summary: Facility Evaluation

raw_content:
Narrative:
On October 16, 2025, License Program Analyst Justine Armstrong(LPA) made an announced visit to the Pro Youth Transitional Housing Placement Program Administrator's Office for the purpose of conducting a post-licensing visit. LPA met with Administrator David Yasutake at 10: AM and toured the administrator's office. The facility is licensed to provide Transitional Housing Placement plus Foster Care (THP + FC) and Non-Minor Dependents (NMD) to 18 participants ages eighteen (18) through twenty one (21). There are currently 9 participants in placement. Applicants will be utilizing the office space located at Palma Dr., Ventura, CA Suit 227. The office is a private suite equipped with one desk, three chairs, and a computer. The Licensing Program Analyst (LPA) also observed a locked file cabinet designated for client files, a printer, a shredder, and extra office supplies on the desk. The office has one door for entry and exit. The office space displays the Facility License, a client roster, an Emergency Disaster Plan, facility map, and Certificate of Compliance. The LPA toured the office and observed three conference rooms: two located upstairs and one downstairs. These conference rooms are available for conducting private and confidential meetings with clients and social workers. (Continued on LIC809C) LPA reviewed 2 staff files, all staff have received FBI, DOJ and Child Abuse Index Check clearances. LPA reviewed 2 client files, each client had needs and service plan, signed personal rights agreement, and a health and safety screening. LPA obtained the LIC 500 and the LIC 9020 for both THP facilities. LPA will be conducting a collateral visit to one of the remote remote THP-FC facility located N Dos Caminos Ave, CA 93003. LPA inquired about visiting the other facility located at remote THP-FC facility Dapper Court. Oxnard 93033, Administrator informed LPA that the house is being sprayed for pest due to fixtures within the facility and clients/staff is away from the home for 4 hours. LPA advised the Administrator to continue to complete emergency disaster drills every 6 months for both facilities and to make sure to document each drill. Exit interview was conducted, there were no deficiencies cited and a copy of this report was left at the facility.

met_with: David Yatsukae


state: CA

facility_name: PROJECT 58

summary: Facility Evaluation

raw_content:
Narrative:
On 4/9/25, at 9: AM, Licensing Program Analyst (LPA) Nancy O'Connell conducted an announced pre-licensing inspection at Project 58, located at Sierra Ct. Palmdale Ca 93350. LPA met with applicant, Chad Adam. At the time of the visit, there are no children in placement. The facility is seeking a license to provide care for twelve (12) ambulatory, Non-Minor Dependents, ages 18-21. As there were no children in placement, no client interviews were conducted, and no client files were available for review. The only interview conducted was with the applicant. Facility Overview: The facility is located within a commercial building (Building B) within suite 103. The entrance to the building can be accessed during office hours and will require a key code during after hours. The lobby of the building has a phone system where visitors can call the suite to be allowed entrance. The suite office is a single office area and has a desk area for staff, locked filing cabinets, a computer, a functional telephone for youth to make telephone calls, a printer, and a board on the wall that maintain all required postings (personal rights, certificate of compliance, staff roster, etc). LPA completed the related Care Tool and verified all requirements. LPA reviewed all related regulations and provided an opportunity for applicant and staff to ask questions. LPA confirmed qualifications of the Administrator and Social Worker roles. LPA confirmed that the applicant is seeking approval to operate a remote site model and confirms that the remote sites will be located within a two-hour driving distance. Applicant communicated that the suite may be used for confidential calls/interviews for youth, but the office building also has a shared conference room, which can be utilized as a confidential meeting space for youth if needed. An exit interview was conducted with applicant, Chad Adam. An electronic copy of this report will be provided to the applicant.

report_type: Facility Evaluation

visit_type: Prelicensing

met_with: Chad Adam, applicant


summary: Facility Evaluation

raw_content:
Narrative:
On 4/9/25, at 10: AM, Licensing Program Analyst (LPA) Nancy O'Connell conducted Component II of the application process for Project 58, was held at the facility office location. Individuals present were Chad Adam (applicant), Greg Howell, Frank De La Cruz (proposed facility administrator), Nancy O'Connell, Licensing Program Analyst (LPA), Community Care Licensing Division. The purpose of the Component II meeting was to review the submitted application and Program Statement, address outstanding items, and resolve any concerns. The following application forms were discussed: Topics discussed: · Criminal background clearance requirements, accessing Guardian and associating current/new employees- applicant was provided information on how to access Guardian, associating new employees · Service delivery- Applicant discussed how clients will receive services within the home and in the community · Medications Storage · Client documents- applicant provided samples of all forms that will be used to create client files. Applicant will store all files in electronic files and provided access to specific staff. · Office hours- applicant discussed how clients will access staff and the office during after-hours · Emergency procedures- applicant discussed emergency procedures and how staff will ensure clients and staff follow established policies/procedures Continued on LIC Program Statement Discussion and Updates Required: · Social Worker exception request · Administrator exception request · All forms will be updated to reflect new facility number · Noloxone waiver · Certificate of compliance for remote site units · Applicant will ensure all community resources to be utilized are reflected in the PS · Admission/discharge policies will be updated as needed to included all criteria for admissions and planned/unplanned discharges The applicant was advised that all revisions and corrections to the application and Program Statement are due by May 7,2025. LPA O'Connell provided a verification signature on applicant Component II certificate. A Pre-Licensing Inspection is scheduled for 4/9/2025. A copy of this report will be provided to the applicant, Chad Adam


summary: Facility Evaluation

raw_content:
Narrative:
On 4/29/25, at 1: PM, Licensing Program Analyst (LPA) Nancy O'Connell conducted Component III of the application process for Project 58. The meeting was held at the Children's Residential Program local unit office in Woodland Hills. Individuals present were Chad Adam, applicant, Greg Howell, THPP Social Worker, Frank De La Cruz, Administrator,and Wendely Moodie-Naranjo, Licensing Program Analyst (LPA), Community Care Licensing Division (CCLD). The purpose of the Component III meeting was to familiarize the applicant and team members with the category specific regulations for the facility, discuss potential problem areas, and provide clarification on related licensing forms and general requirements. Topics discussed: General and category specific regulations, Licensing forms (LIC, 500, LIC 9020, LIC624LE, LIC308, LIC200, LIC9238), Reporting Requirements, Criminal Record Clearance requirements, administrator change process, contact information for CCLD SIR inbox, and officer of the day, Personal Rights, Buildings and Grounds, Inspection Authority, compliance process/civil penalties/plans of corrections Complaint process, CCLD website, and provider resources. The applicant and team members were provided with opportunities to ask questions, and demonstrated agreement and understanding of all material presented. LPA provided a signature on the applicant's orientation certificate and returned the original document to the applicant. LPA will submit the application for final approval and request that the facility be granted a provisional license. A copy of this report was provided to the applicant via email and an electronic signature is retained on file.


summary: Facility Evaluation

raw_content:
Narrative:
On 9/29/25, at 9:50 am, Licensing Program Analyst (LPA) Nestor Gomez arrived at the above facility, for the purpose of conducting a Post Licensing Inspection. LPA Gomez met with Licensee, Chad Adam who granted access to the facility. The current census is 1. During the time of inspection, LPA Nestor conducted an inspection of the following areas: The facility office is located within a commercial building (Building B) within suite 103. The entrance to the building can be accessed during office hours and will require a key code after hours. The lobby of the building has a phone system where visitors can call the suite to be allowed entrance. The suite office is a single office area and has a desk area for staff, locked filing cabinets, a computer, a functional telephone for youth to make telephone calls, a printer, and a board on the wall that maintain all required postings. Vehicles: LPA Nestor inspected one (1) facility vehicles in total. Dodge Chrysler Town and Country (White) with current registration that expires in 5/08/2026. Insured by Charity One Insurance Agency, Inc., that expires on 05/12/2026. Vehicles are in good condition with no issues. Continue on 809-C (Page 1) Staff Interview: LPA Nestor conducted two (2) staff interview with EX and FA. Client Interview: LPA Nestor conducted one (1) client interview with C1. Staff Records Review: LPA reviewed two (2) staff records for the FA and S1. Clients Records Review: LPA reviewed one client record for C1 which meet qualification. LPA Nestor will return to complete the inspection. There were no deficiencies observed or cited at this time. A copy of this report was reviewed and emailed to the Licensee.

met_with: Licensee - Chad Adam


facility_name: PROMESA BEHAVIORAL HEALTH

summary: Facility Evaluation

raw_content:
Narrative:
On 08/19/2021, an unannounced annual inspection is conducted by Licensing Program Analyst (LPA) Tamara Melikian. Met at the THP+FC office by Administrator Arlene Vargas. Currently the program is staffed by the Administrator, a Therapist/Supervising social worker and a case manager. Participant files and staffing files reviewed. Licensee will submit an updated LIC 309 and LIC 500 (Personnel Report). Licensee has an exception for the Administrator which is in the process of being extended at this time. There are no deficiencies to be cited on this date. A copy of this report is left with the Administrator.

visit_type: Annual

met_with: Arlene Vargas


summary: Facility Evaluation

raw_content:
Narrative:
On 12/01/2021, an unannounced annual inspection is conducted by Licensing Program Analyst (LPA) Tamara Melikian. Met at the THPP office by Residential Program Director Arlene Vargas. Currently the program is staffed by the Administrator, a Therapist/Supervising social worker and a case manager. At 1:00PM, participant files and staffing files reviewed. There is an exception on file for the Residential Program Director to continue to be Administrator. An administrator has been hired to fulfill this position, but is not effective as of this date. Licensee will submit an updated LIC 309 and LIC 500 (Personnel Report). There are no deficiencies to be cited on this date. A copy of this report is left with the Residential Program Director.


summary: Facility Evaluation

raw_content:
Narrative:
On 11/30/2022, an unannounced annual inspection is attempted by Licensing Program Analyst (LPA) Tamara Melikian. Met at the THPP office by Residential Program Director Arlene Vargas. The annual could not be completed as it was one day short of the last annual conducted. The annual will be conducted on or after 12/1/2022. There are no deficiencies to be cited on this date. A copy of this report is left with the Residential Program Director.

