summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis went to Adolescent Growth, Inc. on February 07, 2025 at 2:00pm for the purposes of an unannounced Random Annual inspection. LPA met with Christina Tornero, Supervisor and Dr. Joilyn Lewis, President/CEO, and discussed the purpose of today's inspection. LPA and the Supervisor conducted a tour of the facility. The license issued by Community Care Licensing (CCL) allows the licensee to provide care and supervision to six ambulatory clients ages 12-17 years old. The facility is located in a residential neighborhood and has three bedrooms, three bathrooms, living room, dining area, and a kitchen. Currently, there are four clients in placement at the facility. LPA observed a fully stocked refrigerator in the kitchen. Medications, sharp knives, chemicals, and cleaning supplies are kept locked in areas inaccessible to children. The kitchen was observed to be clean and well stocked with several food items (perishable and nonperishable). LPA observed three bathrooms to be in good repair and working order. The First Aid Kit was fully stocked. LPA observed a separate classroom on the premises for the clients' educational activities. The outdoor areas were observed to be free of debris and hazards. LPA did not observe any pools or other bodies of water on the premises. LPA observed all three bedrooms with twin beds, dresser, and closet space. Files were reviewed and all were found to be in order. LPA spoke with three clients during the inspection. Each client was observed to be neat and well groomed. The last fire drill was held on December 12, 2024 at 3:00pm. LPA obtained a client roster during the inspection. Licensee will email LPA a current facility staff roster (LIC500) as well as a copy of the minutes from the most recent Board of Director's meeting. LPA found no Title 22/ILS deficiencies on this date. Exit interview conducted


state: CA

facility_name: ADOLESCENT GROWTH INC.

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis was advised by Licensing Program Manager (LPM) Yan Yeung to conduct a case management inspection to follow up with the facility to ensure staff noted on the most recent LIC 500 were available per the information listed on the report. LPA went to Adolescent Growth, Inc. on August 20, 2025 at 11:20am for the purposes noted above. LPA met with Verenice Perez, Medical Assistant and Bethany Moore, Academic Coordinator/Supervisor and discussed the purpose of today's visit. Individuals noted on LIC 500 are employed with the facility. Facility manager/Supervisor was present during the inspection. LPA found no Title 22/ILS deficiencies on this date. Exit interview done

report_type: Facility Evaluation

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis went to Adolescent Growth, Inc. on December 10, 2025 at 2:40pm for the purposes of conducting a case management inspection. LPA met with Dr. Joilyn Lewis, President/CEO (P/CEO) and John Lewis, COO, and discussed the purpose of today's visit. Currently, there are four clients placed at the facility. LPA randomly reviewed three staff files and found the reviewed files to be in order. LPA spoke with two clients that were present during the inspection (refer to Confidential Names form (LIC 811) dated December 10, 2025). Both clients indicated that staff treats them well and that they are getting plenty to eat. Both clients were observed to be neat and well groomed. LPA also spoke with staff during the inspection. The facility stated that they offer individual therapy, family therapy, and group therapy. Extracurricular activities are available and offered to the clients. Staff receives continuous training throughout their employment at the facility. LPA discussed cameras and the need to obtain a Program Statement Addendum Approval for the use of cameras at the facility. LPA also advised licensee that he would re-submit to them a copy of PIN 24-09-CRP Video Cameras in Children's Residential Congregate Care Facilities to provide them with information concerning video cameras. LPA found no Title 22 deficiencies on this date. Exit interview done

met_with: Dr. Joilyn Lewis, President/CEO and John Lewis, COO


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis was advised by Licensing Program Manager (LPM) Yan Yeung to conduct a case management visit to cite Adolescent Growth, Inc. based on observations made by LPA Olena Maico on Friday, August 08, 2025. LPA went to Adolescent Growth, Inc. on August 12, 2025 at 12:35pm for the purposes noted above. LPA met with Dr. Joilyn Lewis, President/CEO (P/CEO) and John Lewis, COO, and informed both individuals of the citation. LPA advised the P/CEO and the COO that LPA Maico drafted the report and citation and he will present the report and citation verbatim as drafted by LPA Maico. LPA Maico's report is as follows: On 08/08/2025 at 11: AM Licensing Program Analyst (LPA) Olena Maico visited the facility during the unannounced complaint investigation and did not observe Facility Manager or Administrator on premises. During LPA's visit the staff who was at the door stated she was a Medical Assistant (MA. LPA asked if there was another staff on premises and MA stated there was also a Therapist. The MA called the Facility Manager (FM) and the FM stated she took a day off today. LPA asked if the FM or Administrator were on premises and FM said no. FM stated she will be on her way to the facility. At around 12: LPA asked MA if the FM was coming and MA stated the the FM should be here in 10 minutes. At around 12: PM the Administrator arrived at the facility and spoke with the LPA. LPA asked if the Facility Manager is scheduled to be on the premises when the children are present. Administrator stated that the Facility Manager was on premises till AM and the other supervisor also has been present. LPA was shown the video of the person sitting at the desk. LPA inquired why the contradicting information was provided to the LPA and LPA was informed that the Facility Manager was not on premises. LPA requested LIC 500 from the Administrator. LIC 500 was provided to the LPA. LPA did not observe the Facility Manager position on the LIC 500. LPA informed the Administrator that the position is required by the Title 22 and needs to be revised. Title Chapter Article 6 84065 (d) states The licensee shall designate at least one facility manager to be present at the facility at all times when children are present. LPA did not observe Facility Manager or the Administrator present at the facility at the time LPA arrived and there were 3 children at the facility at the time of LPA's visit. The Administrator did not arrive to the facility until 12:40. The facility is being cited for the violation of the section 84065 (d) Administrator. The copy of this report and LIC 809d as well as LIC 811 was provided to the Administrator. Exit interview done. Appeal Rights given


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis went to Adolescent Growth, Inc. on November 20, 2025, at 11:45am to follow up on a Special Incident Report (SIR) that was submitted late to Community Care Licensing (CCL). LPA met with Juan Osorio, Academic Coordinator, and discussed the matter. Information shows that the incident occurred on October 16, 2025 and CCL received the report on October 20, 2025. The facility informed LPA that the late reporting occurred due to a staff error. Based on the late reporting, LPA has determined that a reporting requirement violation has occurred. Therefore, the following deficiency will be cited per Title 22 regulations (see LIC809D). Exit interview done

met_with: Juan Osorio, Academic Coordinator


summary: Facility Evaluation

raw_content:
Narrative:
On October 4, 2022 at 10: AM, LPA Rarela conducted an unannounced case management inspection to the facility in order to cite deficiencies from a previous inspection as detailed below. On September 29, 2022 at 10: AM, LPA Rarela conducted an unannounced inspection to the facility and was informed by staff that there was no facility manager present and did not allow the LPA enter the facility to conduct the unannounced inspection. Per Title 22, Division 6, Chapter 5 84065. Personnel Duties, a licensed facility shall have one or more facility managers on the premises with the authority and responsibility necessary to manage and control the day-to-day operation of a community care facility and supervise the clients. In addition, Per Title 22, Division 6, Chapter 5 84044(b) Inspection Authority of the Department of Licensing Agency, the licensing agency shall have the inspection authority specified in Health and Safety Code section 1538.9. The aforementioned regulations were cited. A copy of this report, LIC 809-D for deficiencies and Appeal Rights were provided to the facility representative.

