summary: Facility Evaluation

raw_content:
Narrative:
On July 3, 2025 at 2: PM Licensing Program Analyst (LPA) Sarina Buchannan made an unannounced case management inspection at the above facility and met with Justin Ma'ae, Facility Administrator, who assisted LPA with the inspection. LPA Zaria Turner was informed that an incident took place in May 2025 in which a client was asked to clean their room before school and when they did not comply their tablet was taken away. LPA requested the following documentation: staff roster with contact information, Clients Needs and Services Plan and Individualized Placement Plan, as well as a copy of the incident report. LPA toured the facility and the facility was in full compliance. LPA also conducted 2 staff interviews and 1 client interview. This case management will remain open. Further investigation is needed. Exit interview conducted and a copy of this report was emailed to Justin Ma'ae, Facility Administrator. LPA was unable to print due to technical issues.


state: CA

facility_name: KAVERE SERVICES - CHERRYLAND HOME

summary: Facility Evaluation

raw_content:
Narrative:
On July 10, Licensing Program Analyst (LPA) Sarina Buchannan made an unannounced follow up case management inspection at the above facility and met with Carlos Cotto, Direct Support Professional, who assisted LPA with the inspection. A walk through of the interior and exterior of the facility was conducted and no deficiencies were noted. On July 3, 2025 (LPA) Sarina Buchannan initiated a case management to follow up regarding an incident that took place in May 2025 in which a client was asked to clean their room before school and when they did not comply their tablet was taken away. Based on interviews conducted and documentation obtained it was confirmed that staff do follow the appropriate procedures as outlined by the clients' individualized placement plan (IPP). The IPP states that the staff are allowed to inform clients that they will not earn time on the facility tablets if they do not complete certain tasks or engage in certain behaviors. LPA also confirmed that the facility does not take away facility tablets as a form of discipline and once clients have earned time it also cannot be taken away. In addition, LPA was unable to confirm the date the alleged incident took place and the client involved stated the facility does not take away their electronics. No further investigation is needed. This case management is now closed. Exit interview conducted and a copy of this report was provided to Carlos Cotto, Direct Support Professional.

report_type: Facility Evaluation

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Connie Goldie on 04/30/2025 at 10:00 am. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Goldie met with Justin Maae, Administrator and inspected the facility inside and out. LPA reviewed 1 of 1 child's records and 5 of 5 staff personnel files on site at the facility. LPA reviewed 1 of 1 child's psychotropic medications and medication records. LPA interviewed 5 of 5 of staff on site to discuss the facilities policies and procedures of operation. LPA interviewed 1 of 1 children currently prescribed psychotropic medication. During the inspection the LPA observed one type B deficiency (see attached 809D page). LPA Goldie cited California Code of Regulations Division Chapter 5 84070(b)(15) Children's Records). LPA Goldie issued one technical violation. This is not a deficiency. LPA conducted exit interview with Justin Maae, Administrator. LPA discussed and provided a copy of documents and appeal rights

met_with: Justin Maae, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On July 10, Licensing Program Analyst (LPA) Sarina Buchannan made an unannounced follow up case management inspection at the above facility and met with Carlos Cotto, Direct Support Professional, who assisted LPA with the inspection. A walk through of the interior and exterior of the facility was conducted and no deficiencies were noted. On May 27, CCL received an incident report with the same date in which staff did not administer three of a client's morning medications. LPA requested the following documentation: Medication Log for May 27th, 2025, staff roster with contact information, staff medication training for staff in question, write ups for staff in question, and a copy of the related incident report. Based on interviews conducted and documentation obtained it was confirmed that the client missed three doses of their prescribed medication on May 27, 2025. LPA was informed that there was a communication error between staff, and they believed the medication had already been administered. During the afternoon shift medication audit staff notified the Facility Administrator of the error. The facility immediately interviewed both staff involved and followed protocol by reporting the appropriate parties. Also, the facility immediately gave both staff involved 2-day suspension and conducted medication training's with both staff on June 3, 2025. Due to the medication errors, facility is being cited a Type A violation (See LIC 809D). This case management that was initially open on July 3, 2025 is now closed. Exit interview conducted and a copy of this report and appeal rights were provided to Carlos Cotto, Direct Support Professional.


summary: Facility Evaluation

raw_content:
Narrative:
On November 4, 2025, Licensing Program Analyst (LPA) Sarina Buchannan arrived unannounced at the above facility for the purpose of conducting a management inspection. LPA met with Justin Ma'ae, Facility Administrator, who assisted with the inspection. A walk through of the inside and outside of the facility was conducted and no out of compliance issues were noted in regard to the physical plant. On October 21, LPA Buchannan received a incident report that took place on October 17, 2025 regarding a client in care. During today's inspection, LPA requested the most recent training on reporting requirements for all staff and 1 staff interview was conducted. Based on documentation obtained and interview conducted it was confirmed that the facility failed to report an unusual incident which threatened a clients safety. LPA was informed that the facility was unaware that the information was reportable and therefore did not report to CCL in a timely manner. LPA was also informed that the facility reached out to the Regional Center and once it was confirmed the incident was reportable they did submit a full 7-Day report immediately to CCL. However due to reports not being submitted timely, a Type B citation is being issued to address the concern. This case management is now closed. The facility is being issued a citation for reporting requirements. (see LIC 809D). Exit interview conducted and a copy of this report and appeal rights were provided to Justin Ma'ae, Facility Administrator.

met_with: Justin Ma'ae, Facility Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On April 24, Licensing Program Analyst (LPA) Sarina Buchannan made an unannounced visit with the purpose of conducting an annual inspection to the above facility using the Compliance and Regulatory Enforcement (CARE) tool. LPA met with Justin Ma'ae, Facility Administrator and a walk through of the interior and exterior was completed. Physical Plant Room one is is a staff office with a copier, bathroom, and closet containing client files and medications which are inaccessible to clients in care. There is a hallway outside of the office which has three locked closets that contain cleaning products and extra toiletries. Room two is a living room with four couches, one TV, and board games. Room four is a client bedroom with a twin bed, a dresser, and a night stand. Room five is a dining room with a table that seats six and a sliding door leading to the backyard. Room six is the kitchen which is connected to the washer dryer area, a client bathroom, and a garage. Room 7 is a client bedroom with a twin bed, two dressers, and a night stand. Room eight is a client bedroom with a twin bed, dresser, and night stand. Room 9 is a loft and has a TV and a desk for activities. Room 10 is a client bedroom with a bed dresser and a night stand. The upstairs hallway has a closet with client toiletries and a bathroom. There are three total bathrooms, one located in the staff office area with a working toilet, and running warm water with a temperature of 115 degrees. There other two bathrooms are client bathrooms with working toilets and running warm water with a temperature of 115 degrees. (report continued on LIC 809C) The backyard is gated with a basketball court, swing set, and a gazebo with a bench. The backyard is clear of debris and clean. The garage has a fooseball table, swing, and a deep freezer but is locked and inaccessible to clients.There is a Ford Transit in good working condition, properly maintained, lights, tires, registration/insurance and working seat belts and is available to transport clients if needed. The following required documents were posted, License and Personal Rights. Disinfectants/cleaning solutions inaccessible to children in care. Refrigerator Temperature at or below 45 degrees. Nonperishable foods one week and fresh perishable foods two days minimum. Menu present and posted in the kitchen area on the fridge. Working telephone is available at the facility. Carbon monoxide and smoke detectors are in working order. First Aid Kit fully stocked. Medication centrally stored, locked/inaccessible to children. Hot water between 105-120 degrees Fahrenheit. Fire Extinguisher up to date and in working order. Toilets wash basin, bath, and shower fixtures in good repair/no leaks/hot water temperature. Soap and Paper towels are available to clients. Bedrooms required linen and furnishings are fully stocked. Facility free of vermin. The following domains were also reviewed during today's inspection, Operations, Disaster Preparedness, Staffing, Emergency Intervention, and Client Records. A total of five staff files and three client files were reviewed. Although there was an additional client placed, LPA did not review file as they had been placed less than a weeks time. LPA also conducted one client interview, three staff interviews, and attempted two client interviews. A review of the Licensing Information System indicates the facility fees are due on May 09, 2026 and will be paid then. All the staff were fingerprint cleared and associated to the facility. Based on confidential interviews conducted there are no concerns for follow up were noted. Exit interview conducted and a copy of this report was left at the facility.

visit_type: Annual


facility_name: KAVERE SERVICES-PINETOWN HOME

summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. No title 22 regulations were cited during today's inspection. Exit interview conducted and a copy of this report was left with Isaac Herrera, Administrator.

