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***This is an amended report*** On May 6, 2022, Community Care Licensing (CCL) received an allegation alleging Minors are using illegal drugs (methamphetamine) while in care. Specifically, it was reported minors are engaging in methamphetamine use at the facility. Record review and confidential interviews could not confirm or dispute the use of methamphetamine at the facility. Confidential interviews confirmed some residents do use methamphetamine however, where and when the use of the illegal drug occurs could not be confirmed. Based on record review and confidential interviews the allegation of Minors are using illegal drugs (methamphetamine) while in care, may or may not have occurred, however it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights to Alpha Connections - Nisqually Nest Program Director Elysia Moore

Investigation Findings:
13***This is an amended report of a report that was originally issued on 9/8/2022*** On 9/8/2022, 2022 at 11: AM Licensing Program Analysts (LPA) Joon Choi and Jessica Peete, met with Alpha Connections - Nisqually Nest Program Director, Elysia Moore to deliver the finding for the above stated allegation. The investigation was conducted by Special Investigator (SI) Britany Hudec and LPA Strickland and included interviews with seven foster youth (Child #1 [C1], Child #2 [C2], Child #3 [C3], Child #4 [C4], Child #5 [C5], Child #6 [C6] and Child #7 [C7]), seven staff members (Staff #1 [S1], Staff #2 [S2], Staff #3 [S3], Staff #4 [S4], Staff #5 [S5], Staff #6 [S6] and Staff #7 [S7]), ADM, two San Diego Department of Children and Family Services (DCFS) County Social Workers (CSW [CSW1] and [CSW2]) two Kings County DCFS CSWs (CSW3 and CSW4), and Kings County DCFS Investigator. In addition, county records and facility records were reviewed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Joon R Choi LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-NISQUALLY NEST, THEFACILITY NUMBER: VISIT DATE: 09/08/2022

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


state: CA

facility_name: ALPHA CONNECTION-NISQUALLY NEST, THE

summary: Complaint Investigation - Unsubstantiated

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Narrative:
allegation. Confidential interviews denied allegation that S1 or any other staff is physically aggressive towards C1. According to confidential information, C1 has a history of making false statements or allegations against peers and staff. While other confidential Information received by Licensing Office stated that this allegation had occurred, and that staff had physically been aggressive towards C1. There were no other known witnesses to this allegation. Based on interviews and confidential information obtained during the course of this investigation, the allegation that Staff are physically aggressive with youth in care, may have occurred, however is not supported or proven by evidence. Therefore, the above allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Group Home (GH) Facility Manager, Kaytee Owen to discuss the investigative findings for the above stated allegation. LPA Mena conducted inspections to the GH on March 16, 2026, and on April 09, 2026. No immediate hazards were observed. LPA Mena interviewed three of three foster children in care [Foster Child # 1 (C1), Foster Child # 2 (C2) & Foster Child # 3 (C3)], County Social Worker (CSW), Facility Administrator (AD), Program Director (PD), two Staff [Staff # 1 (S1) & Staff # 2 (S2)], as well as reviewed facility and client information. Community Care Licensing received information on March 11, 2026, alleging that Facility Staff are physically aggressive towards youth. Information obtained in confidential interviews did not corroborate the allegation with a preponderance of evidence. Confidential interviews provided conflicting statements regarding the Continues on next page UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Nicole Strickland LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-NISQUALLY NEST, THEFACILITY NUMBER: VISIT DATE: 05/01/2026

