summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13On January 14, 2022, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted an announced complaint inspection at the above facility for the purpose of delivering findings. Upon arrival, AGPA met with Taylor Abernethy, Program Manager. On January 9, 2022, AGPA Woodard conducted the initial 10-day complaint inspection. At time of inspection, AGPA conducted a tour with S1 of the cottage, dining hall, and Stone House Kitchen. During the tour of the cottage, AGPA observed food not properly sealed and old fruit. In the dining hall, observed prepared food in a pot with a metal spoon dated 12/31/2021 and also a bowl of prepared Caesar Salad with no date, and Orange Juice marked "Enjoy Before 12/16/21". In the Stone House Kitchen, there was romaine lettuce that was withering and browning marked packaged 12/17/21, a container of molded cheese, another gallon of Orange Juice marked "Enjoy Before 12/16/21", a packaged of hamburger meat with a sticker Reduced to $5 marked "Use by 01/08/2022", a box of snacks in damaged boxes and/or broken seals, and meat in the freezer with reduced stickers marked "use or freeze by Sept 30, 2021, and a box marked Ahi Tuna with a date 7/25 written on it. Based on observations, AGPA Woodard has determined the preponderance of evidence standard has been met. Therefore, the allegations are found to be substantiated. Deficiencies were cited to the facility for Food Service. SubstantiatedEstimated 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: 2 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: HOPE REFUGE, INCFACILITY NUMBER: 425802135

met_with: Taylor Abernethy


state: CA

facility_name: HOPE REFUGE, INC

summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On January 14, Associate Governmental Program Analyst (AGPA) Tonya L Barnes-Woodard conducted an announced complaint visit at Hope Refuge for the purpose of amending the August 15, 2021 report. Upon arrival, AGPA Woodard was greeted by Taylor Abernethy, Program Manager. During the course of the investigation, AGPA observed two out of three dryers out of service at time of inspection on June 5, 2021. Due to there being still one dryer available on the lower campus for use by clients, and if needed, there was one available dryer on the upper campus for use. During multiple inspections at the facility, AGPA did not observe any leaking fire hydrants or any not in working order. Although staff and clients feel the facility poses a fire hazard due to being located in a woodsy area, there was a maintenance man cutting back the dried brush. On occasion toiletries ran low on stock, staff and clients did not confer that toiletries were not provided. Although the facility has an evacuation plan, the majority of staff and clients were not aware of it, and drills were not being performed. Based on confidential interviews with relevant parties, and inspections conducted on various dates, AGPA Woodard determined that the allegations are unsubstantiated. An unsubstantiated finding means although the allegation may have happened, the preponderance of evidence does not prove it. An exit interview was conducted, signature from Facility Representative was received, and a copy of this report was left at the facility. 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: 4 of 4

report_type: Complaint Investigation

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On 04/05/2021, at 1:15pm Licensing Program Analyst (LPA) Enrique Hernandez conducted a Case Management - Incident inspection at Hope Refuge STRTP and met with STAFF #1(S1) in response to a Special Incident Report, submitted to Community Care Licensing (CCL), in order to investigate a possible Neglect / Lack of Supervision violation. The incident, which occurred on 03/31/2021, involved clients (C1) and C2, As they were getting the floaties out of the pool room the clients got into the the first aid kit that was located in the pool room. The clients got two packs of medication a small sharp edge tool without the knowledge of the facility staff. LPA Hernandez conducted confidential interviews with the pertinent parties during the time of the call Further investigation is needed for a final resolution. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 3.1, there are no deficiencies to be cited at this time. Exit interview was conducted and a copy of this report will be emailed to the Licensee, in order to obtain a signature. Signature will be on file.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Staff #1


summary: Facility Evaluation

raw_content:
Narrative:
On 8/25/ Licensing Program Analyst (LPA) Enrique Hernandez made an unannounced inspection of the above facility for the purpose of conducting a plan of correction (POC) visit to clear the deficiency dated 8/06/2021. LPA Hernandez met with the licensee's Sally Cook and Charles Cook who granted access to the facility and together conducted a tour of the facility where that chainsaw was left unattended LPA Hernandez observed during the inspection on 08/25/2021 that the area was free of debris and hazardous materials at the time of the inspection. LPA also received a POC by email on 8/8/2021 by the acting administrator Cesar Argueta stated that Hazardous materials will not be placed unsupervised that could pose a danger to clients in care. LPA Hernandez cleared the deficiency and provided the facility with a POC clearance letter. Exit interview was conducted and a copy of the report will be email to the licensee due to LPA having problems with the computer.

met_with: Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On October 28, 2021 at 8:20am Licensing Program Analysts Licensing (LPA) Enrique Hernandez; Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard and Licensing Program Manager (LPM) Kevin Sauk conducted a Case Management - Incident inspection at Hope Refuge Short Term Residential Therapeutic Program (STRTP), and met with the Facility Administrator David Harper, in response to six (6) Special Incident Reports that were submitted to Community Care Licensing (CCL), in order to investigate a possible violation. C1 medication was not administered by staff # 1 (S1) on four (4) different days, 09/18/2021, 09/20/2021, 09/25/2021, and 10/17/2021. Additionally, S1 did not administer C2 medication for two days on 09/18/2021 and 09/25/2021. [See LIC Confidential Names List form (LIC811), dated 10/28/2021, for names]. LPA conducted confidential interviews at the time of the inspection. At this time, the Department has made no determination on whether a violation has occurred. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 4.0, there are no deficiencies to be cited at this time. Exit interview was conducted and a copy of this report was left with the facility administrator whose signature on this form confirm receipt of this document.

