summary: Facility Evaluation

raw_content:
Narrative:
On April 11, 2025, 9:30AM Licensing Program Analyst (LPA) Rosslyn Gray arrived at the above facility for the purpose of conducting Annual/Required Inspection. BLUME BEHAVIORAL HEALTH Group Home located PERKINS LANE, REDONDO BEACH CA, 90278. A health and risk assessment were conducted. LPA met with the (S1) who granted access to the facility. The facility consists of four (4) bedrooms, an office, two (2) car garage, living room, kitchen, dining area and education room. The facility can also be accessed through entrance in the garage. The facility is seeking a license to provide care and supervision for six (6) clients ages 12-17, ambulatory only. Currently there are Five (5) children in placement. LPA- Gray observed the follow during the inspection: The Group Home Overview: This is a 2-story, All white black trimmed facility four (4) bedrooms, 4 1/2 bath home, located in a residential neighborhood. There is two (2) car garage. There is facility vehicle utilize inspected to in good operating conditions. The facility large trash cans are located in front of the facility. LPA observed a hard wired interconnected combined smoke detector and carbon monoxide detector; tested to be operable. LPA observed two (2) Fire Extinguishers located in the kitchen and on the 1st floor and 2nd floor mounted on the wall in the hallway. All posting requirements were met,(i.e food menu (posted in the kitchen and common area); (regulations, personal rights (posted at the entrance); facility sketch (posted in every room); The LIC 610C Emergency Disaster Plan for Children's Residential Facilities are posted on the wall at the entrance. Outdoor Area: The activity space is free of hazard materials and debris. The ground is completed covered with concrete and a gate leads out 3rd driveway. There is patio furniture and recreational equipment. On the side house stores the electrical utilities, shut-off valves for gas and water, a tank-less Hot Water Heater and central heat and air conditioning unit. LIC Page 1 of LPA observed all windows, screens, and blinds from the inside and outside of the facility were observed to be in good condition. The passageways and porches are unobstructed. 1st Level: Therapy Room/Staff Office#1: located to the left of the front door entrance. This room is used as office space and accessible to staff only, to serve as private setting for therapeutic services and for conducting private interviews. Grievance Box Black mounted on the wall of left side of the entrance left of the facility and locked for confidential. There are locked file cabinets to store the medication logs, files, medical devices, medication boxes and a small refrigerator that is utilized to store the clients prescribed medications. Bathroom #1 is located in this room identified as the staff bathroom. It is a full size bathroom located in this office, equipped with one (1) toilet, one (1) sink, bathtub and a shower observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. First Aid kit is located is this room. It was observed to be equipped with the required items inside (age-appropriate, scissors, tweezers, thermometer, and gauzes, antiseptic, and First Aid Manual Guide. The facility has a working telephone and clients can use the telephone unless restricted by authorized representatives. Laundry Room: Located to the left. It is equipped with a sink white washer and dryer unit. The detergent, chemical and cleaning supplies are stored in a locked closet behind the stairs adjacent to the laundry room. There is a additional small storage area located under stairs that is locked for safety and security. Bedroom #1: Is equipped with two (2) Full-size beds, comfortable mattress, clean linen, blankets and pillows. There are two (2) separate sliding glass door closets. There is adequate lighting, window screens, vertical blinds observed to be in good condition. Bathroom #2 is located in this bedroom. It is equipped with a full size bathroom that has (1) toilet, one (1) sink, one (1) shower and a window with proper vitalization, observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. There is an exit door to the right adjacent to the storage closet that leads to the garage. Garage: Identified as a multi-purpose workroom, utilized based on. The garage door is sealed and the vehicles parked outside in the driveway. LIC Page 2 of 4 2nd Level: Kitchen: The kitchen was observed to be clean and organized. It is equipped with a six (6) burners gas stove and a two (2) sided sink. A two (2) sided double door refrigerator with bottom freezer. Kitchen cleaning supplies, liquids, hand soup, disinfectants and sharp knives are located on the 1st floor locked in a cabinet inaccessible to the children in placement. There is an additional refrigerator with the bottom freezer located in the shared garage. LPA observed ample perishable and nonperishable food items including fresh fruit and snacks. Dining Area: The dining area consists of six (6) seater table with (6) six chairs. There are two (2) chair marble seated at the marble island counter. LPA observed coverage trash cans throughout the facility and two (2) Fire Extinguishers located in the kitchen and 1 adjacent and laundry room. Living Room: The Living Room is fully furnished with sofa, coffee table, a black arm chair. There is a fireplace that is inoperable. There is a 65' television securely mounted on the wall. Bedroom #1 is occupied by one (1) client, equipped with two (2) Full-size beds, comfortable mattress, clean linen, blankets and pillows. There are two (2) sliding glass mirror door closet. There is adequate lighting, window screens, vertical blinds, and three (3) drawer dressers for each client observed to be in good condition. Bedroom #2: is occupied by one (1) client equipped with two (2) Full-size beds, comfortable mattress, clean linen, blankets and pillows. There are one (1) sliding glass mirror door closet. There is adequate lighting, window screens, vertical blinds, and three (3) drawer dressers for each client observed to be in good condition. Bathroom #3 is occupied by two (2) client is full sized bed equipped with one (1) toilet, two (2 sink , bathtub (inoperable for safety purposes) and a shower observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Privacy Room is located on the left side, prep with chairs, two(2) seater sofa with large olive green chair. This room is available to client for relaxation. Clients are permitted to listen to age appropriate music on MP3 players provided my the facility. LIC- Page 3 of Bathroom #5 is full sized adjacent to Bedroom #3 equipped with one (1) toilet, two (2) sinks , 1 bathtub ( made inoperable for safety purposes). and one (1) shower observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. The staff accompany clients to local recreational facilities in the facility vehicle. Clients are accorded dignity in personal relationships with staff and others. The facility will operate within license conditions and limitations including capacity limitations. The Administrator ensured the facility will have the written plan of operation. Facility personnel are instructed to report violations of personal rights. Licensee will report changes in the plan of operation affecting service to clients. Licensee will report client injuries requiring medical treatment. The administrator will provide the Personnel Report (LIC 500) and confirmed that the staff ratio presents for the six (6) clients in placement. The administrator ensured that all will have required criminal record clearance. DOJ, FBI and Child Abuse Response that will meet qualification. There were no deficiencies cited at this time. LPA concluded the Post License Inspection. An exit interview was conducted, and a copy of this report was left at the facility with the Chief Operating Officer/ Alex Hawes on 04/11/ LIC- Page 4 of 4

met_with: Chief Operating Officer/ Alex Hawes


state: CA

facility_name: BLUME BEHAVIORAL HEALTH

summary: Facility Evaluation

raw_content:
Narrative:
On February 15, 2024, 10AM, Component II of the application process for BLUME BEHAVIORAL HEALTH Group Home located VOORHEES AVE REDONDO BEACH CA 90278 was held at the El Segundo Children's Residential Regional Office in El Segundo. Attending Component II were the following individuals: Christina Kiesselbach, Compliance Specialist, Devon Wayt,Compliance Specialist, Basel Shadfan Chief Executive Officer/ Administrator and Licensing Program Analyst (LPA), Rosslyn Gray The purposes of this Component II meeting were to review the incomplete application and Program Statement, to resolve any outstanding concerns that may have existed. The following incomplete application forms were discussed at the meeting: Personnel Report (LIC 500), Group Home Hour Administrator certificate and by-laws. The Gender Population to identify the gender for this facility. The CEO/Administrator determined that the above facility will provide care and supervision for Female; Transportation; Needs and Services; Personal Rights that include, Visitation, Phone calls, Allowances, Discipline policy, Removal and/or Discharge Procedures; Neighborhood Complaint Procedures. The applicants were informed of the Health and Safety Code stated policy and requirements regarding the overconcentration of residential care facilities which are separated by a distance of 300 feet or less from another residential facility unless approval is obtained from the city or county in which the facility will be located. The applicant CEO/Administrator agreed to provide a Business License and a letter of approval from the City on a city letter. The applicants were advised of the following revision and/or corrections needed to the application and/or Program Statement: Sections 1-29 of the Program Statement was reviewed and discussed. Revisions are due February 29, 2024. Pre-Licensing inspection has been scheduled for Thursday March 7, 2024 at AM. A copy of this report was provided to Basel Shadfan Chief Executive Officer(CEO)/Administrator .