report_type: Complaint Investigation

met_with: Kaytee Owen

complaint_status: unsubstantiated


facility_name: ALPHA CONNECTION-SHOSHONEE PLACE, THE

summary: Complaint Investigation - Unsubstantiated - 1 allegation

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clients in this facility. Community Care licensing also received an allegation that minors are unable to sleep while in care. Confidential interviews reported that sometimes at night it's loud. Confidential interviews reported that there are no music playing or loud talking going on at night that prevents clients (C1-C6) from sleeping. Confidential interviews reported that sometimes at night can be noisy but it hasn't been noisy in about two months. Other confidential interviews reported that clients are able to sleep during the night. Based on confidential interviews and information obtained, the allegations that conduct inimical-staff provided drugs and alcohol to minors (C1-C11) while in care, sexual abuse-staff sexually abused the minors (C1-C11) while in care, firearms are present in the facility, staff encouraged the minors (C1-C11) to fight one another while in care, staff did not safeguard the minor's (C5 & C9) personal belongings, minors (C1-C11) are unable to sleep while in care may have occurred, however; is not supported by evidence. Therefore, the allegations are unsubstantiated. A copy of this report and appeal rights were provided to Emanuel Wiley, STRTP Facility Director. witnessing any staff smoking with clients. Confidential interviews reported that S1 denied the allegation. In addition, confidential interviews reported that staff denied witnessing S1 smoking marijuana or providing marijuana to the clients. Confidential interviews reported that staff denied they provided drugs or alcohol to any of the clients at the facility. There were no videos or photographs of the incidents. Community Care Licensing also received an allegation that staff sexually abused the minors (C1-C11) while in care. Confidential interviews reported that clients had sex with S2 but laughed afterwards. Confidential interviews reported that clients bragged they had sex with S2. Confidential interviews denied having a sexual relationship with any of the clients at the facility. Other confidential interviews reported that no one witnessed any inappropriate behavior between clients (C1-C11) and staff. Additionally, a confidential interview denied sexual intercourse with any staff. There were no videos or photographs of the incidents. Community Care Licensing also received an allegation that firearms are present in the facility. Confidential interviews reported that C1 posed with a firearm on social media. Law Enforcement determined the firearm was not real and was an air soft gun. Confidential interviews reported that no firearms were confiscated or on the premises. Confidential interviews reported that clients (C1-C6) haven't had not seen any firearms in the facility. Other confidential interviews reported that clients haven't heard any conversations about firearms between staff and clients (C1-C6). Other information received stated that firearms are present at the facility. Community Care Licensing also received an allegation that staff encouraged the minors (C1-C7) to fight one another while in care. Confidential interviews reported that S3 paid the clients to fight each other as a form of discipline. Other confidential interviews reported that all the clients get along with each other and did not witness staff encouraging clients to fight. Confidential interviews reported that staff doesn't force clients to fight other clients. Confidential interviews reported that some of the clients attempt to have other clients fight each other while other confidential information stated that the allegation was true. Community Care Licensing also received an allegation that staff did not safeguard the minor's personal belongings. Confidential interviews reported that a client (unknown) used C9's scooter. When staff located the scooter, it was returned to C9 damaged/broken. Other confidential interviews reported that staff denied damaging the scooter. Confidential interviews reported that C5 have had some personal items taken by other clients (unknown) and the clients doesn't tell the truth about taking the items. Confidential interviews reported that clients (C1-C4 & C6) haven't had any of their personal belongings taken from staff or from other

Investigation Findings:
13On October 05, 2021 at 4:26pm, Licensing Program Analyst (LPA), Cheraki Davis met with Emanuel Wiley, Short Term Residential Therapeutic Program (STRTP) Facility Director to deliver the finding for the above complaint allegations. The investigation was conducted by Special Investigator Charlotte Jackson of the Community Care Licensing (CCL) Investigations Bureau. Investigation included interviews with Contra Costa County Social Worker, Program Director, Facility Managers, clients (C1-C11), staff, and one adult. Law Enforcement Contact Reports, Appraisal/Needs and Services Plans, Emergency Response Referral Information, and incident reports were reviewed. On May 26, 2021, Community Care Licensing received an allegation which stated staff (unknown) provided drugs and alcohol to minors (C1-C11) while in care. It was reported that staff (unknown) regularly bought drugs and engaged in drug and alcohol use with clients (C1-C11). Confidential interview reported that S1 provided clients with marijuana, took them to buy marijuana, and smoked marijuana with clients at the facility. Other confidential interviews reported that clients denied staff provided them with drugs or alcohol and UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Cheraki Davis LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-SHOSHONEE PLACE, THEFACILITY NUMBER: VISIT DATE: 10/05/2021

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

met_with: Emanuel Wiley


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Additional confidential witness statements indicate that several clients allowance are locked up in the staff office and that the facility staff transport the clients to the store and purchase the items for the clients at the store. CSW also stated that the facility had informed her that they were not going to give C1 his allowance money to hold on his person but instead were going to purchase items that C1 had requested from the store. CSW went on to add that C1 would go AWOL with his money and would return to the home with alcohol, marijuana, and other substances. Based on confidential interviews, the allegation that alleged client #1 (C1) that alleged the clients are not given allowance and that the clients are not provided educational rights., may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Program Director (PD), Amy Osborn. Additional confidential witness statements indicate that C1 was without clothing for approximately two months. Confidential witness statements revealed that C1 had written a list of C1's missing clothing and submitted it to the FM and S1 to fax to the cooperate office. Additional confidential witness statements indicate that C1's missing clothing list was submitted to the corporate office on two different dates. Confidential witness statements revealed that the facility staff were waiting for CEO's approval to release the funds to purchase C1's clothing. During LPA inspection of C1's bedroom C1 had the following items two pair of basketball shorts, a pair of sweats, four pairs of underwear, red pajama pants, and three to four pairs of socks. Additional confidential witness statements indicate that FM and S1 had contacted Program Director, Amy Osborn regarding the funds to purchase C1's clothing. CSW stated that the STRTP facility had informed her that the facility was going to replace C1's clothing. Based on confidential interviews and LPA's observations, and physical inspection at the facility, the facility did not ensure that client #1 (C1) had adequate clothing is Substantiated because the preponderance of evidence standard has been met for the allegation. This poses a potential health, safety, or personal rights risk to clients in care. The facility is being cited under Short-Term Residential Therapeutic Program Interim Licensing Standards (ILS) Chapter 7. Version 3.5 87072(d) Personal Rights (d) The licensee shall ensure that each child, regardless of whether the child is in foster care, is accorded the personal rights specified in Welfare and Institutions Code (WIC) section 16001.9, ...16001.9 (a)(3) To receive...adequate clothing. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Program Director (PD), Amy Osborn.