met_with: Administrator


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On October 28, 2021 at 8:20am Licensing Program Analysts (LPA) Enrique Hernandez; Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard and Licensing Program Manager (LPM) Kevin Sauk conducted an unannounced inspection, at the above-said facility, for the purpose of conducting an Annual Required Inspection. Licensing staff was met by Facility Administrator David Harper who granted access into the facility, who provided a tour of the entire facility, inside and out. Hope Refuges is located in the Los Padres National Forest. The site was a previous recreational campground. There are three residential cottage, main house, dining hall, therapy building, Administration/Music building, school, bathrooms, central kitchen/staff lodging, Laundry room, activity space. This facility will provide services to children, ages 12-17 years, ambulatory only. During the inspection the following was observed: Stone House/Central Kitchen: The Stone House will only be accessible to staff. The house will be off limits to the youth. This is a three (3) bedroom Two and a half (2 1/2) bathroom homes with a living room, dining area and kitchen. The bedrooms are used by Direct Care Staff if they want to stay the night at the facility instead of driving back home. There is a Kitchen located adjacent to the dining room, equipped with one (1) refrigerator in the kitchen and one (1) commercial size walk-in refrigerator and the freezer not in use as freezer located outside the house. The refrigerator/freezer will need to be made inaccessible to the youth, one (1) toaster ovens, one (1) ranges, two (2) ovens, one (1) microwaves, trash can with lid, and fire extinguisher. LPA observed 1 fire extinguishers in the unit. Page 1 of Unit 1 (Olive cottage): Is currently vacant has four (4) bedrooms with a capacity for eight (8) clients with a sink in each bedroom. Two twin beds in each room, dresser, and adequate lighting and closet space. Four (4) bath units with a sink, shower and toilet all operable at time of inspection. There is a living room with a couch and chairs. LPA observed a fire extinguisher in the unit. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that must remain locked at all times and cannot be used as a pass through. There is an exit door to outside in both bedrooms. Med room in each cottage with double locked. A small refrigerator, microwave and non-perishable food supplies must be available in each cottage. Unit 2 (Pine Cottage): Is currently vacant has four (4) bedrooms with a capacity for eight (8) clients with a sink in each bedroom. Two twin beds in each room, dresser, and adequate lighting and closet space. Four (4) bath units with a sink, shower and toilet all operable at time of inspection. There is a living room with a couch and chairs. LPA observed a fire extinguisher in the unit. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that must remain locked at all times and cannot be used as a pass through. There is an exit door to outside in both bedrooms. Med room in each cottage with double locked. A small refrigerator, microwave and non-perishable food supplies must be available in each cottage. Unit 3 (Oak Cottage): Unit 3 (Oak Cottage): Is occupied by five (5) female clients with a capacity for eight (8) clients with a sink on it. Two twin beds in each room, dresser, and adequate lighting and closet space. Four (4) bath units with a sink, shower and toilet all operable at time of inspection. There is a living room with a couch and chairs. LPA observed a fire extinguisher in the unit. All smoke detectors and carbon monoxide detectors were tested and operable at time of inspection. Each bedroom was observed with a connecting door that must remain locked at all times and cannot be used as a pass through. There is an exit door to outside in both bedrooms small refrigerator, microwave. Page 2 of Dining Hall: The front of the hall is equipped with three (3) couches, and dining tables LPA observed a fire extinguisher in the unit. The back of the hall has (1) bathroom No smoke detectors or carbon monoxide detectors available. The Dining hall has two back rooms that are intended to be a nurse station and administration room.Another room with lock cabinet for staff files. LPA observed a bathroom with out of order sign. Therapy Building: The unit has a group therapy area with four (4) chairs, couch, TV stand and bookshelf. The cottage also has two smaller therapy rooms with two (2) couches and a coffee table. No smoke detectors or carbon monoxide detectors available. Administration Building/Music Room: The front of the cottage is for administrator staff used only with six (6) cubicles and office materials. The back of the cottage they have a music room equipped with a piano, guitar and music stand reader. No smoke detectors or carbon monoxide detectors available. School Building: Is used as on-site school and academic space. The front half consist of 6 desks with 5 chairs at each desk. The back half consist of desks and chairs. No smoke detectors or carbon monoxide detectors available. Bath House: Equipped with three (3) toilets three (3) showers and two (2) sinks all operable at time of inspection. There was no hot water at the time of the inspection. Laundry Rooms: The laundry room is located in the screen room with one exterior entrance. There are three (3) washers and three (3) (dryers) sink and fire extinguisher. 3 of Outdoor Space: There is a gated pool on the premises with two outside that they were locked at the time of the inspection bathrooms, storage area and a locked room where pool pump is located. The pool is about 9 feet high with a self-closing key lock mechanism located half way down from top of gate. . LPA observed two (2) ropes courses. One course is small and low to the ground and the second ropes course is approximately 20 feet high. LPA observed a climbing wall about 6-7 feet tall and a Zip-line course. LPA informed administrator the zip-line would need to be made inaccessible to youth and not to be used until the equipment can be inspected and certified. Facility administrator was also informed before Zip-line can be used a part of the program, there must be certified staff in place when Zip-line activity takes place. Per STRTP interim licensing standards section 87087.2(b)(1); the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material which absorbs falls. Sand, woodchips, pea gravel or rubber mats commercially produced purpose, shall be permitted. LPA observed 4 broken windows on storage area that needs to be replaced. LPA will return to continue the annual/ required inspection to review personnel and client's files to ensure it meets regulatory requirements. LPA also will conduct interviews with clients and staff at a later date. A Review of the Facility's Personnel Summary on 10/28/ Reveals That Staff Have Doj/fbi Criminal Record Clearances and a Child Abuse Background Clearance. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 4.0, The following deficiencies are cited Exit interview was conducted and a copy of this report was left with the facility administrator whose signature on this form confirm receipt of this document.

Deficiencies:
80088(e): Deficient Practice Statement
1
2
3
4Based on observation and interviews, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/05/2021
Plan of Correction
1
2
3
4

visit_type: Annual

met_with: Facility Administrator

title:
Fixtures, Furniture, Equipment and Supplies

(e) Faucets used by clients for personal care such as shaving and grooming shall deliver hot water.

This requirement is not met as evidenced by


summary: Facility Evaluation

raw_content:
Narrative:
On November 13, 2021 at 9:30AM, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard made an unannounced visit to Hope Refuge for the purpose of conducting a Case Management Inspection. AGPA met with Direct Care Staff, Trina Garcia. Currently the census is four (4) and the facility is utilizing one out of three cabins. Case Management inspection was conducted to ensure the facility personnel has not removed room doors in Oak cottage prior to receiving approval from Community Care Licensing Division. AGPA inspected Oak Cottage and observed doors were still intact for the four rooms. AGPA observed that bathroom doors were still intact, affording the youth their privacy for changing and doing their daily hygiene. LPA Enrique Hernandez requested that Facility Administrator submit an official request to Community Care Licensing Division including an explanation as to why the doors shall be removed to licensing prior to the removal of the doors. There were no deficiencies observed or cited. Exit interview conducted with staff, and a copy of this report was left at the facility.

met_with: Trina Garcia


summary: Facility Evaluation

raw_content:
Narrative:
On March 23, 2021 at 9:05am Licensing Program Analyst (LPA) Enrique Hernandez made an unannounced call inspection to the above said facility for the purpose of conducting a Case Management Inspection to address concerns regarding reporting requirements. Staff #1 stated that a Special Incident Report that occurred on 3/10/2021 was not submitted until 3/22/2021 to our Department. Staff #1 stated that the Special Incident Report was not sent on a timely manner. LPA informed Staff #1 the importance of submitting the reports in a timely matter PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 3.1, The following deficiency is to be cited Exit interview was conducted and Appeal Rights were issued and a copy of this report will be emailed to the Licensee, in order to obtain a signature. Signature will be on file.


