summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On April 13, 2023, Licensing Program Analyst (LPA) Eduardo Barragan conducted an unannounced annual inspection. LPA was met at the facility by Esmeralda Rodriquez. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris. A pool is located in the backyard. The pool is gated and secured with locking gate. There is adequate indoor and outdoor activity space. All facility smoke detectors and carbon monoxide detectors were tested and observed to be in working order; fire extinguisher is properly charged and serviced. Licensee maintains an adequate supply of perishable and non-perishable foods to prepare the items on the posted menu. LPA observed a minimum 7-day non-perishable and 2-day perishable supply of food. All required forms are posted including Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster, the Emergency Disaster Plan was also posted. Clients medications were observed to be inaccessible and stored in a locked file cabinet in the staff office in a closet. Medication records were observed to be completed with dates and staff initials on dispensing records. There are two cameras at the facility. One was located in the front of the home and the other was located in the backyard. Individual beds were observed with clean linens, pillows, comforters, and mattress in good repair. All three bedrooms contain two twin beds. The facility has two client bathrooms. The water temperature in the bathroom one of two was tested and measured at 116 degrees which is within the appropriate range of 105 degrees to 120 degrees. Per facility staff, no firearms or weapons are allowed in the facility. Continued... Due to computer error the documents were not saved and hard copies with signatures are on file. All client files are stored and locked in the file cabinet in the staff office. LPA reviewed client files to ensure clients had all required documents per Title 22. LPA reviewed staff files and interviewed staff. Prior to inspection LPA reviewed personnel files to ensure they contained all required documentation per Title Regulations. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. All the staff have met the training and qualification requirements per regulations requirements. One deficiency was found. Please refer to 809D. Exit interview was conducted and a copy of this report and appeal rights were provided to Esmeralda Rodriquez, Administrator. Due to computer error the documents were not saved and the hard copies along with signatures are on file.

Deficiencies:
80026(h): Safeguards for Cash Resources, Personal Property, and Valuables

(h) Each licensee shall maintain accurate records of accounts of cash resources, personal property, and valuables entrusted to his/her care, including, but not limited to the following

met_with: Esmeralda Rodriquez, Administrator


state: CA

facility_name: HART COMMUNITY HOMES - BRADY HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Olivia Rosas and Licensing Program Manager (LPM) Angela King conducted a case management inspection on 6/13/23 at 10:18am based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. During this inspection, 5 out of Direct Care Staff and 5 out of 5 youth files were reviewed. 2 out of Direct Care Staff and 2 out of 5 youth were interviewed. (See the Confidential Names List, LIC 811, 6/13/23). The Plan of Operation including policies and procedures were reviewed. Minutes from the board of directors' meetings related to the facility's incidents involving contact with law enforcement were reviewed. Based on the analysis of the confidential interviews and youth file review including the needs and service assessments, quarterly report assessments, and client safety plans. The licensee uses trauma-informed and evidence-based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. LPA Rosas and LPM King, observed documentation of completed training on policies and procedures on when and how to involve law enforcement in response to an incident. Training records show staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance with their Emergency Intervention Plan when there is an immediate risk of serious harm to a child or others. There are no deficiencies cited at this time. A copy of this report was discussed and provided to Administrator Esmeralda Rodriguez.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Esmeralda Rodriguez, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On the date listed above at 6: PM, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced to the facility for the purpose of conducting collateral interviews with two staff. LPA met with Crystal Padilla, Direct Care Staff, and explained that the complaint investigation is not on their facility. LPA conducted two interviews with two staff. LPA toured the facility and the facility was in compliance with Title 22 regulations, Chapter 5, therefore no deficiencies were cited. Due to printer malfunction, a copy of this report will be emailed to the Facility Administrator.

met_with: Crystal Padilla


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Guadalupe Munoz on July 10, 2024 at 10: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Munoz met with Administrator Celia Vasquez and Facility Manager, Yomaira Vasquez. LPA inspected the facility inside and out and did not observe any deficiencies. LPA reviewed two of two child's records and two of staff personnel files on site at the facility. LPA reviewed two of two child's psychotropic medications and medication records. LPA interviewed three staff on site to discuss the facilities policies and procedures of operation. LPA interviewed two of two youth currently prescribed psychotropic. During the inspection LPA did not observe any violations therefore no deficiencies are being cited at this time. LPAs conducted exit interview with Administrator, Celia Vasquez and a copy of this report, LIC 811 dated 7/10/24 were provided to the administrator.

met_with: Celia Vasquez


summary: Facility Evaluation

raw_content:
Narrative:
On September 24, 2024, at 11:00 am, Licensing Program Analyst (LPA) Charmaine Linley conducted an unannounced annual required inspection. LPA was met at the facility by Mya Vasquez, Facility Manager, and Celia Vasquez, Residential Director. The purpose of this inspection is to conduct a required annual for the STRTP. The facility has a capacity of six clients with a current census of five clients. LPA toured the facility with Mya Vasquez and Celia Vasquez. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris. A pool is located in the backyard. The pool is gated and secured with locking gate. There is adequate indoor and outdoor activity space. All facility smoke detectors and carbon monoxide detectors were tested and observed to be in working order; fire extinguisher is properly charged and serviced. Licensee maintains an adequate supply of perishable and non-perishable foods to prepare the items on the posted menu. LPA observed a minimum 7-day non-perishable and 2-day perishable supply of food. The water temperature was measured at 125 degrees at 1:35 pm in the kitchen which is within the appropriate range of 105 degrees to 120 degrees. All required forms are posted including Grievance Procedures, Visitation Policies, Personal Rights form, Foster Care Ombudsman poster, and the Emergency Disaster Plan. Clients' medications were observed to be inaccessible and stored in a locked file cabinet in the staff office. Medication records were observed to be completed with dates and staff initials on dispensing records. There are two cameras at the facility. One was located in the front of the home and the other was located in the backyard. Per facility staff, no firearms or weapons are allowed in the facility. Individual beds were observed with clean linens, pillows, comforters, and mattress in good repair. All three bedrooms contain two twin beds. The facility has two client bathrooms. The water temperature in the bathroom one of two was tested and measured at 106 degrees at 1:36 pm, which is within the appropriate range of 105 degrees to 120 degrees. *** All client files are stored and locked in the file cabinet in the staff office. LPA reviewed a sample of five client files to ensure clients had all required documents per Title 22 (see confidential name list, dated 09/24/2024). LPA interviewed two clients. LPA reviewed a sample of five staff files (see confidential name list, dated 09/24/2024). All staff met the minimum qualifications and training requirements. A review of records shows that all staff have FBI, DOJ, and Child Abuse Index Check clearances. All staff have proof in file of acknowledging the child abuse reporting requirements. LPA interviewed two staff. The licensing fee payments are current. Based on the facility inspection and file reviews on this date, there are no deficiencies found at this time. An exit interview was conducted due to printer malfunction, a copy of this report was emailed to the Facility Administrator, Celia Vasquez. A copy of this report will be placed in the facility file.


summary: Facility Evaluation

raw_content:
Narrative:
On June 30, 2025, at 10: AM, Licensing Program Analyst (LPA) Stefanie Mutialu arrived at the facility to perform an annual inspection upon arrival LPA Mutialu met with Administrator, Celia Vasquez. Upon entrance, the LPA was made aware facility was under construction. A case management has been opened on 06/30/ LPA observed renovations being performed at the facility and Community Care Licensing was not notified. LPA observed a construction worker performing renovations and no furniture in the facility. Per Administrator, Celia Vasquez licensing was notified of renovations when facility notified LPA Linely of facility temporary closure on 02/28/25 and 03/12/2025. LPA advised Administrator, Celia Vasquez there is no mention of restructuring the facility or renovations and only mentions restructuring the program and population served. The facility is receiving a Type B citation. LPA advised the Administrator an inspection must be conducted prior to enrolling clients. The Short-Term Residential Therapy Program facility is being cited for violating California Code of Regulations Title 22, Division 6, Section 80086: Alterations to Existing Building or new facility. An exit interview was conducted with the Administrator, Celia Vasquez. A copy of this report and appeal rights were discussed and provided to the Administrator, Celia Vasquez.

met_with: Administrator, Celia Vasquez.


