summary: Facility Evaluation

raw_content:
Narrative:
On December 12, 2024 at 10:00 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Post Licensing inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). LPA met with Saquintha Magee, Facility Manager. The facility currently has a STRTP license and is licensed to serve ten (10) ambulatory clients age 12 to 17 years old. The facility also provides service to non-minor dependents (NMDs) pursuant to W&I CODE 16501.1(C)(1). There are currently 5 clients, none which are NMDs, at the facility. LPA requested the following: Board of Director Meeting Minutes. The facility is a one-story home with a loft space upstairs and big yard both in front and in the back. The facility has 5 bedrooms, 3.5 bathrooms (including one staff restroom), 2 offices for therapists and administrative staff, living room, dining room, kitchen, laundry room, and activity room (upstairs loft). There are no firearms or ammunition in the facility. There are no bodies of water on the facility premises. LPA conducted a walk-through of the entire facility. Physical Plant The license, facility sketch, personal rights, emergency disaster form, complaints poster, emergency phone numbers and food menu are posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are kept inaccessible and locked in a cabinet located in the kitchen and staff office. Sharps/knives are inaccessible and stored in a locked drawer in the kitchen. Facility has non-perishable food for at least one week and perishable food for at least two days. Medications are centrally stored in a locked cabinet in the office. Smoke and carbon monoxide detectors were tested and in proper working order. Fire extinguishers were fully charged. Room temperatures are maintained at around 66-71 degrees F. The hot water temperature was tested and measured at 108 degrees F. All sinks, showers and toilets are in working order. All beds are in good repair; equipped with good springs, clean mattresses and pillows. Adequate supply of beddings and linens were observed. Overall, facility is clean, safe, sanitary and in good repair. Operations Facility maintains a current, written plan of operation that meets licensing standards. Facility maintains a register of clients and the register is available upon request. Facility maintains and implements written complaint procedures and the procedures are posted in a publicly accessible location in the facility. The board of directors regularly conducts meeting to review and discuss the STRTP's operation. Cash resources are kept on the facility premises in a locked and secure location. Disaster Preparedness Plan Facility maintains a current LIC610C. Written disaster and mass casualty plan of action has been provided and is available at the facility. Emergency Intervention Plan Facility maintains a monthly log of each use of manual restraints that contains all required information. The log is available for review by the Department upon request. LPA observed documentation of Emergency Intervention Training and on-going training. Core/Therapeutic Services Facility provides core services and supports to children and non-minor dependents as appropriate or necessary that are trauma informed, culturally relevant, age and developmentally appropriate and include the following: Medi-Cal specialty mental health services; transition support services; educational and physical, behavioral, and mental health supports; activities to support children and non-minor dependents and services to achieve permanency. During today's inspection, the STRTP was provided four (4) Advisory Notes/Technical Violations (LIC9102TVs). An exit interview was conducted A signed copy of this report, LIC Confidential names list dated 12/12/24, LIC9102TVs, and appeal rights were provided to Joellen Gutierrez, Administrator.. A follow-up is required to complete inspection.


state: CA

facility_name: DAUGHTER PROJECT GIRLS HOME

summary: Facility Evaluation

raw_content:
Narrative:
On December 12, 2024 at 10:00 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP) for the purpose of conducting a Case Management inspection concerning a Special Incident Report (SIR) received by the Department on November 8, 2024. LPA met with Joellen Gutierrez, Administrator. On November 8, 2024, the Department received an SIR indicating that on November 7, a facility staff (S1) (See LIC Confidential Names list dated 12/12/24) was driving three facility clients (C1, C2, and C3) from an outing when one of the clients asked staff to pull over due to feeling ill. S1 did not immediately pull over, which led to an escalated confrontation. No deficiencies were cited during this inspection. A signed copy of this report and LIC811 were provided to Joellen Gutierrez, Administrator. Exit interview conducted. Follow-up is required before completion.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Joellen Gutierrez, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On January 15, 2025, at 09:45 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced follow-up inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP), for the purpose of continuing a Post Licensing inspection. LPA met with Elizabeth Sausedo, Program Coordinator. During this inspection, LPA reviewed the remaining domains in the Compliance and Regulation Enforcement (CARE) tool: Staff Records and Client Records. LPA interviewed two staff and two clients. Staff Records: LPA reviewed four (4) staff records. Staff records contain documentation of the required education and experience requirements and training. All staff subject to criminal records review are fingerprint cleared and associated to the facility at the time of the inspection. Client Records: LPA reviewed five (5) client records. All client records are available to the licensing agency to inspect, audit and copy upon demand. Client records reviewed include, but not limited to, consent forms, court orders, appraisal/needs and services plan, removal/discipline/complaint procedures; medical assessment; safeguards for cash resources, personal property and valuables; education records; personal rights forms; and medication administration records. During today's inspection, the STRTP was issued one (1) Type B deficiency and provided three (3) Technical Advisory Notes/Technical Violations (LIC9102TVs). An exit interview was conducted. A signed copy of this report, LIC809-D, LIC Confidential names list dated 01/15/25, LIC9102TVs, and appeal rights were provided to Elizabeth Sausedo. Inspection complete.

met_with: Elizabeth Sausedo, Program Coordinator


summary: Facility Evaluation

raw_content:
Narrative:
On May 2, 2025, at 4:00 p.m., Licensing Program Analysts (LPAs) Ashley Ruacho and John Bonilla conducted an unannounced Case Management - Incident inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to follow up on an incident report (IR) received by the Department. LPAs met with Carissa Pope, Head of Service. On April 8, 2025, the Department received an IR stating that an incident had occurred on April 2, 2025 with information regarding "intended exploiting" of a youth (C1) (See LIC Confidential Names list dated 05/02/25) for profit. The IR was unclear if any actual exploiting/trafficking of a client occurred. During this inspection, LPAs reviewed relevant incident reports and interviewed two clients and one staff with knowledge of the incidents. LPAs inquiry revealed that no exploitation or trafficking happened while at the facility, staff is proactive when they hear of any potential safety risks involving unauthorized absences and/or meeting anyone off-site, following their emergency intervention plan, and that the situation has stabilized since a client was discharged. No deficiencies were cited during this inspection. A signed copy of this report and LIC811 were provided to Head of Service. Exit interview conducted. No further action required.

met_with: Carissa Pope, Head of Service


summary: Facility Evaluation

raw_content:
Narrative:
On June 17, 2025, at 10:00 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management - Incident inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to follow up on an incident report (IR) received by the Department. LPA met with Elizabeth Saucedo, Program Coordinator. On June 9, 2025, the Department received an IR stating that an incident had occurred on June 7, 2025 with information regarding a client having had multiple seizures, and being taken by the ambulance to the hospital, with a restraint in the ambulance by LE and MET. During this inspection, LPA reviewed relevant incident report, doctor visit report, and client's safety plan and interviewed one staff with knowledge of the incident. The STRTP staff during incident maintained communication between STRTP supervisor and paramedics during incident, client was provided medical attention, and a safety plan has been enacted to address future incidents should they arise. No deficiencies were cited during this inspection. A signed copy of this report and LIC811 (Confidential Names list dated 06/17/25) were provided to STRTP representative. No further action required.

met_with: Elizabeth Saucedo, Program Coordinator


summary: Facility Evaluation

raw_content:
Narrative:
On June 17, 2025, at 10:00 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management - Incident inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to follow up on an incident report (IR) received by the Department. LPA met with Saquintha Magee, Facility Manager . On June 16, 2025, the Department received an IR stating that an incident had occurred on June 15, 2025 with information regarding a client having been administered medication in error, as client had abused a substance in the preceding 24 hours. During this inspection, LPA reviewed relevant incident report, client's Needs and Service Plan, medical records, safety plan, facility medication reports and and interviewed one staff with knowledge of the incident. No deficiencies were cited during this inspection. A signed copy of this report and LIC811 (Confidential Names list dated 06/17/25) were provided to STRTP representative. A follow-up is required.