report_type: Facility Evaluation


summary: Facility Evaluation

raw_content:
Narrative:
On March 07 2023 2: PM Licensing Program Analyst (LPA) Rosslyn Gray arrived at the above facility for the purpose of conducting Pre-Licensing inspection. BLUME BEHAVIORAL HEALTH Group Home located Voorhees Ave. Redondo Beach CA 90278. A health and risk assessment were conducted. LPAs met with the (S1) who granted access to the facility. The facility consists of four (4) bedrooms (1 bedroom will be utilized Therapy Room/Staff Office); two (2) car garage, living room, kitchen, dining area and education room. The facility can also be accessed through entrance in the garage. There is no facility vehicle at the time of this inspection. The facility is seeking a license to provide care and supervision for six (6) female clients ages 12-17, ambulatory only. Currently there are no children in placement. LPA- Gray observed the follow during the inspection: The Group Home Overview: This is a 2-story, All white black trimmed facility four (4) bedrooms, 3 1/2 bath home, located in a residential neighborhood. There is two (2) car garage. Currently there is not a vehicle utilized to transport the clients. The CEO/Administrator will provide information about the company vehicle later to be inspected to be operating in good condition. The facility large trash cans are located in front of the facility. LPA observed a hard wired interconnected combined smoke detector and carbon monoxide detector; tested to be operable. LPA observed two (2) Fire Extinguishers located in the kitchen and on the 1st floor mounted on the wall in the hallway. All posting requirements were met,(i.e food menu (posted in the kitchen and common area); (regulations, personal rights (posted at the entrance); facility sketch (posted in every room); The LIC 610C Emergency Disaster Plan for Children's Residential Facilities are posted on the wall at the entrance. Outdoor Area: The Patio space is free of hazard materials and debris. The passageways and porches are unobstructed. LPA observed patio furniture. The Licensee plan to add recreational equipment for the space and appropriate for children prior to the children's placement. The side house stores the electrical utilities, shut-off valves for gas and water, a tank-less Hot Water Heater and central heat and air conditioning unit. LIC Page 1 of There is an exit door to the left adjacent to the front door. Garage: This is a two car garage identified as a multi-purpose workroom. There are locked file cabinets to store the medication logs, files, medical devices, medication boxes and a small refrigerator that will be utilized to store the clients prescribed medications. It is also utilized to store extra food supply and (PPE) Personal Protection Equipment. 1st Level: Therapy Room/Staff Office#1: located to the right adjacent to the garage door. This room will be used as office space will be accessible to staff only, to serve as private setting for therapeutic services and for conducting private interviews. Bathroom #1 located in this room identified as the children's bathroom which is a Jack and Jill bathroom connect to Bedroom #1. It is a full size bathroom located in this office, equipped with one (1) toilet, one (1) sink , bathtub and a shower observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. First Aid kit is located is this room. It was observed to be equipped with the required items inside (age-appropriate, scissors, tweezers, thermometer, and gauzes, antiseptic, and First Aid Manual Guide. The facility has a working telephone and clients can use the telephone unless restricted by authorized representatives. Bedroom # Is equipped with two (2) Full-size beds, comfortable mattress, clean linen, blankets and pillows. There is adequate lighting, window screens, vertical blinds, and preparation for additional closet space and dressers for each client will be in place prior to clients in placement. Laundry Room: Located on the 1st floor directly down the hall in between bedroom #1 and bedroom #2. It is equipped equipped with a white Samsung washer and dryer unit. The detergent, chemical and cleaning supplies are stored in a locked on the 2nd floor directly to the top of stairs adjacent to Bedroom #3 entrance. There is a additional small storage area located under stairs that is locked for safety and security. Bedroom #2: Is located is adjacent to the laundry room. It is equipped with two (2) twin size beds, comfortable mattress, clean linen, blankets and pillows. There are one (1) sliding glass door closet. There is adequate lighting, window screens, vertical blinds observed to be in good condition. Bathroom #2 located in this room. It is a full size bathroom equipped with one (1) toilet, one (1) sink , bathtub and a shower observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. LIC Page 2 of 4 2nd Level: There is a locked Storage closet utilized cleaning supplies, liquids, hand soup, disinfectants and sharp knives are locked in a cabinet inaccessible to the children in placement. Kitchen: The kitchen was observed to be clean and organized. It is equipped with a six (6) burners gas stove and a two (2) sided sink and a Sharp built in microwave. A two (2) sided double door refrigerator. Kitchen cleaning supplies, liquids, hand soup, disinfectants and sharp knives are locked in a cabinet inaccessible to the children in placement. There is an additional refrigerator with the top freezer located in the garage. LPA observed ample perishable and nonperishable food items including fresh fruit and snacks. Dining Area: The dining area consists of six (6) chairs and a large table. There are three (3) chair marble seated at the marble island counter. LPA observed coverage trash cans throughout the facility and two (2) Fire Extinguishers located in the kitchen adjacent to the kitchen and laundry room. Living Room: The Living Room is fully furnished with sofa, coffee table, and a large sofa and a computer and computer. There is a fireplace that is inoperable. There is a 65' television securely mounted on the wall. Bathroom #3 is a 1/2 bathroom quipped with one (1) toilet, one (1) sink ,observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Bedroom # Is equipped with two (2) Full-size beds, comfortable mattress, clean linen, blankets and pillows. There are one (1) walk in closet. There is adequate lighting, window screens, vertical blinds, and 2 three drawer dressers for each client observed to be in good condition. Bathroom #4 is full sized equipped with one (1) toilet, two (2) sinks , bathtub and a shower observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Bathroom #3 is half sized bathroom adjacent to the Kitchen. equipped with one (1) toilet, and one (1) sink designated for staff, observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Privacy Room is inside bedroom #3 will prep with chairs, beanbags and age appropriate electronic games. There is adequate lighting. LIC Page 3 of The staff will accompany clients to local recreational facilities in the facility vehicle. Clients are accorded dignity in personal relationships with staff and others. The facility will operate within license conditions and limitations including capacity limitations. The Administrator ensured the facility will have the written plan of operation. Facility personnel are instructed to report violations of personal rights. Licensee will report changes in the plan of operation affecting service to clients. Licensee will report client injuries requiring medical treatment. The administrator will provide the Personnel Report (LIC 500) and confirmed that the staff ratio presents for the six (6) clients in placement. The administrator ensured that all will have required criminal record clearance. DOJ, FBI and Child Abuse Response that will meet qualification. There were no deficiencies cited at this time. LPA concluded the Pre-License Inspection. An exit interview was conducted, and a copy of this report was left at the facility with the Chief Executive Officer/ Administrator Basel Shadfan on 03/07/ LIC- Page 4 of 4