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA), Val Wilson, on May 3, 2022, at 2:00PM. During the inspection, LPA Wilson met with Esmeralda Rodriguez, Administrator, and inspected the facility inside and out. LPA reviewed four of the four children's records on site at the facility at 4:30PM. During the review of children's records, LPA Wilson observed 4 out of 4 children (C1, C2, C3, C4) did not have a current Needs & Services Plan. Administrator was unable to locate Needs and Services Plans that provide updates at least every 30 days LPA reviewed three of three of the staff personnel files on site at the facility at 2:30PM. LPA interviewed three of three of staff on site at 3:50PM. LPA interviewed four of the four children currently taking psychotropic medication at 5:00PM. LPA conducted an exit interview with Esmeralda Rodriguez, via phone, and Claudia Bory, Direct Care Staff, at 7: PM. One deficiency was observed (refer to LIC 809D) and cited. Based on the records review and interview, LPA Wilson observed the Needs and Services Plan for four of four children (C1, C2, C3, and C4's) record did not include Needs and Services Plans updated at least every 30 days. The facility will be cited under STRTP ILS, Version 4, Section 87068.3(a) Modifications to The Needs And Services Plan. LPA provided the Summary Report to Claudia Bory, Direct Care Staff, upon completion.

Deficiencies:
87068.3(a): 1
2
3
4
5
6
787068.3(a) Modifications to The Needs And Services Plan
(a) The needs and services plan specified in Section 87068.2 shall be updated at least every 30 days to determine the following


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On February 20, 2024, at 10:30 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Celia Vasquez, Residential Director, to assess a Civil Penalty. LPA Linley conducted confidential interviews and a record review which indicted that there were two staff (S1, S2) who did not have a criminal record clearance prior to working at the facility. LPA reviewed Guardian to ensure that staff had a criminal record clearance, review indicated that S1 and S2's clearances were pending. LPA Linley requested copies of the staff roster and asked for any supporting documents the facility may have and what they provided was incomplete it was only the DOJ clearance. Staff roster indicated that S1 and S2 had been working at the facility. LPA Linley is administering two civil penalties during this visit. The facility is being cited for the violation of California Code of Regulations, Title 22, Division Six, regulation 80019(e) Criminal Record Clearance. Record review confirms S1 and S2 have worked in the facility without a criminal record clearance. An immediate civil penalty is being issued for $1,000. An exit interview was conducted with Celia Vasquez, Residential Director. Due to printer malfunction, a copy of this report and appeal rights were emailed to Celia Vasquez, Residential Director. A copy of this report will be placed in the facility file.

Deficiencies:
80019(e): 1
2
3
4
5
6
780019 Criminal Record Clearance(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On October 24, 2024, at 3:45 pm, Licensing Program Analyst (LPA) Charmaine Linley was at the facility conducting interviews. LPA was in the driveway and observed a 11.5 inch front windshield crack in front of the driver's side. Confidential interviews indicated the crack in the windshield has been there for over a month and the facility staff has been transporting residents in the van. The facility was asked if they had any documentation of the repairs or a repair date scheduled and LPA was informed there were no documents and a date had not been scheduled for the windshield repair. The facility is being cited for violation of the California Code of Regulations, Title Division Six, regulation 80074(c) Transportation. An exit interview was conducted, and appeal rights were reviewed with Mya Vasquez. Due to technical difficulties, a copy of this report and appeal rights were emailed to the Facility Administrator. A signed copy of this report will be kept in the Facility file.

Deficiencies:
80074: Motor vehicles used to transport clients shall be maintained in a safe operating condition.

met_with: Mya Vasquez

title:
1
2
3
4
5
6
780074(c) Transportation


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On November 6, 2024, at 11:45 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced to the facility and met with Celia Vasquez, Facility Administrator, to discuss the records reviewed on November 1, 2024. During a record review of the facility's personnel records, LPA observed there was a change in the Head of Service at the facility. LPA conducted confidential interviews that confirmed that a new Head of Service was employed at the facility on September 19, 2024. The facility did not notify Community Care Licensing of the change in the Head of Service. Based on record review and confidential interviews, the facility is being cited for STRTP Interim Licensing Standards regulation 87061(f) Reporting Requirements. An exit interview was conducted, appeal rights explained, and a copy of this report and appeal rights were provided to Celia Vasquez. A copy of this report will be placed in the facility file.

Deficiencies:
87061(f): Name, facility address, mailing addresses of the new head of service, and the date assumed position.
1
2
3
4
5
6
7Per Celia Vasquez, an email will be sent to LPA by 11/12/2024 by 5:00 pm, of the change in Head of Service with the following: Name, facility address, mailing addresses of the new head of service, and the date assumed position.
8
9
10
11
12
13
14

title: The licensee shall notify the Department, in writing, within ten (10) calendar days of any change in the mental health program head of service. If a new mental health program head of service is hired, the notification shall include the following


facility_name: HARVARD HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
On September 8, Licensing Program Analyst Wayne Aoki conducted a required annual inspection at the Harvard House. LPA was met at the facility by facility Administrator Vernell Watts. LPA conducted entrance interview and completed a tour of the facility. Staff and children's files were reviewed. LPA reviewed the facility's disaster plan. LPAs requested the following updated documents by September 1, 2021. LIC LIC LIC LIC 610C There were no deficiencies cited during this inspection. A copy of this report was left at the facility at the conclusion of the inspection.

visit_type: Annual

met_with: Vernell Watts


summary: Facility Evaluation

raw_content:
Narrative:
On this date, May 4, 2022, an unannounced required annual inspection was conducted by Licensing Program Analyst (LPA) Wayne Aoki. LPA were met by facility Administrator, Vernell Watts. LPA inspected the facility, inside and out. Centrally stored medications and sharps are maintained in a locked closet. LPA inspected the medications for the minors in care. The facility has a written emergency disaster plan. All facility smoke and carbon monoxide detectors were tested and appear to be in appropriate working order, fire extinguisher is properly charged and was last serviced August 23, 2021. Individual beds were observed with appropriate clean linens and are in good repair. There is at least one week supply of nonperishable and a two day supply of perishable foods. The facility is maintained at 72 degrees. Hot water temperature measured 115 degrees. Facility cameras are allowed in the facility and there are no pets. There were 2 staff and 4 minors present during this inspection. All staff and minor's files reviewed. LPA interviewed 2 of the 4 minors (2 minors did not want to speak with the LPA) and 2 staff interviewed. LPA reviewed the facility's disaster plan, sampled medication and reviewed facility logs. LPA requested the following updated documents be sent to LPA by May 31, 2022: LIC 308, LIC 309, LIC 400, LIC 500 and LIC 610C There were no deficiencies cited during this inspection. A copy of this report was left at the facility at the conclusion of the inspection


summary: Facility Evaluation

raw_content:
Narrative:
On May 9, Licensing Program Analyst (LPA) met with Mr. Fletcher to conduct a Case Management regarding the incident of May 5, 2022 where M1 and M2 absconded from the facility and attempted to car jack and individual. M1 assaulted a female driver in attempt to car jack her car. That individual left the scene and returned with her boyfriend who assaulted M2 as M1 ran back to the facility. M1 returned back to the facility and reported that M2 was shot. Upon this disclosure, staff contacted the House Manager (HM) and the HM informed Mr. Fletcher. Upon hearing of the incident Mr. Fletcher went to scene to find out what had happened. Mr. Fletcher was told by Fresno Police Department that M1 assaulted a female driver in hopes of car jacking that individual. The driver left the scene and returned back with her boyfriend who then assaulted M2 as he was still at the scene. M2 was not shot but sustained multiple contusions and was taken to the hospital where he was released the next morning. Mr. Fletcher contacted M1's probation officer and informed him of M1's actions. M1 was taken into custody upon the request of Mr. Fletcher and M1's bed closed. An incident report was sent to Community Care Licensing.