met_with: Saquintha Magee, Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On June 17, 2025, at 10:00 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management - Incident inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to follow up on an incident report (IR) received by the Department. LPA met with Saquintha Magee, Facility Manager. On June 16, 2025, the Department received an IR stating that an incident had occurred on June 15, 2025 with information regarding a client asked staff for hygiene products and was provided scissors and an eyebrow razor, then proceeded to use the products to cut herself. During this inspection, LPA reviewed relevant incident reports, client's Needs and Services Plan, safety plan, client observation log, and reviewed STRTP camera footage from 06/15/25 between the hours of 03:00 p.m. and 07:10 p.m and interviewed the client and one staff with knowledge of the incidents. No deficiencies were cited during this inspection. A signed copy of this report and LIC811 (Confidential Names list dated 06/17/25) were provided to STRTP representative. A follow-up is required.


summary: Facility Evaluation

raw_content:
Narrative:
On August 28, 2025, at 09:45 a.m., Licensing Program Analysts (LPAs) Amber Hunter and John Bonilla, and Licensing Program Manager (LPM) Jean Herring, conducted an unannounced Annual/Required inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). LPAs and LPM met with Joellen Gutierrez, Administrator. The facility currently has a provisional STRTP license and is licensed to serve ten (10) ambulatory clients age 12 to 17 years old. The facility also provides service to non-minor dependents (NMDs) pursuant to W&I CODE 16501.1(C)(1). There are currently 6 clients, none are NMDs, at the facility. LPAs and LPM reviewed the following domains of the Compliance and Regulatory Enforcement (CARE) tool: Physical Plant, Client Records. Physical Plant The license, facility sketch, personal rights, emergency disaster form, complaints poster, emergency phone numbers and food menu are posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are kept inaccessible and locked in a cabinet located in the kitchen and staff office. Sharps/knives are inaccessible and stored in a locked drawer in the kitchen. Facility has non-perishable food for at least one week and perishable food for at least two days. Medications are centrally stored in a locked cabinet in the office. Smoke and carbon monoxide detectors were tested and in proper working order. Fire extinguishers were fully charged. Room temperatures are maintained at around 66-71 degrees F. The hot water temperature was tested and measured at 114 degrees F. All sinks, showers and toilets are in working order. All beds are in good repair; equipped with good springs, clean mattresses and pillows. Adequate supply of beddings and linens were observed. Overall, facility is clean, safe, sanitary and in good repair. (Continued...) Client Records/Clients with Special Health Care Needs: LPAs and LPM reviewed six (6) client records. All client records are available to the licensing agency to inspect, audit and copy upon demand. Client records reviewed include, but not limited to, consent forms, court orders, appraisal/needs and services plan, removal/discipline/complaint procedures; medical assessments; safeguards for cash resources, personal property and valuables; education records; personal rights forms; and medication administration records. During today's inspection, the STRTP was issued two (2) Type B Violations (LIC809-Ds) and provided nine (9) Advisory Notes/Technical Violations (LIC9102TVs). An exit interview was conducted A signed copy of this report, LIC Confidential names list dated 08/28/25, LIC809-Ds, LIC9102TVs, and appeal rights were provided to Joellen Gutierrez, Administrator. A follow-up is required to complete inspection.

visit_type: Annual


summary: Facility Evaluation

raw_content:
Narrative:
On September 3, 2025 at 08:50 a.m., Licensing Program Analysts (LPAs) Amber Hunter and John Bonilla conducted an unannounced follow-up inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP), for the purpose of continuing an Annual/Required inspection. LPAs met with Elizabeth Sausedo, Program Coordinator. During this inspection, LPAs reviewed the remaining domains in the Compliance and Regulation Enforcement (CARE) tool: Operations, Disaster Preparedness, Emergency Intervention Plan, Staffing Records and Core/Therapeutic Services. LPAs also interviewed two (2) staff and one (1) client. Operations Facility maintains a current, written plan of operation that meets licensing standards. Facility maintains a register of clients and the register is available upon request. Facility maintains and implements written complaint procedures and the procedures are posted in a publicly accessible location in the facility. The board of directors regularly conducts meetings to review and discuss the STRTP's operation. Cash resources are kept on the facility premises in a locked and secure location. Disaster Preparedness Plan Facility maintains a current LIC610C. Written disaster and mass casualty plan of action has been provided and is available at the facility. (Continued next page...) Emergency Intervention Plan Facility maintains a monthly log of each use of manual restraints that contains all required information. The log is available for review by the Department upon request. LPAs observed documentation of Emergency Intervention Training and on-going training. Staffing Records LPAs reviewed four (4) staff records. Staff records contain documentation of the required education and experience requirements and training. All staff subject to criminal records review are fingerprint cleared and associated to the facility at the time of the inspection. Core/Therapeutic Services Facility provides core services and supports to children and non-minor dependents as appropriate or necessary that are trauma informed, culturally relevant, age and developmentally appropriate and include the following: Medi-Cal specialty mental health services; transition support services; educational and physical, behavioral, and mental health supports; activities to support children and non-minor dependents and services to achieve permanency. During today's inspection, the STRTP was provided one (1) Advisory Note/Technical Violation (LIC9102TV). An exit interview was conducted A signed copy of this report, LIC Confidential Names list dated 09/03/25, LIC9102TV, and appeal rights were provided to Elizabeth Sausedo, Program Coordinator. Inspection complete.


summary: Facility Evaluation

raw_content:
Narrative:
On September 9, 2025, at 11:45 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Proof of Correction (POC) inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). LPA met with Joellen Gutierrez, Administrator. The STRTP was issued two Type B deficiencies during their last Annual/Required inspection, for CCR 80088(b) and for ILS 87068.2(b)(6). LPA and Administrator conducted a walk through of the facility and observed the corrections made for CCR 80088(b) including clean window sills, screens, and air vents; and reviewed the clients' Needs and Services Plans where the appropriate corrections were made to include the clients' visitation information as per ILS 87068.2(b)(6). No deficiencies were cited during this inspection. Signed copies of all licensing reports were provided to Joellen Gutierrez. Exit interview conducted. No further action required.


summary: Facility Evaluation

raw_content:
Narrative:
On September 9, 2025, at 11:45 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). LPA met with Joellen Gutierrez, Administrator. The purpose of the inspection was to deliver to the STRTP their license. During this inspection, LPA and Administrator discussed the STRTP's capacity and operations. A signed copy of the facility's license and this licensing report were given to Joellen Gutierrez. Exit interview conducted. No further action required.


summary: Facility Evaluation

raw_content:
Narrative:
On October 15, 2025, at 1:45 p.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to follow up on an incident report (IR) received by the Department. LPA met with Joellen Gutierrez, Administrator. On October 2, 2025, the Department received an IR stating that on October 2, 2025, a client (C1)(See Confidential Names list dated 10/15/25) and a peer (C2) left school grounds without permission, were involved in alleged store theft, were aggressive towards staff, and attempted to steal the facility vehicle. During this inspection, LPA interviewed three staff members. No deficiencies were cited during this inspection. A signed copy of this report and LIC811 were provided to Joellen Gutierrez. Follow-up is required.


summary: Facility Evaluation

raw_content:
Narrative:
On October 15, 2025, at 1:45 p.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to follow up on an incident report (IR) received by the Department. LPA met with . On September 22, 2025, the Department received an IR stating that on September 21, 2025, a client (C1)(See Confidential Names list dated 10/15/25) disclosed to a staff member (S1) that another client (C2) had asked C1 to allow her to sleep in her room due to fear of the dark, to which C1 agreed. C1 disclosed to staff of waking up in the middle of the night to find C2 touching C1 in her lower private area. During this inspection, LPA interviewed one staff. No deficiencies were cited during this inspection. A signed copy of this report and LIC811 were provided to Joellen Gutierrez. Follow-up required.


summary: Facility Evaluation

raw_content:
Narrative:
On November 7, 2025, at 10:15 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management - Incident follow-up inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to conclude follow up on an incident report (IR) received by the Department. LPA met with Latrina Johnson, Facility Manager. On June 16, 2025, the Department received an IR stating that an incident had occurred on June 15, 2025 with information regarding a client having been administered medication in error, as client had abused a substance in the preceding 24 hours. Relevant Facts and Findings Interviews and record review revealed that staff administered a psychotropic medication prescribed to a client after the client had disclosed substance abuse. The substance was not disclosed to staff. According to interviews, the facility has a blanket policy not to administer medications after substance abuse. Nevertheless, staff stayed with the client to ensure no adverse reactions. The STRTP is being issued a Technical Violation during this inspection. See LIC9102-TV advisory page. A signed copy of this report, LIC9102-TV, and LIC811 (Confidential Names list dated 06/17/25) were provided to STRTP representative. No follow-up required.