summary: Facility Evaluation

raw_content:
Narrative:
On March 23, 2021 at 9:05am Licensing Program Analyst (LPA) Enrique Hernandez made an unannounced call inspection to the above said facility for the purpose of conducting a Case Management Inspection to address concerns regarding Missed medication improper medication. LPA called staff # 1 and together they discussed incident reports dated 3/10/2021, 3/21/2021, and 3/17/2021.LPA informed staff # 1 that the incidents occurred on three different occasions with three different clients and three different employees. LPA also conducted confidential interviews with clients indicating that this is not the first time this has happened. Staff #1 said training will be provided to properly administer the medications so this doesn't happen again. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 3.1, The following deficiencies are cited Exit interview was conducted and Appeal Rights were issued and a copy of this report will be emailed to the Licensee, in order to obtain a signature. Signature will be on file.


summary: Facility Evaluation

raw_content:
Narrative:
On April 30, 2021, at 9:45 am Licensing Program Analyst (LPA) Enrique Hernandez, conducted an unannounced Case Management-other inspection to Hope Refuge Short Term Residential Therapeutic Program (STRTP) located at the above address. S1 granted access into the facility and together conducted a tour of the entire campus/facility. Hope Refuge is located in Los Padres National Forest. The site was a previous religious recreational campground. There are three residential cottages (Olive, Pine, Oak), stone house, yellow house, dining hall, therapy building, administration/music building, school, bathrooms, central kitchen/staff lodging, laundry room, and activity space. This facility will provide services to female clients, ages 12-17 years old, ambulatory only. During the inspection the following was observed: Oak Cottage Drain cover missing from one of the showers. Three slices of buttered toast on snack table / Undated A dirty plate on the snack table Bag of chips and cereal open. The cottage Smells like skunk/ it was confirmed by the staff A dead cockroach in one of the rooms Pine cottage Mold on the edge of the shower Water jug spout is dirty Continue on LIC 809-C Olive cottage(Vacant) Dead insects all over the rooms Dining Hall Outlet is not securely placed onto the wall. Wall need to be patch Outdoors Three round outdoor table top has graffiti on. Picnic wooden bench near the music room the leg is broken. Bathrooms are not clean/no soap/ no toilet paper and trash cans are full. LPA took pictures of all the deficiencies and Priscilla also took notes and pictures of the deficiencies. Per California Code Regulation, Title 22, Division 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing standars (ILS), the following deficiencies were observed and cited at the time of this inspection. (See LIC809-D) A copy of this report will be emailed to the licensee in order to obtain a signature. Signature will be on file


summary: Facility Evaluation

raw_content:
Narrative:
On 4/30/ Licensing Program Analyst (LPA) Enrique Hernandez conducted a follow-up Case Management - Incident inspection at the above-named facility, which had been initiated on 04/05/2021, and met with Pricilla Saavedra Facility Manager, in order to investigate an incident where a possible Neglect / Lack of Supervision violation may have occurred on 03/31/2021, involved clients (C1) and C2, (See Confidential Names form LIC811 dated 04/30/2021) The staff opened the door to the room by the pool for clients to go in and grab the floaties. C1 and C2 saw the first aid kit in the room unlocked and no one was watching them and obtained two packets of medications and a small sharp-edged tool without the knowledge of the facility staff. Based on all interviews conducted, and because the facility admitted fault, this Department has determined that a Neglect / Lack of Supervision violation had occurred. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 3.1, the following deficiency was cited at the time of this inspection. (See LIC809-D) Exit interview conducted, due to technical difficulties with the printer this report will be email to the facility administrator to obtain signature.


summary: Facility Evaluation

raw_content:
Narrative:
On 8/6/ Licensing Program Analyst (LPA) Enrique Hernandez conducted an unannounced Case Management Inspection at Hope Refuge. LPA met with the Program manager Taylor Abernethy who granted access into the facility. The purpose of the visit was to conduct an Initial complaint investigation that was received on 8/6/2021 and to deliver findings . LPA and the Program Manager conducted a walk through of the entire facility inside and out during today's inspection and it was observed that chainsaw was by the entrance of the facility unattended. Program manager informed the maintenance staff to put away the chainsaw. (See confidential name list LIC811 dated 08/6/2021). Per California Code Regulation, Title 22, Division 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing standars (ILS), the following deficiency has been cited. (See LIC809-D) Exit interview was conducted and a copy of this report was left with the licensee whose signature on this form confirm receipt of this document.


summary: Facility Evaluation

raw_content:
Narrative:
On August 14, 2021 at 2:35PM, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted an unannounced case management inspection at the above facility. Upon arrival, AGPA Woodard was greeted by Trina Garcia, Direct Care Staff and Anthony Figueroa, Chef. During today's inspection, AGPA Woodard reviewed 11 client records, maintenance records, and Cottage daily log book (see LIC 811 - Confidential Names List). On July 24, 2021, AGPA Woodard reviewed 13 current staff files/training. At time of inspection, two staff did not have criminal record clearances Based on records review, the licensee failed to ensure fingerprint clearances has been obtained from Staff Member 1 and 3 (listed on LIC 811-Confidential Names List dated 07/24/2021) which poses an immediate Health, Safety and Personal Rights risk to residents in care. Per California Code Regulation, Title 22, Division 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing standars (ILS), the following deficiency has been cited. (See LIC809-D) Exit interview was conducted and a copy of this report was left with staff.


