summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Manager (LPM) Hillary Hall and Licensing Program Analyst (LPA) Lyta Vue arrived unannounced to the facility for the purpose of a Case Management Inspection. LPM and LPA conducted an inspection of the facility inside and out. The facility submitted a 24 hour Serious Incident Report on 05/31/23 reporting the death of a Transitional Housing Placement Program participant (THP). LPA reviewed and collected records at the facility and interviewed two individuals, CEO (in training) and Director of Social Work. Records indicated the Agency Social Worker (ASW) was making regular contact with the participant and a current Needs and Services Plan was on file. Local Law Enforcement is still investigating, but at this time, no foul play is suspected. The County Coroner will conduct an autopsy. The participant's placing county has been notified. LPA will continue to follow up with the facility as more information becomes available. No citation was issued during this inspection. A copy of this report was provided to the facility. Further investigation is needed to determine the cause of death.

met_with: Crystal Carter-CEO (In training)


state: CA

facility_name: CHILDREN'S HOPE THPP/THP+FC

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Misty Valencia and Lyta Vue arrived unannounced at the facility for the purpose of a case management inspection. LPAs met with Crystal Carter, CEO in training. The Investigations Branch and LPA Valencia conducted the case management. During the course of the case management, it was determined the Resource Parent violated one client's personal rights by making inappropriate and demeaning comments to a Non-minor Transitional Housing client and a minor in the home who was not a client. Comments included telling the client they had been placed in foster care due to their behavior, and telling the other minor Resource Parent wished they'd never met. The client stated the comments occurred in the summer of 2022. Twelve confidential interviews were conducted. Only two of the twelve individuals interviewed reported hearing inappropriate comments. Record review indicates Resource parent has been fostering for 19 years with no prior complaints. No citation is being issued at this time. Following interview with agency supervisor and review of records, Resource parent has already completed additional training in the following areas: -Personal Rights on 1/18/2023 for 2.5 hours and 3/15/2023 for 2.5 hours. -Changing Destructive Adolescent Behavior a 10 week course for 20 hours completed in 2023. Proof of training's were provided to LPA. A signed copy of this LIC 809 report was provided to the facility. Appeal rights were provided, and an exit interview was conducted.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Crystal Carter, CEO in training


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Misty Valencia arrived unannounced to the facility for the purpose of a Case Management Inspection. LPA met with Amelia Wakefield, Assistant program Manager (APM). The Agency submitted a 24 hr Serious Incident Report on 06/20/2023 reporting Transitional Housing Placement Program participant (THP) client was seen on video pulling a knife out and pointing it towards another THP client. APM reported that the agency created a verbal safety plan and requested an Emergency CFT meeting. APM will send LPA the written safety plan and CFT notes when available. No citation was issued during this inspection. A copy of this report was provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 07/19/2023, Licensing Program Analyst (LPA) Misty Valencia met with Crystal Carter CEO in Training at Community Care Licensing Office (CCL), regarding a Case Management (CM) Inspection follow up. The CM is in regards to a death of a client on 5/31/2023. Licensing Program Manager (LPM) Hillary Hall and LPA Lyta Vue conducted an initial inspection of the facility on 6/1/2023, interviewed two staff, and conducted a records review. On 7/7/2023, the Department received records from Local Law Enforcement and the county Coroner, who determined the cause of death. Record review indicated the facility had consistently visited the client, and provided supportive services. No foul play suspected. No citation was issued during this inspection. A copy of this report was provided to the facility. No Further investigation is needed at this time.

met_with: Crystal Carter CEO in Training


summary: Facility Evaluation

raw_content:
Narrative:
On 09/08/2023, Licensing Program Analyst (LPA) Misty Valencia and Cynthia Moreno, Residential Technical Support Analyst arrived unannounced at the facility and met with Crystal Carter, CEO in training. The purpose of the visit was to conduct a Required Annual Inspection of the facility. The last Annual inspection for the facility was on 09/21/21. 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 multiple offices for social workers and multiple confidential interview/visitation rooms. LPA observed the proper postings including: facility license, complaint hotline, and emergency disaster plan. The restrooms for clients and staff were clean. Smoke alarms were in working order, fire extinguishers were current, and a first aid kit was fully stocked. Evacuation drills for the facility were completed quarterly. LPA observed client files that are stored electronically with password protection. The facility has no outstanding fees. The facility has fifty-three (53) clients. Clients live in remote site apartments that resides within two hours from the facility. The facility employs fourteen (14) THP Social Workers and one (1) Case Manager, and five (5) Supervisors. LPA reviewed five (5) Social Worker personnel files. Social work personnel had completed criminal record clearances and met minimum education and experience qualifications. All First Aid and CPR certifications were up to date for Social Worker personnel. continued on 809-C LPA interviewed three (3) social worker personnel. Social work personnel indicated they did not have more than twelve ( 12) clients on their caseload. LPA reviewed five (5) client files. Two of five (2/5) clients had Needs and Services Plan (N&S) that were not signed by placement agency. LPA conducted a Technical Advisory. All Needs and Services Plan were detailed and had adequate supportive services the facility offers to the clients. No citations were given on this date. A signed copy of this LIC-809, LIC-809C, and LIC 9102 reports was provided to Crystal Carter, CEO in training. An exit interview was conducted.

visit_type: Annual


summary: Facility Evaluation

raw_content:
Narrative:
On 11/02/2023, Licensing Program Analyst (LPA) Misty Valencia arrived unannounced to the facility for the purpose of a Case Management (CM) Inspection and met with Crystal Carter CEO in Training. The CM is regarding a death of a Transitional Housing Placement Program participant (THP) on 10/31/2023. LPA conducted an inspection of the facility inside and out, conducted interviews, and records review. On 11/01/ The facility called and informed LPA that they received the information from the placing county social worker about the THP participant. Records reviewed indicated the Agency Social Worker (ASW) was making regular contact with the participant, provided supportive services and a current Needs and Services Plan was on file. Local Law Enforcement is still investigating and the County Coroner will conduct an autopsy. LPA will continue to follow up with the facility as more information becomes available. no citations issued at this time and a copy of this report provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Misty Valencia and Lyta Vue arrived unannounced at the facility for the purpose of a case management, following a record review and met with Heather Payne,Executive Director. While conducting an investigation for a different licensed facility on March 12, 2025, it was alleged an uncleared adult may have resided with a Children's Hope Transitional Housing Placement (THP) participant for up to two years, between 2022-2024. On March 13, 2025, LPA Valencia requested case notes and other participant records from Children's Hope, for the three years the participant was in the program, from 2021-2024. These records were reviewed. Multiple statements were found in the records to indicate the uncleared adult had their own separate residence. The assigned social worker documented conversations with the participant where the participant was informed the uncleared adult could not reside with the participant without obtaining a clearance. The participant signed an agreement indicating they were aware of the rules of uncleared adults and other visitors in the participants' unit. While the uncleared adult was observed by the social worker in the participant's unit on a couple occasions, and known to visit, there was no information that the facility was aware of, or allowed the uncleared adult to reside in the THP participant's remote living apartment. No citations are being issued. A signed copy of this LIC-809 was provided to the facility.

met_with: Heather Payne,Executive Director


summary: Facility Evaluation

raw_content:
Narrative:
On 08/05/2025, Licensing Program Analyst (LPA) Misty Valencia and Lyta Vue arrived unannounced at the facility and met with Crystal Carter, CEO in training. The purpose of the visit was to conduct a Required Annual Inspection of the facility. The last Annual inspection for the facility was on 09/08/23. 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 multiple offices for social workers and multiple confidential interview/visitation rooms. LPA observed the proper postings including; facility license, complaint hotline, and emergency disaster plan. The restrooms for clients and staff were clean. Smoke alarms were in working order, fire extinguishers were current, and a first aid kit was fully stocked. Evacuation drills for the facility were completed quarterly. LPA observed client files that are stored electronically with password protection. The facility has no outstanding fees. The facility has 33 clients. Clients live in remote site apartments that reside within two hours from the facility. The facility employs THP Social Workers, Case Manager, and Supervisors. LPA reviewed Social Worker/Case Worker personnel files. Social work personnel had completed criminal record clearances and met minimum education and experience qualifications. All First Aid and CPR certifications were up to date for Social Worker personnel. continued on 809-C LPA interviewed 3 social worker/case worker personnel. Social work personnel indicated they did not have more than twelve clients on their caseload. LPA reviewed 5 client files. and cited for the following regulation 86270(a)(2)(C) (a) The licensee shall maintain a separate, complete, and current record or file in the THPP for a nonminor dependent. (2) The following shall be included in the nonminor dependent's record or file: (C) A Needs and Services Plan for the nonminor dependent, and if provided, the Transitional Independent Living Plan for the nonminor dependent. A signed copy of this LIC-809, LIC-809C, and LIC-809D reports was provided to Crystal Carter, CEO in training. An exit interview was conducted.


