summary: Facility Evaluation

raw_content:
Narrative:
On April 16, 2021, due to COVID-19, Licensing Program Analyst (LPA) Hillary Hall, conducted an announced pre-licensing tele-inspection via Microsoft Teams for the above facility. LPA met with the facility Administrator, Jeff Curtis and Jamie Murray for the tele-inspection. Jeff gave the LPA a tour of the facility via Microsoft Teams. The facility home is located in a residential area of Redding, CA. The home is not yet furnished, but Jeff reported the furnishings have been purchased, and they are awaiting vendorization from the Regional Center. LPA viewed every room. The house appears clean, organized, and with additional safety precautions in mind for the intended population. The facility has posted Client Personal Rights and the Complaint brochure. The facility has phone service. There is a storage room that holds cabinets that will store client files. The facility has working bathrooms. There is a full kitchen with working appliances. There are no knives being stored in the kitchen at this time. There is a first aid kit located in the kitchen area as well. The facility has working fire extinguishers smoke detectors and carbon monoxide detector. Emergency Disaster Plans and Evacuation Map are posted. No deficiencies were noted during the pre-licensing inspection. LPA recommends licensure approval, and a provisional license will be issued so the facility can begin operation, pending approval of their Program Statement. A post-licensing inspection will be completed within 90-days of this date to determine permanent licensure. A copy of this report been sent to the facility.

met_with: Jeff Curtis and Jamie Murray


state: CA

facility_name: LEVA PENTE

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Hillary Hall arrived at the facility unannounced for a Post-Licensing visit and to review recent incident reports sent to the department. Far Northern Regional Center worker (FNRC) Kathy Bogue was also present at the facility. When LPA arrived, four house staff were present for 2 clients, and two more staff and one more client arrived within minutes. LPA met with House Staff "Vic" for a few minutes before the Administrators named above arrived promptly. LPA received a tour of the home. Facility was clean, and the office with records and medications was locked and organized. Each client had a separate bedroom, with appropriate dresser and closet space, and bed linens. A daily schedule of activities was reviewed, and client charts were available for reference. Kitchen was clean. Backyard was nicely landscaped with chairs, a swing, and a garden area for clients. No deficiencies noted in the physical plant or file review. LPA reviewed recent General Event Reports (GER's) with administrators (AD). FNRC provided LPA with Individualized Program Plan (IPP) for each of the youth in the home. FNRC indicated her youth has excelled in the home, and his behaviors have diminished. He seems happy. AD described the activities available to the youth, and the alternative interventions implemented before utilizing restraints. Staff indicated they are learning to recognize client triggers to diffuse difficult behaviors before they become aggressive. LPA asked what would happen if restraints were not used. Staff and FNRC indicated one client has a history of severe self-injury and gave himself a concussion in the past. Another client is known to attack staff. The facility has lost staff who quit, following being attacked by a client. One female staff at the facility indicated she obtained a bad black eye from client who punched her. LPA asked if clients were able to understand the concept of time. (It was referenced in the GER that clients needed to be safe for 20-30 minutes before earning back privileges.) Staff said the client may not comprehend time. It was suggested a timer with a visual cue be obtained, and FNRC said she would acquire one for the facility to use. The facility uses a Token Economy System for each youth, designed alongside Advanced Crisis Services (ACS). LPA reviewed the role of licensing and exchanged contact information, concluding the interview and tour. A copy of this report was provided to the administrators.

report_type: Facility Evaluation

met_with: Jeff Curtis and Cory Ranberg, Administrators


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Hillary Hall met with Cory Ranberg (S1), Administrator of Leva Pente Group Home at the facility to conduct a required annual inspection. Prior to the inspection, LPA reviewed: Program Statement, Serious incident reports, and complaint history. This home is licensed to provide treatment services for ambulatory children ages 8 - 17 years. There are a total of four youth currently living in the home, all Regional Center client placements. One client was present during the inspection. LPA conducted a walk-through of the facility. There are a total of four bedrooms available for clients, with each having their own bedroom. LPA observed client bedrooms, the living rooms, kitchens, two bathrooms, the backyard area, the garage, and the staff office. LPA observed the bedrooms to be acceptably clean and equipped with the proper items. LPA observed the first aid kit to be complete. LPA observed a locked office where files and medications are stored, and reviewed the medication logs. LPA observed an adequate amount of food, both perishable and non-perishable, meeting regulations. LPA observed the facility to be clean and free of hazards or insects. LPA reviewed the fire clearance, license, program statement sections, four client records and ten staff records. LPA also reviewed operational requirements, and the disaster preparedness plan. The emergency disaster and mass casualty plan were complete. LPA did not interview the one client as the client does not use words to communicate. LPA interviewed two staff. Continued on LIC-9099C Continued from Out of 10 staff files reviewed, 3 did not have current CPR and First Aid. LPA observed the client's psychotropic medication logs were not written on separate Psychotropic Medication Administration Records. LPA observed staff initial training was not present in their files. LPA observed staff had completed 36 hours of annual training in Professional Crisis Management, but no additional training topics were covered. Four deficiencies were observed with three citations being given during this annual inspection. Only one citation for missing initial and annual staff training is being issued. Title 22, Division Chapter 5, Article 06, Section 84065: Personnel Requirements (h) The licensee shall develop, maintain, and implement a written plan for the supervision, evaluation, and training of all child care staff. Title 22, Division 6, Chapter 5, Article 06, Section 84065(j)(7) Annual training is in addition to first aid and CPR training, and other training. Title 22, Division Chapter Article 06. Continuing Requirements Children's Records (13) A separate log for each psychotropic medication prescribed to the child. An exit interview was conducted and a signed copy of this LIC-9099 report, the LIC-9099C, and LIC-9099D was provided to the administrator. Appeal Rights were provided.

visit_type: Annual

met_with: Cory Ranburg, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 6/29/23, Licensing Program Analyst (LPA) Lyta Vue and Misty Valencia arrived unannounced at the facility and met with Cory Ranberg, Administrator. The purpose of the visit was to conduct a Required Annual Inspection of the facility. The last Annual inspection for the facility was on 6/6/22. LPA utilized the CARE Tool to complete the Annual Inspection. The facility is licensed to provide treatment services for ambulatory children age 8 to 17 years old. The facility currently has 4 clients, all Regional Center placement. 3 clients were present during the inspection. The facility is licensed for a maximum capacity of 5. Staff to client ratio is a minimum of 1:1. LPA conducted an inspection of the physical plant, and checked for all necessary requirements. The facility had no noticeable odor and maintained an acceptable room temperature. There are a total of four bedrooms available for clients, with each client having their own bedroom. LPA observed the client bedrooms, living rooms, kitchen, two bathrooms, the backyard, the garage, and the staff office to be clean and organized. LPA observed each client's bedroom to have a closet, a dresser, and a clean mattress. Sheets, blankets, and pillows were in good condition. Every bedroom was decorated with the client's personal items. LPA observed a locked staff office where files and medications are stored. Some Client files were stored electronically with password protection and the rest are in process of transitioning into electronic. LPA observed the proper postings including: facility license, complaint hotline, menu, emergency disaster plan, and client personal rights. Smoke alarms and carbon monoxide were in working order, fire extinguishers were current, and a first aid kit was fully stocked. The facility has no outstanding fees. LPA observed 2 days of perishable food and 7 days of non-perishable food in the kitchen and in the additional refrigerator in the garage. All medications, disinfectants and cleaning solutions were inaccessible and locked. Continued on 809c LPA reviewed 4 client files. No clients were taking court ordered psychotropic medications. Clients were current on CHDP physical exams and dental exams. The client's Needs and Services Plan/Individual Program Plan, were complete and up to date. LPA reviewed 5 staff files. Staff files had completed criminal record clearances and all required initial and annual training. First Aid and CPR certifications were up to date for all staff. Administrators Certificate was valid. LPA interviewed two staff on site. LPA interviewed two clients on site. No citations were given on this date. A signed copy of this LIC-809 and LIC-809C report was provided to Cory Ranberg, Administrator.. An exit interview was conducted.


summary: Facility Evaluation

raw_content:
Narrative:
On 5/01/2024, Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility and met with Cory Ranberg, Administrator. The purpose of the visit was to conduct a Required Annual Inspection of the facility. The last Annual inspection for the facility was on 6/29/23. LPA utilized the CARE Tool to complete the Annual Inspection. The facility is licensed to provide treatment services for ambulatory children age 8 to 17 years old. The facility currently has 3 clients, All three client are Regional Center placements. No clients were present during the facility inspection. Clients were present after school. The facility is licensed for a maximum capacity of 5. Staff to client ratio is a minimum of 1:1 during waking hours and 1:3 during sleeping hours.. LPA conducted an inspection of the physical plant, and checked for all necessary requirements. The facility had no noticeable odor and maintained an acceptable room temperature. There are a total of four bedrooms available for clients, with each client having their own bedroom. LPA observed the client bedrooms, living rooms, kitchen, two bathrooms, the backyard, the garage, and the staff office to be clean and organized. LPA observed each client's bedroom to have a closet, a dresser, and a clean mattress. Sheets, blankets, and pillows were in good condition. Every bedroom was decorated with the client's personal items. LPA observed a locked staff office where files and medications are stored. Client files were stored electronically and paper file copies available for review. LPA observed the proper postings including: facility license, complaint hotline, menu, emergency disaster plan, and client personal rights. Smoke alarms and carbon monoxide were in working order, fire extinguishers were current, and a first aid kit was fully stocked. The facility has no outstanding fees. LPA observed 3 days of perishable food and 6 days of non-perishable food in the kitchen and in the additional refrigerator in the garage. All medications, disinfectants and cleaning solutions were inaccessible and locked. Continued on 809- C page LPA reviewed 3 client files. No clients were taking court ordered psychotropic medications. Clients were current on CHDP physical exams and dental exams. The client's Needs and Services Plan/Individual Program Plan, were complete and up to date. LPA reviewed 3 staff files. Staff files had completed criminal record clearances and all required initial and annual training. First Aid and CPR certifications were up to date for all staff. Administrators Certificate was valid and pending renewal. LPA requested expedited renewal as Administrator filed document with the state back in October of 2023. LPA interviewed 2 staff on site. LPA interviewed 1 clients on site and attempted to interview another client who refused. No citations were given on this date. A signed copy of this LIC-809 and LIC-809C report was provided to Cory Ranberg, Administrator. An exit interview was conducted.

