raw_content:
Narrative:
LPA's observation, interviews conducted, and records reviewed were consistent that a facility employee inappropriately handled a client in care when the client was shoved. Evidence, including interviews, incident and Law Enforcement reports, video footage, and the facility's completed internal investigation, revealed that a facility employee (S2) shoved a client during an incident on 06/21/2023. Additionally, the video footage obtained and reviewed clearly shows the alleged staff forcefully shoving a client. One or more additional facility staff members were present during the incident, and potentially witnessed the employee inappropriately handled a client in care, however did not intervene or accurately report the details of the incident to their supervisor. The facility reported the known incident to the Department on 06/28/2023 and after the conclusion of the facility's internal investigation, several employees were terminated from employment on 06/29/2023 (S2) and 07/05/2023 (S3, S4 and S5). Based on LPA observations, documentation reviewed, and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. The facility was found to have violated STRTP ILS Regulations section 87072(c)(11). No citations were issued to the facility due to the facility taking the appropriate actions in order to enhance and maintain the safety and well-being of all youth in care. Once the facility became aware of the incident(s), the facility staff reported the incident(s) as required. The facility also terminated employment with multiple employees (S2, S3, S4 and S5), who violated youth's personal rights and failed to follow the mandated reporting requirements, related to the incidents involving FC1 and FC2. An exit interview was conducted and a copy of this report and appeal rights were provided to Joelida Brown, Residential Director.

Investigation Findings:
13Licensing Program Analyst (LPA) Stephannie Verna conducted an unannounced complaint inspection with the above facility on October 19, 2023 at 1: PM and met with Joelida Brown, Residential Director. The purpose of the inspection was to deliver complaint findings for the above allegations. On June 29, Licensing Program Analyst (LPA), Stephannie Verna, arrived unannounced at the facility for the purpose of initiating a complaint investigation related to the above allegation. LPA met with Joelida Brown, Residential Director and requested documents for review and completed an inspection of the facility. During the course of the investigation, the following documents were gathered and reviewed: Youth roster, facility reports, SCAR report for one youth, Youth Needs and Services Plans, Incident Reports and Police Reports for multiple youth in care, Employee Roster, Employee Background Clearance documents, documentation pertaining to the agency's Internal Investigation, and video recording footage. Confidential interviews were conducted with five individuals, and attempted with seven individuals, during the period of 06/29/2023 to 10/16/2023. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dara Campos LICENSING EVALUATOR NAME: Stephannie Verna 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: CHILDREN'S HOME OF STOCKTON TRI-PLEXFACILITY NUMBER: VISIT DATE: 10/19/2023

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


state: CA

facility_name: CHILDREN'S HOME OF STOCKTON TRI-PLEX

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Confidential interviews were conducted with three individuals, and attempted with one individual, during the period of 08/22/2023 to 09/15/2023. LPA's observation, interviews conducted, and records reviewed were inconsistent regarding whether staff do not report incidents to a foster child's representative timely, and do not ensure a safe and healthful environment by accorded dignity in their personal relationship with foster child. Evidence, including interviews and incident and police reports, revealed that the facility followed their policies and procedure surrounding reporting requirements, and there was no evidence or statements made to substantiate that staff did not ensure the safety and well-being of a youth in care, or violated the youth's personal rights. In addition, FC1, refused to be interviewed regarding the investigation, and the information reported to the Department could not be corroborated. Based on LPA interviews conducted, and records reviewed, the allegation may have happened or is valid, but there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are found to be UNSUBSTANTIATED. An exit interview was conducted with and a copy of this report was provided to Joelida Brown, Residential Director.

Investigation Findings:
13Licensing Program Analyst (LPA) Stephannie Verna conducted an unannounced complaint inspection with the above facility on October 19, 2023 at 12: PM and met with Joelida Brown, Residential Director. The purpose of the inspection was to deliver complaint findings for the above allegations. On August 31, 2023 at 1: PM Licensing Program Analyst (LPA), Stephannie Verna, arrived unannounced at the facility for the purpose of initiating a complaint investigation related to the above allegations. LPA met with Shelyn Rodriguez-Joufi, Relief Services Supervisor and conducted an inspection of the facility. During the course of the investigation, the following documents were gathered and reviewed: Youth roster, facility reports, SCAR report for one youth, Youth Needs and Services Plans, and Incident Reports and Police Report for multiple youth in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dara Campos LICENSING EVALUATOR NAME: Stephannie Verna 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: CHILDREN'S HOME OF STOCKTON TRI-PLEXFACILITY NUMBER: VISIT DATE: 10/19/2023

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

report_type: Complaint Investigation

met_with: Joelida Brown, Residential Director

complaint_status: unsubstantiated


raw_content:
Narrative:
During the course of the investigation, the following documents were gathered and reviewed: Staff and client roster, Face sheet, Intake Documents for one client in care, including placement document; Incident Reports, Law Enforcement Report and Police Report, cottage logs, Group attendance logs, medical documentation, SCAR report, and Incident Reports, and Needs and Services Plan. Confidential interviews were conducted with six individuals and attempted with two individuals during the period of 07/19/2023 to 10/23/2023. LPA's interviews conducted, and records reviewed were inconsistent regarding whether or not the facility violated a youth in care's personal rights. Upon review of the youth's Needs and Services Plan and medical documentation, the documents revealed that all identified and agreed upon services were attempted and/or addressed while youth was in placement at the facility to ensure youth's needs were met. The facility staff offered youth inpatient and outpatient mental health and substance abuse services, and evidence, including documentation of Substance Abuse Prevention Education (SAPE) Group and medical documentation, revealed that the youth refused services offered and did not attend all group meetings or scheduled medical appointments. Documentation, including Incident Reports and a Police Report, and interviews, revealed that the facility staff encouraged youth from engaging in substance use and from leaving the facility without permission, while also preserving youth's personal rights. When youth left the facility without permission, staff followed their runaway policy and reported missing youth to Law Enforcement. The facility staff also reported another incident which occurred on 07/04/2023 and was mandated to be reported. Additionally, there was no evidence to support the allegation that the facility staff did not keep a minor's information confidential, and multiple individuals interviewed confirmed that FC1 had a personal cell phone while at the facility with access to share information with known and unknown individuals. Based on LPA interviews conducted, and records reviewed, the preponderance of evidence standard has not been met, the above allegations are found to be UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted and a copy of this report was provided to Joelida Brown, Residential Director.

Investigation Findings:
13Licensing Program Analysts (LPAs) Stephannie Verna and Janie Davis conducted an unannounced complaint inspection with the above facility on October 26, 2023 at 10: AM and met with Joelida Brown, Residential Director. The purpose of the inspection was to deliver complaint findings for the above allegations. On July 19, 2023 at 12: PM Licensing Program Analyst (LPA), Stephannie Verna, arrived unannounced at the facility for the purpose of initiating a complaint investigation related to the above allegations. LPA met with Joelida Brown, Residential Director, conducted an inspection of the facility and gathered documentation related to the complaint allegations. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dara Campos LICENSING EVALUATOR NAME: Stephannie Verna 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: CHILDREN'S HOME OF STOCKTON TRI-PLEXFACILITY NUMBER: VISIT DATE: 10/26/2023

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


raw_content:
Narrative:
LPA's interviews conducted, and records reviewed were inconsistent regarding the allegation a minor is recruiting other minors in care to engage in inappropriate activities. Statements given during interviews as well as records reviewed, including Incident Reports, revealed that youth do leave the facility without permission to engage in inappropriate activities, however staff follow their procedures related to the facility's runaway plan and reporting requirements pertaining to runaway youth. Additionally the facility staff maintained communication with Law Enforcement and members of the VICE Unit for Stockton to ensure Law Enforcement had pertinent information to locate runaway youth and adult male recruiters. Two out of seven confidential interviews revealed that there was a known "recruiter" at the facility, FC2. Once this was known the facility took necessary measures to educate youth at risk by offering psycho-education and discharged FC2 to ensure the safety of all youth in care. Confidential interviews and documents reviewed, including facility group curriculum and documents, revealed that staff educate youth on the dangers of engaging in unsafe and inappropriate behaviors in the community, offer groups and individual therapy, create safety plans with youth, and verbally encourage youth to remain on campus, not follow or listen to other youth who may encourage or threaten them to leave with them. Continuously refusing to engage in program services or comply with program rules and engaging in unsafe behaviors resulted in multiple youth involved being discharged from the facility, including FC1, FC2, FC3 and FC4. Additionally, multiple youth reported to be involved in engaging in inappropriate activities refused to be interviewed regarding the investigation, including FC2 and FC3, and information reported to the Department could not be corroborated. Based on LPA interviews conducted, and records reviewed, the preponderance of evidence standard has not been met, therefore the above allegations are found to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted with and a copy of this report was provided to Joelida Brown, Residential Director.