Investigation Findings:
13Licensing Program Analyst (LPA) Jean Stidman, conducted an unannounced inspection to the facility on 6/2/23 at TIME to deliver complaint allegation findings. LPA met with Isaac Herrera, Administrator and discussed the above allegation. During the investigation of Staff pulled minor in care's hair, LPA toured the facility with Marissa Corral, Administrator on 1/24/23 and 2/2/23. On these inspections, LPA inspected the physical plant inside and out, reviewed four client files. On 2/6/23 and 2/23/ LPA obtained documentation for the complaint investigation of client's Admission Agreement, Individual Program Plan (IPP), identification and emergency information, notes, physical, behavior reports and incident reports. LPA conducted interviews on 1/24/23 and 2/2/23 with four clients and two staff. Confidential interviews and records reviewed revealed inconsistencies in statements provided. Based on LPA's observations, interviews which were conducted, and records reviewed, the preponderance of evidence standard has not been met, therefore the above allegation is found to be UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dara Campos LICENSING EVALUATOR NAME: Jean Stidman LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, NATOMAS PARK DR., STE FACILITY NAME: KAVERE SERVICES-PINETOWN HOMEFACILITY NUMBER: VISIT DATE: 06/02/2023

report_type: Complaint Investigation

met_with: Isaac Herrera, Administrator

complaint_status: unsubstantiated


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
VRMC Admission Agreement, Facility Admission Agreement, and Incident Reports for two youths in care. For one youth, LPA requested the following for review: Needs and Services Plan, Photos of injuries, Weekly Case Notes, description of Injuries, and medical documentation. No serious concerns noted. Confidential interviews were conducted with seven individuals, two children, and five adults, and attempted with two adults during the period of 9/18/2024 to 10/21/2024. An investigation was conducted regarding the allegation: Minor sustained unexplained injuries while in care. Five out seven interviews conducted were consistent that minor did not sustain the injuries while in care. S1, S2, S3, S4, and C2 reported that C1 did not sustain bruising in care but would have normal bruising. C1 is non-verbal, has a history of self-injurious behavior and would go on home visits frequently. Additionally, documents reviewed, including Weekly Case Notes, description of Injuries and Needs and Services plan supports the allegation may not have happened. The facility noted all bruises that were visible on the minor and documented the bruising before and after the child was in care. Based on LPA interviews conducted, and records reviewed, the preponderance of evidence standard has not been met, therefore the above allegation is found to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted with and a copy of this report was provided to Marissa Corral, Administrator.

Investigation Findings:
13Licensing Program Analysts (LPAs) Maie Soliman and Jean Stidman conducted an unannounced complaint inspection with the above facility on 11/21/24 at 11:45am and met with Marissa Corral, Administrator. The purpose of the inspection was to deliver complaint findings for the allegation of: Minor sustained unexplained injuries. On 9/18/2024 at 10:40AM Licensing Program Analyst (LPA), Angelique Hill, arrived unannounced at the facility for the purpose of initiating a complaint investigation related to the above allegation. LPA met with Isaac Herrera, Administrator. During the course of the investigation, the following documents were gathered and reviewed: Client Roster, Staff Roster, Work Schedule for June to September 2024, Visitor Sign-In Log, Facility Sketch, UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dara Campos LICENSING EVALUATOR NAME: Jean Stidman LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES INC, PINETOWN CRISIS HOMEFACILITY NUMBER: VISIT DATE: 11/21/2024

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

met_with: Marissa Corral, Administrator


raw_content:
Narrative:
with four children and six staff, during the period of 5/8/25 to 6/4/25. Six out of six staff interviews reported the staff report incidents the next day and they are not discouraged from reporting incidents. Four out of four children and five out of six staff interviewed reported the client records are accurate and not falsified Based on LPA interviews conducted, and records reviewed, the preponderance of evidence standard has not been met, therefore the above allegations are found to be UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur. An exit interview was conducted, and a copy of this report was provided to Isaac Herrera, Administrator.

Investigation Findings:
13Licensing Program Analyst (LPA) Jean Stidman conducted an unannounced complaint inspection on 7/31/25 at 8:30am and met with Isaac Herrera, Administrator. The purpose of the inspection was to deliver complaint findings for the above allegations of facility failed to report incident, staff are discouraged from reporting incidents, and staff falsify client records. On 5/15/ LPA met with Isaac Herrera, Administrator to initiate this complaint investigation. LPA requested the following documents be given to LPA by 5/21/25 for two children in placement between June-October 2024 of Progress Notes, Needs and Services Plan, Medication Administration Records, medical assessment, Incident Reports, Personal and Incidental Funds logs and receipts. The client roster, staff roster or LIC500's, and staff work schedules for April 2024-October 2024. LPA Stidman review of these records reveal that all incidents were reported, and the client's records contain all the required information. Confidential interviews were conducted by LPA's Jean Stidman, Alyssa Burgess and Sarina Buchanan UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dara Campos LICENSING EVALUATOR NAME: Jean Stidman LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES INC, PINETOWN CRISIS HOMEFACILITY NUMBER: VISIT DATE: 07/31/2025

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


summary: Facility Evaluation

raw_content:
Narrative:
4/1/2021 beginning at 2:30pm. LPA spoke with the Administrator and explained the purpose of today's Licensing Program Analyst (LPA) Rob Sandles conducted an unannounced tele-inspection visit to the facility on contact was to conduct a Case Management regarding an incident report that the department received on 3/26/2021. The date of the incident was 3/24/2021 in which a youth had two fingers fractured by his roommate while playing games in their LPA requested following documents: Needs and Service Plan for two Clients, Staff Roster, Staff schedule for 3/22/2021-3/28/2021, and Facility Sketch. LPA inspected the facility and observed Staff and Client files in a locked room separated and filed in locked cabinets. All needed Covid-19 signage posted thru facility. LPA observed posted license and certifications in office. Smoke Detectors worked properly, and Fire Extinguishers were fully charged and up to date. Bedrooms were clear of clutter with client's personal effects. Extra linen and clean towels were observed. Seven days of perishables/14 days of nonperishables. Sharps utensils and Cleaning supplies locked up in separate cabinets. First Aid Kit checked. Bathrooms had proper handwashing signage and soap and paper towel. Temperature checked with clients three times a day. Staff temperature checked beginning of shift and end of shift. No citations were cited. Further investigation needed

met_with: Administrator Amanda Gulley


summary: Facility Evaluation

raw_content:
Narrative:
On 8/17/ Licensing Program Analyst (LPA) Rob Sandles and LPA Shoua Xiong conducted an unannounced visit to the facility beginning at 12: PM. LPAs met with Administrator Amanda Gulley and explained the purpose of today's visit was to conduct an ANNUAL/REQUIRE inspection. LPA Sandles inspected the facility and observed posted: Facility sketch, Evacuation plan, Covid hand washing signage and Facility License. LPA inspected the facility and observed Staff and Client files in a locked room separated and filed in locked cabinets. Smoke Detectors worked properly, and Fire Extinguishers were fully charged and up to date. Carbon Monoxide detectors were working properly. LPA observed that each client was provided their own beds with beddings, dressers, and closet space. Extra linen and clean towels were observed. Seven days of perishables/14 days of nonperishables food items was observed. Sharps utensils and Cleaning supplies were locked up in separate cabinets. The dining area contained a table that seated four. First Aid Kit checked and contained all required supplies. Bathrooms had proper handwashing signage and soap and paper towel. The garage contained play activities and games. Outside area was observed to be free of debris and safety hazards. Water temperature was checked and measured within the required range. LPAs began reviewing four client files but did not finish. LPAs will return on a different date and time to complete client file reviews and the inspection. No deficiencies were cited on today's date. Exit interview conducted and a copy of this report was given to Amanda Gulley, Administrator.

met_with: Amanda Gulley, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Robert Sandles and LPA Shoua Xiong conducted an unannounced visit to to the facility on 8/18/21 beginning at 12: PM. LPAs met with Amanda Gulley, Administrator, and explained the purpose of the visit was to continue the Annual/Required inspection. On today's date upon arrival, there was one staff and no clients present. During the inspection visit, three clients arrived home and there was four staff present. On today's inspection, LPAs reviewed four client files and ten staff files. All client and staff files had all the required documents. LPAs also conducted interviews with three staff and two clients. No deficiencies was cited on today's date. Administrator Amanda Gulley had to leave due to prior engagements. Exit interview was conducted with Lead Staff Lashray Elliott and a copy of this report was given to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 11/15/ Licensing Program Analysts (LPAs) Jean Stidman and Kim Pawlowicz made an unannounced Annual Inspection. During the inspection LPAs met with Amanda Gulley Administrator who assisted with the inspection. LPAs conducted a walk-through of the facility inside and out. Facility staff-client ratio at time of inspection two staff and no kids were present. LPA observed the facility is a two story home with three bedrooms and three bathrooms. I. Physical Plant Posting of license_x__ Personal Rights_x__ Disinfectants/Cleaning solutions inaccessible_x__ Refrigerator Temperature at or below 45 degrees F _x Freezer Temperature at or below 0 degrees_x__ Nonperishable Foods one week and fresh perishable foods two days minimum_x_ Menu present and posted__x__ Working telephone _x__ Carbon monoxide detector x__ Smoke Detector x__ First Aid Kit fully stocked_x__ Common Room available__x_ Dining area (enough seating, furniture good condition, not broke or damaged) _x __Medication centrally stored, locked/inaccessible _x_ Office (locked and privacy) x__ Hot Water was 121 degree Fahrenheit and LPAs observed staff turned it down ___ Fire Extinguishers inspected May 2022. Toilets wash basin, bath and shower fixtures in good repair/no leaks___x__ Soap and Paper towels _x__ Laundry Facilities __x__ Bedrooms-required linen and furnishings _x_ Motor Vehicle properly maintained , lights, tires, registration/insurance and working seat belts__x_ Facility free of vermin __x_ Bedroom (required bedding/furniture, furniture in good repair) _x__ II. Operations Complaint Procedures For Youth Reviewed _x_ Board Minutes Reviewed__x___ III. Disaster Preparedness Quarterly Drills conducted and documented__X_ Disaster preparedness supplies verified _X_____ IV. Emergency Intervention Staff training __X___ V. Staffing Number of Staff files reviewed __4____Criminal record clearances verified _4__ First Aid Certificate__4__ Certified Administrators certificate valid and current_x_ Job title/qualification verified _X__ LPAs were unable to complete the inspection. An exit interview was conducted with Amanda Gulley Administrator and a copy of this report was left with Amanda Gulley Administrator.