met_with: Cory Ranberg- Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 05/15/2025, Licensing Program Analyst (LPA) Misty Valencia arrived unannounced at the facility and met with Cory Ranberg, Administrator. The purpose of the visit was to conduct a Required Annual Inspection of the facility. The last Annual inspection for the facility was on 05/01/2025. LPA utilized the CARE Tool to complete the Annual inspection. The facility is licensed to provide treatment services for ambulatory children ages 8-17 years. The facility currently has 3 clients, all Regional Center placements. 2 client(s) was/were present during the inspection. The facility is licensed for a maximum capacity of 5. Staff to client ratio is 2:3 during the day and 1/3 during night. LPA conducted an inspection of the physical plant, and checked for all necessary requirements. The facility had no noticeable odor and maintained an acceptable room temperature. There are a total of four bedrooms available for clients, with each client having their own bedroom. LPA observed the client bedrooms, living rooms, kitchen, two bathrooms for clients, the backyard, the garage, and the staff office to be clean and organized. LPA observed each client bedroom to have a closet, a dresser, and a clean mattress. Sheets, blankets, and pillows were in good condition. Every bedroom was decorated with the client's personal items. LPA observed a locked staff office where files and medications are stored. LPA observed the proper postings including: facility license, complaint hotline, menu, and emergency disaster plan. Smoke alarms were in working order, fire extinguishers were current, and a first aid kit was fully stocked. continued on 809-C The facility has no outstanding fees. LPA observed 2 days of perishable food and 7 days of non-perishable food in the kitchen and in the additional refrigerator in the garage. Disinfectants and cleaning solutions were inaccessible and stored in one of the kitchens closet. LPA reviewed 3 client files. None of the clients were taking court ordered psychotropic medications. Psychotropic medication logs are available for clients if/when prescribed on a separate Psychotropic Medication Administration Records. Clients were current on CHDP physical exams and dental exams. The client's Needs and Services Plan/Individual Program Plan, were complete and up to date. LPA reviewed 5 staff files. Staff files had completed criminal record clearances and all required initial and annual training. First Aid and CPR certifications were up to date for all staff. Administrators Certificate was valid. LPA interviewed 3 staff on site. LPA interviewed 0 clients. One client is non-verbal, one client had dental work done, and one client was at school and unavailable. No citations were given on this date. A signed copy of this LIC-809 and LIC-809C, report was provided to Cory Ranberg, Administrator. An exit interview was conducted.

met_with: Cory Ranberg, Administrator


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
Licensing Program Analyst (LPA) Lyta Vue arrived unannounced at the facility for the purpose of a Case Management Inspection regarding a record review. LPA met with Cory Ranberg, Administrator. During a record review, prior to the Annual Required Inspection on 5/01/24, LPA Kellie McKinley found no Serious Incident Reports (SIRs) had been received from the facility in recent months. LPA McKinley discussed with Cory Ranberg, Administrator that the Department has not received SIRs from the facility from July 2023 to May 2024. According to the Administrator, staff have been submitting SIRs to the Regional Center, but they did not know SIRs had to be submitted to the Department. LPA McKinley informed the Administrator that the facility must submit all SIRs to the Department timely. LPA McKinley provided the email for where reports need to be sent. The Administrator agreed and stated that reports would be sent going forward. On 5/28/24, LPA Vue received an email from the Administrator which included SIRs. Administrator indicated he had updated management of the proper procedures for reporting to the Department. The facility is being issued a citation for violating Title 22, Division 6, Chapter Section 80061(b): Reporting Requirements: (b) Upon the occurrence, during the operation of the facility, of any of the events specified in (1)... a report shall be made to the licensing agency within the agency's next working day during its normal business hours. In addition, a written report containing the information specified in (2)... shall be submitted to the licensing agency within seven days following the occurrence of such event. A signed copy of this LIC 809 report and LIC 809D were provided to the facility. An exit interview was conducted. Appeal rights were provided.

Deficiencies:
80061(b): (b) Upon the occurrence...of any of the events specified in (1)... a report shall be made to the licensing agency within the agency's next working day during its normal business hours. ....  (2)...within seven days following the occurrence of such event......1
2
3
4
5
6
7New hires, hired staff and managers will be train on regulations of reporting and requirements. Facility will provide proof of training of topic, signature and date.

visit_type: Case Management

title:
1
2
3
4
5
6
7Reporting Requirements


facility_name: LGTC - WILLOW GLEN

summary: Complaint Investigation - Unsubstantiated - 5 allegations

raw_content:
Investigation Findings:
13On 9/3/2024 at 8: AM, Licensing Program Analyst (LPA) Shikya Belfield conducted an unannounced inspection to the above facility. The purpose of this inspection is to inform the facility representative of the findings for the complaint investigation regarding the allegations above. Lead staff Calista Gonzales assisted with the inspection. Based on conducted confidential interviews, it was confirmed that in March 2023, an incident took place in the facility involving serious self-harm injuries and there was no medical attention provided to the client and the client was not taken to the hospital. Based on confidential interviews conducted and a review of the incident report log, it was confirmed that this serious incident was not reported to the department. The preponderance of the evidence has been met. Therefore, these allegations are Substantiated. Facility cited for violations of California Code of Regulations, Title 22, Division Six, Section 80061(b) Reporting Requirements and 80075(a) Health Related Services, as described on the following page LIC9099D. A civil penalty is being assessed. An exit interview was conducted a copy of this form along with Appeal rights was sent to administrator Kat Ramus and Lead staff Calista Gonzales SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Carolyn Flynn LICENSING EVALUATOR NAME: Shikya Belfield 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 26-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. First Street, Ste. FACILITY NAME: LGTC - WILLOW GLENFACILITY NUMBER: 435390043

Allegations:
- SubstantiatedEstimated Days of Completion:
- Estimated Days of Completion:
- UnsubstantiatedEstimated Days of Completion:
- Unsubstantiated Estimated Days of Completion:
- Unsubstantiated Estimated Days of Completion: 90

report_type: Complaint Investigation

met_with: Calista Gonzales

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On June 2, 2022, at 10:45am, Licensing Program Analyst (LPA) Monica Pavia conducted a pre-licensing inspection. LGTC - Willow Glen has submitted an application for a Group Home license, for a capacity of 6 ambulatory children, ages 12-17. This inspection was conducted with Eugene Tilman and Azhar Sultanova and included observation of the following: The facility is a one story home. The home includes three client bedrooms; one bedroom is single occupancy room; one large bedroom will have a capacity of three (applicant will request a waiver; one ADA compliant bathroom and one and a half additional client bathrooms; kitchen and living room; a therapy office; a private space to meet with clients; a staff office. The facility and grounds are in good repair, and free of obstructions; chemicals are stored and locked in the closet; locked and centrally stored medication room/cabinet observed; observed medication logs and discussed procedures for psychotropic medications; first aid kit complete; individual beds are in good repair; food storage space observed; emergency foods observed; nonperishable foods observed; perishable foods will be bought as soon as licensed and have a placement; dining room equipped with tables and chairs accommodating all clients; all smoke detectors were tested by a fire inspector and appear to be in proper working order; carbon monoxide detector observed; fire extinguishers are properly charged; appropriate forms are posted in view of facility clients; and, no firearms or weapons are allowed in the facility or on premises. All staff and client files are electronic and available to Community Care Licensing (CCL). LGTC - Willow Glen's Plan of Operation and Program Statement review will be completed by 6/3/22. LPA Pavia will notify applicant of licensure status, at that time.