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On 12/19/2022, an unannounced case management inspection is conducted by Licensing Program Analyst (LPA) Tamara Melikian. Met at the THPP office by Residential Program Director Arlene Vargas. Currently the program is staffed by the Administrator/Case Manager and a Therapist/Supervising social worker. At 1:30PM, participant files and staffing files reviewed. There are currently 10 participants. Licensee will submit an updated LIC 309 and LIC 500 (Personnel Report). There are no deficiencies to be cited on this date. A copy of this report is left with the Residential Program Director.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/04/2023, an unannounced annual inspection is conducted by Licensing Program Analyst (LPA) Tamara Melikian. Met at the THPP office by Residential Program Director Arlene Vargas and Human Resource Director Arlene Vargas. Currently the program is staffed by the Administrator and a case manager. At 9:45AM, participant files and staffing files reviewed. Licensee will submit an updated LIC 309 and LIC 500 (Personnel Report). There are no deficiencies to be cited on this date. A copy of this report is left with the Residential Program Director.

met_with: Arlene Vargas, Jodee Romero


summary: Facility Evaluation

raw_content:
Narrative:
On 03/04/2024, an unannounced annual inspection is conducted by Licensing Program Analyst (LPA) Tamara Melikian. Met at the THP office by Case Manager Breanna Joyner Armiento. Currently the program is staffed by the Administrator and a case manager. At 9:45AM, participant files and staffing files reviewed. Licensee will submit an updated LIC 309 and LIC 500 (Personnel Report). Deficiency on the attached page. A copy of this report is left with the Case Manager. Signature on deficiency page.

met_with: Breanna Joyner Armiento


summary: Facility Evaluation

raw_content:
Narrative:
On January 27, 2026, Licensing Program Analysts (LPAs) Angelica Borja and Briana Placencia traveled to Promesa Behavioral Health located in Fresno, CA to conduct an unannounced Annual/Random inspection and met with CEO Lisa Weigant . The THPP is licensed to serve ages 18-21 years old. The agency currently employs one Director, one Administrator and one Case Manager. A physical plant inspection of the office was conducted. The office included a confidential meeting space, multiple offices, a locked file room, a storage room, a server room, a game room, two bathrooms, a kitchen and the agency's license was observed. The office appeared clean, safe, sanitary, and in good repair. All passageways are unobstructed, and all doors open freely. The water temperature reads 122.5 degrees. LPAs reviewed client and staff files on this date. There are a total of NMDs in placement and 5 files were reviewed. There are a total of 3 staff members and 3 files were reviewed. One staff was interviewed The agency is CARF accredited through January 31, 2027. A review of Licensing Information System on January 26, 2026 indicates that all facility staff are associated to the THPP and have DOJ, FBI, and child abuse index check clearances. An exit interview was conducted, there were no citations issued during this inspection. A copy of the report was provided at the conclusion of the inspection.

met_with: Lisa Weigant, CEO


facility_name: REAL ALTERNATIVES

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Investigation Findings:
13On 4/15/22 at 1: PM, Licensing Program Analyst (LPA) Alyssa Ng made a visit to the facility to open and close a complaint investigation of the above allegation. LPA met with Ahnjolique Haskins, Director of Transitional Housing and Intake Coordinator Tully Tampakes. During investigating the allegation, LPA Ng conducted confidential interviews with facility staff and social workers. Confidential interviews reveal that facility offered to use the language line as a form of communication but minor did not feel comfortable. At this time, facility does not have staff who speak spanish and offered other resources to help the minor feel comfortable. Although, the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that minor is being discriminated against. Therefore, the above allegation are unsubstantiated. An exit interview was conducted and a copy of this report was sent to Ahnjolique Haskins, Director of Transitional Housing. UnsubstantiatedEstimated 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 1

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

report_type: Complaint Investigation

met_with: Ahnjolique Haskins

complaint_status: unsubstantiated


summary: Complaint Investigation - Unsubstantiated - 3 allegations

raw_content:
Investigation Findings:
13On 10/22/2024 at 9: AM, Licensing Program Analyst (LPA) Shikya Belfield made an unannounced inspection to the above facility. The purpose of this inspection is to inform the facility representative of the findings of the complaint that was investigated regarding the above allegation. LPA Belfield met with Administrator Matthew Holt who assisted with this inspection. Also present during this inspection were three staff. Based on confidential interviews conducted and photo evidence, Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore this allegation is Unsubstantiated. There were no violations of the California Code of Regulations, Title 22, division Six, cited during this inspection. An exit interview was conducted a copy of this report was sent to administrator Matthew Holt. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Carolyn Flynn LICENSING EVALUATOR NAME: Shikya Belfield 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: 90

met_with: Matthew Holt


raw_content:
Investigation Findings:
13On 10/22/2024 at 9: AM, Licensing Program Analyst (LPA) Shikya Belfield made an unannounced inspection to the above facility. The purpose of this inspection is to inform the facility representative of the findings of the complaint that was investigated regarding the above allegation. LPA Belfield met with Administrator Matthew Holt who assisted with this inspection. Also present during this inspection were three staff. Based on confidential interviews conducted and photo evidence, Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore this allegation is Unsubstantiated. There were no violations of the California Code of Regulations, Title 22, division Six, cited during this inspection. An exit interview was conducted a copy of this report was sent to administrator Matthew Holt. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Shikya Belfield 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: 90


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Christopher Rollins made an unannounced required Annual inspection to Real Alternatives (Side by Side) Administrative office. LPA met with Rebecca Hathorn Administrator and Ahnjolique Haskins Program Director (PD). The Transitional Housing Placement Plus Foster Care program (THP-FC) services non-minors dependents. At 11: AM, LPA did a walk through inspection with Administrator and PD of the office. The office has sufficient space for confidential meetings, all participant files and staff files are located in a locked cabinet in a secure location. The agency has their license posted in their office. The office is in compliance with Community Care Licensing (CCL) regulations. LPA spoke with Administrator and PD about the residential units. Administrator stated that all residential units have at least one toilet, sink and tub in working order. Administrator stated that all disinfectants and cleaning supplies are locked up and inaccessible. Administrator notified LPA that the program provides all participants with household essentials and that there are no weapons or firearms stored in the housing units. At 11: AM, LPA reviewed 6 participants files with Administrator and PD. LPA observed Participants files to be complete and found no deficiencies. All documents are complete and up to date. At 12: PM LPA observed 6 staff files with Administrator and PD. LPA observed all 6 staff files to be complete, all documentation is up to date and all staff training were up to date/current. At 1: PM LPA conducted staff interviews with 2 staff. During inspection, LPA received a updated copy of the LIC Personnel Report to maintain their file current. LPA receive an updated list of the Participant Residential Units and LPA reviewed the program Certificate of Compliance for all apartments. A review of Licensing Information System on December 15, 2021 indicates that all facility staff associated to the facility had DOJ, FBI and child abuse index check clearances. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted and a copy of the report was left at the facility. .

met_with: Rebecca Hathorn-Administrator and Ahnjolique Haskins- Program Director


summary: Facility Evaluation

raw_content:
Narrative:
On 3/8/22 at 1: PM Licensing Program Analyst's (LPA) Alyssa Ng and Isabel Mendoza made an unannounced case management inspection at the above facility. The purpose for this inspection is to conduct a case management and follow-up on three incident reports that occurred on 2/2/22, 2/18/22, and 2/21/22. All three incident reports were submitted to Community Care Licensing (CCL) on Friday 3/4/22. LPA also recommended Ahnjolique Program Director to submit only the LIC 624LE or to use only one form when sending in an IR. Due to the lack of information LPA's needed to gather additional information. 1.Incident report involves (P1) (please refer to LIC 811, dated 3/8/22 for confidential names). On 2/2/22 (P1's) apartment was raided, and (P1) was arrested. During inspection, LPA's interviewed (P1's) case manager regarding the incident and obtained copies of case notes, staff phone numbers. It was learned that (P1's) apartment was raided by Oakland Police Department, and the raid occurred because of (P1)'s roommate (P2). (P2) had a warrant for his arrest, and the facility does not have any additional information regarding the warrant. LPA will follow-up with Oakland Police Department. During inspection, Director submitted a copy of incident report pertaining to (P2). Program Director informed LPA that the incident report was submitted to CCL on 2/7/22. However, LPA was unable to confirm and will follow-up with the facility if needed. At this time, (P1's) bed closed on 2/10/22 per probation officers request, and (P2) bed closed on 2/8/22. The facility was last in contact with the (P2) on 2/3/22. 2. Incident report involves (P3). On 2/21/22 neighbors reported to property manager of loud noises/yelling and a knock on the door from P3's girlfriend crying and scared. P3 was ----CONT. ON 809C-------- arrested and released the following day. Program Director told LPA that facility could not find an open bed and therefore, exited the program on 2/22/22. The facility submitted on (2.25.22). Community Care Licensing did not receive IR until 3/4/2022. 3. Incident report involves P4 getting arrested and taken to Santa Rita jail. Program Director told LPA that P4 was released due to it being the wrong person. Program Director was on leave until the 2/22/22 and approved the IR's. Facility will send follow up incident reports, needs and service plans and Case Manager notes for each client no later than Monday (3/14/22) and updated IR's with more information regarding the incident(s). An exit interview was conducted and a copy of this report was sent to the Program Director.