visit_type: Prelicensing

met_with: Basel Shadfan Chief Executive Officer/ Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On April 4, 2024 at 10:00AM Licensing Program Analyst (LPA), Rosslyn Gray met for Component III of the application process for BLUME BEHAVIORAL HEALTH Group Home located BLUME BEHAVIORAL HEALTH Group Home located Voorhees Ave. Redondo Beach CA 90278 was held at the Children's Residential Regional Office in El Segundo. Attending Component III were the following individuals: Christina Kiesselbach, Compliance Specialist, Basel Shadfan Chief Executive Officer/ Administrator and Licensing Program Analyst (LPA), Rosslyn Gray. The purposes of this Component III meeting were to discuss the Child's and Personnel Records, to be documented, retained, maintained, available and posted at the facility for inspections. LPA-Gray discussed the gender population and specific problems and issues of operating a Group Home, such as, reporting requirements, personnel requirements, supervision, intake issues, compatibility, removal/discharge, complaint procedures, transportation, health services, food, allergies, hygiene, gender hygiene products, visitation, personal property, searches, community sensitivity, Electronic Files to store records, ensure the client ratio is based on staff to behavior that may include increasing staff to provide proper supervision, staff training that also include administer of medication and who will be responsible for administering medication. LPA discussed who will ensure the Technicians are aware of the clients triggers and the reason for their placement, and need to provide a Grievance Box for the clients to report anonymous issues and concerns. LPA discussed the procedure of notification when an unusual incident occurs, and documenting on the LIC 624 that include details of who what when where and how. LPA discussed prudent parenting and if the client is resistant to care and or are forced, how will the facility get the clients to buy in. The applicant was informed the fingerprint clearances are Pending status that include the Administrator. A copy of this report was provided to Basel Shadfan Chief Executive Officer (CEO)/Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On July 9, 2024 2: PM Licensing Program Analyst (LPA) Rosslyn Gray and Kenrick Ellis arrived at the above facility for the purpose of conducting Pre-Licensing inspection. BLUME BEHAVIORAL HEALTH Group Home located Voorhees Ave. Redondo Beach CA 90278. A health and risk assessment were conducted. LPAs met with the (S1) who granted access to the facility. The facility consists of four (4) bedrooms (1 bedroom will be utilized Therapy Room/Staff Office); two (2) car garage, living room, kitchen, dining area and education room. The facility can also be accessed through entrance in the garage. There is a facility vehicle observed to be in good condition. The facility is seeking a license to provide care and supervision for six (6) female clients ages 12-17, ambulatory only. Currently there are four (4) children in placement. LPA- Gray observed the follow during the inspection: The Group Home Overview: This is a 2-story, All white black trimmed facility four (4) bedrooms, 3 1/2 bath home, located in a residential neighborhood. There is two (2) car garage. The facility large trash cans are located in front of the facility. LPA observed a hard wired interconnected combined smoke detector and carbon monoxide detector; tested to be operable. LPA observed two (2) Fire Extinguishers located in the kitchen and on the 1st floor mounted on the wall in the hallway. All posting requirements were met,(i.e food menu (posted in the kitchen and common area); (regulations, personal rights (posted at the entrance); facility sketch (posted in every room); The LIC 610C Emergency Disaster Plan for Children's Residential Facilities are posted on the wall at the entrance. Outdoor Area: The Patio space is free of hazard materials and debris. The passageways and porches are unobstructed. LPA observed patio furniture. The Licensee has recreational equipment for the space and appropriate for children. The side house stores the electrical utilities, shut-off valves for gas and water, a tank-less Hot Water Heater and central heat and air conditioning unit. LIC Page 1 of There is an exit door to the left adjacent to the front door. Garage: This is a two car garage identified as a multi-purpose workroom. There are locked file cabinets to store the medication logs, files, medical devices, medication boxes and a small refrigerator utilized to store the clients prescribed medications. It is also utilized to store extra food supply and (PPE) Personal Protection Equipment. 1st Level: Therapy Room/Staff Office#1: located to the right adjacent to the garage door. This room will be used as office space will be accessible to staff only, to serve as private setting for therapeutic services and for conducting private interviews. Bathroom #1 located in this room identified as the children's bathroom which is a Jack and Jill bathroom connect to Bedroom #1. It is a full size bathroom located in this office, equipped with one (1) toilet, one (1) sink , bathtub and a shower observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. First Aid kit is located is this room. It was observed to be equipped with the required items inside (age-appropriate, scissors, tweezers, thermometer, and gauzes, antiseptic, and First Aid Manual Guide. The facility has a working telephone and clients can use the telephone unless restricted by authorized representatives. Bedroom #1 is occupied by two (2) clients. It is equipped with two (2) Full-size beds, comfortable mattress, clean linen, blankets and pillows. There is adequate lighting, window screens, vertical blinds, there is one large closet unit space and dressers for each client. Laundry Room: Located on the 1st floor directly down the hall in between bedroom #1 and bedroom #2. It is equipped with a white Samsung washer and dryer unit. The detergent, chemical and cleaning supplies are stored in a locked on the 2nd floor directly to the top of stairs adjacent to Bedroom #3 entrance. There is a additional small storage area located under stairs that is locked for safety and security. Bedroom #2: is occupied by one client. It is located is adjacent to the laundry room. It is equipped with two (2) twin size beds, comfortable mattress, clean linen, blankets and pillows. There are one (1) sliding glass door closet. There is adequate lighting, window screens, vertical blinds observed to be in good condition. Bathroom #2 located in this room. It is a full size bathroom equipped with one (1) toilet, one (1) sink , bathtub and a shower observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. LIC Page 2 of 4 2nd Level: There is a locked Storage closet utilized cleaning supplies, liquids, hand soup, disinfectants and sharp knives are locked in a cabinet inaccessible to the clients in placement. Kitchen: The kitchen was observed to be clean and organized. It is equipped with a six (6) burners gas stove and a two (2) sided sink and a Sharp built in microwave. A two (2) sided double door refrigerator. Kitchen cleaning supplies, liquids, hand soup, disinfectants and sharp knives are locked in a cabinet inaccessible to the clients in placement. There is an additional refrigerator with the top freezer located in the garage. LPA observed ample perishable and nonperishable food items including fresh fruit and snacks. Dining Area: The dining area consists of six (6) chairs and a large table. There are three (3) chair marble seated at the marble island counter. LPA observed coverage trash cans throughout the facility and two (2) Fire Extinguishers located in the kitchen adjacent to the kitchen and laundry room. Living Room: The Living Room is fully furnished with sofa, coffee table, and a large sofa and a computer. There is a fireplace that is inoperable. There is a 65' television securely mounted on the wall. Bathroom #3 is a 1/2 bathroom quipped with one (1) toilet, one (1) sink ,observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Bedroom # Is occupied with one (1) client, equipped with two (2) Full-size beds, comfortable mattress, clean linen, blankets and pillows. There are one (1) walk in closet. There is adequate lighting, window screens, vertical blinds, and 2 three drawer dressers for each client observed to be in good condition. Bathroom #4 is full sized equipped with one (1) toilet, two (2) sinks bathtub and a shower observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Privacy Room is inside bedroom #3 will prep with chairs, beanbags and age appropriate electronic games. There is adequate lighting. LIC Page 3 of The staff accompanies clients to local recreational facilities in the facility vehicle. Clients are accorded dignity in personal relationships with staff and others. The facility will operate within license conditions and limitations including capacity limitations. The Administrator ensured the facility will have the written plan of operation. Facility personnel are instructed to report violations of personal rights. Licensee will report changes in the plan of operation affecting service to clients. Licensee will report client injuries requiring medical treatment. The administrator will provide the Personnel Report (LIC 500) and confirmed that the staff ratio presents for the six (6) clients in placement. The administrator ensured that all will have required criminal record clearance. DOJ, FBI and Child Abuse Response that will meet qualification. There were no deficiencies cited at this time. LPA concluded the Pre-License Inspection. An exit interview was conducted, and a copy of this report was left at the facility with the Chief Executive Officer/ Administrator Basel Shadfan on 07/09/ LIC- Page 4 of 4


summary: Facility Evaluation

raw_content:
Narrative:
On July 12, 2024 9: AM Licensing Program Analyst (LPA) Rosslyn Gray made an announced visit to BLUME BEHAVIORAL HEALTH Group Home located Voorhees Ave. Redondo Beach CA 90278 for the purpose to conduct the Case Management - Annual Continuation. LPA conducted a Health and safety risk assessment upon arriving at the facility. LPA met with the Program Administrator for the purpose to interview clients and staff. LPA inquired about the current census, requested the Register of Clients in placement and requested to interview all available clients and staff. Client Interviews: LPA interviewed three (3) of the five (5) clients currently in placement. Staff Interviews: LPA conducted a confidential interviews with three (3) on duty staff. LPA previously reviewed on two (2) clients records on July 9, 2024. LPA previously reviewed three (3) staff clients records July 9, There were no deficiencies cited at this time. PER California Code Regulations, TITLE 22, DIVISION 6, CHAPTERS 9.5, there were no deficiencies observed or cited at the time of the visit. LPA concluded the Case Management - Annual Continuation. An exit interview was conducted, and a copy of this report was left at the facility with the Basel Shadfan Chief Executive Officer/ Administrator

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
THIS REPORT WAS RECREATED TO CORRECT THE VISIT TYPE On July 12, 2024 9: AM Licensing Program Analyst (LPA) Rosslyn Gray made an announced visit to the above facility for the purpose to conduct a Case Management - Other Post License Continuation Inspection. LPA conducted a Health and safety risk assessment upon arriving at the facility. LPA met with the Program Administrator for the purpose to interview clients and staff. LPA inquired about the current census, requested the Register of Clients in placement and requested to interview all available clients and staff. Client Interviews: LPA interviewed three (3) of the five (5) clients currently in placement. Staff Interviews: LPA conducted a confidential interviews with three (3) on duty staff. LPA previously reviewed on two (2) clients records on July 9, 2024. LPA previously reviewed three (3) staff clients records July 9, There were no deficiencies cited at this time. PER California Code Regulations, TITLE 22, DIVISION 6, CHAPTERS 9.5, there were no deficiencies observed or cited at the time of the visit. LPA concluded the Post License Continuation Inspection. An exit interview was conducted, and a copy of this report was left at the facility with Basel Shadfan Chief Executive Officer/Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On August 7,2024, at 2:00PM Licensing Program Analyst (LPA), Rosslyn Gray and (LPM) JoAunne Griffin conducted an in office meeting with the Licensee for BLUME BEHAVIORAL HEALTH Group Home VOORHEES was held at the Children's Residential Regional Office in El Segundo. Attending the office meeting were the following individuals Executive Officer/ Administrator (CEO/ADM) Basel Shadfan, Chief Operating Officer (COO)Alex Hawes, and Chief Marketing Officer (CMO) Dan Surico. The purpose of this office meeting was to discuss issues and concerns with Incident Reporting, regulation inquiries, and to ensure that the LIC 624 is completed correctly and submitted in a timely manner. LPA provided guidance to meet the regulations for reporting requirements. LPA provided the PIN 23-02-CRP (Revision of LIC 624-LE, Law Enforcement Contact Report, LIC A Death Report, regulation in reference to Reporting Requirements, 80061 and continuing 84061. LPA reviewed and discussed the Program Statement, Emergency Intervention Plan and the discharge policies. LPA recommended that the Licensee update Program Statement to reflect changes to EIP and discharge policy. A copy of this report was provided to Chief Executive Officer/Administrator (CEO) Basel Shadfan.