visit_type: Prelicensing

met_with: Eugene Tilman


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA's) Shikya Belfield and Lisa Schlembach conducted an unannounced inspection on 11/4/2022 at 10:30 am and met with Azhar Sultanova , who assisted with the inspection. The facility is licensed for a capacity of 6 ambulatory children, ages 12 -17. There is currently one client residing in the facility. During this inspection, the entire facility was toured. The facility and grounds are in good repair, and free of obstructions. There is adequate indoor activity space and materials. Chemicals are stored in a locked cabinet. Locked cabinet where centrally stored medications are kept was observed. During a review of the medication log, LPA Belfield observed that the facility does not have a centrally stored medication destruction form in the medication binder however the client file has the necessary information required to describe the storage, dosage, discontinuance etc. of the prescribed medication. Adequate storage space observed. Individual beds are in good repair, clean mattresses and pillows observed. Bedrooms are accommodating of all required furnishings. Adequate food storage space observed. Supply of two days of perishable foods and 7 days of nonperishable foods observed upon inspection. Weekly menu is posted in the kitchen. Licensee shared an electronic copy of the activity schedule for clients. Facility has a dietary technician that buys and prepare all meals, and provide it to the facility. Fire extinguishers was observed as well as the facility license, client rights, and emergency disaster plan, that were posted. LPA Belfield reviewed one client file C1 (See LIC 811 dated 11/4/22) which was current and complete. Licensee Azhar will provide LPA with copies of staff files by then end of business today 11/4/2022. Due to technical issues with LPA's computer a review of the facility roster was not able to be obtained however, LPA will review this and go over any necessary information needed with Licensee. The department received a denial letter for S1 ( see LIC 811 dated 11/4/2022) and this was discussed with the Licensee and this individual does not work in or at the facility, but was the previous listed Licensee. This facility uses an electronic system for maintaining all files and records for staff and clients. LPA discussed with Licensee Azhar that the facility can use an electronic system and they must submit a plan on how the electronic system will be backed up in case the of technical issues or failures. LPA also informed the Licensee that the facility's versions of licensing forms can be used as long as it has all of the required information needed. There were no violations of the California Code of Regulations, Title 22, Division Six, cited during this inspection. An exit interview was conducted and a copy of this form will be sent to Licensee Azhar Sultanova.

met_with: Azhar Sultanova


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA's) Shikya Belfield conducted an unannounced inspection on 6/22/2023 at 11: AM and met with Brandy Spindel, who assisted with the inspection. The facility is licensed for a capacity of 6 ambulatory children, ages 12 -17. There are currently five clients residing in the facility and were present, along with five staff during this inspection. During this inspection a walk through was conducted staff Serenity Spindel with using the CARE TOOL. LPA observed the facility to be clean and free of obstructions. Fire extinguishers were observed to be in compliance, facility had license properly posted. At this time the inspection cannot be complete. There were no citations issued during this inspection. An exit interview was conducted and a copy of this report was left with Licensee Eugene Tillman and Administrator Brandy Spindel.

met_with: Brandy Spindel


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA's) Shikya Belfield conducted an unannounced inspection on 11/6/2023 at 10: AM and met with staff Fay and administrator Brandy Spindel, who assisted with the inspection. The facility is licensed for a capacity of 6 ambulatory children, ages 12 -17. There are currently five clients residing in the facility and were present, along with three staff during this inspection. During this inspection LPA interviewed five clients and three staff. Client and staff files were sent to this LPA by administrator. LPA reviewed client and staff files. There were not deficiencies cited during the annual inspection. An exit interview was conducted and a copy of this report will be sent to administrator Brandy Spindel.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced inspection on 6/24/2024 at 10: AM and met with Calista Gonzales, Lead Mileau Counselor, who assisted with the inspection. The facility is licensed for a capacity of 6 ambulatory children, ages 12 -17. There are currently five clients residing in the facility and were present, along with five staff during this inspection. During this inspection a walk through was not able to be conducted due to Ms. Gonzales advising this LPA that COVID was present with a staff who had been going in and out of the facility in the last few days. Ms. Gonzales was not certain if anyone else was positive at the time, but precautions were being taken. As such, this LPA conducted a staff interview, reviewed client and staff files, and completed a physical plant inspection of the exterior of the home. This LPA will return for a physical plant inspection, and additional interviews of staff and clients. There were no citations issued during this inspection. An exit interview was conducted at 1: PM, and a copy of this report was left with Ms. Gonzales.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced inspection on 9/9/2024 at 10: AM and met with Calista Gonzales, Lead Mileau Counselor, who assisted with the continued annual inspection. This LPA returned for a physical plant inspection, as well as to verify medication, and file reviews were conducted. It is noted this LPA was unable to open any client/staff interview questions forms. There were no citations issued during this inspection. An exit interview was conducted at 3: PM, and a copy of this report was provided to Ms. Gonzales.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced inspection on 6/16/2025, at 9: AM and met with Briana Green, Medical Staff, who assisted with the inspection. After the physical plant inspection, Calista Gonzales, Lead Mileau Counselor arrived, and assisted this LPA with the rest of the inspection. The facility is licensed for a capacity of 6 ambulatory children, ages 12 -17. There are currently five clients residing in the facility, who were present and in Cognitive Therapy session outside. The clients are currently on a summer schedule, and were in care with five staff during this inspection. As such, this LPA conducted two staff interviews, one client interview, reviewed client and staff files, and completed a physical plant inspection of the exterior of the home. The fire extinguisher was recently checked, and is valid until May 2026. There were no citations issued during this inspection. An exit interview was conducted at 3: PM, and a copy of this report was left with Ms. Gonzales.


summary: Facility Evaluation

raw_content:
Narrative:
On 8/7/2025 at 2: PM, Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced inspection to the above facility. The purpose of this inspection is to conduct a case management inspection regarding an incident the Department of Social Services received as in Incident Report. This LPA met with an Emergency Medical Technician, Kristen Kai, who informed there has been a COVID exposure in the last couple days, and that all staff and clients will be tested tomorrow. Additionally, Ms. Kai informed she is unaware of what occurred at the time of the incident, and that no one who is aware of it is in the facility at the time. Therefore, an exit interview was conducted at 3: PM, and a copy of this report was left with Ms. Kai.

met_with: Kristen Kai


summary: Facility Evaluation

raw_content:
Narrative:
On 9/8/2025 at 1: PM, Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced case management inspection to the above facility. This LPA met with Administrator, Kat Ramus, who assisted with the inspection. The purpose of the inspection was to obtain information regarding a serious incident received by the Department of Social Services via email. The department received an incident report regarding C1 who attempted to self-harm .The purpose of the inspection was to obtain information regarding the incident involving C1 (see LIC811 dated 9/8/25) choking herself with her own sweatshirt during the middle of the night. Upon gathering information, conducting confidential interviews, this LPA discovered were no violations, as the facility followed all protocols regarding this incident. The facility had conducted visual checks every 15 minutes on all clients, and did not observe anything out of the ordinary. Additionally, C1 had conducted the choking in the middle of the night while she was alone in her bedroom for a few minutes, during a time where all the other clients, including her roommate were asleep. Once C1 made staff aware of the choking, C1 was watched by a staff the rest of the night. The following morning, C1 was assessed, and then transported as a 51/50. An exit interview was conducted at 2: PM, and a copy of this report was provided to Ms. Ramus. It is noted the unannounced inspection was conducted at LGTC Willow Glen instead of the above facility where the incident had occurred, due to the correct facility being temporarily closed.

met_with: Kat Ramus


summary: Facility Evaluation

raw_content:
Narrative:
On 9/8/2025 at 2: PM, Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced case management inspection to the above facility. This LPA met with Administrator, Kat Ramus, who assisted with the inspection. The purpose of the inspection was to obtain information regarding a serious incident received by the Department of Social Services via email. The department received an incident report regarding C1 and C2 (see LIC811 dated 9/8/25) engaging in inappropriate touching while in their bedroom when it was time to go to sleep. Upon gathering information, conducting confidential interviews, it was confirmed that C1 and C2 were engaged in inappropriate touching between clients, as they pretended to sleep as staff conducted nightly routine checks every fifteen minutes. Due to Staff following all protocols, and their Program Statement, regarding visual night checks every fifteen minutes, this LPA did not observe any Title 22 deficiencies and/or any violations that had occurred due to negligence on the facility staff. An exit interview was conducted at 3: PM, and a copy of this report was provided to Ms. Ramus.


summary: Facility Evaluation

raw_content:
Narrative:
On 9/8/2025, at 12: PM, Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced Case Management inspection to the above facility. This LPA met with Administrator, Kat Ramus, who assisted with the inspection. The purpose of this inspection was to conduct an inspection regarding a serious incident that was reported to the Department of Social Services via email. Based on confidential interviews conducted, it was confirmed that C1 (see LIC811 dated 9/8/25) had been left unattended by S1 in the Medical room. C1 was able to take medication without any staff being aware, as the medication and minor had both been left unattended. The facility is being cited for violation of California Code of Regulations, Title 22, Division Six, Section 80078(a) Responsibility for Providing Care and Supervision. An exit interview was conducted at 1: PM, and a copy of this report, along with Appeal Rights, was left with Ms. Ramus


summary: Facility Evaluation

raw_content:
Narrative:
On 9/8/2025, at 11: AM, Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced inspection to the above facility. The purpose of this inspection was to conduct a case management inspection regarding an incident the Department of Social Services received as in Incident Report. This LPA met with Administrator, Kat Ramus, who assisted with the inspection. Based on confidential interviews conducted, it was confirmed that C1 (see LIC 811 dated 9/8/25) overdosed on medication she had taken earlier in the day while unattended in the medical room. After confiscating the medication while unattended, C1 later ingested the medication when she was alone in her bedroom. Ultimately, C1 overdosed, and an ambulance was called for assistance for the medical emergency. The facility is being cited for violation of California Code of Regulations, Title 22, Division Six, Section 80078(a) Responsibility for Providing Care and Supervision. An exit interview was conducted at 12: PM, and a copy of this report, along with Appeal Rights, was left with Ms. Ramus.