Investigation Findings:
13On December 21, 2021 at 8:53AM, Licensing Program Analyst (LPA) Jose Gonzalez met with Alpha Connection Shoshonee Program Director (PD), Amy Osborn, to deliver the findings for the above stated allegations. LPA conducted a safety inspection at the facility at 12:09pm on August 13, 2021 and no safety hazards were observed. LPA also reviewed six of six client's records. During the investigation, interviews were conducted with six of six clients (C1, C2, C3, C4, C5, C6), Facility Manager (FM), Staff #1 (S1), and County Social Worker (CSW). The Department received a complaint on August 5, 2021, that alleged the facility did not provide client #1 (C1) adequate clothing. Confidential witnesses stated that C1 did not have enough clothing. Additional confidential witness statements indicate that C1's clothes were taken by C6. Confidential witness statements also revealed that C1 was borrowing clothes from the other clients. **R- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-SHOSHONEE PLACE, THEFACILITY NUMBER: 366402331

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

met_with: Program Director (PD), Amy Osborn


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not allow smoking and will always confiscate marijuana if it is found in the home. While other confidential information received by Licensing Office stated that the allegations had occurred, and that staff encourage minors to fight as well as sell them marijuana and will threaten them if they tell anyone about this. Confidential information received also stated that some staff will allow clients to smoke marijuana in the backyard area. Based on confidential information obtained during the course of this investigation, there is insufficient evidence to prove that allegations that staff encourage minors to fight, sell them marijuana as well as threaten them with isolation or being "beaten up" if they report it, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Facilty Director, Emanuel Wiley to discuss the investigative findings for the above stated allegation. Licensing Program Analyst (LPA), Cheraki Davis conducted an inspection to the Short Term Residential Therapeutic Program (STRTP) on November 22, 2021. Special Investigator (SI), Brittany Hudec interviewed three staff (S1, S2, S3), four foster children (C1, C2, C3 & C4), two County Social Workers (CSW1, CSW), County Investigator (CI) as well as reviewed police, client and facility records. Community Care Licensing received information on November 17, 2021 alleging that staff encourage minors to fight, sell them marijuana as well as threaten them with isolation or being "beaten up" if they report it. Information obtained in confidential interviews did not corroborate the allegations with a preponderance of evidence. Confidential interviews denied that any staff sell marijuana to minors in care or encourage them to fight. Confidential interviews also denied that any staff threaten minors with isolation or physical violence. According to confidential information, staff do UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-SHOSHONEE PLACE, THEFACILITY NUMBER: VISIT DATE: 04/28/2022


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Confidential interviews indicate the facility staff never heard or observed the clients encourage C1 to commit suicide or to harm themself. Additional confidential interviews revealed that C2 had kept C1 from running into the street. Confidential interviews indicate that C1 was encouraged by other clients to commit suicide or harm themselves in a jokingly manner. Additional interviews revealed that C1 was being bullied by C2 and C3. Confidential interviews revealed that C1 never informed the facility staff that C2 and C3 were bullying C1. Confidential interviews indicate that facility staff were aware that C1 was being bullied by C2 and C3. Additional interviews revealed that C1 did not feel safe at the STRTP home. Other confidential interviews reported that C1 was transferred to another STRTP home. Based on confidential interviews, the allegation that alleged facility staff are not protecting client #1 (C1) from other clients in the facility may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Amy Osborn.

