summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced Annual Inspection at the agency and met with Agency Social Worker Supervisor (SWS) Jamie Cobabe, who assisted with the inspection. LPA and SWS conducted a walk-through of the facility and LPA observed: two conference rooms, one file room, seven office spaces, two storage areas, one pantry, two kitchens, three visitation rooms, a staff lounge, the lobby, and four bathrooms. LPA observed no deficiencies. All fire extinguishers were in date and charged. All client files were locked. All areas of the building were clean, in good repair, and had no obstructions in the walkways. There are working smoke detectors. LPA reviewed five staff files and five client files. LPA found that 8 of 15 staff who work at this THPP license are not associated to the license. However, all 15 are DOJ/FBI/CACI cleared and associated to the agency's Sacramento FFA license. LPA found that all other staff requirements were met. For client files LPA found that the Administrator does not sign the Needs and Services Plans as required. One out of five NSPs were out of date, and the one that was out of date, was being drafted. All other requirements for client files were met. LPA interviewed two Social Workers, one Case Manager, and one Social Work Supervisor. On this date the agency was cited for violations of the California Code of Regulations, Title 22, Section 86019(e)(2) and Health and Safety Code (HSC) 1565(a)(7). All citations and advisory notes are reflected in the 809 for the Post Licensing, issued on the same date. An exit interview was conducted with SWS and a copy of this report, appeal rights, and confidential names list was left with her.


state: CA

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced case management inspection regarding an Incident Report that occurred on 4/7/2023 and was submitted to CCL by the agency on 4/10/2023. LPA spoke with Social Work Supervisor (SWS) Jamie Cobabe and Case Manager (CM) Wendy Sanchez-Rico about the incident. LPA collected a client's Needs and Services Plan, staff information, and client information. Further information is needed in order to resolve this case management. LPA conducted an exit interview with SWS and left a copy of this report with her.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Jamie Cobabe


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Alyssa Burgess made an announced Case Management inspection at the facility to interview Director Jenna Bethancourt, regarding an Incident Report that occurred on 4/7/2023 and was submitted to CCL by the agency on 4/10/2023. LPA first opened this CM inspection on 4/17/2023. LPA interviewed Director and collected client documents. Further information is needed in order to resolve this case management. LPA conducted an exit interview with Director and gave a copy of this report to her.

met_with: Jenna Bethancourt


summary: Facility Evaluation

raw_content:
Narrative:
On 3/7/24, LPA Uchenna Ajaero received the following report and discussed it with the LPA. Per LPM, Jodean Hall, this investigation will be handled with a follow up phone call. DESCRIBE EVENT OR INCIDENT (INCLUDE DATE, TIME, LOCATION, PERPETRATOR, NATURE OF INCIDENT, ANY ANTECEDENTS LEADING UP TO INCIDENT AND HOW CLIENTS WERE AFFECTED, INCLUDING ANY INJURIES The client was in THP placement at the Renew on Coloma apartment complex. Maintenance was repairing the dishwasher and had the heater running to try to assess why the heater was not working. The client shared that the heater caught fire and it disintegrated on its own. Fire did not create further damage. Fire department or LE was not called. Maintenace removed the smoke detector from the ceiling and told client that he would come back to repair the heater at another time. 3/ LPA Ajaero contacted the SW and was told the property management office has submitted a request to have the unit fixed. 3/ ASW Nicole contacted LPA and stated the unit has been fixed and the client is settled in the apartment. End of report.


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Interviews and documents reviewed are also consistent that the apartment was in good repair at the time of placement. The challenge is how the agency handled the problems that happened afterwards. CSW, NMD and RP state that the agency did not act in a timely manner and that put NMD and her children in danger. However, Interviews with PM and ASW indicate that the agency put a request to address the problems right away. In addition, PM shared that NMD refused entry into her apartment when maintenance crew arrived at the location. The agency also disclosed that they will pay NMD's relocation fees and return all NMD's savings to her. Based on LPA's observation, interviews conducted, and records reviewed, the preponderance of evidence standard has not been met, therefore the above allegations are found to be UNSUBSTANTIATED. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the allege violations did or did not occur. Not tile 22 regulations were cited during today's inspections. A copy of this report was left at the agency.

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

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

report_type: Complaint Investigation

met_with: Jamie George, THP Case Manager/FFA Social Worker

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) made an unannounced visit to the facility to conduct case management inspection regarding an incident report received by the Department on 6/25/2021. LPA met with Miranda Benavidez, Case Manager (CM), who assisted with the inspection. The incident which occurred on 6/17/2021 involved a client of the THPP attempting suicide by cutting both of her wrists with a knife while in the apartment. The client's fiance was also present in the apartment. Law enforcement, the fire department, and ambulance were on the scene. The client was taken to the hospital and treated, then was placed on a 5150 hold. Law enforcement believed there to be domestic violence from the fiance to the client. The agency wrote in the IR the fiance will no longer be allowed in the apartment. LPA asked questions regarding: 1. How is, and where is, the client currently. 2. How will the agency ensure the client's fiance is not present. 3. How will the agency ensure the client's safety. 4. Is this a proper placement of the client. 5. What oversight and support is provided for this client. 6. What is the agency's future plans for this client. CM stated that she has been contacting the client weekly to check in. CM also called in a wellness check, and conducted a wellness check herself, after the incident. The client is back at the apartment, and the fiance is not allowed on the property, however they were spotted off property engaged in an argument on 6/23/2021. CM, the County Social Worker, and the client will be meeting on 7/8/2021 to discuss safety plan and safety measures to take. In the meantime, LPA has advised CM to make contact with the client daily by phone to ensure she is safe. CM is also going to be getting the client into therapy as well as in contact with WEAVE for support with domestic violence. At 2: PM an exit interview was conducted with CM and a copy of this report will be emailed to CM with a read receipt which will serve as her signature.

met_with: Miranda Benavidez


summary: Facility Evaluation

raw_content:
Narrative:
On September 23, Licensed Program Analyst Chad Cabigon (LPA), and Yuvi Diaz (LPA) conducted an announced case management inspection due to a death report received byThe Department on September 22, 2021. LPAs obtain copies of the participant's entire THP file. Phone interview was conducted with the assigned Program Case Manager, Ellie Fanaika. Further investigation is required.

met_with: Bianca Ruiz


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced annual inspection at the agency and met with Office Manager (OM) Donna Massey, who assisted with this inspection. The facility utilizes their Sacramento FFA office as a satellite office for this license, where the majority of clients are assisted from. Only two clients are in care out of this office. As the files are electronic LPA was able to access them from the licensed location. LPA utilized the CARE Tool for this inspection. LPA conducted a walk-through of the agency with (OM) and LPA observed no deficiencies. LPA reviewed 14 client files, and 10 staff files. LPA found that all clients reviewed did not have any health screenings or TB tests on file, however, all clients are Non-Minor Dependents and are not required to share medical information with the agency. LPA found that one client did not have a Needs and Services Plan in the file as required after 30 days in placement. One client (C7) was missing their NSP, but today is the 30th day, so LPA advised the facility to ensure they include the NSP for that client in their file. Client C6 should have their NSP in file, and a Type B Citation was issued for that deficiency. There were no other issues found in client files. For the staff files, LPA found that no file had any of the staffs' duties described, and a Technical Violation was issued for that. No other issues were found during this inspection. On this date, the facility is being cited for a violation of the California Code of Regulations, Title 22, Division 6, Chapter 7, Section 86068.2(c), Type B. Additionally, LPA issued an advisory note regarding the address and facility information that the agency puts on their incident reports for this license. An exit interview was conducted with OM, and a copy of this report, along with appeal rights and a confidential names list, was emailed to her with a read receipt, which will serve as the record of receipt.

visit_type: Annual

met_with: Donne Massey


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Alyssa Burgess conducted an unannounced case management inspection at the agency and met with Donna Massey, Office Manager (OM1), who assisted with the inspection. LPA is investigating a Child Abuse Clearance Index (CACI) hit that occurred for an individual connected to this agency (P1 - See LIC811). OM contacted her supervisor and the Sacramento office to find out if P1 is in any way involved with the agency. OM1 contacted individuals with the agency and found that P1 is a prospective roommate of a THPP client with this license, but based out of the satellite Sacramento office location. LPA spoke with Asifa Ali, Office Manager (OM2), who checked with the assigned case worker and found that P1 is the boyfriend of the client who has not moved in yet, awaiting fingerprint clearance. There is no paperwork for LPA to collect as the agency is awaiting the clearance before allowing P1 to move in. Further investigation is needed to conclude this case management. LPA conducted an exit interview with OM1 and a copy of this report and LIC811 was emailed to her with a read receipt which will serve as the record of receipt.