summary: Facility Evaluation

raw_content:
Narrative:
On 9/3/2024 at 8: AM, Licensing Program Analyst (LPA) Shikya Belfield conducted an unannounced inspection to the above facility. The purpose of this inspection is to conduct a case management inspection regarding uncleared individuals in the facility who were not criminally record cleared. Based on confidential interviews conducted, it was confirmed that S1 (see LIC811 dated 9/3/2024) was present and working with clients in the facility when they did not have criminal record clearance. Facility is cited for violation of California Code of Regulations, Title 22, Division Six, Section 80019(e)(2) Criminal Record Clearance. A civil penalty is being assessed. An exit interview was conducted a copy of this report along with appeal rights, was left with Kat Ramus.


summary: Facility Evaluation

raw_content:
Narrative:
A meeting was held on March 24, 2026, at 11: AM regarding the above facility. Present in the meeting: Joel Segura, Licensing Program Manager, (LPM), Vaishali Singh-Sood, Licensing Program Analyst (LPA), Azhar Sultanova, ED Clinical Director, from LGTC, and Katherine Remus, ED RTC Program Director, from LGTC. The following was discussed: The purpose of this meeting was to discuss concerns about a serious incident involving a client in care who had taken medication from the Med Room on July 22, 2025, while staff had left the client unattended. After taking the medication, the client later ingested the medication when she was alone in her bedroom. Ultimately, the client took an unknown amount of medication, and the ambulance was called for assistance for the medical emergency. Shortly after going to the hospital, the client was checked by medical staff who cleared her. The facility was cited for a type A violation of California Code of Regulations, Title 22, Division Six, Section 80078(a); Responsibility for Providing Care and Supervision. Ms. Remus stated that staff were re-trained, and updated the training in response to the incident. The staff on duty on time was immediately suspended, and ultimately resigned. An exit interview was conducted at 12: PM, and a copy of this report was provided to Ms. Remus.

met_with: Katherine Remus


facility_name: LGTC CAMBRIAN

summary: Complaint Investigation - Substantiated - 3 allegations

raw_content:
Investigation Findings:
13On 9/3/2024 at 9: AM, Licensing Program Analyst (LPA) Shikya Belfield conducted an unannounced inspection to the above facility. The purpose of this inspection is to inform the facility representative of the findings for the complaint investigation regarding the allegations above. LPA met with Administrator Kat Ramus who assisted with the inspection. Based on confidential interviews conducted and supportive documentation to include but not limit, copies of client files. It was confirmed that clients in care are not treated with dignity or respect by the way they are spoken to by staff. The preponderance of the evidence has been met. Therefore, this allegation is Substantiated. Facility cited for violation of California Code of Regulations, Title 22, Division Six, Section 80072(a)(1) Personal Rights, as described on the following page LIC9099D. An exit interview was conducted a copy of this report along with appeal rights, was sent to administrator Kat Ramus. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Carolyn Flynn LICENSING EVALUATOR NAME: Shikya Belfield 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 26-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. First Street, Ste. FACILITY NAME: LGTC CAMBRIANFACILITY NUMBER: 435390057

Allegations:
- SubstantiatedEstimated Days of Completion:
- Estimated Days of Completion:
- Estimated Days of Completion: 90

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Investigation Findings:
13On 9/3/2024 at 9: AM, Licensing Program Analyst (LPA) Shikya Belfield conducted an unannounced inspection to the above facility. The purpose of this inspection is to inform the facility representative of the findings for the complaint investigation regarding the allegations above. Kat Ramus who assisted with the inspection. Based on confidential interviews conducted and supportive documentation to include but not limit copies of client files, It was confirmed that C1 ( see LIC 811 dated 9/3/2024) was discharged from the facility and the appropriate protocols were not followed according to regulations. The preponderance of the evidence has been met. Facility cited for violation of California Code of Regulations, Title 22, Division Six, Section 84068.4(b) Removal and/or Discharge Procedures as described on the following page LIC9099D. An exit interview was conducted a copy of this report along with appeal rights, was sent to Administrator Kat Ramus. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Carolyn Flynn LICENSING EVALUATOR NAME: Shikya Belfield 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 26-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. First Street, Ste. FACILITY NAME: LGTC CAMBRIANFACILITY NUMBER: 435390057

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


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Investigation Findings:
13On 10/24/24 at 9: AM, Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced inspection to the above facility. The purpose of the inspection was to inform the facility representative of the findings for the above listed allegation. LPA Singh-Sood met with Calista Gonzales, Lead Staff, who assisted with the inspection. During the investigation of the aforementioned allegations, the Reporting Party failed to return the call to this LPA. It is noted confidential interviews were conducted, as well as a review of supportive documentation. However, this LPA could not determine if there had been a violation of any regulation. It was further noted that the interviews that were conducted had nothing but positive experiences regarding the facility. Although the allegation above may have happened, there is not enough of the evidence to support that they are true. Therefore, this allegation is Unsubstantiated. At 11: AM, an exit interview was conducted, and copy of this report was provided to Ms. Gonzales. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Vaishali Singh-Sood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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


investigation_findings: 13On 10/24/24 at 9: AM, Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced inspection to the above facility. The purpose of the inspection was to inform the facility representative of the findings for the above listed allegation. LPA Singh-Sood met with Calista Gonzales, Lead Staff, who assisted with the inspection. During the investigation of the aforementioned allegations, the Reporting Party failed to return the call to this LPA. It is noted confidential interviews were conducted, as well as a review of supportive documentation. However, this LPA could not determine if there had been a violation of any regulation. It was further noted that the interviews that were conducted had nothing but positive experiences regarding the facility. Although the allegation above may have happened, there is not enough of the evidence to support that they are true. Therefore, this allegation is Unsubstantiated. At 11: AM, an exit interview was conducted, and copy of this report was provided to Ms. Gonzales. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Vaishali Singh-Sood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

allegations: UnsubstantiatedEstimated Days of Completion: Unsubstantiated Estimated Days of Completion: Unsubstantiated Estimated Days of Completion:


raw_content:
Investigation Findings:
13On 4/25/25 at 9: AM, Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced inspection to the above facility. The purpose of the inspection was to inform the facility representative of the findings for the above listed allegation. LPA Singh-Sood met with Calista Gonzales, House Supervisor, who assisted with the inspection. During the investigation of the aforementioned allegations, the alleged victim in thisincident refused to return the call to this LPA. It is noted confidential interviews were conducted, as well as a review of supportive documentation. However, this LPA could not determine if there had been a violation of any regulation. It was further noted that the interviews that were conducted had nothing but positive experiences regarding the facility. Although the allegation above may have happened, there is not enough of the evidence to support that they are true. Therefore, this allegation is Unsubstantiated. At 11: AM, an exit interview was conducted, and copy of this report was provided to Ms. Gonzales. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Joel Segura LICENSING EVALUATOR NAME: Vaishali Singh-Sood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA's) Shikya Belfield conducted an announced pre-Licensing inspection on 12/26/2023 at 11: AM and met with Licensee Eugene Tillman and administrator Brandy Spindel who assisted with the inspection. The facility is licensed for a capacity of 6 ambulatory children, ages 12 -17. There are currently no clients residing in the facility and were present, along with three staff during this inspection. The facility is a one story home. The home includes two client bedrooms; one bedroom is double occupancy room; one large bedroom will have a capacity of four (applicant will request a waiver; one ADA compliant bathroom and one and a half additional client bathrooms; kitchen and living room; a therapy office; a private space to meet with clients; a staff office. The facility and grounds are in good repair, and free of obstructions; chemicals are stored and locked in the garage; locked and centrally stored medication room/cabinet observed; medication logs and discussed procedures for psychotropic medications; first aid kit complete; individual beds are in good repair; food storage space observed; emergency foods observed; nonperishable foods and perishable foods will be bought as soon as licensed and have a placement; dining room equipped with tables and chairs accommodating all clients; all smoke detectors were tested by a fire inspector and appear to be in proper working order; carbon monoxide detector observed; fire extinguishers are properly charged; observed were the appropriate forms posted in view for facility clients; and, no firearms or weapons are allowed in the facility or on premises. All staff and client files are electronic and available to Community Care Licensing (CCL). LGTC - Cambrian Plan of Operation and Program Statement review will be completed by 12/29/23. LPA Belfield will notify applicant of license status, at that time. At this time the inspection is concluded and there were no deficiencies cited. A copy of this report will be sent to Licensee Eugene Tillman and administrator Brandy Spindel.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an announced pre-Licensing inspection on 9/11/2024 at 1: PM and met with Licesned Program Administrator, Clarissa Joseph, who assisted with the inspection. The facility is licensed for a capacity of 6 ambulatory children, ages 12 -17. There were three clients present, along with three staff during this inspection. The facility is a one story home. The home includes two client bedrooms; one bedroom is double occupancy room; one large bedroom will have a capacity of four (applicant will request a waiver; one ADA compliant bathroom and one and a half additional client bathrooms; kitchen and living room; a therapy office; a private space to meet with clients; a staff office. The facility and grounds are in good repair, and free of obstructions; chemicals are stored and locked in the garage; locked and centrally stored medication room/cabinet observed; medication logs and discussed procedures for psychotropic medications; first aid kit complete; individual beds are in good repair; food storage space observed; emergency foods observed; nonperishable foods and perishable foods will be bought as soon as licensed and have a placement; dining room equipped with tables and chairs accommodating all clients; all smoke detectors were tested by a fire inspector and appear to be in proper working order; carbon monoxide detector observed; fire extinguishers are properly charged; observed were the appropriate forms posted in view for facility clients; and, no firearms or weapons are allowed in the facility or on premises. All staff and client files are electronic and available to Community Care Licensing (CCL). At 4: PM, the inspection was concluded, and there were no deficiencies cited. A copy of this report was provided to Licensee Eugene Tillman.