Investigation Findings:
13On May 27, 2022, at 10:55 am, Licensing Program Analysts (LPA's) Jose Gonzalez and Darlene Oseguera met with Program Director (PD), Amy Osborn to deliver the findings for the above-stated allegations. LPA conducted a safety inspection at the facility at 10:01 am on November 12, 2021, and no immediate health and safety hazards were observed. LPA also reviewed eight of eight clients' records. During the investigation, interviews were conducted with seven of seven clients (C1, C2, C3, C4, C5, C6, and C7), Facility Director (FD), Program Director (PD), Staff #1 (S1), and Staff #2 (S2). The Department received a complaint on November 3, 2021, that alleged facility staff are not protecting client #1 (C1) from other clients in the facility. Confidential interviews indicate that facility staff protects all clients. Additional confidential interviews revealed that the facility staff intervened immediately when the clients argued or fought. Confidential interviews indicate that facility staff separates the clients into different areas of the home. Additional confidential interviews revealed that the facility staff was trained in trauma informed care and de-escalation techniques.R- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-SHOSHONEE PLACE, THEFACILITY NUMBER: VISIT DATE: 05/27/2022

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


raw_content:
Narrative:
The Department received a complaint on November 16, 2021, that alleged that the facility staff did not report client #1 (C1), client #7 (C7), and client #8 (C8) absences to the school; the facility staff is not ensuring that clients get to school on time, and the facility staff does not ensure clients are picked up from school on time. More specifically, students have excessive absences, unexcused absences, and consistent tardy arrivals to school and the tardiness is largely due to the facilities inability to get students to school on time. It was also reported that it is almost a daily occurrence that the students are picked up late, resulting in the need for teaching staff to call to remind the facility of student release times. Confidential interviews revealed that C1, C7, and C8 tardiness and absences were not reported to the school. Interview information revealed that C1, C7, and C8 miss educational instruction time when transported to school late by staff. Confidential interviews indicate that the facility staff was not instructed to report the client's tardiness or absence to the school. Additional confidential interviews revealed that facility staff is often transferred from one facility to another facility to assist with ratio, supervision, and school transportation. Confidential interviews reported that the facility staff call off and this creates an issue with transporting the clients to school on time. Additional confidential interviews revealed that facility staff is instructed to assist additional facilities with school transports, which also results in the clients arriving late to school. Confidential interviews indicate that the facility staff is often one to two hours late in picking up clients from school. Additional confidential interviews confirmed that facility staff is late picking up the clients from school. Confidential interviews indicate that the facility staff does not pick up the clients on time because they are instructed to assist another facility with school pick up for their clients. LPA received additional information that the facility staff could not drive the company vehicles because the facility auto insurance did not cover the staff members. Confidential interviews reported that the facility does not provide enough staff to transport the clients to and from school and that some clients refuse to attend school and are not given consequences. Based on confidential interviews and evidence gathered that the facility staff does not report client #1 (C1), client #7 (C7), and client #8 (C8) absences to the school, the facility staff are not ensuring that clients get to school on time, and the facility staff do not ensure clients are picked up from school on time are substantiated as the preponderance of evidence standard has been met for the allegations. This poses a potential Health, Safety, or Personal Rights risk to children in care. The facility is being cited under Short-Term Residential Therapeutic Program Interim Licensing Standards (ILS) Chapter 7. Version 4, 87078 (c) Responsibility for Providing Care. *******Continued 9099c****** An exit interview was conducted. A copy of this report and appeal rights were provided to Program Director (PD), Amy Osborn. The Department also received an allegation that the staff did not safeguard the client's personal items. Confidential interviews indicate that the facility staff does not safeguard clients' personal items. Additional confidential interviews revealed that the facility staff does not safeguard the client's personal items when a client's absent without approved leave. Confidential interviews indicate that the other clients remove the absent without approved leave client's personal items. Additional confidential interviews revealed that C7 personal items were missing. Confidential interviews indicate that the facility staff did not safeguard C7's personal belongings. Other confidential interviews revealed that the C1 was bullied for a brand-new pair of Nike shoes. CSW2 stated that when she retrieved C7's personal items, they were transferred to another home and placed in the bedroom. CSW2 stated that the facility staff informed CSW2 that some clients had gotten into C7s personal belongings. Confidential interviews denied the allegation. Based on confidential interviews that alleged that the facility staff is not providing supervision resulting in inappropriate interactions between clients in care, clients are not accorded privacy while in care, clients drink alcohol, and staff did not safeguard the client's personal items while in care may have occurred however, it is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted. A copy of this report and appeal rights were provided to Program Director (PD), Amy Osborn. On November 16, 2021, the Department received a complaint that alleged that the facility staff is not providing supervision resulting in inappropriate interactions between clients in care. Confidential interviews indicate that the other clients were bullying C1, C7, and C8. Additional confidential interviews revealed that the facility staff did not observe C1, C7, and C8 being bullied by the other clients in care. Confidential interviews indicate that the facility staff was not informed that the clients were bullying the C1, C7, and C8 at home. Additional confidential interviews revealed that the facility staff did observe C1, C7, and C8 being bullied by the other clients in care. Confidential interviews indicate that the facility staff was aware and informed that the other clients were bullying the C1, C7, and C8 at home. Additional confidential interviews denied the allegations. The Department also received allegations that the clients are not accorded privacy while in care and the clients drink alcohol while in care. Confidential interviews indicate that the clients are accorded privacy at home. Additional confidential interviews revealed that the facility staff was not discussing a client's confidential and personal information in front of the other clients. Confidential interviews denied the allegation. Additional confidential interviews revealed that the facility staff addressed a client's confidential and personal information in front of the other clients. Confidential interviews indicate that staff heard and observed discussing a client's confidential and personal information in front of the other clients. Additional confidential interviews denied the allegations. Confidential interviews indicate that the clients are allowed to drink alcohol at the home. Additional confidential interviews revealed that empty liquor bottles have been observed, confiscated, and thrown away during room searches. Confidential interviews indicate that the clients are absent without approved leave and steal alcohol from a store and return to the home under the influence. Additional confidential interviews revealed that the facility staff had not observed the client drinking alcohol at home. Confidential interviews indicate that the clients do not drink alcohol at the house. Additional confidential interviews denied the allegations. Confidential interviews indicate that the clients empty their pockets when they return from absent without approved leave. Other confidential interviews revealed that the facility staff conducted bedroom and perimeter searches, and no alcohol bottles were observed. ***********CONTINUED on LIC C************