summary: Facility Evaluation

raw_content:
Narrative:
On 06/09/ Licensing Program Analyst (LPA) Misty Valencia and Lyta Vue arrived unannounced at the facility and met with Crystal Carter, CEO in training for the purpose of a case management inspection regarding social worker ratios and qualifications. LPAs Valencia and Lyta Vue conducted the case management. During the course of the inspection, LPAs Valencia and Vue conducted a records review. LPAs Valencia and Vue reviewed records including: LIC- Personnel Report, job descriptions, and social worker caseloads. Facility Records reviewed indicated the following: -Four (4) Social Worker Assistants (SWAs) and One (1) Social Worker are over capacity on their caseload, meaning they are assigned more than twelve (12) Transitional Housing Placement Program participants (THP) clients, or more than 18 foster youth, or a combination. Due to the majority of the clients on the caseloads being THP, the citation is issued to the THP facility, not the Foster Family Agency facility license. Based on records reviewed, the following citation is issued: Health and Safety Code Section 1559.110(g)(2)(D) allows for a caseload maximum of 12 clients Transitional Housing Placement clients. While not cited, the licensee was also in violation of Interim Licensing Standards FFA Article 09.7. Continuing Requirements 88265. Social Worker Ratios (b) A foster family agency shall employ one full-time social worker for every 18 children or nonminor dependents, or fraction thereof, in placement. A signed copy of this LIC 809 and LIC 809D report was provided to the facility. Appeal rights were provided, and an exit interview was conducted.

met_with: Crystal Carter, CEO


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
Licensing Program Analyst (LPA) Misty Valencia arrived unannounced at the facility on this date for the purpose of a case management inspection following a record review. LPA met with Amelia Wakefield ISFC Assistant Program Manager (APM. LPA reviewed two social worker meeting agendas dated 9/12/23 and 10/11/23, which indicated Transitional Housing Participants would be fined $25 for missing a visit with their agency social worker. LPA conducted a follow up interview with Crystal Carter CEO in training on this date. CEO in training confirmed the policy has been implemented, but no participants have been fined. The policy is not mentioned in the agency Program Statement, nor was the new policy reviewed or discussed with the Department. The agency is being cited per Title 22, Division 6, Chapter 1, Section 80022(k): Plan of Operation (k) The facility shall operate in accordance with the terms specified in the Plan of Operation and may be cited for not doing so. A signed copy of this LIC 809 and 809D were provided to the facility. Appeal rights were also provided.

Deficiencies:
80022(k): Plan of Operation
(k)

met_with: Amelia Wakefield ISFC Assistant Program Manager (APM)

title:
1
2
3
4
5
6
7Section 80022(k)

description:
Plan of Operation
(k)


facility_name: CHILDREN FIRST THPP/THP+FC

summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Based on LPA's observations, interviews which were conducted, and records reviewed, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. 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) Kellie McKinley arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Karen Kemp - Regional Director. LPAs Kellie McKinley and Misty Valencia conducted the complaint investigation. LPA Misty Valencia opened the investigation with the facility on 9/11/23 and Karen Kemp, Regional Director, was interviewed. During the course of the investigation, LPAs interviewed One former client, a County Social Worker, an Agency Social Worker, a Probation Officer, and a property manager. LPA reviewed records from the facility including: Needs and Services Plan, Agency social worker case notes, Serious Incident Reports, receipts, and additional notices and eviction documentation. The facility indicated a client was given written notice of termination from the program. The client was absent from care and unable to assist with their own move from the housing unit. Interviews and record review were inconsistent regarding the client being informed of the move timely and being able to access their belongings upon their return continued on 9099-C page UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: CHILDREN FIRST THPP/THP+FCFACILITY NUMBER: VISIT DATE: 11/29/2023

report_type: Complaint Investigation

met_with: Karen Kemp- Regional Director

complaint_status: unsubstantiated


raw_content:
Narrative:
This resulted in files being incomplete. LPA found 1 file in which the Needs and Services Plan was duplicated but not updated. LPA reviewed 6 files for clients who were discharged. LPA found 3 of 6 discharged clients to not have a signed copy of written removal or discharge. The Program Director stated that former staff did provide support services to the clients but did not provide proper documentation. Also, during an interview PD explained that the process for documenting maintenance requests is for the the case managers to write them in case notes. During file review, 6 clients had files showing maintenance as being requested, 5 of these files were observed to have no documentation provided in subsequent case notes as to whether the issue(s) had been resolved. LPA reviewed six files of clients who had been discharged from the agency. Two out of six clients were given proper written notice of discharge but had to be discharged before the scheduled date due to emergency circumstances, which were documented. LPA observed proper written notice was given to one additional client. Three clients had no record of written notice of discharge notice in the file. Based on LPA's observations, interviews which were conducted, and records reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. Citations are being issued for violating Interim Licensing Standards Section 86270, Non-Minor Dependents Records and 86268.4, Removal or Discharge Procedures A signed copy of this LIC-9099 report, the LIC-9099C, and LIC-9099D were provided to the facility. An exit interview was conducted. Appeal rights were provided. Two clients reported lack of support to understand their finances as being a big concern. Interviews with ASW's, CSWs, and clients point to living conditions as being a potential barrier to meeting goals, however, all agreed that it is very difficult to secure more desirable housing. Both CSW's, a probation officer, and two clients reported the Agency Social Workers are dedicated to meeting the needs and providing great supervision to the clients. While maintenance and pest control issues were commonly reported, three of four clients and four of seven agency social workers agreed that these problems were addressed promptly. LPA observed case notes written by current staff to be more detailed and thorough than case notes written by previous staff. Interviews with previous staff conflict with interviews with current staff who all reported that they are given the support and supervision from administration that allows them to provide proper care and supervision to meet clients' needs. Based on LPA's observations, interviews which were conducted, and records reviewed, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. 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) Tina Thorn arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with NAME, TITLE. LPA Thorn conducted the complaint investigation. LPA opened the investigation with the facility on 01.30.24 and met with Program Director, Karen Kemp. During the course of the investigation, LPA interviewed 4 clients, 7 current and former case managers (CM), 2 county social workers (CSW), Program Directors, 1 property manager, Chief Operations Officer, 3 current and former Administrative Assistants, and 1 probation officer. LPA reviewed records from the facility including Agency case notes, prior complaint history, Serious Incident Reports, Child, and Family Team notes (CFT), Needs and Service Plans for clients, Placement Roster, Lease agreements, discharge summary, and written notice. LPA observed during file review, that 6 of 15 client's files reviewed did not provide documentation that behavior contracts or CFTs that were referenced as being scheduled, were ever completed. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Tina Thorn 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: CHILDREN FIRST THPP/THP+FCFACILITY NUMBER: VISIT DATE: 04/19/2024

met_with: Karen Kemp, Program Director


summary: Facility Evaluation

raw_content:
Narrative:
On 07/28/2023, Licensing Program Analyst (LPA) Wendy Brown arrived unannounced at the facility and met with Karen Kemp, Regional Director. The purpose of the visit was to conduct a Required Annual Inspection of the facility. The pre-licensing inspection, for the facility was on 12/28/2021. 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. At the facility LPA observed two offices that can be used as confidential interview rooms and one large common room. LPA observed the proper postings including: facility license, complaint hotline, and emergency disaster plan. The restroom for clients and staff was clean and readily accessible with the available key. Smoke alarms were in working order, fire extinguishers were current, and a first aid kit was fully stocked. Evacuation drills for the facility are completed quarterly. LPA observed client files were stored in a multi-locked area. The facility has no outstanding fees. The approved capacity for the facility is 49. The facility has 32 non-minor dependent clients. Currently clients live in remote site apartments. No clients are currently in mentor homes. No client resides more than two hours from the facility. The facility employs three social workers and one supervisor. LPA reviewed four social worker files and one housing coordinator personnel file. Social work personnel had completed criminal record clearances and met minimum education and experience qualifications. All First Aid and CPR certifications were up to date for Social Worker personnel. LPA interviewed the two staff who were in-office that work with participants, one social worker and one case manager. Social work personnel do not have more than 12 clients on their caseload. Continue on Lic809-c LPA reviewed five client files. All clients had signed Admission Agreements. Client files had current Needs and Service Plans signed by the client and placing agency. Needs and Services Plan detailed adequate supportive services the facility offers to the clients. No citations were given on this date. A signed copy of the LIC-809, LIC-809C, and LIC9102 documents were provided to Karen Kemp. An exit interview was conducted.

met_with: Karen Kemp, Regional Director


summary: Facility Evaluation

raw_content:
Narrative:
On 04.19.24, Licensing Program Analyst (LPA) Tina Thorn arrived unannounced at the facility for the purpose of a Case Management inspection following a record review. LPA met with Karen Kemp, Program Director. While conducting a record review on 4.5.2024, LPA Thorn found Incident Reports (IRs) that were submitted to the LPA for a complaint investigation, that had not been previously submitted to the Department within the seven-day requirement. The time period for when the IR's occurred was between 02.26.23 and 04.04.23 and involved incidents of medical emergency, aggressive act towards self and staff member, and possession of ammunition. PD agreed that she will be checking the Ir's more closely. Agency is issued one citation for violating Title Division Chapter 1. 80061: Reporting Requirements: (b) Upon the occurrence, during the operation of the facility, of any of the events specified in (1)... a report shall be made to the licensing agency within the agency's next working day during its normal business hours. In addition, a written report containing the information specified in (2) below shall be submitted to the licensing agency within seven days following the occurrence of such event. A signed copy of this 809 and 809D were provided to WHOM. Exit interview conducted and appeal rights provided.