met_with: Amanda Gulley Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPAs) Jean Stidman and Kim Pawlowicz made an unannounced annual inspection on 12/22/2022 at 1: PM. During the inspection LPA met with Amanda Gulley, Administrator who assisted with the inspection. LPAs conducted a walk-through of the facility inside and out. Facility staff-client ratio at time of inspection two staff and four clients present. Number of staff interviewed two Number of clients interviewed four. LPA observed # _3_bedrooms, # _2__bathrooms LPAs reviewed the following: VI. Client Records Number of Clients files reviewed ___5___Needs and Services Plan X Centrally Stored Medication and log reviewed _ X JV Reviewed X Psychotropic Medication and log reviewed X _Cash Resources_ X _ Compatible Assessment_ X VII. Core/Therapeutic Services Trauma Informed Practices are implemented as needed (including specialty mental health services and extracurricular activities and social supports) X Facility citation violation of California Code of Regulations, Title 22, Division 6, regulation 80088(e)(1) Fixtures, Furniture, Equipment and Supplies. During the inspection on 11/15/22 & 12/22/22 the water temperature was 121 degrees Farenheit which poses an immediate health, safety or personal rights risk to persons in care. The facility turned the hot water temperature down during the inspection. An exit interview was conducted with Amanda Gulley Administrator and a copy of this report was left with Amanda Gulley Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 8/22/ Licensing Program Analyst (LPA) Jean Stidman met with Amanda Gulley, Administrator for the purpose of a case management inspection. LPA reviewed three client medication administration records and obtained documentation of Centrally Stored Medication and Destruction Record, Kavere Services Medication Administration and Inventory Record and Medication Passer for three clients and Checker Sign-Off form for one client. Exit interview conducted and a copy of this report was left with Amanda Gulley, Administrator.


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On 8/22/ Licensing Program Analysts (LPAs) Jean Stidman and Donna Edwards met with Amanda Gulley, Administrator for the purpose of a Annual Inspection. LPAs Stidman and Edwards conducted a walk-through of the facility inside and out. Facility had three staff present at the beginning of the inspection and no kids were present at the beginning of the inspection, during the inspection two clients arrived after school, Number of staff interviewed _ Number of clients interviewed _ LPA observed # _3_bedrooms, # _3_bathrooms. LPA inspected and/or reviewed the following: Physical Plant Posting of license_ok_ Personal Rights_ok_ Disinfectants/Cleaning solutions inaccessible_ok_ Refrigerator Temperature at or below 45 degrees F _41 degrees_ Freezer Temperature at or below 0 degrees_-5 degrees Nonperishable Foods one week and fresh perishable foods two days minimum_ok_ Menu present and posted__ok_ Working telephone _ok_Carbon monoxide detector_ok_ Smoke Detector ok First Aid Kit fully stocked_ok__ Common Room available_ok_ Dining area (enough seating, furniture good condition, not broke or damaged) _ok Medication centrally stored, locked/inaccessible N/A Office (locked and privacy) N/A Hot Water between 105-120 degree F (Properly labeled if over 125 degree F)_114 degrees Fire Extinguisher (note inspection date) charged May 2023_ Toilets wash basin, bath and shower fixtures in good repair/no leaks/hot water temperature _ok_ Soap and Paper towels ok_ Laundry Facilities(available)_ok_ Bedrooms-required linen and furnishings _ok_Motor Vehicle properly maintained, lights, tires, registration/insurance and working seat belts_ok_ Facility free of vermin _ok_ LPAs observed the storage container/deck box on the back patio has a broken lid. Facility citation violation of California Code of Regulations, Title 22, Division 6, regulation 80087(a) Buildings and Grounds. Operations Complaint Procedures Posted _ok_ Board Minutes Reviewed_ok_ Disaster Preparedness Fire Drills conducted and documented ok Disaster preparedness supplies verified ok Emergency Intervention Review of manual restraint log ok Staff training _ok_ Staffing/Volunteers Number of Staff files reviewed _4__Criminal record clearances verified 4___ First Aid Certificate__ok_ Certified Administrators certificate valid and current__ok_ Job title/qualification verified _ok_ The Annual fees were reviewed for compliance in the regional office and are current. Exit interview conducted and a copy of this report was left with Amanda Gulley, Administrator. .

Deficiencies:
80087(a): Deficient Practice Statement
1
2
3
4Based upon inspection of the facility the storage container/deck box on the back patio has a broken lid which poses an potential Health, Safety or Personal Rights risk to residents in care
POC Due Date: 09/22/2023
Plan of Correction
1
2
3
4

title:
80087(a) Buildings and Grounds The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.

This requirement is not met as evidenced by


summary: Facility Evaluation

raw_content:
Narrative:
On 12/28/ Licensing Program Analyst Jean Stidman conducted a case management inspection at the facility regarding incidents that occurred on 12/7/23, 12/12/23, and 12/14/23. LPA reviewed the facility manual restraint logs and obtained documentation of the Monthly Manual Restraint Log for December 2023. LPA observed at the beginning of the inspection there were three clients and three staff present. Further investigation is needed. A copy of this report was reviewed and left with Rachael Garza, DSP

met_with: Rachael Garza, DSP


summary: Facility Evaluation

raw_content:
Narrative:
On 2/1/ Licensing Program Anslyst (LPA) Jean Stidman met with Ramandeep Kaur, DSP, for the purpose of a case management inspection regarding an incident that occurred on 12/12/23. LPA observed there were no clients and no other staff at the facility during the inspection. LPA interviewed one staff. Further investigation is needed. A copy of this report was reviewed and left with Ramandeep Kaur DSP.

met_with: Ramandeep Kaur DSP


summary: Facility Evaluation

raw_content:
Narrative:
On 2/26/ Licensing Program Analyst (LPA) Jean Stidman met with Ashley Gonzales, DSP, for the purpose of a case management inspection regarding an incident that occurred on 12/12/23. LPA observed there were no clients were present and two staff were at the facility during the inspection. LPA interviewed one staff. Further investigation is needed. A copy of this report was reviewed and left with Ashley Gonzales, DSP.

met_with: Ashley Gonzales, DSP


summary: Facility Evaluation

raw_content:
Narrative:
On 2/28/ Licensing Program Analyst (LPA) Jean Stidman met with Sonia Gomez, House Lead, for the purpose of a case management inspection regarding an incident that occurred on 12/12/23. LPA observed there were three clients present and three staff were at the facility during the inspection. LPA interviewed three staff and two clients. Further investigation is needed. A copy of this report was reviewed and left with Sonia Gomez, House Lead

met_with: Sonia Gomez, House Lead


summary: Facility Evaluation

raw_content:
Narrative:
On 3/5/ Licensing Program Analyst (LPA) Jean Stidman met with Sonia Gomez, House Lead, for the purpose of a case management inspection regarding an incident that occurred on 12/12/23. During the Case Management investigation LPA interviewed eight staff and two clients. During the investigation it was determined that the restraint was justified per California Code of Regulations, Title 22 regulation 84300(b) as the client was exhibiting assaultive behavior exposing an immediate danger to themselves or others. A copy of this report was reviewed and left with Sonia Gomez, House Lead.


summary: Facility Evaluation

raw_content:
Narrative:
On 3/5/ Licensing Program Analyst (LPA) Jean Stidman met with Sonia Gomez, House Lead, for the purpose of a case management inspection regarding an incident that occurred on 2/23/24 when a client attempted to leave the facility. Sonia Gomez, House Lead,stated the client was not prevented from leaving the facility but was offered alternative activities. No further investigation is needed A copy of this report was reviewed and left with Sonia Gomez, House Lead