Investigation Findings:
13Licensing Program Analyst (LPA) Stephannie Verna conducted an unannounced complaint inspection with the above facility on November 09, 2023 at 01: PM and met with Joelida Brown, Residential Director. The purpose of the inspection was to deliver complaint findings for the above allegation. On July 24, 2023 at 11: AM Licensing Program Analysts (LPAs), Stephannie Verna and Donna Edwards, arrived unannounced at the facility for the purpose of initiating a complaint investigation related to the above allegation. LPA met with Joelida Brown, Residential Director. LPA conducted an inspection of the facility and gathered documents related to the complaint investigation. During the course of the investigation, the following documents were gathered and reviewed: Staff and client roster, Client Face sheets, Needs and Services Plans, Incident Reports and Law Enforcement Reports for two youth in care (FC1 and FC2); Police Reports, email correspondence, Facility Reports and Cottage Logs. Seven confidential interviews were conducted with six individuals, and interviews were attempted with 8 individuals, during the period of 07/19/2023 to 11/03/2023. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dara Campos LICENSING EVALUATOR NAME: Stephannie Verna 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: CHILDREN'S HOME OF STOCKTON TRI-PLEXFACILITY NUMBER: VISIT DATE: 11/09/2023

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


raw_content:
Narrative:
Based on multiple statements given during confidential interviews it was revealed that youth's medical appointments are scheduled by staff and staff take youth to scheduled medical appointments. Upon review of medical documents, there was no evidence to corroborate the allegation that staff are not ensuring youth are taken to their medical appointments. Eight confidential interviews conducted revealed that youth refuse to attend some or all medical appointments, and when this happens medical appointments are cancelled and rescheduled. Medical appointments have also had to be rescheduled so a youth could attend another necessary appointment, or when staff have called out for their scheduled shift and coverage staff cannot be identified to transport and attend the youth's medical appointment with them. When this occurs medical appointments are rescheduled. Additionally, while youth in placement do engage in inappropriate activities, facility staff intervene when there is knowledge of inappropriate activities, address concerns with youth and youths' Authorized Representative, offer individual and group therapy services, and involve Law Enforcement and other Departments as necessary, to engage with and prevent youth from engaging in inappropriate and unsafe activities and to ensure the health and safety of all youth in in care. Based on documentation reviewed, including incident reports, and statements gathered from interviews revealed that more than one facility staff member provided inaccurate information on facility documentation, including facility reports and incident reports, when documenting incorrect details surrounding an incident that occurred on 06/21/2023. Additionally, two additional statements given during interviews corroborated other known or suspected incidents of falsification of incident report documentation. The facility took measures to ensure the facility policies and procedures are adhered to and documentation contains accurate information. Once the facility was made aware of the incident and inaccurate completion or omission of documentation, an internal investigation was conducted and the staff involved in the incident and falsification of documentation were terminated from employment. Information gathered from interviews and review of documentation however, did not corroborate the allegation that medical appointment documentation was falsified by facility staff. While the facility is submitting incident reports as required, evidence shows that reports are not accurate and some information has been omitted that may allude to regulatory violations, however there is no regulatory statute surrounding accuracy and/or omitance of information reported. Based on LPA interviews conducted, and records reviewed, the preponderance of evidence standard has not been met, therefore the above allegations are found to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted with and a copy of this report was provided to Joelida Brown, Residential Director. LPA's interviews conducted, and records reviewed were consistent that the facility was out of ratio. Six out of eleven statements given during confidential interviews revealed that there have been instances, including as recent as October 2023, where the facility was single staffed and out of ratio due to staff calling out of their scheduled shift. The length of time that staff was reported to be single-staffed and out of ratio were an hour to an entire shift. When staff call out of their scheduled shifts, the facility attempts to identify staff to fill the shifts, but there have been times when coverage has not been located, leaving the facility out of Direct Care Staff/Child Ratios. Based on LPA documentation reviewed, and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. The facility is being issued one citation regarding deficiencies to STRTP ILS Regulations, section 87065.5(b), Direct Care Staff/Child Ratios. The facility is also being issued one Civil Penalty for a second cited violation within 12 months. An immediate civil penalty of $150 is issued on today's date. If the deficiency is not corrected, a civil penalty of $50 per day begins and accrues until corrected. An exit interview was conducted with and a copy of this report and appeal rights were provided to Joelida Brown, Residential Director.

Investigation Findings:
13Licensing Program Analyst (LPA) Stephannie Verna conducted an unannounced complaint inspection with the above facility on November 09, 2023 at 02: PM and met with Joelida Brown, Residential Director. The purpose of the inspection was to deliver complaint findings for the above allegations. On July 19, 2023 at 12: PM Licensing Program Analyst (LPA), Stephannie Verna, arrived unannounced at the facility for the purpose of initiating a complaint investigation related to the above allegations. LPA met with Joelida Brown, Residential Director and conducted an inspection of the facility. LPA gathered documentation related to the complaint investigation. During the course of the investigation, the following documents were gathered and reviewed: Staff and client roster, Client Face sheets, staff schedules, Cottage Schedules/Calendars, After-Hours Program Manager, Resource Officer and Support Specialist Reports, and Cottage Logs. Confidential interviews were conducted with 11 individuals and attempted with 10 individuals during the period of 07/19/2023 to 11/03/2023. continued on LIC9099-c SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dara Campos LICENSING EVALUATOR NAME: Stephannie Verna 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: CHILDREN'S HOME OF STOCKTON TRI-PLEXFACILITY NUMBER: 390332238

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


raw_content:
Narrative:
Confidential interviews were conducted with fourteen individuals and attempted with nine individuals during the period of 08/01/2023 to 11/03/2023. LPA's observation, interviews conducted, and records reviewed were inconsistent that staff do not meet the clients hygiene needs while in care, staff are unable to safeguard the facility grounds, and staff are not ensuring the minors' rooms are properly maintained while in care. Statements given during interviews revealed that youth in placement at times engage in unsafe or aggressive behaviors with peers and staff. When this occurs, staff utilize interventions obtained from trainings received, including Crisis Prevention Intervention strategies. When necessary, the staff contact Law Enforcement for support and to ensure the safety of youth and staff. The facility employs a Resource Officer (RO) who monitors the facility grounds at night and addresses any safety concerns. Also, upon review of documentation, including RO Reports and Law Enforcement Reports, the facility staff and RO contacted Law Enforcement as needed or required regarding trespassing and other safety concerns. The facility also has installed additional locked gates at access points at the facility, after multiple incidents of trespassing occurred. On August 01, 2023 it was observed that the facility had installed locking gates to deter trespassing and limit unauthorized access onto the facility grounds. Additionally, documentation reviewed, including invoices for repairs and pest services rendered, outlined the completed necessary repairs the facility had completed to the facility grounds, gates, and doors and windows, to ensure that the facility is safeguarded from unauthorized individuals and pests and rodents. Statements given during interviews revealed that staff encourage youth to complete their hygiene tasks, provide hygiene products and supplies, teach youth skills related to good hygiene habits, and offer psycho education regarding negative effects of not having good hygiene habits. While some youths are receptive to prompting and complete their hygiene tasks, other youth refuse or are aggressive and staff are not punitive in their approach with youth who refuse to practice good hygiene habits. Staff will continue to encourage youth to practice good hygiene habits and offer psycho education or involve other members of the youth's treatment team to implement other strategies to support the youth, including issuing incentives or a showering schedule. continued on 9099-c Statements given during interviews revealed that staff assist with the maintenance of youth bedrooms if the youth's room is unclean or unsanitary and they refuse to clean it. Some youth refuse to allow staff to help them, and staff educate youth on the importance of cleaning their rooms, especially if there is a health concern. If the client is not receptive to the prompts, staff will offer physical assistance to complete cleaning tasks, and the refusals are addressed with the youth's treatment team. If youth refuse to ensure their room is clean and sanitary, staff will ensure cleanliness by entering the youth's bedroom to remove garbage, old food and dishes, and ensure that the youth's room is clean and sanitary. The department has conducted a complaint investigation regarding the allegations: Staff do not meet the clients' hygiene needs while in care, Staff are unable to safeguard the facility grounds, and Staff are not ensuring the minors rooms are properly maintained while in care. Based on LPA observations, interviews conducted, and records reviewed, the preponderance of evidence standard has not been met, therefore the above allegations are found to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted, and a copy of this report was provided to Dolores Servin, Cottage Manager.