met_with: Donna Massey


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced case management inspection at the agency and met with Social Worker Supervisor (SWS) Mercedes Robinson, who assisted with this inspection. On 10/25/2021, CCL received an incident report which stated during the rain storm on 10/24/2021, portions of the apartment the participant lived it were severely damaged and unlivable. The participant was offered to stay in a hotel by the THPP until a remedy could be made for the apartment, however the participant found housing through a family member. LPA asked about the safety measures that were put in place for this client, and how the agency made sure the alternative residence was a safe space for the client. SWS stated the ASW inspected the home during move-in, and all was compliant. LPA also asked about the furnishings and equipment in the new residence, which SWS stated that the participant has everything he needs. LPA asked about the financial support the participant receives and if it was lowered. SWS confirmed that the participant gets no less financial support because of this move. The client intends to live at the new residence for the remainder of his time with the THPP. The new home is also within the required distance of the THPP. SWS stated that all paperwork was updated. LPA found that the THPP met the participant's needs and no further investigation is required. An exit interview was conducted with SWS and a copy of this report was emailed to her with a read receipt which will serve as the record of receipt.

met_with: Mercedes Robinson


summary: Facility Evaluation

raw_content:
Narrative:
On 01/12/ Licensing Program Analyst (LPA) Chad Cabigon conducted an unannounced inspection in the Environmental Alternatives (EA) - Sacramento THPP (Transitional Housing Placement Program) office located at Northgate Blvd., Sacramento 95834; the purpose of which was to formally close a case management inspection that was conducted on 12/07/2020. That inspection was regarding the deaths of two THPP participants for whom services were provided under the now-closed THPP license that was attached to the office address at Cottonwood Street, Woodland. As part of the 2020 case management inspection, LPA interviewed EA personnel and other individuals who were either involved in the deceased clients' cases or had knowledge of the matter. LPA also reviewed relevant records. No deficiencies were cited as a result of the case management inspection. A copy of this report is being provided to EA.

met_with: Kitty Cannon, Office Manager


raw_content:
Narrative:
Confidential interviews were completed on 06/19/24, 08/28/24, 09/16/24. LPA Martinez attempted to interview FY1 on 07/26/24, 08/26/24, and 09/04/24. Despite these multiple attempts, no statements were successfully gathered from FY1. 1. Failure to Provide Reasonable Accommodations and Adequate Support Confidential interviews revealed that FY1 was assisted in starting the application process for housing. FY1 application was initially denied due to concerns about FY1 communication style and behavior. The decision was later reconsidered, leading to an offer of housing. Interviews also disclosed evidence from FY1 indicating FY1 decision not to move forward with the placement. FY1 was not an official client but was being considered for placement LPA Martinez attempted to interview FY1 on 07/26/24, 08/26/24, and 09/04/24. Despite these multiple attempts, no statements were successfully gathered from FY1. 2.Discrimination and Retaliation Against the Client Confidential interviews revealed no direct evidence of discrimination or retaliation. FY1 was not an official client but was being considered for placement. FY1 application was initially denied due to concerns about communication style and behavior.The decision was later reconsidered by the THPP leading to an offer of housing. Interviews also disclosed evidence from FY1 indicating decision not to move forward with the placement. LPA Martinez attempted to interview FY1 on 07/26/24, 08/26/24, and 09/04/24. Despite these multiple attempts, no statements were successfully gathered from FY1. Based on the confidential interviews and records reviewed, the complaint against the THPP is unsubstantiated. An unsubstantiated determination means the allegation lacks a preponderance of the evidence to prove that the violation occurred. There are no deficiencies to be cited at this time. LPA Martinez conducted an exit interview and provided a signed LIC 9099 to the STRTP representative.

Investigation Findings:
13On 09/20/24, Licensing Program Analyst (LPA) Joe Martinez conducted a follow-up complaint inspection at the Short Term Residential Therapeutic Program (STRTP).LPA Martinez met with the facility representative named above. The purpose of the inspection is to deliver the finding for the above allegations. On 06/18/24, the Community Care Licensing Division of the California Department of Social Services received a complaint from the Centralized Complaint and Information Bureau (CCIB) with the following allegation(s): 1.Failure to Provide Reasonable Accommodations and Adequate Support 2.Discrimination and Retaliation Against the Client LPA Martinez investigated the above allegation. The investigation included a review of records and confidential interviews, but it was not limited to these. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Yan Yeung LICENSING EVALUATOR NAME: Joe Martinez 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 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION LA & TRI-COASTAL CR, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: ENVIRONMENTAL ALTERNATIVES DBA EA FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 09/20/2024

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

met_with: Veronica Lopez


facility_name: ENVIRONMENTAL ALTERNATIVES DBA EA FAMILY SERVICES

summary: Facility Evaluation

raw_content:
Narrative:
On March 30, 2023 at approximately 1: PM, Licensing Program Analyst (LPA) Raymond Wu conducted a virtual Component II session via Zoom with applicant, Environmental Alternatives. Present at the meeting from Environmental Alternatives were Jenna Bethancourt, THP Program Director and Kylie Martinez, Social Worker Supervisor. During the meeting the following items were discussed and requested: 1. LIC 308 - Add K. Martinez to LIC 308 as an individual with administrative responsibility 2. Board Resolution regarding the LIC 308 above 3. County Letter of Support Aspects such as housing locations, continuing requirements, and more were also discussed. The Pre-Licensing inspection is tentatively scheduled for Thursday, April 06, 2023. An exit interview was conducted and a copy of this report was provided to the applicant.

met_with: Jenna Bethancourt, THP Program Director


summary: Facility Evaluation

raw_content:
Narrative:
On April 06, 2023 at approximately 10: AM, Licensing Program Analysts (LPAs) Raymond Wu and Joe Martinez conducted a pre-licensing inspection and Component III meeting at the facility. The THPP is located in the CityServe non-profit building. LPA met Kylie Martinez, Social Worker Supervisor. The program will use host families, long-term hotel units, and apartment units to place Non-Minor Dependent (NMD) participants. . Licensee will inform CCL prior to the first client moving into a living unit. A tour of the office was conducted. LPA observed the following: the office is located in a secured suite inside a large building that is professionally maintained. There is an attendant in the lobby to assist and direct visitors. The office has multiple private rooms to meet with clients. Staff members have desks, cubicles, and the necessary equipment to perform their duties. There are bathrooms for staff and client use as well as a kitchen area. Hazardous items are secured and locked away. There are file cabinets in place to secure staff and client files. Fire extinguishers and a centralized fire sprinkler system are in place. The building has a dedicated security team that patrols the exterior and interior of the building. LPAs observed the facility to be in good repair, well-equipped, and ready for operation. A Component III meeting was also held and best practices and common regulations were discussed with the applicant. An exit interview was conducted and a copy of the report was provided to the agency.

visit_type: Prelicensing


summary: Facility Evaluation

raw_content:
Narrative:
On September 07, 2023 at approximately 11: AM, Licensing Program Analyst (LPA) Raymond Wu conducted a post-licensing inspection at the facility. The THPP is located in the CityServe non-profit building. LPA met Yoana Andrade, Case Manager. The program uses host families, long-term hotel units, and apartment units to place Non-Minor Dependent (NMD) participants. A tour of the office was conducted. LPA observed the following: the office is located in a secured suite inside a large building that is professionally maintained. There is an attendant in the lobby to assist and direct visitors. The office has multiple private rooms to meet with clients. Staff members have desks, cubicles, and the necessary equipment to perform their duties. There are bathrooms for staff and client use as well as a kitchen area. Hazardous items are secured and locked away. There are file cabinets in place to secure staff and client files. Fire extinguishers and a centralized fire sprinkler system are in place. The building has a dedicated security team that patrols the exterior and interior of the building. Currently, clients are situated in an extended stay hotel that is approximately 8 minutes away from the office. Construction of apartments that are right next to the office is currently underway and clients will move to these apartments in the near future. A walk-through of a client unit was toured and no immediate concerns were observed. There is an on-site office that Case Managers utilize at the hotel. A review of client and staff records were conducted. The facility utilizes a digital filing system and all required documents for clients and staff were present. No deficiencies were cited during today's visit. An exit interview was conducted and a copy of this report was provided to the Licensee.

met_with: Yoana Andrade, Case Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 5/2/24, Licensing Program Analyst (LPA) Claudia Portillo conducted an unannounced inspection at the facility and met with the representative above. LPA spoke to Kylie Martinez, Social Worker Supervisor (SWS) over the phone regarding a Special Incident Report (SIR) that was submitted to Community Care Licensing (CCL) on March 29, 2024. The SIR stated that Non-Minor Dependent (NMD) #1 (C1) (see confidential names form LIC 811) was raped by her boyfriend in her apartment. Census: Children 37. Based on an interview conducted with the SWS and record review (SIR), the NMD had placed a restraining order against her boyfriend, but the status of the restraining order is still pending. The Agency staff had offered the NMD medical care and support services such as domestic violence programs in which she refuse to attend. The NMD is still residing in her apartment unit and has been informed to contact her social worker, any other staff or law enforcement in case she feels unsafe. The agency is in constant contact with the NMD to ensure she feels safe. At this current moment, the boyfriend remains in jail. SWS will provide LPA with copies of the contact notes, NSP and any additional documents to support this case management via email. No further follow-up required. A technical advisory was issued for reporting requirements A copy of LIC 809 and LIC 811 was provided to the facility representative above.