summary: Facility Evaluation

raw_content:
Narrative:
On September 23, 2021 at 03: PM, Licensing Program Analyst (LPA) Regina Martin conducted an unannounced Case Management inspection at Hope Refuge, Inc. for the purpose of delivering findings into self reported incident received February 23, 2021, involving clients #1 (C1) and #2 (C2); (refer to Confidential Names form LIC811, dated 09/23/21). LPA met with Taylor Abernethy Program Manager and together the findings are discussed. The incident report alleged sexual assaultive behavior by Client #2 (C2) on Client #1 (C1). The incident was referred to Investigations Bureau, Investigator, Phillipe Ryan Miles. During the investigation, confidential interviews were conducted with C1, Staff #1 (S1), Program Director/Administrator, and assigned Social Worker for C2. The investigation also included review of corresponding facility Special Incident Report, contact with the Santa Barbara Sheriff's Department and review of client and facility file history. Information revealed on February 22, 2021, C1 reported to Program Director/Facility Administrator that during an outing on February 18, 2021, C2 touched C1 inappropriately while in the facility vehicle. It was revealed that C2 squeezed C1's breast and at some point, digitally penetrated C1. Information obtained indicates S1 was inside of the Post Office at the time of the incident as S1 had left clients alone inside the vehicle. Witness account of the incident corroborate claims that C2 touched C1 inappropriately twice while alone and unattended in the facility vehicle. (Continued on page LIC809-C) Confidential interviews further revealed S1 was not aware of the incident between C1 and C2 until informed during a manager's meeting; after which, C1 and C2 were separated and placed in separate cottages. Supervision was elevated for client's safety. Facility Administrator admitted that staff failed to provide adequate care and supervision according to their facility policy. Investigator Miles' attempts to interview C2 were unsuccessful due to C2's AWOL status (absent without permission) after graduating facility's program. Based on the information obtained, there is enough evidence to support claim that Staff failed to ensure adequate supervision to clients C1 and C2 posing an immediate Health, Safety and Personal Rights risk to clients in care; therefore, the finding for neglect/lack of supervision is Substantiated. Facility is cited per California Code of Regulations, Title 22: 80078 (a) Responsibility for Providing Care and Supervision. Because this is a repeat violation of the same subsection within a 12-month period, an immediate civil penalty of $250 is assessed. A copy of this report, the Confidential Names List and appeal rights were provided to the Facility Administrator. (Continued on page LIC809-D)

met_with: Taylor Abernethy Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 12/10/2021, at 9:45am Licensing Program Analyst (LPA) Enrique Hernandez conducted an unannounced follow Case Management - Incident inspection at Hope Refuge from the initial inspection that was conducted on 10/28/2021. LPA met with the Taylor Abernethy`Program Manager (PM), who granted access into the facility. LPA and Program Manager (PM) discussed the six (6) Special Incident Reports that were submitted to Community Care Licensing (CCL), in order to deliver the findings. Client #1 (C1) medication was not administered by staff # 1 (S1) on four (4) different days, 09/18/2021, 09/20/2021, 09/25/2021, and 10/17/2021 as prescribed by the physician. Additionally, S1 also did not administer medication to Client # 2 (C2) in two different days 09/18/2021 and 09/25/2021. [See LIC Confidential Names List form (LIC811), dated 12/10/2021, for names]. After reviewing all confidential interviews conducted on 10/28/2021 and incident reports received from the facility, it was confirmed that staff # 1 (S1) did not administer medication to (C1 and C2) on the above dates. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 4, the following deficiency has been cited. (See LIC809-D) Exit interview was conducted and a copy of this report was left with the Program Manager whose signature on this form confirm receipt of this document.

met_with: Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 01/27/2022, at 8:30am Licensing Program Analyst (LPA) Enrique Hernandez conducted an unannounced Case Management - Incident inspection at Hope Refuge. LPA met with David Harper Facility Administrator (FA), who granted access into the facility. LPA and FA discussed the three (3) Special Incident Reports that were submitted to Community Care Licensing (CCL), dated 12/21/2021, 1/14-1/16/2022 and 1/16/2022 in order to deliver the findings. Three incident reports that were submitted to CCL stated that Client #1 (C1) Client#2 (C2) and Client #3 (C3) missed their medication. Staff #1, Staff #2 and Staff #3 did not administer the clients medication. . [See LIC Confidential Names List form (LIC811), dated 01/27/2022, for names]. After reviewing all incident reports received from the facility, it was confirmed that S1, S2 and S3 did not administer medication to C1, C2 and C PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 4, the following deficiency has been cited. (See LIC809-D) Exit interview was conducted, and a copy of this report will be emailed due to technical difficulties with the LPA's printer.


facility_name: HOUSE OF BETHESDA, THE

summary: Facility Evaluation

raw_content:
Narrative:
On December 17, 2021 at 9:00am, Licensing Program Analyst (LPA), Daphne Edison made an announced visit to The House of Bethesda for the purpose of conducting a Case Management (Post Licensing) inspection visit. This was a follow-up visit which took place on November 12, 2021 at the above location in which no one was at the home. LPA Edison met with Robert Smith, Licensing Executive Director who granted access to the facility and a tour was conducted. The home is licensed to provide care and supervision to six (6) children, ages 13 -17 years old, ambulatory only. There is a provisional license with an expiration date of May 4, 2022. There is no swimming pool or bodies of water on the premises. The census today is zero (0). The home is set up as follows: This is a one story house with three (3) bedrooms, two (2) bathrooms, living room, two (2) staff offices, dining area, kitchen/laundry area, and outdoor space. Living Room: There is adequate furniture which appears to be in good condition. There is a sofa and desk with an operable computer. Staff Office #1: Located off of the living room. There is a desk with an operable computer, fax machine, and closet space. All medications kept will be double locked in the staff office inside of a locked box. Staff Office #2: Located to the right of Staff Office #1. There is a desk with an operable computer, fax machine, and closet space. Dining Area: There is one table with six (6) chairs. Report Cont. on LIC 809-C. Kitchen/Laundry Area: There is a working stove/oven with four (4) gas burners, and two refrigerators/freezers. There is a fully charged fire extinguisher located to the right once entering the kitchen. The kitchen trash can have a tight lid on it. All cleaning supplies will be kept locked in cabinets above the washer and dryer. The knives will be kept locked in the kitchen cabinet and will only be accessible to employees. Hot water is delivered at a safe temperature range. Bedroom #1: Is vacant and furnished with two (2) twin size beds. There are adequate drawers, closet space, and lighting in this room. The beds have comfortable mattresses, clean linens, blankets, and pillows which are all in good repair. The windows have security bars with a working emergency release handle. Bedroom #2: Is vacant and furnished with two (2) twin size beds. There are adequate drawers, closet space, and lighting in this room. The beds have comfortable mattresses, clean linens, blankets, and pillows which are all in good repair. Bedroom #3: Is vacant and furnished with two (2) twin size beds. There are adequate drawers, closet space, and lighting in this room. The beds have comfortable mattresses, clean linens, blankets, and pillows which are all in good repair. The windows have security bars with a working emergency release handle. Bathroom #1: (Located in Staff office #2) Clean and operable at the time of visit. Hot water is delivered at a safe temperature range. Bathroom #2: (Located next to Bedroom #3). Clean and operable at the time of visit. Hot water is delivered at a safe temperature range. Outdoor Space: LPA Edison observed the entrance area and backyard to be free of debris and hazardous materials. Garage: The detached garage is kept locked and is only used for storage space. Report Cont. on LIC 809-C. The facility is clean, safe, sanitary, and in good repair. There are storage cabinets in the hallway where extra linens will be kept. Medicines, disinfectants, and cleaning solutions will be inaccessible to children in care. No more than two (2) children will share one bedroom. There are no weapons in the facility. Sharp knives will be stored in a locked cabinet and inaccessible to children. Staff will ensure all sharp objects are returned and locked in the lock sharps box. Adequate supervision will be provided for children in care. Children will be accorded personal rights. Children in care will be supported and encouraged to participate in extracurricular activities. Children in care will be able to contact the licensing agency or Ombudsperson in confidence without threats or punishment for making complaints. All posting requirements are met. Children in care will not be restricted in telephone use except by court order. There is a working telephone line available for clients to use. All smoke detectors and carbon monoxide are operable and meet statutory requirements. All fire extinguishers are fully charged. LPA Edison observed age appropriate First Aid supplies which also contains tweezers and a thermometer. The home is expected to operate within the capacity and limitations of the license. Currently, there are no clients or staff at the facility. Facility is still waiting to receive CARF accreditation and mental health certification and does not expect to have staff or clients return until July 2022. There were no deficiencies observed or cited at the site visit Exit interview was conducted and a copy of this report will be emailed to the facility.