met_with: Latrina Johnson, Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On November 7, 2025, at 10:15 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management - Incident follow-up inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to conclude follow up on an incident report (IR) received by the Department. LPA met with Latrina Johnson, Facility Manager. On September 22, 2025, the Department received an IR stating that on September 21, 2025, a client (C1)(See Confidential Names list dated 10/15/25) disclosed to a staff member (S1) that another client (C2) had asked C1 to allow her to sleep in her room due to fear of the dark, to which C1 agreed. C1 disclosed to staff of waking up in the middle of the night to find C2 touching C1 in her lower private area. Relevant Facts and Findings LPA was unable to reach a client for interview. Another confidential interview revealed conflicting statements regarding the events of the night. Staff interviews revealed that the clients were supervised all night and denials that any incidents occurred, as the clients were in sight all night. There were no Title 22 deficiencies noted as a result of this Case Management. A signed copy of this report and LIC811 were provided to STRTP representative.. No follow-up required.


summary: Facility Evaluation

raw_content:
Narrative:
On March 26, 2025 at 3:00 p.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP) for the purpose of concluding a Case Management concerning a Special Incident Report (SIR) received by the Department on November 8, 2024. LPA met with Joellen Gutierrez, Administrator. On November 8, 2024, the Department received an SIR indicating that on November 7, a facility staff (S1) (See LIC Confidential Names list dated 03/26/25) was driving three facility clients (C1, C2, and C3) from an outing when one of the clients asked staff to pull over due to client 2 needing to vomit. Per S1, she was unable to stop the vehicle due to being on the freeway, resulting in clients escalating. When clients began attempting to open the car door, S1 pulled the vehicle over to stop and saw a California Highway Patrol (CHP) officer who she asked for assistance. When S1 went to speak to CHP, she locked the clients in the car. The CHP escorted the group to a gas station. S1 locked the clients in the vehicle while she went inside the gas station to decompress. When S1 returned to the van, the youth exited, followed by S1 locking the clients out of the vehicle. S1 started the van, which caused the doors to unlock, at which time the clients re-entered the vehicle to retrieve their belongings. At this point, S1 pushed C1 out of the front passenger side of the van and made a racist remark, which was overheard by a STRTP staff on the phone. S1 was suspended on November 8, 2024, and terminated on November 13, 2024 as a result of the incident. ... Based on information obtained from incident reports, CPS investigation narrative, and interviews conducted, it was revealed that S1 did not follow the STRTP's plan of operation for de-escalating conflict and managing emergencies. In addition, S1 also violated C1's personal rights. The STRTP was issued three (3) deficiencies. Refer to LIC809D. Exit Interview was conducted. A signed copy of this report, LIC811, and LIC809Ds were provided to Joellen Gutierrez, Administrator. Appeal rights explained.


summary: Facility Evaluation

raw_content:
Narrative:
On November 7, 2025, at 10:15 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management - Incident follow-up inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to conclude follow up on an incident report (IR) received by the Department. LPA met with Latrina Johnson, Facility Manager. On June 16, 2025, the Department received an IR stating that an incident had occurred on June 15, 2025 with information regarding a client asked staff for hygiene products and was provided scissors and an eyebrow razor, then proceeded to use the products to cut herself. Relevant Facts and Findings LPA reviewed relevant incident reports, client's Needs and Services Plan, safety plan, client observation log, and reviewed STRTP camera footage from 06/15/25 between the hours of 03:00 p.m. and 07:10 p.m and interviewed the client and one staff with knowledge of the incidents. LPA's review of camera footage, facility staff supervised a client by way of video camera between the hours of 3:50 p.m. and 5:50 p.m. on June 15, 2025, against facility's program statement as written in Chapter 15, page 129. The facility was issued a Type B violation during this inspection. Refer to LIC809-D deficiency page. A signed copy of this report, LIC809-D, and LIC811 (Confidential Names list dated 06/17/25) were provided to STRTP representative. No follow-up required.


summary: Facility Evaluation

raw_content:
Narrative:
On November 7, 2025, at 10:15 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management - Incident follow-up inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to conclude follow up on an incident report (IR) received by the Department. LPA met with Latrina Johnson, Facility Manager. On October 2, 2025, the Department received an IR stating that on October 2, 2025, a client (C1)(See Confidential Names list dated 10/15/25) and a peer (C2) left school grounds without permission, were involved in alleged store theft, were aggressive towards staff, and attempted to steal the facility vehicle. Relevant Facts and Findings Interviews revealed that a facility staff left vehicle keys in the ignition while exiting the vehicle to conduct a bag check of clients. Clients were able to access the vehicle, with the keys in the ignition. Staff was able to retrieve keys from vehicle due to client's inability to operate the vehicle. The STRTP is being issued a Type B deficiency during this inspection. See LIC809-D deficiency page. A signed copy of this report, LIC809-D, and LIC811 were provided to Joellen Gutierrez. No follow-up required.


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
The investigation revealed that C4 was placed at the facility on March 1, 2025. The JV-220(A) revealed that the physician treated C4 on June 3, 2025 and indicated that C4 was not currently on medication. The PC indicated that the delay in getting C4's medication resulted from the facility not being able to make contact with the CSW. The facility emailed the CSW about the JV-220(A) on July 2, 2025 and sent a second email on July 7, 2025. The CSW responded on July 7, 2025 indicating that the facility could send the CSW the JV-220(A) to submit to court. The LPA observed the email thread between the facility and the CSW. At the time the allegation was received on July 8, 2025, it does not appear that the JV-220(A) had been processed by the court. There was a statement made that the facility was not following the court order and providing C4 with therapy services. The LPA reviewed the Appointment Log for C4 and observed that C4 attended Group Therapy, Assessments, Individual Rehab, Group Rehab, Individual Therapy monthly from March 4, 2025 until July 6, 2025. The LPA observed that some of the services were provided more than once a month. There were statements that several clients and a staff that hit C4 and that staff called C4 names. The investigation revealed that C4 had a physical altercation with C2 that was broken up by the SFM. According to the SFM, no other clients were involved physically, but were onlookers. The SFM stated that law enforcement was called, but C4 was unable to provide a statement due to leaving the facility without permission. The FM denied the allegations and stated that the FM got along with C4. The investigation revealed conflicting statements on who was calling who names. There was a statement that C4 called C2 names which was one of the reason for the fight. The LPA was unable to obtain sufficient evidence to corroborate the allegations. There was no preponderance of the evidence to substantiate the allegations. So, although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegations are unsubstantiated. There are no deficiencies to be cited regarding these allegations. A copy of this complaint was provided to the facility representative at the signing.

Investigation Findings:
13On December 15, 2025, Licensing Program Analyst (LPA), Karen McGee, delivered the findings of the complaint investigation to the facility. The LPA met with Senior Facility Manager, Saquinta Magee. On July 8, 2025, Monterey Park Children's Residential Program (MPCRP), received a complaint with the above mentioned allegation. Confidential interviews were conducted that included, but were not limited to: two clients - Client (C4) via telephone on September 25, 2025 and C8 at school on October 17, 2025; three staff, Program Coordinator (PC) Elizabeth Sausedo at the facility on October 9, 2025, and Senior Facility Manager (SFM) Saquintha Magee and Facility Manager (FM) Aleyah Dailey via telephone on October 15, 2025. After a few attempts, the LPA was unable to contact clients, C1, C2, C3, C5, C6 and C7. The LPA reviewed the following documents: the facility's email thread with the County Social Worker (CSW), the JV-220(A) Physician's Statement Attachment, the Medication Administration Record (MAR), Short-Term Residential Therapeutic Program (STRTP) Placement Review, Appointment Log, and the Superior Court of California County of San Bernardino Status Review Report, Child Protective Services Investigative Narrative. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Karen McGee LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION MONTEREY PARK CRP RO, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: DAUGHTER PROJECT GIRLS HOMEFACILITY NUMBER: VISIT DATE: 01/15/2026