met_with: Veronica Lopez, Office Manager


summary: Facility Evaluation

raw_content:
Narrative:
On July 29, 2024, at 1: PM, Licensing Program Analysts (LPAs) Gilbert Gutierrez and Brent Lockhart conducted a case management inspection to the Transitional Housing Placement Program (THPP) Office and met Office Manager, Veronica Lopez. The purpose of the inspection was to provide the amended LIC 809 with deficiency and civil penalty assessment issued to licensee on 05/16/24 due to staff (S4) see LIC 811 (Confidential Names List) has no clearance transfer and not associated to the THPP. On May 28, 2024, the Department received the appeal letter from licensee and upon management review determined that staff S4 was associated to licensee's Foster Family Agency (FFA) on 11/07/23 and then to the THPP on 05/17/24, after the inspection. Based on the information, the deficiency citation and civil penalty assessment was dismissed. In lieu of the deficiency, an advisory note is hereby issued to licensee. The amended report will read as follows: PHYSICAL PLANT The facility license is posted in a prominent location. All participant records are maintained in a secure area or locked file cabinets in the administrative office. The administrative office has telephone service on the premises. OPERATIONAL REQUIREMENTS The facility maintains a register of participants available upon request. The facility is currently operating within licensing regulations. DISASTER PREPAREDNESS The facility has an emergency and disaster plan for the THPP NMD participants. The emergency plan shall include emergency information, instructions, and telephone numbers, including a 24-hour emergency number for the licensee and the participant's responsible party. STAFF RECORDS There is a total of nine (9) staff; three (3) of which are full time case managers and one (1) social worker supervisor. Staff records are available upon request. The agency complies with client to social worker ratio. The Program Director of placement program meets the education and experience requirements, completed the required training, file contains the Statement acknowledging requirement to report child abuse, fingerprint, and child abuse index check clearances and current with CPR and first aid. CLIENT RECORDS The facility currently has thirty-six (36) transitional housing placement participants ages 18-21 years old. The facility ensured the participants record are maintained locked on site in the THPP office. At the time of the inspection, participant 3's NSP was not signed by her and by her authorized representative. LPAs reviewed five (5) personnel records, five (5) participant's record (refer to Confidential Names form LIC 811 dated 05/16/24) and interviewed two (2) staff. An exit interview was conducted and a copy of the amended LIC 809, LIC 809C and LIC 9102TV were provided to the facility representative. A deficiency citation was issued at the time of the inspection.

met_with: Kylie Martinez, Veronica Lopez


summary: Facility Evaluation

raw_content:
Narrative:
On May 1, 2024, at 9: AM, Licensing Program Analyst (LPA) Gilbert Gutierrez conducted a case management inspection at the Transitional Housing Program (THP) Office and met Office Manager, Veronica Lopez. The purpose of the inspection was to amend the LIC 809 with deficiency citation issued to the facility on 02/28/24. On 01/24/24, a Special Incident Report (SIR) was received by the Department. The SIR indicated that on 12/30/23, participant reference #1 (P1) see Confidential Names List (LIC 811) was arguing with his girlfriend at the apartment complex and the police was called. This resulted with participant being arrested but then let go. The participant was not charged. P1's authorized representative was notified. P1 was placed in a 30-behavior contract and his girlfriend was not allowed in the apartment. LPA reviewed the client file. LPA gathered the information from the case manager (CM) that she found out about the incident from the property manager, which was not indicated on the incident report. P1 denied the incident. CM visits the apartment weekly however, P1 canceled the meeting after the incident happened. There was no update regarding the incident as P1 was not charged. Based on the information gathered, CM found out about the incident on 01/19/24 and sent the report to the Department on 01/24/24. No other information provided to LPA. After the Department received more information from licensee and upon further review, it was found that the facility notified the Department via email on 01/19/24 regarding the incident. Therefore, the citation is rescinded. An exit interview was conducted and a copy of the amended LIC 809 and LIC 9102TA were provided to the facility representative. No deficiency citation was issued at the time of the inspection.


facility_name: ENVIRONMENTAL ALTERNATIVES DBA: EA FAMILY SERVICES

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Robyn Word made an announced pre-licensing inspection on 1/10/21 at 1: PM and met with Lee Peters, Office Manager. LPA toured the office space that will be jointly used for Foster Family Agencies and Transitional Housing Placement Programs. LPA observed the main office to have a reception area and a file area where all of the files are locked and inaccessible to individuals without keys. LPA observed that there is an adequate amount of privacy for interviews and office meeting space as well as storage. There is an office space for Social Workers. LPA observed eight smoke detectors in the office space. The facility has provided a program statement that has been approved. The agency is ready to be licensed for the Transitional Housing Program at this time. The Transitional Housing Program will serve nonminor dependents this is the population to be served with this license at this time. Exit interview was conducted and documentation was provided to the Office Manager.

met_with: Lee Peters, Office Manager.


raw_content:
Narrative:
LPA observed minor repairs needed inside client's apartment, which could be addressed by the management company and were not a health or safety issue for the client. The heater was not functioning for several weeks, but the ASW and management company addressed it. The client was given a portable heater until the heater was repaired. The ASW was responsive to the calls from the client and assisted by contacting the apartment management company on several occasions for the client. The agency addressed the client's minor pest control problem by ensuring there were two separate visits to the unit by a pest control company. In addition, the ASW dropped off several cans of bugs spray to the client. The client never contacted the property management company regarding the minor repairs needed. Work orders placed were done so by the ASW and were regarding the heater and pests. It is unclear if client was aware they were responsible for contacting the property management company for maintenance. Based on LPA's observations, interviews which were conducted, and records reviewed, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. No citation were given. A copy of this report was electronically sent at the time of the visit. An exit interview was conducted.

Investigation Findings:
13On 7/13/2023 at 1: PM Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced and met with Reese Howell Offcie manger for the purpose of delivering the complaint findings into the allegations listed above. LPA delivered findings in person to Shasta St, Redding, CA 96001. On 4/18/ LPA McKinley conducted an unannounced complaint investigation and interviewed Naomi Hatch, Agency Social Worker. LPA discussed the allegations and requested the following documents: Needs and Services, Case Notes, accounting records, copies of Transitional Housing Placement agreement and placement agency agreements for five clients. LPA inspected the client's apartment on 4/18/2023. During the investigation, LPA interviewed the reporting party, one client, two facility staff, two county social workers, and three property management staff. LPA conducted a records review. continued on 9099- C page UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: ENVIRONMENTAL ALTERNATIVES THPP/THP+FC-REDDINGFACILITY NUMBER: VISIT DATE: 07/13/2023

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

met_with: Reese Howell - Office Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 1/23/23, Licensing Program Analyst (LPA), Uchenna Ajaero, made an unannounced Annual Required Inspection visit to the agency. However, FAS did not provide the option for the Annual Required button in the 'Type of Visit' Window. Therefore, the Case management - Annual Continuation button was utilized for this Annual Required Inspection. LPM, Jodean Hall was notified. LPA met Dale Giddings, Social Worker Supervisor, (SWS) and Naomi Hatch, Agency Social Worker (ASW) and informed them of the purpose of the visit. LPA Ajaero inspected and reviewed Postings of facility license, Personal Rights Poster, Toilets, wash basin, bath and shower fixtures appeared to be in good repair, no leaks and delivering hot water. LPA observed there to be soap and paper towels available in the bathrooms. The Office was clean and organized. The LPA reviewed records for the THP program. The agency uses a computer database for record keeping. The Agency HR Supervisor, Sara Bodenham issued a log in ID and password for LPA to access files. THPP records show that staff members meet education and experience requirements, as listed in the LIC 859. Currently there are two THPP clients admitted. Agency Social Worker (ASW) Naomi Hatch stated that due to the fact that these youths are between the ages of 18 through 25 years, they retain the right to what documents they provide the Agency. Tthey have 2 other clients whose admission is still pending. Clients are provided accommodation at apartments. The agency is contacted by either the youth, probation officers and or County Case Workers. The apartments are in Redding, California. LPA is not inspecting them at this time. No citation was issued at this time. Exit interview was conducted. LPA provided a copy of this report to Dale Giddings, Social Worker Supervisor