met_with: Robert Smith - Licensing Executive Director


summary: Facility Evaluation

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Narrative:
On May 3, 2022 at 8:53am, Licensing Program Analyst (LPA), Daphne Edison made an announced visit to The House of Bethesda for the purpose of conducting an Annual Required Inspection visit. LPA Edison met with Robert Smith, Director who granted access to the facility and a tour was conducted. The home is licensed to provide care and supervision to six (6) children, ages 13 -17 years old, ambulatory only. There is a provisional license with an expiration date of May 4, 2022. There is no swimming pool or bodies of water on the premises. On the date of this visit, the census is zero (0). The home is set up as follows: This is a one-story house with three (3) bedrooms, two (2) bathrooms, living room, two (2) staff offices, dining area, kitchen, laundry area, and outdoor space. Living Room: Equipped with a sofa, desk, TV, First Aid Kit, and a computer. Staff Office #1: Located off the living room. Equipped with a desk, computer, fax machine, and closet space. Staff Office/Therapy Room #2: Located to the right of Staff Office #1. Equipped with a desk, computer, fax machine, and closet space. Dining Area: Equipped with a table and six (6) chairs. Kitchen: Equipped with a working stove/oven with four (4) gas burners, refrigerator/freezer, and a kitchen trash can with a tight-fitting lid. Laundry Area: Equipped with a washer, dryer, and refrigerator for extra food storage. Bedroom #1: Vacant. Equipped with two (2) twin size beds and a TV. There are adequate drawers, closet space, and lighting in this room. The beds have comfortable mattresses, clean linens, blankets, and pillows which are all in good repair. The window has a security bar with a working emergency release handle. Continued on LIC 809-C Bedroom #2: Vacant. Equipped with two (2) twin size beds and a TV. There are adequate drawers, closet space, and lighting in this room. The beds have comfortable mattresses, clean linens, blankets, and pillows which are all in good repair. Bedroom #3: Vacant. Equipped with two (2) twin size beds and a TV. There are adequate drawers, closet space, and lighting in this room. The beds have comfortable mattresses, clean linens, blankets, and pillows which are all in good repair. The window has a security bar with a working emergency release handle. Bathroom #1: (Located in Staff Office #2) Equipped with a toilet, bathtub/shower combination. Safe and sanitary operating condition. Bathroom #2: Equipped with a toilet, bathtub/shower combination. Safe and sanitary operating condition. Outdoor Space: Entrance area is free of debris and hazardous materials. Backyard: Free of debris and hazardous materials. Garage: The detached garage is kept locked and is only used for storage space. The facility is clean, safe, sanitary, and in good repair. There are storage cabinets in the hallway where extra linens will be kept. Disinfectants, and cleaning solutions will be kept in the laundry area in locked cabinets inaccessible to children in care. There are no weapons in the facility. All medications kept will be double locked in the staff office inside of a locked box. Sharp knives will be stored in a locked cabinet/drawer in the kitchen and inaccessible to children. LPA unable to review client records and conduct client interviews due to no children in care. Children in care must be supervised and protected at all times. Children must be accorded dignity in personal relationships with staff and others. Children must be able to contact the licensing agency or Foster Care Ombudsperson in confidence without threats or punishment for making complaints. It was reported that children will attend school, extracurricular, cultural, and personal enrichment activities. Continued on LIC 809-C LPA unable to review staff records and conduct staff interviews due to no staff currently. Caregiver(s)/adults working/residing in the facility must have DOJ/FBI criminal record clearances and Child Abuse Index Checks. Emergency Mass Disaster Casualty Plan was available for review. LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. The facility must operate within the capacity and limitations of the license. Smoke detectors and carbon monoxide detectors tested audible and were in appropriate working order. The facility has two (2) regulation fire extinguishers fully charged. LPA Edison observed age appropriate First Aid supplies which also contain scissors, tweezers, and a thermometer. Hot water was tested within a safe range. Currently, there is no staff at the facility. Facility is still waiting to receive CARF accreditation and Mental Health Approval. · LPA observed cameras in home but was informed by Director cameras will not be utilized · Perishable food will be supplied prior to resident move-in · Landline telephone service must be set up prior to resident move-in Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted and a copy of this report will be emailed to the Director.

met_with: Robert Smith-Director


facility_name: INSPIRING PATHWAYS

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Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the complaint alleging facility staff is not providing a safe environment for youth. The information obtained reveal inconsistencies. There is no evidence that the staff are not providing a safe environment for youth, but the youth still felt unsafe in the home. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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: Shannon Blanchard


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Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the complaint alleging staff do not ensure that minors in care participate in school and facility is not meeting minor's mental health needs. LPA interviewed staff and social workers as well as obtained documents. Clients were not interviewed because one client (C1) refused to speak with LPA and the other client (C2) is on AWOL status. According to interviews and records, minors refused to attend school on several occasions. It is unclear if the enrollment process was delayed by the STRTP or the county but ultimately, clients were enrolled in school. As far as mental health needs, the STRTP was recently approved for in-home mental heatlh services but is contracted with the county to provide mental health services. C1 was attending therapy sessions regularly although is it unclear if there was a delay in the services. Although the allegations may have happened or are valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report was emailed to the facility for signature. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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


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Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the complaint alleging facility staff do not prevent minors from awoling. LPA interviewed staff and clients as well as reviewed staff's training records and incident reports. Based on the interviews and incident reports, staff attempt to prevent minors from running away, but the minors ignore staff's directives and leave the home anyway. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was emailed to the facility for signature. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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: Complaint Investigation - Unsubstantiated - 1 allegation