met_with: Basel Shadfan Chief Executive Officer/Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On April 10, 2025, 9:30AM Licensing Program Analyst (LPA) Rosslyn Gray arrived at the above facility for the purpose of conducting Annual/Required Inspection. BLUME BEHAVIORAL HEALTH Group Home located Voorhees Ave. Redondo Beach CA 90278. A health and risk assessment were conducted. LPA met with the (S1) who granted access to the facility. The facility consists of four (4) bedrooms (1 bedroom will be utilized Therapy Room/Staff Office); two (2) car garage, living room, kitchen, dining area and education room. The facility can also be accessed through entrance in the garage. There is a facility vehicle observed to be in good condition. The facility is seeking a license to provide care and supervision for six (6) female clients ages 12-17, ambulatory only. Currently there are five (5) children in placement. LPA-Gray observed the follow during the inspection: There is an exit door to the left adjacent to the front door. Garage: This is a two (2)car garage identified as a multi-purpose workroom. It is also utilized to store extra food supply and (PPE) Personal Protection Equipment. 1st Level: Therapy Room/Staff Office#1: located to the right, adjacent to the garage door. This room will be used as office space will be accessible to staff only, to serve as private setting for therapeutic services and for conducting private interviews. There are locked file cabinets to store the medication logs, files, medical devices, medication boxes and a small refrigerator utilized to store the clients' prescribed medications. LIC Page 1 of Bathroom #1 located in this room identified as the children's bathroom which is a Jack and Jill bathroom connect to Bedroom #1. locked and inaccessible to the therapy room. It is a full size bathroom located in this office, equipped with one (1) toilet, one (1) sink, bathtub and a shower observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. First Aid kit is located is this room. It was observed to be equipped with the required items inside (age-appropriate, scissors, tweezers, thermometer, and gauzes, antiseptic, and First Aid Manual Guide. The facility has a working telephone, and clients can use the telephone unless restricted by authorized representatives. Bedroom #1 is occupied by two (2) clients. It is equipped with two (2) Full-size beds, comfortable mattress, clean linen, blankets and pillows. There is adequate lighting, window screens, vertical blinds, there is one large closet unit space and dressers for each client. Laundry Room: Located on the 1st floor directly down the hall in between bedroom #1 and bedroom #2. It is equipped with a white Samsung washer and dryer unit. There is an additional small storage area located under stairs that is locked in safety, security, and detergent, chemical and cleaning supplies are stored. Bedroom #2: is occupied by two (2) clients. It is located is adjacent to the laundry room. It is equipped with two (2) twin size beds, comfortable mattress, clean linen, blankets and pillows. There are one (1) sliding glass door closet. There is adequate lighting, window screens, vertical blinds observed to be in good condition. Bathroom #2 located in this room. It is a full-size bathroom equipped with one (1) toilet, one (1) sink, bathtub and a shower observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. 2nd Level: Directly to the top of stairs adjacent to Bedroom #3 entrance. Private Room#2 utilized for client to de-escalate and personal space. LIC Page 2 of Kitchen: The kitchen was observed to be clean and organized. It is equipped with a six (6) burners gas stove and a two (2) sided sink and a Sharp built in microwave. A two (2) sided double door refrigerator. Kitchen cleaning supplies, liquids, hand soup, disinfectants and sharp knives are locked in a cabinet inaccessible to the clients in placement. There is an additional refrigerator with the top freezer located in the garage. LPA observed ample perishable and nonperishable food items including fresh fruit and snacks. Dining Area: The dining area consists of six (6) chairs and a large table. There are three (3) chair marble seated at the marble island counter. LPA observed coverage trash cans throughout the facility and two (2) Fire Extinguishers located in the kitchen adjacent to the kitchen and laundry room. Living Room: The Living Room is fully furnished with Olive Green sofa, coffee table, and a large sofa and a computer. There is a fireplace that is inoperable. There is a 65' television securely mounted on the wall. Bathroom #3 is a 1/2 bathroom quipped with one (1) toilet, one (1) sink, observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Bedroom # Is occupied with one (1) client, equipped with two (2) Full-size beds, comfortable mattress, clean linen, blankets and pillows. There are one (1) walk in closet. There is adequate lighting, window screens, vertical blinds, and 2 three drawer dressers for each client observed to be in good condition. Bathroom #4 is full sized equipped with one (1) toilet, two (2) sinks, bathtub and a shower observed to be in good condition. The water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Privacy Room#2 is inside bedroom #3 will prep with chairs, beanbags and age-appropriate electronic games. There is adequate lighting. The staff accompanies clients to local recreational facilities in the facility vehicle. Clients are accorded dignity in personal relationships with staff and others. The facility will operate within license conditions and limitations including capacity limitations. The Administrator ensured the facility will have the written plan of operation. Facility personnel are instructed to report violations of personal rights. Licensee will report changes in the plan of operation affecting service to clients. Licensee will report client injuries requiring medical treatment. LIC Page 3 of The administrator will provide the Personnel Report (LIC 500) and confirmed that the staff ratio presents for the six (6) clients in placement. The administrator ensured that all will have required criminal record clearance. DOJ, FBI and Child Abuse Response that will meet qualification. There were no deficiencies cited at this time. LPA concluded the Annual/Required Inspection An exit interview was conducted, and a copy of this report was left at the facility with the Chief Operating Officer/ Alex Hawes on 04/10/ LIC- Page 4 of 4

visit_type: Annual


facility_name: BNI TREATMENT CENTER - AGOURA

summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On August 2, 2024, Licensing Program Analyst (LPA) C. White arrived at BNI Treatment Center - Agoura for the purpose of delivering findings for the allegation listed above. LPA met with Administrator, Maria Sarkisian. During investigation of the allegation, LPA conducted confidential interviews and reviewed documents. Based on interviews, statements provided did not determine that staff administered medication to minor without responsible party's consent. Staff denied the allegation and stated parental consent is obtained during client intake. Client statement could not be obtained. Based on information obtained, the allegation is found to be unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. There were no deficiencies cited. An exit interview was completed, and a copy of this report was left with the Administrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Bernice Karnsrithong LICENSING EVALUATOR NAME: Charmetha White LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

report_type: Complaint Investigation

met_with: Administrator - Maria Sarkisian

complaint_status: unsubstantiated


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
LPA received conflicting testimonies regarding the medication administration. Witness testimony claimed that medication is not administered or logged accurately. Nurse and doctor interviews shared that the process and logs are correct. Clients had no complaints about their medications. Based on the available information, LPA gathered from interview evidence from staff and clients, and from observations and records review the preponderance of the evidence standard has not been met; therefore, the allegation that the "Staff are not ensuring that minors in care are administered their medications according to physicians' instructions." is found to be unsubstantiated. Allegations: "Licensee is not safeguarding the confidentiality of minors in care." During the course of the investigation, LPA interviewed involved staff and witnesses. Witness testimony explained that the nurses' station, where clients receive their medication and do their general health checks, is located upstairs above the entry way in an open loft area. Witness claimed that performing medical services in that area breached client confidentiality due to the nature of the room. Witness claimed that confidential medical information being shared between nurses or from nurse to client can be easily overheard from the nurses' station because of its location. Nurse testimony shared that most transfer of medical information happens via secure email, so it can't be overheard. Nurses also shared that they are conscious of the location, and while they always try to maintain confidentiality in the nurse station, sometimes they will go outside to share information if they deem it necessary to keep client confidentiality. Nurses also shared that they do not allow any client upstairs, while doing their daily medication procedures. Other facility staff testified that they have never heard the nurses from upstairs. While sometimes staff can tell that nurses are upstairs, the conversation is not clear or understandable from downstairs. Client testimonies shared that they have never overheard nurses' conversations from downstairs. All clients reported that they feel safe and that their personal information has been kept confidential. LPA observed the nurses' station and the living room under it. While being an open room above the entryway, LPA observed that the nurses' station can not be heard clearly from downstairs. LPA received conflicting testimonies regarding the confidentiality from the nurses' station. While witness testimonies shared that clients' medical information is being overheard and breached, client and staff testimonies shared that confidentiality is kept, and the nurses' station does not violate client confidentiality. Based on the available information, LPA gathered from interview evidence from staff and clients, maintaining that the nurse staff and station uphold confidentiality and LPA observations of the area, the preponderance of the evidence standard has not been met; therefore, the allegation that the "Licensee is not safeguarding the confidentiality of minors in care." is found to be unsubstantiated. Allegations: "Licensee is not ensuring that the facility is kept free from mold." During the course of the investigation, LPA interviewed involved staff, clients, and witnesses. Witness testimony claimed that there was a mold under the kitchen sink. Staff and client interviews shared that they had not seen or experienced any mold in the facility or specifically under the kitchen sink. LPA examined and under the kitchen sink did not observe any mold. LPA took pictures of the area under the sink. LPA received conflicting testimonies regarding the mold under the sink. LPA did not observe any mold under the sink. Based on the available information LPA gathered from interviews and observation evidence, the preponderance of the evidence standard has not been met; therefore, the allegation that the "Licensee is not ensuring that the facility is kept free from mold" is found to be unsubstantiated. Allegations: "Licensee is not addressing a pest infestation at the facility." During the course of the investigation, LPA interviewed involved staff, clients, and witnesses. Staff, clients, and witnesses admitted that there was a situation where a mouse got into the house, specifically the fridge. The general testimony consensus was that during a weekend, a mouse got into the facility, presumably through an open door, and then got into the fridge. It is not known how long the mouse was in the fridge, but it did not die in the fridge. The facility's response was to call pest control, set traps, throw away the contaminated food, clean the fridge, and check the cabinets for contamination. Staff and client testimony shared that there has not been any other pest problems since. LPA observed pest control invoice records from the facility proving their response to the situation. All client interviews shared that they are satisfied with the facility's response. While all interviews admitted that there was an issue with a mouse in the facility, all testimony evidence said that this was a singular issue, not a recurring problem. LPA observed the set traps and the invoice for the pest control, proving the facility had a quick and appropriate response. Based on the available information LPA gathered from interviews and observation evidence, the preponderance of the evidence standard has not been met; therefore, the allegation that the "Licensee is not addressing a pest infestation at the facility" is found to be unsubstantiated. Allegations: "Licensee is not ensuring that minors in care are provided an adequate quantity of food." During the course of the investigation, LPA interviewed involved staff, clients, and witnesses. Witness testimonies shared that the facility locks up the food and that the clients can not access food freely. Staff testimonies shared that the facility provides 3 hot meals daily to the clients on a specific schedule, the clients have open and free access to a mini fridge with healthy snacks including fruit, yogurt, milk, and cheese, there are unhealthy snacks like chips and cookies that are offered at specific times and are otherwise kept locked. Client interviews confirmed that they have access to snacks from the mini-fridge whenever they want, and they can eat the leftovers of the chef made meals. No clients LPA observed the full fridge filled with food for the clients, the chef cooking the clients an adequate amount for lunch, the locked unhealthy snacks, and the accessible mini fridge of healthy snacks. LPA received conflicting testimonies regarding the client's access to food. Clients and Staff shared that there is healthy food and snacks accessible 24/7 to clients. Based on the available information LPA gathered from interviews and observation evidence, the preponderance of the evidence standard has not been met; therefore, the allegation that the "Licensee is not ensuring that minors in care are provided an adequate quantity of food" is found to be unsubstantiated. No deficiencies cited. Exit interview conducted, and a copy of this report was given to Nurse Maribell Gutierez.