met_with: Clinard Fletcher


summary: Facility Evaluation

raw_content:
Narrative:
On 05/18/2022, Licensing Program Analyst (LPA) Tamara Melikian conducted a follow up SB Psychotropic Medication inspection at the above facility office to review staff files and training. Met at the facility office by Administrator Clinard Fletcher and Program Director Vernell Watts. Files reviewed at 1:20PM. There were no deficiencies cited on this date. A copy of this report was left with Program Director Vernell Watts upon completion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced annual inspection was conducted by LPA (Licensing Program Analyst's) Reyna Martinez. LPA met with Joe Vargas, House Manager and inspected the facility, inside and out. Centrally stored medications are maintained in a locked closet in a locked cabinet. Sharps and Toxic chemicals are kept locked. The facility has a written emergency disaster plan. All facility smoke detectors and carbon monoxide were tested and appear to be in appropriate working order, fire extinguisher is properly charged and was last serviced August 2022. Individual beds were observed with appropriate clean linens and are in good repair. There is at least one-week supply of nonperishable and a two-day supply of perishable foods. The facility is maintained at 69 degrees. Hot water temperature measures 112.6 degrees. Facility has cameras in common areas of the facility. No firearms or weapons are allowed in the facility. Appropriate staff/client ratios were verified during this inspection. The facility employs 1 facility manager and 8 direct care staff, 2 behavior specialist's, 1 clinician and 1 clinical supervisor. Personnel Files are maintained at the main office, but were brought to the facility for review. 3 staff was available to be interviewed. LPA reviewed the facility's disaster plan, sampled medication and reviewed facility logs. 6 records of clients were reviewed. LPA interviewed 1 of the 6 minors (5 minors did not want to speak with the LPA). There were no deficiencies cited during this inspection. A copy of this report was left at the facility at the conclusion of the inspection

met_with: Joe Vargas


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced annual inspection was conducted by LPA (Licensing Program Analyst's) Reyna Martinez. LPA met with Joe Vargas, House Manager and inspected the facility, inside and out. Centrally stored medications are maintained in a locked closet in a locked cabinet. Sharps and Toxic chemicals are kept locked. The facility has a written emergency disaster plan. All facility smoke detectors and carbon monoxide were tested and appear to be in appropriate working order, fire extinguisher is properly charged and was last serviced August 2023. Individual beds were observed with appropriate clean linens and are in good repair. The facility is CARF Accredited through 09/30/2025, and Mental Health Program Approval through 07/31/2024. There is at least one-week supply of nonperishable and a two-day supply of perishable foods. The facility is maintained at 70 degrees. Hot water temperature measures 118.5 degrees. Facility has cameras in common areas of the facility. No firearms or weapons are allowed in the facility. No pools. Appropriate staff/client ratios were verified during this inspection. The facility employs 1 house manager and 10 direct care staff, 2 behavior specialist's, 2 clinician and 2 clinical supervisor. Staff files were reviewed and meet all regulatory requirements. 1 staff was available to be interviewed. LPA reviewed the facility's disaster plan, sampled medication and reviewed facility logs. 4 records of clients were reviewed. 1 client was available for interview. There were no deficiencies cited during this inspection. A copy of this report was left at the facility at the conclusion of the inspection


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analysts (LPAs), Olivia Medrano and Briana Placencia arrived at Harvard House STRTP for the purpose of conducting an unannounced Case Management inspection and met with House Manager Joe Vargas. The purpose of the inspection was to discuss an incident report received late on December 31, 2024. A Technical Advisory CCR 80061(b) is being cited. An exit interview was conducted, and a copy of this report and the Technical Advisory was provided at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On the above listed date, an unannounced annual inspection was conducted by Licensing Program Analysts (LPAs) Olivia Medrano and Reyna Martinez. LPAs met with Joe Vargas, House Manager and inspected the facility, inside and out. Centrally stored medications are maintained in a locked closet in a locked cabinet. Sharps and Toxic chemicals are kept locked. The facility has a written emergency disaster plan. All facility smoke detectors and carbon monoxide were tested and appear to be in appropriate working order, fire extinguisher is properly charged and was last serviced August 2024. Individual beds were observed with appropriate clean linens and are in good repair. The facility is CARF Accredited through 09/30/2025, and Mental Health Program Approval through 07/31/2025. There is at least one-week supply of nonperishable and a two-day supply of perishable foods. The facility is maintained at 73 degrees. Hot water temperature measures 107.7 degrees. Facility has cameras in common areas of the facility. No firearms or weapons are allowed in the facility. No pools. Appropriate staff/client ratios were verified during this inspection. The facility employs 1 house manager and 8 direct care staff, MHRS staff, 2 clinician and 2 clinical supervisors. Staff files were reviewed and 2 staff was available to be interviewed. LPAs reviewed the facility's disaster plan, sampled medication and reviewed facility logs. 5 records of clients were reviewed. There were no clients available for interviews LPAs will interview at a later time. A review of the Licensing Information System on 2/11/2025 indicated that all facility staff are associated to the STRTP had DOJ, FBI, and child abuse index check clearances. Two deficiencies are being cited at todays visit on the attached LIC809-D page. A copy of this report and appeal rights was left at the facility at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced annual continuation inspection was conducted by Licensing Program Analyst (LPA) Reyna Martinez. LPA met with Joe Vargas, House Manager. The purpose of the inspection was to continue client interviews. 1 client was available for interview. (C1 see LIC811 dated 03/19/2025) There were no deficiencies cited during this inspection. A copy of this report was left at the facility at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On September 29, 2025, Licensing Program Analyst (LPA) Olivia Medrano traveled to Harvard House STRTP located in Fresno, CA, to conduct an unannounced Case Management inspection at the facility and met with Joe Vargas, House Manager. The purpose of the inspection was to discuss an Incident Report (SIR) submitted to the department on September 8, 2025. According to the incident report, a client reported they were inappropriately sexual touching by another client in the STRTP. LPA discussed bedroom sharing agreements, adequate staffing, and client safety plans. There are no deficiencies to be cited on this date. An exit interview was conducted and a copy of this report was provided to Joe Vargas at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On 05/02/2022, an unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Tamara Melikian at 1:00PM. During the inspection, LPA met with Vernell Watts, Program Director and Joe Vargas, House Manager and inspected the facility inside and out. LPA reviewed two children's records for the facility at 1:20PM. Staff records will be inspected at a later date. A medication count was conducted at 1:50PM. LPA interviewed one staff at 2:15PM. LPA did not interview any children in the home as the children were at school and will be interviewed at a later date. Deficiencies on the attached page. LPA conducted exit interview with Vernell Watts, Program Director and Joe Vargas, House Manager. LPA provided the summary report to Vernell Watts, Program Director and Joe Vargas, House Manager upon completion.

met_with: Vernell Watts, Joe Vargas


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On this date, Licensing Program Analyst (LPA) Reyna Martinez conducted a case management visit at the STRTP and met with Joe Vargas. The purpose of the meeting was to discuss incident report's emailed to Community Care Licensing (CCL) on August 30, 2023. Based on further interviews and records review, for incidents that occurred on August 25, 2023 with Staff (S1). Clients (C1), (C2), (C3), (C4), and (C5) reported that S1 failed to provide supervision, protection, and care of the clients individually and in groups. S1 allowed clients in care to engage in inappropriate aggressive acts with each other without intervening. Licensee investigated and terminated S1 for violation of health and safety codes. Based on the information obtained, the STRTP is being issued a citation for the Personnel Duties 87065.2(b)(1). Interim Licensing Standards are being cited on the attached LIC809D page. An exit interview was conducted, and a copy of the report and appeal rights were provided to the facility.

Deficiencies:
87065.2: (1) Supervision, protection, and care of children at all times, individually and in groups.

title: PERSONNEL DUTIES (b) Direct care staff shall perform the following duties


summary: Facility Evaluation

raw_content:
Narrative:
On February 5, 2026, Licensing Program Analyst (LPA) Olivia Medrano traveled to Harvard House STRTP located in Fresno, CA, to conduct an unannounced Case Management inspection at the facility and met with Joe Vargas, House Manager. During the course of another investigation, LPA discovered there was another incident that occurred on December 13, 2025, at the STRTP. The Department did not receive the incident report until January 22, 2026. A deficiency is being issued today for CCR 80061(b)(2) Reporting Requirements. (See LIC 809D) An exit interview was conducted and a copy of this report and appeal rights were provided to the STRTP.


summary: Facility Evaluation

raw_content:
Narrative:
On February 5, 2026, Licensing Program Analyst (LPA) Olivia Medrano traveled to Harvard House STRTP located in Fresno, CA for the purpose of an Annual Inspection and met with Joe Vargas, House Manager. The STRTP currently has Administrator, Program Manager, House Manager, Direct Care Staff, Clinicians, Clinical Supervisors, and Mental Health Rehabilitation Specialist. There is an adequate supply of nonperishable and perishable foods. The facility is maintained 72 degrees. Hot water temperature measures 119.3 degrees. Facility has cameras in common areas of the facility. No firearms or weapons are allowed in the facility and there are no bodies of water. Staff files were reviewed and meet all regulatory requirements. 3 staff and 3 clients were available to be interviewed. LPA reviewed the facility's disaster plan and psychotropic medication log. No deficiencies were issued. STRTP will send LPA an updated LIC 500, Accreditation information, and training for staff for the last year. An exit interview was conducted and a copy of this report was left at the STRTP.


summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On February 5, 2026, Licensing Program Analyst (LPA), Olivia Medrano traveled to Harvard House STRTP located in Fresno, CA to conduct an unannounced complaint inspection and met with Joe Vargas, House Manager. The purpose of the inspection was to deliver the finding for the above complaint allegation. The Department has investigated the complaint alleging Group home staff used inappropriate physical intervention on client. During the course of the investigation, LPA conducted confidential interviews, reviewed files, and obtained pertinent documentation. Based on conflicting interviews, it was determined that although the allegation may have happened, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted and a copy of this report and appeal rights were provided to the STRTP at the conclusion of the inspection. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Olivia Medrano LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

report_type: Complaint Investigation

complaint_status: unsubstantiated


facility_name: HARVEST SAFE HAVEN FOR BOYS

raw_content:
Narrative:
Regarding the allegation that a minor is being hit while in care, it was specifically alleged that C1 stated that C1 was hit and beaten at the facility. During the investigation, confidential interviews denied that C1 was hit or beaten at the facility. It was added that C1 got along with staff and other clients. LPA attempted to interview C1, C2 and C3, however they refused to be interviewed. LPA attempted to interview C4 and C6 on multiple occasions. LPA was unable to gather additional information. In regard to the allegation that staff threatened a minor, it was specifically alleged that staff stated they were going to whoop C1 later. During the investigation, confidential interviews denied that staff threatened C1 or any other client. It was added that C1 never reported being threatened to staff. LPA attempted to interview C1, C2 and C3 however they refused to be interviewed. LPA attempted to interview C4 and C6 on multiple occasions. LPA was unable to gather additional information. Based on confidential interviews, the allegations that C1 was being hit while in care and that staff threatened C1 may have occurred, however, there was not a preponderance of evidence to support or deny the allegations. Therefore, the above allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with the appeal right were reviewed and provided to facility representative.

Investigation Findings:
13On June 27, 2024, Licensing Program Analyst (LPA) Rafael Enriquez arrived at Harvest Safe Haven Short Term Residential Therapeutic Program (STRTP) and met with Administrator Lachelle Fenison to deliver the finding for the allegations stated above involving the STRTP staff and clients (C1, C2, C3, C C5 and C6) as listed on the Confidential Names List (LIC 811) dated June 27, 2024. On November 21, 2023, LPA Enriquez initiated the investigation at the STRTP and obtained pertinent documents. Additionally, LPA conducted a safety inspection of the STRTP, no immediate health and safety hazards were observed. During the inspection, LPA interviewed staff S1, S2, S3, S4, and C5. LPA attempted to interview C1, C2 and C3, however they refused to be interviewed. LPA attempted to interview C4 and C6 on multiple occasions. On November 15, 2023, Community Care Licensing (CCL) received a complaint alleging that a minor is being hit while in care and staff threatened a minor. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Rafael Enriquez 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 19-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, MAIN ST., SUITE FACILITY NAME: HARVEST SAFE HAVEN FOR BOYSFACILITY NUMBER: VISIT DATE: 06/27/2024

met_with: Administrator Lachelle Fenison


raw_content:
Narrative:
Regarding the allegation that that staff did not prevent minor from sending inappropriate pictures while in care, it was specifically alleged that C1 sent one of the group home staff pictures of private parts that appear generated online. During the investigation, confidential interview stated that staff received pictures of a man in underwear and a picture of a sexual related toy to staff's personal cellphone. It was added that staff did not have a company phone and that staff's phone number was written on the board in the office. Other confidential interviews stated that inappropriate pictures were sent to the printer in the staff office. The confidential interviews continued stating that the clients had lost the Wi-Fi privilege, and the printer was taken off the Wi-Fi. LPA attempted to interview C1, C2 and C3 however they refused to be interviewed. LPA attempted to interview C4 and C6 on multiple occasions. An additional witness interview did not reveal any information the allegation. Based on confidential interviews, the allegation that staff did not prevent C1 from sending inappropriate pictures while in care may have occurred, however, there was not a preponderance of evidence to support or deny the allegation. Therefore, the above allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with the appeal right were reviewed and provided to facility representative.

Investigation Findings:
13On June 27, 2024, Licensing Program Analyst (LPA) Rafael Enriquez arrived at Harvest Safe Haven Short Term Residential Therapeutic Program (STRTP) and met with Administrator Lachelle Fenison to deliver the finding for the allegation stated above involving the STRTP staff and clients (C1, C2, C3, C C5 and C6) as listed on the Confidential Names List (LIC 811) dated June 27, 2024. On December 07, 2023, LPA Enriquez initiated the investigation at the STRTP and obtained pertinent documents. Additionally, LPA conducted a safety inspection of the STRTP, no immediate health and safety hazards were observed. During the inspection, LPA interviewed staff S1, S2, S3, S4 and C5. LPA attempted to interview C1, C2 and C3 however they refused to be interviewed. LPA attempted to interview C4 and C6 on multiple occasions. On December 07, 2023, Community Care Licensing (CCL) received a complaint alleging that staff did not prevent minor from sending inappropriate pictures while in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Rafael Enriquez 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 19-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, MAIN ST., SUITE FACILITY NAME: HARVEST SAFE HAVEN FOR BOYSFACILITY NUMBER: VISIT DATE: 06/27/2024


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
In regard to the allegation that staff do not properly safeguard the minors' personal belongings, it was specifically reported that when items get stolen staff do not assist and have even said on occasions it's not staffs fault client's get stolen from even when staff are asked to monitor client's belongings, therefore, clients are not reimbursed for stole items. During investigation, multiple interviews disclosed that each client is given a lock box to keep their smaller belongings and client's may store belongings in the office as well. In addition, a confidential interview disclosed that clients are aware from the beginning that if they do not store their belongings in their lock box nor the office, then staff will not be responsible for stolen belongings but if they are stolen from either of the two options then staff will replace and take full responsibility. In addition, multiple confidential interviews disclosed that when a client gets something stolen, staff do not do anything about it nor reimburse clients. Another confidential interview disclosed that when stuff gets stolen staff do a great job reimbursing clients. LPA received conflicting information. In regard to the allegation that staff do not prevent the minors from attacking other minors, it was specially disclosed that a staff member was jumped and attacked by three clients and the facility has done nothing. During investigation, multiple confidential interviews disclosed that fights are not a common occurrence at the facility. In addition, a confidential interview disclosed that all staff have TCI (trauma informed care) training including de-escalation techniques and intervene properly. Multiple confidential interviews disclosed that when a fight occurs staff will break it up. In regard to the allegation that staff do not provide adequate care and supervision to the minors and that staff do not ensure the minors attend school consistently, it was specifically reported that clients continuously AWOL (absent without leave) and don't attend school. During investigation, multiple interviews disclosed that certain clients refuse to attend school, staff work with them by looking into independent school programs where clients only need to attend class a few days a week and that has worked well for clients. In addition, a confidential interview disclosed that when a client AWOLs staff will take away home passes and that all clients attend school unless they are sick. Additionally, another confidential interview disclosed that staff watch clients AWOL and if they don't come back staff will call the police, and that staff do not make sure clients attend school. Furthermore, multiple confidential interviews disclosed that staff use incentives to get clients to attend school and to prevent client's AWOLs. Another confidential interview disclosed that staff do not make sure clients attend school. LPA received conflicting information. In regard to the allegation that staff threaten the minors with eviction, it was specifically reported that staff threaten to kick out clients. During investigation, multiple confidential interviews disclosed that staff have never threatened to evict a client. In addition, a confidential interview disclosed that staff will have conversations with clients to remind them they are to abide their contracts otherwise they will be removed. Another confidential interview disclosed that the administrator will have conversations at Child, Family and Team (CFT) meetings if a client needs to be removed for their own safety but not threatened with eviction. Another confidential interview disclosed that staff will threaten to kick clients out whenever staff get annoyed. LPA received conflicting information. In regard to the allegation that staff do not provide the minors with water, it was specifically reported that clients can go days without water because staff forget. During investigation, multiple confidential interviews disclosed that there is always water available at the facility. In addition, a confidential interview disclosed that one time the clients went three days without water. Multiple confidential interviews disclosed that there is a water dispenser that always has water, and clients are all given a reusable water bottle that they may refill whenever they want. Additionally, a confidential interview disclosed that when the water jug runs out clients may replace it themselves and do not need to wait on staff. LPA received conflicting information. In regard to the allegation that staff do not provide comfortable accommodations for the minors, it was specifically reported that clients can't even comfortably sleep without the worry of something happening. During investigation, multiple confidential interviews disclosed that a client may request a bedroom change and staff will accommodate clients as long as it's appropriate. In addition, multiple confidential interviews disclosed that they feel safe living at the facility. Another confidential interview disclosed that staff provide comfortable accommodations for clients. Other confidential interviews disclosed that clients feel safe at the facility. Based on interviews, the allegations that staff do not properly safeguard the minors personal belongings; staff do not prevent the minors from attacking other minors; staff do not provide adequate care and supervision to the minors; staff do not ensure the minors attend school consistently; staff threaten the minors with eviction; staff do not provide the minors with water; staff do not provide comfortable accommodations for the minors may have occurred, however, there was not a preponderance of evidence to support the alleged violations, therefore, this allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Administrator Trainee, Christie Anderson.