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Investigation Findings:
13Licensing Program Analyst (LPA) Daiquiri Boyd conducted a follow-up complaint inspection to the STRTP and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegation regarding inappropriate sexual activity between monos while in care. During the course of the investigation, Investigations Bureau conducted interviews. The information obtained during the interviews, indicated that the clients in care had inappropriate sexual activity in the home, none of the staff indicated that they were aware of these activities. Type A: This poses an immediate health and safety risk to clients in care.Based on the LPA's observations, interviews and records review which were conducted, the preponderance of evidence standard has been met, therefore, the above allegation is found to be substantiated. A copy of the report and Appeal Rights was provided to the FFA. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Daiquiri Boyd 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, E SHAW AVE This is an official report of an unannounced visit/investigation of a complaint received in our office on 03/18/2021 and conducted by Evaluator Daiquiri Boyd PUBLICCOMPLAINT CONTROL NUMBER: 24-CR- FACILITY NAME:INSPIRING PATHWAYSFACILITY NUMBER: ADMINISTRATOR:BLANCHARD, SHANNONFACILITY TYPE: ADDRESS: W. Bryman St.TELEPHONE: (559) 585- CITY:HANFORDSTATE: CAZIP CODE: CAPACITY:6CENSUS: 6DATE: 06/28/ UNANNOUNCEDTIME BEGAN: 04: PM MET WITH:Shannon BlanchardTIME COMPLETED:06: PM 9Facility Staff are using marijuana with the minors in the home Staff allows minors to smoke while in care Minors have access to illegal drugs while in care INVESTIGATION FINDINGS: 13Licensing Program Analyst (LPA) Daiquiri Boyd and Priscilla Zamudio conducted a follow-up complaint inspection to the STRTP and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegations. Investigations Bureau conduted this investigation and found, through interviews, that there was no stories that could be cooberated. Although the allegation may have happened or may be valid, there is not a preponderance of the evidence to prove the above allegation; therefore, the allegation is unsubstantiated.. LPA provided a copy of the report to the STRTP. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Daiquiri Boyd 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: 3 of Control Number 24-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, E SHAW AVE FACILITY NAME: INSPIRING PATHWAYSFACILITY NUMBER: 167206801

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


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Investigation Findings:
13On October 7, 2021, Licensing Program Analyst (LPA) Cynthia Galindo conducted a follow-up complaint inspection at Inspiring Pathways on behalf of LPA Priscilla Zamudio and spoke with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegations. LPA Zamudio interviewed staff, clients and reviewed pertinent documents. Based on interviews conducted and information gathered, there were some discrepencies found. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. A copy of this report and appeal rights were left with Shannon. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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


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Investigation Findings:
13On October 7, 2021, Licensing Program Analyst (LPA) Cynthia Galindo conducted a follow-up complaint inspection at Inspiring Pathways on behalf of LPA Priscilla Zamudio and spoke with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegations. LPA Zamudio interviewed staff, clients and reviewed pertinent documents. Based on interviews conducted and information gathered, there were some discrepancies found. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. A copy of this report and appeal rights were left with Shannon. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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

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Narrative:
2. Staff driving foster children with suspended license: A staff member admitted that her license had been suspended. She stated that she had notified the Administrator that she was not allowed to drive but stated she could not provide dates of when the suspension was in effect. Staff member has since provided valid license and plan of correction will be cleared at today's visit. This is a TYPE A violation 3. Facility staff did not safeguard a foster child's funds. In this particular case while the client's regular allowance and clothing allowance were accounted for, her personal funds that had been stored in the locked box came up short. Staff stated that tracking the client's personal funds has been an issue in the past. The Administrator replaced the missing funds. This is a TYPE B violation. TYPE A violations pose an immediate risk to the health and safety of the clients in care while TYPE B violations pose a potential risk to the health and safety of the clients in care. Based on the LPA's observations, interviews and records review which were conducted, the preponderance of evidence standard has been met, therefore, the above allegations are found to be substantiated. A copy of the report and Appeal Rights was provided to Zelisa Gayton

Investigation Findings:
13On December 13, 2021, Licensing Program Analyst (LPA) Rachel Bruce conducted a follow-up complaint inspection to Inspiring Pathways, STRTP. The purpose of the inspection was to deliver the findings for the above complaint allegations. On September 13, 2021, the above allegatsion were referred to Communciaty Care Licensing for investigation. During the course of the investigation, Community Care Licensing (CCL) conducted interviews with clients, staff, county social worker as well as reviewed documentation on clients and staff. The information obtained during the interviews, indicated the following: 1. Administrator allowed a foster child to be at an unknown residentail home unsupervised. Interviews revealed that a foster child was taken out of the county and transported to Fresno County to get her hair braided. Prior approval was not obtained by her County Social Worker who indicated she would not have allowed the outing had she been notified. This is a TYPE A violation. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Rachel A Bruce 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 24-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, E SHAW AVE FACILITY NAME: INSPIRING PATHWAYSFACILITY NUMBER: VISIT DATE: 12/13/2021

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

met_with: Zelisa Gayton, Childcare Worker

complaint_status: SUBSTANTIATED


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Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Zelisa Gayton. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the complaint alleging facity did not provide a safe environment for minor and minor has access to sharp objects. LPA interviewed residents, staff and social worker as well as obtained documents. Due to the inconsistencies in the interviews, the allegations are unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of evidence to provide the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 3

met_with: Zelisa Gayton


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Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Natalia Yado. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the complaint alleging staff bully residents. LPA interviewed residents, staff and social worker as well as obtained documents. Due to the inconsistencies in the interviews, the allegations are unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of evidence to provide the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 3

met_with: Natalia Yado


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Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Natalia Yado. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the complaint alleging minor was being bullied by other minors in the home; minor wasn't provided adequate allowance and staff provided private information to others. LPA interviewed residents, staff and social worker as well as obtained documents. LPA was not able to speak with C1 but she did speak with other residents and obtained documents that reveal C1 received her allowance. Due to the inconsistencies in the interviews, the the allegations are unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of evidence to provide the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 3