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
continued from Interviews and record review indicated a Social Work Supervisor (SWS) had not completed case notes or Needs and Service Plans timely. The Needs and Service Plans (NSP) which were available for LPA to review were not signed by the client, and not specific to the client. Case notes were incomplete and unavailable when LPA first requested them. SWS later stated the missing notes were "at home," and if they had known LPA was going to the office they would have asked another staff member "to go to my house to retrieve them." SWS noted concerns with the client on the case notes, but no follow up services were documented. SWS provided LPA with a chart documenting the dates of their home visits with clients. The dates on the chart did not match the dates of the submitted case notes. For 6 clients, the chart reflects that the SWS made home visits, however the corresponding case notes says there was no home visit on that date. When interviewed, a client on SWS's case load indicated home visits usually lasted about 5-10 minutes. A social worker indicated the training provided upon hire was not nearly sufficient and SWS was not readily available when the social worker had questions. SWS admitted during an interview that their case notes and NSP's were not current, and this was partly due to the facility being short staffed, and the SWS on vacation. Based on the preponderance of evidence that was met through interviews, observation, and record review, the allegation of: Social work supervisor duties are not being met is SUBSTANTIATED. The Social Worker Supervisor had a caseload and failed to fulfill duties as a Social Worker. Due to missing and incomplete notes, there is insufficient evidence to verify the Social Work Supervisor was supervising the placement of the participant and providing supportive services. The facility is cited per Title 22, Division 6, Chapter 7, Article 06. Continuing Requirements Section 86065.3(f)(2-4) Social Work Personnel (f) Social work personnel shall be responsible for the following: (2) Supervision of the placement of participants in the THPP participant living unit. (3) Development and updating of the needs and services plan of THPP participants. (4) Provision of support services to THPP participants. A signed copy of this LIC-9099, LIC-9099C, and LIC 9099D were provided to the facility. Appeal Rights were given. An exit interview was conducted.

Investigation Findings:
13Licensing Program Analyst (LPA) Misty Valencia arrived at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA Valencia met with Shannon Pierce, Chief Operations Officer (COO). LPA Hillary Hall, LPA Shannon Parks, and LPA Misty Valencia conducted the complaint investigation. The complaint was opened with the facility on 8/1/22. LPAs met with Chief Operations Officer to discuss the allegations. During the course of the investigation, LPA's interviewed seven facility staff and three clients. LPA reviewed relevant records from the facility including: Agency social worker case notes for multiple clients, Needs and Service Plans, facility LIC-500, staff training log, and job descriptions for social workers and supervisors. The complaint alleges: Social work supervisor duties are not being met. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Daniel Allmon LICENSING EVALUATOR NAME: Misty Valencia 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: CHILDREN FIRST THPP/THP+FCFACILITY NUMBER: VISIT DATE: 09/23/2022

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

complaint_status: SUBSTANTIATED


raw_content:
Narrative:
Interviews and record review indicate a maintenance staff who is without a criminal record clearance, did go into the homes of Transitional Housing Participants (THP) without being monitored by a staff person who did have a criminal record clearance. The participants were present in the home at the time. COO reported the policy is that all maintenance staff who do not have clearances, are to be monitored by a cleared staff member at all times, in the presence of a client. Interviews concluded the policy was not followed. The maintenance staff has been employed about 1 ½ years and his primary job is maintenance of the THP housing units Based on the evidence that was met through interviews, observation, and record review, the allegation of: Staff are working at the facility without being background check cleared is SUBSTANTIATED. The facility is cited per Title 22, Division 6, Chapter 7, Section 86019(b)(2), Criminal Record Clearance: (b) The following persons are exempt from the requirement to submit fingerprints: (2) A third-party repair person, or similar retained contractor, if all of the following apply: (A) The individual is hired for a defined, time-limited job. (B) The individual is not left alone with participants. (C) When participants are present in the room in which the repair person or contractor is working, a staff person who has a criminal record clearance or exemption is also present. A signed copy of this LIC-9099, LIC-9099C, and LIC 9099D were provided to the facility. Appeal Rights were given. An exit interview was conducted.

Investigation Findings:
13Licensing Program Analyst (LPA) Misty Valencia arrived at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA Valencia met with Mike Logan, CEO/Administrator. LPAs Hillary Hall and Misty Valencia conducted the complaint investigation. The complaint was opened with the facility on 9/15/22. LPA met with the Chief Operations Officer (COO) to discuss the allegation. During the course of the investigation, LPA's interviewed seven facility staff and four clients. LPAs reviewed relevant records from the facility including: Facility LIC-500, Criminal Record Clearances, and Staff training log. The complaint alleges: Staff are working at the facility without being background check cleared. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Daniel Allmon LICENSING EVALUATOR NAME: Misty Valencia 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: CHILDREN FIRST THPP/THP+FCFACILITY NUMBER: VISIT DATE: 09/30/2022

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

met_with: Mike Logan, CEO/Administrator


raw_content:
Narrative:
training on budgeting, leading to occasionally running out of food. Clients indicated ASW's were willing to provide food when the clients ran out. Client dissatisfaction was also related to the client's refusal to meet program goals. ASW case notes were inconsistent with some duplicated entries, making it difficult to determine the quality of services provided to the THP. Based on LPA's observations, interviews, and record reviews, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. No citations were issued. A signed copy of this this report was provided to the Facility. Conclusion An exit interview was conducted with Ben Evans.

Investigation Findings:
13On 4/ /2023 at 1: PM Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced and met with Ben Evans Human Resouce and Technolgy for the purpose of delivering findings for the complaint investigation. LPA delivered findings in person to Antelope Blvd, Red Bluff, CA 96080. On 1/19/2022, Licensing Program Analyst (LPA) Misty Valencia and Lyta Vue opened the investigation and met with Shannon Pierce, Chief Operation officer (COO). During the course of the investigation, LPA McKinley and LPA Wendy Brown interviewed six agency social workers (ASW), six Transitional Housing clients (THP), COO, and a former staff person. LPA Kellie McKinley conducted a records review. ASW's reported and documented meeting with THP 2- 4 times a month. Some THP reported meetings with ASW's were occasionally cut short. Four of six clients interviewed rated the program highly and reported no concerns. These clients reported ASW's met their basic needs and provided adequate supervision. Two of six clients reported their only concern was a lack of UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: CHILDREN FIRST THPP/THP+FCFACILITY NUMBER: VISIT DATE: 04/07/2023

met_with: Ben Evans Human Resouces and Technolgy


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
social workers had 12 clients or less aside from one social worker who had 14 clients. Based on observations, interviews which were conducted, and records reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. As no other Health and Safety violations were observed and the needs of the clients were being met, no citations are being issued. Facility agreed to immediately redistribute the clients to ensure social workers are not over case load requirements. An exit interview was conducted, and signed copy of this report was provided to Ben Evans. . Appeal rights were provided.