met_with: Dr. Linda LaBrie


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis went to Adolescent Growth, Inc. on February 13, 2026 at 12:28pm for the purposes of an unannounced Random Annual inspection. LPA met with Eliza Haury, Therapist, and discussed the purpose of today's inspection. LPA and the Therapist conducted a tour of the facility. The group home is located in a residential neighborhood and currently has five youth in placement. The facility is licensed to serve six clients ages 12-17 years old. The facility has three bedrooms, three bathrooms, living room, group room, dining area, classroom space, and a kitchen. There is adequate perishable and nonperishable food supply at the facility. Medications, sharp knives, chemicals, and cleaning supplies are kept locked in areas inaccessible to children. LPA observed three bathrooms in good repair and working order. LPA observed all three bedrooms with twin beds, dressers, and closet space. The outdoor areas were observed to be free of debris and hazards. LPA did not observe any pools or other bodies of water on the premises. There is adequate seating in the living room and dining areas. Smoke alarm in the hallway was operable. Files were reviewed and found to be in order. LPA spoke with staff and clients during the inspection. The clients appeared neat and well groomed. There are visible cameras on the premises in the common areas and outdoors. Licensee will email LPA a current facility staff roster (LIC500), client roster, and a copy of the minutes regarding their most recent Board of Director's meeting. LPA found no Title 22/ILS deficiencies on this date. Exit interview conducted

visit_type: Annual

met_with: Eliza Haury, Therapist


facility_name: ADOLESCENT GROWTH, INC.

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Staff and local police also confirmed that incidents occurred at the facility but were not properly reported and incidents were not documented on written incident reports sent to the Licensing agency. As such, specific incidents can not be evaluated for supervision requirements being met. However, incidents reported by the police to LPA do not confirm that a lack of supervision was the cause of any incident or that there was a violation related to any incident. Despite staff statements that the facility was understaffed, statements also indicate that staff did work overtime and/or step in to ensure supervision. Additionally, the facility has temporarily closed the facility, and there are no residents in care at this time. Although the allegation may have happened or is valid, based on LPA's observations and interviews with residents and staff, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is Unsubstantiated. LPA is issuing one advisory, per California Code of Regulations, Title 22, Chapter 5, Section Responsibility for Providing Care and Supervision. An exit interview was conducted, and a copy of this report left with Administrator Joy Lewis.

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

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

report_type: Complaint Investigation

met_with: Administrator Joy Lewis; CFO John Lewis

complaint_status: unsubstantiated


raw_content:
Narrative:
... Residents were left in the milieu to get ready for bed while staff went down the hall to prepare night medications. Staff returned to the milieu between 3 and 5 minutes later, but the exact time could not be confirmed. However, it was long enough for R1 and R2 to engage in sex in R1's room. Due to the known risk, there should have been enhanced supervision. The youth were separated and checked in with separately. Later, clinical staff responded and came to the facility that night. R1 was informed that this event was grounds for discharge. In response, R1 packed a bag and left the facility that night on an unauthorized absence. Based on staff interviews, R1 was not properly informed of this, triggering the leave. The police located the youth and were informed by clinical staff, as confirmed by clinical staff, that the youth could not return to the facility. R1 waited with police and then waited on the porch the next day until R1's parent could pick up R1. Staff kept an eye on the youth on the porch and provided food. However, the youth should have been encouraged to remain in the facility with enhanced supervision to keep youth separate from each other and the discharge procedures followed properly. R1 was prescribed the psychotropic medication Zoloft, AM dose, and an informed consent was signed by the parent, consenting to the administration of the medication while R1 was in the facility's care. However, it was confirmed that the medication was not administered because R1 was assessed by the facility's hired nurse practitioner, who continued the Zoloft and added additional medications, for which a new medication consent form needed to be signed by the parent(s). However, there should be no lapse in administration of medications, especially psychotropic medications. Documents and witness and staff interviews indicate that R1 was admitted on 7/14/21 and left the facility on 7/15/21. Per Administrator and CFO, R1 was assessed on 7/15/21 afternoon. The AM Zoloft dose should have been administered on 7/15/21 morning. The preponderance of evidence standard has been met, and therefore the above allegations are found to be Substantiated. LPA is issuing three citations, per California Code of Regulations, Title 22, Sections 84065. Staff/Child Ratios, 84068. Removal and/or Discharge Procedures, and Health Related Services. An exit interview was conducted, appeal rights provided, and a copy of this report left with Administrator Joy Lewis. LPA is issuing an advisory per California Code of Regulations, Title 22, Section Personal Rights and advises that the facility document when medications are transferred out of the facility at discharge similar to the documentation of medication at admission. An exit interview was conducted, and a copy of this report was left with Administrator Joy Lewis.

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

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

met_with: Administrator Joy Lewis


raw_content:
Narrative:
Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. Therefore, the allegations are UNSUBSTANTIATED. An exit interview was conducted, and a copy of this report was given to Facility Administrator whose signature confirms the receipt of this report.

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

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

met_with: Administrator, Joy Lewis and Licensee John Lewis


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

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

met_with: Joy Lewis - Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On Wednesday 6/16/21 at 9:33AM, Licensing Program Analyst (LPA) Mariah Hawkins made a visit to the facility to conduct a required annual inspection. A screening email and phone call were sent/attempted prior to the visit. Safety precautions were taken, including face masks, hand sanitizer, disinfectants, and social distancing. Additionally, LPA is vaccinated, tested negative for COVID-19 on Monday 6/14/21, and does not have any symptoms of COVID-19. LPA met with Dr. Linda LaBrie, Clinical Supervisor, and informed of the purpose of the visit. At 9:45AM, LPA conducted a tour of the facility and grounds. The facility is clean and free of debris. The grounds are free of obstructions and are well-maintained. The kitchen is stocked with food to meet the needs of the residents in care and meets the mandated 7-day non-perishable and 2-day perishable standard. Food items are in date and are labeled by date of purchase. Cleaners and sharps are kept in locked storage areas downstairs, and the laundry room (upstairs) is locked. There is a sign-in and screening table set up by the front entrance that includes a sign-in sheet, a thermometer, and hand sanitizer. At 10:05AM, LPA observed some kitchen cleaner in a high cabinet in the kitchen. Staff immediately moved these to the locked cleaning cabinet. At 10:22AM, LPA observed that the water temperature in the upstairs resident bathroom measured 125. F. LPA advises that, per California Code of Regulations, Title 22, Section 80088, hot water at vanity sinks should measure between 105 and F, and measurements above F require a hot water warning sign. Staff agreed to post a sign here until the hot water temperature can be lowered. At 10:35AM, LPA observed that there are cameras located in the following locations: facility entrance, front office, front living/dining area, back living room, classroom, and upstairs lounge. On 5/29/20, the facility was informed that a camera waiver is required before cameras can be used or fixed onto walls. LPA advises that the facility immediately deactivate the cameras and submit a waiver request for approval to use cameras. At 10:50AM, LPA reviewed the facility files that were accessible to present staff. Emergency documentation was stored for each resident in an emergency information binder in the staff office. Staff and resident records, such as admission agreement, consent forms, etc. are only accessible to director, who agreed to send LPA the requested documents. LPA requested the following: most current LIC Personnel Summary, LIC Emergency Plan, all staff qualifications (LIC 501), all staff training record for 2020-current, each resident's face sheet, needs and services, admission agreement, and treatment/medical consent forms. There are no citations and two advisories. A follow-up to review the facility files will be conducted. An exit interview was conducted, and a copy of this report was left with Dr. Linda LaBrie, whose signature on this form confirms receipt.