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegations. During the investigation, LPA interviewed staff and clients as well as obtained relevant documents. Interviews and documents reveal that youth accessed a sharp object that was used to injure another youth during a fight. On April 16, 2022, staff provided the youth with an eyebrow razor and when the eyebrow razor was returned later that day, the blade was missing. Interviews confirm that staff was aware that the blade was missing but yet no attempts were made to locate the blade. Staff did not provide the proper care and supervision by locating the missing blade after becoming aware that it was missing. The next day, the same youth who returned the eyebrow razor with the missing blade, got into that fight with another youth and staff did not intervene. The youth sustained injuries during the fight. Staff failed to protect the youth by not stopping the fight. Based on the information obtained, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations are being cited on the attached LIC 9099D. Additional citations are being issued on a Case Management. An exit interview was conducted, and a copy of the report and appeal rights were provided to the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, E SHAW AVE This is an official report of an unannounced visit/investigation of a complaint received in our office on 04/20/2022 and conducted by Evaluator Cynthia M Galindo PUBLICCOMPLAINT CONTROL NUMBER: 24-CR- FACILITY NAME:INSPIRING PATHWAYSFACILITY NUMBER: ADMINISTRATOR:BLANCHARD, SHANNONFACILITY TYPE: ADDRESS: W. Bryman St.TELEPHONE: (559) 585- CITY:HANFORDSTATE: CAZIP CODE: CAPACITY:6CENSUS: 6DATE: 07/13/ UNANNOUNCEDTIME BEGAN: 10: AM MET WITH:Natalia YadoTIME COMPLETED:11: AM 9Facility staff are not adequately supervising minors while in care. INVESTIGATION FINDINGS: 13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the complaint alleging facility staff are not adequately supervising minors while in care. Interviews and records reveal staff were present during the altercation between the youth but there are inconsistencies in how the incident occurred. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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: 2 of Control Number 24-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, E SHAW AVE FACILITY NAME: INSPIRING PATHWAYSFACILITY NUMBER: 167206801


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegations. LPA has investigated the allegations. LPA conducted interviews as well as obtained relevant documents. There were inconsistencies in the interviews and the documentation did not provide evidence that any of the above mention allegations occurred. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 3


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Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegation. During the investigation, LPA interviewed staff and clients as well as obtained relevant documents. Confidential interviews and documents reveal that facility staff did not notify responsible parties of the minor's day pass. On July 11, 2022, minor was authorized by the court a day pass with bio family. Interviews confirm that facility staff allowed minor to leave the home however, staff did not notify the county social worker or probation officer. Additionally, on June 24, 2022, minor was granted a day pass by the facility without notifying responsible parties. According to the facility's Program Statement, section 13, Family Visitation, "all off-site passes, including overnights, must be approved by the authorized representative/placement agency and IP treatment staff". As a result, facility is in violation of their Program Statement. Based on the information obtained, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations are being cited on the attached LIC 9099D. An exit interview was conducted, and a copy of the report and appeal rights were provided to the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 24-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, E SHAW AVE FACILITY NAME: INSPIRING PATHWAYSFACILITY NUMBER: 167206801


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegation. During the investigation, LPA interviewed staff and clients as well as obtained relevant documents. Confidential interviews and documents reveal that facility was not aware of minor's whereabouts and staff did not check ID when minor was picked up for a day pass. On July 11, 2022, minor was authorized a day pass with bio family. When the minor was picked up, staff did not ensure minor was picked up by only authorized individuals according to the minor's Needs and Services Plan as they did not verify identification. Facility staff assumed minor was picked up by bio family and would spend the time with bio family. However, interviews reveal minor was not picked up by bio family and did not spend the time with bio family. As a result, facility staff did not know minor's true whereabouts and allowed minor to leave the facility with an unauthorized individual. Based on the information obtained, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations are being cited on the attached LIC 9099D. An exit interview was conducted, and a copy of the report and appeal rights were provided to the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 24-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, E SHAW AVE FACILITY NAME: INSPIRING PATHWAYSFACILITY NUMBER: 167206801


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the complaint alleging staff did not provide youth with appropriate supervision. LPA interviewed staff and obtained relevant documents. There were inconsistencies in the interviews and the documentation did not provide evidence that any of the above mention allegation occured. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 3


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Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the complaint alleging staff did not prevent youth from punching another youth and did not prevent youth from AWOLing. LPA interviewed staff, and clients as well as obtained relevant documents. There were inconsistencies in the interviews and the documentation did not provide evidence that any of the above mention allegation occured. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 3


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Natalia Yado. The purpose of the inspection was to deliver the findings for the above complaint allegation. During the investigation, LPA interviewed staff and obtained relevant documents which revealed that facility staff mismanaged youth's medications while in care. Confidential interviews confirm that staff gave youth the medication she arrived with and was provided by the county social worker. Youth was placed in the home on August 17, 2022 and was discharged from the home on September 13, 2022. The facility received a copy the JV223 that was granted on July 19, 2022 after youth was placed in the home. A copy of the JV223 was obtained from the facility but only consisted of two pages with no list of the medication prescribed. Medication records are consistent with the medication the youth received during her stay at the home. However, the youth's Needs and Service Plan for August lists a different set of medication which does not match the medication records. According to the JV220 an JV220 attachment provided by the CSW, the medication listed on the NSP was the correct medication that was prescribed and should have been given to the youth. The facility staff did not confirm with the county social worker the medication the youth was to take according to the JV223 that was granted on July 2022. Based on LPA's observations and interviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations are being cited on the attached LIC 9099D. An exit interview was conducted, and a copy of the report and appeal rights were provided to the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 24-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, E SHAW AVE FACILITY NAME: INSPIRING PATHWAYSFACILITY NUMBER: 167206801


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo and Briana Placencia conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegation. During the investigation, LPA interviewed staff and clients which revealed that staff did not prevent youth from leaving the home and staff left youth on the side of the road. Confidential interviews and documents confirm that youth was left on the side of the road. The incident report provided to the Department does not indicate that staff implemented the Intervention Continuum as the early interventions according to the facility's program statement, to prevent youth from leaving the home.. Based on the information obtained which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations are being cited on the attached LIC 9099D. An exit interview was conducted, and a copy of the report and appeal rights were provided to the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 24-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, E SHAW AVE FACILITY NAME: INSPIRING PATHWAYSFACILITY NUMBER: 167206801


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo and Briana Placencia conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the complaint alleging facility staff did not protect youth; youth sustained injury after an altercation and youth does not feel safe in the home. LPA interviewed staff and youth as well as obtained police report and medical records. There were inconsistencies in the confidential interviews and documentation does not demonstrate the youth sustained the injuries alleged. Although the allegations may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 3


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Natalia Yado. The purpose of the inspection was to deliver the findings for the above complaint allegation. During the investigation, LPA interviewed staff and clients which revealed that staff did not provide supervision to the minors in care. Confidential interviews and documentation reveal that staff left youth unsupervised for a brief moment which allowed her to have access to the facility's vehicle keys and AWOL with the facility's vehicle. Based on the information obtained, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations are being cited on the attached LIC 9099D. An exit interview was conducted, and a copy of the report and appeal rights were provided to the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 24-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, E SHAW AVE FACILITY NAME: INSPIRING PATHWAYSFACILITY NUMBER: 167206801