Investigation Findings:
13On June 3, 2022, at 10:56 am, Licensing Program Analysts (LPAs) Jose Gonzalez and Darlene Oseguera met with Alpha Connection Shoshonee Program Director (PD), Amy Osborn, to deliver the findings for the above-stated allegations. LPA conducted a safety inspection at the facility on November 22, 2021, at 11:15 am, and deficiencies were observed. During the tour of the facility, LPA observed the following drug paraphernalia items in the back yard: a green apple used as a marijuana pipe with marijuana residue, two red lighters, and two tip flitters white tips used from cigars. LPA also observed drug paraphernalia in bedroom #2, a green apple used as a marijuana pipe with marijuana residue, and a bag of tobacco in a dresser drawer. Please refer to report dated 06/10/2022. LPA also reviewed six of six clients' records. During the investigation, interviews were conducted with seven of seven clients (C1, C2, C3, C4, C5, C6, and C7), Facility Director (FD), Staff #1, (S1), and Staff #3 (S3), County Social Worker #1(CSW1), and County Social Worker #2 (CSW2). LPA attempted to interview C8 but was unsuccessful due to C8 being absent without approved leave (AWOL). ***CONTIUNED on LIC 9099C****** SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Jose Gonzalez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-SHOSHONEE PLACE, THEFACILITY NUMBER: VISIT DATE: 06/10/2022

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

met_with: Program Director (PD) Amy Osborn


raw_content:
Narrative:
allegations with a preponderance of evidence. Confidential interviews denied allegations that staff allowed client to AWOL. According to confidential interviews, staff always try and persuade children from AWOLing and will counsel them and give them options in order for them to change their minds. Confidential interviews also stated that once a client is in the process of going AWOL, staff will follow that client as far as possible and will file a missing persons report, as well as notify that child's County Social Worker or Probation Officer. Confidential interviews also denied that staff allow or encourage foster children to fight, or that they take them off grounds in order to fight. According to confidential interviews, staff will always intervene whenever there is a physical altercation, as well as try and de-escalate and separate children in order to prevent fights from occurring. While other confidential information received by Licensing Office stated that these allegations had occurred. Based on confidential information obtained during the course of this investigation, the allegations of a lack of supervision resulting in Child # (C1) AWOLing (Absence without official leave) from facility, as well as staff not preventing inappropriate behavior between minors, more specifically that staff allow children to fight each other, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Facility Manager, Manny Wiley to discuss the investigative findings for the above stated allegations. Licensing Program Analysts (LPAs), Jose Gonzalez and Daniel Mena conducted an inspection to the Short Term Residential Therapeutic Program (STRTP) on November 20, 2021 at 9:54am and on June 16, 2022 at 11:20am. No immediate hazards observed. LPAs Gonzalez and Mena interviewed five staff (S1, S2, S3, PD & FD), four of five foster children (C2, C3, C4 & C5), as well as reviewed client and facility records. LPAs were unable to interview Child # 1 (C1) due to their current whereabouts being unknown. Community Care Licensing received information on November 24, 2021 alleging a lack of supervision resulting in Child # (C1) AWOLing (Absence without official leave) from facility, as well as staff not preventing inappropriate behavior between minors, more specifically that staff allow children to fight each other and even take them to public parks in order to fight. Information obtained in confidential interviews did not corroborate the UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-SHOSHONEE PLACE, THEFACILITY NUMBER: VISIT DATE: 06/23/2022