Investigation Findings:
13Licensing Program Analyst (LPA) Stephannie Verna conducted an unannounced complaint inspection with the above facility on November 16, 2023 at 12: PM and met with Dolores Servin, Cottage Manager. The purpose of the inspection was to deliver complaint findings for the above allegations. LPA conducted an inspection of the facility. On August 01, 2023 at 11: AM Licensing Program Analyst (LPA), Stephannie Verna, arrived unannounced at the facility for the purpose of initiating a complaint investigation related to the above allegation. LPA met with Shelyn Rodriguez-Joufi, Relief Services Supervisor. LPA conducted an inspection of the facility and gathered documents related to the complaint investigation. During the course of the investigation, the following documents were gathered and reviewed: Staff and client roster, Client Face sheets, Needs and Services Plans, Cottage Daily/Weekly Schedules, Chore Charts, Employee Job Descriptions, Employee Handbook, Facility Reports and Cottage Logs for the months of June and July 2023, Email Correspondence, Repair and Pest Service Invoices, and Photos. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dara Campos LICENSING EVALUATOR NAME: Stephannie Verna 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: CHILDREN'S HOME OF STOCKTON TRI-PLEXFACILITY NUMBER: VISIT DATE: 11/16/2023

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

met_with: Dolores Servin, Cottage Manager


raw_content:
Narrative:
In the instances of clients threatening peers at the facility, interviews revealed that when staff overhear or are made aware of threats made, staff intervene in coaching youth on the facility rules, including safety standards and respecting others. Staff reminded youth involved to respect each other and each other's differences. There was no evidence to support the facility staff did not intervene when a known threat was made to FC1 by another peer in care. Upon review of incident reports, there was documentation of FC1 verbally threatening peers, and of staff interventions given to youth. Ultimately, FC2 was discharged from the facility. Based on LPA observations, interviews conducted, and records reviewed, the preponderance of evidence standard has not been met, therefore the above allegations are found to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted and a copy of this report was provided to Joelida Brown, Residential Director.

Investigation Findings:
13Licensing Program Analyst (LPA) Stephannie Verna conducted an unannounced complaint inspection with the above facility on January 08, 2024 at 04: PM and met with Joelida Brown, Residential Director. The purpose of the inspection was to deliver complaint findings for the above allegation. On October 12, 2023 at 12: PM Licensing Program Analyst (LPA), Stephannie Verna, arrived unannounced at the facility for the purpose of initiating a complaint investigation related to the above allegations. LPA met with Joelida Brown, Residential Director. LPA conducted an inspection of the facility and collected documents for review. During the course of the investigation, the following documents were gathered and reviewed: Meal Menus, Client Roster, Needs and Services Plan, LIC 602, and Incident Reports for one youth in care. Confidential interviews were conducted with six individuals, and attempted with three individuals, during the period of 10/12/2023 to 11/03/2023. LPA's interviews conducted, and records reviewed were inconsistent that staff did not prevent a minor from threatening another minor while in care. continued on LIC-9099-c UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dara Campos LICENSING EVALUATOR NAME: Stephannie Verna 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: CHILDREN'S HOME OF STOCKTON TRI-PLEXFACILITY NUMBER: VISIT DATE: 01/08/2024

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


raw_content:
Narrative:
Based on the Investigative Branch Investigator interviews conducted, and records reviewed, the preponderance of evidence standard has not been met, therefore the above allegations are found to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted and a copy of this report and appeal rights were provided to Dolores Servin.

Investigation Findings:
13Licensing Program Analyst (LPA) Kayla Green conducted an unannounced complaint inspection with the above facility on June 12, 2024 at 1:00PM and met with Dolores Servin Interium Residential. The purpose of the inspection was to deliver complaint findings for the above allegations. Confidential interviews were conducted by Investigative Branch Investigator Melissa Weaver with 11 individuals, and attempted with 1 individual, during the period of 3/12/24 to 5/29/24. The Investigative Branch has conducted a complaint investigation regarding the allegations: Facility Staff provided alcohol for Minors. Facility staff engaged in alcohol use with minors. During the investigation, interviews were inconsistent that the prior employees engaged in providing alcohol to minors or engaging in drinking alcohol with the minors. The minors C4 and C7 denied the allegations happened. The prior employees denied that it also occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dara Campos LICENSING EVALUATOR NAME: Kayla Green 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: CHILDREN'S HOME OF STOCKTON TRI-PLEXFACILITY NUMBER: VISIT DATE: 06/12/2024

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

met_with: Dolores Servin Interium Residential Director


raw_content:
Narrative:
The department has conducted a complaint investigation regarding the allegations: Staff did not prevent an altercation between minors Staff did not safeguard minor's belongings During the investigation, 10 interviews were conducted and two were attempted and documents reviewed that showed inconsistencies in whether the allegations occurred or not. Regarding the staff not preventing altercations between youth, FC1 stated that staff didn't prevent altercations between minors, while FC3, S9, S3, FC4, and FC2 had stated that the Staff followed the program statement and do their best to prevent and stop the fights using de-escalation, body proximity and if needed restraining. Regarding the safeguard of belongings, S9, S3, and S10 said the staff are supposed to lock doors when clients leave, and they tell clients not to let others in their rooms. S10 and S3 did not witness any belongings being destroyed. FC1 had confirmed that they aren't allowed to let anyone in their rooms, but others would still go in and destroy her things. FC4, FC5, FC3, and FC2 were inconsistent in how their items are safeguarded. Based on LPA interviews conducted, and records reviewed, the allegation may have happened or is valid, but there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are found to be UNSUBSTANTIATED. An exit interview was conducted and a copy of this report and appeal rights were provided.

Investigation Findings:
13On June 27, 2024 at 10: AM License Program Analyst (LPA) Kayla Green arrived at the Agency to deliver allegation findings. LPA Green met with Dolores Severin, Interim Residential Director and discussed the above allegations. On April 05, 2024, at 11: AM Licensing Program Analyst (LPA), Stephannie Verna, arrived unannounced at the facility for the purpose of initiating a complaint investigation related to the above allegations. LPA met with Dolores Servin, Interim Residential Director. LPA requested the following documents for review: Client Roster, Staff Roster and Schedule, Needs and Services Plan, CFTS notes/Preservation Plan, Personal Belongings and Inventory Log, Safety Plans ,and Incident Reports for one youth in care. Confidential interviews were conducted with ten individuals, during the period of 4/05/2024 to 6/14/2024. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dara Campos LICENSING EVALUATOR NAME: Kayla Green 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: CHILDREN'S HOME OF STOCKTON TRI-PLEXFACILITY NUMBER: VISIT DATE: 06/27/2024

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


facility_name: CHILDREN'S HOPE GROUP HOME

raw_content:
Narrative:
It was alleged a facility client was touched inappropriate while in care by an unknown perpetrator. Confidential statements obtained indicated contradictory information due to the insistence then denial of the allegation. Facility staff interviewed denied witnessing any inappropriate or sexual interaction among clients at the facility nor subjecting any clients to abuse. Based on the information gathered, although the allegation may have happened or is valid, the preponderance of evidence to prove the allegation was not met, therefore the allegation is unsubstantiated. A copy of this report, Confidential Names Form and Appeal Rights were provided to the facility representative. There were no deficiencies cited during this inspection.