Investigation Findings:
13On 4/7 /2023 at 1: PM Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility and met with Ben Evans- Human Resouce and Technology for the purpose of delivering the findings for the complaint investigation. LPA delivered findings in person to Antelope Blvd, Red Bluff, CA 96080. On 1/19/2022, Licensing Program Analysts (LPA) Misty Valencia and Lyta Vue opened the complaint with the facility and met with Shannon Pierce, Chief Operation Officer (COO). Over the course of the investigation, LPA Wendy Brown conducted a records review and interviewed one Transitional Housing Placement (THP) client. LPA Kellie McKinley interviewed six social workers, the COO, five THP clients, one former staff person, and conducted an additional records review. Records indicate one THP social worker was over the maximum limit of clients on their caseload. Health and Safety Code Section 1559.110(g)(2)(D) allows for a caseload maximum of 12 clients. All facility THP SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: CHILDREN FIRST THPP/THP+FCFACILITY NUMBER: VISIT DATE: 04/07/2023

met_with: Ben Evans- Human resouces and Technolgy


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
A records review did not determine any cash resources withheld from the client, other than when the CSW requested the program withhold funds due to client's non-compliance with program requirements, and when the client had overdue bills and the funds needed to be withheld from the client's cash resources to ensure the bills were paid. No signatures from the client were obtained to verify client's agreement with the funds being withheld. Based on LPA's observations, interviews which were conducted, and records reviewed, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. 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) Kellie McKinley arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Shannon Pierce- COO LPA McKinley conducted the complaint investigation. LPA opened the investigation with the facility on 10/04/23 and met with Ben Evans- HR and Technology manager. During the course of the investigation, LPA interviewed one THP participant, the THP Director, two Agency Social Workers, One County Social Worker (CSW), and one Independent Living Program worker. LPA conducted a records review. LPA reviewed relevant records from the facility including: Needs and Services plans, case notes, CFT notes, THP file documentation, and disbursement payments. Information obtained from interviews and records was inconsistent regarding the allegation of client not being afforded dignity in their personal relationships with others. Minimal details were provided to investigate this allegation. Continued on 9099-C page UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: CHILDREN FIRST THPP/THP+FCFACILITY NUMBER: VISIT DATE: 12/13/2023

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

met_with: Shannon Pierce- Chief Operating Officer


raw_content:
Narrative:
Interviews and records were consistent that a participant moved three times while in placement. The authorized representative was notified the first two times of the participant being relocated to a new living unit, and was notified of the third move the day of. Interviews and records were inconsistent as to if the authorized representative was notified prior to the third move. Based on LPA's interviews 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) Yesenia Vallejo arrived unannounced at the facility on 06/27/2025 for the purpose of delivering findings for the complaint investigation. LPA met with Robin Freisheim, Senior Recruitment/Marketing Manager. Vallejo conducted the complaint investigation. LPA initiated the investigation with the facility on 04/17/2025 and met with Shannon Pierce. During the course of the investigation, LPA interviewed one THP Director, one case manager, one county social worker, and one participant. LPA reviewed records including case notes, needs and services plan, THP participant's policy and procedures, utility bills, emails, text messages, Certificates of Compliance, THP monthly payment request, and photographs of participant's living unit. Amended to update findings to public. No edits to report. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Yesenia Vallejo 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: CHILDREN FIRST THPP/THP+FCFACILITY NUMBER: VISIT DATE: 06/27/2025

met_with: Robin Freisheim- Senior Recruitment/Marketing Manager


raw_content:
Narrative:
Interviews conducted were consistent in that there were no discrepancies regarding any refunds. During a records review, LPA was unable to determine if there were any discrepancies as there were no notes to determine what the participant's funds were used for at the end of each month. It was alleged the staff did not issue a proper refund to a participant. Per interview, all deductions were verbally explained to the participant when the participant exited the program. During the explanation with the participant, it was determined that the participant forgot about some funds provided while participating in the program. Prior to entering the program, the participant signed the Participation Contract acknowledging what funds would be removed when the participant exited the program. Based on LPA's observations, interviews, and record reviews, 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 and the LIC-9099C were provided to the facility. An exit interview was conducted.

Investigation Findings:
13Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Haley Maennche- Director of Foster Care Services. LPAs Valencia and Lyta Vue conducted the complaint investigation. LPA Vue initiated the complaint investigation with the Agency on 08/07/2025. During the course of the investigation, LPA interviewed the Agency Director (AD), Administrative Assistant (AA), THP Director (THPD), and one attorney. LPA attempted multiple times to reach the participant that was involved but was unsuccessful. LPA reviewed records including: Needs and Services plans (NSP), Agency Social Worker case notes, Placement Roster, Serious Incident Reports (IR), Agency Social Worker (ASW) caseload list, THP-FC and THPP Participation Contract Agreement, THP+FC Payment request, and THP+FC quickbooks budget log for 4 youths in placement. continuation on 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: CHILDREN FIRST THPP/THP+FCFACILITY NUMBER: VISIT DATE: 10/07/2025


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Danielle Walker-Flores conducted unannounced annual inspection on 02/24/22 and met with Ben Evans - Human Resource Manager who assisted with the inspection. The LPA used the CARE Inspection Tool and initiated a review of the Physical Plant, Operations, and Disaster Preparedness. Facility was clean and organized. First Aid kit was complete. LPA observed that the license is posted in a prominent area and visible by the public as required. LPA observed that the facility can accommodate for private interviews. LPA observed that there are restrooms available for participants and visitors. LPA observed that there is a file room for confidentially stored and locked files as required. During the inspection on this date, LPA reviewed 5 participant files and interviewed two staff during the inspection. The annual inspection will continue on 02/25/22 for final audit of the program.

met_with: Ben Evans - HR and Technology Compliance Manager


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPA) Danielle Walker-Flores, Robyn Word, and Kellie McKinley arrived at the agency on 02/25/22 at 9:30am to conclude the annual inspection from 02/24/22. LPA reviewed six THP participant files. Files were well organized and contained initial and updated Needs and Services plans, admission agreements, and safeguards for cash resources. Files were missing medical assessments and results of tuberculosis (TB) examination. Licensee explained difficulties in getting participants to agree to medical assessments as young adults. Provider Information Notice (PIN) 21-17-CRP released in May of 2021 clarifies the requirement for children and non minor dependents in Children's Residential facilities to undergo an examination for TB. Licensee explained the difficulties in implementing changes during a pandemic and provided proof of training that was conducted in October 2021 regarding TB exams. At this time, California Code of Regulations Section 86069(a)(1) Participant Medical Assessment is being cited. Exit interview was conducted with Shannon Pierce and appeal rights discussed.

met_with: Shannon Pierce - Chief Operating Officer


summary: Facility Evaluation

raw_content:
Narrative:
On 3/23/2023, Licensing Program Analysts (LPAs) Misty Valencia and Kelly McKinley conducted unannounced annual inspection and met with Shannon Pierce Chief Operations Officer, who assisted with the inspection. LPAs Valencia and McKinley utilized the CARES tool to conduct the inspection. The Agency currently has seventy-one (71) clients. Facility was clean and organized. First Aid kit was complete. LPAs observed that the license is posted in a prominent area and visible by the public as required. LPAs observed that the facility can accommodate for private interviews, there are restrooms available for participants and visitors. LPAs observed that there is a file room for confidentially stored and locked files as required. During the inspection, LPAs reviewed ten (10) staff files and interviewed three (3) staff during the inspection. LPAs reviewed ten (10) THP participant files. Client files were well organized and contained initial and updated Needs and Services plans, admission agreements, and safeguards for cash resources. Two (2) Staff files were missing medical assessments and results of tuberculosis (TB) examination. At this time, California Code of Regulations Section 86066(a)(11) (12)(a)The Licensee shall ensure that personnel record are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information. (11) A health Screening specified in Section 86065(I)(1) (12) Tuberculosis test documents as specified in Section 86065(l)(1). This requirement was not met by; LPAs observed that Staff #8 and #10 has no health screening or TB test in the personal files. LPA provided an Advisory Note-Technical Violation. Exit interview was conducted with Shannon Pierce and report copy provided.

met_with: Shannon Pierce Chief Operations Officer.


summary: Facility Evaluation

raw_content:
Narrative:
On this date Licensing Program Analyst (LPA) Kellie McKinley and Yesenia Vallejo arrived unannounced at the facility and met with Ben Evan Director of Business Operations. The purpose of the visit was to conduct a Required Annual Inspection of the facility. The last Annual inspection for the facility was on 3/23/2023. 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 multiple offices for social workers and two confidential interview/visitation rooms. LPA observed the proper postings including: facility license, complaint hotline, and emergency disaster plan. The restrooms for clients and staff were clean. Smoke alarms were in working order, fire extinguishers were current, and a first aid kit was fully stocked. Evacuation drills for the facility were completed quarterly. LPA observed client files were stored electronically with multi-factor authentication and password protected as well as and in hard copy format. The facility has no outstanding fees. The facility has Non-Minor Dependent clients. Clients live in remote site apartments. No client resides more than two hours from the facility. The facility employs Social Worker(s) and Case Managers, and 1 of Supervisor/Program Manager. LPA reviewed Social Worker personnel files including the THP directors file. Social work personnel had completed criminal record clearances and met minimum education and experience qualifications. All First Aid and CPR certifications were up to date for Social Worker personnel. LPA interviewed 3 social worker personnel and one social worker supervisor. Social work personnel indicated they did not have more than 12 clients on their caseload. LPA reviewed 5 client files. All clients had signed Admission Agreements. Client files had current Needs and Service Plans, signed by the client and placing agency. Needs and Services Plan detailed adequate supportive services the facility offers to the clients. No citations were given on this date. A signed copy of this LIC-809 report was provided to Ben Evans -Director of Business Operations. An exit interview was conducted.