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

met_with: Manny Wiley


raw_content:
Narrative:
interviews reported that the smoking only happens off grounds, while conflicting statements reported some residents smoke at the facility in their rooms or back yard. Record review did provide evidence of marijuana contraband being found on the grounds of the facility and in the rooms of the residents, however where the contraband was utilized was not able to be determined based on record review. CCL received a second allegation alleging the facility smells of marijuana. Specifically it was reported that during a facility visit, a visitor entered a bedroom and observed the bedroom to have a strong odor of marijuana. Confidential interviews could not confirm or dispute the facility smelling of marijuana. Confidential interviews reported residents often return to the facility after smoking marijuana and therefore a resident may smell of marijuana while the resident is in the facility. Based on confidential interviews and record review the allegations of minors smoke marijuana at the facility and the facility smells of marijuana, may or may not have occurred, however it is not supported or proven by the evidence. Therefore, the allegation are unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights to Alpha Connections - Shoshonee, Facility Director (FD), Manny Wiley.

Investigation Findings:
13On July 13, 2022 at 2:45 pm Licensing Program Analyst (LPA), Nicole Strickland, met Alpha Connections - Shoshonee, Facility Director (FD), Manny Wiley, to deliver the findings for the above stated allegations. The investigation was conducted by LPA Jose Gonzalez and LPA Strickland. LPA Gonzalez conducted an inspection of the facility on February 4, 2022 at approximately 8:49 am and no immediate deficiencies were observed. The investigation included interviews with Program Director (PD), Administrator (ADM), Staff #1 (S1), (FM), six foster children (Child #1 [C1], Child #3 [C3], Child #4 [C4], Child #8 [C8], Child # 9 [C9] and Child #10 [C10]) and one County Social Worker (CSW), In addition, county records and facility records were reviewed. On January 31, 2022, Community Care Licensing (CCL) received an allegation alleging Minors smoke marijuana at the facility. Confidential interviews confirmed some residents smoke marijuana however, conflicting reports of where the residents are when smoking the marijuana were reported. Some confidential UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-SHOSHONEE PLACE, THEFACILITY NUMBER: VISIT DATE: 07/13/2022

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

met_with: Manny Wiley,


raw_content:
Narrative:
Confidential interviews indicate that the minors do not feel safe at the home because other minors are threatening them when the facility staff are not monitoring their interactions. The Department also received allegations that facility staff #1 (S1) is sleeping during work shifts. Confidential interviews indicate the facility staff is not sleeping during work shifts. Additional confidential interviews revealed that S1 is sleeping during the nocturnal shift. Confidential interviews indicate that S1 and the facility staff conduct headcounts every 10 minutes. Confidential interviews revealed that they have not observed S1 sleeping at the STRTP home nor have they observed S1 working a nocturnal shift at the home. Confidential interviews disclosed that it was observed that S1 was sleeping during their shift. Based on confidential interviews, the allegation that facility staff are not providing supervision to the minors in care and that facility staff #1 (S1) is sleeping during work shifts may have occurred, however is not supported, or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Program Director (PD), Amy Osborn.

Investigation Findings:
13On July 28, 2022, at 10:55 am, Licensing Program Analysts (LPA's) Jose Gonzalez and Joon Choi met with Program Director (PD), Amy Osborn to deliver the findings for the above-stated allegations. LPA conducted a safety inspection at the facility at 2:05 pm on March 18, 2022, and no immediate health and safety hazards were observed. LPA also reviewed six of six clients' records. During the investigation, interviews were conducted with six of six clients (C1, C2, C3, C4, C5, and C6), Facility Manager (FM), and Staff #1 (S1). The Department received a complaint on March 18, 2022, that alleged facility staff are not providing supervision to the minors in care. Confidential interviews indicate that facility staff are providing supervision for the minors in care. Additional confidential interviews revealed that the facility staff intervened immediately when the residents argued or fought. Confidential interviews indicate that the facility staff are checking on the minors. Additional confidential interviews revealed that minors are picking on other minors when the facility staff are not supervising the minors. R- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION-SHOSHONEE PLACE, THEFACILITY NUMBER: VISIT DATE: 08/05/2022