met_with: Dale Giddings, Social Worker Supervisor


summary: Facility Evaluation

raw_content:
Narrative:
On 9/05/2024, Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility and met with Lacy Weinberg Office Manager. The purpose of the visit was to conduct a Required Bi-Annual Inspection of the facility. The last Bi-Annual inspection for the facility was on 1/23/2023. LPA utilized the CARE Tool to complete the inspection. LPA conducted an inspection of the physical plant and checked for all necessary requirements. The facility was clean and organized and maintained an acceptable room temperature. The facility has five offices for social workers and three confidential interview/visitation rooms. LPA observed the proper postings including: facility license, complaint hotline, and emergency disaster plan. The restrooms for clients and staff were clean. Smoke alarms were in working order, fire extinguishers were current, and a first aid kit was fully stocked. Evacuation drills for the facility were completed quarterly. LPA observed client files were stored in locking file cabinets. The facility has no outstanding fees. The facility has 0 minor clients and Non-Minor Dependent clients. Clients live in apartments. No client resides more than two hours from the facility. The facility employs Social Worker/ Case Manager, and 1 of Supervisors/Program Manager. LPA reviewed Social Worker personnel files. Social work personnel had completed criminal record clearances and met minimum education and experience qualifications. All First Aid and CPR certifications were up to date for Social Worker personnel. LPA interviewed 1 social worker personnel. Social work personnel indicated they did not have more than 12 clients on their caseload. LPA reviewed 3 client files. All clients had signed Admission Agreements. Client files had current Needs and Service Plans, signed by the client and placing agency. Needs and Services Plan detailed adequate supportive services the facility offers to the clients. No citations were given on this date. A signed copy of this LIC-809 and LIC-809C report was provided to Lacy Weinberg Office Manager. An exit interview was conducted.

met_with: Lacy Weiberg- Office Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 4/07/26, Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility and met with Lacy Weinberg - Office Manager. The purpose of the visit was to conduct a Required Annual Inspection of the facility. The last Annual inspection for the facility was on 9/05/24. LPA utilized the CARE Tool to complete the Annual inspection. LPA conducted an inspection of the physical plant, and checked for all necessary requirements. The facility was clean and organized and maintained an acceptable room temperature. The facility has one office fora social workers and one confidential interview/visitation rooms. LPA observed the proper postings including: facility license, complaint hotline, and emergency disaster plan. The restrooms for clients and staff were clean. Smoke alarms were in working order, fire extinguishers were current, and a first aid kit was fully stocked, evacuation drill for the facility were completed quarterly. LPA observed client files were stored electronically with password protection. The facility has no outstanding fees. The facility has 0 minor clients and Non-Minor Dependent clients. Clients live in homes or remote site apartments. No client resides more than two hours from the facility. The facility employs Social Worker/Case Managers, and Supervisors/Program Manager. LPA reviewed Social Worker personnel files. Social work personnel had completed criminal record clearances and met minimum education and experience qualifications. Page 1 of All First Aid and CPR certifications were up to date for Social Worker personnel. LPA interviewed 0 social worker personnel, but interviewed the office manager. The Office Manager indicated the Social Worker does not have more than 12 clients on their caseload. LPA reviewed 3 client files. All clients had signed Admission Agreements. Two of three client files had current Needs and Service Plans, signed by the client and placing agency. Needs and Services Plan detailed adequate supportive services the facility offers to the clients. Facility is issued a citation per Title 22 regulation 86168.2 (a) (c) A signed copy of this LIC-809, LIC-809C, and LIC 809D, report was provided to Lacy Weinberg- Office Manager. An exit interview was conducted. Appeal rights were provided.

met_with: Lacy Weinberg- Office Manager


facility_name: ENVIRONMENTAL ALTERNATIVES THPP/THP+FC TRACY

summary: Facility Evaluation

raw_content:
Narrative:
On December 30, 2022 at 12: PM Licensing Program Analyst (LPA) Stephannie Verna arrived at the facility for the purpose of conducting an unannounced Case Management inspection related to a capacity decrease. LPA Verna met with Rocio Martinez, Social Worker Supervisor. LPA Verna conducted one interview and completed a facility inspection. LPA Verna reviewed control of property, deed, and lease agreements and other documents for clients in care, as well as the client register. LPA Verna will conduct a follow-up regarding this Case Management. No citations were issued during today's visit. The facility was issued a copy of this report and an exit interview was conducted with Rocio Martinez, Social Worker Supervisor.


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On May 10, 2023 at 11: AM, Licensing Program Analyst (LPA) Stephannie Verna arrived at the above facility for the purpose of completing an unannounced required Annual Inspection. LPA Verna met with Kyle Denton, Office Manager and Sydney Johnson, Office Manager. Environmental Alternatives is a Transitional Housing Placement Program (THPP) that supports Non-Minor Dependents (NMD) in creating and achieving independent living goals, and fostering independence. LPA Verna completed an inspection of the physical plant, the office and THPP office. LPA observed the facility sketch, disaster plan and facility license was posted in a prominent place in the office. The office had three levels. All three levels contained staff offices. The main level had visitation room, kitchen, bathroom and client file storage. The upper level had a bathroom. The lower level had a recreation area, bathroom, and storage closets/rooms. Carbon monoxide and smoke alarms were tested and in working condition. The water temperature was tested and measured at 108.3 degrees Fahrenheit. The fire extinguishers were charged and last inspected in May 2023. Files and cleaners were not left accessible to clients or others. The agency was observed to be clean, safe, and in good repair with the exception of one observation. LPA Verna observed the client restroom's on (the main floor) bathroom stall door did not close fully or lock and was not in good repair. continued on 809-c LPA completed the staff file review and reviewed a total of five staff files. The staff files contained the required documentation, with the exception of: While the agency does have written job descriptions and duties, they are not stored in the personnel records of five out of five employees (electronic). It was observed that LIC Personnel Records forms did not include all employee information such as date of hire and drivers license number, but the agency has documents on file including copies of drivers license's. LPA Verna reviewed of a total of five client files. From files and documents reviewed on today's date, it was observed that the client files contained the required documents with the exception of: Health and medical records were missing in five out of five client files, however three out of five client files documented the client declined to share health and medical information with the THPP. Also, there were five out of five client records which did not contain the LIC 602 or a medical assessment (health screening and TB test/results). Additionally, there was no record on file that the client refused to obtain a health screening and TB test/results. The facility stated that the clients have the right to refuse to share medical information, and they file documents the clients agree to share. Additionally, client files reviewed did contain completed Transitional Independent Living Plans (TILP), when provided by the placing county. LPA Verna conducted 3 staff interviews. The annual inspection was completed on today's date. The facility is being issued five Technical Advisories. Additionally, the facility is being issued one citation regarding deficiencies to Building and Grounds, CCR Title Regulation section 80087(a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. See LIC 809-D for citation and POC information. An exit interview was completed and a copy of this report and appeal rights were discussed and was provided to Kyle Denton, Office Manager and Sydney Johnson, Office Manager.

Deficiencies:
80087(a): Deficient Practice Statement
1
2
3
4Based on observation and interviews, the licensee did not comply with the section cited above in one client restroom, where the restroom door was in need of repair and was observed to not close or lock, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/16/2023
Plan of Correction
1
2
3
4

title:
Building and Grounds
(a)	The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.

This requirement is not met as evidenced by


summary: Facility Evaluation

raw_content:
Narrative:
On 05/30/2025 at 12:45 p.m. Licensing Program Analyst (LPA) Elena Gonzalez-Soto arrived at the above agency and conducted an unannounced Annual Inspection. LPA met with Sydney Johnson, Office Manager who assisted with the inspection. LPA inspected and reviewed the following: Client Records: five files reviewed contained admission agreement, Identification & emergency information, Needs and Services Plan, and Transitional Independent Living Plan. Operations: reviewed Plan of Operation Certificate of Compliance: reviewed batch of five clients and signed, and reviewed list of all participants and living units. LPA obtained a copy of the facility's LIC 500. Further inspection is needed to complete required Annual Inspection. No citations were issued during today's inspection. An exit interview was conducted and a copy of this report was issued to

met_with: Sydney Johnson, Office Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 06/03/2025 at 10:45 a.m. Licensing Program Analyst (LPA) Elena Gonzalez-Soto arrived at the above agency and conducted an unannounced Annual Inspection continuation. LPA met with Sydney Johnson, Office Manager who assisted with the inspection. LPA inspected and reviewed the following: Physical Plant: license is posted in public, accessible area and records are maintained in secured area. Disaster Preparedness: Reviewed Emergency Disaster Plans for a batch of five clients, plans included emergency information and telephone numbers. Staff Records: five files reviewed contained: five criminal record clearances, five valid driver's licenses, LPA observed S1, S2, S3, and S4 did not have training related to the sexual and reproductive rights of children in foster care, all other required training has been completed. The facility is being issued a Technical Violation for California Code of Regulations, Title 22, Division Chapter 7, Article 06. Continuing Requirements, 86065 (f)(4) Personnel Requirements. An exit interview was conducted and a copy of this report was issued to Sydney Johnson, Office Manager.


facility_name: FAMILY CARE NETWORK, INC.