Investigation Findings:
13On 8/13/25 at 10: AM , Licensing Program Analyst (LPA) Reagan Cohen arrived at the above facility and met with Nurse Maribell Gutierez for the purpose of delivering complaint findings regarding the above allegation. Allegation: "Staff are not ensuring that minors in care are administered their medications according to physicians' instructions." During the course of the investigation, LPA interviewed involved staff and witnesses. Witness testimony claimed that nurses are improperly logging clients' medication, leading to errors and mishaps with clients' medications. Nurses and doctors' testimony shared that there are no mistakes or errors with administering and logging clients' meds. Nurses walked LPA through the medication preparation, administration, and tracking process. LPA observed the EMAR to be accurate and up-to-date. Client testimonies shared no complaints or issues with the nursing staff or the medication administration. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Reagan Cohen LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: BNI TREATMENT CENTER - AGOURAFACILITY NUMBER: VISIT DATE: 08/13/2025

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

met_with: Maribell Gutierez, Nurse


summary: Facility Evaluation

raw_content:
Narrative:
On 03/11/2022 at 9am, Licensing Program Analyst (LPA) arrived at the facility for the purpose of conducting an annual inspection. LPA Karnsrithong had conducted health and safety assessment upon arriving at the facility. LPA Karnsrithong met Maria Sarkisian, Administrator for the facility who granted access and tour of the facility. The current census is (4) and there are four (4) staff present in the facility. The facility's CARF accreditation is currently being renewed and they will come on Monday, March 14, 2022 to finalize the accreditation. During the inspection LPA Karnsrithong has observed the following: The facility is in a residential neighborhood. It is licensed to care and supervise up to six (6) male and female youth ages 12 to 17 ambulatory only. The facility is a two-story home with three (3) detached units being used as a gym, accounting/payroll, and therapy room. The therapy room is two-story detached unit. There are two (2) therapists who facilitates these rooms for the clients during sessions. The downstairs therapy room has couch, an office desk, chair, and rug. The upstairs therapy room has a large table, office chairs, couch, office desk and chair for the therapist. All therapy rooms have smoke/carbon monoxide alarms and first aid kits. The gym/office room is two (2) story unit. The downstairs is used as a gym that houses sporting equipment for clients and upstairs is used as an office for accounting/payroll. A first aid kit and smoke/carbon monoxide alarm are located in the this unit. The education room is located next to the pool. It has desks, chairs, and computers for clients to use. There are fire extinguishers on all the detached units. All outdoor and indoor passageways are free of debris and obstruction. Front Area: The front part of the property has a private driveway that leads to the parking area and the main driveway. There are stairs that leads to the main foyer. There are trees in the front part of the of the house. Utility shut off valves are located in front of the main property. (Page 1 of 2) The main entrance has a seating unit. COVID-19 checks are done in the front door area. There is a countertop bar located in the the front reception area as well. Dining Area: The dining room is located in the front portion of the main property. It has a large table with eight (8) chairs. It has a cabinet and has a large window overlooking the front part of the property. Outside Area: The facility has a rolling backyard. There are patio furniture's throughout the outside area. There is a pool has a clear fence surrounding it that is self-closing and is at least five feet in height. The pool is clean and well maintained. The pool valves are located in the back side of the property. The pool area has chairs and a volleyball net available for clients to use. Kitchen Area: The facility has a large kitchen which is located in the back side of the main house. It has six (6) stove gas burner, a refrigerator, air fryer, microwave, toaster, coffee maker, and dishwasher. Temperature logs for the refrigerator and sink water are checked regularly and documented. There is ample supplies of perishable and non-perishable foods for clients. There is a breakfast nook next to the kitchen that has a mini-fridge that has the clients snacks. It has a table and dining chairs. All sharp objects are locked up and inaccessible for clients. There are two (2) fire extinguishers in the kitchen area. The food preparation area is kept clean and well maintained. All kitchen cabinets are labeled and organized. There are sufficient pots, pans, utensils, plates and cups for clients to use. There is a chef that prepares all the meals for the children and is aware of all dietary restrictions. Clients are being served nutritious meals daily. Menus are posted in the kitchen. Common Room: There are two (2) common room located downstairs for clients to use. One is used for group activities and one is used for recreational use. There are couches and tables for clients and staff to use. All living room furniture are in good condition. Nurse Office: The nurse office is located upstairs. It has a mini refrigerator to store medications, cabinets, first aid kits, defibrillator, blood borne pathogens kit, computer, office desk, and chairs. Medication is maintained by the pharmacologist. The nurse is on call 24/7. All psychotropic and over the counter medications are stored in this office. This office is kept locked when staff is not present. (Page 2 of 2) Laundry Room: The laundry room has a washer and dryer unit. It has a shelf for laundry supplies for clients and staff to use. It is kept locked when not in use. Bathroom: There are three (3) full size bathrooms in main property. There is one (1) bathroom located downstairs with a shower, toilet, sink, mirror and cabinets. There are two (2) bathrooms located upstairs. One bathroom upstairs is only used by staff and is also used to store COVID and cleaning supplies. All personal and contraband items of clients are also stored in this room. There is a tub in this bathroom but is not being used. The other upstairs bathroom is used by clients. All bathrooms are clean and water temperature are all in safe range. Bedrooms: There are four (4) bedrooms in the facility. One is located downstairs and three (3) upstairs. Each bedroom has a sturdy and clean mattress, adequate lighting and storage. Downstairs bedroom has a sliding door that leads to the back yard. The upstairs bedrooms have window screens that are in good condition. Shed: There is a utility shed located in the side of the house. This is used to store garden and cleaning equipment for the facility. It is also next to the air condition units. Clients are being accorded of their personal rights. Psychiatrists provides services to clients once a week. Clients have regular activities such as beach outing, surfing, and equine. There is a Physician Assistant in the facility as well. Licensed Vocational Nurse and counselors administers medication to clients. Therapeutic services are provided at a minimum of three times a week. LPA Karnsrithong interviewed two (2) staff and one (1) client. All counselors and nursing staff have access to the keys to the facility. There is one (1) facility vehicle being used to transport clients that is in good working condition. There are no deficiencies cited at this time. Exit interview was conducted with Maria Sarkisian, Administrator. A copy of this report will be provided to the facility. (Page 3 of 3)