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


raw_content:
Narrative:
Confidential interviews disclosed that facility staff has observed the residents smoking in the backyard behind the shed. Additional confidential interviews revealed that the residents are instructed to smoke outside the home. Confidential interviews stated that residents use their community passes to smoke cigarettes or marijuana. During the safety inspection, the LPA observed in bedroom #3 bathroom the following drug paraphernalia items: a green apple used as a pipe with residue, a pen used as a pipe with aluminum foil and residue, and a plastic bottle used as a pipe with aluminum foil and residue and the bedroom had a marijuana smoke odor. Based on LPA confidential interviews and observations that alleged the residents are smoking marijuana at the facility is substantiated as the preponderance of evidence standard has been met for the allegation. This poses an immediate health, safety, or personal rights risk to clients in care. The facility is being cited under Short-Term Residential Therapeutic Program Interim Licensing Standards (ILS) Version 4. Section 87087(c) Buildings and Grounds. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Evonnda Hull. Additional confidential interviews revealed that the facility staff was trained in ProACT. Confidential interviews indicate the facility staff never observed R1 being assaulted or bullied by R2 or R3. Additional confidential interviews revealed that R2 and R3 were bullying R1. Confidential interviews indicate that R2 and R3 would take R1 personal items and not return them to R1. Confidential interviews revealed that R1 never informed the facility staff that R2 and R3 were bullying R1. Additional interviews revealed that R1 was being intimidated by two other residents. Confidential interviews disclosed that R1 was missing some his personal items. Other confidential interviews reported that R1 was transferred to another home. Based on confidential interviews, the allegation that alleged facility staff is not protecting resident #1 (R1) from resident #2 (R2) and resident #3 (R3) in the facility may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Evonnda Hull.

Investigation Findings:
13On May 12, 2022 at 10:55 am, Licensing Program Analysts (LPA's) Jose Gonzalez and Joon Choi met with Facility Administrator (FA), Evonnda Hull to deliver the findings for the above-stated allegations. LPA conducted a safety inspection at the facility at 9:29 am on October 22, 2021. LPA observed in bedroom #3 the following drug paraphernalia items: a green apple used as a pipe with residue, a pen used as a pipe with aluminum foil and residue, and a plastic bottle used as a pipe with aluminum foil and residue and the bedroom had a marijuana smoke odor. LPA also reviewed eight of eight clients' records. During the investigation, interviews were conducted with eight of eight clients (C1, C2, C3, C4, C5, C6, C7, and C8), Facility Director (FD), Program Director (PD), Staff #1 (S1), Probation Officer (PO), and County Social Workers (CSW and CSW2). On October 18, 2022, the Department received a complaint that alleged residents were smoking marijuana at the facility. Confidential interviews revealed that the facility staff allows the residents to smoke marijuana at home. Additional confidential interviews revealed that the facility staff instructed the residents to smoke cigarettes or marijuana in the backyard or on their community day pass. ***CONTINUED LIC C*** SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Jose Gonzalez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION GROUP HOME FOR CHILDRENFACILITY NUMBER: VISIT DATE: 05/12/2022

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


raw_content:
Narrative:
medication to C1 and staff is not providing C1 with therapeutic services. Furthermore, the interviews did not provide any further specific details. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Guy Williams.

Investigation Findings:
13On June 29, 2022, at 10: AM Licensing Program Analyst (LPA) Michael Almaraz conducted an unannounced inspection at the facility to deliver the findings of the above allegations. LPA met with administrator Guy Williams. LPA Jose Gonzalez conducted an inspection at the facility on December 7, 2021 at 08: AM and no immediate deficiencies were observed. LPA Darlene Oseguera completed the investigation. Four of four children (C1, C2, C3, C4), four staff and facility administrator were interviewed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Michael Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: ALPHA CONNECTION GROUP HOME FOR CHILDRENFACILITY NUMBER: VISIT DATE: 06/29/2022

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

met_with: Guy Williams


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

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

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


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

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

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

met_with: Elysia Moore


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

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

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


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

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

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

met_with: Morgan Tyler


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

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

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


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

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

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

met_with: Morgan Tyler, Facility Director


facility_name: AMANA HOME

summary: Facility Evaluation

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

report_type: Facility Evaluation

visit_type: Prelicensing

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


summary: Facility Evaluation

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

met_with: Cherry Agravante, Patrick Orea


summary: Facility Evaluation

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On 4/10/26 at AM, Licensing Program Analyst (LPA) Kimberly Hall conducted an unannounced Annual inspection. LPA Hall met with Jasmin Nelson and Kaycee Makalintal. LPA Hall informed staff members of the purpose of the visit. The facility has a census of 3 clients. One client is non-verbal. Two clients were in care upon arrival. All clients appeared to be in good spirits. LPA Hall toured the facility site and observed the one story facility to be clean, free from obstruction, and in good repair. LPA Hall then toured the dining room. The tables and chairs were solid and the room was clean, organized. The living room consisted of a large sectional couch with plenty of seating space . Toys, games, and other activities were in a cabinet which also serves as storage. Room was at a comfortable temperature. The water temperatures were measured at 118F. The menu was posted and the food supply was good, well organized. Sharp objects and cleaning solutions were locked away and inaccessible for clients in care. There are charged operable fire extinguishers, carbon monoxide and smoke detectors throughout the facility. All medications were locked and inspected. The facility has 4 single bedrooms. Each client has their own bedroom, and each bedroom is fitted with appropriate furnishings, clean linens, and table space. The first aid kit was observed to be complete. There are no open bodies of water on the property. At 1: PM LPA Hall reviewed all 3 client files and three staff files, all appeared complete. During inspection, it was learned that the facility is not giving a set allowance amount and giving the youth money upon request which is done more than monthly per cash resources. The facility is requested to update their program statement to reflect the allowance duration if this will be done weekly or what specific date in the month, and the specific amount of each youth's allowance. This is to be submitted to LPA Hall by Friday April 24, 2026. LPA interviewed one client and two staff. Another client was at school and one is non-verbal. The facility received one Technical Violation, 84077(a)(2) Client Records. Annual inspection was completed via CARE Inspection Tools. An exit interview was conducted, and a copy of this report was provided to Kaycee Makalintal, whose signature on this form confirms receipt.