summary: Facility Evaluation

raw_content:
Narrative:
On 07/06/2022 at 11: AM, Licensing Program Analysts (LPA's) Alyssa Ng and George Karkazis conducted a visit to the main office of the above facility. On 07/05/2022, LPA Ng was informed that an 20 year old client of the facility had died from being shot multiple times in the back on 07/01/2022. LPA met with Bonnie Meyer, Housing Service Manager (HSM). LPA Ng collected copies of the Transitional Independent Living Plan, the client's progress notes, case plan goals for client and roommate, and any other information regarding the client. LPA also discussed with HSM what steps the facility is taking to help staff and youth process the incident. Clinical Case Manager and Youth Specialist were also in attendance. HSM discussed the plan following the incident. The facility is providing and will continue to provide grief counseling to clients and staff. Facility has also provided extra support to clients by utilizing therapeutic services, etc. There is a session scheduled to debrief and discuss the next steps for the staff, and more resources being provided to the clients. The facility is also working with the county worker to coordinate a meeting with the client's family to collect their belongings. LPA conducted an exit interview with Bonnie Meyer, Housing Service Manager at 12: PM. Facility will provide updates on what was discussed during the debriefing meeting and when the family collects the client's belongings.

met_with: Bonnie Meyer


summary: Facility Evaluation - 2 deficiencies

raw_content:
Narrative:
Licensing Program Analyst (LPA) Jonathan Medina conducted an unannounced required annual inspection of the Real Alternatives (Side by Side) administrative office. LPA met with Program Manager De'Misha Barker. The Transitional Housing Placement Plus Foster Care (THP-FC) program serves non-minor dependents. During the inspection, LPA received an updated copy of the LIC Personnel Report to ensure the facility's records remain current. LPA also obtained an updated list of the Participant Residential Units. A review of the Guardian background check system on March 19, 2025, confirmed that all facility staff associated with the program had cleared DOJ, FBI, and Child Abuse Index checks. At 10: AM, LPA conducted a walkthrough inspection of the office with the Program Manager. The office has sufficient space for confidential meetings, and the agency's license is prominently posted. LPA observed a designated room where clients can relax, a clothing room where clients can select items, and another room where clients can pick up personal hygiene products and contraceptives. No deficiencies were observed. At 11: AM, LPA reviewed five staff files. The program is paperless and utilizes Paylocity to upload staff documents and Relias to track staff training. During this review, LPA identified two deficiencies in the CARE tool assessment. Specifically, some personnel folders were missing documentation of past work experience and job duties. Additionally, certain required staff training sessions had not been completed to meet regulatory requirements. Please refer to the LIC 809-D for details. Continues on LIC 809-C. At 1: PM, LPA reviewed five client files with the Program Manager. Client files have also been converted to a paperless system using a program called TIER. During the review, LPA identified four deficiencies, including missing Health and Education Passports or equivalent documentation, the absence of immunization records, missing required signatures in Needs and Services Plans, and outdated Transitional Independent Living Plans (TILPs). Please refer to the LIC 809-D for further details. At 2: PM, LPA began but did not complete the operational requirements section of the CARE tool. One technical violation was observed regarding the specification of clients' ambulatory status. LPA will return on another date to complete the inspection. As a result of today's inspection, seven deficiencies are being cited in accordance with the California Code of Regulations (CCR) and Interim Licensing Standards (ILS), 86066(a), 86065(f)(3), 86270(a)(2)(B), 86270(a)(2)(B)(1), 86268.3(d), 86068.3(a), and 86069(b)(1) . See LIC 809-D pages for details. An exit interview was conducted, during which the report and appeal rights were discussed and provided to Facility Manager De'Misha Barker.

Deficiencies:
86066(a): Personnel Records

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information
86068.3(a): Modifications to Needs and Services and Transitional Independent Living Plans

(a) The needs and services plan and TILP specified in Section 86168.2 shall be reviewed at least every six months to determine the following

met_with: De'misha Barker - Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 03/26/2025 at 10: AM, Licensing Program Analyst (LPA) Jonathan Medina conducted an unannounced visit to complete the required two-year inspection of the Real Alternatives (Side by Side) administrative office. LPA met with De'Misha Barker, Program Manager. At 10: AM, LPA reviewed the Operations section of the CARE tool. The program currently has 15 units with a capacity of 30, currently serving 21 clients. No deficiencies were observed, and all records were well maintained digitally. At 11: AM, LPA reviewed the facility's Disaster Preparedness section of the CARE tool. The program maintains client files digitally, making them easily accessible to all staff members in the event of an emergency. Staff also utilize a mobile application called M Copilot, which stores all client-specific documents, including emergency contacts, date of birth, social worker contact information, and bedroom location. Additionally, personal documents such as Needs and Services Plans and TILPs are stored in a computer application called TIER. The facility did not have records of quarterly drills available for review upon request. Please refer to the LIC809-D page for further details. Two technical violations were also noted in this section of the CARE tool regarding the location of the water shutoff valve and the description of how the emergency generator should be used. As a result of today's visit, one deficiency is being cited in accordance with Health and Safety Code (HSC) §1565(c). An exit interview was conducted, appeal rights were discussed, and a copy of this report was provided to Facility Manager De'Misha Barker.


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
mitigate the concern. Additional interviews with the clients, and LPA Valencia's review of records indicates staff had been providing consistent supportive services to ensure the client's safety. CMs documented that they were meeting with the clients at least weekly to make sure all clients felt safe and encouraged them to reach out to Law Enforcement (LE) in emergency situations. All clients are adults and learning how to become independent. Based on interviews conducted by LPAs Valencia and Vallejo, 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. A signed copy of this LIC-9099 report, the LIC-9099C, and appeal rights were provided to the facility. An exit interview was conducted.

Investigation Findings:
13Licensing Program Analyst (LPA) Wendy Brown arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Morgan Douglas, Program Coordinator. LPA Misty Valencia conducted the complaint investigation. LPA Valencia initiated the investigation with the facility on 01/13/2025 and met with Pat Sweeney, Administrator and conducted a Health and Safety Inspection of one of the apartments. During the course of the investigation, LPAs Misty Valencia, Yesenia Vallejo, and Licensing Program Manager (LPM) Hillary Hall conducted the complaint investigation. LPA Valencia and LPA Vallejo and LPM Hall interviewed three clients, two witnesses, two county social workers (CSW), one county social worker supervisor (CSWS), two case managers (CM) and Administrator (Admin). LPA Valencia reviewed records including Needs and Services Plans for all clients, CM case notes for all clients, prior complaint history, Serious Incident Reports, and lease agreements for all four clients. It was alleged that the Facility did not ensure client safety. One client voiced that they were feeling unsafe to the CM. The CM immediately responded to the concern and searched the home to address and UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Wendy Brown 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: REDWOOD COMMUNITY ACTION AGENCY THPP/THP+FCFACILITY NUMBER: VISIT DATE: 02/13/2025

met_with: Morgan Douglas, Program Coordinator


facility_name: REDWOOD COMMUNITY ACTION AGENCY THPP/THP+FC

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPA) Katherine Deaton and Kellie McKinley conducted an annual inspection at the facility address located above. The LPAs reviewed all participant records and found signed copies of personal rights and all school records, immunization records, and medical records that were provided. Current, signed Certificates of Compliance were also found in the participant files. The LPAs then conducted a facility inspection of the Administrative office located at G St, Eureka, CA. The facility is clean, safe, and sanitary. The LPAs reviewed all staff records. Personnel meet education and experience requirements. Annual evaluations are maintained. Staff have appropriate background and Child Abuse Central Index checks on file. LPA Deaton found that two staff records that had vehicle insurance information that recently expired. LPA Deaton received current vehicle insurance information following the in-person inspection. LPA Deaton contacted Pat Sweeney, Administrator (AD). AD stated that there is one Transitional Housing Placement Provider (THPP) Participant with a child residing in their living unit; the THPP and participant are aware that disinfectants / poisons are to be kept inaccessible to the child. All participant living units have at least one toilet, sink and tub or shower in working order. Participants and their minor children are provided with household essentials. There are no firearms stored in THPP participant living units. There are no participants who are non-ambulatory; licensee is aware of the fire clearance requirement. The THPP administrative office and participant living units have telephone service. No citations were issued throughout the course of this investigation.