met_with: Ben Evans- Director of Business Operations


summary: Facility Evaluation

raw_content:
Narrative:
On 4/24/25, Licensing Program Analyst (LPA) Yesenia Vallejo arrived unannounced at the facility for the purpose of a case management, following review of Serious incident reports and related interviews, involving a Transitional Housing placement (THP) participant. LPA Kellie McKinley and Licensing Program Manager (LPM) Hillary Hall previously reviewed Serious Incident Reports and conducted interviews regarding a THP participant allegedly harboring clients who had absconded from another facility. LPA Vallejo met with Charlotte Spencer site and requested records for one participant including facility contact notes for previous 6 months, most current Needs and service, and placement information, for additional review. No citations issued on this date. Further investigation is needed. A signed copy of this LIC 809 was provided to the facility.

met_with: Charlotte Spencer


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Kellie McKinley arrived at the facility on this date for the purpose of a case management inspection regarding deficiencies found in record review LPA met with Haley Maennche- Director of Foster Care Services. LPA reviewed records including: Needs and Services plans (NSP). LPA observed the participants Needs and Services plans (NSP) were completed within 30 days of placement, but none are signed by the county social worker. The following NSPs were not signed by all parties. Reporting Period-07/02-08/02/2024-signed by Administrator and THP Social Worker. (not by the youth) · Reporting Period-07/02-10/02/2024-signed by Administrator, THP Social Worker and the youth · Reporting Period-10/02/2024-01/02/2025-signed by Administrator, THP Social Worker and the youth · Reporting Period-01/02-04/02/2025- signed by Administrator and THP Social Worker. (not by the youth) The facility is being issued the following citation from Interim Licensing Standards (ILS) version 6, Section 86268.3 (d) The Needs and Services Plan shall be signed by the nonminor dependent, the THPP administrator or social work personnel, and the person or agency responsible for placing the nonminor dependent, such as a social worker or probation officer, and maintained in the records for the nonminor dependent as specified in Section 862170, Nonminor Dependents' Records.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Misty Valencia arrived unannounced at the facility for the purpose of delivering a case management investigation. LPAs Hillary Hall and Misty Valencia received a Serious Incident Report (SIR) from the facility dated 10/27/22. The facility reported a Non-Minor Transitional Housing Participant called their on-call social worker at 6pm to report hallucinations from a fentanyl and methamphetamine overdose. The facility Program Director approved for an Uber to pick up the participant and transport them to the Emergency Room (ER). The Uber driver had to call the facility to report the participant was incoherent and uncooperative at the ER. The SIR indicated the facility last heard from the participant at 11pm and was not sure of their location as the participant did not stay at the ER. The following day, the facility terminated the participant from the program for non-compliance and substance use. LPA followed up with the facility to ensure the participant was found. Facility indicated the participant was admitted to a detox center the next day. Based on record review and an interview with the Program Director, the facility did not send a social worker to assist the participant due to feeling it "was not safe for a single, female social worker." The Program Director indicated 911 should have been called to assist the participant. Following the participant's report of having overdosed, the facility failed to call for immediate medical services (911), failed to personally transport the participant to the ER, nor did they go to the hospital to meet the participant to ensure their safety. continued on 809-C continued from The facility is cited per Title 22, Division 6, Chapter 7, Article 06. Continuing Requirements Section 86065.3(f)(2, 4) Social Work Personnel (f) Social work personnel shall be responsible for the following: (2) Supervision of the placement of participants in the THPP participant living unit. 4) Provision of support services to THPP participants. A signed copy of this LIC-809 and LIC 809D report were provided to the facility. An exit interview was conducted, and appeal rights provided.

met_with: Shannon Pierce, Chief Operations Officer (COO)


raw_content:
Narrative:
Interviews and records were consistent that when one NMD moved into their apartment, an inspection was completed and the apartment was determined to be cleaned and sanitary at the time. A certificate of compliance was issued. After the NMD had moved in, they observed evidence of pests in the apartment. Property Management was notified by the NMD. The facility was notified and they arranged for pest control service to treat the NMD's apartment. LPA verified work from the pest control company. Pests reportedly continue to be a concern, but the degree reported in interviews is inconsistent. The NMD is actively seeking new housing with assistance from the county and agency social worker. Based on LPA's observations, interviews which were conducted, and records reviewed, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. A signed copy of this LIC 9099 report, the LIC 9099-C, and appeal rights were provided to the facility. An exit interview was conducted.

Investigation Findings:
13Licensing Program Analyst (LPA) Yesenia Vallejo arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Marrisa Juarez, Regional Director. LPA Vallejo conducted the complaint investigation. Licensing Program Manager (LPM) Hillary Hall initiated the investigation with the facility on 9/30/25 and met with Reyna Lopez. During the course of the investigation, LPA interviewed two agency social workers (ASW), one County Social Worker (CSW,) and one non-minor dependent (NMD). LPA reviewed records including: case notes, agency placement agreement, Needs and Service Plans (NSP's), home inspection checklist, emergency plan, photos, and pest control records. Continued on LIC 9099-C. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Yesenia Vallejo 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: CHILDREN FIRST THPP/THP+FCFACILITY NUMBER: VISIT DATE: 10/23/2025

met_with: Marrisa Juarez- Regional Director


summary: Facility Evaluation

raw_content:
Narrative:
On 06/24/2025 at 10: AM, Licensing Program Analyst (LPA) Yesenia Vallejo met with Children First Transitional Housing Regional Director, Karen Kemp to conduct a pre-licensing inspection at their new location. The new THPP/THP+FC facility is conveniently located for the public. LPA conducted a walk through of the facility. LPA observed as you enter the building the office has a reception waiting area with a glass room divider that overlooks into the reception office. In order to be let in to the office building, receptionist unlocks the door manually with a clicker button. The receptionist sits at the front end of the office and there are two desk areas behind receptionist for additional working space. The building has six offices, four are occupied by staff, each with a keypad required for entry, another office is used as a private visitation room, and the other as an additional meeting space. There is a staff lounge located at the back end of the office which is also used for staff meetings. There is a storage closet that contains food and supplies for clients if needed, and two key lock boxes for client and staff keys. To the left side of the hallway there is an additional hallway where two all gender bathrooms are located, one bathroom is for clients and the other has is staff only. At the back end of the building there is an additional point of entry by the handicapped designated parking and is wheelchair accessible. Client files are confidential and locked in filing cabinets in reception area. Additional files waiting to be scanned are located in the locked storage closet. There are four locked mailboxes outside each staff office that can be used to temporary store client files when staff is out. Emergency Disaster Plan and foster youth bill of rights is posted in the reception waiting area. An exit interview was conducted with facility representative, and a copy of the report was provided.

visit_type: Prelicensing

met_with: Karen Kemp-Regional Director


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Yesenia Vallejo arrived at the facility on this date for the purpose of a case management inspection regarding deficiencies found in record review. LPA met with Marissa Juarez, Regional Director (RD). LPA reviewed records including four Needs and Services plans (NSP) for four non-minor dependents from 2025. LPA observed 3 out of 4 not signed by authorized representatives, 1 out of 4 not signed by non-minor dependents. 4 out of 4 did not show evidence of the non-minor dependent participating in the development of the NSP. 4 out of 4 do not show evidence of current service needs or plans of how the agency will provide services to meet the non-minor dependents' needs. During an interview Agency Social Worker (ASW) stated non-minor dependents and ASW only work collaboratively on the "participants goal" sheet of the NSP which is a standalone document. However, the signature line for non-minor dependent is contradictory because it reads "I participated in the development of this Appraisal/Needs and Service Plan and have been offered a copy". The facility is issued one citation for ILS 86268.3 (b,c, and d). A signed copy of this LIC-809 and LIC-809D were provided to the facility. An exit interview was conducted and Appeal rights provided.

met_with: Marissa Juarez- Regional Director


facility_name: COURAGE TO CHANGE

summary: Facility Evaluation

raw_content:
Narrative:
On November 5, 2024, a Component II Orientation was conducted by LPA Licensing Program Analyst (LPA) Vanessa Galvan met with Administrator Susan Gambini, Program Director Gary Bonds, and Intake Case Manager Alex Gonzales. The following was addressed and discussed: The program expectation/review. An overview of the first revision letter. Informed the applicants of corrections needing to be made to the application for section A. Revisions to the Plan of Operation (POO)/Program Statement (PS) to meet regulatory standards. Foster Care Rates application Guardian Association The Pre-License inspection is scheduled 11/21/2024 at 10:00 am at the location of N. Anderson Road, Exeter, CA 93221. A copy of this report was provided to Susan Gambini at the conclusion of the meeting.