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

report_type: Complaint Investigation

met_with: Sanquinta McGee

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On March 4, 2026, at 10:45 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to follow up on an incident report (IR) received by the Department. LPA met with Saquintha Magee, Facility Manager . On November 25, 2025, the Department received an IR stating that on November 23, 2025, a client (C1)(See Confidential Names list dated 03/04/26) and a peer (C2) engaged in a physical altercation after words were exchanged. After being separated, C2 was restrained by facility staff for a prolonged period of time, 48 minutes according to IR submitted. In the aftermath of the incident, C1 was arrested for their role in the incident. During this inspection, LPA reviewed copies of Needs and Services Plans for C1, C2, and C3, completion certificates for restraint training for four (4) staff members, LIC Personnel Report, and the November 2025 staff schedule. One client stated that she did not wish to be interviewed. No deficiencies were cited during this inspection. A signed copy of this report and LIC811 were provided to Saquintha Magee. Follow-up is required.


summary: Facility Evaluation

raw_content:
Narrative:
On March 4, 2026, at 10:45 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to follow up on an incident report (IR) received by the Department. LPA met with Saquintha Magee, Facility Manager . On November 25, 2025, the Department received an IR stating that on November 23, 2025, a client (C1)(See Confidential Names list dated 03/04/26) engaged in self-harm. As a result, two (2) facility staff performed a manual restraint on C1 with a duration of 42 minutes as per the IR submitted to the Department. During this inspection, LPA reviewed copies of Needs and Services Plans for C1, completion certificates for restraint training for two (2) staff members, LIC Personnel Report, and the November 2025 staff schedule. One client stated that she did not wish to be interviewed. No deficiencies were cited during this inspection. A signed copy of this report and LIC811 were provided to Saquintha Magee. Follow-up is required.


summary: Facility Evaluation

raw_content:
Narrative:
On March 4, 2026, at 10:45 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to follow up on an incident report (IR) received by the Department. LPA met with Saquintha Magee, Facility Manager . On December 11, 2025, the Department received an IR stating that on December 8, 2025, two (2) clients (C1, C2)(See Confidential Names list dated 03/04/26) were being picked up from an outing and informed a staff member (S1) that they did not want to go home yet. C1 and C2 walked away from S1 and when they returned, C1 climbed onto the facility vehicle. As S1 attempted to get C1 down, C2 began throwing things at S1. S1 exited the vehicle to shake off the items thrown at her, and C1 proceeded to try to obtain the vehicle keys from S1. S1 grabbed C1's hand to stop her. The clients then began yelling at S1. As a result, S1 had to perform a one person restraint on C1 twice, for two minutes each. During this inspection, LPA reviewed copies of Needs and Services Plans for C1 and C2, LIC Personnel Report, and the December 2025 staff schedule. Facility Manager informed LPA that one (1) staff member separated from the facility before their initial Pro-Act training day. One client stated that she did not wish to be interviewed. No deficiencies were cited during this inspection. A signed copy of this report and LIC811 were provided to Saquintha Magee. Follow-up is required.


summary: Facility Evaluation

raw_content:
Narrative:
On April 2, 2026, at 09:30 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to follow up on an incident report (IR) received by the Department. LPA met with Joellen Gutierrez, Administrator. On March 26, 2026, the Department received an IR stating that on March 25, 2026, a client (C1)(See Confidential Names list dated 04/02/26) disclosed to facility staff that while on unauthorized leave approximately two weeks prior, they were taken advantage of and may possibly be pregnant. During this inspection, LPA reviewed copies of Needs and Services Plans for C1, LIC Personnel Report, LIC Register of Clients, and relevant IRs for incidents occurring on 03/17/26, 03/18/26, and 03/22/26. Client stated that they did not wish to be interviewed. LPA interviewed a staff and a county social worker by phone and attempted to contact one additional staff during this inspection. No deficiencies were cited during this inspection. A signed copy of this report and LIC811 were provided to Joellen Gutierrez, Administrator. Follow-up is required.


summary: Facility Evaluation

raw_content:
Narrative:
On April 2, 2026, at 09:30 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to follow up on an incident report (IR) received by the Department. LPA met with Joellen Gutierrez, Administrator. On March 30, 2026, the Department received an IR stating that on March 29, 2026, a client (C1)(See Confidential Names list dated 04/02/26) disclosed to facility staff that they were assaulted while away from the facility on unauthorized leave. During this inspection, LPA reviewed copies of Needs and Services Plans for C1, LIC Personnel Report, LIC9020, and relevant IR dated 03/29/26. Client stated that they did not wish to be interviewed. LPA interviewed an authorized representative by phone during this inspection. No deficiencies were cited during this inspection. A signed copy of this report and LIC811 were provided to Joellen Gutierrez, Administrator. Follow-up is required.


summary: Facility Evaluation

raw_content:
Narrative:
On April 16, 2026, at 10:45 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to follow up on an incident report (IR) received by the Department. LPA met with Joellen Gutierrez, Administrator. On March 30, 2026, the Department received an IR stating that on March 29, 2026, a client (C1, see LIC Confidential Names list dated 0416/26) was observed to be smoking marijuana in the facility's backyard. Staff secured the facility's windows and doors while C1 was outside and conducted a room search of C1's room to search for contraband. During this inspection, LPA reviewed copies of Needs and Services Plan for C1, LIC Personnel Report, LIC Register of Clients, and IR dated 03/29. No deficiencies were cited during this inspection. A signed copy of this report and LIC811 were provided to Joellen Gutierrez, Administrator. Follow-up is required.


summary: Facility Evaluation

raw_content:
Narrative:
On April 16, 2026, at 10:45 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to follow up on an incident report (IR) received by the Department. LPA met with Joellen Gutierrez, Administrator. On March 30, 2026, the Department received an IR stating that on March 29, 2026, a client (C1, see LIC Confidential Names list dated 0416/26) was in a restroom getting ready to go shopping. Two staff members (S1 and S2) went to the restroom to see if C1 was ready to go on the outing and found a locked door. S1 unlocked the door, and C1 was observed fully clothed coming out from behind the shower wall, laughing and with low and red eyes, putting something in their back pocket. During this inspection, LPA reviewed copies of Needs and Services Plan for C1, LIC Personnel Report, LIC Register of Clients, and IR dated 03/29. No deficiencies were cited during this inspection. A signed copy of this report and LIC811 were provided to Joellen Gutierrez, Administrator. Follow-up is required.


summary: Facility Evaluation

raw_content:
Narrative:
On April 16, 2026, at 10:45 a.m., Licensing Program Analyst (LPA) John Bonilla conducted an unannounced Case Management inspection at Daughter Project Girls Home, a Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to follow up on an incident report (IR) received by the Department. LPA met with Joellen Gutierrez, Administrator. On January 8, 2026, the Department received an IR stating that on January 7, 2026, a client (C1, see LIC Confidential Names list dated 0416/26) had access to disinfectants, cleaning solutions which posed a danger. C1 reported to staff she drank 2 mouthfuls of window cleaner while using a staff restroom. During this inspection, LPA reviewed copies of Needs and Services Plan for C1, LIC Personnel Report, LIC Register of Clients, and IR dated 01/07/26. LPA interviewed one client and one staff during inspection. No deficiencies were cited during this inspection. A signed copy of this report and LIC811 were provided to Joellen Gutierrez, Administrator. Follow-up is required.