Investigation Findings:
13On 04/25/2025, at 11: AM, Licensing Program Analyst (LPA) Maya Chavez conducted an unannounced visit to Harvest Safe Haven for Boys and met with Administrator Trainee, Christie Anderson to deliver the investigative finding for the allegations listed above. This complaint concerns staff at the facility and clients 1-6 (C1, C2, C3, C4, C5, and C6) as listed on the Confidential Names List (LIC 811). On 11/05/2024, Community Care Licensing (CCL) received a complaint that staff do not properly safeguard the minors personal belongings; staff do not prevent the minors from attacking other minors; staff do not provide adequate care and supervision to the minors; staff do not ensure the minors attend school consistently; staff threaten the minors with eviction; staff do not provide the minors with water; staff do not provide comfortable accommodations for the minors. On 11/15/2024, LPA MaryJane Perez conducted a health and safety inspection at the facility and no immediate health and safety hazards were observed. In addition, LPAs obtained documents pertinent to the investigation and interviewed staff 1-4 (S1, S2, S3, and S4), and clients 1, 2, 4, and 6 (C1, C2, C4, and C6), C4's county social worker (CSW), and client 3 and 5 (C3 and C5) refused to be interviewed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Maya Chavez 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 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: HARVEST SAFE HAVEN FOR BOYSFACILITY NUMBER: VISIT DATE: 04/25/2025

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

met_with: Administrator Trainee- Christie Anderson


raw_content:
Narrative:
the neighbors have been calling and reporting that some clients have been disturbing them. Another confidential interview stated that the clients do not disturb the neighbors. Additional confidential interviews stated that they believe staff does as much as they could when it comes to doing a good job supervising the clients. On the other hand, confidential interview stated they believe the staff needs to have more supervision on the clients when they are outside or when they leave facility. Based on confidential interviews and a review of pertinent documents, the allegation that staff did not adequately supervise minors may have happened or is valid but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted a copy of this report, LIC 811 and appeal rights were explained and given to facility manager Jeamah Johnson.

Investigation Findings:
13On June 27, 2025, Licensing Program Analyst (LPA) Maryjane Perez made an unannounced visit to Harvest Safe Haven for Boys STRTP and met with facility manager Jeamah Johnson to deliver the finding for the above stated allegation. On May 06, 2025, Community Care Licensing received complaint allegation that staff did not adequately supervise minors. On May 08, 2025, LPA M. Perez conducted a health and safety inspection of the facility, and no hazards were observed. Lpa M. Perez interviewed staff 1 (S1), staff 2 (S2), staff 3 (S3), staff 4 (S4), staff 5 (S5), staff 6 (S6), client 1 (C1), client 2 (2), client 3 (C3), client 4 (C4), client 5 (C5) and client 6 (C6). During investigations, confidential interviews reported that clients are always supervised by staff while in care, but clients have unauthorized absences frequently. Other confidential interviews stated that staff keep in contact with the clients when they have an unauthorized absence. Other confidential interviews stated that when a client has an unauthorized absence, they will come back around 11PM or even as early as 4AM but once they are back, they regain staff supervision. Another confidential interview stated that UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: MaryJane Perez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: HARVEST SAFE HAVEN FOR BOYSFACILITY NUMBER: VISIT DATE: 06/27/2025

met_with: Facility Manager- Jeamah Johnson


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
S4 became upset by this and retaliated by pepper spraying C2 and C3. Furthermore, it was reported that S4 also physically struck C1, C2 and C3 during this incident. A review of the facility's video surveillance footage showed that S4 was sprayed with "silly string" by C2 and C3. The video footage revealed that S4 appeared to have pepper sprayed C2 and C3 (this was later admitted by S4). In addition, the video showed that C1, C2 and C3 physically reacted by attacking S4 after S4 pepper sprayed C1 and C2, therefore, S4 hit C1, C2 and C3. The video clearly shows S4 throwing closed fist punches on the minors' head and body areas. Confidential interviews with staff and clients corroborated the allegations. Confidential interviews also reported that S4 admitted to brining in an unauthorized chemical agent (pepper spray) into the facility. Further confidential interviews also confirmed that S4 admitted to physically striking clients in care. Confidential interviews and document review confirmed that Law Enforcement responded to the facility and arrested. S4 was charged with child abuse according to the report. Based on confidential interviews, a review of pertinent documentation and a review of the facility's video surveillance footage, the preponderance of evidence standard has been met, and the allegations that that staff hit C2 in care and staff pepper sprayed C1 and C2 in care are substantiated. The facility is being cited for violation of Interim Licensing Standards (ILS) section 87072(c)(11) Personal Rights, (c) The licensee shall ensure that each child...is accorded the personal rights.... (11) To be free of physical...emotional, or other abuse, ... humiliation, intimidation, ridicule,...mental abuse, or other actions ... interference with the daily living functions... (see LIC 9099D). An exit interview was conducted. A copy of this report (LIC 9099), deficiencies page (LIC 9099D) and appeal rights were explained and given to Lachelle Fenison, Administrator.

Investigation Findings:
13On 07/17/2025, at 08: AM, Licensing Program Analyst (LPA) Joon Choi conducted an unannounced visit to Harvest Safe Haven for Boys (STRTP) and met with Administrator Lachelle Fenison to deliver the investigative findings for the allegation listed above. On 11/06/2024, Community Care Licensing received allegations that staff hit minor in care and staff pepper sprayed minors in care. On 11/15/2024, LPA Maryjane Perez conducted a health and safety inspection at the STRTP, and no immediate health and safety hazards were observed. During the investigation, LPA Perez obtained documents pertinent to the investigation and interviewed C1, C2, C3, C4 and C6 (C1-C4, C6) and staff 1, 2, 3, 6 and 7 (S1-S3, S6, S7). C5 declined LPA's request for an interview and staff 4 and 5 were interviewed by Riverside County Open Case Investigations (OHI). In regard to the allegations that staff (S4) hit minor (C1) in care and staff (S4) pepper sprayed minors (C2, C3) in care; it was reported that C2 and C3 sprayed S4 with "silly string." It was further reported that CONTINIUED ON THE NEXT PAGE SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Joon R Choi LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: HARVEST SAFE HAVEN FOR BOYSFACILITY NUMBER: VISIT DATE: 07/17/2025

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

met_with: Lachelle Fenison, Administrator

complaint_status: SUBSTANTIATED


raw_content:
Narrative:
Another interview indicated that there were two staff present that day, which limited their ability to intervene effectively. Other confidential interviews reported that staff remained calm and used verbal de-escalation techniques when they became aware of the argument between C1 and C2. One interviewee stated that they were not present during the incident and did not inflict or observe any bite mark on C1. Based on confidential interviews and a review of pertinent documents, the allegation that staff do not prevent C2 from causing harm to C1 may have happened or is valid but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, a copy of this report, LIC 811 and appeal rights were explained and given to administrator trainee Shameka Garner.