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
Licensing Program Analysts (LPAs) Jean Stidman and Elena Gonzalez-Soto made an unannounced Annual inspection on 8/21/24 at 9:45am During the inspection LPA met with Sonia Gomez, Lead DSP who assisted with the inspection. LPA conducted a walk-through of the facility. There was one child and two staff present at the beginning of the inspection and one other client and two staff arrived during the inspection. Number of staff interviewed three Number of clients interviewed none _ LPA observed the facility is a two story home with three bedrooms, two bathrooms and one staff office. LPA inspected and/or reviewed the following: Physical Plant Posting of license_X_ Personal Rights__X__ Disinfectants/Cleaning solutions inaccessible__X_ Refrigerator Temperature at or below 45 degrees F 39 degrees Freezer Temperature at or below 0 degrees_-6 degrees F Nonperishable Foods one week and fresh perishable foods two days minimum__X_ Menu present and posted__X_Working telephone __X_ Carbon monoxide detectors __X_Smoke Detector _X_ First Aid Kit fully stocked_X__ Common Room available__X__ Dining area (enough seating, furniture good condition, not broke or damaged) __X_ Medication centrally stored, locked/inaccessible _X_ Office (locked and privacy) _X_ Hot Water between 105-120 degree F (Properly labeled if over 125 degree F 115.5 degrees_ Fire Extinguishers inspected May 2024. Toilets wash basin, bath and shower fixtures in good repair/no leaks/hot water temperature _x Soap and Paper towels __X_ Laundry Facilities(available) __X_ Bedrooms have required linen and furnishings __X_ Motor Vehicle properly maintained, lights, tires, registration/insurance and working seat belts_X_ Facility free of vermin _X__ Bedroom (required bedding/furniture, furniture in good repair) __X___ Operations Complaint Procedures For Youth Posted _X__ Board Minutes Reviewed __X__ Disaster Preparedness Disaster and mass casualty plan updated and available __X__ Quarterly Drills conducted and documented X Disaster preparedness supplies verified __X___ Emergency Intervention Review of manual restraint log _X_ Staff training _X___ Staffing/Volunteers Number of Staff files reviewed _five Criminal record clearances verified _five_ First Aid Certificate__five__ Certified Administrators certificate valid and current__X_ Client Records Number of Clients files reviewed two Individual Program Plan two Centrally Stored Medication and log reviewed two Psychotropic Medication and log reviewed two_Cash Resources__two__ Facility citation violation of California Code of Regulations, Title 22, Division 6, regulation 80075(f) Health Related Services The following items were reviewed for compliance: · Annual fees · Administrator Certificate for: Isaac Herrera Program Director · Emergency Disaster Plan (per H&S Code 1565) · Annual Emergency Intervention Log · Personnel Roster, Facility Sketch, LIC500 and LIC610C. An exit interview was conducted and a copy of this report was left with Sonia Gomez, Lead DSP.

Deficiencies:
80075(f): Deficient Practice Statement
1
2
3
4Based on record review, the licensee did not comply with the section cited above in one out of five staff files which poses a potential health, safety or personal rights risk to persons in care. Staff S1 is missing documentation of current training in first aid from persons qualified by agencies including but not limited to the American Red Cross.
POC Due Date: 09/21/2024
Plan of Correction
1
2
3
4

met_with: Sonia Gomez, Lead DSP

title:
80075(f) Health Related Services
Staff responsible for providing direct care and supervision shall receive training in first aid from persons qualified by agencies including but not limited to the American Red Cross.

This requirement is not met as evidenced by


summary: Facility Evaluation

raw_content:
Narrative:
On 6/27/ Licensing Program Analyst (LPA) Jean Stidman met with Richard Herrera, Executive Administrator, for the purpose of closing this facility. LPA conducted an inspection of the facility and verified there have been no children or staff present since October 2024. The original license was surrendered to LPA. No violations were cited. No further investigation is needed. The facility is closed effective 6/27/25. LPA provided a copy of this report to Richard Herrera Executive Administrator on this date.

met_with: Richard Herrera Executive Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 2/2/ Licensing Program Analyst (LPA) Jean Stidman met with Marissa Corral Administrator for the purpose of a Case Management Inspection from two incidents that occurred on 1/29/23 regarding medication errors. LPA conducted record reviews of two client files. On 1/29/23 staff failed to conduct a medication audit to verify if the correct amount of medication was given during a home visit. This medication audit was not conducted until 1/31/23 causing the facility to report the incident later than is required by regulation. Facility is cited Facility citation violation of California Code of Regulations, Title 22, Division 6, regulation 80061(b) Reporting Requirements. Upon the occurrence, during the operation of the facility, of any of the events specified in (1) below, 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) below shall be submitted to the licensing agency within seven days following the occurrence. LPA provided a copy of this report to Marissa Corral Administrator on this date.

met_with: Marissa Corral Administrator


raw_content:
Narrative:
The Department has investigated the complaint that facility staff inappropriately restrained a minor. When discussing restraints with the clients, staff and other individuals, the youth are restrained only when they are a danger to themselves or other individuals in the home, it is a last resort and other de-escalation techniques have failed. A copy of Kavere Services Emergency Interventions Plan is located within the Program Statement which outline the use of restraints. The Reporting Party (RP) was following up on the use of restrains to confirm whether it was against regulations, which was determined that the home can use restraints. This was determined by Pro Act training records, Program Statement, Emergency Intervention Plan, and confidential interviews. On December 27, 2023, C1 was restrained using the prone method (restrained person is on their stomach) by staff and the restrain lasted for five minutes and C1 had no marks. The reporting party stated that a second incident occurred on December 29, 2023, where the prone method was used again by staff and C1 was restrained for five minutes, and no marks were observed. Later the same day, December 29th, C1 was restrained again using the prone method by staff C1 was restrained for two minutes, released and no marks were observed. When clients are restrained, the staff is watching their breathing and talking with them. The reason C1 was restrained was due to self-harming and staff aggression. This agency has investigated the complaint regarding the above allegation. We have found that the complaint was Unsubstantiated, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. No title 22 regulations were cited during today's inspection. A copy of this report and appeal rights were given to the agency.

Investigation Findings:
13Licensing Program Analyst (LPA) Mary Shelton conducted a visit to the home on 4/24/2024 at 11: PM, and LPA spoke with the Administrator, to deliver findings of the investigation on the complaint allegation as stated. LPA Shelton informed the complaint investigation included a Physical Plant Inspection of the home on 1/19/2024. The initial 10-day complaint inspection was conducted by LPA Connie Goldie, which included a walkthrough of the facility inside and outside on 1/19/2024. LPA Goldie opened the complaint and requested documentation related to the clients and staff at the facility to include client roster, face sheets, staff roster, including staff contact information and schedule for current month, facility sketch, Pro-Act certificates, restraint logs for December 2023, and Needs and Services Plan and case notes for C1. LPA Shelton interviewed Clients, staff, Pro Act Trainer, and the Program Administrator UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Mary Shelton LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES, INC/TRANSITIONAL SVC PRGM.FACILITY NUMBER: VISIT DATE: 04/24/2024

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

met_with: Marc Verzosa, Administrator


raw_content:
Narrative:
The Administrator stated that they did not take the client's laptop, and only asked the client if they could charge the laptop while the client slept at night. The client would stay up all night playing games on the laptop. The staff LPA interviewed stated the client would stay up late until 2: AM, and they would ask the client to turn in their laptop for the night so that they can go to sleep, however the client felt it was their right to use it. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted with FM and a copy of this report, confidential names list, and appeal rights were provided to him.

Investigation Findings:
13Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced complaint investigation inspection at the facility and met with Chiang Thompson Facility Manager (FM) who assisted with the inspection. LPA investigated this complaint by reviewing incident reports, and by conducting confidential interviews with the Reporting Party, the Administrator, one staff, three clients, one client's parent, and the client's Regional Center Service Coordinator (SC) between 1/24/2025 and 6/10/2025. During LPA's interview with the client, they stated that staff took their laptop on one or two ocassions overnight due to the client not going to sleep; staff have not kept the laptop, and staff have not prevented the client from doing anything they needed to do on it. The client's parent confirmed that the client had a hard time sleeping and their grades at school were suffering, so during an IEP meeting they arranged for the school to only allow the Wi-Fi to work while at school since the facility could not take the laptop from the client. Additionally, the parent stated that the facility staff were not supposed to take the laptop at night. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Alyssa M Burgess LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES, INC/TRANSITIONAL SVC PRGM.FACILITY NUMBER: VISIT DATE: 06/18/2025

met_with: Chiang Thompson


facility_name: KAVERE SERVICES, INC/TRANSITIONAL SVC PRGM.

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Shoua Xiong conducted an unannounced inspection visit to the facility on 10/20/21 beginning at 12: PM. LPA met with Najon Saina, Administrator, and explained the purpose of the visit was to conduct an Annual/Required inspection of the facility. At the time of this visit, present in the home was one client in care, two staff members, and the Administrator. On today's date, LPA completed a physical inspection of the home, inside and outside. This facility is a two story home with three client bedrooms, one office room with a bathroom, two client bathrooms, a living room, kitchen, garage, and a front and back yard area. The locked staff office was observed to contain staff and client files. There are current two clients placed in the facility. Each client was provided their own bedroom with beddings, dressers, closet space, and lamps. Smoke detectors were operational and observed in bedrooms, office, hallways, and the common area. There is a charged and serviced fire extinguisher, working carbon monoxide detector, and a complete first aid kit with a manual present in the facility. The facility's water temperature was tested and was within the required range of 105-120 degrees F. The facility was observed with the required two days' worth of perishable and seven days' worth of non-perishable food items. The facility was observed to have an extra refrigerator and pantry shelf in the garage for extra food supplies. The outside areas was observed to be well maintained and free of safety hazards. On today's date, LPA reviewed ten staff files. All staff files were found to be complete with the required documents present. LPA was unable to finish the Annual inspection and will return on another date and time to continue the inspection. No deficiencies were cited on today's date. Exit interview conducted and a copy of this report was given to Najon Saina, Administrator.