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the complaint alleging Adminstrator was inappropriate with youth. LPA interviewed staff and client as well as obtained documents. There were inconsistencies in the confidential interviews and documentation does not demonstrate the youth sustained the injuries alleged. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 3


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Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the complaint alleging staff made inaprropriate comments to youth and threw an item at youth. LPA interviewed staff and clients as well as obtained documents. There were inconsistencies in the confidential interviews. Although the allegations may have happened or are valid, there is not a preponderance of evidence to provide the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 3


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the complaint alleging staff are not supervising youth in care. LPA interviewed staff and client as well as obtained documents. There were inconsistencies in the confidential interviews and documentation does not demonstrate the staff did not supervise youth. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 3


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Investigation Findings:
13Complaint Specialist C.K. Kinney(CS) traveled to Inspiring Pathways and met with Natalia Yado to investigate complaint. CS conducted confidential interviews and delivered findings of investigation. Due to inconsistencies in the information obtained a preponderance of the evidence could not be found to prove the allegation occurred as reported. Although the allegation may or may not be valid, or may or may not have happened without a preponderance of the evidence the allegation is deemed unsubstantiated. No deficiencies observed or cited. Copy of this report and LIC Appeal Rights left at the facility at conclusion of inspection. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Charles Kinney 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


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Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shianne Pickering.The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the complaint alleging minor is being threatened by another minor while in care. LPA interviewed staff and clients as well as obtained documents. There were inconsistencies in the confidential interviews. Although the allegation may have happened or are valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 3

met_with: Shianne Pickering


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Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shianne Pickering. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the complaint alleging staff do not prevent minors from engaging in physical abuse toward another minor and do not prevent minors from verbally abusing another minor in care. LPA interviewed staff and clients as well as obtained documents. There were inconsistencies in the confidential interviews. Although the allegations may have happened or are valid, there is not a preponderance of evidence to provide the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 3


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Investigation Findings:
13Licensing Program Analyst (LPA) Reyna Martinez conducted a complaint inspection at Inspiring Pathways and met with Natalia Yoda. The purpose of the inspection was to deliver the findings for the above complaint allegation. Based on confidential interviews and further review, the above allegation is found to be Unsubstantiated. There were inconsistencies in the confidential interviews. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violations did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Reyna Martinez 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FRESNO RO, E SHAW AVE This is an official report of an unannounced visit/investigation of a complaint received in our office on 07/03/2023 and conducted by Evaluator Cynthia M Galindo PUBLICCOMPLAINT CONTROL NUMBER: 24-CR- FACILITY NAME:INSPIRING PATHWAYSFACILITY NUMBER: ADMINISTRATOR:BLANCHARD, SHANNONFACILITY TYPE: ADDRESS: W. Bryman St.TELEPHONE: (559) 585- CITY:HANFORDSTATE: CAZIP CODE: CAPACITY:6CENSUS: 6DATE: 09/29/ UNANNOUNCEDTIME BEGAN: 11: AM MET WITH:Shannon BlanchardTIME COMPLETED:12: PM 9Staff did not prevent a child from attacking other children in care. Minor had access to a sharp object while in care. INVESTIGATION FINDINGS: 13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the complaint alleging staff did not prevent a child from attacking other children in care and minor had access to a sharp object while in care. LPA interviewed staff and clients as well as obtained documents. The information obtain does not demonstrate the facility is in violation of the allegations. Additionally, there were inconsistencies in the confidential interviews. Although the allegations may have happened or are valid, there is not a preponderance of evidence to provide the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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: 2 of Control Number 24-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FRESNO RO, E SHAW AVE FACILITY NAME: INSPIRING PATHWAYSFACILITY NUMBER: 167206801

met_with: Natalia Yoda


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the complaint alleging minors are engaging in appropriate behavior while in care. LPA interviewed staff and clients as well as obtained documents. The information obtain does not demonstrate the facility is in violation of the allegation. Additionally, there were inconsistencies in the confidential interviews. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 3


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Cynthia Galindo conducted a complaint inspection at Inspiring Pathways and met with Zelisa Gayton. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the complaint alleging staff do not ensure safe environment is provided for minor in care. LPA interviewed staff and youth as well as obtained relevant documents. There were inconsistencies in the confidential interviews. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Cynthia M Galindo 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 3


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Reyna Martinez conducted a complaint inspection and met with Zelisa Gayton. The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the complaint alleging facility staff did not provide a safe environment for minor resulting in minor being inappropriately touch while in care. LPA conducted interviews and obtained documentation.There were inconsistencies in the confidential interviews. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Reyna Martinez 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:
13On the above date, Licensing Program Analyst (LPA) Reyna Martinez conducted a complaint inspection and met with Zelisa Gayton. The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the complaint alleging Staff did not provide comfortable accommodations for minor. LPA conducted interviews and obtained documentation.There were inconsistencies in the confidential interviews. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tamara Melikian LICENSING EVALUATOR NAME: Reyna Martinez 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:
13On the above date, Licensing Program Analyst (LPA) Reyna Martinez conducted a complaint inspection and met with Shannon Blanchard, Administrator. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the complaint alleging Facility staff is not providing adequate amount of food to children in care; Facility staff is not providing adequate hygiene products to children in care; Facility staff does not ensure that children in care is receiving adequate medical care; and Facility staff does not ensure that child's glasses are in good condition. LPA conducted interviews and obtained documentation.There were inconsistencies in the confidential interviews. Although the allegations may have happened or is valid, there is not a preponderance of evidence to provide the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tamara Melikian LICENSING EVALUATOR NAME: Reyna Martinez 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:
13On August 27, Licensing Program Analysts (LPAs) Miriam Flores and Olivia Medrano conducted a complaint inspection and met with Administrator, Shannon Blanchard. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the complaint alleging that staff did not provide adequate food service and staff denied minors access to food. LPA conducted interviews and reviewed supportive documentation. There were inconsistencies in the confidential interviews. Although the allegations may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted with Administrator, Shannon Blanchard. A copy of this report and appeal of rights was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tamara Melikian LICENSING EVALUATOR NAME: Miriam Flores 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

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Narrative:
On August 24, 2021, Regional Manager, Nelson Martinez; Licensing Program Manager, Juanita Arroyo; and Licensing Program Analyst, Jessica Rodriguez conducted a Microsoft Teams Meeting with Administrator, Shannon Blanchard; Board Member, Michelle Goodin; Facility Manager, Koy Saephanh; Kings County Department Representatives: Devon Modlin, Marcus Sifuentes, and Edith Mata to conduct a a non-compliance conference. The conference is documented on LIC 91111 dated 08/24/2021.