facility_name: DELILU ACHIEVEMENT HOME

summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13This amended report supersedes report dated 04/12/2020. On April 12, 2021, Licensing Program Analyst (LPA) Charmetha White contacted the above location via telephone for the purpose of delivering findings on the above allegation. LPA spoke to Program Supervisor, Jameka Johnson and discussed the findings. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Interviews and records did not produce corroborating evidence to support the allegation. Staff denied the allegation and stated they do not use profanity when speaking to clients and that they do not have the ability to control how long hospitals place clients on holds. Staff #4 stated she built a good rapport with Client #1 and said she uses crisis communication when speaking to clients in order to prevent situations from escalating. Additionally, Client #1 stated Staff #4 has never been mean to her, has never cursed at her, and said Staff #4 is her favorite person at the facility. Based on information obtained the allegation regarding Personal Rights is found to be unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. No deficiencies cited. Exit interview completed and copy of this report was emailed to Program Supervisor, Jameka Johnson for signature. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith 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

met_with: Program Supervisor - Jameka Johnson


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

raw_content:
Narrative:
Based upon confidential interviews, and Analyst Cooper's virtual inspection of the facility bathrooms, it was determined the facility bathrooms were dirty. In the bathroom with pink walls, this Analyst observed a cigarette butt and ashes on the floor; a bowl with a spoon and dried food sitting on the back of the toilet; dark stains around the base of the toilet bowl; multiple red drops on the floor and wall; and black residue on the side of the medicine cabinet. In the bathroom with white walls, this Analyst observed dark stains near the door locks and handle; short hairs on the rim of the tub; smeared dried red substance on the floor; dark stains on the curtains; yellow dried substance that was running down the floor from behind the toilet with hair in it; and soap scum on the shower walls. The allegations are Substantiated (1) Staff did not make sure minor was seen by a physician and (2) Facility bathrooms are dirty. Facility cited for violation of the California Code of Regulations, Title 22, Division 6, Chapter 1, Section: Client Medical Assessment 80069(a) and Section: Buildings and Grounds 80087(a). A copy of this report and appeal rights were provided to Administrator Sylvia Steinhart via email.

Investigation Findings:
13Out of State Group Home Certification Analyst Cassandra Cooper contacted the facility at 10:30 a.m. on April 28, 2021 and spoke with Administrator Sylvia Steinhart to discuss the findings of the investigation regarding the allegations listed above. During the course of the investigation, Analyst Cooper conducted confidential interviews with the complainant, six youth, six staff, a Social Worker, and Hospital Personnel. This Analyst also obtained a copy of the facilities intake procedures, reviewed four youth files, and conducted a virtual inspection of the facility bathrooms. Based upon confidential interviews with youth, staff, and Hospital Personnel, it was determined that staff did not make sure six out of the eight youth placed in the program were seen by a physician within 30 days of placement. Facility Administrator Sylvia Steinhart reported to Analyst Cooper on 03/02/2021 that three youth have not had medical appointments since being placed, and that two of the three have brought this to her attention. (continued on page 2) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Cassandra Cooper LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: DELILU ACHIEVEMENT HOMEFACILITY NUMBER: VISIT DATE: 04/28/2021

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

Deficiencies:
80069(a): Prior to or within 30 calendar days following the acceptance of a client, the licensee shall obtain a written medical assessment of the client...

met_with: Sylvia Steinhart

title: Client Medical Assessment


raw_content:
Narrative:
Based upon confidential interviews conducted indicated staff asked crisis management questions when the alleged victim wanted to self-harm. After the alleged victim informed staff of wanting to self-harm and while the staff was notifying other members in the facility, the alleged victim was left alone and went into a restroom for approximately 15 minutes where the attempted self-harm occurred. Immediately after, staff notified the proper authorities to deal with the manner. Based on confidential interviews and a review of facility documents, although the allegations that Lack of supervision resulting in inappropriate interactions between minors and Staff did not prevent minor from self-harming may have happened or is valid, there is not a preponderance of the evidence to prove that the incidents occurred. Therefore, the allegations are unsubstantiated. A copy of this report and appeal rights were provided to Administrator Sylvia Steinhart via email.

Investigation Findings:
13Out of State Group Home Certification Analyst Cassandra Cooper contacted the facility at 11:31 a.m. on April 28, 2021 and spoke with Administrator Sylvia Steinhart to discuss the findings of the investigation regarding the allegations listed above. During the course of the investigation, Analyst Cooper interviewed the complainant, the alleged victim, seven staff, five youth, and the alleged perpetrator. Analyst Cooper also obtained documents including incident reports, Head Check logs, a written statement by the alleged victim, and information from the Behavioral Log dated 02/21/2021. Interviews conducted were inconsistent that inappropriate interactions between minors occurred. There were statements and written evidence that the alleged victim and the alleged perpetrator were left alone on 02/21/2021 in a bedroom for a period of approximately 15 minutes and were observed by staff during room checks. Later that day, documentation was written into the Behavioral Log that the alleged victim reported feeling uncomfortable around the alleged perpetrator; however, it did not state the reason why. Approximately a month later, the alleged victim recanted their statement dyning inappropriate activities. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Cassandra Cooper LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: DELILU ACHIEVEMENT HOMEFACILITY NUMBER: VISIT DATE: 04/28/2021

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


raw_content:
Investigation Findings:
13On 09/21/2021, Licensing Program Analyst (LPA) Charmetha White arrived at the above location for the purpose of concluding the investigation and to deliver findings on the above allegations. LPA spoke with the Facility Manager, Carlos Davis. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Interviews and records did not produce corroborating evidence to support the allegations. Staff denied all allegations. Staff stated none of the staff have falsified documents. Staff said the facility does not have a rat infestation and that the facility is serviced regularly by a Pest Control company. Staff stated unsafe food has never been served to any child and none of the staff have reported to work under the influence of any kind. Client interviews said they have not seen staff come to work under the influence and that staff are serving food per the menu. Clients revealed that rats have been seen outside by the back shed, but not inside the facility. Based on information obtained, the allegation is found to be unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith 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 2

met_with: Facility Manager - Carlos Davis


raw_content:
Investigation Findings:
13During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Staff denied the allegation and stated Child #1 awoled 07/15/2020 and Child #1's bed was closed 07/23/2020. Staff stated awol procedures were followed, a missing person report was filed with law enforcement, and the child's social worker was notified. LPA was unable to obtain a statement from Child #1 as the child's whereabouts are unknown. Based on information obtained statements and records did not produce corroborating evidence to support the allegation, facility staff did not adequately supervise minor in care. Therefore, the allegation is determined to be unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. This facility forfeited its license as of November 8, 2021 and is no longer in operation. There are no deficiencies cited at this time. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith 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


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Investigation Findings:
13This facility is closed. Licensing Program Analyst will send a copy of this report to the Chief Operating Officer Craig@delilu.org and will also cc: Operation's Manager at madeline.jones@delilu.org. During the course of this investigation, LPA interviewed pertinent parties. Staff stated a client's parent was called by staff to come to the facility, when the parent arrived the parent hit a bathroom door with a hammer while clients were inside the bathroom. Client interviews revealed a client's parent came to the facility and was banging and kicking on the bathroom door while they were inside. Based on interviews and information obtained, the department has determined the preponderance of evidence standard has been met, therefore the allegation is found to be Substantiated per California Code of Regulations Title Division Chapter 5. Facility cited for violation of California Code of Regulations, Title Division 6, regulation SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith 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 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: DELILU ACHIEVEMENT HOMEFACILITY NUMBER: 198203559

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

complaint_status: SUBSTANTIATED


raw_content:
Investigation Findings:
13During the course of this investigation, LPA interviewed pertinent parties. Interviews did not produce corroborating evidence to support the allegation. Staff denied the allegation and stated they did not end the client's placement. Based on the information obtained, this investigation, it is being closed as Unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove violations occurred. This facility forfeited its license as of November 8, 2021 and is no longer in operation. There are no deficiencies cited at this time. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith 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