met_with: Clarissa Joseph


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an announced pre-Licensing inspection on 12/19/2024 at 10: AM and met with Rey Nardsalinas, Licensed Vocational Nurse, who assisted with the inspection. The facility is licensed for a capacity of 6 ambulatory children, ages 12 -17. There were three clients present, along with three staff during this inspection. The facility is a one story home. The home includes three client bedrooms; all bedrooms are double occupancy rooms; and three total bathrooms. There is a kitchen and living room; a therapy office (ADU); which is the private space to meet with clients; and a staff office (ADU or garage). The facility and grounds are in good repair, and free of obstructions; chemicals are stored and locked in the garage; locked and centrally stored medication room/cabinet observed; medication logs and discussed procedures for psychotropic medications; first aid kit complete; individual beds are in good repair; food storage space observed; emergency foods observed; nonperishable foods and perishable foods will be bought as soon as licensed and have a placement; dining room equipped with tables and chairs accommodating all clients; all smoke detectors were tested by a fire inspector and appear to be in proper working order; carbon monoxide detector observed; fire extinguishers are properly charged; observed were the appropriate forms posted in view for facility clients; and, no firearms or weapons are allowed in the facility or on premises. All staff and client files are electronic and available to Community Care Licensing (CCL). At 3: PM, the inspection was concluded, and there were no deficiencies cited. Due to this LPA being unable to gain access to medical records, P&I, and other pertinent documentation, a follow-up inspection will be conducted. A copy of this report was provided to Licensee Eugene Tillman.

met_with: Rey Nardsalinas


summary: Facility Evaluation

raw_content:
Narrative:
On today's date, this Licensing Program Analyst (LPA) Singh-Sood returned to the facility at 10: AM, and met with Administrator, Kat Ramus, who assisted with the inspection. LPA was able to review medical records, client and staff files. There were no citations issued during this inspection. An exit interview was conducted at 2: PM, and a copy of this report was provided to with Ms. Remus.


summary: Facility Evaluation

raw_content:
Narrative:
On 03/18/25 at 09: AM, Licensing Program Analysts (LPA) Vaishali Singh-Sood and (LPA) Omar Sawyer conducted an unannounced inspection to the above facility.The purpose of this inspection is to conduct a case management inspection regarding adding beds to a room to increase capacity to for the room. Upon arrival LPA's met with House Manager, Kalista Gonzales, who assisted with the inspection. Ms. Gonzales also provided LPA's with information needed to determine required for the requested exception/waiver. During the physical plant inspection LPA's were able to determine adequate spacing for the room with 4 beds. LPA, Vaishali Singh-Sood was able to take pictures and a video of the room and there should not be an issue with having 4 beds occupying the room. It is noted that the beds that are currently "Twin XL" size and the Licensee would like to decrease the size to just a "Twin" size. It is recommended that the size of "Twin XL" should remain in the room. During this inspection there were not any deficiencies cited. Additionally, an exit interview was conducted with Ms. Gonzales at 10: AM, including a copy of this report.

met_with: Kalista Gonzales


summary: Facility Evaluation

raw_content:
Narrative:
On 9/3/2024 at 9: AM, Licensing Program Analyst (LPA) Shikya Belfield conducted an unannounced inspection to the above facility. The purpose of this inspection is to conduct a case management inspection regarding information received by the department. The department received information regarding incidents taking place at the facility that have not been reported to the department. LPA met with Administrator Kat Ramus who assisted with the inspection. Based on confidential interviews conducted and supportive documentation to include but not limit copies of clients, staff files, and staff schedules, it was confirmed that seven staff worked at the facility ( see LIC811 dated 9/3/2024) without having criminal record clearance. Facility cited for violation of the California Code of Regulations, Title 22, Division, Six, Section 80019(e)(2) Criminal Record Clearance as described on the following page LIC809D. A civil Penalty is being assessed. During this inspection LPA requested the following documents: Needs and service plans for all current clients, staff training records from January 1, 2024 to 9/3/2024, staff schedules, Staff files, and copies of client files, At this time, more information is needed to conclude this case management. An exit interview was conducted and a copy of this report along with appeal rights will be sent to administrator Kat Ramus.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced Annual inspection on January 29, 2026, at 10: AM, and met with Calista Gonzales, House Supervisor, who assisted with the inspection. The facility is licensed for a capacity of 6 ambulatory children, ages 12 -17. There were two clients present, along with four staff during this inspection. The facility is a one story home. The home includes three client bedrooms; all bedrooms are double occupancy rooms; and three total bathrooms. There is a kitchen and living room; a therapy office (ADU); which is the private space to meet with clients; staff office (ADU or garage), medical room, and a storage supply room. The facility and grounds are in good repair, and free of obstruction; chemicals are stored and locked in the storage closet; locked and centrally stored in the medication room; medication logs are on an online system; first aid kit complete; individual beds are in good repair; nonperishable foods and perishable foods were an adequate supply, dining room equipped with tables and chairs accommodating all clients; all fire/cabon monoxide detectors are in working order. The fire extinguisher was inspected last year, and was properly charged. The appropriate forms were posted in view for facility clients; and, no firearms or swimming pools are on the facility premises. All staff, client, and medicalt files are electronic and available to Community Care Licensing (CCL). At 3: PM, an exit interview was conducted. There were no deficiencies cited, and a copy of this report was provided to Ms. Gonzalez.


facility_name: LIGHTFULLY - DRAGONFISH

summary: Facility Evaluation

raw_content:
Narrative:
On July 11, 2023, at 10:30AM, Licensing Program Analyst (LPA) Carol Anderson conducted an announced pre-licensing inspection. LPA met with Taylor Stead, VP of Operations for San Diego, Caitlyn Bottom, Group Home Administrator, Jacob Kagel, Program Manager/Facility Manager and Alyssa Retuya Compliance Coordinator. The facility is four bedrooms, three and half bathroom's single-family home, with attached garage. The applicant is applying for a group home with the capacity of six ambulatory clients' ages 12-17 years old. LPA inspected the interior and exterior of the facility. Living room, dining room, kitchen area, laundry room, staff offices, group therapy rooms, and art therapy classroom. Staff offices are located throughout the facility. Medications and first aid kit with first aid manual will be locked in the medication room in locked cabinets in the nursing office. Disinfectants and cleaning solutions will be locked in hall closet in the laundry room. Sharp knives will be locked in the hall closet in living room hallway. Hot water temperature was reading in the bathroom sink 115 degrees F. Bedroom set up upstairs as follows: Bedroom 1: designated for two clients, two full beds, two night stands, closet space and two dress drawer for each client, with shared bathroom inside bedroom #1. Bedroom 2: designated for two clients, two full beds, two night stands, closet space and two dress drawers for each client, with shared bathroom inside bedroom #2. Bedroom 3: designated for one client, one full bed, two night stand, closet space and one eight cubic feet dress drawers, with bathroom inside bedroom #3. Bedroom 4: designated for one client, one full bed, two night stand, closet space and one eight cubic feet dress drawer, with bathroom inside bedroom #4. Staff office is located upstairs. Fire clearance was approved. Smoke detectors are operating and fire extinguishers are properly charged and serviced. Clients will be allowed to make and receive confidential telephone calls. The staff and client files will be electronically stored on computer database and will be accessible for Community Care Licensing (CCL) to review at any time. Personal Rights, Emergency Disaster Plan and Facility Sketch. Per Taylor Stead, VP of Operations for San Diego, there are no weapons in the facility. Also, per Taylor Stead cameras will be installed at another date and time. The Backyard is set up as follows: Facility has a pool covered with Katchakid Pool Safety Net; there is no fence surrounding the pool. LPA will verify if a fence needs to surround the pool area. The backyard is fully fenced. Also, patio furniture. Large grassy area. The applicant has been informed that the address to this facility is available to the public. All Incident Reports (IRs) will be sent via e-mail to: cclpaccr@dss.ca.gov. The reporting requirements were reviewed with the applicant on this date. Upon managers final review, the license will be provided. An exit interview was conducted, a copy of this report was discussed left with Taylor Stead, VP of Operations for San Diego