met_with: Maria Sarkisian, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 12/05/24 at 10: AM Licensing Program Analyst (LPA) Reagan Cohen and Licensing Program Manager (LPM) Lakescia Smith arrived at BNI Treatment Center Agoura for an annual/random inspection and met with Administrator Maria Sarkisian. LPA and LPM requested and were given a copy of the staff roster (LIC 500) and the client Roster (LIC 9020). LPA and LPM then conducted a facility inspection. The Group Home is licensed to provide care/supervision up to six (6) clients and has a current census of three (3). There is a swimming pool on premises. This is a two-story home with 4 bedrooms, 3 full bathrooms, nursing station, 2 living rooms, dining room, kitchen, laundry area, front yard, back yard with a swimming pool and school house, a unattached garage that has extra food storage and two therapists rooms, and another unattached backyard garage with a downstairs gym and upstairs records room. The facility only accepts private placement clients. LPA and LPM observed the facility license posted in public view in the front enterance, posted activity schedule for clients in the living room, and a posted menu for the month in the kitchen. There is one non-operable fireplace. There are no security bars on windows. There are working smoke detectors and carbon monoxide detectors in the home. All 7 out of 7 fire extinguishers were fully charged. Facility has adequate supply of perishable and nonperishable food for at least one week and extra of both in the garage. Facility has operable land line that has been removed from its locked cabinet and is now open to all clients. All knives were kept on chefs person making them inaccessible to clients. Bathrooms were clean and sanitary and cleaning solutions were made inaccessible. LPA and observed a laundry room with adequate amount of extra towels, linens, and blankets. Report continued on LIC 809-C. Living room and dinning area have adequate seating capacity. The facility has adequate indoor and outdoor space. The front and backyard were found to be clean of debris and observable hazards. The facility has a working washer and dryer. The facility uses video surveillance. LPA and LPM informed Administrator to submit revisions to the program statement that reflects the facilities usage of video cameras. Backyard pool is kept locked with a key, not with a self latching lock. Administrator confirmed that all staff have keys that unlock the swimming pool area. LPA and LPM observed pool door being stuck and not closing or locking when exiting the pool area. Administrator informed LPA and LPM that maintenance would come and adjust the alignment to allow the door to close and lock. Medications are stored in the nurses office which is on the seconded floor of the main house. The office is kept locked, but inside the office LPA and LPM observed an unlocked fridge storing medication that needs to be kept temperature controlled, and one container of dry medication not locked with the clients other medication. LPA and LPM also observed a locked container of medication intended for destruction that has not been disposed of yet. LPA and LPM also observed clients hygiene products stored in the nursing station. The nursing station also houses the surveillance camera monitors. Bedroom #1 is located downstairs, it has 2 beds with storage attached under the bed frame. LPA observed that the second bed in the room is blocking the sliding door exit to the backyard. LPA and LPM advised Administrator to remove the second bed that is blocking the sliding door. Bedroom #1 had no other storage units, including no extra closets or drawers. LPA observed and tested working smoke/carbon monoxide detector. Bedroom #2 is upstairs and has two beds both with storage drawers under the bed frames. LPA and LPM observed and tested working smoke/carbon monoxide detector in the room. LPA and LPM also observed a sliding door that leads to the balcony. LPA tested the sliding door and found it to be stuck. Bedroom also has a master bathroom that is attached to it that is used as storage space and kept locked. LPA and LPM informed Administrator to not use clients bedroom as passageway to facility storage room. Administrator shared that they would create another entrance to the storage room to avoid using the bedroom as a passageway. LPA and LPM observed that smoke/carbon monoxide detector are working. Report continued on LIC 809-C. Bedroom #3 is upstairs it has 2 beds with storage attached under the bed frame. LPA observed a window with a missing screen in the bedroom. Bedroom also has a closet for extra storage space. LPA and LPM observed an odor coming from the bedroom. Administrator stated that client in the room wets the bed and while the mattress is water proof the staff consistently change the sheets and blankets, yet the room still caries the odor. LPA and LPM observed that smoke/carbon monoxide detector are working. Bedroom #4 is upstairs it has 2 beds with storage attached under the bed frame. Bedroom also has a closet for extra storage space. LPA and LPM observed that two out of the three lights in the room were not working. LPA and LPM observed that the facility has 8 beds but only has a capacity of 6. LPM and LPA informed Administrator that the facility can only have a maximum of 6 beds which matches their maximum capacity of 6. Bathroom #1 is downstairs. LPA tested the sink water temperature to be at 60 degrees F. Bathroom #2 is upstairs and has two sinks both with water temperature at 120 degrees F. LPA also observed some ants in the shower. The following deficiencies were cited see 809-D. Exit interview completed. A copy of this report was given to Maria Sarkisian.

met_with: Maria Sarkisian


summary: Facility Evaluation

raw_content:
Narrative:
On 1/24/25 at 9:50 am Licensing Program Analyst (LPA) Reagan Cohen met with Administrator Maria Sarkisian to conduct an unannounced Case Management Annual Continuation Inspection for BNI Treatment Center Agoura. LPA interviewed staff on policies, procedures, and practices. LPA interviewed clients about their experiences with the facility and program. LPA completed CARE Tools Inspection checklist. LPA conducted a facility vehicle safety inspection. LPA reviewed a copy of the minutes from the previous board of directors meeting. LPA reviewed staff files for training, criminal records clearance, health, qualifications, and more. LPA reviewed facility disaster training. LPA completed Case Management Annual Inspection. Exit Interview was conducted, and a copy of this report was given to Administrator Sarkisian.


summary: Facility Evaluation

raw_content:
Narrative:
On August 22, 2025, Licensing Program Analyst (LPA), C. White made an unannounced visit to BNI Treatment Center - Agoura for the purpose of conducting a Case Management visit regarding an Incident. LPA met with Lead Residential Counselor, Erik Lopez and was granted access to the facility. Special Incident Report 0000336-FN was reported to the Department on 03/10/2024. The incident occurred on 03/09/2024. The incident started that a client stole bottle of Benadryl and took multiple pills. Based on the information provided, and interview conducted, the client snatched the pills on while facility nurse was passing medication. Staff contacted 911 immediately, the client was taken to emergency room for an evaluation and released back to the facility the same day. During the investigation LPA requested copies of the LIC 500, C1's hospital paperwork, behavior log documentation for C1 from 03/08/2024 - 03/13/2024, and C1's discharge summary report. Based on information obtained, further investigation is needed. PER California Code Regulation, there are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report was emailed to the Administrator, Maria Sarkisian.

met_with: Erik Lopez - Lead Residential Counselor


facility_name: BNI TREATMENT CENTERS

summary: Facility Evaluation

raw_content:
Narrative:
On October 29, 2024, at 2: PM, a Component II Office Meeting was held to discuss the application received for BNI Treatment Centers Attending Component II were the following individuals: Proposed administrator Maria Sarkisian, Licensing Program Analyst Connie Jones-Steward and Licensing Program Manager Lakescia Smith. The purpose of this Component II meeting was to review and discuss the application and Program Statement and to resolve any outstanding concerns and issues The following issues were discussed. 1. Job description for administrator will be included in program statement. 2. The proposed administrator change for BNI, Agoura will need to be approved before Maria Sarkisian can be approved as administrator for this facility. 3. LIC 401: The Monthly Operating Statement is incomplete. A realistic estimated cost is needed for each item. An LIC 401 is needed for all existing facilities. 4. LIC 404: An updated Release of Financial Information is needed along with verification of financial resources 3 times greater that the combined expenses for all facilities. 5. LIC 610: Items III and V will be completed. 6, Facility Sketch: Bedroom dimensions, notation of bedroom windows, location of utility shutoffs, number of clients per bedroom will be included. 7. The Fire Clearance has not been received. 8.The Emergency Intervention Plan is incorrect, It should not contain information on emergency evacuation procedures. 9. The Runaway Plan will be updated to t include a continuum of interventions to prevent runaways. 10. House rules surrounding rights of clients to private visitation were discussed and clarified. 11.. House Rule Regulations were discussed and clarified. Clients will perform chores on a voluntary basis. 12. Operating Agreement is needed that designates Maria Sarkisian to act for the LLC Parental authority is needed for psyche meds. Applicant will include their procedures for obtaining parental authorization for administration of psychotropic medications. Applicant will provide a sample menu and sample calendar of activities. Prelicensing visit is scheduled for November 19th, 2024 at 10: AM


summary: Facility Evaluation

raw_content:
Narrative:
On November 19, 2024, Licensing Program Analyst Connie Jones-Steward met with Maria Sarkisian to conduct a pre-licensing evaluation of the facility. The following was observed. This is a four bedroom, four and a half bathroom home located in an unincorporated area of Calabasas, CA. There are no security bars on windows. There are plans to install a pool or a ball court in the backyard. The applicants will inform the Department if either choice is made. Bedrooms All bedrooms are on the 2nd floor and there is a nursing station that will be manned by a licensed nurse while clients are in their bedrooms. All bedrooms have beds and linens in good condition. There is the required drawer and closet space for each bedroom. There is a nursing station situated near the bedrooms. There are automatic blinds on the bedroom windows. Bathrooms/Kitchen/Dining Area All bathrooms are clean and well maintained. The bathroom on the first floor is a half bath. There is a stove and a refrigerator. The propane supply was disconnected due to high winds, therefore the hot water temperature and the stove burners could not be checked. No sharp knives will be stored on the premises; the chefs will bring their knives on a daily basis and take them at the end of their shift. However knives will be locked up while the chefs are on duty. There is a breakfast nook. There is a dining table that seats eight. Fire/Yard Safety All fireplaces are safely screened. There are currently no bodies of water on the premises. There are working smoke detectors in the hallways and bedrooms along with a carbon monoxide detector in the hallway. There are fully charged fire extinguishers throughout the house. The yard perimeter is fenced to provide safety from the steep hills. The patio and yard areas present no visible hazards. LPA informed Ms. Sarkisian that the fire marshal will have to approve the use of the garage as a rec room. Misc: There are several complete first aid kits on the premises. There is also a supply of first aid items in the nursing station. Medications will be locked in the nursing station. Household cleaners will be locked in the laundry room. The following items will be reviewed during the return inspection: Applicant will have the propane supply activated so that safe water temperature and working stove condition can be verified. LPA will verify that the automatic blinds that cover the bedroom windows are working. LPA will verify that the doorway behind the 2nd bed in bedroom number 4 is covered. Applicant will either tint or cover windows in the dining and kitchen areas to ensure privacy of clients. LPA will also review the facility vehicle for safety.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward held a Face Time meeting with Maria Sarkisian to verify completion of the corrections pre-licensure. LPA was able to verify the following: The automatic window blinds in all four bedrooms are working. The hot water temperature is 119 degrees. The doorway behind 2nd bed in bedroom number 4 is covered. There are curtains in the dining room area. LPA Jones-Steward will forward the application to LPM Lakescia Smith for approval.