raw_content:
Investigation Findings:
13On 08/23/2024 at 11:30AM, Licensing Program Analyst (LPA) Jhane Haynes made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegations and deliver the findings. LPA spoke with TAYS Housing Manager(THM) and together discussed the investigative findings. During the investigation LPA Haynes interviewed and accounted for all relevant parties. Based on interviews gathered, guests are to leave by midnight. Safety checks were conducted by program and no unauthorized guests nor contraband was found. Parties involved denied drug use on property. Statements to corroborate the above allegations could not be obtained. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur therefore is UNSUBSTANTIATED. An exit interview was conducted, and a copy of this report was emailed to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Jhane Haynes LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Darci Rice TAYS Housing Manager(THM)


summary: Facility Evaluation

raw_content:
Narrative:
On March 15, 2022, at 11:20am Licensing Program Analysts (LPAs), Enrique Hernandez and Nancy O'Connell made an unannounced visit to the above facility for the purpose of a Required- Year visit. LPAs met with Brian Redin the Director of the administrative office of the THPP who provided a tour of the administrative offices. Director private room for the file reviews. LPA observed that the facility license was posted in public view, cabinets for THPP files were locked and kept in a secure area, Bill of Rights for clients were posted in visible area of building, Livescan is available on site. Licensee is operating within the conditions and limitations specified on the license. Annual fee is current. Due to time constraints, the LPAs will return to review staff and client files, in order to complete Annual required inspection. A copy of this report was discussed with the Director Due to technical difficulties, LPA will email Director a copy of this report.

met_with: Director


summary: Facility Evaluation

raw_content:
Narrative:
On 10/17/23 at 11:20AM, Licensing Program Analysts (LPA) Jhane Haynes and Christine Wilson made an unannounced visit to the above facility for the purpose of an Annual/Required visit. LPA Haynes and LPA Wilson met with the facility administrator (FA) Brian Redin who granted access into the office, provided a tour of the administrative office and private room for the file reviews. This is a one story office building located at Kendall Rd in San Luis Obispo, CA. It features the following: Lobby area containing three counseling rooms and a therapy room for clients. Hall leading to the first office sections that contains a board room for meetings, the offices for human resources/payroll, a break room with patio access and desks for volunteers/interns. There are two additional rooms for training and conferences. At the end of the hall, there is a facility room for maintenance staff that services the administrative office and off-site housing. Wrapping around the hall features an open concept room with desks available to rehab and wrap staff as well as cubicles for social workers. Client files are centrally stored in locked file cabinets in the shared workspace between foster care and transitional age youth staff. See 809-C LPAs observed: Records of C1,C2,C3,C4,C5 includes a personalized case plan, TB clearance, education if applicable and budgeting. Each participant's record contains copies of important documents including, but not limited to: A copy of the staff roster was provided and reveals that all staff have obtained a criminal record clearance with DOJ, FBI, and Child Abuse Response. LPA conducted staff interviews with FA and HM. See LIC811(confidential names) dated 10/17/2023. Due to time constraints, LPAs will return 10/18/2023 to review staff files and visit off-site locations. No deficiencies will be cited this day. An exit interview was conducted, and a copy of this report will be emailed to facility manager.

met_with: Brian Redfin Facility Administrator (FA)


summary: Facility Evaluation

raw_content:
Narrative:
On 10/18/2023 at 09: AM Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of continuing the Annual/Required visit initiated 10/17/23. LPA Haynes met with the Facility Administrator (FA) who provided access to facility and a private room to review staff files of FA, HM, SW and AC. See 811(Confidential Names). Staff files are stored electronically. Desiree Del Rio (HR) granted staff file access. LPA observed each staff file contained health screening, TB results, description of job duties, educational records, DOJ, FBI and CACI clearances as well as past required and upcoming trainings. Facility utilizes volunteers in terms of an internship. Based on staff interview, there are no volunteers employed at this time. LPA also conducted staff interviews with AC and SW. LPA Haynes and HM Darci Rice HM toured 2 off site apartments.(See 812 dated 10/18/23) Family Care Network has units in San Luis Obispo, Atascadero, Arroyo Grande, Santa Maria and Orcutt that are less two hours from administrative office. Per Title Division Chapter 7, one deficiency will be cited at this time. See 809-D for details. An exit interview was conducted and a copy of this report and appeal rights were emailed to facility administrator.

met_with: Darci Rice (HM)


summary: Facility Evaluation

raw_content:
Narrative:
On 04/08/24 at 01: PM Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of conducting a case management inspection for an incident received by the department on 04/04/24. Participant passed away due to overdose. LPA met with Facility Administrator(FA) Brian Redin who granted access to the facility. LPA conducted interview with FA and S1. LPA obtained contact information of P1's probation officer and parent. Further investigation is needed to determine whether a violation occurred. There are no deficiencies to be cited today. An exit interview was conducted and a copy of this report will be emailed to the facility administrator.

met_with: Brian Redin Facility Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 07/25/24 at 03:00PM Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of concluding a case management incident initiated 04/08/24. Death of client. LPA met with the Facility Administrator(FA) Brian Redin who granted access to the facility. The department determined no violation occurred. Client was enrolled in various services to support and address substance abuse. Apartment was searched by facility and police department for contraband, and none was found at the time of initial arrest. No deficiencies will be cited at this time. An exit interview was conducted and this report was emailed to the Facility Administrator.

met_with: Brian Redin Facility Administrator(FA)


summary: Facility Evaluation

raw_content:
Narrative:
On 07/25/24 at 03:00PM Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of conducting a case management incident inspection for incident received by the department on 06/14/24. Resident's medicine was not refilled timely resulting in asthma attack. LPA met with the Facility Administrator(FA) Brian Redin who granted access to the facility. LPA conducted confidential interview with FA. LPA obtained client's contact information. Further investigation is needed to determine whether a violation occurred. No deficiencies will be cited at this time. An exit interview was conducted and this report was emailed to the Facility Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 07/25/24 at 03:00PM Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of conducting a case management incident inspection for incident received by the department on 04/26/24 involving resident, child and unauthorized adult. LPA met with Facility Administrator(FA) Brian Redin who granted access to the facility. LPA conducted confidential interview with FA. LPA obtained client and client's probation contact information and police report number. Further investigation is needed to determine whether a violation occurred. No deficiencies will be cited at this time. An exit interview was conducted and this report was emailed to the Facility Administrator.


facility_name: FD NALLS - NALLS FOUNDATION

raw_content:
Narrative:
Based on 5 confidential interviews, information provided in incident reports related to the complaint allegation, inconsistencies in statements and lack of corroboration, the allegation is determined to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted, and a copy of the report and appeal process was provided to the Program Administrator.

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

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

met_with: Program Director


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst, (LPA) Tana Kinder conducted a required inspection with the Program Manager on 9/24/201. LPA inspected the office space and observed a fully charged fire extinguisher, first aid kit, personal rights, a copy of the license and evacuation plan are posted in a prominent location. LPA observed a fully-wired sprinkler system. Personnel and client files are kept in a locked cabinet in a locked room. LPA reviewed 4 client files and 4 staff files. LPA used the CARE Tool to conduct the required inspection. An exit interview was conducted and a copy of the report was emailed to fdnallsfoundation@gmail.com.

met_with: Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Yuvi Diaz made an unannounced annual inspection on November 3, 2022, at 10:30AM LPA Diaz met with Tina Dollison, Program Manager who assisted annual with the inspection. LPA Diaz conducted a walk-through of the facility inside and out. Facility is in a three story building. Office is located on the second floor. Office has two large rooms, with working desks. LPA Diaz inspected and/or reviewed the following: I. Physical Plant: Posting of license, Personal Rights, Covid Poster, Facility Sketch, and Emergency Disaster Plan. Disinfectants/Cleaning solutions inaccessible, Working telephone. Carbon monoxide detectors and Smoke Detector were all in working condition. First Aid Kit fully stocked. II. Operations: Was reviewed. III. Disaster Preparedness: Disaster and mass casualty plan updated and available, IV. Staffing/Volunteers: LPA Diaz reviewed three staff files. Files has criminal record clearances.First Aid Certificate, Certified Administrators certificate valid and current Job title/qualification verified IV.Client Records: Number of Clients files reviewed two. All files had Needs and Services Plan, Agreement, Personal Rights, and Compatible Assessment. Report continues on LIC809-C The following items were reviewed for compliance in the regional office prior to the facility inspection: · Annual fees are to date. · Emergency Disaster Plan was posted · Personnel Roster, Facility Sketch, LIC 500, LIC 610C and LIC 308 · Waivers and Exceptions No deficiencies were cited. Two technical advisory's were noted. An exit interview was conducted with Tina Dollison, Program Manager. A copy of this report was emailed.