met_with: Clinical Supervisor Dr. Linda LaBrie


summary: Facility Evaluation

raw_content:
Narrative:
On November 8th, 2022 at 3: PM Licensing Program Analyst (LPA) Alyssa Ng conducted an unannounced case management inspection. The purpose of the inspection was to confirm that the above address ( Vista Ridge Court, Concord, CA 94518) is no longer operating as a Children's Residential Facility and has no children in placement. On 10/11/21, LPA Mariah Hawkins learned in staff interviews (Please refer to complaint # 14-CR-20210716093941) that the facility was temporarily closed. LPA confirmed this with the administrator. No formal notice of closure was sent to the Licensing agency. LPA Ng made multiple attempts to get in contact with the Administrator/Licensee. LPA Ng left voicemail's and email correspondence regarding the overdue of fees and to get an update on the facility. There were no cars outside. During inspection, it was confirmed that the above address has no residents living inside. Adolescent growth is officially closed.


summary: Facility Evaluation

raw_content:
Narrative:
On 06/20/24 at 1:15 p.m., Licensing Program Analyst (LPA) Brenda Rodriguez conducted an unannounced visit to the above facility. The purpose of this visit was to complete the required annual inspection. LPA Rodriguez met with Medical Assistant Emani Burks, at the above facility to conduct the required annual inspection. LPA Rodriguez used the CARE Inspection Tool. LPA Rodriguez conducted the physical plant inspection. Personnel Files are maintained safely online. LPA Rodriguez reviewed one (1) client file. LPA Rodriguez discussed the following with Emani Burks, Medical Assistant: client files and the physical plant inspection. Two technical assistances were cited at this time. At this time, the inspection is not complete. LPA Rodriguez will be back at a later day to complete the required annual inspection. LPA Rodriguez conducted an exit interview, and a copy of this document was given to Medical Assistant Emani Burks.

met_with: Emani Burks, Medical Assistant


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On 07/29/24 at 12:20 p.m., Licensing Program Analyst (LPA) Brenda Rodriguez conducted an unannounced visit to the above facility. The purpose of this visit was to complete the required annual inspection. LPA Rodriguez met with Medical Assistant Emani Burks, at the above facility to conduct the required annual inspection. LPA Rodriguez used the CARE Inspection Tool. LPA Rodriguez conducted one confidential staff interview. The clients present at the time did not want to get interviewed. Three deficiencies (CCR 80023(a), CCR 84365(d), and CCR 80066(a)) and two technical violations (CCR 84009(a) and CCR 84072(a)) were cited at this time (see more on LIC 809Ds). Appeal rights were discussed and provided. The required annual inspection is complete. LPA Rodriguez conducted an exit interview, and a copy of this document was emailed to Administrator Joy Lewis and Medical Assistant Emani Burks whose signature on this form confirms receipt.

Deficiencies:
80066(a): Personnel Records

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
LPM is issuing a citation for California Code of Regulations (CCR) Title 22, Division 6, Chapter 5, Section 84078(b), 84065(b) and CCR Title 22, Division Chapter 1, Section 80075(b). The facility is being issued a citation on the attached page LIC 9099-D. An exit interview was conducted, appeal rights discussed, and a copy of this report was emailed to Joy Lewis, Administrator. Documents were sent via email due to the virtual meeting. Joy Lewis will sign all documents and send back to LPM Pierotti via email.

Investigation Findings:
SubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:

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

met_with: Joy Lewis, Administrator John Lewis, CFO

complaint_status: SUBSTANTIATED


raw_content:
Narrative:
An exit interview was conducted, appeal rights discussed, and a copy of this report was emailed to Joy Lewis, Administrator. Documents were sent via email due to the virtual meeting. Joy Lewis will sign all documents and send back to LPM Pierotti via email.

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

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


summary: Facility Evaluation

raw_content:
Narrative:
***On 05/12/2025 at 10:30am, Licensing Program Analyst (LPA) Kristin Pierotti and Licensing Program Manager (LPM) Carolyn Flynn conducted an unannounced Case Management inspection visit at the facility to review and amend the Case Management that was conducted on 04/18/2025. LPA and LPM met with John Lewis and Joy Lewis and informed of the purpose of the visit.*** Licensing Program Analysts (LPA's) Shikya Belfield and Omar Sawyer conducted an unannounced inspection at the above facility on 4/18/2025 at 10: AM. The purpose of this inspection is to conduct a case management regarding concerns observed by the department. Present during this inspection was one staff, Paul Lozito who assisted with this inspection. A review of medication logs was observed by LPAs and several errors were observed in the documentation of psychotropic medications being administered. Based on a review in the administrator certification system, the current administrator does not have a current administrator certification. LPAs are issuing a citation for California Code of Regulations (CCR) Title 22, Division 6, Chapter 5, Article 6, Section 84064(b) Administrator Qualifications and Duties and a citation for CCR, Title 22, Division 6, Chapter 5, Article 6, Section 84070(b)(16) Children's Records. LPA identified three areas in which Technical Support was given in the form of a Technical Violation. (See associated LIC9102 forms). An exit interview was conducted a copy of this form along with appeal rights will be sent to staff Lozito and administrator Joy Lewis. ***An exit interview was conducted, appeal rights discussed and a copy of this report was left with John Lewis, whose signature confirms receipt of this document.***