summary: Facility Evaluation

raw_content:
Narrative:
On June 29, 2021 at 2: PM, Licensing Program Analyst (LPA) Charmetha White arrived at the facility for the purpose of conducting an Annual/Required Inspection Visit. LPA met with Facility Manager, Keta Davis who granted access to the facility and a tour of the facility was conducted at 2: PM. Currently residing in the facility are 7 clients. The facility is licensed to care for 8 female clients. The census this day is seven. This two-story home located in a residential area and the home is set up as follows: 5 bedrooms, 3 bathrooms, a staff office, living room, dining room, kitchen, laundry area, a therapy room, and a backyard. All bedrooms are located on the second floor, bedrooms #1, #2, #3 are furnished with two twin beds, bedrooms #4 and #5 are furnished with one twin bed. Bedroom # LPA observed both beds to have sagging mattresses. Bedroom # LPA observed one bed to have a sagging mattress, and the screen on the window to be full of dirt. Bedroom # LPA observed one bed to have a sagging mattress. Bathrooms: LPA tested the hot water in all bathrooms and found the temperature to be between 105-120 degrees (F). The bathroom faucet located in bedroom #1 was broken. Living room: LPA observed the furniture to be removed and the room to be under construction as facility floor is being replaced. Dining room: is equipped with a wood table and chairs. At the time of this inspection LPA observed the living room furniture to be placed in dining room along with a sofa that had paint thrown on it. Kitchen: was observed to be clean and was equipped with a 4-burner gas stove, a refrigerator/freezer, dishwasher, and a microwave. The kitchen trash can was covered with a lid. The facility was observed to have a two-day supply of perishable foods and a one week supply of non-perishable food and appear to be following the posted menu. Report continued on LIC 809-C. Staffing office: LPA observed the files to be removed and the room to be under construction as facility floor is being replaced. LPA observed all sharp knives and prescribed medications to be placed in a locked file cabinet located in a locked hall closet and made inaccessible to clients in care. The first aid kit was checked and found to be complete. Smoke detectors and carbon monoxide detectors were tested were in appropriate working order. The facility has regulation fire extinguishers. LPA observed the facility to have adequate indoor and outdoor activity space. The front and backyards were inspected and found to be clean and free of debris and observable hazards. All required forms are posted. At time of this inspection this facility does not have a permanent Administrator. This facility employs Facility Managers, Case Managers, and 13 direct care staff. LPA discussed the following with the Facility Manager: Incident reporting, including incidents related to Law Enforcement contacts as well as incidents involving Emergency Intervention. Personnel files were not reviewed as files are maintained off-site. A review of client records was also completed on this date. LPA will return to cited deficiencies observed during this inspection. A copy of this report was left with the Facility Manager.

met_with: Facility Manager - Keta Davis


summary: Facility Evaluation

raw_content:
Narrative:
On 08/18/2021 at 3: PM, Licensing Program Analyst (LPA) Charmetha White conducted a Plan Of Correction (POC) Inspection at the above location to ensure deficiencies initially cited on 07/02/201 have been corrected. LPA met with Facility Manager, Keta Davis and was granted access into the facility. During the inspection LPA observed the following: The mattresses in bedroom #1, bedroom #2, and bedroom #3 have been replaced with new mattresses. The faucet in the bathroom attached to bedroom #1 has been repaired and found to be in working condition. Additionally, the Licensee provided LPA with a written detailed policy addressing the NSP development process, that included proper authorized signatures and tracking processes to ensure timely completion and adherence to ILS regulations. Deficiencies, initially cited on 07/02/2021 have been cleared. An exit interview was conducted and a copy of this report was issued to the facility.


summary: Facility Evaluation - 2 deficiencies

raw_content:
Narrative:
On July 2, 2021 at 4: PM, Licensing Program Analyst (LPA), Charmetha White conducted an unannounced visit for the purpose of conducting a Case Management - Deficiencies Inspection for the deficiencies that were observed during the Annual/Required Inspection, 06/29/2021. LPA met with the Facility Manager, Keta Davis who granted access to the facility. During the inspection, LPA conducted a walk through of the home and observed: The mattresses in bedroom #1, bedroom #2, and bedroom #3 were sagging and needed to be replaced. The window screen in bedroom #2 was dirty. The bathroom faucet located in bedroom #1 was broken. LPA reviewed all seven client files and found client records did not have timely nor complete Needs and Services Plans. Deficiencies were cited. (See LIC 809-D) Exit interview was conducted, appeal rights explained, and a copy of this report was left with the Facility Manager.

Deficiencies:
80088(b): All window screens shall be in good repair and be free of insects, dirt and other debris.
80088: All toilets, hand washing and bathing facilities shall be maintained in safe and sanitary operating condition.

title:
1
2
3
4
5
6
780088 (b) Furniture, Fixtures, Equipment, and Supplies

title: (e)(3) Furniture, Fixtures, Equipment, and Supplies


facility_name: DELILU ACHIEVEMENT HOME #2

raw_content:
Investigation Findings:
13On 09/02/2021, Licensing Program Analyst (LPA) Charmetha White arrived at the above location for the purpose of concluding the investigation and to deliver findings on the above allegations. LPA spoke with the Facility Manager, Stefani Lipsey and discussed the findings. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Interviews and records did not produce corroborating evidence to support the allegations. Staff denied the allegations and stated no one is falsifying any documents. Staff stated none of the staff are on drugs and they have never witnessed any staff reporting to work under the influence of alcohol. Staff stated the staff do not yell at or call the clients inappropriate names. Client interviews revealed that clients have not seen staff come to work under the influence and Client #1 denied being bullied by staff. In addition, documents obtained did not corroborate the allegations. Based on information obtained, the allegation is found to be unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith 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 2

met_with: Facility Administrator - Stefani Lipsey


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

raw_content:
Investigation Findings:
13This facility is closed. Licensing Program Analyst will send a copy of this report to the Chief Operating Officer Craig@delilu.org and will also cc: Operation's Manager at madeline.jones@delilu.org. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Staff stated they store client items in a lock closet per client request. Staff confirmed Client #1 flat irons were being stored in the locked closet, however staff denied having knowledge of what happened to the flat irons. Client #1 stated her flat irons went missing from a locked facility closet. Based on interviews and information obtained, the department has determined the preponderance of evidence standard has been met, therefore the allegation is found to be Substantiated per California Code of Regulations Title Division Chapter 5. Facility cited for violation of California Code of Regulations, Title Division 6, regulation 80026 (b) Safeguards for Cash Resources, Personal Property, and Valuables of Residents. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith 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 Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: DELILU ACHIEVEMENT HOME #2FACILITY NUMBER: 198209576

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

Deficiencies:
80026: If a client is accepted for or maintained in care, his/her cash resources, personal property, and valuables not handled by a person outside the facility who has been designated by the client or his/her1
2
3
4
5
6
7A POC was not issued as this facility is no longer in operation and has forfeited its license as of November 8, 2021.
8
9
10
11
12
13
14authorized representative shall be handled by the licensee or facility staff, and shall be safeguarded in accordance with the requirements specified in (c) through (n).


raw_content:
Investigation Findings:
13During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Interviews and records did not produce corroborating evidence to support the allegations. Staff denied the allegations and stated anytime something needed to be fixed maintenance was called and would come out to make the repairs. Staff stated all staff had received emergency intervention training. Staff stated DCFS came out and conducted a Needs and Service Training. Additionally, LPA conducted a walk through on 06/18/2021 and observed the facility to have monthly NSP's for January 2021 through April 2021. Based on the information obtained, this investigation, it is being closed as Unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove violations occurred. This facility forfeited its license as of November 8, 2021 and is no longer in operation. There are no deficiencies cited at this time. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith 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 2


summary: Facility Evaluation

raw_content:
Narrative:
On June 28, 2021 at 10: AM, Licensing Program Analyst (LPA) Charmetha White arrived at the facility for the purpose of conducting a Annual/Required Inspection Visit. LPA met with Administrator, Stefani Lipsey who granted access to the facility and a tour of the facility was conducted at 10: AM. Currently residing in the facility are four (4) clients. The facility is licensed to care for 6 female clients, ages 12 -17 years, ambulatory only. The census this day is four. The facility is a single story home located in a residential neighborhood and it is set up as follows: 4 bedrooms, 3 bathrooms, a living room, a dining room, kitchen, staff office, a laundry area, therapy office, and a detached garage. Bedroom #1, #2, and #3 are equipped with two (2) twin beds, 2 dressers, and an exit window. Bedroom #4 is being utilized as the staffing office and it is equipped with a desk, a chair, and a cabinet. All bedrooms were observed to have adequate closet space. Each room was observed to have appropriate clean linens. Bathrooms: were checked and found to be in working order. The hot water was tested, and the temperature was found to be between 105-120 degrees (F). Both the living room and dining room furniture was in good repair. The kitchen was observed to be clean and was equipped with a working 6-burner gas range/oven, a refrigerator/freezer, and a microwave. The kitchen trash can was covered with a lid. The facility was observed to have a two-day supply of perishable foods and a one-week supply of non-perishable food and appear to be following the posted menu. All sharp knives are kept locked in a cabinet located in the laundry area and made inaccessible to clients in care. All prescribed medications are centrally stored in a locked box located in a locked closet along the hallway which is made only accessible to employees. Report continued on LIC809C. LPA observed a hard-wired fire alarm system, along with a pull alarm system. Carbon monoxide detector was tested and was in appropriate working order. The facility has regulation fire extinguishers readily available and fully charged. LPA observed the facility to have adequate indoor and outdoor activity space. The front and backyards were inspected and found to be clean and free of debris and observable hazards. There is no pool or bodies of water on the premises. There are no weapons or guns on the premises. LPA observed the detached garage to be used for conference room. All required forms are posted. The Administrator is present at the facility a minimum of 20 hours a week, as verified by the staff schedule. Appropriate staff/client ratios were verified during this inspection. The facility employs Facility Manager, Case Manager, and 9 direct care staff. LPA discussed the following with the Administrator: Incident reporting, including incidents related to Law Enforcement contacts as well as incidents involving Emergency Intervention. Personnel files were not reviewed as files are maintained off-site. Client records were reviewed and found to be missing timely Needs and Services Plans. Based on today's inspection one deficiency was cited per California code of regulations Title 22 division 6. A copy of this report was left with the Facility Administrator.