facility_name: BNI TREATMENT CENTERS CALABASAS

summary: Facility Evaluation

raw_content:
Narrative:
On September 10, 2020 at 10:30 a.m. Licensing Program Analyst (LPA) Cameo Banks made a virtual telephone visit to the above facility, for the purpose of conducting a Post-Licensing Inspection. LPA virtually met with Administrator, Maria Sarkisian, who provided a tour of the entire physical plant inside and out. This facility is designed to accept private placements to provide care/supervision for six (6) ambulatory only clients, ages 12-17 years. There are six clients in placement at this time. The home is set up as follows: This home is located in a remote residential neighborhood. The two-story home has four (4) bedrooms, eight and a half (8.5) bathrooms, group therapy room, school room, two (2) therapy rooms, laundry room, Administration office, nursing station room, dining area, kitchen, backyard with pool, and attached garage, which will be used a fitness room. 1st Floor: The first level of the home includes the following: Kitchen- The kitchen and surrounding area were equipped with fully operable kitchen appliances and dining table with seating with eight chairs. The kitchen was fully stocked with ample eating utensils, pots/pans, plates, bowls and cups. Fire extinguisher located in the kitchen was noted to be up to date. The was at least a two day supply of perishable food supplies and 7 day supply of non-perishable food in pantry located to the right of the kitchen. The knives are stored in locked Administrator office. Dining room-There is a wooden table with eight chairs. School room-This room has a total of six individual desks and three computers. Laundry room-This room has a front loading washer and dryer. Laundry detergent is in locked cabinet. Living room-There are three sofa chairs and one large sofa which appears to be in new condition. Fireplace in living room has screen. There are numerous fully charged fire extinguishers available. Both therapy rooms and Group therapy room are furnished with chairs and sofas. Bathrooms: There are a total of 8.5 bathrooms; 1.5 bathrooms located on the 1st floor. Toilet, sink and tub/showers are in safe, clean, and operating condition in all bathrooms. Report continued on 809-C 2nd Floor: The second level of the home includes the following: Bedroom #1: This room is equipped with two queen size beds. There are adequate drawer space and lighting in this room. This room has a patio backdoor entrance/exit that has a manual lock. All windows in this room can not be opened. There are no security bars on the windows. An alarm system has been installed on all windows and doors. This room also has a private bathroom which is locked. Bedroom # This room is equipped with one queen size bed. There are adequate drawer and closet space and lighting in this room. All windows in this room can be opened. This room also has a private bathroom which is locked. Bedroom # This room is equipped with one queen size bed. There are adequate drawer and closet space and lighting in this room. All windows in this room can be opened. This room also has a private bathroom which is locked. Bedroom # This room is equipped with two queen size beds. There are adequate closet and drawer space and lighting in this room. This room has a patio backdoor entrance/exit that has a manual lock. All windows in this room can not be opened. This room also has a private bathroom which is locked. Nursing station-This room has one desk, one mini fridge, cabinet with hygiene supplies and locked cabinet where medication is stored. Employee and client files also stored in nurses office station. Storage closet: surplus of non perishable foods, feminine hygiene products, toiletries, office supplies, hand sanitizing wipes 2nd storage closet: Specifically COVID-19 supplies that include paper towels, face shields , masks, disinfectant, bleach, hand sanitizer hall closets:(3) remains locked. contains individual caddies with grooming baskets, towels, art supplies, and clients empty luggage Admin office: adequately furnished and remains locked. Sharp objects are locked in Administrator's file cabinet. Report continued on 809C Backyard: Backyard is clean and free of debris. Swimming pool has a gate that is at least 5 feet with outside self latching lock.There is a ping pong table, BBQ grills with attached dishwasher, sink and mini fridge. Garage: Garage is used as a fitness gym, punching bag and gloves, yoga mats, resistance bands, two stationary bikes, jumps ropes, foam rollers and a screen television. The garage also contains a second refrigerator which hold extra food supplies. Facility is clean, safe, sanitary and in good repair. Facility has non-perishable foods for one week and perishable foods for two days. Facility provides nutritious snacks between meals. Facility posts child's rights if licensed to provide foster care for six or more children. Children are not restricted in telephone use except by court order. Children are accorded dignity in personal relationships with others in the home. Children live in a safe, healthy, comfortable facility and will be treated with respect. Children can contact the licensing agency or foster Care Ombudsperson in confidence without threats or punishments for making complaints. Children in care will be supervised & protected at all times. Due to restrictions due to COVID-19, LPA unable to physically visit facility to review client and staff files. Files will be reviewed at a later date. Adults working/residing in the facility have DOJ/FBI criminal record clearances. Adults working/residing in the facility have Child Abuse Index Checks. Facility personnel meet staff qualification requirements. Facility personnel meet staff training requirements. Emergency Disaster Mass Casualty Plan: Current and available for review. Facility operates within license conditions & limitations including capacity limitations. There were no deficiencies cited at this time. Exit Interview was conducted, and a copy of this report will be emailed to Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On May 25, 2021 at 10:00 a.m. Licensing Program Analyst (LPA) Cameo Banks made a virtual telephone visit to the above facility, for the purpose of conducting an Annual/Required Inspection. LPA virtually met with Administrator, Maria Sarkisian, who provided a tour of the entire physical plant inside and out. This facility is designed to accept private placements to provide care/supervision for six (6) ambulatory only clients, ages 12-17 years. There are six clients in placement at this time. The home is set up as follows: This home is located in a remote residential neighborhood. The two-story home has four (4) bedrooms, eight and a half (8.5) bathrooms, group therapy room, school room, two (2) therapy rooms, laundry room, Administration office, nursing station room, dining area, kitchen, backyard with pool, and attached garage, which will be used a fitness room. 1st Floor: The first level of the home includes the following: Kitchen- The kitchen and surrounding area were equipped with fully operable kitchen appliances and dining table with seating with eight chairs. The kitchen was fully stocked with ample eating utensils, pots/pans, plates, bowls and cups. Fire extinguisher located in the kitchen was noted to be up to date. The was at least a two day supply of perishable food supplies and 7 day supply of non-perishable food in pantry located to the right of the kitchen. There is also a miniature refrigerator with snacks for the youth. The knives are stored in locked Administrator office. Dining room-There is a wooden table with eight chairs. School room-This room has a total of six individual desks and six computers. Laundry room-This room has a front loading washer and dryer. Laundry detergent is in locked cabinet. Living room-There is one large sofa chairs which appears to be in new condition and four bean bags for sitting. Fireplace in living room has screen. There are numerous fully charged fire extinguishers available. Both therapy rooms and Group therapy room are furnished with chairs and sofas. Bathrooms: There are a total of 8.5 bathrooms; 3.5 bathrooms located on the 1st floor. Toilet, sink and tub/showers are in safe, clean, and operating condition in all bathrooms. Report continued on 809-C 2nd Floor: The second level of the home includes the following: Bedroom #1: This room is equipped with two queen size beds. There are adequate drawer space and lighting in this room. This room has a patio backdoor entrance/exit that has a manual lock. All windows in this room can not be opened. There are no security bars on the windows. There An alarm system has been installed on all windows and doors. This room also has a private bathroom. Bedroom # This room is equipped with one queen size bed. There are adequate drawer and closet space and lighting in this room. All windows in this room can be opened. This room also has a private bathroom which is locked. Bedroom # This room is equipped with one queen size bed. There are adequate drawer and closet space and lighting in this room. All windows in this room can be opened. This room also has a private bathroom. Bedroom # This room is equipped with two queen size beds. There are adequate closet and drawer space and lighting in this room. This room has a sliding backdoor entrance/exit that has a manual lock. There are two windows in this room, and one window can be opened. This room also has a private bathroom. Nursing station-This room has one desk, one mini fridge, cabinet with hygiene supplies and locked cabinet where medication is stored. Employee and client files also stored in nurses office station. Storage closet: surplus of non perishable foods, feminine hygiene products, toiletries, office supplies, hand sanitizing wipes 2nd storage closet: Specifically COVID-19 supplies that include paper towels, face shields , masks, disinfectant, bleach, hand sanitizer hall closets:(3) remains locked. contains individual caddies with grooming baskets, towels, art supplies, and clients empty luggage Admin office: adequately furnished and remains locked. Sharp objects are locked in Administrator's file cabinet. Sitting area, one sofa 2 bean bags Report continued on 809C Backyard: Backyard is clean and free of debris. Swimming pool has a gate that is at least 5 feet with outside self latching lock. There is a ping pong table, BBQ grills with attached dishwasher, sink and mini fridge. Garage: Garage is used as a fitness gym, punching bag and gloves, yoga mats, resistance bands, two stationary bikes, jumps ropes, foam rollers and a screen television. The garage also contains a second refrigerator which hold extra food supplies. Facility is clean, safe, sanitary and in good repair. Facility has non-perishable foods for one week and perishable foods for two days. Facility provides nutritious snacks between meals. Facility posts child's rights if licensed to provide foster care for six or more children. Children are not restricted in telephone use except by court order. Children are accorded dignity in personal relationships with others in the home. Children live in a safe, healthy, comfortable facility and will be treated with respect. Children can contact the licensing agency or foster Care Ombudsperson in confidence without threats or punishments for making complaints. Children in care will be supervised & protected at all times. Due to restrictions due to COVID-19, LPA unable to physically visit facility to review client and staff files. Files will be reviewed at a later date. Adults working/residing in the facility have DOJ/FBI criminal record clearances. Adults working/residing in the facility have Child Abuse Index Checks. Facility personnel meet staff qualification requirements. Facility personnel meet staff training requirements. Emergency Disaster Mass Casualty Plan: Current and available for review. Facility operates within license conditions & limitations including capacity limitations. There were no deficiencies cited at this time. Exit Interview was conducted, and a copy of this report will be emailed to Administrator.