met_with: Paul Lozito


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On 11/21/25 at 10:00am, Licensing Program Manager (LPM) Kristin Pierotti, LPM Carolyn Flynn, LPM Isabel Diego, and Licensing Program Analyst (LPA) Celeste Aparicio and Regional Manager (RM) Helga Wong conducted a virtual meeting with the facility to conduct an Informal Meeting. The purpose of this meeting was to discuss concerns observed by the department. Present during the meeting, representing the facility: Joy Lewis, Administrator and John Lewis, CFO. The following were topics discussed based on concerns the department observed during past inspections: Criminal Background Clearance: During the course of an inspection at the facility, record review revealed that one staff on the LIC500 did not have criminal background clearances associated with the facility. This is a violation of California Code of Regulations (CCR), Title 22, Division 6, Chapter 1, Section 80019(e)(3). The facility is being issued a citation on the attached page LIC 809-D. Additionally, as mandated in Section 80019, LPA is assessing an immediate civil penalty of $100 for a maximum of 5 days in violation, in which S6 worked on site, for a total of $500. Administrator Qualifications and Duties: During the course of the inspection at the facility, record review revealed that the Facility Administrator did not have hours listed on the LIC500. Based on confidential interviews, it was revealed that the Facility Administrator was not on site. The Administrator was not readily responding to Licensing via emails and phone calls. This is a violation of CCR, Title 22, Division 6, Chapter 5, Section 84064(c). The facility is being issued a citation on the attached page LIC 809-D. Inspection Authority: The facility personnel have not been readily available when the Department has attempted contact. Documents have not been readily available when requested and multiple requests had to be made to obtain the documentation. This is a violation of CCR, Title 22, Division 6, Chapter 5, Section 84044(b). The facility is being issued a citation on the attached page LIC 809-D. LPM Pierotti has determined that S1's conduct is inimical to the safety of the client(s) of the facility. LPM Pierotti is issuing a citation for Health and Safety Code (HSC) Section 1558. The facility is being issued a citation on the attached page LIC 809-D. LPM Pierotti gave an overview of next steps should problems persist at the facility. A non-compliance conference could be held which requires increased oversight which can last for up to two years. During this meeting, Technical Support Program (TSP) services were offered. LPM Pierotti will email the TSP information to Administrator, Joy Lewis. An exit interview was conducted, appeal rights discussed, and a copy of this report was emailed to Joy Lewis, Administrator. Documents were sent via email due to the virtual meeting. Joy Lewis will sign all documents and send back to LPM Pierotti via email.

Deficiencies:
80019: (3) Request a transfer of a criminal record clearance as specified in Section 80019(f).

title: Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to....  shall prior to working... in a licensed facility


summary: Facility Evaluation

raw_content:
Narrative:
On Tuesday 11/09/21 at 12:50PM, Licensing Program Analyst (LPA) Mariah met with Administrator Joy Lewis and CFO John Lewis and informed of the purpose of the visit, which was to issue citations for deficiencies found during the course of an investigation at the facility. During investigation, it was discovered that multiple incidents occurred at the facility, including incidents in which the police were called. Local police confirmed that police responded to incidents on 06/08/21 for a 5150 evaluation, 06/13/21 for an unauthorized absence, 06/16/21 for a suicide threat and 5150, 06/23/21 for a traffic complaint by a neighbor for which police contacted the facility, and 06/29/21 for suicide threat and 5150. None of these incidents or police contacts were reported to the Licensing agency. Only one report was submitted for an incident on 07/25/21. Additionally, the report for an incident in which two residents engaged in sexual activity at the facility was not properly reported to the Licensing agency. Review of resident R1's (See LIC Confidential Names) Medication Administration Record (MAR) indicated that medication administration is not properly documented. The MAR used is an excel sheet rather than the LIC 622A and LIC 622B, or variation that includes all required information. The MAR was missing the dosage information for the medications and the chart of staff names administering medications. Only staff initials were included. There is disparity in administration time of medications that may be PRN and administered as advocated for by the youth. For instance, the same night medication was administered as early as 8:06PM and as late 11:51PM, and the morning medication was administered as early as 8:14AM and as late as 10:52PM. The latter may be a typo in the AM versus PM. However, the log does not document which medications are PRN or if medications not administered were missed or not administered for another reason. Lastly, the log includes all medications, including Sertraline (brand name is Zoloft), a psychotropic medication. Psychotropic medications must be logged separately on the LIC 622B or variation that includes all the same required information. On 10/11/21, LPA learned in staff interviews that the facility was temporarily closed. LPA confirmed this with the administrator. No formal notice of closure was sent to the Licensing agency. LPA is issuing two citations and one advisory, per California Code of Regulations, Title 22, Sections 80061(b) Reporting Requirements, 84070(b)(13) Children's Records, and 80061(e) Reporting Requirements. An exit interview was conducted, appeal rights provided, and a copy of this report left with Administrator Joy Lewis.


raw_content:
Investigation Findings:
13On September 15, 2022 at 9: AM, Licensing Program Analysts (LPA) C. White conducted an unannounced visit to Adolescent Growth for the purpose of delivering findings on the above allegations. LPA met with Facility Chef, Brian Constantino and discussed the complaint 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 allegations. Staff provided inconsistent statements regarding client's blood pressuing not being taken. Staff denied not having client medication and not have anyone to cook for the clients. Staff stated food is purchased weekly and facility bathrooms are cleaned multiple times a day per COVID requirements. Client interviews revealed facility bathrooms are cleaned multiple times a day and staff cook 3 times a day. Client interviews did not reveal issues with medications. Based on information obtained, the allegations are found to be unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. No deficiencies cited. Exit interview completed and a copy of this report was left with facility staff. 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 2

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

met_with: Facility Chef, Brian Constantino


raw_content:
Investigation Findings:
13On September 15, 2022 at 9: AM, Licensing Program Analysts (LPA) C. White conducted an unannounced visit to Adolescent Growth for the purpose of delivering findings on the above allegations. LPA met with Facility Chef, Brian Constantino and discussed the complaint findings. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Confidential interviews and records produced corroborating evidence to support the allegation. Staff confirmed the facility/program manager is not always present at the facility. Client interviews revealed there is one program manager that works in the facility. Based on interviews and information obtained, the department has determined the preponderance of evidence standard has been met, therefore the allegation is found to be Substantiated per California Code of Regulations Title Division Chapter 5. Facility cited for violation of California Code of Regulations, Title Division 6, regulation: 84065(d) Personnel Requirements. SubstantiatedEstimated 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 El Segundo, CA Facility Name: Adolescent Growth, INC.FACILITY NUMBER: 198206911

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


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Narrative:
On December 16, 2021, Investigator Hector met with licensees, requested additional information and issued a 10-Day Complaint Notification. The investigation continued consisting of, confidential interviews and contacts with, five former residents, five staff members, Facility Administrator, Facility Director, and other associated parties. The investigation further included review of related client and staff files, facility file history, facility records, and review of related Los Angeles Police (LAPD) report and LAPD associated records. On October 28, 2020, LAPD responded to Adolescent Growth, Inc. concerning an alleged sexual assault between Y1 and Youth #2 (Y2) reportedly occurring on October 27, 2020, for which Y2 was subsequently arrested. Records reviewed found that the facility failed to report the incident occurring between Y1 and Y2 to CCL and further failed to report the incident concerning Y2's related arrest. The investigation revealed a pattern of inappropriate behavior of youths in the facility occurring prior to the incident on October 27, 2020, yet measures were not taken to stop that behavior. Information obtained revealed staff failed to conduct room checks every 15 minutes in the evening and staff was usually working solely in the evenings. Staff on duty during the incident involving Y1 and Y2, had reported needing more support, including more staff and/or training resources, in order to effectively perform their job duties. Request for more help during the night shifts was not supported as Administration did not provide staff's request. A review of records found multiple incidents including, but not limited to, youth's absence without permission occurring in October 2020, in which local law enforcement was called and responded to the facility, that were never reported to Community Care Licensing. Statements obtained indicate incidents were submitted to facility administration; however, Investigator's request for these incident reports were not produced. (Continued on page LIC9099-C) Based on information from record review and confidential interviews, the preponderance of the evidence standard has been met. The Department has determined substantiated findings for neglect/lack of supervision contributing to inappropriate sexual activity between Y2 and Y1; Failure to Report incidents and failure to allow CCL staff entrance into the facility during initial complaint notification. The above-mentioned concerns pose an immediate and potential health, safety and personal rights risk of harm to youth placed in care. The following citations are issued in accordance with California Code of Regulations, Title 22, Division 6, Chapter 5; 84065. Personnel Duties; Reporting Requirements and Inspection Authority. [See page LIC9099-D for cited deficiencies]. An exit interview was conducted, and appeal rights were discussed. A copy of this report, Confidential Names List and appeal rights were provided to Facility Administrator.