met_with: Tina Dollison, Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On September 29, 2023, at 10: AM, Licensing Program Analyst (LPA) Shalisa Stiger arrived at the above facility for the purpose of conducting an Annual Inspection. LPA Stiger arrived at Suite 240 and observed the door to be locked. LPA Stiger knocked and waited. LPA Stiger called the contact numbers on the facility profile and was unable to get in contact. With nothing further, LPA Stiger left the facility. LPA Stiger emailed the Administrator for business hours and to provide a copy of this report.

met_with: Facility Location


summary: Facility Evaluation

raw_content:
Narrative:
On October 10, 2023, at 10: AM, Licensing Program Analyst (LPA) Shalisa Stiger made an unannounced annual inspection. LPA Stiger met with Tina Dollison, Program Manager who assisted with the annual inspection. LPA Stiger conducted a walk-through of the facility. The facility is in a three story commercial building. Office is located on the second floor and has two large rooms with working desks. LPA Stiger inspected and reviewed the following: I. Physical Plant: Posting of license, Personal Rights, Covid Poster, Facility Sketch, and Emergency Disaster Plan. Disinfectants/Cleaning solutions inaccessible, Working telephone. Fire extinguisher in working condition. Smoke Detector working for commercial building. LPA Stiger did not test smoke detector due to being a commercial building. First Aid Kit observed and fully stocked. II. Operations: Was reviewed. III. Disaster Preparedness: Disaster and mass casualty plan updated and available. IV. Staffing/Volunteers: LPA Stiger reviewed two (2) staff files including the Administrator file. Files have certifications, criminal record clearances. First Aid Certificate, Certified Administrators certificate valid and current Job title/qualification verified. IV.Client Records: Number of Clients files reviewed two (2) client files. All files had Needs and Services Plan, Agreement, Personal Rights, and Compatible Assessment. LPA Stiger reviewed the Discharge Plan and Policy located on Needs and Services document. Report continues on LIC809-C.. The following items were reviewed for compliance in the regional office prior to the facility inspection: Annual fees are to date, Emergency Disaster Plan was posted, Personnel Roster, Facility Sketch, LIC 500, LIC 610C and LIC 308, Waivers and Exceptions. No deficiencies were cited. An exit interview was conducted with Tina Dollison, Program Manager. A copy of this report was emailed.


summary: Facility Evaluation

raw_content:
Narrative:
On 05/12/2026 at around 2: PM Licensing Program Analyst (LPA) Chad Cabigon arrived at this Transitional Housing Placement Program's (THPP) office to start its Required/Annual Inspection. LPA met with Program Director Tina Dollison who facilitated the inspection. A review was started on both staff and client records. More time is needed to complete the inspection. A copy of this report is being provided to FD Nalls.

met_with: Tina Dollison, Program Director


summary: Facility Evaluation

raw_content:
Narrative:
On 05/13/ Licensing Program Analyst (LPA) Chad Cabigon continued the Required/Annual Inspection for this Transitional Housing Placement Program (THPP). This agency operates a remote site model with its participant units located in San Francisco and in Fairfield--both of which are within two hours' travel by automobile. The Program currently has two clients whose files were reviewed and found to contain all the required documents/elements; these records were kept in a secured file cabinet within the Program's office. LPA also reviewed three staff files that also contained all the required documents/elements. The agency's office was separate and secure from other tenants sharing the office building; there was ample space for confidential interviews to be conducted as needed, and the license was posted in a conspicuous area. This Transitional Housing Placement Program (THPP) is found to be in substantial compliance with Regulations; no deficiencies are being cited as a result of the inspection. A copy of this report is being provided to the agency.


facility_name: FIRST PLACE FOR YOUTH

summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Christopher Rollins conducted a follow-up complaint inspection with First Place for Youth and spoke with Emily Jensen Chief Impact and People Officer (CIPO). The purpose of the inspection was to deliver the findings for the above complaint allegations. During the course of investigating the allegations, LPA Rollins conducted confidential interviews with staff, clients, social workers and conducted client file review. Confidential interviews reveal conflicting stories about resident was threatened by another resident. Confidential interviews reveal conflicting stories about facility staff failing to provide a safe enviroment for particpant. Confidential Interviews reveal that there was a verbal altercation but there were conflicting reports that during the altercation there was threatening words exchange. Based on interviews and documentation there was not enough evidence to prove that facility staff failed to provide a safe enviroment,resident was threatened by another resident, and resident engaging in verbal altercation. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that facility staff failed to provide a safe enviroment, resident was threatened by another resident and residents engaging in verbal altercation, therefore the above allegations are unsubstantiated. Exit interview conducted with CIPO and report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: Christopher Rollins 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

met_with: Emily Jensen- Chief Impact and People Officer


raw_content:
Narrative:
Based on interviews and documentation there was not enough evidence to prove that facility staff failed to provide a safe environment for participant, participant was threatened by another participant, staff did not accord participant privacy, facility staff spoke inappropriately to participant and facility staff did not ensure that a non minor parent provided proper care for participant child. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that facility staff failed to provide a safe environment for participant, participant was threatened by another participant, staff did not accord participant privacy, facility staff spoke inappropriately to participant and facility staff did not ensure that a non minor parent provided proper care for participant child, therefore the above allegations are unsubstantiated. Exit interview conducted with Administrator and report was left at the facility.

Investigation Findings:
13Licensing Program Analyst (LPA) Christopher Rollins conducted a follow-up complaint inspection with First Place for Youth and spoke with Lauren Grayman- Administrator. The purpose of the inspection was to deliver the findings for the above complaint allegations. During the course of investigating the allegations, LPA Rollins conducted confidential interviews with staff, clients, social workers and conducted client file review. Confidential interviews reveal conflicting stories about resident was threatened by another resident. Confidential interviews reveal conflicting stories about facility staff failed to provide a safe enviroment for particpant and particpant was threatened by another particpant. Confidential Interviews reveal conflicting stories about facility staff did not accord particpant privacy, facility staff spoke inapproprately to particpant and facility staff did not ensure that a non minor dependent parent provided proper care for the child. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: Christopher Rollins 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 14-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, TRAEGER AVE., SUITE FACILITY NAME: FIRST PLACE FOR YOUTHFACILITY NUMBER: VISIT DATE: 01/05/2022

met_with: Lauren Grayman-Administrator


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Alyssa Ng conducted a follow-up complaint inspection with First Place for Youth and spoke with Lauren Grayman- Administrator. The purpose of the inspection was to deliver the findings for the above complaint allegations. During investigation, incident reports and records were reviewed, and confidential interviews were conducted. Based on interviews and record review, LPA spoke to Administrator regarding apartment and let LPA know that the apartment was put on a treatment plan when roaches were first reported but client moved out. First Place For Youth gave up the lease due to client no longer being at the unit. The agency has investigated the complaint alleging apartment has roaches and mold. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. No citations were given due to the apartment being put on a pest control treatment plan when first notified about the incident. An exit interview was conducted, and a copy of the report was left with the Administrator. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Alyssa Ng LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

met_with: Lauren Grayman

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Investigation Findings:
13On 10-5-22 12:21PM, Licensing Program Analyst (LPA) George Karkazis conducted a follow up complaint investigation at First Place For Youth and met with Chloe Whittlesey, Program Manager. The purpose of the inspection was to deliver the findings of the above complaint allegation. During the investigation, LPA Karkazis conducted confidential interviews with staff and clients. During confidential interviews with LPA Karkazis, it was disclosed that there was an infestation of mice in one of the apartments. It was also disclosed that the facility immediately began addressing the problem by bringing in glue traps and hiring an exterminator. A verbal and written timeline of the service was provided to LPA Karkazis, to fix the mice infestation, and relocation of clients until the rodents were gone. It was also disclosed to LPA Karkazis that a few months ago it took First Place For Youth three weeks to address a bug infestation in their apartment. Photos of rat droppings were also obtained. Based on confidential interviews, photos, and records review, the preponderance of evidence standard has been met to determine that staff were not assisting to keep residents free of rodents. Therefore, the above allegation is substantiated. First Place For Youth has taken immediate steps to irradicate rodents and shall not be cited at this time. An exit interview was conducted, Appeal Rights were provided, and a copy of this report was left with Chloe Whittlesey, Program Manager. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Mendoza LICENSING EVALUATOR NAME: George Karkazis LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

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

met_with: Chloe Whittlese, Program Manager


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Investigation Findings:
13On 11/08/2022 at 12:20PM, Licensing Program Analyst (LPA) Lisette Valenzuela conducted a visit to the above agency to deliver the findings on the listed allegation. LPA met with Dereassa Chambers, Program Manager. During the course the investigation, LPA conducted confidential interviews. According to confidential interviews, and record review, LPA Valenzuela concluded, the allegations that facility staff are not providing assistance to Non-Minor Dependent, had inconsistent support.Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated, and no Title 22 deficiencies were observed. Exit interview was conducted and a copy of this report was emailed to Dereassa Chambers, Program Manager, whose signature on this form confirms receipt of these documents. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Carolyn Flynn LICENSING EVALUATOR NAME: Lisette Valenzuela LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