Investigation Findings:
13On October 10, 2025, Licensing Program Analyst (LPA) Maryjane Perez made an unannounced visit to Harvest Safe Haven for Boys STRTP and met with Administrator Trainee Shameka Garner to deliver the finding for the above stated allegation. On August 11, 2025, Community Care Licensing received complaint allegation that staff do not prevent the minors from causing harm to another minor. On August 20, 2025, LPA M. Perez conducted a health and safety inspection of the facility, and no hazards were observed. In addition, LPA M. Perez interviewed staff 1-7 (S1-S7), and clients 1-4 (C1-C4). During investigations, multiple confidential interviews provided varying accounts of the incident involving C1 and C2. One interview reported that C1 was bitten in the stomach by C2, and that no other clients were involved. Several interviews confirmed that C1 and C2 were arguing inside the home, and the two staff on duty attempted to separate them to prevent further escalation. Another interview stated that C1 and C2 were successfully separated, with C1 placed in their bedroom and C2 outside. However, C1 reportedly jumped out the bedroom window to reach C2, after which a physical altercation occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: MaryJane Perez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: HARVEST SAFE HAVEN FOR BOYSFACILITY NUMBER: VISIT DATE: 10/10/2025

met_with: Admistrator Trainee- Shameka Garner


summary: Facility Evaluation

raw_content:
Narrative:
An informal conference was held with Harvest Safe Haven For Boys to discuss current Community Care Licensing (CCL) concerns. Present at the meeting was LaCresha Cook, Regional Manager, Abdoulaye Traore, Licensing Program Manager, Adaleyci Caballero, Licensing Program Analyst, Shanae Pharaoh, Licensing Program Analyst, Lachelle Fenison, Harvest Safe Haven For Boys Administrator, Daniel Park, Harvest Safe Haven For Boys Chief Executive Officer, Susan Pennington, Harvest Safe Haven For Boys Licensed Clinical Social Worker Supervisor, Jason Brunt, Harvest Safe Haven For Boys Board President, Diana Wagner, System of Care Branch, Janelle Ross, Riverside County Placement Liaison, Karen Atkins, Riverside County, David Guitierez, Sandi Snelgrove, Alexandria, Andrews, Department of Health Care Services, Juan Bretado, Riverside County Probation, and Rose Collins, San Bernardino County Placement Liaison. The following information was discussed: SIR's are required to have additional information to indicate precursor to incidents, interventions used according to EIP, and staff follow up. Level system needs to be trauma informed. AWOL policy needs to be trauma informed. EIP needs to be more trauma informed. Program must ensure staff understand the EIP. Update to Program Statement. The facility has agreed to the following: The Clinical Supervisor will review all incident reports before submitting to CCL to ensure clinical interventions, follow-up, and debriefing summary are included. Program Statement will include updated incentive system addendum. Facility has implemented training and coaching for staff with the Rehab Specialist. Facility will update their Program Statement to address areas mentioned above. Facility will update their Program Statement to include the Risking Connection Model and additional treatment for creating a trauma informed milieu. Facility will ensure staff are receiving training on implementing three trauma informed interventions for all incidents occurring at the facility. Facility will submit their corrective action plan including their addendum to their Program Statement by October 1, 2021. A copy of this report was given and explained to Lachelle Fenison.

met_with: Lachelle Fenison


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Manager, Angela King, Licensing Program Analyst, Margaret Lentner conducted a case management inspection on September 28, 2021, at 10:28am, based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. 5 out of Direct Care Staff and 6 out of 6 youth files as identified on the LIC 811 confidential names dated 9/28/2021, were reviewed. 3 out of Direct Care Staff and 3 out of 6 youth were interviewed. The Plan of Operation including policies and procedure were reviewed. A copy of this report was discussed and provided to Lachelle Fenison, Administrator STRTP.

met_with: Lachelle Fenison - Admin and Daniel Park CEO


summary: Facility Evaluation

raw_content:
Narrative:
On March 4, 2022 at 9:30AM, Licensing Program Analyst (LPA) Shanae Pharaoh conducted an unannounced Annual Required Inspection and met with Facility Director Daniel Park and Administrator Lachelle Fenison. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Administrator. The facility is set up as follows: · Bedroom #1: Has two twin beds -Sleeps C1 and C2 · Bedroom #2: Has two twin beds - Sleeps C3 and C Bedroom #3: Has two twin beds -Sleeps C5 and C The facility was inspected inside and out with Facility Administrator. The facility is a one story residence with 3 bedrooms and 2 bathrooms, a study room, staff office, and mental health office. Four clients were present at time of inspection. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. The bathrooms were clean and in good repair. The hot water in the Kitchen was measured to be an adequate temperature. All hazardous items have been properly made inaccessible to areas where clients will have access. The medications were stored and locked in a cabinet in the staff office. The medication logs are kept updated and the dispensing records had no discrepancies. Cleansers/chemicals are locked and stored in a cabinet in the garage. Sharp knives are inaccessible and stored in a locked cabinet in the staff office. The First Aid Kit is located in the staff office and contained all required supplies. The facility's smoke detectors in the bedrooms were checked and operable. The carbon monoxide detector located in the hallway was operable. There are no guns or weapons in the facility as stated by Facility Administrator. The following required posted items were observed accessible to clients: Grievance Procedures, Personal Rights, Ombudsman Poster, Visitation policies, and current menu. The Facility received Mental Health Approval on January 21, 2022 and CARF Accredidation expires on , The facility received Mental Health Approval effective January 21, 2022 - January 21, 2023 and CARF Accredidation expires on May 31, 2024. LPA observed a minimum 7-day non-perishable and a 2-day perishable supply of food; snacks availabletwo clients were interviewed during the inspection. The facility outside grounds were also inspected and it was observed to be clean and well maintained. Patio furniture was available. Emergency exits were free from obstruction. There are no bodies of water on the premises. 6 of 6 client and and five of 13 staff files were reviewed during the inspection. All staff that work at the facility have Department of Justice and Child Abuse Clearance Index clearances. A review of administrative records indicate that the facility has paid their current licensing fees. LPA did not observed lock boxes for 6 of 6 clients C1, C2, C3, C4, C5 and C6 and LPA did not observe the hire dates located in 4 of 5 staff files S1, S2, S3 and S5. The administrator purchased the lock boxes and updated the staff files with their hire dates during the inspection. Based on the facility inspection and file reviews on this date, there are no deficiencies found at this time. An exit interview was conducted and a copy of this report was be provided to the facility representatives.

met_with: Administrator - LaChelle Fenison


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Dina Camara conducted a case management inspection 06/28/22 at 8: AM based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. During this inspection, 10 out of Direct Care Staff and 6 out of 6 youth files were reviewed. 3 out of Direct Care Staff and 4 out of 6 youth were interviewed. (See the Confidential Names List, LIC 811, dated 06/28/22). The Plan of Operation including policies and procedures were reviewed. Minutes from the board of directors' meetings related to the facility's incidents involving contact with law enforcement were reviewed. Based on the analysis of the confidential interviews and youth file review including the needs and service assessments, youth case plans, quarterly assessments, and crisis intervention plans, the licensee uses trauma-informed and evidence-based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. LPA Dina Camara observed documentation of completed training on policies and procedures on when and how to involve law enforcement in response to an incident. Training records show staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance to their Emergency Intervention Plan when there is an immediate risk of serious harm to a child or others. There are no deficiencies cited at this time. A copy of this report was discussed and provided to Daniel Park, Executive Director.

met_with: Daniel Park, Executive Director


summary: Facility Evaluation

raw_content:
Narrative:
On June 07, 2024, at 9: AM, Licensing Program Analysts (LPAs) Rafael Enriquez and Maryjane Perez conducted an unannounced required 2-year inspection and met with Licensee Daniel Park. LPAs disclosed the purpose of the visit and was granted entry into the facility. Two clients were present and three staff were present in the facility during the inspection. The facility is a four bedroom, two bathroom house composed of one office, two living rooms, a dining area and kitchen. One bathroom is located inside the office for staff. The facility has an outdoor space accessible to clients in care. Facility Manager Patrick Holland accompanied LPAs inside and out of the facility during inspection. A physical plant inspection was completed and included the following areas: Facility grounds are clean and free of debris and observable hazards. There is adequate indoor and outdoor activity space. Video games and movies were observed for children's recreation time. All facility smoke detectors and carbon monoxide detectors are in appropriate working order; fire extinguisher is properly charged and serviced. Licensee maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. All required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster. Medications are locked and centrally stored in a locked cabinet in the staff office. Licensee had provisions for contraceptives to be held in individually locked containers by clients. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. The hot water in the client's bathroom was measured to be 107.6 degrees. Facility has cameras in common areas of the facility. The facility has an exception on file to use the cameras and are meeting the terms and conditions. Administrator Lachelle Fenison is present at the facility a minimum of 20 hours a week, as verified by LIC Personnel Report. Appropriate staff/client ratios were verified during this inspection. The facility employs one Therapist, two Clinical Social Worker, a Facility Manager, and Direct Care Staff. Licensee has obtained a Mental Health contract with Riverside County. Licensee has obtained National Accreditation through Commission on Accreditation of Rehabilitation Facilities (CARF). The Accreditation is valid through May 31, 2027. Licensing fee payments have been paid and there is currently a balance of $0.00. Personnel files were reviewed to ensure they contained all required documentation per Title Regulations. Personnel files are maintained off-site at the corporate office. All appropriate personnel who require Caregiver Background Checks have received Criminal Record and Child Abuse Index clearances. A review of clients' records was also completed. Client and staff interviews were conducted and revealed no health and safety concerns. An exit interview was conducted, and a copy of this report was given to Licensee Daniel Park.