Investigation Findings:
13On October 11, 2022 at 11:00, Licensing Program Analyst (LPA) Regina Martin met with licensees to issue investigative findings concerning the above-mentioned allegations. On December 8, 2021, Community Care Licensing (CCL) received a complaint alleging neglect/lack of supervision as Youth #1 (Y1) was reportedly sexually assaulted by another youth resident while in care (see LIC811, dated October 11, 2022). The allegation was investigated by Licensing Special Investigator Edward Hector of CCL Investigations Bureau. On December 14, 2021, Investigator Hector attempted to conduct an unannounced visit at the facility (Adolescent Growth, Inc.) to initiate the investigation into reported claims; however, after Investigator Hector arrived at the facility, identified himself with a State business card, an official State badge and photo identification positively confirming Investigator's employment with the State of California, Investigator Hector was refused access into the facility by facility staff member and further denied entry by facility supervisor to no avail. When Investigator Hector asked the facility supervisor for their name, they replied that their name was "Program Manager" and refused to further identify themselves. (Continued on page 9099-C) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin 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 El Segundo, CA Facility Name: Adolescent Growth, INC.FACILITY NUMBER: VISIT DATE: 10/11/2022

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

met_with: Joilyn Lewis and John Lewis


summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On November 9, 2022, Licensing Program Analysts (LPA) C. White conducted an unannounced visit to the facility for the purpose of delivering findings on the above allegations. LPA met with Facility Manager, April Barnes and discussed the complaint findings. During the course of this investigation LPA conducted confidential interviews and reviewed records. Staff denied speaking inappropriately towards minors. Staff stated they would never provoke minors to act inappropriately towards each other. Staff stated retalition against minors is not allowed. Staff stated minors are not denied the use of restrooms. Staff denied failing to provide client records to authorized representatives. Client interviewed stated staff would get upset when clients would speak up for each other. Client interview did not reveal that staff provoked inappropriate behaviors between minors nor prevented minors from using the restroom. The information obtained did not produce corroborating evidence to support the allegations. Thus, the allegations are found to be unsubstantiated, meaning although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. No deficiencies cited. Exit interview completed and a copy of this report was left with facility staff. 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 2

met_with: Facility Manager - April Barnes


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Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward investigated the above allegations. LPA interviewed Staff 1 and Staff 2. LPA attempted to interview Staff 3 but she was on jury duty and then on indefinite leave. LPA could not reach Staff 3. Likewise LPA could not reach C1 and C2 as they have been returned to their parents. None of the current clients were in residence when the alleged incidents took place, Due to inability to interview the involved clients or all involved staff, the above allegations are resolved as "unsubstantiated". Unsubstantiated means that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward 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: Sushma Nagisetty, primary therapist


raw_content:
Investigation Findings:
13On Nov. 16, 2023, Licensing Program Analyst Connie Jones-Steward investigated the allegations that licensee did not properly address a bedbug infestation, staff did not ensure that a client received timely medical attention, clients are not transported to their medical appointments, and medical staff are not adequately trained, LPA interviewed one licensee and one medical associate. None of the clients named in the complaint were still residing in the facility therefore no clients were interviewed, LPA Jones-Steward inspected all bedrooms and reviewed staff personnel files. There was no sign of infestation at the time of the inspection, although it was confirmed that a client had insect bites on their body and the beds and frames were replaced out of caution. Personnel files indicate that staff education and training meet Title 22 requirements and that staff who transport clients have driver's licenses. Mr, & Mrs Lewis stated although the facility van is in the repair shop, they have an alternate vehicle to transport clients to medical and other appointments and sometimes clients are transported in employee vehicles. LPA Jones-Steward was not able to confirm nor negate the validity of the allegations. Therefore they all resolved as inconlusive. An inconclusive finding means that although an allegation my be true or valid, there inadequate information to find conclusively that it did happen UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward 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: Laura Meza, John Lewis, Joy Lewis


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Investigation Findings:
13On Nov. 16, 2023, Licensing Program Analyst Connie Jones-Steward and LPM Lakescia Smith investigated the allegations that staff are not administering minor's medications as prescribed,staff do not have access to minor's records, staff do not provide minors with activities and facility washer is in disrepair. LPA interviewed one licensee and one medical associate. None of the clients named in the complaint were still residing in the facility therefore no clients were interviewed, LPA Jones-Steward and LPM Smith inspected the medical control logs and all doses were accounted for. The staff that was present was able to demonstrate that she had access to the client's computerized records. The administrator provided an activity calendar that listed many activites. However LPA was unable to determine if clients had supplies for art projects. LPA and LPM observed on the date of inspection, that the washer and dryer were working, but were unable to determine if clients had washed clothes by hand due to non-working washing machine and dryer LPA Jones-Steward was not able to confirm nor negate the validity of the allegations. Therefore they all resolved as inconlusive. An inconclusive finding means that although an allegation my be true or valid, there inadequate information to find conclusively that it did happen UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward 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: John Lewis, Joy Lewis, Laura Meza