met_with: Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 4/10/ Licensing Program Analyst (LPA) Kellie McKinley met with Administrator to conduct a death investigation. LPA inspected the facility. The facility walkways and hall ways were free and clear of obstructions. The fire extinguisher were current on inspections. The bathrooms were found clean and sanitary. The water temperature was found to be within the require limits. There are several office spaces within the facility all organized and some with storage of facility equipment. The facility has a working phone line. The smoke and carbon monoxide detectors are in function order. The first Aid kit contained the required supplies. The kitchen area was found clean with no dishes in the sink and the counter only with kitchen equipment. The garbage's are covered with lids. Food supplies are sufficient for 3-5 days and dry goods for 5-7 days. LPA interviewed the administrator and the case manager for C1. LPA collected documentation found pertinent to the investigation of C1's death. The autopsy was conducted on 4/07/2023. The coroner found nothing from the autopsy to determine cause of death. Information was shared by Administrator via his contact with the coroner. The coroner collected many documents and medications while at C1's apartments for the investigation. A toxicology report was requested by the coroner. The toxicology report should be completed with 6 to 8 weeks time. An exit interview was conducted and a copy of this report electronically sent to the administrator. Further investigation is needed to determine the cause of death. (NOTE:Original completed 4/10/2023 and not saved in system- this is a copy of the original)

met_with: Patt Sweeney - Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 6/20/2023 at 10: AM Licensing Program Analyst (LPA) Kellie McKinley met with Administrator Patt Sweeney via Zoom for the purpose of a case management regarding the death of a client. During the course of the case management investigation, LPA McKinley reviewed the coroner's report and Law enforcement records. interviewed the administrator, the case manager, and the client's County Social Worker. LPA McKinley and Licensing Program Manager (LPM) Hillary Hall received a copy of the coroners report on 6/6/2023 which stated the reason for the client's death. No foul play is suspected. No citation is being issued. An exit interview was conducted. A signed copy of this report was provided to the facility.

met_with: Patt Sweeney- Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 7/19/23, Licensing Program Analyst (LPA) Lyta Vue arrived unannounced at the facility and met with Patrick Sweeney, Program 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 6/28/21. 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 five offices for social workers and two confidential interview/visitation rooms. LPA observed the proper postings including: facility license, complaint hotline, personal rights, 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 locked filing cabinets and in locked offices. The facility has no outstanding fees. The facility has no minor clients and Non-Minor Dependent clients. Clients live in either mentor homes or remote site apartments. No client resides more than two hours from the facility. The facility employs two Case Managers, one program Coordinator, and one of Supervisors/Program Manager. LPA reviewed 4 staff personnel files. All 4 staff completed criminal record clearances and met minimum education and experience qualifications which 2 are Case Managers. All First Aid and CPR certifications were up to date for all 4 staff personnel which 2 are Case Managers. LPA interviewed 3 staff personnel which 2 are Case Managers. 1 staff personnel was not present. One Case Worker personnel indicated they did not have more than 12 clients on their caseload. LPA reviewed 2 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. (*For facilities with minors, indicate whether CHDP Physical, dental, and JV 220 are current.) Continued on 809c No citations were given on this date. A signed copy of this LIC-809 (and LIC-809C) report was provided to the Program Manager (PM). An exit interview was conducted. Appeal rights were provided (if applicable)

met_with: Patrick Sweeney, Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 06/24/25, Licensing Program Analysts (LPAs) Lyta Vue and Kellie McKinley arrived unannounced at the facility and met with Patrick Sweeney, Program Manager (PM). The purpose of the visit was to conduct a Required Bi-Annual Inspection of the facility. The last Annual inspection for the facility was on 07/19/23. LPAs utilized the CARE Tool to complete the Annual inspection. LPAs 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 two (2) offices for Case Managers and one (1) confidential interview/visitation room. LPAs 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 expire August 2025, and a first aid kit was fully stocked. Evacuation drills for the facility were completed quarterly. LPAs observed client files were stored in a locked file in a locked office. The facility has no outstanding fees. The facility has two (2) Non-Minor Dependent clients. Clients live in offsite apartments. No client resides more than two hours from the facility. The facility employs two (2) Case Managers (CM), and one (1) Program Manager. Annual Report continued on 809c LPAs reviewed two (2) Case Managers and one (1) Program Manager personnel files. Case Managers/Staff personnel had completed criminal record clearances and met minimum education and experience qualifications. All First Aid and CPR certifications were up to date for Case Managers and Program Manager personnel. LPAs reviewed two (2) client files. All clients had signed Admission Agreements. Client files had current Needs and Service Plans, signed by the clients 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 Pat Sweeney, Program Manager (PM). An exit interview was conducted.


facility_name: REDWOOD COMMUNITY SERVICES, INC

summary: Facility Evaluation

raw_content:
Narrative:
On 9/28/22, Licensing Program Analyst (LPA) Brian Bertoli conducted a pre-licensing inspection at the Transitional Housing Placement Program (THPP) for purposes of a change of location. Note that LPA was not able to enter visit on the day it occurred due to not being able to access the Pre-licensing Visit Type. LPA Bertoli met with Program Managers Lorraine Montano and Samantha Stafford and inspected the facility. The office is conveniently located for the public. This location previously housed the RCS Foster Family Agency and Adoptions Agency. The office has a reception area, multiple private offices, and conference room/training room (all of which can be also be used for confidential meetings). There is adequate parking available. Emergency Disaster Plan will be revised to show THPP. License will be posted as soon as issued. Masks and hand sanitizer are available. All files will be kept confidential and locked in the office and separated from visiting areas. Personnel files are stored securely at the administrative office on S Orchard St in Ukiah. Telephones, computers, fax and copying machines are operable. There are two all-gender bathrooms. Fire extinguishers are current. There are fire sprinklers, smoke detectors, and carbon monoxide detectors. A complete first aid kit is readily accessible. A Redwood Community Services sign is posted outside of the office. Prior to today's visit, the application for the relocation was received and reviewed by LPA Bertoli. An updated LIC 500 has been submitted. No deficiencies in the Physical Plant during today's inspection. Due to recent completion of the THPP Annual Inspection, no files were reviewed and no interviews completed. LPA Bertoli determined that the facility meets Title 22 regulations for the operations of a THPP. An exit interview was conducted and a copy of this report was given to the facility. LPA Bertoli will submit the application for license and forward to the facility when issued.

met_with: Lorraine Montano and Samantha Stafford


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli conducted a post-licensing inspection at the Transitional Housing Placement Program (THPP). The new license was generated by a change of location. LPA Bertoli met with Program Manager Samantha Stafford and inspected the facility. The office is conveniently located for the public. This location previously housed the RCS Foster Family Agency and Adoptions Agency. The office has a reception area, multiple private offices, and conference room/training room (all of which can be also be used for confidential meetings). There are two all-gender bathrooms. Fire extinguishers are current. There are fire sprinklers, smoke detectors, and carbon monoxide detectors. A complete first aid kit is readily accessible. A Redwood Community Services sign is posted outside of the office. There is adequate parking available. Emergency Disaster Plan and License are posted. Masks and hand sanitizer are available. All files will be kept confidential and locked in the office and separated from visiting areas. Personnel files are stored securely at the administrative office on South Orchard St in Ukiah. Telephones, computers, fax and copying machines are operable. An updated LIC 500 has been submitted and all staff have appropriate clearance. No deficiencies were cited at today's inspection. An exit interview was conducted and a copy of this report was given to the facility.

met_with: Samantha Stafford


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst Brian Bertoli conducted an unannounced visit to the THPP/THPP+NMD Administrative office to conduct an Annual/Required inspection. LPA met with Program Specialist Coni Shepard and Program Manager Samantha Stafford, who assisted with the inspection. The THPP has a capacity of 12 and services both THPP and THPP+NMD participants and THPP Plus contracted through the County. There is currently one participant in care (no minors and one Non-Minor Dependent). The facility uses a remote site model and currently has apartment units. LPA inspected the THPP office, which is one story. It has a reception area, multiple private offices, restroom, and a conference room. Files are stored in a locking cabinet in a locked room. The license and Emergency Disaster Plan (LIC610C) forms are posted. LPA completed a Care Tools inspection and reviewed participant records - one Non-Minor Dependent. The participant file is acceptable. LPA Bertoli conducted three staff interviews at the facility and three record reviews (at the Administrative Office on S Orchard St.). Advisory Notes were issued for the Needs and Services Plan missing projected date for completing the program and for the Health Assessment. No Title 22 deficiencies are being cited at this time. An exit interview was conducted and a copy of this report was left with the facility.

met_with: Samantha Stafford and Coni Shepard


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst Brian Bertoli conducted an unannounced visit to the THPP/THPP+NMD Administrative office to conduct an Annual/Required inspection. LPA met with Program Specialist Coni Shepard and Program Manager Samantha Stafford, who assisted with the inspection. The THPP has a capacity of 12 and services both THPP and THPP+NMD participants and THPP Plus contracted through the County. There are currently no participants in care. The facility uses a remote site model and currently has apartment units. LPA inspected the THPP office, which is one story. It has a reception area, multiple private offices, restrooms, and a conference room. Files are stored in a locking cabinet in a locked room. The license and Emergency Disaster Plan (LIC610C) forms are posted. LPA completed a Care Tools inspection and conducted staff interviews at the facility and record reviews (assisted by HR Director Pamela Lucas at the Administrative Office on S Orchard St.). All files were acceptable. No Title 22 deficiencies are being cited at this time. An exit interview was conducted and a copy of this report was left with the facility.