met_with: Najon Saina, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Shoua Xiong conducted an unannounced inspection visit to the facility on 10/22/21 beginning at 10: AM. LPA met with the facility's Shift Lead Supervisor, Roberto Rodriguez, and explained the purpose of the visit was to conduct an Annual Continuation of the inspection which had began on 10/20/22. At the time of this inspection, there was one staff present. During the process of this inspection, one client arrived on site along with a second staff. On today's date, LPA completed the rest of the inspection along with reviewing two client files. During client file review, LPA observed that each file was complete with the required documentation. LPA interviewed three staff members and one client in care. LPA was unable to interview the second client as they were currently still at school. The second client is also non-verbal. No deficiencies were cited on today's date. Exit interview conducted and a copy of this report was given to the Shift Lead Supervisor, Roberto Rodriguez.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/13/22, Licensing Program Analyst, (LPA) Uchenna Ajaero, paid an unannounced annual/required inspection visit and met with the facility administrator (AD), Kate Rush. LPA Ajaero introduced herseld to the AD and informed her of the purpose of the visit. Entrance checklist was provided to the administrator. The licensing fees are current. The facility is licensed for 2 youths and has 2 youths currently placed. The facility has a third bed in the case of an emergency. At 12:45 am we toured the bedrooms and they were neat. The beds were made, they had sheets, bed covers, comforter and top sheet with 2 pillows. The rooms were bright and lighted, the dressers were neat and closed appropriately, there were clothes hanging in the closet and more clothes folded away in the dressers. In the hall way there were clean folded linens, towels and personal toiletries. AD checked the alarm in the rooms and hall way and we observed that they all worked. At 1:05 am, we toured the kitchen. It was clean and organized. There were fresh fruits on the counter for the residents. The fridge was clean, there were no open foods. There was perishable food for about two days and nonperishable food for about 5 days in the kitchen area and more in the garage. There were client's rights poster on the wall, the youths activities and a menu on the refrigerator. AD stated she has clients who are traumatized by the wording of the Foster Kids on the current personal rights poster so she has a smaller sized current version from the Department of Social Services site posted alternatively. . At 1:25 am we inspected the garage. It was clean. There was hand washing sink in the garage, cleaning supplies were locked up in a cabinet, there was an extra fire extinguisher in the garage, there was a fridge with perishable food items and boxes of emergency foods and house items. At 4:00 pm LPA Ajaero interviewed AD, and S1, FY1 and FY2. LPA reviewed Community Care Licensing file, unusual incident reports, facility roster, facility profile and complaint history. LPA reviewed 2 client files. All documents were compliant per regulations. No deficiency is cited today. The annual required investigation is not complete. Staff will return tomorrow to complete the inspection. Exit interview was conducted, a copy of the report was provided, appeal rights were discussed and emailed.

met_with: Kare Rush, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
This is the second day of the annual required inspection. Licensing Program Analyst (LPA) Uchenna Ajaero conducted an unannounced inspection visit to the facility on 10/14/22 beginning at 10: AM. LPA met with Kate Rush, the facility administrator (AD) and explained the purpose of the visit was to conduct an Annual Continuation of the inspection which had began on 10/13/22. At the time of this inspection, there was one staff present. LPA completed the rest of the inspection along with reviewing three staff files. During the staff file review, LPA observed that each file was complete with the required documentation. LPA interviewed one staff member. LPA was unable to interview any client because they were currently still at school. No deficiencies were cited on today's date. Exit interview was conducted and a copy of this report was given to Kate Rush,the Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Katherine Rush, Administrator on 5/25/23 at 10:45am. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Stidman met with Katherine Rush, Administrator and inspected the facility inside and out. LPA reviewed zero child's records and four staff personnel files on site at the facility. LPA did not review any child's psychotropic medications and medication records due to one clients is not a dependent of the courts (aka foster child) and the other client has been in placement less than 30 days. LPA interviewed four staff on site to discuss the facilities policies and procedures of operation. LPA did not interviewed any children currently prescribed psychotropic medication due to one clients is not a dependent of the courts (aka foster child) and the other client has been in placement less than 30 days. LPA observed the sliding glass door screen was not on the door. The administrator provided documentation of a work order to have this repaired has been requested. LPA observed one metal chair in the backyard has a bent leg. LPA observed the administrator remove the chair. LPA provided a copy of this licensing report to Katherine Rush, Administrator. No deficiencies are being cited at this time. LPA conducted exit interview with Katherine Rush, Administrator..

met_with: Katherine Rush, Administrato


summary: Facility Evaluation

raw_content:
Narrative:
On 6/6/23, Licensing Program Analyst, (LPA) Uchenna Ajaero arrived at Kavere Services in Stockton to conduct an annual required inspection. Due to the delay in conducting the inspection, FAS did not upload the CARE TOOLS and excel worksheet for the inspection. This is a record of all items checked and reviewed and the result. LPA observed all required postings on the board. License is posted for public view. LPA observed and tested smoke detectors and carbon monoxide detectors. There is a quiet room downstairs, one office with files, desks, and lockers upstairs. LPA observed 2 bedrooms with appropriate bedding and furniture. All bathrooms were checked and were clean. The water tested at the required temperature. The hallway cabinet contained extra linens, towels, blankets, cleaning supplies, and hygiene products. All cleaning chemicals were locked and inaccessible to clients and stored away daily in the garage. LPA observed medications and sharps to be locked. There were 3 fire extinguishers on site. They were last checked in May of 2023. LPA reviewed 2 youth and 5 staff files, LIC 858 and LIC 859. All required documents were observed in the files. First aid kits had all required items. LPA observed the kitchen refrigerator, freezer and pantry to be filled with perishable and non- perishable food items. LPA observed an adequate supply of utensils, dishes and a menu. A trash bin with a lid is located in the kitchen. The living room was observed to have adequate furniture and lamps LPA observed the outdoor area to be clear of clutter and debris. The garage contained holiday decorations, tools, can goods, emergency / disaster supply. No citations issued during this inspection. A copy of this report was left with Alfonso Jauregui, House Manager

met_with: Alfonso Jauregui, House Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 8/18/23 about 10:45AM, Licensing Program Analyst, (LPA) Uchenna Ajaero made an unannounced annual inspection visit to Kavere Services Inc/Transitional Services Program home in Stockton. LPA Ajaero met Yolanda Dodero, Direct Support Provider (DSP) and informed her of the purpose of the visit which is to conduct an annual inspection. There was one youth at home while the second youth returned about 2pm. LPA Ajaero toured the facility inside and outside. The following items were observed and evaluated: Facility license posted openly in public view. First aid kit available and had an adequate supply of items. Cleaning Supplies: Adequate, locked and stored. Buildings and Grounds: Facility was clear of hazards and observed to be clean, safe and sanitary. Fire extinguishers checked; smoke detectors are working. Carbon monoxide detectors tested and in working order. Doors and Passageways: Clean and free of obstructions. Emergency Exit Plan and Mass Casualty Disaster Plan, floor plan, menu, personal rights, and activity schedule all posted in the facility. Telephone: Available and in operable condition. Adequate and clean linens and mattresses were present. Adequate food supply including perishable and non-perishable items. 1 vehicle had valid insurance and up to date registration First aid kit in the vehicle Staff conducted 2 client interviews.


summary: Facility Evaluation

raw_content:
Narrative:
On 9/20/23, Licensing Program Analyst, (LPA) Uchenna Ajaero completed this annual inspection. No deficiency was cited. This completes the annual inspection.

met_with: Alfonso Jaugeriu, House Lead


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPAs) Mary Shelton and Michelle Silvas made an unannounced annual inspection on 10/23/24 at 8:30AM and met with Marc Verzosa, Administrator and Sona Gomez, House Lead who assisted with the inspection. LPAs did advise the agency that the inspection is being completed with the use of the CARE Tool. LPA Shelton and Michelle Silvas conducted a walk-through of the facility inside and out. There was one client home from school during the inspection. LPAs observed three bedroom and each room had one bed with storage space. There are two bathrooms for clients equipped with soap and paper towels. LPAS Shelton and Silvas inspected and/or reviewed the following: · Postings of facility license and Personal Rights Poster were appropriately posted. · Disinfectants/Cleaning solutions were inaccessible and locked as required. · Nonperishable Foods for one week and fresh perishable for foods two days minimum were present. · Menu was present and posted. · LPA observed a working telephone on the premises. · Carbon monoxide detectors and Smoke Detectors were present and functioning. · First Aid Kit was present and fully stocked as required. · Common Room (living room) was available as was a separate room for client's visits. · Dining area with enough seating for clients in care was present and in good condition. · Medication was centrally stored, locked/inaccessible. Centrally stored medication and log reviewed. Con't LPAs reviewed one staff file and two client files then one client was interviewed. There is a staff office located on the second floor. · Motor Vehicle appeared to be properly maintained. LPA observed lights, tires, registration/insurance and working seat belts at the time of the inspection. · LPA observed that the facility appeared to be free of vermin. · LPA reviewed complaint procedures for clients. · Board Minutes were reviewed. · Disaster Preparedness was updated and available for review, quarterly drills are completed and logged in a binder and there are disaster preparedness supplies available and verified by LPA. · Staff training was in compliance. · Criminal record clearances were verified by LPAs and in compliance. · Staff file reviewed had First Aid Certificates and CPR cards with a valid date as required. · Certified Administrators certificate was valid and current. · Staff job title/qualification were verified along with the required Hours of initial training. · Compatible Assessment was reviewed (clients have their own bedroom) and discussed with the Administrator. · Youth are provided Core/Therapeutic services access through the Kavere Services or an offsite location. · Trauma informed practices are implemented as needed (including specialty mental health services and extracurricular activities and social supports) per discussion with the administrator. The following items were reviewed for compliance in the regional office prior to the facility inspection: Administrator Certificate for Marc Verzosa, Administrator is current and verified. LPA requested the following documents from the facility as part of the annual review: LIC 500 and current client roster. No citations were issued to the agency at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA), Connie Goldie on 06/05/2025 at 09: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Goldie met with Sonia Gomez, Administrator and inspected the facility inside and out. LPA reviewed 0 of 0 child's records and 4 of 4 staff personnel files on site at the facility. LPA reviewed 0 of 0 child's psychotropic medications and medication records. LPA interviewed 4 of 4 staff on site to discuss the facilities policies and procedures of operation. LPA interviewed 0 of 0 children currently prescribed psychotropic medication. LPA provided a copy of this licensing report to Sonia Gomez, Administrator. A technical advisory was provided. This is not a deficiency. . No deficiencies are being cited at this time. LPA conducted exit interview with Sonia Gomez, Administrator.