summary: Facility Evaluation

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Narrative:
On November 9, 2021 at 11: AM, Licensing Program Analyst (LPA) Charmetha White arrived at ( ) for the purpose of conducting an Annual Random Inspection. LPA met with the Facility Manager, who granted access to the location and together a tour of the entire facility was conducted both inside and out. The facility is licensed to provide care and supervision services for six (6) children, ages 12-17 years old, ambulatory only. The census today is four (4). The program only accepts Private Placement Clients. The facility is set up as follows: This is a two-story home with 3 bedrooms, 2 full bathrooms and 2 half bathrooms, staffing offices, a therapy room, living room, dining room, kitchen, classroom, laundry area, conference room, a nursing office, and a backyard. Living room/community area: has ample seating, and a non working fire place. Dining room: is equipped with a table and seating for 6 people. Kitchen: is equipped with two (2) freezers/refrigerators, an oven, stove top with four (4) functional burners, dishwasher, and ample cabinet/storage space. Sharp objects and chemicals are kept in locked cabinets. Classroom: is located next to the kitchen. It is equipped with a multiple tables and seating, and lockers for children in care. The room contains two doors, one leading outside to the right of the home and the other leading to the garage both doors remain locked. Laundry Area: is located in a closet inside the classroom and has a stackable washer/dryer combination. Staffing offices: Three (3) staffing offices are located on the first floor. Therapy room: is located to the right of the entry way along a hallway at the front of the home. It is equipped with two desk and three chairs. Nursing Office: is located to the right of the entry way along a hallway next to the therapy room. It is equipped with a double locked cabinet that contains medications and the First Aid Kit. Conference room: is located on the second floor and is used for meetings. The room is equipped with a TV, a table, and seating for more than 8 people. Report continued on LIC 809C. Bedrooms: All bedrooms are located on the first floor to the left of the entry way. Each bedroom is equipped with two twin beds, ample closet and drawer space. Bedrooms #1 and #2 both have sliding glass doors leading to the left side of the house. Bedroom #3 contains a bathroom and an exit door leading to the backyard. Bathrooms: Bathroom #1 and a ½ bathroom are located on the first floor along the hallway to the left of the entry way. Bedroom #3 contains Bathroom #2 and there is a ½ bathroom located on the second floor next to the conference room. All bathrooms were observed to be in good repair and working order. The hot water temperature was tested and found to be between 105-120 degrees (F). LPA observed four (4) fire extinguishers throughout the home and all were found to be in good condition. The smoke and carbon monoxide detectors were tested and found to be in working order. Medications are stored in a locked cabinet located in the nursing room and made inaccessible to children in care. All doors and exits are attached to an alarm system that alerts staff when doors are opened. There is a working telephone readily accessible. LPA observed the home to be clean, safe, and sanitary. Passageways, stairways, inclines, ramps and open porches are unobstructed. The front and backyard were clean and free of debris. There are no firearms or dangerous weapons in the facility. There was no swimming pool, hot tub, spas, nor similar bodies of water located at the facility. LPA reminded Licensee to ensure the following: Children are accorded personal rights and the corresponding form is in their file. Children are supported and encouraged to participate in extracurricular activities. Children are allowed and encouraged to contact the licensing agency, in confidence, without threats or punishment for making complaints. Children are accorded dignity in personal relationships with others in the home. Licensee acknowledges abuse reporting requirements. During the visit, LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. All posting requirements for Group Home Licensure and Emergency Plan were met. The Program has a total of six Staff. LPA interviewed all six Staff members and all Children in care. LPA will return on a later date to review client and staff files. There were no deficiencies noted on this date. An exit interview was conducted, and a copy of this report was signed and left with the Facility Manager.

met_with: Facility Manager - Azadeh Ebrahimi


summary: Facility Evaluation

raw_content:
Narrative:
On November 10, 2021 at 10: AM, Licensing Program Analyst (LPA) Charmetha White arrived at the above location for the purpose of reviewing client and staff records in order to complete the STRTP Annual Required Inspection which began on 11/09/2021. LPA met with the Facility Manager, Azadeh Ebrahimi who granted access to location and provided the electronic files. The Program has a four (4) clients and six (6) staff. LPA reviewed all client and staff files. This inspection included an overview of required Core Services and Supports and an inspection of facility records of the staff and clients. LPA discussed the following with the Facility Manager: Incident reporting, including incidents related to Law Enforcement contacts as well as incidents involving Emergency Intervention. Discussed procedures for CFT (Child and Family Team) meetings. Licensee is meeting all requirements. There were no deficiencies noted on this date. An exit interview was conducted and a copy of this report was signed and left with the Facility Manager.


summary: Facility Evaluation

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Narrative:
On October 11, 2022 at 10: AM, a Non-Compliance Meeting was conducted at the El Segundo Regional Office to discuss compliance issues with Adolescent Growth, Inc. Present at the Non-Compliance Meeting were the following individuals: 1. Joilyn Lewis, CEO/Administrator 2. John Lewis, COO 3. Kellee Coleman, Regional Manager 4. LaKescia Smith, Licensing Program Manager I 5. Stephen Kim, Staff Service Manager I 6. Charmetha White, Licensing Program Analyst 7. Connie Jones-Steward, Licensing Program Analyst 8. Zena Phillips, Licensing Program Analyst The purpose of the meeting was to discuss the following: 1. Substantiated IB complaint dated 12/08/2021 2. Reporting requirements 3. LE Contact 4. Lack of Supervision 5. Staffing issues Regional Manager, Kellee Coleman discussed with licensee the concerns related to the Substantiated IB Compliant. Report continued on LIC 809C. Licensee informed Regional Manager the incident was not reported to the department because an internal investigation conducted by the Administrator revealed that the allegations were not true as the client retracted the allegation. It was advised during the meeting that the Licensee will attend the Quarterly Provider meetings, train staff on reporting requirements, submit timely incident reports, and conduct three (3) month check ins with their assigned analyst for the next twelve (12) months to ensure the department is receiving incident reports. Copies of the following regulations discussed and provided to the licensee during the meeting: H&S 1533; H&S 1538.7; 80044; 80061; 84065.2; 84078; 80078; 84061; Additionally, the following Provider Notices were discussed and provided to the licensee during the meeting: PIN 17-04-CRP; 17-11-CRP. An exit interview was conducted with licensee, a copy of this report was given to the licensee at the end of the Office Meeting.

met_with: Administrator - Joilyn Lewis and COO - John Lewis


summary: Facility Evaluation

raw_content:
Narrative:
On November 16, Licensing Program Analyst Connie Jones-Steward arrived at the facility to conduct the annual required evaluation. The following was observed: This is is a two-story home with 3 bedrooms, 1 full bathrooms and 3 half bathrooms, staffing offices, a therapy room, living room, dining room, kitchen, classroom, laundry area, conference room, a nursing office, and a backyard. The census today is 5. The facility only accepts private placements clients. There is one non-operable fireplace. There are no security bars on windows. There are working smoke detectors and carbon monoxide detectors. Two out of three fire extinguishers were fully charged. There was a complete first aid kit. All trash containers were covered as required. All knives and medications were safely stored. Refrigerator and kitchen stove were in working condition. The food supply met Title 22 requirements. All bedrooms have two beds in good condition with the required linens an the required drawer and closet space. There were no physical plant deficiencies found on this date. LPA will return at a later date to review client and staff records and conduct interviews.

met_with: April Barnes, Floor Lead


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met with the administrator to continue and complete the the annual inspection. LPA reviewed employee files, client file and interviewed employees. Only 1 client has been in residence for more than 30 days, so only that file was reviewed. On this date, client and staff files were found to be complete. There were no deficiencies found as a result of this inspection. This concludes the annual inspection of 2022.