met_with: Coni Shepard, Samantha Stafford and Pamela Lucas


facility_name: REMI VISTA THPP/THP+FC - CHICO

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Katherine Deaton conducted a pre-licensing inspection on 4/8/2021 at the new Remi Vista THPP/THP+FC-CHICO (THPP) location at Floral Avenue Suite 30, Chico, CA 95973. The LPA arrived at the facility donning a facemask and applied hand sanitizer. The LPA met with Rose Mary Marquez, (RM), Admin. who confirmed there have been no recent COVID-19 positives, exposures, or symptoms at the facility. RM prefers and in-person visit. Serenity Coleburn, Social Worker / Case Worker (CW) for THPP program was not present at the time of the inspection. The LPA toured the facility inside and out. The THPP is still in the process of moving in; boxes were visible however the facility is safe and sanitary. The office telephone is in proper working order. Staff residential and participant living unit phones have service at all times. There are no non-ambulatory THPP participants however RM is aware of the fire clearance request requirement. CW is the only staff who works with the four THPP participants. The LPA reviewed CW's personnel file and found a copy of CW's child abuse index check and criminal record clearance. The LPA found evidence that annual performance evaluations are being provided. Participant records were not available at the time of the inspection. The THPP does not allow participants to store firearms or other weapons in THPP participant living units. Participant are provided household essentials and have at least one toilet, sink and tub or shower in working order. There are three participants with children who reside in their living unit; participants are aware of the requirement that disinfectants and other items that could pose a danger must be made inaccessible. The LPA reviewed participant records on 4/15/2021 and found copy of personal rights forms. The LPA made multiple attempts to tour a THPP participant living unit without success. The facility does not maintain Certificates of Compliance for the participant living units. The LPA made contact with Troy Foster, Quality Assurance Officer who will develop the Certificates of Compliance and ensure all regulatory requirements are met. A copy of this report will be emailed to the facility with a read receipt requested.

met_with: Rose Mary Marquez


facility_name: REMI VISTA THPP/THP+FC CRESCENT CITY

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Katherine Deaton conducted an annual inspection at the facility address located above using the CARES Inspection Tool. The facility is clean, safe, and sanitary. The LPA conducted one staff interview. The facility has no clients in care; this location provides community-based counseling services. The LPA initiated the Physical Plant, Operational Requirements, Disaster Preparedness, and staff file reviews. Due to time constraints this inspection will be completed at a later date. No citations have been issued.

met_with: Becky Bohannon


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Katherine Deaton continued the annual inspection at the facility address located above using the CARE Inspection Tool. The facility has no clients in care; this location provides community-based counseling services. The LPA completed the Physical Plant, Operational Requirements, Disaster Preparedness, and staff file reviews. Advisory Note - Technical Violations were issued for Title Section 86065(a)(1)(A) and Health and Safety Code Section 1565(c). See attached LIC9102 reports. The LPA conducted exit interviews with Rebecca Bohannon, Office Manager and Troy Foster, Quality Assurance Officer. No citations were issued throughout the course of this inspection.

met_with: Rebecca Bohannon


facility_name: RENAISSANCE PRIDE

raw_content:
Narrative:
Evidence indicated that NMD1 was diagnosed with a medical skin condition prior to placement and there was no evidence that NMD1 skin irritation was due to the conditions of the water in the bathroom in the unit. NMD1 remains as a resident in the unit. Due to lack of evidence obtained during the investigation, LPA determines that the allegations are Unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that a violation occurred. There are no deficiencies cited at this time. An exit interview was conducted and a copy of this report was left at the Administrative office with the Youth Advocate Ndidi Chikezie

Investigation Findings:
13On June 14, 2024, at 10: AM, Licensing Program Analyst (LPA), Rosslyn Gray made an unannounced visit to conclude the complaint investigation. Prior to entering the facility LPA Gray conducted a health and safety risk assessment. During the investigation, LPA Gray conducted confidential interviews and reviewed documentary evidence. Based on confidential interviews, review of documentary evidence, and observation of the bathroom in the unit there is no evidence or witnesses to support a physical plant violation occurred. Licensee denied the allegations.Statements indicated that staff addressed the report of mold present in the bathroom, took precautionary measures, and temporary relocated the Non-Minor Dependent (NMD1) while the unit was being inspected by maintenance staff for mold. LPA toured the bathroom during the investigation and no mold was observed. Bathroom was observed to be free of hazards and sanitary. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Rosslyn Y. Gray LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: RENAISSANCE PRIDEFACILITY NUMBER: VISIT DATE: 06/14/2024

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

met_with: Youth Advocate Ndidi Chikezie


summary: Facility Evaluation

raw_content:
Narrative:
On 05/26/2022 at 10am, Licensing Program Analyst (LPA) Bernice Karnsrithong arrived at the facility office for the purpose of conducting a Case Management-Incident that occurred on 05/02/2022. Health and safety risk assessment were conducted upon arriving at the facility. LPA Karnsrithong met with Olivia Ofomata, Youth Advocate and Office Manager. The current census is twenty-eight (28). A Special Incident Report (SIR) #810620 dated 05/02/2022 stated that a client had seizures on April 27, 2022 and was taken to the hospital for medical treatment. SIR indicated that this was caused due to client stopping to take her psychotropic medication. During the visit, LPA Karnsrithong conducted one (1) staff interview and reviewed documentary evidences. At this time, not all parties are available and additional time is needed for this case management. There are no deficiencies cited at this time. Exit interview was conducted with Olivia Ofomata and a copy of this report will be provided.

met_with: Youth Advocate/Office Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 06/07/2022 at 9am, Licensing Program Analyst (LPA) Bernice Karnsrithong arrived at Renaissance Pride Main Office for the purpose of delivering Case Management-Incident findings. LPA Karnsrithong met with Olivia Ofomata, Office Manager and Youth Advocate for the agency. Health and safety risk assessment were conducted upon arriving the main office. A special incident report (SIR) #810620 dated 05/02/2022 stated that a client was taken to the hospital/urgent care to seek medical treatment. During the case management, LPA Karnsrithong has conducted confidential interviews and reviewed documentary evidences. Statements were consistent that client seek medical treatment from symptoms resulting from stopping her psychotropic medications. There was no evidence to corroborate that staff are not complying with emergency intervention procedures. This agency has conducted a case management-incident and has found that the case management was unfounded, meaning that the allegation is false, could not have happened and/or is without a reasonable basis. There are no deficiencies cited at this time. Exit interview was conducted with Olivia Ofomata, Office Manager/ Youth Advocate and a copy of this report will be provided to the facility.

met_with: Olivia Ofomata, Office Manager/Youth Advocate


summary: Facility Evaluation

raw_content:
Narrative:
On 11/16/2022, Licensing Program Analyst (LPA) C. White arrived at the above location for the purpose of conducting a 2-Year Required Inspection of the Transitional Housing Placement Administrative Office. LPA met with Executive Director, Chris Onyegbaduo. LPA was granted access and toured the entire facility. The program is licensed to provide THPP services to children 16-17 years old and THP+FC Services to Non Minor Dependents up to 49 beds. The current census is 33. This facility is located in a multilevel office building. The facility has 4 separate office rooms, a receptionist area, a waiting room, and a bathroom. The office rooms are set up as follows: Upon entering the office there is a waiting room area available for clients/visitors which is equipped with 2 couches, a coffee table and a small side table. There is a receptionist area, utilized by the facility manager. The office has a bathroom, and 4 separate rooms. Office room #1: is equipped with locked storage cabinets used to store client files. The room remains locked at all times. Office room #2: is used as the staff break room. Office room #: is equipped with a desk, chair, and a computer. The room is used by case managers and clients should they need computer access. Office room #4: is equipped with a large table and seating for at least 10 people. The room is used as a conference room for both staff and client meetings. Report continued on LIC 809C. This program utilizes the remote site housing model and ensures the following services will be applicable: 1.) Participants have their own bedroom; 2.) No more than two participants share a bathroom: 3.) No more than two participants share a refrigerator; 4.) On-site supervisor available 24/7 to support, assist and oversee the needs of the participants: 5.) Assigned Social Workers assist and meet with participants a minimum of once a week (face-to-face); and 6.) Supervision, if needed, for the distribution of prescription medication. The organization also utilizes the iTrack system to report Special Incidents to CCL. A total of four (4) client files were reviewed. All Client Records are current and contained the required documentation including: Admission Agreements, Allowance Logs, Savings Deposit records, Receipts, Needs and Services Plans, Personal Rights forms. A total of five (5) staff files were reviewed. All staff files contained caregiver background checks, criminal record and child abuse index check clearances, and current First Aid/CPR cards. Personnel Files are maintained on-site. LPA obtained a copy of the facility personnel report, LIC 500. The facility operates within license conditions and limitations including capacity limitations. LPA will return at a later date to conduct staff and client interviews. No deficiencies were observed or cited at the time of this inspection. A copy of this report was left at the with the Executive Director.