met_with: Susan Gambini, Gary Bonds, and Alex Gonzales


summary: Facility Evaluation

raw_content:
Narrative:
On November 22, 2024, Licensing Program Analysts (LPAs) Vanessa Galvan and Olivia Medrano traveled to the Courage to Change Transitional Housing Program office located in Exeter, CA. LPAs met with Administrator Susan Gambini and Program Director Gary Bonds. The purpose of a scheduled pre-licensing inspection. A general overview of their program and a tour of the facility was provided. This facility has a reception area, waiting area, and office space for staff. Observed fixtures and furniture, equipment and supplies necessary for this operation. Also observed locked closet for client and staff files in order to ensure confidentiality. There is confidential space for meeting with clients on an as needed basis. The above licensee meets the requirements to be licensed as a THPP serving clients age 18-21 within a two hour driving radius pending approval of updates requested during the component II orientation. Applicant will submit updated version of the program statement and application to Foster Care Rates. On a quarterly basis, facility is to submit a roster of THPP clients that includes client names, dates of birth, county worker, current address of placement and certificate of compliance for each unit. A copy of this report was discussed and provide to Gary Bonds at the conclusion of the inspection.

met_with: Gary Bonds & Susan Gambini


summary: Facility Evaluation

raw_content:
Narrative:
On June 19, 2024, Licensing Program Analyst (LPA) Vanessa Galvan met with Applicant/Program Director Gary Bonds. The purpose of the meeting was to conduct a Technical Assistant meeting to discuss the Program Statement, fourth revision letter and get a status update. The following was addressed and discussed: The program expectation/review. An overview of the fourth revision letter. Reviewed fourth revisions from applicant- A & B sections, and Plan of Operation (POO)/Program Statement (PS). Foster Care Rates application status LPA a copy of Title 22, Division 6, Chapter 7, Article 03. Application Procedures, section 86022, Plan of Operation A copy of this report was provided to Gary Bonds at the conclusion of the meeting.

met_with: Gary Bonds


summary: Facility Evaluation

raw_content:
Narrative:
On February 6, 2026, Licensing Program Analyst (LPA), Vanessa Galvan traveled to Courage to Change Transitional Housing Placement Program located in Exeter, CA and met with Program Director Gary Bonds, Case Manager Juan Rodriguez, and Administrative Assistant Debbie Lopez. The purpose of the inspection was to provide Technical Assistance (TA) regarding record requirements and Regulatory standards. LPA provided TA for the client and staff records. LPA reviewed the Program Statement and Title 22, Division 6, Chapter 7, Subchapter 2. Transitional Housing Placement Program for Nonminor Dependents with the Program Director. A copy of this report was provided to Gary Bonds at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On February 6, 2026, Licensing Program Analyst (LPA), Vanessa Galvan traveled to Courage to Change Transitional Housing Placement Program located in Exeter, CA and met with Program Director Gary Bonds, Case Manager Juan Rodriguez, Human Resource Generalist Ray Lopez and Administrative Assistant Debbie Lopez. The purpose of the inspection was to conduct a Component III Orientation. LPA reviewed Transitional Housing Placement Program Rules, Regulations, and licensing forms to prepare Licensee to maintain and operate their facility and provide information to avoid potential problems areas. The following were addressed and discussed: Title 22, Division 6, Chapter 7, Subchapter 2. Transitional Housing Placement Program for Nonminor Dependents and General Regulations. Safeguards for Cash Resources, Personal Property, and Valuables, Bonding, Finances, Accountability. Reporting Requirements, Emailing Incident Reports to the CCLD Inbox Fresno. Administrator & Social Worker- Qualifications and Duties, Personnel Requirements, and Criminal Record Clearance. Admission Agreements, Participants Medical Assessment, Register of Clients, Personal Rights. Telephones, Transportation, Health Related Services, Food Services, Responsibility for Care & Supervision, Activities, Building and Grounds. Inspection Authority of Licensing Agency, Department Approval for Remote Site Model, Waivers and Exceptions. Complaints and the LPA, Deficiency Types, Extension Request, Types of Civil Penalties, Providers Information Notices (PINs), Complaint and Regulatory Enforcement CARE Tools, Officer of the Day, TSP Services. This report was discussed and provided to Gary Bonds at the conclusion of the inspection.


summary: Facility Evaluation

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Narrative:
On February 19, 2026, Licensing Program Analyst (LPA), Vanessa Galvan traveled to Courage to Change Transitional Housing Placement Program located in Exeter, CA and met with Program Director Gary Bonds and Administrative Assistant Debbie Lopez. The purpose of the inspection is to conduct a post-licensing inspection. LPA Galvan conducted a physical plant inspection and included the following observation and checks: client and staff files are kept in locked filing cabinets. The agency has adequate confidential meeting space, space for Social Worker and Case Manager to complete job duties. The facility has a current copy of the license, Facility Sketch, Client Personal Rights, LIC 610C, posted in a common area. The agency has a client register roster LIC 9120, with all required information. The agency's office is located within two hours of travel time of the THPP participants living units. The agency employs (1) Administrator (1) Social Worker Supervisor/Social Worker, (1) Program Director, (1) Case Manager, (1) Administrative Assistant. LPA Galvan reviewed three staff files. A review of the staff files on this date indicates that all facility staff have received child abuse index and fingerprint clearances. Agency staff meets the requirements of respective job descriptions. Staff files meet regulatory standards. The agency currently has (1) THPP NMD participants. LPA Galvan reviewed (1) THPP NMD Participant files on this date. Client files meet regulatory standards. LPA reviewed an updated LIC 500, roster of clients, and certificate of compliance for the THPP unit. LPA discussed the client's medical assessments, TILP documentation. No deficiencies were cited on this date. An exit interview was conducted, and a copy of this report was provided to Gary Bonds at the conclusion of the inspection.


facility_name: COVENANT COMMUNITY SERVICES,INC

summary: Facility Evaluation

raw_content:
Narrative:
On July 13, 2021 at 9: AM, Licensing Program Analyst (LPA) Zeyda Loera conducted a Pre-licensing inspection visit of the facility. LPA met Randy Martin, CEO/Administrator. This Transitional Housing Placement Program (THPP) will share the same suite with Covenant Community Services and Covenant Coffee. Currently, the THPP office is staffed by one (1) CEO/Administrator, (1) Manager of Operations, (1) Administrator Assistant, As soon as, Covenant is licensed one (1) Social Work and one (1) Case Management will be hired. LPA completed a tour of the THPP's administrative office. The office is conveniently located for the public. LPA observed individual office for the CEO/Administrator. Manager of Operations and Administrator Assistant are sharing an office. The social worker and case management will have workspace in a common space. There is large conference room, small conference room and copy/storage room. The THPP participant records will be filed in a locked filing cabinet in the copy room and the THPP employee records will be filed in a locked cabinet in the Manager of Operations/ Administrator Assistant office. The THPP will have available computers and printers for participants' use. This THPP will use Remote Site models to place non-minor dependent (NMD) participants. Currently, the program has identify an available apartment with four (4) apartment units. Each unit has two (2) bedrooms and one (1) bathroom. A copy of the lease agreement and a sample floor plan was provided. The THPP will complete and sign a Certificate of Compliance for each THPP participant living unit, as defined in Section 86001(c)(2), that verifies that the participant living unit meets the requirements of the Health and Safety Code Section 1501(b)(5). (Ref. California Code of Regulations, Title 22, Division 6, Chapter 7, Article 3, Section 86030.5.) The THPP has not identified any host families at this time. The applicant will notify the Department once host families are identified. LPA concluded the visit at 1: PM. A signed copy of this report was provided to the applicant.

met_with: Randy Martin, Adminstrator


summary: Facility Evaluation

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Narrative:
On July 27, 2023 at 11: AM, Licensing Program Analyst Elva Lopez and Licensing Program Manager Jean Herring conducted a required 2- year inspection at the Transitional Housing Placement Program (THPP) office. LPA and LPM met with Randy Martin, Administrator. During this inspection, a tour of the THPP administrative office was conducted with Mr. Martin. The THPP administrative office shares the same office with Covenant THP Plus Program. The office is conveniently located for the public. The office has a reception area, file room, copy area, conference room and individual offices for the Administrator and Program Managers. Currently the THPP has no non-minor dependents (NMD) in placement. THPP participant records will be kept in steel filing cabinets located in the file room which is kept locked at all times. The THPP personnel records are kept upstairs in the administrator's office. The administrative office has telephone service at all times. LPA and LPM reviewed the following: disaster preparedness plan, administrator's record, and background clearances. LPA and LPM interviewed staff #1. During this inspection, LPA and LPM provided three(3) Advisory Notes-Technical Violations related to training requirements and Disaster Plan. The program has no remote sites at this time. A signed copy of this report was provided to the licensee along with LIC TV. Exit interview conducted.