Investigation Findings:
13On September 9, 2021 at 12: PM, Licensing Program Analyst (LPA) Joshua Rarela conducted a follow-up complaint inspection to deliver the findings of a complaint investigation concerning the allegation above. The complaint was investigated by Community Care Licensing, Investigations Branch, Investigator Tiffany Brunelli. LPA Rarela met with the facility representative named above and discussed the findings. During the course of the investigation, Investigator Brunelli interviewed the placing agency social worker on 3/8/21 and 3/12/21, and the facility client on 3/10/21; LPA Rarela interviewed facility staff on 3/8/21 (see Confidential Names Form dated September 9, 2021). Investigator Brunelli and LPA Rarela also reviewed documents including the placing agency records, child's Needs and Services Plan (NSP), incident reports, client roster and personnel records. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Joshua Rarela LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: CHILDREN'S HOPE GROUP HOMEFACILITY NUMBER: VISIT DATE: 09/09/2021

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

met_with: Joshua Borden, Facility Manager


raw_content:
Narrative:
Page Staff denied the allegations. Staff interviewed stated the client would seek attention from staff and clients and they would intervene when the other clients would get annoyed by client#1. Client#2 did not want to provide a statement. Other clients denied the allegations and stated they were supervised and nobody touched others inappropriately. Client#1 stated he was touched inappropriately and staff talked to client#2 about it. Staff stated they did not witness the allegation, but they would supervise the clients and they would not allow it to happen. Statements obtained from interviews conducted with social workers revealed no concerns regarding the allegations. Based on information gathered from interviews conducted and records reviewed the allegations were unsubstantiated. Although the allegations may have happened or are valid the standard of the preponderance of evidence was not met. A copy of this report and confidential names form were provided to the above mentioned facility representative. Exit interview conducted. No deficiencies were cited.

Investigation Findings:
On July 28, 2023 at 10:15AM, Licensing Program Analyst (LPA) Pedro Ramos conducted a follow up complaint inspection. During the inspection LPA met with Josh Borden, Assistant Director. The purpose of the inspection was to deliver findings for the above-mentioned complaint allegation. During the course of the investigation LPA conducted interviews with five clients ,4 staff on 7/10/23 and social service practitioner 7/12/23. In addition, conducted a file review on 7/10/23 and toured the facility. LPA obtained copies of staff contact information, incident reports and client information. It was alleged staff did not prevent minor from being harmed and bullied by another minor,dDue to lack of supervision minors engaged in inappropriate interactions and staff did not provide a safe and comfortable environment for minor in care. (Continued on Page 2) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tira Logan LICENSING EVALUATOR NAME: Pedro Ramos LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: CHILDREN'S HOPE GROUP HOMEFACILITY NUMBER: VISIT DATE: 07/28/2023

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

met_with: Josh Borden, Assistant Director


raw_content:
Narrative:
On 4/14/23 the Department received a complaint alleging client is being inappropriately touched by other clients in care. The facility staff indicated C1 has not disclosed to being touched by the other clients. The other clients have not disclosed to being touched by C1. The facility staff indicated clients are always supervised. C1 when interviewed indicated none of the clients living at the facility have touched C1 inappropriately. C1 stated C1 has not touched any of the clients. C1 stated staff is always supervising the clients. LPA attempted to interview two additional clients however LPA was unable to obtain statements from the clients. LPA reviewed the county interview with CSW which indicated C1 has sexualized behaviors and CSW has no concerns with the facility. CSW feels it is a good place for C1. Based on the interviews and records reviewed the allegation is/are found unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove the allegation. Appeals rights were provided and discussed with the facility representative mention above. There were no deficiencies cited.

Investigation Findings:
13On July 28, 2023, at 10: AM Licensing Program Analyst Larry Cabral (LPA) conducted a follow-up inspection for the purpose of providing findings for the above complaint allegation. LPA Cabral met with the STRTP Assistant Director Josh Borden. During the investigation, LPA Cabral interviewed two facility staff (S1 & S2) on 4/17/23. LPA interviewed one client (C1) and attempted to interview two clients on 5/1/23 (see Confidential Names Form LIC 811 dated July 28, 2023). LPA Cabral attempted interview one county social worker (CSW) on 4/21/23. LPA reviewed incident reports and client's needs and services plan (NSP) from the facility. LPA reviewed the other agency's interview with CSW on 7/21/23. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Larry Cabral LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION LA & TRI-COASTAL CR, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: CHILDREN'S HOPE GROUP HOMEFACILITY NUMBER: VISIT DATE: 07/28/2023

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


raw_content:
Narrative:
Confidential interviews reveal that the identified client was 18 years old and was in placement at the facility for five years. The identified client was employed and was transitioning to an independent living placement. The identified client admitted to engaging in substance abuse during placement and voluntary attended an outpatient rehab program. The investigation revealed that the identified client left the facility the night before to drive a family member to work. The identified client returned to the facility after an hour and did not show any sign of being under the influence. The identified client showed another client three pills that were in a plastic baggie. The other client observed the identified client go to the bathroom and assumed the identified client took the pills. The identified client went to sleep and was found deceased the following morning by staff, who tried to wake up the client. A small plastic baggie with two and a half small blue pills was found in the identified client's pants pocket. Additional interviews and records reviewed showed no evidence to support the allegation. Staff regularly conduct room cleaning and room checks; staff never found any illegal drugs in the identified client's room. Staff will search clients' belongings if there is any suspicion of drug use. Staff conduct bed checks at night to make sure clients are in their bedrooms asleep and not AWOL. The police incident report did not suspect any foul play. The coroner's report is still pending but the cause of death indicated was "probable acute fentanyl toxicity" and the secondary cause as "cardiomegaly." Based on the above information, the allegation is closed as unsubstantiated due to the lack of preponderance of evidence to support it. A copy of the following reports were provided at the conclusion of the inspection: LIC9099, LIC9099-C and LIC Confidential Names. Appeal rights were provided and explained. There was no deficiency citation issued.

Investigation Findings:
13On August 4, 2023 at 11: AM, Licensing Program Analysts (LPAs) Irene Yamamoto and Angelina Garibaldo conducted an unannounced complaint inspection at the facility. LPAs met with the facility representative named above. The purpose of the inspection is to deliver the finding for the above allegation. The investigation was conducted by the Department's Investigations Branch (IB), assigned to Investigator Dennis Douglas. The investigation into the allegation includes the following: Investigator Douglas served the 10-day complaint notification at the facility on 4/28/23. Between 4/28/23 and 7/21/23, Investigator Douglas conducted confidential interviews with staff and other related parties. Pertinent documents such as the police incident report, EMS report, case management reports and clinical reports were obtained and reviewed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Irene Yamamoto LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: CHILDREN'S HOPE GROUP HOMEFACILITY NUMBER: VISIT DATE: 08/04/2023

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


raw_content:
Narrative:
Based on the information gathered during confidential interviews, relevant parties denied the allegations indicating the client participates in client's care plan and is aware of what is in client's care plan. Confidential interviews indicated client has no issues with the facility, client feels comfortable and safe at the facility. Confidential interviews indicated all staff are trained on clients' care plans and are kept updated on care plans. LPA reviewed client's care plan which indicated staff needs to put away all sharp objects, let client vocalize client's feelings, provide extra support, and contact the CCRT team. The care plan is signed by client. LPA reviewed staff training documentation for the facility. Based on the interviews and records reviewed the allegations is/are found unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the allegations. Appeals rights were provided and discussed with the facility representative mentioned above. There were no deficiencies cited.