met_with: Taylor Stead


facility_name: LIGHTFULLY - FIREFLY

summary: Facility Evaluation

raw_content:
Narrative:
On June 11, 2024, 11:00AM, Licensing Program Analyst (LPA) Carol Anderson conducted an announced pre-licensing inspection for a change in relocation from Vista Lago Terrace,Escondido, CA, 92029 to Santa Fe Drive, Encinitas, CA 92024, to the above facility. LPA met with Taylor Stead, LMFT, Director of Clinical Quality, Emily Walkey, V.P. Regional Operation, Caitlyn Bottom, Group Home Facility Administrator and Yvette Gough, Associate Clinical Director. There are no clients currently resides at the facility. The facility is a two story house with seven bedrooms, six bathrooms, and two car garage. The facility is set up as follows: First Floor: Front door entry, living room, dining room, kitchen area, pantry, one bathroom, therapy room, staff's office. Second Floor: The bedrooms are set up as follows: Bedroom 1: designated for one client, one full bed, one dresser drawer, night stand, closet space, night lamp and bathroom. Bedroom 2: designated for two clients, two full beds, two dresser drawers, two night stands, closet space, two night lamps. Bedroom 3: designated for one client, one full bed, one dresser drawer, one night stand, closet space, one night lamp. Bedroom 4: designated for two clients, two full beds, two dresser drawers, two night stands, closet space, two night lamps and bathroom. Laundry room area is located upstairs, one bathroom located in the hallway, staff's workstation is in the hallway and nursing station. Each room has adequate clean linens, pillows, blankets, comforters, mattress pads, and mattresses. The hot water in was measured to be 109 degrees Fahrenheit. The following required forms were posted in the facility: Personal Rights form, and California "See Something Say Something Poster". Clients and staff files will be stored in the electronic database will always be available to Community Care Licensing as requested. Backyard: Group room, fire pit and adequate patio furnishing. The fire clearance has been approved. The applicant has been informed that the address to this facility is available to the public. All special incident reports (SIR's) will be sent via e-mail to: cclpaccr@dss.ca.gov. The reporting requirements were reviewed with the applicant on this date. The applicant was provided with an updated Facility Personnel Report Summary at the time of this visit and understands that once the license is approved, all employees and volunteers shall have an approved criminal record clearance for Community Care Licensing and be associated to this facility. The fire clearance has been approved. Based on the facility pre-licensing inspection and facility records' review, no deficiencies were noted at time of the inspection. An exit interview was conducted, and a copy of this report was left with Taylor Stead, LMFT Director of Clinical Quality.

met_with: Taylor Snead, LMFT


raw_content:
Narrative:
Regarding the allegation that staff did not adequately supervise minor(s) resulting in minor inappropriately touching other minor(s) while in care, confidential interviews revealed that C1 and C2 were challenging C3 in a playful game. Confidential interviews revealed C3 physically picked up C1 without C1's consent and C1 was touched inappropriately. However, conflicting confidential interviews revealed that C1 and C2 made up the story that C3 touched C1 and C2 inappropriately. Regarding the allegation that staff did not report incidents regarding minor in care, as necessary, confidential interviews revealed that staff wrote up incidents involving C1 and reported the incidents to C1's authorized representative. However, conflicting confidential interviews revealed that C1's authorized representative did not receive reports of incidents that occurred while C1 was placed at the facility. Regarding the allegation that staff did not adequately supervise minor in care resulting in minor watching inappropriate content while in care, confidential interviews revealed that C1 turned to television channel that had vulgar language and explicit images. However, confidential interviews revealed that staff immediately turned the television to a channel that was suitable for general viewing with appropriate content. Regarding the allegation that staff did not adequately supervise minor in care resulting in minor communicating with unauthorized adult(s) while in care, confidential interviews revealed that C1 contacted their biological mother although C1 is forbidding was forbidden to have any contact with biological mother. However, confidential interviews revealed that staff was not provided an unapproved or approved contact telephone list for C1, so staff was not aware that C1 was not allowed to contact their biological mother. Based on interviews and documentation reviewed, the allegations that staff did not adequately supervise C1 and C2 resulting in C1 and C2 being inappropriately touched by C3 while in care, staff did not report incidents regarding C1 in care, as necessary; staff did not adequately supervise C1 in care resulting in C1 watching inappropriate television shows, and staff did not adequately supervise C1 in care resulting in C1 communicating with biological mother despite there being a no contact order in place forbidding C1 communicating with biological mother, may have occurred, however, the allegations are not supported or proven by the evidence gathered; therefore, the allegations are determined to be unsubstantiated. The allegations may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted and a copy of this report and appeal rights were provided to Caitlyn Sarwan, Clinical Director.

Investigation Findings:
13On November 1, 2024, at 12:00PM, Licensing Program Analyst (LPA) Carol Anderson arrived at Lightfully Firefly at Santa Fe Drive, Encinitas, California,92024, to deliver the findings of the above allegations. Lightfully- Firefly #374690057 located at Vista Lago Terrace, Escondido, CA 92029, the facility closed on 6/13/24 due to change relocation. LPA met with Caitlyn Sarwan, Clinical Director. LPA initiated a complaint inspection at the facility on 1/09/2024 at 12:00PM, and no immediate deficiencies were observed. During the investigation, interviews were completed with witnesses and staff. LPA attempted to interview Client 1 (C1), Client 2 (C2), Client 3 (C3). LPA was unsuccessful at attempts to interview clients. In addition, LPA reviewed C1 and C2's files and other pertinent documents. LPA reviewed law enforcement police report as well as incident report. On January 8, 2024, Community Care Licensing (CCL) received a complaint alleging staff did not adequately supervise minor(s) resulting in minor inappropriately touching other minor(s) while in care, staff did not report incidents regarding minor in care as necessary, staff did not adequately supervise minor in care resulting in minor watching inappropriate content while in care, staff did not adequately supervise minor in care resulting in minor communicating with unauthorized adult(s) while in cares revealed that C1 and C2 made up the story that C3 touched C1 and C2 inappropriately. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: Carol Anderson 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 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # FACILITY NAME: LIGHTFULLY - FIREFLYFACILITY NUMBER: VISIT DATE: 11/01/2024

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

met_with: Caitlyn Sarwan,Clinical Director


raw_content:
Narrative:
behaviors; it was reported that while C1 was in care at the facility, C1 was sexually assaulted (no details provided) by C2 on more than one occasion. It was further reported that these incidents would never have occurred if C1 and C2 had been properly supervised. Confidential interviews reported that on one occasion, C2 "digitally penetrated" C1, but that C2 stopped when C1 asked C2 to stop. Confidential interviews reported that on another occasion, C2 snuck into C1's room and engaged in kissing and touching behaviors with C1. Confidential interviews reported that S1 was in charge of supervising C1 and C2 on at least one of these occasions. Reviews of pertinent documents revealed that S1 admitted to being deficient in terms of properly supervising C1 and C2 on one of these occasions which directly resulted in one or more of these incidents occurring. An additional document review revealed that the facility terminated S1's employment after S1's admitted to the incident. Based on confidential interviews and a review of pertinent documentation, the preponderance of evidence standard has been met, and the allegation that staff did not prevent C1 and C2 from engaging in inappropriate behaviors is substantiated. The facility is being cited for violation of Title 22, Division 6, Chapter 1, Article 06. Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the client's needs (see LIC 9099D) An exit interview was conducted. A copy of this report (LIC 9099), deficiencies page (LIC 9099D) and appeal rights were explained and given to Director Caitlyn Sarwan.

Investigation Findings:
13On 07/30/2025, at 10: AM, Licensing Program Analyst (LPA) Joon Choi conducted a visit to Lightfully Behavioral Services located at Paseo Del Norte, Suite 250, Carlsbad, CA 92011, and met with the Director of Clinical Operations Caitlyn Sarwan to deliver the investigative findings for the allegation listed above. The facility listed on the LIC 802 complaint has been closed since 06/13/2024. On 08/13/2024, Community Care Licensing received an allegation that staff did not prevent minors from engaging in inappropriate behaviors. On 08/19/2024, LPA Carol Anderson visited Santa Fe Drive, Encinitas, CA, 92024 to initiate a complaint investigation on Lightfully- Firefly Group Home #374690057. During the investigation, LPA Anderson obtained documents pertinent to the investigation. In addition, LPA Choi reviewed those pertinent documents and interviewed Client 1 (C1). Client 2 (C2) declined LPA Choi's request for an interview. In regard to the allegation that staff (S1) did not prevent minors (C1, C2) from engaging in inappropriate CONTINUED ON THE NEXT PAGE SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Joon R Choi LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # FACILITY NAME: LIGHTFULLY - FIREFLYFACILITY NUMBER: VISIT DATE: 07/30/2025

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

met_with: Caitlyn Sarwan, Director


summary: Facility Evaluation

raw_content:
Narrative:
On July 11, 2023, 11:45AM, Licensing Program Analyst (LPA) Carol Anderson conducted a pre-licensing inspection for a change in relocation from Santa Fe Drive, Encinitas, CA 92024, to the above facility. LPA met with Taylor Stead, VP of Operations for San Diego, Caitlyn Bottom, Group Home Administrator, Ashley Hopkins, Program Manager/Facility Manager and Karissa Matthews, Clinical Director and Alyssa Retuya Compliance Coordinator. There are no clients currently resides at the facility. The facility is five bedrooms, three and half bathroom's single-family home, with attached garage. The applicant is applying for a group home with the capacity of six ambulatory clients' ages 12-17 years old. LPA inspected the interior and exterior of the facility. Living room, dining room, kitchen area, laundry room, group therapy rooms, classroom, staff lounge area. Staff offices are located throughout the facility. Medications and first aid kit with first aid manual will be locked in the medication room in locked cabinets in the nursing office. Disinfectants and cleaning solutions will be locked in cabinet in the laundry room. Hot water temperature was reading in the bathroom sink 105 degrees F. Bedroom set up upstairs as follows: Bedroom 1: designated for two clients, two full beds, two night stands, closet space and two dress drawers for each client, shared bathroom inside bedroom #1. Bedroom 2: designated for two clients, two full beds, two night stands, closet space and two dress drawers for each client. Bedroom 3: designated for two clients, two full beds, two night stands, closet space and two dress drawers, with shared bathroom inside bedroom #3. Staff office is located upstairs. Fire clearance was approved. Smoke detectors are operating, and fire extinguishers are properly charged and serviced. Clients will be allowed to make and receive confidential telephone calls. The staff and client files will be electronically stored on computer database and will be accessible for Community Care Licensing (CCL) to review at any time. Personal Rights, Emergency Disaster Plan and Facility Sketch. Per Taylor Stead, VP of Operations for San Diego, there are no weapons in the facility. Also, per Taylor Stead cameras will be installed at another date and time. The Backyard is set up as follows: Facility has a pool covered with Katchakid Pool Safety Net; there is no fence surrounding the pool. LPA will verify if a fence needs to surround the pool area. The backyard is fully fenced. Also, patio furniture. Large grassy area. The applicant has been informed that the address to this facility is available to the public. All Incident Reports (IRs) will be sent via e-mail to: cclpaccr@dss.ca.gov. The reporting requirements were reviewed with the applicant on this date. Upon managers final review, the license will be provided. An exit interview was conducted, a copy of this report was discussed left with Taylor Stead, VP of Operations for San Diego