met_with: Administrator, Stefani Lipsey


facility_name: DELILU ACHIEVEMENT HOME #3

raw_content:
Investigation Findings:
13On July 29, 2021 at 1: PM, Licensing Program Analyst (LPA), Charmetha White arrived at the above location for the purpose of delivering findings on the above allegation. LPA met with Facility Manager, Tawana Newbell and discussed the findings. During the course of this investigation, LPA interviewed pertinent parties, reviewed records, and obtained relevant documents. Staff stated Client #1 was issued her money while she was still in placement. Staff admitted Client #1's clothing was not stored properly. Staff admitted Client #1's Social Security card had been misplaced and was located then given to Client #1's Social Worker. LPA was unable to obtain a statement from Client #1. Based on interviews and information obtained, the department has determined the preponderance of evidence standard has been met, therefore the allegation is found to be Substantiated per California Code of Regulations Title Division Chapter 5. Facility cited for violation of California Code of Regulations, Title Division 6, regulation 80026 (b) Safeguards for Cash Resources, Personal Property, and Valuables of Residents. Exit interview was conducted, Appeal Rights were issued and a copy of this report was left at the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith 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 Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: DELILU ACHIEVEMENT HOME #3FACILITY NUMBER: 198208930

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

Deficiencies:
80026: If a client is accepted for or maintained in care, his/her cash resources, personal property, and valuables not handled by a person outside the facility who has been designated by the client or his/her authorized representative shall be handled by the 1
2
3
4
5
6
7Facility staff will maintain accurate records of client's case resources, personal property, and valuables. A written accounting ledger with columns for income, disbursements, and balances and a space for client's signature will be drafted. Cash given to clients from their account will require client's signature. Receipts for purchases shall be obtained and placed
8
9
10
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14licensee or facility staff, and shall be safeguarded in accordance with the requirements specified in (c) through (n).

met_with: Facility Manager - Tawana Newbell


raw_content:
Investigation Findings:
13This facility is closed. Associate Governmental Program Analyst will send a copy of this report to the Chief Operating Officer Craig@delilu.org and will also cc: Operation's Manager at madeline.jones@delilu.org . Associate Governmental Program Analyst (AGPA) Tonya Barnes-Woodard and Licensing Program Analyst Charmetha White conducted the investigation into the above allegation. AGPA queried fingerprint associations in Guardian to located staff to conduct interviews as well as conducted a query of CWS/CMS to locate children who were placed in the home. Based on confidential interviews obtained during the investigation process, the allegation could not be corroborated. Although the allegations may have happened or are valid, there was not a preponderance of the evidence to prove that the alleged violation occurred., therefore the Medication allegation was unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Tonya Barnes-Woodard LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Facility Representative


raw_content:
Investigation Findings:
13This facility is closed. Associate Governmental Program Analyst will send a copy of this report to the Chief Operating Officer Craig@delilu.org and will also cc: Operation's Manager at madeline.jones@delilu.org . Associate Governmental Program Analyst (AGPA) Tonya Barnes-Woodard and Licensing Program Analyst Charmetha White conducted the investigation into the above allegation. AGPA queried fingerprint associations in Guardian to locate staff, as well as obtained staff phone numbers through interviews conducted, and queried CWS/CMS to locate children who were placed in the home during the time of the allegation. Based on confidential interviews obtained during the investigation process, the allegation could not be corroborated. Although the allegations may have happened or are valid, there was not a preponderance of the evidence to prove that the alleged violation occurred., therefore the Personal Rights allegation was unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Tonya Barnes-Woodard LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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


raw_content:
Investigation Findings:
13On 05/03/2022, Licensing Program Analyst (LPA) Bernice Karnsrithong had completed the above complaint investigation. During the investigation of the allegations that staff does not adequately supervise group home children and that the facility does not provide a safe environment for group home child, LPA Karnsrithong had conducted confidential interviews. Statements did not produce corroborating evidence to support that staff does not adequately supervise children while in care and that the facility did not provide a safe environment for clients. Due to lack of evidence obtained during the investigation, LPA determines that the allegations are unsubstantiated at this time meaning, although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. This facility is no longer in operations and has forfeited its licensed as of November 08, There are no deficiencies cited at this time. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Bernice Karnsrithong 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


raw_content:
Investigation Findings:
13This facility is closed. Licensing Program Analyst will send a copy of this report to the Chief Operating Officer Craig@delilu.org and will also cc: Operation's Manager at madeline.jones@delilu.org. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Based on confidential interviews and records obtained during the investigation process, the allegations could not be corroborated. Although the allegations may have happened or are valid, there was not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the allegations staff falsified facility records, facility has rat infestation, staff served residents unsafe food, staff under the influence are not able to provide proper care for children, and facility staff allow minors to smoke on premises were unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith 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 2

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


raw_content:
Investigation Findings:
13This facility is closed. Licensing Program Analyst will send a copy of this report to the Chief Operating Officer Craig@delilu.org and will also cc: Operation's Manager at madeline.jones@delilu.org. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Based on confidential interviews and records obtained during the investigation process, the allegations could not be corroborated. Although the allegation may have happened or is valid, there was not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation facility operating out of ratio is unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith 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

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


raw_content:
Investigation Findings:
13This facility is closed. Licensing Program Analyst will send a copy of this report to the Chief Operating Officer Craig@delilu.org and will also cc: Operation's Manager at madeline.jones@delilu.org. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Based on confidential interviews and records obtained during the investigation process, the allegations could not be corroborated. Although the allegation may have happened or is valid, there was not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation facility night shift staff sleep while on duty at their shift unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith 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

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


raw_content:
Investigation Findings:
13This facility is closed. Licensing Program Analyst will send a copy of this report to the Chief Operating Officer Craig@delilu.org and will also cc: Operation's Manager at madeline.jones@delilu.org. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Based on confidential interviews and records obtained during the investigation process, the allegations could not be corroborated. Although the allegation may have happened or is valid, there was not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegations facility did not provide food of the quality and quantity to meet the to meet the needs of the clients, facility did not provide care and supervision to meet the needs of the clients, and staff did not assist clients with medications as needed is determined to be unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith 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 2