met_with: Licensee- Daniel Park


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Jose Gonzalez on September 09,2025 at approximately 9: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Gonzalez met Administrator, Lachelle Fenison and Administrator Trainee Shameka Garner, and conducted a tour of the facility. During the visit there were three staff present and 4 client's at the facility. LPA reviewed one client record and two of staff personnel files on site at the facility. LPA reviewed one client psychotropic medications and medication records. LPA interviewed two staff on site to discuss the facilities policies and procedures of operation. During the inspection the LPA observed no deficiencies. LPA provided a copy of this licensing report to Administrator Lachelle Fenison.


summary: Facility Evaluation

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Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Leslie Covarrubias on March 2, 2023 at 9: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Covarrubias met with Administrator, Lachelle Fenison and inspected the facility inside and out. LPA reviewed two of child's records and three of staff personnel files on site at the facility. LPA reviewed two of child's psychotropic medications and medication records. LPA interviewed three of staff on site to discuss the facilities policies and procedures of operation. LPA attempted to interview 1 of children currently prescribed psychotropic medication. During the inspection the LPA observed deficiencies (see attached 809D), plan of corrections were discussed and appeal rights were provided. LPA provided a copy of this licensing report to Administrator, Lachelle Fenison.

met_with: Administrator, Lachelle Fenison


summary: Facility Evaluation

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Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Joon Choi on February 28, 2024 at 08: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Choi met with Administrator Lachelle Fenison and conducted a health and safety inspection of the facility. LPA reviewed three of child's records and three of staff personnel files on site at the facility. LPA reviewed three of child's psychotropic medications and medication records. LPA interviewed two staff on site to discuss the facilities policies and procedures of operation. LPA will attempt to interview two children, currently prescribed psychotropic medications, at their school(s), after this facility visit. During this facility visit, one child currently prescribed psychotropic medications, asked to be interviewed at a future time and date (due to currently being sick). During the inspection LPA observed one deficiency (see attached 809D), plan of correction was discussed and appeal rights were provided. LPA conducted exit interview with Administrator Lachelle Fenison and provided a copy of this report.


summary: Complaint Investigation - Substantiated

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Narrative:
Information revealed C2 was the victim of sexual assault from C1. C2 was reportedly scared of C1 and C1 forced C2 to engage in sexual acts. According to statements from an eyewitness having firsthand accounts of the incident occurring on December 10, 2020, it was observed C2 was not performing sexual acts, but was receiving sexual acts from C1. While statements provided contradicting information, the incident may have been a consensual encounter. The incident occurred during the overnight shift. The incident was reported to staff who contacted C2 privately and C2 confirmed that he performed oral sex on C1. C1 was moved to a single room after the incident. All appropriate reporting and contacts were completed concerning the incident. According to statements, C2 complied with C1 due to being threatened by C1 and feeling scared. Statements obtained revealed contradicting information concerning a pre-established rule that requires residents who share a room with their roommates to keep their doors open when both residents are occupying the room. In addition, statements revealed that not all staffs properly conduct 15-minute room checks of the residents as facility policy require staff to conduct. Based on information gathered, the preponderance of evidence standard has been met and the Department has determined facility neglected to adequately monitor residents resulting in inappropriate sexual contact by C1 and C2; thus, posing potential risk to the children placed in care. Therefore, facility is cited under the California Code of Regulations, Title 22, Section Responsibility for Providing Care and Supervision. See page 9099D for deficiency. Exit interview conducted; Appeal Rights issued and a copy of this report will be emailed to Ms. Delgado for signature.

Investigation Findings:
13On May 3, 2021, Licensing Program Analyst (LPA) Regina Martin met with Daisy Delgado, Director of Residential Programs via Microsoft Teams Meeting to deliver and discuss findings from the investigation concerning the allegation as mentioned above. The investigation was conducted by Community Care Licensing Special Investigator, Edward Hector. On December 14, 2020, Community Care Licensing received claims alleging a lack of supervision resulting in inappropriate sexual contact between clients as it was reported that Client #2 (C2) was a victim of sexual assault by Client #1 (C1) while in the facility. The investigation included a review of client files, review of the Los Angeles Sheriffs Department report and confidential interviews conducted with clients and staff members. The investigation revealed from gathered information, C1 and C2 engaged in oral sex. Reportedly, C1 coerced C2 to have oral sex with him. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Alan Henry LICENSING EVALUATOR NAME: Regina Martin LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: HATHAWAY-SYCAMORES CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 05/03/2021

met_with: Daisy Delgado


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Narrative:
Staff indicated that Child #1 never mentioned any pain or head injury. However, Child #1 was taken to hospital to address escalated behavior. There were no injuries noted during hospital visit. There were no witnesses, documentary or physical evidence to corroborate allegations. There was no evidence to suggest that Child #1 was injured as a result of restraint. Additionally, there was no evidence to suggest that facility is serving a poor quality of food based on review of menus, client and staff statements. Interviews were also held with both clients and staff. Clients expressed that during some meals, inside of chicken was observed to be pink in color. Clients indicated although food is not seasoned well, there is a variety of food to chose from. Staff expressed that clients have complained about taste of food and alternatives were provided. Staff were not able to confirm that poultry served was raw or pink. Due to lack of evidence, although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove or disprove that a violation occurred; therefore, the above allegations are Unsubstantiated

Investigation Findings:
13On July 7, 2021 at 2:30 p.m. Licensing Program Analyst (LPA) Cameo Banks conducted a follow-up complaint inspection via Microsoft Teams to Hathaway-Sycamores and spoke with Daisy Delgado, Director of Residential Programs. The purpose of the inspection was to deliver findings for the above complaint allegations. During investigation of the allegations, LPA conducted interviews and reviewed documents. Based on interviews, there were no statements to suggest Child #1 sustained a head injury while being restrained by staff. Nor was there evidence to support facility is serving a poor quality of food. Staff denied all allegations. Staff indicated that Child #1's behavior had become unsafe and as a result, initiated a Pro-Act standing restraint. Staff continued to use continued to use crisis communication as they explained to Child #1 that he was going to be escorted to Program Support Services (PSS). While in PSS, Child #1 continued to pose a threat to himself by tieing his sock around his neck tightly. Child #1 was placed in another restraint to remove his shoes, which had laces, to further prevent client from causing self harm. Staff stated they did not observe any head injuries on Child #1. Continued on LIC809-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Cameo Banks LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: HATHAWAY-SYCAMORES CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 07/07/2021

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

met_with: Daisy Delgado Director of Residential Programs


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Narrative:
There were no witnesses identified to corroborate the allegation. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove or disprove that a violation occurred. Therefore, the allegation is unsubstantiated. There are no deficiencies cited at this time. Exit interview was conducted, Appeal Rights were issued and a copy of this report will be sent to the facility.