met_with: Executive Director, Chris Onyegbaduo


summary: Facility Evaluation

raw_content:
Narrative:
On February 2, 2023, Licensing Program Analyst (LPA) Charmetha White arrived at the above location for the purpose of conducting a Case Management Annual Continuation visit. LPA met with Facility Administrator, Chris Onyegbaduo and was granted access to the facility. LPA informed the Administrator, three of the facility's remote THPP sites would be inspected on this day, for compliance with Title Regulations. The Administrator provided the following three addresses. Site #1: E. Arrow Hwy Unit # Covina, CA. Site #2: E. Arrow Hwy Unit # Covina, CA. Site #3: E. Badillo Street Covina, CA. Administrator, agreed to meet LPA at each site to grant access to the units for inspection. LPA inspected all three units and found each unit to be clean and in good repair. No deficiencies were observed or cited. A copy of this report was left with the Administrator.

met_with: Administrator, Chris Onyegbaduo


summary: Facility Evaluation

raw_content:
Narrative:
On 11/25/2025, Licensing Program Analyst (LPA) C. White arrived at the above location for the purpose of conducting a 2-Year Required Inspection of the Transitional Housing Placement Administrative Office. LPA met with Executive Director, Chris Onyegbaduo. LPA was granted access and toured the entire facility. The program is licensed to provide THPP services to children 16-17 years old and THP+FC Services to Non Minor Dependents up to 49 beds. The current census is 31. This facility is located in a multilevel office building. The facility has 4 separate office rooms, a receptionist area, a waiting room, and a bathroom. The office rooms are set up as follows: Upon entering the facility there is a waiting room area available for clients/visitors which is equipped with 2 couches, a coffee table and a small side table. To the right of the doorway a receptionist area, utilized by the facility manager. Straight in front of the waiting area is a short hallway; on the right side of the hallway is the facility bathroom, and along the hallway are 4 separate rooms. Office room #1: is closest to the bathroom; it is equipped with locked storage cabinets and utilized for client files and the room remains locked at all times. Office room #2: is used as for storage. Office room #3: is equipped with a desk, chair, and a computer. The room is used by the administrator and clients should they need computer access. Report continued on LIC 809C. (Page 1 of 2) Office room #4: is equipped with a large table and seating for at least 10 people. The room is used as a conference room for both staff and client meetings. This organization uses the remote site housing model and ensures the following services will be applicable: 1.) Participants will have their own bedroom; 2.) No more than two participants will share a bathroom: 3.) No more than two participants will share a refrigerator; 4.) There is a supervisor available 24/7 to support, assist and oversee any needs of the participants: 5.) Assigned Social Worker to assist and meet with participants a minimum of one time per week in person with daily contact; and 6.) Supervision, if needed, with the distribution of any prescription medication. The organization utilizes the iTrack system to report Special Incidents to CCL. LPA reviewed a total of five (5) client files. All Client Records are current and contained the required documentation including: Admission Agreements, Allowance Logs, Savings Deposit records, Receipts, TILP, Personal Rights forms. LPA reviewed a total of five (5) staff files. All staff files show that staff meet qualifications and regulatory requirements. Personnel files contained caregiver background checks, criminal record and child abuse index check clearances, and current First Aid/CPR cards. Personnel Files are maintained on-site. LPA obtained a copy of the facility personnel report, LIC 500. The facility operates within license conditions and limitations including capacity limitations. No deficiencies were observed or cited at the time of this inspection. A copy of this report was left at the with the Executive Director. (Page 2 of 2)

met_with: Chris Onyebanduo - Executive Director


summary: Facility Evaluation

raw_content:
Narrative:
On December 11, 2025, Licensing Program Analyst (LPA) C. White arrived at the above location for the purpose of conducting a Case Management Annual Continuation visit. LPA met with Executive Director, Chris Onyegbaduo and was granted access to the facility. LPA informed the Administrator, two of the facility's remote THPP sites would be inspected on this day, for compliance with Title Regulations. The Administrator provided the following three addresses. Site #1: S Manhattan Pl. Los Angeles, CA. Site #2: W. 126th Street Apt. A Hawthorne, CA. Administrator, agreed to meet LPA at each site to grant access to the units for inspection. LPA inspected both units and found each unit to be clean and in good repair. No deficiencies were observed or cited. A copy of this report was emailed to the Executive Director.


summary: Complaint Investigation - Unsubstantiated - 1 deficiency - 1 allegation

raw_content:
Narrative:
Based on the clients concerns and history, increased supervision and support should have been provided to clients. It was confirmed that there was alcohol in the facility in the refrigerator that belonged to facility staff. The preponderance of evidence has been met, therefore these allegations are substantiated. California Code of Regulations Title 22, Division 6, and Interim Licensing Standards (ILS), sections 86278(a) responsibility for providing care and supervision, 86187(f) buildings and grounds, 86172(b)(2) Personal Rights, are being cited on the attached LIC9099D. An exit interview was conducted, appeal rights were given, and a copy of this report was left with Licensee Kimberly Graves.

Investigation Findings:
13On 10/19/22 at 12: PM, Licensing Program Analyst (LPA) Alyssa Ng conducted an unannounced inspection to the above facility. The purpose of this inspection is to deliver the findings for the above complaint allegations. LPA Ng met with Licensee Kimberly Graves who assisted with the inspection. Based on confidential interviews conducted by LPA Belfield, obtained supportive documentation to include but not limit, staff schedule, client roster, incident reports, staff and client communications, and copies of client files. It was confirmed that client was experiencing threatening behaviors and suffered emotionally from another client in the facility. It was confirmed that facility staff smokes on the facility premises. ----------Cont. on 9099C------------------- 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 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 San Bruno, CA Facility Name: R.Y.S.E. RAISING YOUTH TO STRIVE FOR EXCELLENCEFACILITY NUMBER: VISIT DATE: 10/19/2022

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:

Deficiencies:
86187(f): infliction of pain: humiliation: intimidation: ridicule: coercion: threat: physical, sexual, emotional mental, or other abuse....

met_with: Kimberly Graves

title:
The licensee shall prohibit smoking in the facility and on the grounds of the facility.
This requirement was not met as evidenced by,1
2
3
4
5
6
7Facility Staff will not smoke on the facility premises.
8
9
10
11
12
13
14 It was confirmed that facility staff smokes on the facility premises and although clients were told not to smoke in the facility, the facility staff did not follow this rule. This poses a potential health, safety, or personal rights risk to the clients in care.8
9
10
11
12
13
14
Deficiency Dismissed
Type B
11/19/2022
Section Cited
CCR
86172(b)(2)1
2
3
4
5
6
7Personal Rights 86172(b)(2) To be free from corporal or unusual punishment


facility_name: R.Y.S.E. RAISING YOUTH TO STRIVE FOR EXCELLENCE

summary: Facility Evaluation

raw_content:
Narrative:
On 10/19/22 at 10: AM, Licensing Program Analyst (LPA) Alyssa Ng made an unannounced required two year inspection to Raising Youth To Strive For Excellence (R.Y.S.E) Administrative office. LPA met with Kimberly Graves, Licensee. Currently, there are no clients in care. At 10: AM, LPA did a walk through inspection with Administrator of the office. The office has sufficient space for meetings, all participant files and staff files are located in a locked cabinet in a secure location. The agency has their license posted in their office. The office is in compliance with Community Care Licensing (CCL) regulations. LPA spoke with Administrator about the residential unit. Administrator stated that the residential unit has all working toilets, sinks and tubs. Administrator notified LPA that the program provides all participants with household essentials. At 11: AM, LPA reviewed 3 participants files with Administrator. LPA observed all 3 participants files to be complete and found no deficiencies. All documents are complete and up to date. At 11: AM LPA observed 2 staff files to be complete, all documentation is up to date and all staff training were up to date/current. LPA Ng interviewed 2 staff. During inspection, LPA requested a updated copy of the LIC Personnel Report to maintain their current filet. A review of Licensing Information System on October 19th, 2022 indicates that all facility staff associated to the facility had DOJ, FBI and child abuse index check clearances. Per Title Regulations, no deficiencies were cited during this inspection. Exit interview conducted and a copy of the report was left at the facility.


summary: Facility Evaluation

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Narrative:
Visit was attempted on 10/25/23 at AM. LPA will return at a later date to conduct annual. See LIC 812 pertaining to attempted visit.


summary: Facility Evaluation

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Narrative:
On 11/2/23 at 11: AM, Licensing Program Analyst (LPA) Brenda Rodriguez and Licensing Program Analyst (LPA) Paul Simien conducted an unannounced visit to the above facility. The purpose of this visit was to complete the required annual inspection. LPA's met with Kimberley Graves, Administrator (ADM), at the above facility to conduct the required annual inspection. LPA Rodriguez and LPA Simien reviewed five staff, conducted physical plant inspection, and reviewed the disaster preparedness plan. All personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. Personnel Files are maintained on-site in locked cabinets. LPA's reviewed the facilities operations, disaster preparedness plan. LPA discussed the following with the Administrator: staff files, disaster preparedness plan, operations, and Compliance Certification requirements. No staff present to conduct interviews The inspection is complete. Four technical violations and two technical assistance were cited at this time. LPAs conducted an exit interview, and a copy of this document was emailed to ADM. Note this document was signed by licensee on 11/7 due to a save conflict with the original document.

