The fire clearance has been approved. Based on the facility pre-licensing inspection review, no deficiencies were noted at the time of inspection. Upon Licensing Program Manager's final review, the license will be provided. An exit interview was conducted, and a copy of this report was given to the facility.

met_with: Marie Noel