met_with: Randy Martin, Administrator


summary: Facility Evaluation

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Narrative:
On Wednesday December 10, 2025, at 11:00AM, Licensing Program Analyst (LPA) Humberto Flores, conducted an unannounced Case Management Inspection, at Covenant Community Services, Transitional Housing Placement Program (THPP) and met with THPP Social Worker (SW)Linda Sandoval and Case Manager (CM) Linda Sandoval. The purpose of the inspection was to gather information about the below incident reported via Special Incident Report (SIR). The SIR that the THPP reported to Community Care Licensing Division (CCLD) stated that "...youth was last seen at housing site Monday afternoon". After a review of the SIR and Case Notes LPA Flores verified that Participant #1 (P1) was last seen, in-person on site on August 4, 2025. According to documentation provided from P1's file, staff reviewed the facility cameras and observed P1 leaving the facility on Tuesday 8/05/25, at 11:36AM. Documentation from P1's file states that on 08/07/25, she was arrested for trespassing a property and released shortly after, this last Law Enforcement Contact was not notified to CCLD. The facility representative was instructed to send to CCLD an addendum of the SIR that reported the absent without leave (awol) of P1 and a separate SIR to report her arrest on 08/07/2025. An LIC Advisory Notes/Technical Assistance and an Advisory Notes/Technical Violation will be issued. No further inspection is needed. cont.# A copy of this report, LIC9102 and LIC811, was provided to the facility representative. Exit interview conducted.

met_with: Social Worker, Elizabeth Hurley


facility_name: COVENANT HOUSE CALIFORNIA

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mercy Gago and Licensed Program Manager 1 (LPM) Alan Henry, had a Zoom Meeting/ Office Tour with Marissa Espinoza, Covenant House California Senior Vice President of the Southern CA Region. The administrative office is located at N. Western Avenue Los Angeles, CA 90027. LPA Gago and LPM Henry toured the office at 1325. Western Avenue, Los Angeles, CA 90027. The tour encompassed the Administrative Executive area, Human Resources Office, Therapy Office, and a conference room. Staff indicated that there are single rooms that will be utilized as therapy rooms or to speak to participants privately. Staff indicated that participate records shall be maintained in a secure area or a locked file cabinet in the administrative office, while staff records shall be maintained in a secure area in the Human Resources office. LPM advised to submit criminal background transfer requests for Bill Bedrossian and Marissa Espinoza. Exit interview completed.

met_with: Marissa Espinoza


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) Mercy Gago and Licensed Program Manager 1 (LPM) Alan Henry, had a Zoom conference meeting with Bill Bedrossian, Chief Executive Officer; Ami Rowland, Chief Operations Officer; and Marissa Espinoza, Senior Vice President of the Southern CA Region. THPP application and Program Statement were reviewed and discussed with staff. The following documents are needed and should be submitted to licensing within 30 days, June 23, 2020. 1. Revise program section to reflect Covenant House California's policies and procedures concerning when and how to involve law enforcement in response to an incident at THPP living unit, and how these polices and procedures will be communicated to staff, participants, and to participant's authorized representatives. 2. Follow up with bank regarding Financial information Release and Verification. 3. Submit Criminal background transfer requests for Bill Bedrossian and Marissa Espinoza. Exit interview completed.

met_with: Bill Bedrossian, Marissa Espinoza, and Ami Rowland.


summary: Facility Evaluation

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Narrative:
On January 5, 2022 at 12pm Licensing Program Analyst (LPA) Donald Martin arrived at the above facility for the purpose of conducting a Post Licensing Inspection. LPA was met by Beverly Meza-Administrator and allowed into the office Due the CEO not being in the office, LPA was unable to access the office files and facility documents needed to conduct the inspection. LPA will reschedule the visit to a later date. Nothing further to report at this time.

met_with: Beverly Meza-Administrator


summary: Facility Evaluation

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Narrative:
On February 24, 2022 at 10am Licensing Program Analyst (LPA) Donald Martin conducted an Annual/Required inspection for the above facility. LPA met with Beverly Meza, Administrator and conducted a facility walk through. The tour encompassed the Administrative Executive area, Human Resources Office, Therapy Office, and a conference room. Staff indicated that there are single rooms that will be utilized as therapy rooms or to speak to participants privately. Staff indicated that participate records shall be maintained in a secure area or a locked file cabinet in the administrative office, while staff records shall be maintained in a secure area in the Human Resources office. Administrator stated that they have yet to receive any clients. The facility is still in contact with DCFS about the matter. No deficiencies were cited at the time of the visit.


summary: Facility Evaluation

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Narrative:
On July 5, 2022 at 1pm Licensing Program Analyst (LPA) Donald Martin conducted an Annual/Required inspection for the above facility. LPA met with Lailanie Jones, SVP and conducted a facility walk through and file review. The tour encompassed the Administrative Executive area, Human Resources Office, Therapy Office, and a conference room. Staff indicated that there are single rooms that will be utilized as therapy rooms or to speak to participants privately. Staff indicated that participate records shall be maintained in a secure area or a locked file cabinet in the administrative office. Administrator stated that they have yet to receive any clients. The facility is still in contact with DCFS about the matter. Staff folder-(BB) All documents are present. CPR/First Aid has expired. SVP stated that all staff will be certified as a group at the end of July. No deficiencies were cited at the time of the visit.

met_with: Lailanie Jones-SVP


summary: Facility Evaluation

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Narrative:
On June 21, 2022 at 11:30am Licensing Program Analyst (LPA) Donald Martin arrived at the above facility for the purpose of conducting a Required Annual Inspection for the THPP program. LPA met with SVP, Lailanie Jones and conducted a facility walk through and file review. The tour encompassed the Administrative Executive area, Human Resources Office, Therapy Office, and a conference room. Staff indicated that there are single rooms that will be utilized as therapy rooms or to speak to participants privately. Staff indicated that participate records shall be maintained in a secure area or a locked file cabinet in the administrative office. Administrator stated that they have yet to receive any clients. The facility is still in contact with DCFS about the matter. Staff folder-(LJ) All documents are present. No deficiencies were cited at the time of the visit.


facility_name: CREATIVE ALTERNATIVES, INC.

summary: Facility Evaluation

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Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco traveled to the Creative Alternatives Foster Family Agency in Turlock for the purpose of conducting an unannounced Annual inspection and met with Program Administrator Bruce Cresswell. LPA Tinoco reviewed 2 staff files and 9 client files. No Deficiencies were cited on todays visit. A copy of this report was left at the agency at the conclusion of the inspection.

met_with: Bruce Cresswell


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco traveled to the Creative Alternatives Foster Family Agency in Turlock for the purpose of conducting an unannounced Annual inspection and met with Program Administrator Bruce Cresswell. LPA Tinoco reviewed 3 staff files and 5 client files, conducted 2 staff interviews and a walk through inspection of the main THP office. One type B Deficiency was cited on todays visit. A copy of this report was left at the agency at the conclusion of the inspection along with Appeal Rights.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco traveled to the Creative Alternatives Main Office in Turlock for the purpose of conducting an unannounced Annual Required inspection and met with Program Administrator, Bruce Cresswell. The agency employs Social Worker and Administrator for the THP Program. LPA Tinoco reviewed 2 staff files and 5 client files. 1 staff interview was conducted on this date. A Guardian check conducted on 4/15/26 confirmed that all the staff on the LIC500 are fingerprint cleared and associated to the facility. A walk through inspection of the main THP office was conducted on this date. LPA observed the office to be clean and in good repair, adequate office space and ability to maintain staff and client files locked. Technical Violations for training were issued on today's date. A copy of this report was signed and provided at the conclusion of the inspection.