met_with: Administrator: Kimberly Graves


summary: Facility Evaluation

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Narrative:
Visit was attempted on 12/18/234 at AM. LPA will return at a later date to conduct annual. See LIC 812 pertaining to attempted visit.


summary: Facility Evaluation

raw_content:
Narrative:
On 11/13/2025 at 12: PM, Licensing Program Analyst (LPA) Brenda Rodriguez conducted an unannounced visit to the above facility. The purpose of this visit was to complete the required Annual Inspection. LPA Rodriguez met with Administrator Kimberly Graves, at the above facility to conduct the required annual inspection. There are no clients in care at the moment. LPA Rodriguez conducted the physical plant inspection, reviewed plan of operations plan and reviewed the disaster preparedness plan binder. Personnel Files are maintained on-site in locked cabinets. LPA Rodriguez discussed the following with the Administrator: disaster preparedness plan, and plan of operations plan. LPA Rodriguez reviewed one (1) staff file. LPA Rodriguez conducted one (1) confidential staff interview. The required Annual Inspection is complete. No deficiencies were cited. An exit interview was conducted, and a copy of this report was given to Administrator Kimberly Graves, whose signature on this form confirms receipt.

met_with: Kimberly Graves, Administrator


facility_name: SAFE STEPS YOUTH PROGRAM

summary: Facility Evaluation

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Narrative:
On 7/10/25, an informal office meeting was held with the applicant to discuss the facility site and grounds. The meeting was held virtually over Microsoft Teams. Representing the applicant was Chief Program Officer Helen Ayala. Representing Community Care Licensing were Regional Manager Helga Wong, Licensing Program Manager Isabel Diego, Licensing Program Manager Joel Segura, and Licensing Program Analyst Mariah Hawkins. The following items were discussed: - The applicant's current utilization of the propose facility site. - The applicant's plan for how the site will be utilized upon licensure of the transitional housing placement program. - The applicant's current and planned utilization of the neighboring facility site. An exit interview was conducted, and a copy of this report was emailed to Helen Ayala, who agreed to return a signed copy to Licensing Program Analyst Mariah Hawkins.

met_with: Helen Ayala, Chief Program Officer


facility_name: SAN DIEGO YOUTH SERVICES

raw_content:
Narrative:
on a consistent basis. Agency administration stated checks were conducted weekly and no evidence of the child living in the unit was obtained. It was corroborated that an individual was seen on camera entering and exiting out of the unit. It was also reported that a backpack, not belonging to either client, was in the unit. Due to being unable to interview clients, LPA Harris was unable to determine if the child was residing in the unit. It was also reported that participants were engaging in drug activity and storing firearms in the unit. Due to welfare check conducted in order to find the child on AWOL status, it was reported that drug paraphernalia and a firearm was found in the home. Administrators stated there were no contraband found in the home. It was stated that a bottle of medication was found, but not able to determine if the medication was prescribed. Administrators denied that a firearm was found, but other support staff said there was a firearm present during the inspection. Again, LPA Harris was unable to obtain additional information regarding the allegation due to the inability to interview clients. Based on interviews and information obtained, participants are allowing an authorized minor to reside in the living unit, engaging in drug activity at the living unit, and storing firearms at the living unit, may or may not have occurred; therefore, the allegations are unsubstantiated at this time.

Investigation Findings:
13On December 20, 2021, at 11: AM, Licensing Program Analyst (LPA) Jazmond Harris met with Youth Advocate, Kate Perterson to deliver the findings for the investigation pertaining to the listed allegations. Program Coordinator, Berenice Perez was contacted via phone. LPA Carol Anderson initiated the investigation on June 16, 2021 and attempted to interview Client #1 and Client #2 (See Confidential Names List (LIC 811) dated December 20, 2021, however; whereabouts of clients are unknown at this time. During the investigation, LPA Harris conducted interviews with Administrator, Case Manager, Support Staff, and County Social Worker. LPA Harris was also unable to interview Client #1, Client #2, and assigned social workers. On June 14, 2021, Community Care Licensing (CCL) received information which stated participants are allowing an authorized minor to reside in the living unit, engaging in drug activity at the living unit, and storing firearms at the living unit. It was reported that a child was residing in the home with clients. It was reported that information had been obtained that a child who was reported on AWOL (absent without leave) status was living in the unit. It was reported that the child was seen on surveillance entering and exiting the unit UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Jazmond D Harris 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 08-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: SAN DIEGO YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 12/20/2021

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

met_with: Youth Advocate-Kate Peterson


raw_content:
Narrative:
Confidential interviews indicated C1 would not sleep at the apartment complex for consecutive days. Confidential interviews indicated C1 would be gone for 10 days and wouldn't take out their trash to the apartment complex dumpster. Confidential interviews also indicated C1 refused for their unit to be fumigated. Regarding the allegation non- minor is not provided unit keys, it was reported that C1 never received a key to their door. During the investigation, confidential interviews indicated C1 requested for keys two times and the facility offered a keypad lock for C1 and C1 refused. Documents reviewed indicated a request was submitted for keys. LPA received conflicting information. Regarding the allegation that a non- minor is being evicted. Confidential interviews and record review indicated C1 was placed on a 14-day supportive plan to avoid eviction and a 30-day notice to terminate tenancy. Confidential interviews disclosed that C1 was being evicted for failing to follow the program housing guidelines such as meeting with case worker on a weekly basis, maintaining full time productivity of a minimum of 32 hours a week of school or work, making rental payments, no pets at apartment complex, safe behavior guidelines and visitor restrictions. The confidential interviews continued stating that C1 would miss meetings with case manager and C1 was not enrolled in school nor employed. Additional confidential interviews reported that C1 was interested in joining the military and was speaking with a recruiter. Confidential interviews indicated C1 was behind on their rent and C1 had a dog on site which was not allowed unless proper documentation was submitted to the program. Confidential interviews revealed conflicting statements. Based on confidential interviews and record review, the allegations that C1's unit has pests, C1 is not provided unit keys, and C1 is being evicted, may have occurred, however, there was not a preponderance of evidence to support or deny the allegations. Therefore, the above allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this signed report was provided to Jose Ayala, Program Manager.

Investigation Findings:
13On March 21, 2024, at 10: AM, Licensing Program Analyst (LPA) Lucero Jauregui conducted an unannounced complaint inspection and met with Jose Ayala, Program Manager. The purpose of the inspection is to deliver the finding for the above allegations. LPA conducted an inspection of the facility on September 19, 2023, and no deficiency were noted. During the investigation, LPA conducted two staff interviews (S1- S2), one client interview (C1), and obtained housing debrief log dated 9/11/23, pest control invoice, 14-day contract dated 8/21/23 and 30-day notice dated 9/7/23. On September 15, 2023, Community Care Licensing (CCL) received the allegations that non-minor's unit has pests, non-minor is not provided unit keys, and non-minor is being evicted. Regarding the allegation of non- minor's unit has pests, it was specifically reported the apartment complex is infested with cockroaches and the infestation was not resolved even after an exterminator came in. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: LUCERO JAUREGUI 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 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # FACILITY NAME: SAN DIEGO YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 03/21/2024

Allegations:
- UnsubstantiatedEstimated Days of Completion:
- Unsubstantiated Estimated Days of Completion:
- Unsubstantiated Estimated Days of Completion: 0

met_with: Jose Ayala, Program Manager


summary: Facility Evaluation

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Narrative:
On 7/07/21 at 9: AM, Licensing Program Analyst (LPA) Daniel Mena and Licensing Program Manager (LPM) Natasha Dunlap conducted an unannounced required annual inspection. LPA Mena met with Program Manger, Jasmine Trammell. LPA Mena and LPM Dunlap inspected the administrative office. The facility is licensed to provide Transitional Housing Placement (THP) services for Nonminor Dependents (NMD). The facility provides care for 30 participants ages eighteen (18) through twenty-one (21) years old. There are currently 24 participants residing in the program, which included remote sites in San Diego County.The Administrative Office is located at Spring Drive, Spring Valley, CA 91977. The administrative office is in a portable on San Diego Youth Services (SDYS) property in room #29. The facility has three offices within the portable. Office #1 is the Program Administrator office. Office #2 is the file room and Program Assistant. Office #3 is the Program Coordinator. The Youth Advocates' desks are located in main area of the portable. The administrative offices have working telephone. The facility has an additional room for meetings, interviews and orientation. The facility also is able to reserve larger conference rooms on the property. The participants' files (See Confidential Name List, LIC 811, date: 07/07/21) are stored and locked in a cabinet located in office #2. The participants' files were review. The participants' files were complete. Staff files are located off-site in the main administration building. Copies of staff files were provided and reviewed. There were no deficiencies observed on this date in accordance to Title 22, Division 6 of the California Code of Regulations. An Exit interview was conducted and a copy of this report was provided to Program Manager.