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

met_with: Dereassa Chambers


summary: Complaint Investigation - Substantiated

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Investigation Findings:
13At 11:45AM on December 1, 2022, Licensing Program Analysts (LPAs) Lisa Schlembach and Shikya Belfield conducted an unnanounced complaint inspection at the above-listed agency. The LPAs met with Administrator Lauren Grayman and DeReassa Chambers (County Program Manager - Santa Clara County) who assisted with the visit. Program Director Rachel Carlos made herself available via telephone for the duration of the visit. Based on confidential interviews, staff and client file reviews, and review of other agency documentation it was confirmed that the agency did not ensure that all participants had safe, healthy, and comfortable homes to live in. An exit interview was conducted with Lauren Grayman, and a copy of this report, along the associated deficiency page and appeal rights was emailed to Lauren Grayman and Rachel Carlos. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Carolyn Flynn LICENSING EVALUATOR NAME: Lisa Schlembach 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 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: FIRST PLACE FOR YOUTHFACILITY NUMBER: 015650108


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Investigation Findings:
13On 10-4-23 10:29AM, Licensing Program Analyst (LPA) Karkazis conducted an unannounced inspection at First Place for Youth and met with Rachael Carlos, Regional Director of Programs, who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. Regarding the allegation that THP is not meeting participant's needs: Licensing Program Analyst (LPA) conducted confidential interviews with staff, clients, and conducted document research. During confidential interviews, inconsistent information was provided. Some interviewees stated that the facility was not doing anything to meet the client's needs while other interviewees were providing alternatives to meet the participant's needs. LPA conducted document research and found that all participants were safe and not in danger, and alternative living arrangements provided. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the THP is not meeting participant's needs. Therefore, the above allegation is UNSUBSTANTIATED. An exit interview was conducted and a copy of this report was given to Rachael Carlos, Regional Director of Programs. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: George Karkazis LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

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


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Investigation Findings:
13On 12-8-23 10:38AM, Licensing Program Analyst (LPA) George Karkazis conducted an unannounced inspection at First Place For Youth, and met with De Reassa Chambers, Clinical Program Manager, who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. The complaint alleged that staff did not keep the apartment free of cockroaches. LPA conducted confidential interviews, document research and obtained photos of cockroaches in the apartment. A written timeline of services was provided to LPA Karkazis. Based on the information obtained, there is a preponderance of evidence to prove the above allegation is SUBSTANTIATED. First Place For Youth has since relocated the client and shall not be cited at this time. An exit interview was conducted, Appeal Rights were provided, and a copy of this report was left with De Reassa Chambers, Clinical Program Manager. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lidia Tinoco LICENSING EVALUATOR NAME: George Karkazis 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO RO, TRAEGER AVE., SUITE This is an official report of an unannounced visit/investigation of a complaint received in our office on 09/26/2023 and conducted by Evaluator George Karkazis PUBLICCOMPLAINT CONTROL NUMBER: 14-CR- FACILITY NAME:FIRST PLACE FOR YOUTHFACILITY NUMBER: ADMINISTRATOR:LAUREN GRAYMANFACILITY TYPE: ADDRESS:426 17TH STREET, #100TELEPHONE: (510) 272- CITY:OAKLANDSTATE: CAZIP CODE: CAPACITY:250CENSUS: 60DATE: 12/08/ UNANNOUNCEDTIME BEGAN: 10: AM MET WITH:De Reassa Chambers, Clinical Program ManagerTIME COMPLETED:12: PM 9Staff entered the minors apartment without prior consent. INVESTIGATION FINDINGS: 13On 12-8-23 10:38AM, Licensing Program Analyst (LPA) George Karkazis conducted an unannounced inspection at First Place for Youth, and met with De Reassa Chambers, Clinical Program Manager, who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. The complaint alleged that staff entered the minor's apartment without consent. LPA Karkazis conducted confidential interviews and document research which provided inconsistent information. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation occurred. Therefore, the allegation is UNSUBSTANTIATED. An exit interview was conducted and a copy of this report was given to De Reassa Chambers, Clinical Program Manager. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lidia Tinoco LICENSING EVALUATOR NAME: George Karkazis 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: 2 of 2

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


summary: Facility Evaluation

raw_content:
Narrative:
On 05/18/2026 at 3: PM, Licensing Program Analyst (LPA) Jasmine Cardeno made an unannounced visit to conduct a Case Management inspection regarding an incident report that was reported to and received by the Department. LPA knocked on the front door of the facility and met with Education and Employment Specialist, Chidimma Ezeokoli. LPA introduced herself and presented her badge to Education and Employment Specialist, Chidimma Ezeokoli. LPA informed Education and Employment Specialist the purpose of the inspection is to conduct a Case Management visit regarding the incident report that the Department received. At 3: PM, Education Employment Specialist contacted youth C1's assigned Education and Employment Specialist, Maria Rangel-Vargas (S1), via telephone call. LPA informed the purpose of the visit and the purpose of the telephone call is to conduct an interview regarding the incident report. LPA conducted an interview with S1 via telephone call. The interview with S1 is detailed in a corresponding LIC-812 form. At 4: PM, LPA met with Clinical Program Manager (PM1), De-Reassa Chambers, who arrived on-site to the facility after facility staff contacted and informed PM1 that LPA would like to meet with PM1 for the Case Management inspection. LPA introduced herself to PM1 and presented her badge and provided her business card to PM1. LPA informed PM1 the purpose of the inspection is to conduct a Case Management visit regarding an incident report that the Department received. LPA conducted an interview with PM1, and while LPA and PM1 met for the interview, PM1 was in communication with youth C1's assigned Youth Advocate, Milele Hare (S2). PM1 stated that S2 was currently off work for the day, but S2 stated that they can conduct the interview via telephone call. At 4: PM, LPA conducted an interview with PM1 in PM1's office and S2 via telephone call. The interview with PM1 and S2 is detailed in a corresponding LIC-812 form. At 5: PM, LPA requested documents from the facility from C1's file including: Placement Agreement form, Identification of Driver's License, Emergency Contact Information, Transitional Independent Living Plan, and Home Visits and Youth Meetings documents. At 5: PM, LPA conducted a walk-through of the facility facilitated by PM1. PM1 guided LPA through the facility and LPA observed available office meeting rooms and desk spaces for Youth Advocates, Education and Employment Specialists, and program staff. LPA observed the downstairs area to be clean and have office rooms and two available bathrooms. The office rooms can be locked and have filing cabinets that are locked and store confidential files securely. PM1 stated that confidential files are locked in filing cabinets and there are also files kept on secure SharePoint folders. PM1 guided LPA upstairs, and LPA observed more spaces that are available to hold meetings with youth. An exit interview was conducted with Clinical Program Manager, De'Reassa Chambers, whose signature on this page indicates receipt of this report. A copy of this report, along with the LIC 811-Confidential Names form was given to Clinical Program Manager, De'Reassa Chambers.


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Narrative:
LPA obtained SIR's #835286 and #837766, training log for unscheduled visits, NMD1 notice of lease violation, photos of alcohol bottles in NMD1 apartment, and NMD1 signed program agreement including substance abuse policy. Based on the interviews conducted and documentary evidence, the information gathered did not produce corroborating evidence to support the above said allegation. LPA Edison was not able to determine if the above said allegation occurred, therefore the allegation is determined to be unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. Based on the observations made during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Regional Director of Programs.

Investigation Findings:
13On March 2, 2023 at 2:09pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to First Place for Youth and spoke with Lamont Walker, Regional Director of Programs. The purpose of this visit was to deliver the findings for the above complaint allegation. During the investigation, a total of one (1) witness, three (3) Non-Minor Dependents, and three (3) staff were interviewed. Confidential interviews and inconsistent statements made by staff, witnesses, and Non-Minor Dependent #1 (NMD1) did not substantiate the allegation, Youth is not given privacy. Statements made by S1 and NMD1 did not confirm that NMD1 was not dressed when S1 entered NMD1's bedroom. Confidential interviews revealed upon inspection of NMD1's unit, multiple alcohol bottles were observed by S1 and the smell of marijuana in the unit. Additional confidential staff interviews also revealed NMD1 violated the program agreement on illegal activities/drug use/ alcohol use. Documentary evidence revealed S1 training on conducting unscheduled visits to participant units and notice of NMD1's notice of lease violation. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Daphne Edison 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: FIRST PLACE FOR YOUTHFACILITY NUMBER: VISIT DATE: 03/02/2023