met_with: Maria Sarkisian Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 04/21/2022 at 10am, Licensing Program Analyst (LPA) Bernice Karnsrithong arrived at the facility for the purpose of conducting an annual site inspection. LPA Karnsrithong met with Maria Sarkisian, Administrator who granted access and tour of the facility. Health and safety risk assessment were conducted during the visit. COVID-19 check in were conducted in the front entrance. The facility is licensed to provide care and supervision up to six (6) male and female youth ages twelve to seventeen (12 to 17) years of age. The current census at the time of the visit is 6. During the visit LPA Karnsrithong has observed the following: This group home is located in a residential neighborhood. The facility is a two-story home. The entrance has parking for staff and visitors. There is a stairway that leads to the front door/main entrance of the facility. Upon entering the facility, staff checks in visitors temperature and abides to COVID- Protocols. The facility has four (4) bedrooms, eight (8) bathrooms. Safety drills are conducted once a month and is recorded in their safety binder. A physician assistant comes in once a day and a psychologist meets with clients three (3) times a week. During the inspection, the clients were at equine outing. LPA Karnsrithong has reviewed two (2) staff files and three (3) client files. LPA Karnsrithong has interviewed one (1) staff during the inspection. There is one (1) facility vehicle that transports clients. First Floor: The first floor has three (3) fire extinguishers that are located in the common room, kitchen hallway, and gym. There are four (4) bathrooms located in the first floor. Three (3) bathrooms are used by clients and one (1) bathroom is dedicated for employees only. The employee bathroom is kept locked. All bathrooms have a toilet, sink, and cabinets. It has ample lighting and all water temperatures are in the safe range. There are two (2) closets located downstairs. (Page 1 of 4) Common Room/Living Room: This is located in front of the main entrance. It has couches, coffee table, television, and a fireplace that is non-operational. The Emergency Disaster Plan and Facility Sketch Plan is posted in this area. A closet is also located next to the common room that stores board games. The common room has a sliding door that leads to the outdoor patio. Outdoor Patio Area: This area has outdoor patio furniture that is clean and in good repair. It also has a ping-pong table that is securely attached. There is an outdoor kitchen set but the facility only uses grill for cooking; the refrigerator and dishwasher is not being used. There is sink as well in the outdoor kitchen area. Therapy Rooms: There are two (2) individual therapy rooms that is equipped with couches, desk, table and chairs. It has picture windows. There is ample lighting in the therapy rooms. There is a full-size bathroom in the individual therapy rooms that is equipped with toilet, sink, and shower. The bathroom has cabinets. The therapy bathrooms are in good repair and well maintained. The temperature inside the therapy room are within the safe range. Group Therapy Room: The group therapy room is located next to the stairway. It has chairs and a dry erase board used during group sessions. School Room: The school room is equipped with desks, computers and cabinets. Clients conduct school/educational activities in this room. There is a teacher that supervises the clients when the school room is being used. There is ample lighting in the school room and the temperature is within the safe range. Hallway: The hallway has a small library that is enclosed with a glass sliding door. It has books for clients to use. Pantry Room: The pantry room is next to the kitchen/dining area. There is ample supply of perishable and non-perishable food items. (Page 2 of 4) Kitchen/Dining Area: The kitchen/dining area has a two (2) dining tables and ten (10) chairs. Licensing postings, menus, kitchen rules, and facility sketch plans are posted in the dining area. There is a kitchen island that has a separate sink and cabinets for utensils. There is a six (6) range gas burner stove that has a griddle and oven. There is hood range as well with the stove. There is a toaster, microwave, and a small snack refrigerator. Another sink is located next to the kitchen windows. There is ample cabinet space that stores in cups, plates, and other food preparation equipment. Sharp items are brought in by the chef and is only taken out when being used. Chef is responsible for storing the sharp items away from the facility. The chef prepares all meals for the children and accommodates to dietary restrictions as needed. Food preparation is clean and is free of any litter. There is a trash can with a fitted lid in the kitchen/dining area. Laundry Room: The facility has a separate and enclosed laundry room equipped with a working washer and dryer. Laundry supplies are kept in this room. Cleaning and disinfectant supplies are stored in a cabinet in and is kept locked at all times. Staff does laundry for the clients in the group home. Gym Room/Fitness Room: The attached garage is currently being used as a gym/fitness room. It has sports equipment, treadmill, exercise bikes, and other exercise supplies. The attached garage leads to the driveway and to a basketball court. There is a fridge on the side of the gym used to store other perishable food supplies. The water heater is also located in the gym room and has a wooden housing. Second Floor: The second floor has plexi glass partitions located in the stairway. All four (4) bedrooms are located upstairs. The Administration Office and Nursing Station is also located upstairs. There are four (4) bathrooms in the second floor. All bathrooms are clean and have water temperature in the safe range. Administrative Office: This room is not connected to the client's living area. It has big desk, closet for storage, fire extinguisher, first aid kit, and dry erase board. It also has a couch. This office room also has its own full-size bathroom that has a working toilet, sink and shower. The shower is not being used. There is a closet space inside the Admin office bathroom that is used to store facility supplies. (Page 3 of 4) Bedrooms: All bedrooms are equipped with queen size beds, sturdy mattress, ample storage space and adequate lighting. Room 1 has two (2) beds and shared by two (2) clients. Room 1 has a full size bathroom with a non-operational tub, a shower and double sink vanity. Room 1 also has a non-operational fireplace that is blocked off by a plexi glass. There are cabinets in the vanity sink. Room 2 and 3 have one bed and only have one (1) client each room. Both Room 2 and 3 have its own full-sized bathrooms equipped with toilet, sink, and shower. Room 4 has two (2) full sized beds and has its own full size bathroom as well. It is also equipped with toilet, sink, and shower. There are patio doors in the bedrooms and is kept locked at all times. When the patio doors are open, an alarm signal goes off to inform staff. There are window screens in all bedrooms and are in good repair and free of insects or debris. Hallway Closet: There are two (2) closet space located in the 2nd floor. It is used to store hygiene and emergency supplies. Nursing Station-This room has one desk, one mini fridge, cabinets with hygiene, first aid and other medical supplies. Medication logs are also kept in this room. A nurse compliance checklist binder is also kept in this room to monitor compliance with medication administration. There is a nursing staff onsite all day. Outdoor Area: The backyard is fenced in. A pool that is gated with a self-close latch is located in the backyard. Currently, the facility is making an organic garden for the clients to use. All utility shut off valves are located outside the group home. There are no deficiencies cited at this time. Exit interview was conducted with Maria Sarkisian, Administrator and a copy of this report will be provided to the facility. (Page 4 of 4)


summary: Facility Evaluation

raw_content:
Narrative:
On March 30, 2023, at 1: PM, Licensing Program Analyst (LPA) Charmetha White made an unannounced visit to BNI Treatment Centers - Calabasas for the purpose of conducting a Case Management for Special Incident Report #03-2023-34-CM-08. The incident occurred 03/14/2023 and the incident report was received by the Department on 03/20/2023. LPA met with Administrator/Director of Operations, Maria Sarkisian and discussed the incident. During this visit, confidential interviews were conducted. Additional interviews will be conducted on a later date. LPA requested a copy of hospital discharge for Client #1 (C1), copy of the police report regarding the incident or law enforcement contact information for the date of the incident including police report number, current LIC 500, Child and Family Team (CFT) meeting notes for Client #1 (C1), and a copy of the safety plan implemented for C1. Additionally, LPA requested to view video footage of the incident. The Director of Operations stated a copy of the video footage would be requested from the internal IT Department and all other requested information would be emailed to LPA. LPA will follow-up with the Director of Operations to review video footage within the next two (2) weeks. Based on the information gathered, this incident needs further investigation. Based on the observations made during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Administrator/Director of Operations.

met_with: Maria Sarkisian - Administrator/Director of Operations


summary: Facility Evaluation

raw_content:
Narrative:
On November 16, 2023, at 9: AM, Licensing Program Analyst (LPA) C. White arrived at the facility to deliver findings for the Case Management referral dated March 20, 2023. Based on the incident report, confidential interviews, and documentary evidence; statements were consistent that adequate supervision was provided, and that appropriate emergency intervention procedures and protocols were implemented to support the safety of the client. There was no corroborating evidence that supports that a violation occurred. This case management has been found to be unsubstantiated. There are no deficiencies cited at this time. Exit interview was conducted with Maria Sarkisian, Administrator/Director of Operations. A copy of this report was emailed to the Administrator/Director of Operations.