Investigation Findings:
13On June 4, 2024, at 9: AM Licensing Program Analyst Larry Cabral (LPA) conducted a follow-up inspection for the purpose of providing findings for the above complaint allegation. LPA Cabral met with the facility administrator Michael Sudyka. During the investigation, LPA Cabral interviewed two facility staff (S1 & S2) on 3/13/24 and one client (C1) on 4/22/24. LPA attempted to interview another facility staff (S3) on 5/23/24 (see Confidential Names Form LIC 811 dated June 4, 2024). LPA reviewed incident reports, C1's safety plan, NSP, Health and Education Passport, CFT meeting notes. LPA reviewed the other agency's delivered service logs. On 3/8/24 the Department received a complaint alleging the facility staff did not communicate client's care plan with client. The facility staff are not properly trained to meet the client's care needs. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Larry Cabral LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION MONTEREY PARK CRP RO, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: CHILDREN'S HOPE GROUP HOMEFACILITY NUMBER: VISIT DATE: 06/04/2024

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

met_with: Michael Sudyka, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On October 20, Licensing Program Analyst (LPA) Juliet Robles conducted an unannounced inspection at the facility at 11: AM. LPA met with Michael Sudyka, Administrator and Joshua Boden, Facility Management. The purpose of the inspection was to conduct an Annual/Required inspection of the facility. The facility has a Short Term Residential Therapeutic Program (STRTP) license. The STRTP has a Mental Health Program Certification that expires on 02/04/2022. The STRTP's National Accreditation will expire on 12/31/21. This STRTP is licensed to serve up to six (6) ambulatory children ages 7-17 years of age. The facility also provides services to non-minor dependents pursuant to W&I Code 16501.1 (C)(1). There are six (6) ambulatory minors that are in placement. This facility is a one story home with three (3) bedrooms, two and a half (2.5) bathrooms, two (2) living rooms, one (1) office, kitchen, laundry room, dining room, detached garage, front and back yard. During the inspection a copy of the Register of Facility Clients and Personnel Report was provided upon request. The following topics were inspected: PHYSICAL PLANT: A tour of the facility was conducted at 11: AM, along with Michael Sudyka.The License is placed in a prominent place, in the reception are of the facility. Children's foster rights, facility sketch plan and fire clearance were posted. LPA Robles observed that the facility is clean, safe, sanitary and in good repair. The passageways and ramps are unobstructed. The disinfectants and cleaning solutions were stored away from the kitchen areas, food preparation areas to the children. Laundry room located off dining room occupied by washer/dryer and is utilized to house facilities knives, cleaning materials and medications all located in upper locked cabinets. The food is safe and of the quality and the quantity necessary to meet the needs of the clients. Supplies of staples non-perishable foods for one week and perishable foods for two days are maintained in the facility. The temperature in the rooms that clients occupy are maintained between 68 and 85 degrees (F) and the hot water temperature was at 110 degrees (F). Operations Facility maintains a current, written plan of operation that meets licensing standards. Facility maintains a register of clients and the register is available upon request. Facility maintains and implements written complaint procedures and the procedures are posted in a publicly accessible location in the facility. The board of directors regularly conducts meeting to review and discuss the STRTP's operation. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill at least quarterly for each shift. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Needs and Services Plan for each client, medication records, and contact information for each client's responsible party and physician. Emergency Intervention Plan Facility does not use manual restraint for emergency interventions. Facility utilizes technique of group and individual behavior management like crisis prevention and alternative methods of handling aggressive and assaultive behavior. Core/Therapeutic Services Facility provides core services and supports to children as appropriate or necessary that are trauma informed, culturally relevant, age and developmentally appropriate and include the following: Medi-Cal specialty mental health services; transition port services; educational and physical, behavioral, and mental health supports; activities to support children with services to achieve permanency. Staff Records LPA at 1: PM started to review four (4) personnel records. All individuals subject to criminal records review have been fingerprinted and signed a Criminal Record Statement. Personnel records are maintained on the licensee, administrator and each employee. The administrator meets the required qualifications and/or experience. Documentation of the required education and experience requirements are maintained in the personnel file. On today's inspection, LPA interviewed two (2) staffs and four (4) clients. LPA was provided with Board Minute Meetings, an updated LIC 309 and activity schedule. The following are six (6) Type B deficiencies cited today: 1) Emergency Intervention Plan:Emergency Intervention Plan - Type B: 87095.65(b)(6). 2) Emergency Intervention Plan - Type B: 87095.65(d)(1)(C). 3) Staffing Records - Type B: 87065.1(c)(1) 4) Staffing Records - Type B: 87065.1(c)(2) 5) Staffing Records - Type B: 87065.1(c)(6)(A) 6) Staffing Records - Type B: 87065.1(d)(1) Appeal rights provided. An Annual/Required Continuation inspection is required. An exit interview was completed and a signed copy of this report was provided to the facility representative.

report_type: Facility Evaluation

visit_type: Annual

met_with: Joshua Borden


summary: Facility Evaluation

raw_content:
Narrative:
On October 21, Licensing Program Analyst (LPA) Juliet Robles conducted an unannounced inspection of the facility at 9: AM. LPA met with Michael Sudyka, STRTP Administrator and Joshua Boden, Facility Management. The purpose of the inspection was to conduct a Case Management - Annual Continuation inspection of the facility. During this inspection, LPA reviewed the Clients Record. Currently there is client present in the facility. Client Records All client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to, consent forms, court orders, appraisal/needs and services plan, removal/discipline/complaint procedures; medical assessment; safeguards for cash resources, personal property and valuables; education records; personal rights forms; and medication administration records. LPA reviewed four (4) client records. There are no citations assessed during this inspection. The facility representative was provided information on where to locate Provider Information Notices (PINs), and Compliance and Regulatory Enforcement (CARE) Tools, for Children's Residential licensees please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process. An exit interview was conducted and a copy of this report and LIC 811 is provided to the Administrator. Exit interview conducted.

visit_type: Case Management

met_with: Michael Sudyka


summary: Facility Evaluation

raw_content:
Narrative:
On December 07, 2022, at 10: AM, Licensing Program Analyst (LPA) Johanna Lofton and conducted an unannounced case management inspection at Children's Hope Group Home Short Term Residential Therapeutic Program to follow up on a death incident involving Client #1 (C1). LPA Lofton met with Administrator Michael Sudyka. On December 6, 2022, Children's Hope Group Home reported to the Department that on the morning of December 6, 2022 an 18-year-old male resident was found deceased on his bed. At the time of the visit the cause of death was inconclusive pending coroner's report. STRTP's Administrator went to C1's room at 7:00am because he failed to pick up his mother from work that morning. Administrator reported C1 was unresponsive when he called out his name and when he touched him he was cold and stiff. Administrator informed the staff and 911 was called. The police and paramedics were at the facility within minutes. C1 was pronounced dead and the San Bernardino Coroner was summoned to pick up the body. LPA Lofton interviewed the facility administrator, facility manager, facility therapist and the facility's assistant administrator. LPA Demetris Teal joined the investigation at 1:45pm and interviewed the clients. During the inspection, LPAs obtained the facility's LIC500 and Client's Roster. A signed copy of this report was provided to the facility representative along with LIC 811 (Confidential names list.) via email. This case needs further investigation.