met_with: Sonia Gomez, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 01/12/ Licensing Program Analyst (LPA) Sarina Buchannan made an unannounced visit for the purpose of conducting an annual inspection to the above facility using the Compliance and Regulatory Enforcement (CARE) tool. LPA met with Takiesha Ward, Direct Support Professional, and a walk through of the interior and exterior was completed. Physical Plant Room one is a quiet room with a bean bag, a rug, and cubes with age appropriate activities. Room two is a living room with two couches, a television, and an entertainment stand. Room three is a dining room with a table, four chairs, and a slider to the backyard. Room four is a kitchen that is fully stocked with First Aid kits, and a supply of fresh perishable food for two days and non-perishable food one week. The kitchen has a door that leads to the garage. Room five is a garage with backup perishable and non-perishable food as well as extra toiletries for clients. Upstairs are rooms six, seven, and eight which are client bedrooms. All client bedrooms have a bed with required linens, a dresser, and a night stand in good repair. Room eight is laundry room with cleaning supplies, operable washer and dryer, and is kept locked at all times. Room nine is the office which has two monitors, three desks and a staff bathroom. There are three total bathrooms all with required paper towels, working toilets, and running warm water with a temperature of at least 105 degrees. The backyard is gated with a fruit tree and is clear of debris and clean. There is a Toyota Sienna in good working condition, properly maintained, lights, tires, registration/insurance and working seat belts and is available to transport clients if needed. (report continued on LIC 809C) The following required documents were posted; license, personal rights, Emergency Disaster Plan, and grievance procedures. Disinfectants/cleaning solutions were inaccessible to children in care. Refrigerator Temperature at or below 45 degrees. Menu present and posted in the kitchen area on the fridge. Working telephone is available at the facility. Carbon monoxide and smoke detectors are in working order. First Aid Kit fully stocked. Medication centrally stored, locked/inaccessible to children. Hot water between 105-120 degrees Fahrenheit. Fire Extinguisher is up to date and in working order. Toilet, wash basin, bath, and shower fixtures in good repair/no leaks/hot water temperature. Soap and Paper towels are available to clients. The facility free of vermin. The following domains were also reviewed during today's inspection, Operations, Disaster Preparedness, Staffing, Emergency Intervention, Special Health Care Needs, and Client Records. A total of five staff files and three client files were reviewed. LPA also conducted three client interviews and three staff interviews. A review of the Licensing Information System indicates the facility is up to date on their facility fees. All the staff were fingerprint cleared and associated to the facility. Based on confidential interviews conducted there are no concerns for follow up were noted. LPA did issue one technical assistance and technical violation. Exit interview conducted and a copy of this report was provided to the facility.


raw_content:
Narrative:
There were no additional witnesses that could either corroborate or negate the incident that happened and interviews yielded conflicting information whether any physical contact occurred. One interview denied that physical contact took place, one interview could not be conducted due to diminished capacity for communication. This agency has investigated the complaint alleging that staff put a client in a choke hold. The allegation may have happened or is valid, but there is not a preponderance of evidence to prove the alleged violation occurred. We have found that the complaint was unsubstantiated at this time. An exit interview was conducted with staff and a copy of this report and appeal rights were provided to staff.

Investigation Findings:
13On this date at 4: PM Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced complaint investigation inspection at the facility and met with staff Lakasha Brown who assisted with inspection. LPA investigated this complaint by reviewing staff statements, the facility incident report, a text message, and by conducting confidential interviews with two clients, four staff, the Administrator, and one client's parents between 11/25/2025 and 3/19/2026. This complaint stems from an allegation that staff placed a youth in a choke hold following youth being aggressive with staff. Confidential interviews revealed that there are some inconsistencies pertaining to the date of occurrence and the staff involved. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tamara Jensen-Hill LICENSING EVALUATOR NAME: Alyssa M Burgess LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES, INC/TRANSITIONAL SVC PRGM.FACILITY NUMBER: VISIT DATE: 03/30/2026

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

met_with: Lakasha Brown


facility_name: KAVERE SERVICES/STOCKTON CRISIS HOMES

raw_content:
Narrative:
The Department has investigated the complaint that the client sustained unexplained injuries and client was sexually assaulted. Client sustained unexplained injuries. It was reported during a restraint on 1/9/2024 that C1 had visible scratches on C1's neck, as well as a bloody noise, and was complaining about leg pain. During a confidential interview with the Department's Investigation Bureau Investigator, (IB) Jorge Jauregui C1 stated that C1 had been restrained by staff due to C1's behavior. C1 did not remember when the incident occurred. C1 did not mention any unexplained injuries. C1 stated that C1 felt safe at Kavere. The reporting party stated that there was not any evidence that supported the current allegation and believe the force that staff used to restrain C1 was appropriated to guarantee not only the staff's safety but also C1's safety. The reporting party stated the scratches that C1 sustained were minor and did not require medical treatment. The reporting party did not see any injuries to C1's legs or bruises. The social worker has no concern about the staff. Based on the investigation, observation, records reviewed, and interviews conducted, the complaint findings are UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Client was sexually assaulted. During confidential interviews C1 stated that C1 had not been touched inappropriately by Kavere staff. C1 also stated C1 felt safe at the home. The reporting party did not see any evidence that supported the allegation. C1 also stated to the reporting party that C1 made up the allegation. C1 was upset for not being allowed to play music videos. The social worker for C1 stated that he did not have any concerns regarding staff. Based on the investigation, observation, records reviewed, and interviews conducted, the complaint findings are UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. No title 22 regulations were cited during today's inspection. A copy of this report and appeal rights were given to the agency.

Investigation Findings:
13Licensing Program Analyst (LPA) Mary Shelton conducted a visit to the home on 2/14/2024 at 8: AM, and LPA spoke with the Administrator to deliver findings of the investigation on the complaint allegations as stated. LPA Shelton informed the complaint investigation included a tour of the facility on 1/19/2024. LPA Shelton informed the Administrator this case was investigated by the Department's Investigation Bureau Investigator, (IB) Jorge Jauregui. The initial 10-day complaint inspection was conducted by LPA Connie Goldie, at the home on 1/19/2024 which, included a Physical Plant Inspection of the home and obtaining of relevant documents: related to the clients and staff at the facility to include client roster, face sheets, staff roster, including staff contact information and schedule for current month, facility sketch, Pro-Act certificates, restraint logs for January 2024, and Needs and Services Plan and case notes for C1. Investigator, (IB) Jorge Jauregui, interviewed the reporting party, social worker, Intern and C1. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Mary Shelton LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES/STOCKTON CRISIS HOMESFACILITY NUMBER: VISIT DATE: 02/14/2024

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


raw_content:
Narrative:
The Department has investigated the complaint that Staff used prohibited restraints on a youth causing marks. C1 was not interviewed for the purpose of this complaint. The bio-parents thought it was best for C1 not to be interviewed. C2 is non-verbal and LPA was unable to establish a rapport. C3 did not want to talk about being restrained. When discussing restraints with the staff and other individuals, the youths are restrained only when they are a danger to themselves or other individuals in the home, it is a last resort and other de-escalation techniques have failed. A copy of Kavere Services Emergency Interventions Plan is located within the Program Statement which outline the use of restraints. Staff conducted a body check on C1 and found several marks on C1's lower back and a small mark on C1's chin. Staff stated the injuries could have occurred before the restraint. C1 grabbed staff's glasses, started swinging on staff, biting, and grabbing staff. The Pro Act trainer reviewed the Incident Report dated 2/11/2023 and stated that the injuries could have occurred when C1 wedged himself between the bed and door. Staff interviewed stated they never put pressure to the back when doing a restraint. Based on the investigation, observation, records reviewed, and interviews conducted, the complaint findings are UNSUBSTANTIATED at this time meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. No title 22 regulations were cited during today's inspection. A copy of this report and appeal rights were given to the agency.