met_with: Joilyn and John Lewis


summary: Facility Evaluation

raw_content:
Narrative:
On November 16, Licensing Program Analyst Connie Jones-Steward and Licensing Program Manager Lakescia Smith arrived at the facility to conduct the annual required evaluation. The following was observed: This is is a two-story home with 3 bedrooms, 1 full bathrooms and 3 half bathrooms, staffing offices, a therapy room, living room, dining room, kitchen, classroom, laundry area, conference room, a nursing office, and a backyard. The census today is 2. The facility only accepts private placements clients. There is one non-operable fireplace. There are no security bars on windows. There are working smoke detectors and carbon monoxide detectors in the home. LPA observed that the smoke detector in bedroom #2 had hanging wires and no battery, However, there were working smoke detectors in the hallways between the bedrooms. Two out of three fire extinguishers were fully charged. There is a first aid kit that is missing a first aid manual LPA observed uncovered trash cans in the bathrooms. All knives and medications were safely stored. Refrigerator and kitchen stove were in working condition. The supply of non-perishable foods does not meet Title 22 requirements, All bedrooms have two beds in good condition with the required linens and the required drawer and closet space. LPA observed torn window and door screens in all three bedrooms. Hot water temperature in client bathroom was tested at 135 degrees which is outside the safe temperature range See LIC 809-D for deficiencies. Exit interview completed

met_with: Joy and John Lewis


summary: Facility Evaluation

raw_content:
Narrative:
On October 30, Licensing Program Analyst Reagan Cohen and Licensing Program Manager Lakescia Smith arrived at the facility and met with Dr. Joy Lewis and John Lewis to conduct the annual required evaluation. There are no clients in care. LPA and LPM conducted a walk through of the facility. The following was observed: This is is a two-story home with 3 bedrooms, 1 full bathrooms and 3 half bathrooms, staffing offices, a therapy room, living room, dining room, kitchen, classroom, laundry area, conference room, a nursing office, and a backyard. The facility only accepts private placements clients. There is one non-operable fireplace. There are no security bars on windows. There are working smoke detectors and carbon monoxide detectors in the home. One out of two fire extinguishers were fully charged. Facility has non perishable food for one week. Facility has operable land line. All knives and medications were safely stored. Medications are stored in the medication office. Cleaning solutions were made inaccessible. Bathrooms were clean and sanitary. There are no bodies of water. Client records were not available because there are no clients in care. Living room and dinning area have adequate seating capacity. The facility has adequate indoor and outdoor space. The front and backyard were found to be clean of derbies and observable hazards. The facility has a working washer and dryer. The facility uses video surveillance. LPA will forward the new requirements to maintain video cameras on the premises. All bedrooms have two beds in good condition with the required linens and the required drawer and closet space. LPA observed torn window and door screens in all three bedrooms. Exit interview completed. A copy of this report was given to Dr. Joy Lewis.

met_with: Dr. Joy Lewis


summary: Facility Evaluation

raw_content:
Narrative:
On 8/29/25 at 9: AM LPA arrived at the above facility to conduct a case management-other visit. LPA arrived at the facility but no one was present at first. LPA called the administrator. Administrator Joy Lewis was in LA conducting a staff training. LPA and Administrator agreed to meet at the facility at 11: AM. LPA informed Administrator that the purpose of the visit was to review staff and client files and to ensure that the facility had a compliant filing system that allows for CCL to review the files when needed. LPA and Administrator meet at 12:30 due to Administrator having car troubles. LPA requested to review some staff and client files from the previous three years. Administrator confirmed that files are saved directly on to a facility computer for storage and access. Administrator explained that when a staff or client leaves there files are deleted from the computer. LPA reviewed the administrator files and observed that the LIC forms are assigned to the Abundant Life Facility at Zindell Ave. LA, CA 90040, facility number 197804869. LPA observed LIC 503 missing the physician signature. LPA requested client files from 2023 including for C1 & C2. Administrator could not remember those name, and did not have any client files saved. LPA requested to review staff file for S3. Administrator said they don't have that file or any other staff files. LPA informed Administrator that they need to keep staff and client files for at least three years after they exit. Administrator stated that because no one is in the facility they don't keep files there but at the office for easier access. Administrator stated that when they have staff and clients a copy of the files will be kept at the facility. Exit Interview conducted, and a copy of this report was given to the administrator.

met_with: Joy Lewis Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 9/23/ LPA arrived at the above facility to conduct an unannounced case management visit regarding the facility files for clients and staff. LPA called the administrator and sent emails to request the visit. It took a while for LPA to get in contact with Administrator. Later administrator responded and LPA and administrator were able to meet up at the facility around 12: PM. LPA and Administrator talked about staff and client files. During a previous visit on 8/29/ LPA was informed that the facility had not saved any of the previous client or staff files. LPA reminded Administrator that per CCR 80066 (d) & 80070 (g) staff and client files are supposed to be saved for at least 3 years. LPA also discussed with Administrator the administrator files. During a previous visit on 8/29/ LPA observed that the administrator file was filled with LIC forms associated to "Abundant Life & Adolescent Growth INC." #197804869, a now closed facility. LPA informed Administrator that these forms would have to be updated to reflect the current "Adolescent Growth INC." facility #198206911. LPA also requested a copy of the Administrators CPR/First Aid. LPA discussed contact and returning calls/emails from licensing with Administrator. LPA informed Administrator that there was an attempted visit conducted on 9/12, in which Administrator never responded to LPA. Administrator informed LPA that there was a family funeral that day. LPA understood and encouraged Administrator to still respond via voicemail or email at a later time in the future. Administrator acknowledged. The facility is being cited based on CCR 80066 (d) & 80070 (g) due to staff and client files not being available for CCL review. See LIC 809-D. Exit interview conducted. A copy of this report was given to the Administrator.

met_with: Dr. Joy Lewis Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward visited the facility and met with the primary therapist in response to an Incident Report dated 07/03/23. The report indicated that C1 attempted suicide on 06/30/23. The facility response was to discharge the client because she attempted suicide. However the facility plan of operation indicates that the facility's program is designed to treat clients who attempt suicide. Therefore the discharge of C1 was in violation of Adolescent Growth, Inc's plan of operation and thus a violation of Title 22. The facility was cited under Section 80022(k) of Title 22


facility_name: AIM GROUP HOME

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced inspection at the facility for the purpose of conducting an Annual/Required inspection. LPA Singh-Sood met with Administrator, Florietto Alano and both toured the facility, inside and out at 12: PM. The Group Home is licensed to serve six clients, ages 7-18 years. Currently, there are five clients in placement. This facility is a one story house, consists of 5 client bedrooms and 3 client bath. Staff files and client files were reviewed and are kept locked to ensure confidentiality. Hot water temperature was checked and was observed to be 113 degrees Fahrenheit. First aid kit was observed. Food supply, linens and fire extinguisher were observed. There is sufficient perishable food for two days and nonperishable food for 7 days. Smoke detectors were observed and operational. Medication storage and procedures were reviewed. There is no pool or firearms on the premises. The following documents are posted in the facility: facility license, emergency disaster plan, facility sketch, menu, activity calendar and personal rights. Fingerprint clearances were reviewed using a Facility Personnel Report Summary dated 4/29/22. All facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances and/or exemptions. There were no Title 22 deficiencies observed during this visit. Appeal Rights were provided and discussed. Exit interview was conducted with Mr. Alano, and a copy of this report was issued.