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


raw_content:
Investigation Findings:
13During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Interviews and records did not produce corroborating evidence to support the allegations. Staff denied the allegations and stated the facility was inspected in March 2020 and maintenance fixed the issues that were pointed out shortly after the inspection. Staff stated all staff have received emergency intervention training as it is a requirement for employment. Staff stated Needs and Service Plans are completed every 30 days. Additionally, LPA conducted a walk through on 06/16/2021 and observed the facility to have monthly NSP's for January 2021 through April 2021. Based on the information obtained, this investigation, it is being closed as Unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove violations occurred. This facility forfeited its license as of November 8, 2021 and is no longer in operation. There are no deficiencies cited at this time. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith 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


raw_content:
Investigation Findings:
13During the course of this investigation, LPA conducted confidential interviews. Statements obtained did not produce corroborating evidence to support the allegations that staff did not ensure minor attended an appointment, that minor's educational needs are not being met, and that minor is not afforded privacy. Due to lack of evidence obtained during the investigation, LPA determines that the allegations are unsubstantiated at this time meaning, although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. This facility is no longer in operations and has forfeited its licensed as of November 08, There are no deficiencies cited at this time. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith 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 2


summary: Facility Evaluation

raw_content:
Narrative:
On June 28, 2021 at 2: PM, Licensing Program Analyst (LPA) Charmetha White arrived at the facility for the purpose of conducting an Annual/Required Inspection Visit. LPA met with Administrator, Lisa Seibel of the facility was conducted at 2: PM. Currently residing in the facility are six (6) clients. The facility is licensed to care for 6 female clients, ages 12 -17 years, ambulatory only. The census this day is six. The facility is a two-story home located in a residential neighborhood and it is set up as follows: 4 bedrooms, 2 bathrooms, a living room, a dining room, kitchen, staff office, a basement, a laundry area, an activity room, a detached garage, and a backyard. Bedrooms #1 is equipped with two twin beds, two dressers, a closet and there are two window. LPA observed the drawers on one of the dressers need to be fixed and a small hole in the wall above that dresser. Bedroom #2 is equipped with two twin beds, two dressers, and a closet. This room shares a Jack and Jill restroom with bedroom #3. LPA observed the bathroom door on located in bedroom #2 to be coming off the hinges at the top and a hole in the screens on the windows. Bedroom #3 is equipped with two twin beds, two dressers and was observed to have adequate closet space. Bedroom #4 is utilized as the facility's therapy room and it is equipped with a couch and two chairs. Bathrooms were checked and found to be in working order. The hot water was tested, and the temperature was found to be between 105-120 degrees (F). The living room and dining room furniture was in good repair. The kitchen was observed to be clean and was equipped with a 5-burner gas stove, a refrigerator/freezer, dishwasher, and a microwave. The kitchen trash can was covered with a lid. The facility was observed to have a two-day supply of perishable foods and a one-week supply of non-perishable food and appear to be following the posted menu. All sharp knives are kept locked in the staffing office located off the kitchen and made inaccessible to clients in care. All prescribed medications are centrally stored in a locked cabinet in the laundry area and made only accessible to employees. Report continued on LIC 809-C. The first aid kit was checked and found to be complete. Smoke detectors and carbon monoxide detectors were tested were in appropriate working order. The facility has regulation fire extinguishers. LPA observed the facility to have adequate indoor and outdoor activity space. The front and backyards were inspected and found to be clean and free of debris and observable hazards. LPA observed the detached garage to be used for storage. All required forms are posted. The Administrator is present at the facility a minimum of 20 hours a week, as verified by the staff schedule. Appropriate staff/client ratios were verified during this inspection. The facility employs Facility Managers and 10 direct care staff. LPA discussed the following with the Administrator: Incident reporting, including incidents related to Law Enforcement contacts as well as incidents involving Emergency Intervention. Personnel files were not reviewed as files are maintained off-site. Client records were reviewed and found to be missing CFT documentation and timely Needs and Services Plans. LPA discussed the deficiencies found during today's inspection. LPA will return at a later date to cite deficiencies found. A copy of this report was left with the Facility Administrator.

met_with: Administrator - Lisa Seibel


summary: Facility Evaluation

raw_content:
Narrative:
On July 29, 2021 at 3: PM, Licensing Program Analyst (LPA) Charmetha White conducted a Plan Of Correction (POC) Inspection at the above location to ensure deficiencies initially cited on 07/02/201 have been corrected. LPA met with Facility Manager, Tawana Newbell and was granted access into the facility. During the inspection LPA observed the following: Bedroom #1 - the dresser drawers in bedroom #1 was fixed and the hole in the wall was repaired. Bedroom #2 - The hinges on the bathroom door was repaired and the window screen had been replaced. Additionally, the Licensee provided LPA with a written detailed policy addressing the NSP development process, that included proper authorized signatures and tracking processes to ensure timely completion and adherence to ILS regulations. Deficiencies, initially cited on 07/02/2021 have been cleared. An exit interview was conducted and a copy of this report was issued to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 04/11/2022 at 2:30pm, Licensing Program Analyst (LPA) Bernice Karnsrithong arrived at Dream Home Care V and met Lisa Seibel, former administrator to Delilu Achievement Home #3 for the purpose of conducting a collateral visit. During this time, LPA Karnsrithong conducted an interview with Lisa Seibel, a former employee at Delilu Achievement Home #3 regarding a complaint that was made on 06/18/2021. At this time, there is insufficient information regarding the said complaint. The complaint needs further investigation. The facility has been closed since September, 2021 and the licensee no longer have an active license during the time of visit. There are no deficiencies cited at this time.

met_with: Lisa Seibel


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On July 2, 2021 at 2: PM, Licensing Program Analyst (LPA), Charmetha White conducted an unannounced visit for the purpose of conducting a Case Management - Deficiencies Inspection for the deficiencies that were observed during the Annual/Required Inspection, 06/28/2021. LPA met with the Facility Administrator, Lisa Seibel who granted access to the facility. During the inspection, LPA conducted a walk through of the home and observed: Dresser drawers in bedroom #1 needed to be fixed and a hole in the wall above the dresser in bedroom #1. The bathroom door located in bedroom #2 coming off the hinges and holes in window screens located in bedroom #2. LPA reviewed all six client files and found client records did not have timely nor complete Needs and Services Plans. Deficiencies were cited. (See LIC 809-D) Exit interview was conducted, appeal rights explained, and a copy of this report was left with the Facility Administrator.

Deficiencies:
80088(b): All window screens shall be in good repair and be free of insects, dirt and other debris.

met_with: Facility Administrator - Lisa Seibel


facility_name: DIGNITY STRTP

raw_content:
Narrative:
Continue from page 1 . . . The staff denied the allegations and stated that the staff does room checks every 15 minutes and that the staff covers both floors in the facility. The staff stated that one staff is downstairs when minors are downstairs and another staff is upstairs when there are other minors upstairs. The staff stated that the staff intervenes when minor are having issues with each other and try to solve the issue by separating and listening to each minors information. The staff stated that the minor are redirected when having friction with each other, are given warnings for behavior and a special incident report is written after or when reported. The staff stated that the minors are redirected when horse playing around the facility and are given explanations to not do it. The confidential interviews revealed contradicting statements. There was information that a minor was hit on several occasions in his room and was thrown ice or shoes by other minors in the home, it was also reported that a minor was told by another minor not to come out of the room or would be hit. Other statements stated that the minor was not hit by another minor purposely physically and that the minors in the home sometimes horse play around. It was also reported that no items were thrown to the minor and that the minor was not threaten to be beaten. The confidential interviews revealed that the staff checks on the minor around the facility and that two staff split the floors when minors are on different floors in the home. It was also reported that the staff redirects the minors when the minor don't follow instructions or are having behaviors. The County Social Workers for the minors in questions were not available to give a statement. Based on the interviews and records reviewed, the allegations are found to be unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove the allegations. Copies of LIC9099, LIC9099C, LIC811 and Appeals rights were provided and discussed with the facility representative mentioned above. There were no deficiencies cited.

Investigation Findings:
13On July 11, 2024, Licensing Program Analyst (LPA) Heriberto Perez conducted a follow-up complaint inspection to the above facility and met with Jerry Philips, Lead Facility Manager. The purpose of the inspection was to deliver the finding for the above complaint allegations. During the course of the investigation, LPA interviewed two youths and one staff on 06/11/24, LPA interviewed four minors on 06/14/24, LPA interviewed one staff via telephone on 07/03/24, LPA interviewed one staff via telephone on 07/08/24 and LPA interviewed two staff via telephone on 07/09/24 (see Confidential Names Form LIC 811 dated July 11, 2024). LPA also reviewed documents including but not limited to Client's rooster, staff rooster, Client's Need and Service Plans, Special Incident Reports (SIR) and other documents. It was alleged Staff does not prevent a minor from attacking another minor, Staff does not prevent a minor from throwing items at another minor and Staff does not prevent a minor from threatening and intimidating another minor. It was also alleged Staff did not properly report incidents involving a minor. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Heriberto Perez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: DIGNITY STRTPFACILITY NUMBER: VISIT DATE: 07/11/2024

met_with: Jerry Philips, Lead Facility Manager