Investigation Findings:
13Licensing Program Analyst (LPA) Mary Shelton conducted a visit to the home on 4/24/2024 at 12: PM, and LPA spoke with the Administrator, to deliver findings of the investigation on the complaint allegation as stated. LPA Shelton informed the complaint investigation included a Physical Plant Inspection of the home on 1/10/2024. The initial 10-day complaint inspection was conducted by LPA Mary Shelton, at the agency on 1/10/2024 included a review of the facility and obtaining of relevant documents: documentation related to the clients and staff at the facility to include client roster, face sheets, staff roster, including staff contact information and schedule for current month, facility sketch, Pro-Act certificates, restraint logs, and Needs and Services Plan and case notes for C1. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Mary Shelton LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES/STOCKTON CRISIS HOMESFACILITY NUMBER: VISIT DATE: 04/24/2024

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


raw_content:
Narrative:
Allegation 1. Staff inappropriately restrained minor resulting in injuries. During the initial interview of FC1 at school, FC1 revealed that S1 pushed FC1 down and tried to choke FC1. During the second interview, FC1 stated there were two staff members who choked FC1. When LPA questioned FC1 about the inconsistency, FC1 declined any further response to the LPA's questions. Staff denied restraining FC1. Based on LPA's confidential interviews and documents reviewed, the allegation that Staff inappropriately restrained minor resulting in injuries is unsubstantiated, meaning that the allegation lacks a preponderance of evidence to prove that the violation occurred. Allegation 2. Staff inappropriately spoke to minor in care. It was alleged that S1 made inappropriate threats to FC1 during an altercation. FC1 did not recall the alleged statements when LPA interviewed FC1 on both occasions. Staff denied the alleged threats to FC1. Based on LPA's confidential interviews and documents reviewed, the allegation that Staff inappropriately spoke to minor in care is unsubstantiated, meaning that the allegation lacks a preponderance of evidence to prove that the violation occurred. Allegation 3. Staff refused to provide food to minor. During LPAs interview with FC1, FC1 stated that staff refused to provide a second helping of food to FC1. FC1 got angry and began to destroy things at the facility. S1 stated the FC1 never requested a second helping of food but began picking on FC2 while at the table and then directed his anger to staff once he got up from the table. S2 and S3 did not observe the incident but was later told of the incident by S1. Based on LPA's confidential interviews and documents reviewed, the allegation that Staff refused to provide food to minor is unsubstantiated, meaning that the allegation lacks a preponderance of evidence to prove that the violation occurred. Exit interview was conducted with Noel Maldonado, the DSP. A copy of the report and Appeal Rights were provided to the facility.

Investigation Findings:
13On 5/30/24 about 4: PM, Licensing Program Analyst, (LPA) Uchenna Ajaero conducted an unannounced complaint investigation visit to deliver finding for this allegation. LPA Ajaero met with Noel Maldonado, the DSP and informed him of the purpose of the visit. On 3/12/2024, LPA Ajaero visited the facility and met with the Administrator. LPA requested and received client file (C1) and obtained copies of Identification Sheet, Needs and Service Plans, IEP, and Progress Reports from January to March 2024. LPA interviewed the Administrator, (AD) and one staff member, (S1). LPA Ajaero interviewed FC1, FC1's teacher and three staff between 3/13/24 and 3/21/24. LPA reinterviewed FC1 on 4/1/2024. FC2 is nonverbal and could not be interviewed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Uchenna Ajaero LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: KAVERE SERVICES/STOCKTON CRISIS HOMESFACILITY NUMBER: VISIT DATE: 05/30/2024

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

met_with: Noel Maldonado, DSP


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Jean Stidman and Stefanie Whitlow on 5/5/21 at 9am. During the inspection, LPA Stidman & Whitlow met with Najon Saina, Administrator and inspected the facility inside and out. Due to restrictions of COVID-19, this inspection was conducted via Facetime. All files and medication documents were sent to LPA Stidman prior to the inspection. LPA did not review any child's records at the facility. LPA reviewed four staff personnel files prior to the inspection. LPA interviewed three staff on site at 9:00am. LPA did not interview any children currently taking psychotropic medication. No deficiencies being cited at this time. One Advisory Notes for Technical Violation and one Advisory Note for Technical Assistance were given. LPA conducted exit interview with Najon Saina, Administrator at 10:30am. LPA provided the Summary Report to Najon Saina, Administrator upon completion by email with a request for signature and to scan this back to the LPA Stidman with their signature on this date.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Jean Stidman and Stefanie Whitlow on 5/6/21 at 8:00am. During the inspection, LPA Stidman & Whitlow interviewed one staff on site. Due to restrictions of COVID-19, this inspection was conducted via Facetime. All files and medication documents were sent to LPA Stidman prior to the inspection. LPA interviewed one staff on site at 8:00am. LPA conducted exit interview with Najon Saina, Administrator at 8:30am. LPA provided the Summary Report to Najon Saina, Administrator upon completion by email with a request for signature and to scan this back to the LPA Stidman with their signature on this date.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Shoua Xiong conducted an unannounced inspection visit to the facility on 10/19/21 beginning at 10: AM. LPA met with Najon Saina, Administrator, and explained the purpose of the visit was to conduct an ANNUAL/REQUIRED inspection. At the time of arrival, there was one staff on shift and zero clients present, as they were currently in school. On today's date, LPA conducted a physical inspection of the home. LPA observed that each client was provided their own bedroom with beds, beddings, dressers, closet space, and adequate lighting. Extra linen and hygiene supplies was observed in hall closets. Smoke Detectors was present in each bedroom, in the hall, in the common area, and was in working condition. LPA observed an operating carbon monoxide detector and a charged fire extinguisher in the home. LPA observed that the facility had two refrigerators and stocked kitchen cabinets which contained more than two days' worth of perishable food items and seven days' worth of non-perishable food items. Knives, cleaning solutions, and medications were stored in locked closets. A complete First aid kit along with the manual was present in the facility. All sink faucets and toilets was observed to be in working order. The hot water was tested and was within the required range of 105 degrees F and 120 degrees F. The outside area was clean and free of safety hazards. LPA also conducted a review of two client files. LPA observed that the files were complete and had all the required documents. LPA conducted one staff interview. Two residents in care arrived from school around 3: PM. LPA attempted to conduct interviews with residents but was unable to complete the interviews due to one resident ending the interview early and the second resident refusing to speak with LPA. LPA was unable to begin reviewing staff files. LPA informed Administrator that they will return on another date and time to complete the Annual inspection process. No deficiencies were cited on today's date. Exit interview conducted and a copy of this report was given to Najon Saina, Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Shoua Xiong conducted an unannounced inspection visit to the facility on 10/20/21 beginning at 10: Am. LPA met with Najon Saina, Administrator, and explained the purpose of the visit was for an Annual Continuation of the inspection visit which began on 10/19/21. On today's date, LPA reviewed ten staff files. All staff files were found to be complete with the required documents present. However, LPA had technical difficulty and was unable to access and continue using the CARES inspection tool document. LPA will return on a different date and time to complete the inspection process. No deficiencies were cited on today's date. Exit interview conducted and a copy of this report was given to the Administrator, Najon Saina.


summary: Facility Evaluation

raw_content:
Narrative:
On 8/17/22, Licensing Program Analysts, (LPAs) Uchenna Ajaero and Connie Goldie, paid an unannounced annual/required inspection and met with the facility administrator (AD), Kate Rush. LPAs introduced themselves and informed the AD of the purpose of their visit. Entrance checklist was provided to the administrator. The licensing fees are current. The facility is licensed for 3 youths and has 2 youths currently placed. At 11:05 am, the LPAs and the AD toured the home. The kitchen was clean and organized, There were fresh fruits on the counter for the residents. The fridge was clean, there were no open foods. There was perishable food for about two days and nonperishable food for about 5 days. There were client's rights poster on the wall but it was outdated but the AD posted a current one. AD stated she has clients who are traumatized by the wording Foster Kids on the current personal rights poster so she printed a current version from the Department of Social Services site. At 11:30 am we inspected the garage. It was clean. There was hand washing sink in the garage, cleaning supplies were locked up in a cabinet, there was an extra fire extinguisher in the garage, there was a fridge with perishable food items and boxes of emergency foods. At 11:45 am we toured the bedrooms and they were neat. The beds were made, they had sheets, bed covers, comforter and top sheet with 2 pillows. The rooms were bright and lighted, the dressers were neat and closed appropriately, there were clothes hanging in the closet and more clothes folded away in the dressers. In the hall way there were clean folded linens, towels and personal toiletries. AD checked the alarm in the rooms and hall way and we observed that they all worked. . At 2:00 pm LPA Ajaero interviewed AD, S1 and S2. LPA's reviewed Community Care Licensing file, unusual incident reports, facility roster, facility profile and complaint history. LPAs reviewed 2 client files. All documents were compliant per regulations. One technical advisory was given and we explained to the AD that a technical advisory is not a deficiency. No deficiency is cited today. Exit interview was conducted, a copy of the report was provided, appeal rights were discussed and emailed.