visit_type: Annual

met_with: Maria Jasmin Nelson, Licensee Kaycee Makalintal, Administrator/Licensee


facility_name: ANESTA

summary: Facility Evaluation

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

met_with: Jamie Murray- Partner


summary: Facility Evaluation

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

met_with: Facility manager


summary: Facility Evaluation

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

met_with: Nicole Eccles- Facilty Manager


summary: Facility Evaluation

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

met_with: Tawney Newbury- Facility Manager Cory Ranberg- Administrator


facility_name: ANGELES VISTA CHILDREN'S HOME

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

Investigation Findings:
13On January 6, 2022 at 12: PM Licensing Program Analyst (LPA), Zena Phillips conducted a follow-up complaint investigation visit to Angeles Vista Children's Home and met with Annieyln Dumas /Administrator. The purpose of the visit was to deliver findings for the above complaint allegation. Youth sustained unexplained injuries while in care During the investigation process by Licensing Program Analyst (LPA), Zena Phillips, all relevant parties have been accounted for. Based on the interviews conducted, the above allegation is found to be unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove or disprove that a violation occurred. Supporting evidence include the following: Staff #1 stated that Child 1 sustained injuries from Child UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: ANGELES VISTA CHILDREN'S HOMEFACILITY NUMBER: VISIT DATE: 01/06/2022

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

met_with: Annielyn Dumas/ Administrator


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

Investigation Findings:
13On March 16, 2022 @ 12: PM Licensing Program Analyst (LPA), Zena Phillips conducted a follow-up complaint investigation visit to Angeles Vista Children's Home and met with Jermaine Trottie Administrator. The purpose of the visit was to deliver findings for the above complaint allegations. During the investigation process by Licensing Program Analyst (LPA), Zena Phillips, all relevant parties have been accounted for. Based on the interviews conducted, the above allegations are found to be unsubstantiated, meaning that although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove or disprove that a violation occurred. LPA Phillips observed cleaning solutions and automatic dispenser with thermometer installed at front entrance. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: ANGELES VISTA CHILDREN'S HOMEFACILITY NUMBER: VISIT DATE: 03/16/2022

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

met_with: Jermaine Trottie/ GH Administrator


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

Investigation Findings:
13On April 21, 2022, @ 1: PM Licensing Program Analyst (LPA), Zena Phillips and LPA Kuliema Calloway conducted a joint follow-up complaint investigation visit to Angeles Vista Children's Home and met with Annielyn Dumas Administrator who granted access to the facility. The purpose of the visit was to deliver findings for the above complaint allegation. During the investigation process by LPA Phillips confidential interviews were conducted with relevant parties, reviewed Special Incident Reports, medical appointment notice, and Needs and Service Plan of Child #1 in care. LPA Phillips attempted interview with Child #1 but unable to conduct interview due to Child #1 is non verbal. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: ANGELES VISTA CHILDREN'S HOMEFACILITY NUMBER: VISIT DATE: 04/21/2022

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

met_with: Annielyn Dumas /Administrator


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

Investigation Findings:
13On 11/29/2022 @ 8: AM Licensing Program Analyst (LPA), Zena Phillips conducted a follow-up complaint investigation visit to ANGELES VISTA CHILDREN'S HOME and met with Valerie Onyeachonam/Direct Care Staff who granted acess to the facility. The purpose of the visit was to deliver findings for the complaint allegations. During the investigation of the allegations: Staff did not prevent minor from self harming. Facility not providing one on one supervision to minor. Facility did not ensure minor was fed. Minors needs are not being met. LPA Phillips conducted five (5) confidential interviews and reviewed the following documentarty evidence:, Needs and Services Plan, medical appointments, medication log, staff and client files, facility menu and client log of food consumed. LPA observed nurse at facility for client assessment clean and dress wounds. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: ANGELES VISTA CHILDREN'S HOMEFACILITY NUMBER: VISIT DATE: 11/29/2022

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

met_with: Valerie Onyeachonam/Direct Care Staff