met_with: Jasmine Trammell


summary: Facility Evaluation

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Narrative:
On March 27, 2023, at 9: AM, Licensing Program Analyst (LPA) Gloria Meza-Gonzalez conducted an unannounced inspection at the above facility. LPA Meza-Gonzalez met with Case Manager (CM) Ashley Parra and Program Manager (PM) Berenice Perez. The purpose of the inspection is to conduct a random annual. The facility is licensed to provide transitional housing placement plus foster care for non-minor dependents for 30 participants ages eighteen (18) through twenty-one (21) years old. There are currently 13 participants in the program. The Administrative Office is located at Spring Drive, Spring Valley, CA 91977. The administrative office is in a portable on San Diego Youth Services (SDYS) property in room #29. LPA Meza - Gonzalez inspected the administrative office. The facility has three offices within the portable bungalow. Office #1 is the Program Coordinator's office. Office #2 is the file room and Program Assistant's Office. Office #3 is the Program Administrator's office The Youth Advocates' desks are located in the main area of the bungalow. The administrative offices have working telephones. The facility also is able to reserve conference rooms on the property for meetings, interviews, and orientation with receptions services. The participants' files (See Confidential Name List, LIC 811, date: March 27, 2023) are stored and locked in a cabinet located in office #2. Five participants' files were reviewed. The participants' files were complete. Staff files are located off-site in the main administration building. The staff files were brought to the facility. Five staff files were reviewed. The staff files were complete. LPA Meza-Gonzalez conducted one staff interview due to one staff was present. There were no deficiencies observed on this date in accordance with Title 22, Division 6 of the California Code of Regulations. An Exit interview was conducted and a copy of this report was provided to PM Perez.

met_with: Ashley Parra and Berenice Perez


summary: Facility Evaluation

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Narrative:
On February 25, 2025 at 10: AM, Licensing Program Analyst (LPA) Lucero Jauregui met with Haley Veniegas, Director of Services and Jose Ayala, Program Manager , to conduct a change in relocation/pre-licensing inspection. The previous license #374603938 location Spring Drive, Spring Valley, CA 91977. The office is conveniently located for the public. The office space area has a waiting area, confidential case meeting space, program manager office, and case workers office space. LPA observed Emergency Disaster Plan, Personal Rights, and Grievances posted in a prominent area for participants to view. License will be posted as soon as it is issued. Participants files are locked in file cabinets and accessible electronically. Staff files are maintained electronically and accessible for review. Telephone is accessible in program managers office. Fire extinguisher is properly charged. A first aid kit is located in the case meeting office. The bathrooms are located outside the suite. The facility has demonstrated compliance with Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report was provided to Haley Veniegas, Director of Services.

met_with: Haley Veniegas, Director of Services & Jose Ayala, Program Manager


facility_name: SBCS -TROLLEY TRESTLE TRANSITIONAL LIVING PROGRAM

summary: Facility Evaluation

raw_content:
Narrative:
On 09/28/2021 at 09:30 a.m., Licensing Program Manager (LPM Ann Valenzuela and Licensing Program Analyst (LPA) Marisol Lopez conducted an unannounced inspection for the purpose of conducting a required annual. LPM and LPA met with Facility Administrator Xavier Martinez and conducted an inspection of the facility. The facility is licensed to provide Transitional housing placement plus foster care (THP+FC) services for 27 participants to non-minor dependents. LPA and LPM inspected both indoor and outdoor areas of the facility. The facility has 15 participants in care. The facility administrative office is located on site. Facility utilizes apartment complex housing model and has 17 apartment homes. There are ten apartment homes that have two bedrooms and seven apartment homes that have 1 bedroom on two different sites. Files are located in locked file cabinets within locked offices. There are no physical plant deficiencies. Staffing: The agency employee's the following assigned staff under the THP program. Program Director/Administrator, Program Coordinator/Social Worker Supervisor, Housing Coordinator; Case manager/Social Worker and Resident Manager. All employees have the required experience, and training for their current job employment. LPM and LPA reviewed 5 staff files and Non-minor dependent files. During the review, 1 out of 5 staff (S1) did not maintain a criminal record clearance in the staff file as required, all personnel records are not maintained at facility site, 5 out of 5 staff (S1-S5) files are missing a completed Child Abuse Central Index check (LIC 198A) and a Criminal Record Statement (LIC508). All staff files met the minimum qualifications for training requirements. The facility provided a list of clients and certified apartment information, current Personnel Report (LIC 500), Designation of Facility Responsibility (LIC 308) and all staff have current CPR certificates on file. (see continuation form LIC 9099-C dated 09/28/21) The non-minor dependent files were complete and included a signed Needs and Service plan, Transitional Independent Living Plan (TILP) and case progress notes were current. All client files reviewed were complete and had the requirement documents. Based on LPM and LPA's records review, the facility is cited under Title 22, Division 6, Chapter Criminal Record Clearance section 80019(d), 80019(j),Child Abuse Central Index section 80019.2(b) and Personnel Records section 80066(e). An exit interview was conducted, and a copy of this report was given the Program Administrator Xavier Martinez.

met_with: Xavier Martinez


summary: Facility Evaluation

raw_content:
Narrative:
On April 6, 2023, at 11: AM, Licensing Program Analysts (LPAs) Gloria Meza-Gonzalez and Lucero Jauregui conducted an unannounced inspection. LPAs Meza-Gonzalez and Jauregui met with Program Administrator (PA) Xavier Martinez. The purpose of the inspection is to conduct a random annual inspection. The facility is licensed to provide Transitional housing placement plus foster care (THP+FC) services for 27 participants to non-minor dependents. There are currently 10 participants in care. LPAs Meza-Gonzalez and Jauregui inspected both indoor and outdoor areas of the facility with PA Martinez. The facility administrative office is located on-site. The facility utilizes an apartment complex housing model and has apartment homes. There are ten apartment homes that have two bedrooms and seven apartment homes that have 1 bedroom on two different sites. The facility has two offices, Administrative office and housing office. The Program Administrator is located in the administrative office. The staff files are in a locked cabinets. The participate files are located housing office locked in filing cabinets within a locked office. There are no physical plant deficiencies. The agency employs the following assigned staff under the THP program. Program Administrator, Housing Coordinator; Case Manager. LPA Jauregui reviewed three staff files. LPA Jauregui observed the staff files met the minimum qualifications for training requirements. LPA Jauregui observed that all employees have the required experience and training for their current job employment. LPA Meza-Gonzalez conducted two staff interviews. See page 2 - LIC809C LPAs Meza-Gonzalez and Jauregui reviewed five participants files (see confidential name list, LIC811, dated: April 6, 2023). The non-minor dependent files were complete and included a signed Needs and Service plan, Transitional Independent Living Plan (TILP) and case progress notes were current. LPAs Meza-Gonzalez and Jauregui observed the participants files reviewed were complete and had the requirement documents. There were no deficiencies observed on this date in accordance with Title 22, Division 6 of the California Code of Regulations. An Exit interview was conducted and a copy of this report was provided to PA Martinez.


summary: Facility Evaluation

raw_content:
Narrative:
On October 15, 2024, at 11: AM, Licensing Program Analyst (LPA) Lucero Jauregui conducted an unannounced inspection at the facility and met with Hillary Sloan, Program Administrator. The purpose of the inspection is to conduct a case management. On October 10, 2024 the Department received a report regarding alleged abuse and neglect to a client in care. LPA Jauregui conducted one staff interview, one client interview, obtained Special Incident Reports and reviewed maintenance requests. Based on information gathered, further information is needed and the case management will be extended. An exit interview was conducted and copy of this report was provided to Hillary Sloan, Program Administrator.

met_with: Hillary Sloan, Program Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On September 25, 2025, at 9: AM, Licensing Program Analyst (LPA) Lucero Jauregui conducted an unannounced inspection. LPA Jauregui met with Youth in Transition Director Hillary Sloan and Housing Coordinator Shomari Bond. The purpose of the inspection is to conduct an annual inspection. The facility is licensed to provide Transitional housing placement plus foster care (THP+FC) services for 27 participants to non-minor dependents. There are currently 19 participants in care. LPA inspected the areas of the facility with Shomari Bond. The facility administrative office is located on-site. The facility utilizes an apartment complex housing model and has apartment homes. There are ten apartment homes that have two bedrooms and seven apartment homes that have 1 bedroom on two different sites. The facility has two offices, Administrative office and housing office. The Youth is Transition Director is located in the administrative office. The staff files are maintained by Human Resources and were made accessible electronically. The participant files are located in the housing office locked in filing cabinets. The agency employs the following assigned staff under the THP program. Youth in Transition Director, Housing Coordinator; and Case Managers. LPA Jauregui reviewed five staff files (S1-S5) and conducted two staff interviews. LPA Jauregui observed the staff files met the minimum qualifications for training requirements. LPA Jauregui observed that all employees have the required experience and training for their current job employment. Continued.... LPA reviewed six participants files (P1-P6) (see confidential name list, LIC811, dated: September 25, 2025). The non-minor dependent files were complete and included a signed Needs and Service plan, Transitional Independent Living Plan (TILP) and case progress notes. LPA observed the following items posted: Facility License, Facility Sketch, Text Hotline numbers, Phone Helpline numbers, Childcare Assistance bulletins, Emergency Evacuation checklist, LGBTQ Support schedule, Event bulletins and seventeen cameras in common areas of the facility. Based on today's review there are no deficiencies observed at this time. An exit interview was conducted and due to printer difficulties a copy of this report was emailed to to Hillary Sloan.

met_with: Hillary Sloan, Youth in Transition Director and Shomari Bond, Housing Coordinator