met_with: Michael Sudyka- Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On May 28th, 2024, at 10: AM Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced inspection at the above facility for the purpose of conducting an annual/required inspection. LPA met with Administrator, Michael Sudyka. LPA and Administrator toured the facility. LPA obtained and reviewed the following updated documentation: · LIC Personnel and Client Roster · LIC C Emergency Disaster Plan · Board of Directors report and Program Statement · Employee Grievance Policy/ Grievance Procedures · Emergency Preparedness: Disaster and Mass Casualties Drills · Emergency Evacuation Routes · Complaint Procedures This facility is a one-story home with three (3) bedrooms, two and a half (2.5) bathrooms, two (2) living rooms, one (1) office, kitchen, laundry room, dining room, detached garage, front and back yard. LPA observed the facility license, facility sketch, Grievance Procedures, Personal Rights, visitation policies, emergency disaster plan and activity calendar posted by the front entrance of the facility. The facility has a working telephone that is accessible to clients and staff. All passageways and grounds were free of any obstructions. The medications and cleaning solutions were locked inside the cabinets in separate storage rooms. There were perishable foods enough for 3 days and non-perishable foods enough for client's consumption for more than a week. Each bedroom has two twin beds with clean sheets and linens. There were drawers and closet space in each bedroom for client use. The hot water temperature was tested and was in working order. There is one (1) fire extinguishers throughout the facility, all fully charged and all last serviced on February 27th, 2024. At the time of this inspection the facility was observed to be clean, safe, and in good repair. The facility has two vehicles used to transport clients one is a Toyota Corolla and a Toyota Scion. The vehicles have active insurance policies and current registration. The facility maintains the equipment/vehicle and vehicles are monitored by the Administrator. The vehicles are serviced as needed. Facility does not use manual restraint for emergency interventions. Facility utilizes technique of group and individual behavior management like crisis prevention and alternative methods of handling aggressive and assaultive behavior. Facility provides core services and supports to children as appropriate or necessary that are trauma informed, culturally relevant, age and developmentally appropriate and include the following: Medi-Cal specialty mental health services; transition port services; educational and physical, behavioral, and mental health supports; activities to support children with services to achieve permanency. Client Records All client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to, consent forms, court orders, appraisal/needs and services plan, removal/discipline/complaint procedures; safeguards for cash resources, personal property and valuables; education records; personal rights forms; and medication administration records. For this review, five (5) San Bernardino County placement clients were selected for the sample to assess the level of care and services they receive. All client files reviewed were missing a Tuberculous Test. C1's file did not have a completed initial medical assessment within the 30-day time frame. A citation will be issued today for these deficiencies. Additionally, LPA reviewed four (4) staff files for compliance with Title Regulations and Interim Licensing Requirements. All staff records LPA conducted an interview with three (3) staff members and two (2) clients. Citations were issued during today's inspection. A plan of correction was discussed and developed with the above representative. An exit interview was conducted and a copy of this report along with the appeal rights were given to the Administrator. .

met_with: Administrator - Michael Sudyka


summary: Facility Evaluation

raw_content:
Narrative:
On September 28, 2021, at 10:45 am Licensing Program Analyst (LPA) Belinda Gilmer conducted an unannounced Case Management inspection at this facility and met with Michael Sudyka. The purpose of this inspection was to discuss and cite this group home facility for failing to report an epidemic Outbreak that occurred on 08/22/2021. The Special Incident Report wasn't reported until after Licensing Program Analyst called the facility to conduct a risk assessment on 09/22/21, did LPA Gilmer learn that a foster child (ref. # 1) had tested positive for COVID 19 on 08/22/21. As per the California Code of Regulation, Title 22 section 80061(b)(1)(H) reporting requirements did LPA learn of the Epidemic outbreak should have been reported. As the facility failed to report the group home will be cited as stated above. A copy of the facility evaluation, the confidential names list, and appeal rights were discussed with Me. Sudyka during the exit interview.


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Pamela Silva, Juliet Robles and Gilbert Gutierrez on 12/14/22 at 9: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPAs met with Michael Sudyka, Administrator, and inspected the facility inside and out. LPAs reviewed two (2) client records and two (2) staff personnel files on site at the facility. LPAs reviewed two (2) client psychotropic medications and medication records. LPAs interviewed two (2) staff on site to discuss the facility's policies and procedures of operation. No clients available for interview at the time of the inspection. LPAs issued two (2) deficiency citations at the time of the inspection. An exit interview was conducted and a copy of the LIC 809, LIC 809D, LIC 811, LIC TV and Appeal Rights were provided to the Administrator.

Deficiencies:
87068.2(a): Social Work staff shall obtain the information specified in Section 87070, and shalll develop an individual needs and services plan, within 30 days of placement...

title:
1
2
3
4
5
6
7Needs and Services Plan


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Pamela Silva and Juliet Robles on November 6, 2023 at 11: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPAs Silva and Robles met with Administrator, Michael Sudyka, and inspected the facility inside and out. LPAs reviewed 4 of child's records and 2 of staff personnel files on site at the facility. LPAs reviewed 4 of child's psychotropic medications and medication records. LPAs interviewed 1 of staff on site to discuss the facility's policies and procedures of operation. LPAs interviewed 2 of children currently prescribed psychotropic medication. During the inspection, LPAs observed deficiencies (see attached 809-D). Plan of corrections were discussed and appeal rights were provided. LPAs provided a copy of this licensing report to Michael Sudyka, Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Timika Martin, Pamela Silva and Juliet Robles on 11/18/24 at 11: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPAs met with Interim Administrator, Michael Sudyka and inspected the facility inside and out. LPAs reviewed three (3) children records and three (3) of staff personnel files on site at the facility. LPAs reviewed three (3) children psychotropic medications and medication records. LPAs interviewed two (2) of staff on site to discuss the facility's policies and procedures of operation. LPAs were unable to interview children currently prescribed psychotropic medication due to being unavailable. LPAs will conduct interviews at a later date. During the inspection, LPAs observed deficiency (see attached 809-D). Plan of correction was discussed, and appeal rights were provided. LPAs provided a copy of this licensing report to the Interim Administrator.

met_with: Administrator, Michael Sudyka


raw_content:
Narrative:
Based on the information gathered during confidential interviews, relevant parties denied the allegation indicating the sharp utensils were locked in a cabinet. The client somehow over reached into a small opening and grabbed a knife. Confidential interviews indicated after a couple of minutes client was compliant and gave the knife to staff. Social worker had no concerns and stated the child had behaviors and the facility went above and beyond with the care of the client. Clients interviewed stated they felt safe at the facility. Based on the interviews and records reviewed the allegation is found unsubstantiated. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the allegation. Appeals rights were provided and discussed with the facility representative mentioned above. There were no deficiencies cited.

Investigation Findings:
13On April 22, 2026, at 9: AM Licensing Program Analyst Pedro Ramos (LPA) conducted a follow-up inspection for the purpose of providing findings for the above complaint allegation. LPA met with the facility administrator, Michael Sudyka. During the investigation, LPA interviewed three facility staff (Administrator,S1 & S2) and four clients (C1-2-3-4). LPA interviewed one social worker (see Confidential Names Form LIC 811 dated April 22,2026). LPA reviewed incident reports, safety plan, NSP, Health and Education Passport. On 11/19/25 the Department received a complaint alleging due to lack of supervision, minor broke into locked knives and threatened another minor. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tira Logan LICENSING EVALUATOR NAME: Pedro Ramos LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: CHILDREN'S HOPE GROUP HOMEFACILITY NUMBER: VISIT DATE: 04/22/2026

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

met_with: Mike Sudyka, Administrator


facility_name: CHILDREN'S RECEIVING HOME OF SACRAMENTO

summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
The question of whether or not a Program Supervisor was counted towards the staffing ratio was not made explicit by the documented statements obtained by LPA Eunice-McLean from children and staff-CRH management stated that whenever a scheduled Residential Counselor calls off, and no other previously unscheduled replacement can cover by the time the shift starts, the facility's Program Supervisor or Supervisor-on-Duty (SOD) leaves that position's post in the supervisor hub to slot in for the call-off at the dorm in need, ensuring that the ratio is met. It is reasonable that, because the children (or even some staff) may not understand this protocol as it happens, they may still describe the situation as being "short-staffed" simply because of the call-off; but the proper staffing ratio can still be met if a supervisor is present in that dorm. Such language is recurrent in several incident reports written by these direct-care Residential Counselor staff: i.e. "unable to shadow due to limited staff/being the only staff," etc.-particularly when documenting children who go AWOL (unauthorized absence or leaving of the facility). However, it is also consistently documented that a supervisor, program manager, or other supporting staff do attempt to follow absconding minors per the facility's program protocol. After further review, there is not enough corroboration among the obtained statements to definitively determine an actual out-of-ratio incidence, let alone regular occurrence. Based on the above, the preponderance of evidence standard has not been met; therefore, the allegations are found to be UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. No Interim Licensing Standards or Title Regulations are being cited.