summary: Facility Evaluation

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Narrative:
On August 12,2022 at 10:00AM, Licensing Program Analyst (LPA) Carol Anderson conducted a pre-licensing visit. This applicant is applying for a group home with the capacity of 6 ambulatory clients for adolescent children ages 12-17 years old. The applicant will be receiving private pay clients only. LPA met with Taylor Stead, Vice President of Operations, San Diego, Stephanie Thompson, Facility Administrator/Director of Clinical Operations The facility is a two story house with seven bedrooms, six bathrooms, and two car garage. The facility is set up as follows: First Floor: Front door entry, living room, dining room, kitchen area, pantry, one bathroom, therapy room, staff's office. Second Floor: The bedrooms are set up as follows: Bedroom 1: designated for one client, one full bed, one dresser drawer, night stand, closet space, night lamp and bathroom. Bedroom 2: designated for two clients, two full beds, two dresser drawers, two night stands, closet space, two night lamps. Bedroom 3: designated for one client, one full bed, one dresser drawer, one night stand, closet space, one night lamp. Bedroom 4: designated for two clients, two full beds, two dresser drawers, two night stands, closet space, two night lamps and bathroom. Laundry room area is located upstairs, one bathroom located in the hallway, staff's workstation is located in the hallway and nursing station. Each room has adequate clean linens, pillows, blankets, comforters, mattress pads, and mattresses. The hot water in was measured to be 111 degrees Fahrenheit. Balcony area: There will be a home school on site, Arts and Crafts room with bathroom. The facility smoke detectors and carbon monoxide detectors were tested and were observed to be in working order; fire extinguisher is properly charged and serviced. The facility has a fully equipped first aid kit and first aid manual. The facility does not have cameras. The applicants stated there were no weapons in the home. Cleansers/chemicals will be stored locked in staff's office. Sharp knives will be inaccessible and stored in a locked cabinet in the kitchen cabinet. The following required forms were posted in the facility: Personal Rights form, and California "See Something Say Something Poster". Clients and staff files will be stored in the electronic database will always be available to Community Care Licensing as requested. Backyard: Group room, fire pit and adequate patio furnishing. The fire clearance has been approved. The applicant has been informed that the address to this facility is available to the public. All special incident reports (SIR's) will be sent via e-mail to: cclpaccr@dss.ca.gov. The reporting requirements were reviewed with the applicant on this date. The applicant was provided with an updated Facility Personnel Report Summary at the time of this visit and understands that once the license is approved, all employees and volunteers shall have an approved criminal record clearance for Community Care Licensing and be associated to this facility. All documents have been received according to Title 22 regulations. Based on the facility pre-licensing inspection, the facility is ready for license. Exit Interview was conducted, and a copy of this report was given to Taylor Stead, Vice President of Operations


facility_name: LIGHTFULLY - SHIMMER

summary: Facility Evaluation

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Narrative:
On July 24, 2023, at 8:30am, Licensing Program Analyst (LPA) Monica Pavia conducted a pre-licensing inspection. Lightfully - Shimmer has submitted an application for a Group Home license, for a capacity of 6 ambulatory children, ages 12-17. This inspection was conducted with Clodagh Rafferty and included observation of the following: The main living facility is a two story home. The first floor includes one (1) restroom, nurse's office, group therapy room, living room, dining room, storage closet and kitchen. The second floor includes four (4) client bedrooms, three (3) restrooms, staff office and storage closets. The backyard includes three (3) detached garages being utilized for staff office with kitchen, therapy room and art/school room. There is a 500 gallon well in the backyard that provides drinking water for the facility. The facility and grounds are in good repair, and free of obstructions; chemicals are stored and locked in the closet; locked and centrally stored medication room/cabinets observed; observed medication logs and discussed procedures for psychotropic medications; first aid kit complete; individual beds are in good repair; food storage space observed; emergency foods observed; perishable foods and nonperishable foods will be bought as soon as licensed and clients are placed; private chef to start and post menu once facility receives clients; sharps will be locked in kitchen cabinet; dining room equipped with tables and chairs accommodating all clients; all smoke/carbon monoxide detectors were tested and appear to be in proper working order; fire extinguishers are throughout the house and are properly charged; there is no pool on the premises; and, no firearms or weapons are allowed in the facility or on premises. All client and staff files are electronic and available to Community Care Licensing (CCL). The following items will be addressed and pictures emailed to LPA Pavia: - front water fountain (no water) will be filled or covered - Personal Rights (direct verbiage) will be posted in common area - complaint procedures will be posted in common area - emergency exit sign for 2nd floor double doors leading to balcony - lattice or other covering will be placed around 500 gallon well - request waiver for slatted bed bases (no box spring needed) - 84088(c)(1) All staff will be fingerprint cleared prior to working at this facility location. This facility is ready for licensure once the above has been addressed.

met_with: Clodagh Rafferty


summary: Facility Evaluation

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Narrative:
On 05/13/24 at 10:45AM Licensing Program Analysts (LPA's) Celeste Aparicio made an unannounced inspection to the facility for the purpose of ensuring that the facility is not operating. LPA observed the facility to be vacant, furnished, free from debris, and in good repair. LPA inspected the entire outside of the property. LPA observed no persons to be on or within facility property.


facility_name: LILY'S HOME

summary: Facility Evaluation

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Narrative:
On Wednesday October 20, Licensing Program Analysts (LPA) Isabel Mendoza made an unannounced inspection to conduct an annual required inspection. LPA met with Administrator Alona Quintos, and Assistant Administrator Julienne Baris. The facility has a census of four clients. One client was present during LPA Mendoza inspection, and during inspection another two arrived. LPA was unable to interview clients due to all three clients being non-verbal. However, LPA observed clients to be in good spirit. LPA interviewed both staff members during todays inspection. The facility is clean, safe and sanitary and in good repair. All passageways are unobstructed. There are no pools or bodies of water. All disinfectants, cleaning solutions and poisons are locked in the garage. Per Administrator there are no firearms in the facility. The inspected bedrooms were furnished accordingly. The kitchen is clean and sanitary. At 1: PM the water temperature measured 97 degrees, the administrator adjusted the heater, and at PM the water measured 114 degrees . The facility has sufficient two day perishable and seven day nonperishable food supply. Medications are locked and were all inspected. All medication binders were complete. The facility has Personal Rights and Emergency Disaster Plans are posted and in clear view. At 1: PM, LPA Mendoza reviewed all 4 client files, and all files were complete. LPA advised the facility for the clients that are unable to sign any LIC forms because of their developmental disability to include a note in the signature line. [Please Cont. To Lic 809-c...] At 2: PM LPA Mendoza reviewed six staff files and all files were complete. Staff training hours meet the minimum requirements. A review of Guardian Background Check System printed on October 19, 2021 indicate that all facility staff have clearances. LPA obtained a copy of LIC 500, LIC 610, and copy of the Administrators certificate. No deficiencies were observed today. A copy of this report was left with the Administrator.

met_with: Alona Quintos (Administrator) and Julienne Baris (Assist. Administrator)


summary: Facility Evaluation

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Narrative:
On Thursday March 24, Licensing Program Analysts (LPA) Isabel Mendoza made an unannounced inspection to conduct an annual required inspection. LPA met with Administrator Alona Quintos. Later in the inspection, Assistant Administrator, Julienne Baris arrived. The facility has a census of four clients, and all clients were at school. The facility is clean, safe and sanitary and in good repair. All passageways are unobstructed. There are no pools or bodies of water. All disinfectants, cleaning solutions and poisons are locked in the garage. Per Administrator there are no firearms in the facility. The inspected bedrooms were furnished accordingly. The kitchen is clean and sanitary. The water temperature measured 114 degrees. The facility has sufficient two day perishable and seven day nonperishable food supply. Medications are locked and were all inspected. All medication binders were complete. The facility has their license posted in a prominent area, Personal Rights and Emergency Disaster Plans are also posted and in clear view. At 9: AM, LPA Mendoza reviewed all 4 client files, and all files were complete. However, three clients are currently over the age of 18. (C1) (please refer to LIC 811, for confidential names, dated 03/24/22. ) will be turning 21 years old this year, and (C2) will be 23 on 3/28/22. LPA reminded the facility per Welfare and Institution Code 11710 (a) "Child with special health care needs" means a child, or a person who is 22 years of age or younger who is completing a publicly funded education program..." The Administrator informed LPA Mendoza that there Assistant Administrator will be opening an adult facility and is currently is the process. [Please refer to LIC 809-C for continuation page.. LPA Mendoza is requesting the facility to submit an age exception to CCL for (C1) and (C2) no later than Friday 4/1/22. Also, reminded the facility that they shall develop a plan on having all clients out of the facility before there 22nd birthday, and if not the facility must submit an age exception before the clients 22nd birthday. LPA Mendoza reviewed all six staff files and all files were complete. All staff meet the required training requirements. An exit interview was conducted and the facility was issued one technical violation. A copy of the report will be emailed to the Administrator.