facility_name: CRITTENTON SERVICES FOR CHILDREN & FAMILIES SVCS

summary: Facility Evaluation

raw_content:
Narrative:
On 8/31/21 at 9: AM, Licensing Program Analyst (LPA) Donald Martin conducted an Annual Inspection. LPA met with the Program Director, Kendra Tankersley -Davis, who gave LPA a tour of the office. The Administrative Office, is located at Pacific Commerce Dr. Rancho Dominguez, CA 90221. The Facility is Licensed to provide Transitional Housing Placement-Plus Foster Care (THP+FC) services to Non-Minor Dependents up to 30 participants ages eighteen (18) to twenty one (21). There are currently 6 participants in placement. The office is set up as follows: This office is a two-story office space. This office is used for Participants, Administrator, Case Managers, and for the THP for NMD program. First floor: lobby/sitting which includes the Reception area. Access is gained via keycard entry. LPA observed the following: 2 supply closets, 4 bathrooms, 2 conference rooms, meeting rooms, a break room, staff offices, and chart room. The charts room is also keycard entry and contained several file cabinets were secured with a padlock. Second floor: 2 bathrooms, staff offices, training room, and clinical offices. COVID 19 signage and office policies were posted on the main door and throughout the building. Additionally, there was hand sanitizer and hand washing station. LPA will travel to the Fullerton location; E. Chapman Ave. # Fullerton, CA. 92831 to view the staff and client records. Cont. 809-C LPA arrived at the Fullerton Corporate Office to view the Staff and Client charts. LPA met with Program Director Kendra Tankersley-Davis and Vice President of Community Services, Cesar Salgado, LPA viewed the Staff file of Case Manager, Tiffany Ramirez. All documents were present and in order as well as all training hours completed. LPA viewed the client file of Maria Ramirez, DOB 5/5/01. All documents were present and in order. No deficiencies were cited at the time of inspection. Exit interview was conducted and a copy of this report was left with the Program Director, Kendra Tankersley-Davis.

met_with: Kendra Tankersley- Davis-THPP Program Director


summary: Facility Evaluation

raw_content:
Narrative:
On June 16, 2022 at 12:37pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Crittenton Services for Children and Family Services for the purpose of conducting an Annual Required Inspection. LPA met with Kendra Tankersley -Davis, Program Director who granted access into the administrative office and together a tour was conducted. The Administrative Office is located at Pacific Commerce Dr. Rancho Dominguez, CA 90221. The Facility is licensed to provide Transitional Housing Placement-Plus Foster Care (THP+FC) services to Non-Minor Dependents up to thirty (30) participants ages 18-21 years of age. There are currently seven (7) participants in placement. The office is set up as follows: This is a two-story office space. This office is used for Participants, Administrator, Case Managers, and for the THPP for NMD program. First floor: Has a lobby/sitting area which includes a reception area. Reception area is equipped with eight (8) sofa chairs, love seat, coffee table, and two (2) end tables. Access to this area is gained via card entry. There are four (4) supply closets, four (4) bathrooms, two (2) conference rooms, meeting rooms, staff break room, staff offices, and chart room. All bathrooms are clean and sanitary. Hot water tested within a safe temperature range. The chart room is also accessed via keycard entry and contains several file cabinets secured with padlocks. First Aid kit had tweezers, scissors, and thermometer. All regulation fire extinguishers were fully charged and operable. All smoke detectors/carbon monoxide detectors tested audible. Second floor: Has two (2) bathrooms, several staff offices, training room, and clinical offices. All bathrooms are clean and sanitary. Hot water tested within a safe temperature range. Continued on LIC 809-C COVID 19 signage and office policies were posted on the main door and throughout the building. Additionally, there was hand sanitizer and hand washing station. Caregiver(s)/adults working/residing in the facility have DOJ/FBI criminal record clearances and Child Abuse Index Checks. LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. All posting requirements were met. LPA will review staff records and conduct staff interviews on a later date. LPA advised Program Director of email address to submit Special Incident Reports (SIR's). Program Director stated staff and client files are kept in the corporate office in Fullerton, CA. LPA advised Program Director that files must be made available for inspection at the facility. LPA also advised that a written request must be made to Community Care Licensing if the licensee wishes to keep the files at the corporate office in Fullerton. LPA will review client records and conduct unit site inspections on a later date. Program Director advised all participant housing is in Buena Park and Anaheim. LPA advised Program Director of Licensing Fees of $908.00 due by August 8, 2022. No deficiencies were cited at the time of inspection. Exit interview was conducted and a copy of this report will be emailed to the Program Director.


summary: Facility Evaluation

raw_content:
Narrative:
On July 14, 2022 at 9:14am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Crittenton Services for Children and Family Services for the purpose of conducting a Case Management Visit for an Annual Required Inspection which took place on June 16, 2022. LPA met with Kendra Tankersley -Davis, Program Director who granted access into the administrative offices. The Administrative Office is located at Pacific Commerce Dr. Rancho Dominguez, CA 90221. The Facility is licensed to provide Transitional Housing Placement-Plus Foster Care (THP+FC) services to Non-Minor Dependents to thirty (30) participants ages 18-21 years of age. On the date of this visit, there are eight (8) participants in placement. The office is set up as follows: This is a two-story office space. This office is used for Participants, Administrator, Case Managers, and for the THPP for NMD program. During this visit, LPA reviewed three (3) staff records and conducted three (3) staff interviews. Caregiver(s)/adults working/residing in the facility have DOJ/FBI criminal record clearances and Child Abuse Index Checks. Emergency Mass Disaster Casualty Plan was available for review. LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. Direct care staff have valid CPR and First Aid training. All posting requirements were met. During this visit, LPA reviewed five (5) client records. Client records contained copies of Needs and Service Plans and Medical Authorizations signed by each child and their authorized representative. Children are accorded dignity in personal relationships with staff and others. Continued on LIC 809-C Off Site Living Units Inspected: 1. Lincoln Avenue #4203, Buena Park, CA 90660 2. Lincoln Avenue #1203, Buena Park, CA The off-site living units were inspected, and the following was observed: The licensee operates within capacity limitations. There were no firearms or other weapons observed inside of the living units. No bodies of water on living unit premises. Overall, the offsite living units are safe, sanitary, and in good repair for the safety and wellbeing of clients, employees, and visitors. Smoke detectors and carbon monoxide detectors tested audible and are in operable condition in the living units. There is a fully charged regulation fire extinguisher in the units. Hot water was tested in the inspected living units and is within a safe temperature range. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit Interview was conducted, and a copy of this report will be emailed to the Program Director.


summary: Facility Evaluation

raw_content:
Narrative:
On August 13, 2024, at 2:30pm, Licensing Program Analyst (LPA) Kim Dear, Justine Armstrong and (LPM), Licensing Program Manager, Bernice Karnsrithong made an unannounced visit to Crittenton Services for Children and Family Services located at Pacific Commerce Dr. Rancho Dominguez, CA 90221, for the purpose of conducting an annual required Inspection. LPA's and LPM met with Elizabeth Arellano, the Program Director who provided entry and tour of the facility. LPA was provided the current census and LIC 500 employee roster by the Program Director. The Facility is licensed to provide Transitional Housing Placement Plus Foster Care (THP+FC) services to Non-Minor Dependents, up to thirty (30) participants ages18-21 years of age. There are currently (7), seven participants in placement. First floor: A tour of the facility was conducted and inspected all emergency evacuation procedures. The lobby/sitting area has a reception area with eight (8) sofa chairs, love seat, coffee table, and two (2) end tables. Access to this area is gained via card entry. There are four (4) supply closets, four (4) full bathrooms, two (2) conference rooms, meeting rooms, staff break room, staff offices, and chart room. All bathrooms, (2), two, are clean and sanitary. The entry and exit to the chart room is accessed via key card(s). The facility has several file cabinets secured by padlocks, and there are adequate amount of First- Aid kits that are available throughout the floor. All fire extinguishers, smoke/ carbon monoxide detectors were tested and operable. Two (2) Client files and two (2) staff files were reviewed however, no client(s) present during the inspection. One (1) staff required interviewed was not completed and will also be rescheduled later On August 26, 2024 at 10:00am, Licensing Program Analyst (LPA) Kim Dear, made an announced visit to Crittenton Services for Children and Family Services located at Pacific Commerce Dr. Rancho Dominguez, CA 90221, for the purpose of conducting an interview with Kathlene Raymundo, (1) one of the current Case Managers. Elizabeth Arellano, the Program Director allowed access to the conference room. This office is used for participants, administrator(s), and case managers, for the THPP for NMD program. The facility continues to be licensed to provide transitional housing placement, plus foster care/ (THP+FC) services to non-minor dependents; up to thirty (30) participants, ages 18-21 years of age. There are currently (7), seven participants in placement. At the inspection's conclusion, it was determined that all practices and procedures maintain compliance. An exit review was conducted with the program director and a copy of the inspection will be provided. There were no deficiency identified at this time.

met_with: Elizabeth Arellano


facility_name: DAISY'S HOUSE

raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward conducted an investigation of the above allegations. LPA interviewed Clients #1, #2 and #3 and reviewed their written statements. LPA Jones-Steward also interviewed Staff #1. LPA Deborah Lee interviewed Program Manager Rickia Egans and Staff #1. A copy of the internal investigation, social worker's report and safety plans were all reviewed. Based on a review of the available evidence and due to inconsistent stories from the involved parties, LPA Jones-Steward was not able to substantiate that Staff #1 requested to shower in the clients' apartment or that Staff #1 entered the clients' living quarters inappropriately. Therefore both allegations are resolved as unsubstantiated. Unsubstantiated means that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: David Egans