met_with: Kate Rush, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 8/18/22, Licensing Program Analysts, Uchenna Ajaero and Connie Goldie returned to the facility to complete the Annual Continuation Inspection visit that began on 8/17/22. LPAs met with the Administrator Kate Rush, AD. to assist with completion of inspection. No deficiencies were cited. At 1:10 pm LPAs interviewed C1 as he had a minimum day at school. LPA reviewed 2-staff records, and Administrator's training records and documents, and the LIC 500. LPAs interviewed C2 at 3:40 pm. Exit interview was conducted, appeal rights were discussed and document emailed to Administrator and return receipt requested.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Katherine Rush, Administrator on 5/25/23 at 9:30am. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Stidman met with Katherine Rush, Administrator and inspected the facility inside and out. LPA reviewed zero child's records and two staff personnel files on site at the facility. LPA did not review any child's psychotropic medications and medication records due to the clients are not dependents of the courts (aka foster children). LPA interviewed two staff on site to discuss the facilities policies and procedures of operation. LPA did not interviewed any children currently prescribed psychotropic medication due to the clients are not dependents of the courts (aka foster children). LPA observed the backyard fence on the left side of the yard (as you're facing the house from the street) has a board missing. The administrator provided documentation of a work order to have this repaired has been requested. LPA provided a copy of this licensing report to Katherine Rush, Administrator. No deficiencies are being cited at this time. LPA conducted exit interview with Katherine Rush, Administrator..

met_with: Katherine Rush, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 05/30/2023, at 08: AM, Licensing Program Analyst, (LPA) Uchenna Ajaero, met with the Administrator Kate Rush to conduct an unannounced Annual / Required inspection of the facility. This facility is a Group Home. LPA Ajaero gave the Administrator the Entrance Checklist Form LIC 9239. The facility consists of three bedrooms and two bathrooms. There are a total of two clients. At 11:30 am, we started a walk through of the facility for the inspection. The facility was observed to be clean, organized, and free of debris and clutter. The home contained a living room, a kitchen, dining room, and office. The dining room and multi-media room had a table for the clients to sit and eat, and complete activities and homework. The clients bedrooms were observed to be bright, contain an individual bed, clean linens, clothes were organized in the closet and there were multiple storage space for client property. It was observed that several documents were posted on the board for easy access. The facility license, facility sketch, emergency plan, emergency telephone numbers, and fire clearance were observed to be posted in a prominent place. The fire extinguisher was observed to be charged and up-to-date and was last serviced in May 15, 2023. In the hallway were two closets. One contained extra blankets and linens. The other one contained client activities, games, books and craft items. The refrigerator and freezer had enough food to last more than 2 days. The pantry held enough nonperishable food that will last more than 5 days. There were varieties of snacks in the home. LPA Ajaero completed the Personnel Review of two staff working at this facility. LPA compared them to the list of staff on Guardian who are associated with this facility and who are cleared and eligible to work in the facility and there were no discrepancies. LPA Ajaero completed the LIC 859 file review for 2 staff members ensuring their documents were up to date and in compliance. LPA Ajaero Reviewed the medications of both youths at this facility. The following were checked for compliance: First aid kit available and it had an adequate supply of items. Clients' medication kit stored and MARs updated. Cleaning Supplies: Adequate, locked and stored. Water temperature was below 110 degrees F. Facility kitchen had knives and other accessories in a locked cabinet. Adequate food supply including perishable and non-perishable items Fire extinguishers checked; smoke detectors and carbon monoxide detectors are working but not checked due to the clients being at home. Emergency Exit Plan and Mass Casualty Disaster Plan, menu, and activity schedule were posted in the facility. Telephone: Available and in operable condition. Staff and Client files: Reviewed and all required documents were present. Staff gave LPA the LIC 9239 with required documents. Licensing Program Analyst, (LPA) Uchenna Ajaero completed an exit interview today. No Title 22 citations were issued during this inspection. A copy of this report, has been provided to the Administrator, Kate Rush.


summary: Facility Evaluation

raw_content:
Narrative:
On 4/11/24, LPA Uchenna Ajaero attempted to conduct and annual investigation at the Kavere Monique location but no one was at the home. LPA contacted the Administrator Marc and he said he was not available and staff is out shopping at the time since all the youths are at school. LPA will conduct this visit at a later time.


summary: Facility Evaluation

raw_content:
Narrative:
On 4/18/24, Licensing Program Analyst, (LPA) Uchenna Ajaero made an unannounced visit to Kavere Home in Stockton to conduct the annual inspection of the facility. During the inspection LPA conducted a health and safety inspection of the home with the administrator, Marc Verzosa. The following were checked for compliance: First aid kit available and it had an adequate supply of items. Clients' medication kit stored and MARs updated. Cleaning Supplies: Adequate, locked and stored. Water temperature was below 110 degrees F. Facility kitchen had knives and other accessories in a locked cabinet. Adequate food supply including perishable and non-perishable items Fire extinguishers checked; smoke detectors and carbon monoxide detectors are working but not checked due to the clients being at home. Emergency Exit Plan and Mass Casualty Disaster Plan, menu, and activity schedule were posted in the facility. Telephone: Available and in operable condition. Staff and Client files: Reviewed and all required documents were present. Staff gave LPA the LIC 9239 with required documents. Licensing Program Analyst, (LPA) Uchenna Ajaero completed an exit interview today. No Title 22 citations were issued during this inspection. A copy of this report, has been provided to the Administrator, Marc Verzosa.

met_with: Marc Verzosa


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst made an unannounced annual inspection at the facility and met with staff Yvonne Hernandez who assisted with the inspection. Administrator Sonia Gomez arrived shortly after and assisted LPA with the inspection. LPA conducted a walk-through of the facility with staff Noel Maldonado and observed the following: one dining area, kitchen, hallway, living room, two client bedrooms, two bathrooms, the garage, one staff office, and the backyard. The clients' bedrooms met requirements and had the necessary personal storage space, with clean, complete bedding. Clients had appropriate clothing, in reasonable quantities. One client's closet doors were off track and possibly needed to be repaired. The food at the facility met the standards for a minimum of 2 days perishable and 7 days non-perishable, with a variety of meals and snacks. The facility's menu was posted, as well as their activity plan. The carbon monoxide detector and smoke detector were tested and operational. There was no hot water sign indicating hot water above the coffee machine and water machine as required. There were three (roughly 4 inch) holes in the ground near the perimeter of the house in the backyard which need covers. There was one section of fencing in the backyard which staff stated was rotting due to the sprinkler, resulting in exposed rusty nails. The inside of the home was clean, safe, sanitary, and in good repair. The temperature inside the home was comfortable for clients, staff, and guests. The facility has a cordless phone on the premises for client use. Client files, money, and medications were locked up/inaccessible to clients as required. The Board of Directors meets on at least a quarterly basis as required. The meeting notes were available to LPA to inspect. The board either did not discuss, or did not document, current complaints and incident reports reviewed for each facility. The facility is conducting fire and disaster drills at least quarterly for each shift as required. The facility's emergency disaster plan/mass casualty plan is complete, meeting all requirements. It had not been signed off on as having been reviewed however, since 10/2023. On this date, the Administrator reviewed and signed. The plan stated the facility will utilize an ice chest and "blue ice" to preserve any medications which require refrigeration in the event of a power outage, however the facility did not have an ice chest. One client was not able to communicate with LPA, and the other client did not want to speak to LPA on this date. LPA will attempt to speak with the client on another date. The staff files and training records are maintained at another one of the licensee's facilities, and due to the time, LPA could not review them on this date. LPA advised for the records to be present at this facility for when LPA returns to complete the annual. No citations were issued during today's inspection. LPA is issuing advisory notes, which are not citations. An exit interview was conducted with the Administrator, and a copy of this report was provided to her.

met_with: Yvonne Hernandez & Sonia Gomez


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced annual continuation inspection to continue the annual started on 5/30/2025. LPA met with Administrator Sonia Gomez who assisted with the inspection. LPA reviewed 5 personnel files: Staff, Facility Manager, and Administrator, and found the following: All staff are fingerprint cleared and associated as required. All staff are trained with the additional 1 hour of Facility Manager Training. All staff have current Pro-Act Training for emergency interventions. All staff have received the required annual training hours. The Administrator's duties were missing from her file, which she put in the file during this inspection. All staff reviewed have had a Health Screening and TB test as required. All staff are qualified for their roles, and evidence of such was in their files as required. The facility has consultants who meet with the clients as required including BCBAs and interns, a Psychiatrist, and a Recreation Therapist. All staffs' First Aid and CPR are current. All staffs' drivers' licenses are current. LPA reviewed two client files and found: All client records are present, except for the signed discipline policy. Both clients' files have the required Needs and Services Plans, Immunizations, TB test, Cash Resources/records, Medication Administration Records, authorization from parents/guardians to take psychotropic medications, and identifying information. The Cash Resources Log for C2 was off by $2, due to staff missing the receipt saying $17 for a haircut that usually cost $15. This was corrected during this inspection. LPA interviewed one client, one staff, and the Administrator. Staff/Administrator were knowledgeable about the clients and facility practices. LPA advises staff be given a refresher on the Mandated Reporting process. No citations were issued. LPA issued Advisory Notes for Technical Violations, and these are not citations. An exit interview was conducted with Administrator and a copy of this report and confidential names list were provided to her.

met_with: Sonia Gomez


summary: Facility Evaluation

raw_content:
Narrative:
On 1/12/ LPA Sarina Buchannan arrived unannounced at the above facility for the purpose of conducting a case management inspection. LPA was met by Takiehsa Ward, who assisted LPA with the inspection. LPA conducted a walk through of the facility and no deficiency was noted. LPA did not conduct interviews or obtain any documentation. This case management is closed. No further investigation needed. Exit interview conducted and a copy of this report was provided to the facility.

met_with: Takiesha Ward, Direct Support Professional