Investigation Findings:
UnsubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:

met_with: Elisianna Rios and Georgeta Muresan, Administrators


raw_content:
Narrative:
There was a lack of corroboration between clients C1 and C2's statements concerning a Residential Counselor staffer who purportedly had yelled at them. Client C3 stated that if youth perceive staff to be yelling at them, this was always within the context of those staff having to be stern when the youth are being "extremely rude or disrespectful," but that staff are not aggressive when they have to talk to youth in a more firm manner. All three staff interviewed were consistent in saying that under no circumstances is it justified to yell at children. As for the Wi-Fi codes: by all accounts, access to the internet is only restricted after PM, at which point onwards clients can gain access to the internet using Wi-Fi codes that can be bought by points they accumulate for good behavior. This is a reasonable incentive program that the facility implements. C1 claims that no Wi-Fi code was given when internet access was needed for schoolwork; neither of the two other clients interviewed corroborated this. Based on LPA's interviews and a records review, the preponderance of evidence standard has not been met; therefore, the allegations are found to be UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. No Interim Licensing Standards or Title Regulations were cited as a result of this complaint investigation. Exit interview conducted and a copy of this report is being provided to the facility.

Investigation Findings:
UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Chad Cabigon 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 23-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, NATOMAS PARK DR., STE FACILITY NAME: CHILDREN'S RECEIVING HOME OF SACRAMENTOFACILITY NUMBER: VISIT DATE: 08/03/2021

met_with: Georgeta Muresan & Elisianna Rios


raw_content:
Narrative:
Most of the youth residents interviewed described the care and supervision provided by the facility as average most of the time--that is, staffing was sufficient; but most of the clients also described a lack of supervision occurring intermittently even with direct-care staff on hand, to the extent that potentially inappropriate interactions could occur between youth residents. Based on LPA's interviews, the preponderance of evidence standard has not been met; therefore, the allegation is found to be UNSUBSTANTIATED. 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. No Title Regulations or Interim Licensing Standards were cited as a result of this investigation. Exit interview conducted and a copy of this report is being provided to the facility.

Investigation Findings:
13On 11/15/2021, at approximately 4: PM, LPA Chad Cabigon conducted an unannounced follow-up inspection at this facility to deliver the findings of, and close, this complaint investigation. LPA was met by Adminstraor Georgeta Muresan with whom this report was discussed. LPA conducted interviews with the following: seven youth residents from different dorms, County Case Workers for said youths, two direct-care staff, and the Facility's Food Services Supervisor. An onsite, in-person tour of the interior and exterior areas of the facility's campus was conducted on 08/16/2021, with focus on the facility's kitchen and dining areas. The following records were reviewed: training documention for certain staff, the Needs & Services Plans for the children, and the facility's roster and/or placement history for the time period in question. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Chad Cabigon 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 23-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, NATOMAS PARK DR., STE FACILITY NAME: CHILDREN'S RECEIVING HOME OF SACRAMENTOFACILITY NUMBER: VISIT DATE: 11/15/2021

met_with: Georgeta Muresan


raw_content:
Narrative:
Client (C1) stated that C1 was choked by another client (C2) from behind for about 10 seconds before staff intervened and separated them. This length of time was independently corroborated by CRH Administrator Elisianna Rios who described the incident in question off video footage she had reviewed as part of the facility's internal investigation into the incident. This incident took place in the rec hall situated between two dorms-per Ms. Rios, the intervening staffer was initially off-camera but was seen to come into the frame to get in between C1 & C2 which would have suggested that the staff-person maintained visual supervision of the clients who were in the communal space at the time. No injuries resulted from this interaction and C1 was moved into a different dorm shortly after this incident. On the question of whether or not there was a Lack of supervision resulting in minor being choked by another minor in care, while the choking act was undisputed, there was not enough indication to necessarily concur that it took place because of a lack of of supervision on the staff's part. Based on LPA's interviews and a review of records, the preponderance of evidence standard has not been met; therefore, the allegation is found to be UNSUBSTANTIATED. 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. No Interim Licensing Standards or Title Regulations were cited as a result of this investigation. Exit interview conducted and a copy of this report, and of the Appeal Rights, is being provided to CRH.

Investigation Findings:
13On 01/14/2022, at approximately 2: PM, Licensing Program Analyst (LPA) Chad Cabigon conducted a follow-up inspection at this facility to deliver the findings of, and close, this complaint investigation. LPA was met by Administrator Georgeta Muresan with whom the following report was discussed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Chad Cabigon 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 23-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, NATOMAS PARK DR., STE FACILITY NAME: CHILDREN'S RECEIVING HOME OF SACRAMENTOFACILITY NUMBER: VISIT DATE: 01/14/2022


raw_content:
Narrative:
Client (C1) detailed the multiple incidents of unwelcomed advances (sexual or otherwise in nature) by another client (C2) and stated that these occurrences had always taken place in places on campus and during times where no staff were around. C1 stated that these incidences were initially not disclosed to any facility staff (not even therapists) or, if C1 did bring it up to staff, that C1 only described these advances in a way that did not sound overly concerning, and that C1 attempted to try to dissuade C2 from continuing to do these things in the meantime, but that as C2 persisted C1 finally notified staff of C2's actions. C1 was then moved into a different dorm shortly after. C1 added that, in the interim (during the time between when C1 told staff/administration and when C1 was finally moved), staff did keep a close eye on C2 and discouraged the two clients from being close to or even interacting with each other. Based on LPA's interviews and a review of records, the preponderance of evidence standard has not been met; therefore, the allegation is found to be UNSUBSTANTIATED. 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. No Interim Licensing Standards or Title Regulations were cited as a result of this investigation. Exit interview conducted and a copy of this report, and of the Appeal Rights, is being provided to CRH.

Investigation Findings:
13On 01/14/2022, at approximately 2: PM, Licensing Program Analyst (LPA) Chad Cabigon conducted a follow-up inspection at this facility to deliver the findings of, and close, this complaint investigation. LPA was met by Administrator Georgeta Muresan with whom the following report was discussed. Prior to the start of investigation, a review of the Children's Receiving Home of Sacramento's (CRH or facility) history of complaints, deficiencies, and recurring required inspections was conducted. On 10/08/2021, an unannounced onsite inspection to open the complaint was conducted at CRH-an interview with Facility Administrator Elisianna Rios was conducted and the following records had already been requested as part of another recently-started investigation: the Needs & Services Plans for the clients in question and the staff roster for the time period of interest. Interviews were conducted with the following individuals: four facility client residents including the alleged victim, one facility employee, and CRH administrators. (CONTINUNED ON NEXT PAGE, 9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Chad Cabigon 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 23-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, NATOMAS PARK DR., STE FACILITY NAME: CHILDREN'S RECEIVING HOME OF SACRAMENTOFACILITY NUMBER: VISIT DATE: 01/14/2022


raw_content:
Narrative:
C1 did not think that staff could have anticipated this particular incident for them to have prevented C1's attempt altogether; however, C1 expressed that staff can do a better job "checking in" sooner or more frequently with them in general. C2 stated that C1 is frequently placed under Close Supervision (CS) but that, in C2's opinion, C1 could still find a way to engage in self-harm even under CS. Both C1 and C2 indicated feeling safe in the facility while a third client (C3) expressed that, if anything, CRH staff/administration respond too harshly when a client engages in self-harm, being overly prohibitive or restrictive with activities or clients' access to certain items. Based on interviews and reviewed records, the preponderance of evidence standard has not been met; therefore, the allegation that Staff did not ensure client's safety while in care is found to be UNSUBSTANTIATED. 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. No Interim Licensing Standards or Title Regulations were cited as a result of this investigation. Exit interview conducted and a copy of this report, as well as the Appeal Rights, is being provided to the facility.