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

met_with: Lamont Walker-Regional Director of Programs


summary: Facility Evaluation

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Narrative:
On July 30, 2021 at 11:20am Licensing Program Analyst (LPA), Emelyn Sanchez P. made an unannounced visit to the First Place for Youth THPP+FC, for the purpose of conducting an Annual/Required Inspection Visit. LPA, Sanchez P met with Facility Administrator, Jamie Kugelberg who granted access and provided a tour of the Administrative Office which is located at the above said address on the 6th floor of an executive suite that is shared amongst other companies. The facility is licensed to provide transitional housing placement plus foster care (THP+FC) to Non-Minor Dependents only. The office is set up as follows: This is a 13 room office with a lobby area, one small conference room, one large conference room, lunch/break room and printing area. The lobby area has two desks along the wall with three operating computers and chairs. There is also one round table with a sofa and two sofa chairs and small table. The receptionist desks are located to the left when entering the office space. The small conference/classroom area has a table with more then 10 chairs for seating. The large conference room has a large table with 9 chairs and a desk/cabinet with an operating computer to the left when entering the room. The lunch/break room area has a small table with three chairs, microwave, and refrigerator/freeze for staff to use. Clients are not allowed inside the break room without a staff member. In the assigned office space for the Regional Director are the staff files locked in a small cabinet. All client files are kept locked in cabinets in the office room assigned to the Youth Advocates. This office is used by clients, office personnel, and social workers. The facility was inspected and the following was observed: The licensee operates within capacity limitations. A review of all staff clearances conducted on 7/30/2021 indicate that all individuals who require background checks have received criminal record clearances and child abuse index clearances or exemptions. All posting requirements were met. Report Cont. on LIC 809-C. LPA will return to the facility at later date to complete the Annual Inspection (i.e Staff/Client Records review and conduct Staff/Client interviews) No deficiencies observed at the time of the visit. Exit Interview was conducted and a copy of this report was left at the facility.

met_with: Facility Administrator


summary: Facility Evaluation

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Narrative:
On August 19, 2021 at 8:00am Licensing Program Analyst (LPA), Emelyn Sanchez P. made an announced visit to the First Place for Youth THPP+FC, for the purpose of conducting a Case Management- Annual Continuation Inspection Visit. LPA, Sanchez P. met with Facility Administrator, Jamie Kugelberg who granted access into the Administrative Office which is located at the above said address on the 6th floor of an executive suite that is shared amongst other companies. The facility is licensed to provide transitional housing placement plus foster care (THP+FC) to Non-Minor Dependents only. LPA Sanchez P. reviewed ten (10) Staff records and ten (10) Client records. LPA Sanchez P. conducted nine (9) staff interviews with Staff #1, Staff #2, Staff #3, Staff #4, Staff #5, Staff #6, Staff #8, Staff #9, and Staff #10. LPA Sanchez P. also conducted eight (8) client interviews with Client #2, Client #3, Client #4, Client #5, Client #6, Client #7, Client #9, and Client #10. No deficiencies observed at the time of the visit. Exit Interview was conducted and a copy of this report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On June 9, 2022 at 9:31am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to First Place for Youth THPP+FC, for the purpose of conducting a two (2) year Required Inspection. LPA Edison met with Lamont Walker, Regional Director of Programs who granted access and provided a tour of the Administrative Office which is located at the above said address on the 6th floor of an executive suite that is shared with other companies. The facility is licensed to provide transitional housing placement plus foster care (THP+FC) to two-hundred and fifty (250) Non-Minor Dependents only. The census on the date of this visit is one hundred thirty-three (133). The office is set up as follows: This is a thirteen (13) room office with a lobby area, one small conference room, one (1) large conference room, lunch/break room and printing area. The lobby area has two (2) desks along the wall with three (3) operable computers. There is also one (1) round table with a sofa, two (2) chairs, a and small table. The receptionist desks are located to the left when entering the office space. The small conference/classroom area has a table with ten (10) or more chairs for seating. The large conference room has a large table with nine (9) chairs and a desk/cabinet with an operable computer to the left upon entrance to the room. The lunch/break room area has a small table with three (3) chairs, microwave, and refrigerator/freezer for staff use. Clients are not permitted inside of the break room unless accompanied by a staff member. Staff files are kept locked in a small cabinet in the office occupied by the Regional Director of Programs. Client files are kept locked in cabinets in the office occupied by the Youth Advocates. The Youth Advocate office is also used by clients, office personnel, and social workers. Continued on LIC 809-C During this visit, LPA reviewed three (3) staff records and conducted two (2) staff interviews. Caregiver(s)/adults working/residing in the facility have DOJ/FBI criminal record clearances and Child Abuse Index Checks. Emergency Mass Disaster Casualty Plan was available for review. LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. Direct care staff have valid CPR and First Aid training. All posting requirements were met. During this visit, LPA reviewed three (3) client records. Client records contained copies of Needs and Service Plans and Medical Authorizations signed by each child and their authorized representative. Children are accorded dignity in personal relationships with staff and others. Off Site Living Units Inspected: 1. El Segundo Blvd. #4, Compton, CA 90222 2. Denker Ave. #B , Gardena, CA The facility was inspected, and the following was observed: The licensee operates within capacity limitations. There were no firearms or other weapons observed inside of the living units. No bodies of water on living unit premises. Overall, the offsite living units are safe, sanitary, and in good repair for the safety and wellbeing of clients, employees, and visitors. Smoke detectors and carbon monoxide detectors tested audible and are in operable condition in the living units. There is a fully charged regulation fire extinguisher in the units. Hot water was tested and is in a safe temperature range. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit Interview was conducted, and a copy of this report will be emailed to the Regional Director of Programs.


summary: Facility Evaluation

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Narrative:
On August 18, 2022 at 1:16pm, Licensing Program Analyst (LPA), Daphne Edison made an unannounced visit to First Place for Youth for the purpose of conducting a Case Management for Special Incident #823167, Non-Minor Dependent (NMD) Death. LPA met with Lamont Walker, Regional Director of Programs and discussed the incident. A Special Incident Report was submitted to Community Care Licensing (CCL) on August 12, 2022 for the incident which occurred on August 5, 2022, when Non-Minor Dependent #1 (NMD1) (see Confidential Names List, LIC 811 dated 8/18/2022) was involved in a fatal automobile accident in the state of Idaho. During this visit, confidential interviews were conducted with Staff #1. Additional staff interviews will be conducted on a later date. Staff interview conducted on this day revealed that NMD1 had driven alone to the state of Idaho where NMD1 was involved in a fatal automobile accident. Staff interviews also revealed that upon being notified of the death of NMD1, the facility staff immediately notified Community Care Licensing (CCL) of the death of NMD1. Additionally, LPA Edison learned that NMD1's placement with First Place for Youth was closed effective August 5, 2022 per the date of NMD's death . Based on the information gathered at this time, the facility took proper action regarding the incident in question and no violation will be cited on this day regarding this case management incident. Exit interview was conducted, and a copy of this report will be emailed to the Regional Director of Programs.


summary: Facility Evaluation

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Narrative:
On February 14, 2023 at 8:40am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to First Place for Youth THP+FC for the purpose of conducting a Case Management for Special Incident Report #841202. LPA met with Lamont Walker, Regional Director of Programs and discussed the incident. During this visit, confidential interviews were conducted. Additional interviews will be conducted at a later date. LPA discussed CCL Reporting Requirements with licensee. LPA requested and was provided a copy of the current LIC 500 and the participant list. This case management needs further investigation. Based on the observations made during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Regional Director of Programs.


summary: Facility Evaluation

raw_content:
Narrative:
On September 29, 2023, Licensing Program Analyst (LPA) C. White made an unannounced visit to First Place for Youth THP+FC for the purpose of conducting a Case Management Visit in regard to Special Incident Report #919788 dated 09/25/2023; received by CCL on 09/26/2023. LPA met with Clinical Program Manager, Mariya Libman and discussed the incident. Per the report the incident occurred on 09/24/2023. During this visit, a confidential interview was conducted. Additional interviews will be conducted at a later date. LPA requested and was provided the following: a copy of the current LIC 500, the current participant list, contact information for Client #1 and Client #2. This case management needs further investigation. Based on the information gathered during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report was emailed to the Clinical Program Manager.

met_with: Mariya Libman - Clinical Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 7/31/2024, at 11: AM, Licensing Program Analyst (LPA) Regina Martin attempted an unannounced Case Management - Incident inspection at First Place For Youth. LPA Martin later spoke with Administrator via telephone in response to Special Incident Report (SIR #: 1054175) submitted to Community Care Licensing (CCL) on 6/25/2024. LPA Martin informed the incident has been referred to CCL Investigations Branch, Investigator Edward Hector. Upon completion of the investigation, the investigation findings will be delivered and discussed. LPA Martin requested the following documents to be emailed including Client Roster, Personnel Report (Schedule) LIC500, and Needs and Services and Transitional Independent Living Plan for subject participant. Please submit requested documents to LPA Regina Martin at regina.martin@dss.ca.gov The incident requires further investigation. There are no deficiencies cited per California Code of Regulations, at this time. A copy of this report was emailed to Administrator for signature.