met_with: Administrator, Alona Quintos


summary: Facility Evaluation

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Narrative:
On 3/16/23 at 1PM, Licensing Program Analyst (LPA) Mariah Hawkins conducted a required annual inspection. LPA met with Administrator Alona Quintos and informed of the purpose of the visit. The CARE Inspection Tool was used to conduct this inspection. At arrival, all residents were at school. Administrator indicated that all three residents are nonverbal. One resident returned before end of visit, and LPA observed resident to be dressed in clean, well-fitting clothes, to be provided a snack, and to be closely supervised by present staff. LPA interviewed two staff. LPA also reviewed 5 staff files, all 3 resident files, and inspected the facility site and grounds. LPA observed the facility to be clean and organized, no safety hazards, chemicals locked and inaccessible, bedrooms clean, beds with mattress protectors and mattress pads, organized storage for residents, kitchen clean and food in good quantity and quality and properly stored. All files reviewed were complete. Medications are stored and logged correctly. Resident money is recorded and maintained appropriately. Staff were knowledgeable of facility policies and reporting requirements. The CARE Inspection Tool and LPA did not find any deficiencies at this visit. An exit interview was conducted, and a copy of this report was left with Administrator, whose signature on this form confirms receipt.

met_with: Alona Quintos


summary: Facility Evaluation

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Narrative:
On 03/12/24 at 10:30AM Licensing Program Analysts (LPA's) Celeste Aparicio and Jasmine Cardeno made an unannounced inspection to the facility for the purpose of conducting the facility's annual inspection. LPAs met with Administrator Alona Quintos who helped facilitate the inspection. At arrival, all residents were at school. Administrator indicated that the two residents are nonverbal. One resident returned before end of visit, and LPA observed resident to be dressed in clean, well-fitting clothes, and to be closely supervised by present staff. At the start of the inspection LPAs conducted a walk through of the facility, inside and out. LPAs observed centrally stored medications maintained in a locked cabinet. Sharps and Toxic chemicals are kept locked. There is at least one-week supply of nonperishable and a two-day supply of perishable foods. The facility is maintained at 70 degrees. Hot water temperature measures at 106 degrees. The facility has a written emergency disaster plan and has conducted a biannual review of the Emergency Intervention Plan. Five records of personnel/ staff members were reviewed to ensure staff meet regulatory requirements. All personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. Personnel Files are maintained on-site.Two client records were reviewed and appeared to be complete with sufficient documentation. LPA discussed the following with the Administrator: anchoring the hammock for safety and submitting an age exception request to Licensing for one of the clients in care. LPA issued two Technical Violations regarding the discussions above. An exit interview was conducted, and a copy of this report was left with Administrator, whose signature on this form confirms receipt.


summary: Facility Evaluation

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Narrative:
On March 21, 2025 at 10:25AM, Licensing Program Analysts (LPAs) Will Ea and Mariah Hawkins conducted an unannounced required annual inspection of the facility. LPAs met with Administrator Alona Quintos and informed of the purpose of the visit. LPAs inspected 5 staff files and observed all to be complete. All staff have a background clearance associated to the facility. LPAs inspected both current clients' files and observed all to be complete. Both clients are nonverbal. LPAs observed both clients in care upon their return from school. Both clients were dressed in clean, well-fitting clothing and appeared comfortable around staff. LPAs observed staff to be attentive to clients. LPAs toured the facility site and observed no hazards. The facility is maintained in safe and sanitary condition. There are two single-occupancy bedrooms and two bathrooms. There is food supply to meet the needs of the clients in care. Sharps and chemicals are stored where inaccessible to clients. Facility license, clients' rights, and grievance procedures are posted in the facility. The facility has a complete first aid kit and emergency supply bags. Using the CARE Inspection Tool, no deficiencies were observed. An exit interview was conducted, and a copy of this report and the licensee's appeal rights was provided to Administrator.

met_with: Alona Quintos, Facility Administrator


summary: Facility Evaluation

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Narrative:
On Friday, March 20th 2026, Licensing Program Analyst (LPA) Mariah Hawkins conducted a visit for a required/annual inspection. LPA met with Administrator Alona Quintos and informed of the purpose of the visit. LPA reviewed 5 personnel files. LPA observed files to contain required documentation. Staff had background clearances. Staff had current first aid and intervention training certifications. Staff files also reflected the required number of annual training hours. LPA observed 3 clients in care. LPA observed clients to appear comfortable in the home. LPA observed staff providing continuous supervision and engagement to all clients. Staff and clients appeared familiar with each other, and LPA observed staff to be able to understand clients' nonverbal cues. No deficiencies were observed during today's visit. A continuation visit will be conducted to complete this inspection. An exit interview was conducted, and a copy of this report was provided to Administrator.

met_with: Administrator Alona Quintos


summary: Facility Evaluation

raw_content:
Narrative:
On Thursday, March 26th 2026, Licensing Program Analyst (LPA) Mariah Hawkins conducted an annual continuation visit, continuing from the inspection initiated on March 20th 2026. LPA met with Administrator Alona Quintos and informed of the purpose of the visit. LPA toured the facility site and grounds. LPA observed the facility to be clean, sanitary, and free of hazards. LPA observed all rooms to be well-lit and well-organized. Age and developmentally appropriate toys and activities were available in the living room. Chemicals, knives, and medications were stored in locked storage areas. Hot water measured within the permitted range. LPA observed that no as-served menus were maintained and advised that these be maintained moving forward. See LIC TV. LPA reviewed client records for all clients in care. LPA observed all files to contain required documentation, including care plans, medication administration records, and admission agreements. LPA observed that one client's file did not contain written authorization for two over-the-counter medications. However, a parent was able to verbally authorize over the phone during today's visit. LPA advised that written authorization be maintained moving forward. See LIC TV. Based on discussion with Administrator, LPA provided written technical assistance on the current procedures for submitting age exceptions. See LIC TA. No citations were issued at today's visit. An exit interview was conducted, and a copy of this report and attached LIC 9102s were provided to Administrator.


facility_name: LINDSEY'S CARE HOME LL

summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) Tamara Hill met with Tyesha Lindsey, Administrator at the Licensing Office on 6/24/25 at 10: AM to conduct a Component II inspection. LPA Hill and Ms. Lindsey went over the needed corrections for the application. Some of the items discussed during the inspection were consistency throughout the program statement in that there are several sections that require detailed information that varied throughout the different sections. LPA Hill discussed the use of blanket statements not being allowed and discipline policies that are required to be positive and not punitive. LPA Hill and Ms. Lindsey discussed the needed corrections could be submitted by August 1, 2025. End of documentation for this office inspection.

met_with: Tyesha Lindsey, Licensee


summary: Facility Evaluation

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Narrative:
On August 29, 2025 at 11: AM, Licensing Program Analyst (LPA) Connie Goldie conducted an in person office meeting with Tyesha Lindsey, Administrator. The purpose of the meeting was to continue the Group Home application process by receiving the revisions and answering questions. LPA Goldie explained the purpose of the meeting to Ms. Lindsey. LPA Goldie communicated that LLC can not be a sole proprietor for a Group Home. Administrator will do an amendment to LLC to include another individual. Applicant will provide LIC400, LIC401, LIC402 and LIC404 and revisions to LPA on 09/02/2025 as she only had original copies. LPA scheduled Component III for September 10, 2025 at 09: AM- 12: PM. Exit interview completed at 12: PM

met_with: Tyesha Lindsey, Administrator


facility_name: LIZA'S HOME

summary: Complaint Investigation - Unsubstantiated

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Narrative:
Although the allegation may have happened or is valid, based on LPA's observations and interviews, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. Therefore, the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report and the licensee's appeal rights were provided to Administrator Melissa Ferreras.

Investigation Findings:
13On 7/18/25, Licensing Program Analyst (LPA) Mariah Hawkins conducted an unannounced complaint investigation visit at the facility. LPA met with Administrator Melissa Ferreras and informed of the purpose of the visit. The purpose of the visit was to deliver findings for the investigation of the above allegation. During the investigation, LPA inspected the facility site, conducted confidential interviews with staff and witnesses, including authorized representatives, and reviewed relevant client records and incident reports. All clients in care are nonverbal or limited verbal. Per the complaint report, the allegation that staff handled minor in a rough manner pertains to a report that staff mishandled a client when trying to prevent the client from exiting the facility. Interviews and record review reflected inconsistent or limited witnesses and statements. Due to limited witnesses, inconsistent evidence, and the involved client's nonverbal status, LPA was unable to determine whether a violation did or did not occur. SEE PAGE UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Mariah Hawkins 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 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO RO, TRAEGER AVE., SUITE FACILITY NAME: LIZA'S HOMEFACILITY NUMBER: VISIT DATE: 07/18/2025

met_with: Administrator Melissa Ferreras