Investigation Findings:
13On 02/18/2022, at approximately 4: PM, Licensing Program Analyst (LPA) Chad Cabigon delivered the findings of this investigation. LPA was met by Georgeta Muresan & Elisianna Rios with whom the report was discussed. Prior to the start of investigation, a review of the Children's Receiving Home of Sacramento's (CRH or facility) history of complaints, deficiencies, relevant incident reports, and recurring required inspections was conducted. On 10/22/2021, the complaint was opened at CRH by way of an unannounced onsite inspection-a tour of the interior and exterior areas of the facility's physical plant was done, and interviews with four clients, two direct-care staff, and Facility Administrator Georgeta Muresan were conducted. Needs & Services Plans for the clients referenced and the staff roster for the time period of interest were also obtained. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Chad Cabigon 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 23-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, NATOMAS PARK DR., STE FACILITY NAME: CHILDREN'S RECEIVING HOME OF SACRAMENTOFACILITY NUMBER: VISIT DATE: 02/18/2022

met_with: Georgeta Muresan, Elisianna Rios


raw_content:
Narrative:
they addressed them and keep revising the strategies to prevent inappropriate behaviors. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. No title 22 regulations were cited during today's inspection. Exit interview conducted and a copy of this report and appeal process was provided.

Investigation Findings:
13Licensing Program Analysts (LPAs) Tana Kinder and Shalisa Stiger conducted an unannounced complaint inspection at the facility on 9/21/22 and no citations were issued. On 12/12/22 at 4PM LPA Kinder met with the Admissions and Program Coordinator to deliver complaint findings. LPA Kinder conducted 7 interviews. LPA Kinder obtained and reviewed copies of the following documentation: 3 youth's needs and service plans, incident reports related to the complaint allegation, Staff contact information, 3 emailed correspondences related to the allegation. Based on records reviewed and 7 interviews, staff provided supervision and despite that, inappropriate behaviors occurred. New strategies were implemented once staff became aware of a few inappropriate incidents. Additionally, the client named in the complaint retracted some of the allegations made but restated some of the incidents as being true. Other individuals did corroborate the type of behavior alleged to have occurred by the same client, but were not able to give specific dates or times. The information regarding the stated incidents changed, yet others stated there had been similar issues with the same individual and once staff became aware, Continued... UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Tana Kinder 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 23-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, NATOMAS PARK DR., STE FACILITY NAME: CHILDREN'S RECEIVING HOME OF SACRAMENTOFACILITY NUMBER: VISIT DATE: 12/12/2022

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

met_with: CEO


raw_content:
Narrative:
Although the facility did submit an Incident Report regarding the incident in question (which was reportable) to Community Care Licensing, CRH was unable to provide confirmation that the report or notification was ever sent to C1's responsible party or authorized representative (CM-a Sacramento County Social Worker). Based on LPA's interviews and record review, the preponderance of evidence standard has been met; therefore, the allegation is found to be Substantiated. A 9102TV (Advisory Notes - Technical Violation) is being issued. A copy of this report, and of the Appeal Rights, is being provided to the facility. All three CRH personnel who reviewed the footage of the incident corroborated that, though the former Residential Counselor (S1) engaged in an unnecessary "power struggle" with youth C1, at no point did S1 actually put his hands on C1. The same CRH personnel did confirm that, in another incident involving another youth, S1 had utilized physical contact that was non-assaultive but was sufficiently inappropriate to cause S1's employment to be terminated. There was corroboration between two CRH youths on S1 pushing C1, but the details were inconsistent: C1 stated that the push was more of a nudge, whereas another youth (C2) stated that the push was strong enough to knock C1 back. As for the allegation that Staff made inappropriate comments, C1 did not cite a specific comment that S1 made that C1 understood to be inappropriate, nor was there enough coherent corroboration among the interviewees to support the allegation. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the allegations are Unsubstantiated. A copy of this report, and of the Appeal Rights, is being provided to the facility.

Investigation Findings:
UnsubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:

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

met_with: Kari Hanson, Clinical Director


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
C1 denied being touched in any sexually inappropriate manner by S1. C1 did maintain that S1 applied manual restraints on C1 multiple times and, in at least one instance, S1 did so improperly: C1 described S1 putting an arm around C1's neck, hurting C1. This was not seen in the reviewed recording, and some of the other details that C1 described were inconsistent with what could be observed in the video footage-S1 was never in C1's bedroom for more than 2 minutes at a time in a span of about eight total minutes from when the exchange started to when C1 exited the dorm; whereas C1 stated that S1 was in the dorm room for 20 minutes. What was clear in the footage was S1 pushing, with both hands, C1 from behind in an apparent attempt to prevent C1 from exiting the dorm. And though the pushing did not appear to have enough force to cause C1 to lose balance and/or fall to the ground, the action was not trauma-informed. The staffer in question was terminated due to this incident. Based on conducted interviews and a review of the records, the preponderance of evidence standard has been met; therefore, the allegation is found to be Substantiated. Section 87072(c)(11) of the Interim Licensing Standards is being cited on the attached LIC 9099D. A copy of this report and of the Appeal Rights are being provided to the facility.

Investigation Findings:
13On 03/29/ Licensing Program Analyst (LPA) Chad Cabigon conducted an unannounced inspection at this Short Term Residential Therapeutic Program (STRTP) and met with Clinical Director Kari Hanson to whom the findings of this complaint investigation were delivered. The following report was discussed: This Department investigated an allegation that Staff inappropriately touched youth in care. Investigator Chris Krogstad of Community Care Licensing's (CCL) Investigations Branch (IB) took the referral as an assignment. As part of the investigation, Inv. Krogstad interviewed one Children's Receiving Home (CRH) youth (C1) and two facility administrators; Inv. Krogstad also reviewed video surveillance footage from two different camera angles of the incident in question. LPA Cabigon interviewed the former CRH staffer (S1) involved and an additional CRH youth (C2). The following records were obtained: S1's corrective action history in CRH and C1's Needs & Services Plans. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Chad Cabigon 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 23-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, NATOMAS PARK DR., STE FACILITY NAME: CHILDREN'S RECEIVING HOME OF SACRAMENTOFACILITY NUMBER: VISIT DATE: 03/29/2023

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

met_with: Kari Hanson

complaint_status: SUBSTANTIATED


raw_content:
Narrative:
The youth communicated conflicting information about possible health issues but facility staff decided to move forward with contacting a clinic and trying to schedule a medical appointment. The soonest appointment was a month out. The facility medical staff continued to pursue other options but did not communicate this to direct care staff who were also pursuing treatment options. The miscommunication resulted in the youth having to access medical treatment through the emergency department. Regarding redirection of client behaviors, the initial behaviors identified by the treatment team were not manifesting while in the presence of staff at the facility. The behavior that resulted in the need for medical treatment was a newer manifestation of an ongoing issue which is now being addressed. Regarding communication with the parents, staff are in communication with the youth's parents but there is a difference of opinion as to who should report information provided by the school as the school has contact with the parents and the youth's parents maintain educational rights. There has been clarification about the responsibility since this incident. Regarding the youth missing 3 days of school, there is a discrepancy between the school and the facility as to when the facility was made aware of the need to have a medical note for the youth to return to school. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview conducted, a copy of this report and the Appeal Rights were provided to the Agency.

Investigation Findings:
UnsubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:

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

met_with: Administrator


raw_content:
Narrative:
Based on information obtained from the Employee Evaluation, the staff at issue has effective listening and communication skills, ability to initiate without direction, dependable, and a diligent steward of entrusted resources. Documentation reviewed in the staff file did not contain negative reviews nor information to suggest this staff person employed for 7 years has conducted themselves unprofessionally. Witness interviews describe this staff as nice, trustworthy, strict when children don't listen to prompts, experienced, and say they never heard staff make inappropriate comments or say unkind words to any child. One witness said staff used unkind and inappropriate words towards them, that they're ugly and lazy, and said they need to lose weight. That witness felt insulted physically. Although the allegation that staff speak to a minor in an inappropriate manner may have happened, or may be valid, there is not a preponderance of the evidence to prove the alleged violation did, nor did not occur, therefore, the allegation is UNSUBSTANTIATED. LPA conducted exit interview, provided appeal rights and delivered this report 08-09-2023.

Investigation Findings:
UnsubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:

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

met_with: Elisianna Rios, Administrator