Investigation Findings:
13On October 6, 2021, Licensing Program Analyst (LPA) Bernice Karnsrithong and Licensing Program Manager (LPM) JoAunne Griffin conducted a follow-up complaint inspection and met with Jodi Maberry, Administrator. The purpose of the inspection was to deliver findings for the above complaint allegation. During the course of investigating the allegation youth was inappropriately restrained, LPA conducted confidential interviews and reviewed Child and Family Team Meeting Minutes, Needs and Service Plan, Incident Reports and facilities emergency intervention policies and procedures. Based on confidential interviews and documentary evidence did not suggest that client in care was restrained inappropriately while in care. Confidential interview indicated that client in care was restrained by staff for attempting to leave the facility, however did not sustain any injuries as a result of the restraint. Confidential interviews indicated that restraints are conducted when clients in care pose imminent danger to self and others, staff have to be Pro-Act trained and two or more staff must conduct the restraint. Documentary evidence did not indicate that client in care was restrained inappropriately. Continued on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Bernice Karnsrithong LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: HATHAWAY-SYCAMORES CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 10/06/2021

met_with: Jodi Maberry, Administrator


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Narrative:
Once staff became aware of physical altercations between Child # 2 & Child #3 with Child #1, staff took appropriate action by separating clients, changing cottages and increasing supervision. Staff #2 did admit that residents return from outside facility with marijuana and other contraband but once discovered confiscated by staff. Staff #2 stated an ongoing issue with residents but facility is doing best to search rooms and confiscate items from residents immediately. Staff #1 stated Child #1 returned from school with paper clip and self harmed after not getting way but staff confiscated paper clip. Staff #1 stated that Child #1 had regular medical appointments and medication monitored closely by physician due to Child #1 ongoing health care needs as evidence in medical. records. Based on the interviews conducted, file and record review, the above allegations are found to be Unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove or disprove that a violation occurred. The department has investigated the above complaint allegations and determined the complaint is Unsubstantiated. . There were no deficiencies cited at this time. Exit interview was conducted, and a copy of this report will be emailed to Tasian Taylor, Administrator

Investigation Findings:
13On April 20, 2022, at 8: AM Licensing Program Analyst (LPA), Zena Phillips conducted a follow-up complaint investigation visit to HATHAWAY-SYCAMORES CHILD AND FAMILY SERVICES and met with Tasian Taylor Administartor. The purpose of the visit was to deliver findings for the above complaint investigation. LPA Phillips reviewed facility files and conducted confidential interviews with relevant parties. After conducting the confidential interviews and reviewing the following documents: Individual health care plan, child and family team meeting notes, medical visit log and. Special Incident Reports evidence reveals the following: There were no statements to determine that staff failed to intervene when residents engaged in physical altercations. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: HATHAWAY-SYCAMORES CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 04/20/2022

met_with: Tasian Taylor Administartor


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Narrative:
The allegations may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. On July 17, 2021, at approximately 2:15pm, Client#1 (C1) suffered a seizure while on an outing to Hurricane Harbor waterpark in the city of Valencia. C1 was swimming in the water pool and was walking out when collapsed to a seizure. Waterpark lifeguards approached C1 and took him out of the pool. Lifeguards told Staff#2 (S2) that C1 will be transported to a local hospital Emergency Room (ER) via ambulance. Per facility C1 had seizures regularly and staff was trained on what to do if a seizure happened. S2 was at eyesight of C1 when he was in the pool and was present during the incident. S2 was informed by the waterpark lifeguard that they would need to transport him to ER as protocol. S2 informed the lifeguard that C1 was with the facility and had seizures regularly. S2 drove with the other two clients in the outing to Henry Mayo Hospital ER in the city of Valencia. C1 upon coming back to normal called relatives to informed them of the incident. The facility was informed by S2 and Valencia Fire Department that C1 had a seizure and was being transported to the ER. C1 was kept was conscious and in observation. C1 was released from the ER at 7:15pm. The hospital requested for C1 to get checked by his neurologist on Monday, 07/18/2021. Facility reported incident to county of placement, and Social Worker. LPA Rosas conducted interviews with client, pertinent parties, and facility staff regarding to incident on 07/21/2021. There were no witnesses identified to corroborate the allegation. During the course of investigating the allegation of staff did not prevent minors from engaging in physical altercations resulting in injuries. LPA Rosas conducted confidential interviews and reviewed Child and Family Team Meeting Minutes, Needs and Service Plan, Emergency Intervention Plan, Special Incident Reports and facilities emergency intervention policies and procedures. Based on confidential interviews and documentary evidence did not suggest that staff did not prevent minors from engaging in physical altercations resulting injuries. Incident Reports had S1 as the aggressor in some incidents with other clients in the facility and in others as the victim. The incidents reported having staff present during the events. The facility always has two to three staff to supervise clients in placement. Report continues on LIC9099-C Page 2 of Confidential interviews indicated that restraints are conducted when clients in care pose imminent danger to self and others, staff must be Pro-Act trained and two or more staff must conduct the restraint. The facility also used variety of verbal redirecting techniques to calm clients during crisis. There was not enough information to corroborate the allegation. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has decided that the allegations of Neglect/Lack of Supervision are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was left at the facility. Page 3 of 3

Investigation Findings:
13On November 9, 2022, at 12:00pm, Licensing Program Analyst (LPA) Olivia Rosas conducted an unannounced inspection to Hathaway-Sycamores Child and Family Services for the purpose of concluding the investigation on the above allegations and to deliver the findings. LPA Rosas, met with Staff#1 (S1) and together discussed the investigation details. During the investigation process, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted inspection and conducted interviews on August 28, 2021. In addition, LPA Rosas interviewed witnesses and pertinent parties related to the investigation. Individuals mention in this complaint are identify on the Confidential Names List (LIC811) dated November 9, 2022. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the Neglect/Lack of Supervision allegation staff left minor unattended resulting in minor needing medical attention and staff did not prevent minors from engaging in physical altercations resulting in injuries. Report continues LIC-9099C Page 1 of UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Olivia Rosas LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: HATHAWAY-SYCAMORES CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 11/09/2022

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

met_with: Staff#1 (S1)


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Narrative:
Furthermore, Staff stated when they were notified of the alleged incident, staff spoke to both clients and immediately placed in the clients in separate cottages. Staff stated they also called in a SCAR and notified each client's placement agency. LPA made multiple unsuccessful attempts to obtain a statement from Client #1 and Client #2. Based on information obtained, the allegation is found to be unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. There were no deficiencies cited. An exit interview was completed, and a copy of this report was left with the Director of Residential Programs.

Investigation Findings:
13On April 6, 2023, Licensing Program Analyst (LPA) C. White conducted an unannounced visit to above location for the purpose of concluding the investigation and deliver findings on the above allegation. LPA spoke with the Director of Residential Programs - Daisy Delgado and discussed the findings. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Confidential interviews and records did not produce corroborating evidence to support the allegation. Staff denied the allegation, Staff did not prevent inappropriate behaviors between minors. Staff stated clients in care a not left unsupervised. Staff stated when clients are in their rooms the doors are left open slightly, and staff conduct room checks every 15 minutes. Staff stated also verbal redirection is used to discourage clients from room visitation. Report continued on LIC 9099C. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: HATHAWAY-SYCAMORES CHILD AND FAMILY SERVICESFACILITY NUMBER: VISIT DATE: 04/06/2023


facility_name: HATHAWAY-SYCAMORES CHILD AND FAMILY SERVICES

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Investigation Findings:
13On October 5, 2023, Licensing Program Analyst (LPA) C. White conducted an unannounced visit to above location for the purpose of concluding the investigation and deliver findings on the above allegations. LPA spoke with the Director of Residential Programs - Daisy Delgado and discussed the findings. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Confidential interviews and documents did not produce corroborating evidence to support the allegations. Staff denied the allegations. Staff stated they do not physically or verbally abuse any client in care, that they utilize a trauma informed approached to care for all client in care. Staff stated Client #1 was Spanish speaking, that multiple staff speak the client's language and were able to communicate with Client #1. LPA was unable to obtain a statement from Client #1. Based on information obtained, the allegations are found to be unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. There were no deficiencies cited. An exit interview was completed, and a copy of this report was left with the Director of Residential Programs. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3


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Investigation Findings:
13On January 16, 2024, Licensing Program Analyst (LPA) C. White conducted an unannounced visit to above location for the purpose of concluding the investigation and deliver findings on the above allegations. LPA met with Assistant Vice President, Timothy Lin and discussed the findings. Uncleared persons in facility During the course of this investigation, LPA conducted confidential interviews and reviewed records. Staff denied the allegations. Staff stated they do not sneak unauthorized people into the facility for any reason, that no staff has sold drugs to any clients, and that if a client was found to be in possession of any type of weapon, the weapon would be confiscated and an emergency CFT meeting would take place. Client statements did not produce corroborating evidence to support the allegation. Additionally, there were no witnesses to support the allegations. Based on information obtained, the allegations are found to be unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. There were no deficiencies cited. An exit interview was completed, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Assistant Vice President - Timothy Lin