met_with: Florietto Alano


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Vaishali Singh-Sood conducted an unannounced inspection at the facility for the purpose of conducting an Annual/Required inspection at 9: AM. LPA Singh-Sood met with House Manager, Nonet Alano, and both toured the facility, inside and out. During the time of the inspection, 1 client, and 3 staff were present. It is noted the client was non-verbal and an interview could not be conducted. Ms. Alano also informed this LPA that they will be submitting an application to convert the home into an adult home by the beginning of November. The Group Home is licensed to serve six clients, ages 7-18 years. Currently, there are five clients in placement. This facility is a one story house, consists of 5 client bedrooms and 3 client bath. Staff files and client files were reviewed and are kept locked to ensure confidentiality. Hot water temperature was checked and was observed to be 111 degrees Fahrenheit. First aid kit was observed. Food supply, linens and fire extinguisher were observed. There is sufficient perishable food for two days and nonperishable food for 7 days. Smoke detectors were observed and operational. Medication storage and procedures were reviewed. There is no pool or firearms on the premises. The following documents are posted in the facility: facility license, emergency disaster plan, facility sketch, menu, activity calendar and personal rights. Fingerprint clearances were reviewed using a Facility Personnel Report Summary dated 10/17/23. All facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances and/or exemptions. There were no Title 22 deficiencies observed during this visit. Appeal Rights were provided and discussed. Exit interview was conducted with Ms. Alano at 2: PM, and a copy of this report was issued.

met_with: Nonet Alano


facility_name: AIR GROUP HOME

summary: Facility Evaluation

raw_content:
Narrative:
On February 18, 2025 at 9: AM, Licensing Program Analyst (LPA) Pamela Silva conducted a virtual Component II session via Teams with applicant, Air Group Home. Present at the meeting from Air Group Home was Kedra Creer, President. During the meeting, the following items were discussed: 1. All requested revisions in the application documents (LICs) have been submitted by applicant and will be reviewed by LPA Silva. 2. Staff Associations - Ms. Creer stated that she has associated herself and the Administrator to Air Group Home on Guardian. 3. Emergency Disaster Plan 4. Use of Video Cameras - Ms. Creer will add the Use of Video Cameras to their Program Statement per PIN 24-09-CRP. LPA asked questions on the facility's Program Statement/Plan of Operation regarding population to be served, client age range and source of placement. Ms. Creer was informed that the Program Statement is currently being reviewed and that all revisions/corrections requested should be submitted to LPA Silva for review. An exit interview was conducted, and a copy of this report was provided to Ms. Creer.

met_with: Kedra Creer


facility_name: ALLYJIRI HOMES

summary: Facility Evaluation

raw_content:
Narrative:
On 8/27/2025 at 10: AM, Licensing Program Analyst (LPA) Shikya Belfield and LPA Omar Sawyer met with Allyjiri Homes Licensee, Alex Omoko, at the San Jose Regional Office. The purpose of this meeting is to discuss the Plan of Operation and Program Statement for the Group Home Application that was submitted to the department on 7/21/2025 and the Revisions that were submitted to the department on 8/18/2025. Based on two reviews of the application submitted, there are several parts of the application that need clarification, signatures, and updates to reflect the population served. The following was discussed. Population to be served Program policies around the specific population. Application documents Financial information regarding the facility. LPA Belfield went over the above topics with the licensee, LPA provided copies of LIC401A, LIC309, LIC500, and a copy of the third letter of revisions request for the program statement. LPA will provide the link for the regulations home page for Licensee to reference. LPA Belfield and LPA Sawyer discussed any questions that Licensee had. The meeting was concluded.

met_with: Alex Omoko


summary: Facility Evaluation

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Narrative:
On 12/30/2025 at 11: AM, Licensing Program Analyst (LPA) Shikya Belfield and LPA Omar Sawyer met with Allyjiri Homes Licensee / Administrator, Alex Omoko and Co-Licensee Ajiri Alex Omoko, at the San Jose Regional Office. The purpose of this meeting is to conduct the component II of the licensing process. The following was discussed: LPA's went over missing information needed for Board of directors. LPA's observed that the requested changes for LIC308 were updated. Administrative responsibilities were discussed as well as staffing ratios. Staff training and requirements were discussed including topics and requirements of trainers, information to be found in the California Code of Regulations. LPA discussed with the Mr. Omoko the need for the program statement to reflect how the program will accomplish its purpose and goals as some of the methods are not clear. LPA discussed client money management. LPA's answered all questions presented by Licensee's at this time. All information discussed will be included in the revision information that will be sent to Mr. Omoko no later than January 2, 2026. Meeting was concluded.


summary: Facility Evaluation

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On March 16, 2026, at 12: PM Licensing Program Analysts (LPA) Shikya Belfield conducted a scheduled pre-licensing inspection at the above facility. LPA met with Alex Omoko, Licensee / Administrator and Ajiri Alex Omoko. There are no clients currently placed at the facility. LPA conducted a tour of the facility, reviewed operating requirements with applicant representatives, and discussed the pending items to be completed prior to licensure. Facility was clean and in good repair. LPA inspected 4 bedrooms and 3 bathrooms. One bedroom is dedicated as an office space for staff. Bedrooms were observed to have storage space and beds with proper linens, with extra linens/towels located in each bedroom. Lights were functioning. LPA observed a week supply of nonperishable foods. There are kitchen utensils, silverware, and dishes in the kitchen cabinets and drawers. The trash cans have tight-fitting lids. The backyard is clean and free of obstruction and hazards. LPA observed client rights posted, proper templates posted for menus and activities. There are locked storage areas for medications, sharps, and toxic substances. Cleaning compounds were stored separately from food supplies. Client files and staff files will be stores in the staff office. The following items need to be completed prior to licensure. - More activity supplies and educational supplies will be purchased. - more linens will be purchased to meet the needs of the number of clients requested to be served. - Grievance / complaint policy will be posted in the facility as it was not observed today. - facility sketch / emergency disaster forms need to be posted in the facility. - Applicant will submit all requested documentation as proof prior to becoming licensed. An exit interview was conducted and a copy of this report was left with Applicant Alex Omoko whose signature confirms receipt.

visit_type: Prelicensing


facility_name: ALPHA CONNECTION-ANOKA RANCH, THE

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Confidential interviews confirmed an altercation did occur in the facility and the whereabouts of staff during the altercation was unknown. Record review revealed a second video was observed by SI and noted an additional altercation between C3 and C4 occurred on the basketball court at the facility where again no staff supervision was observed. Confidential interviews confirmed the second altercation occurred and the whereabouts of staff during the altercation was unknown. Based on confidential interviews and observation of video footage the allegation lack of supervision resulting in minors (C1, C2, and C3) getting into an altercation with another minor in the home is substantiated. The preponderance of evidence standard has been met. Facility is cited for violation of California Code of Regulations regulation 80078(a) Responsibility for providing care and supervision (a) The licensee shall provide care and supervision as necessary to meet the client's needs. An Enhanced Civil Penalty (ECP) determination is pending. If an ECP is assessed a Community Care Licensing (CCL) representative will return to the facility to deliver the penalty assessment. A copy of the report was discussed and provided along with appeal rights to Alpha Connection - Anoka Ranch, Administrator Evonnda Hull.

Investigation Findings:
13On July 29, 2021 at 11:20am Licensing Program Analyst (LPA), Nicole Strickland, met with Alpha Connection - Anoka Ranch, Administrator Evonnda Hull to deliver the findings for the above stated allegation. The investigation was conducted Community Care Licensing (CCL) Investigation Branch Special Investigator (SI) Marlon Williams and LPA Kendal Zirbes. The investigation included interviews with Program Director (PDir), Administrator (ADM), County Social Worker (CSW), three of six residents (Child #1 [C1], Child #2 [C2], Child #3 [C3]), two staff members (Staff #1 [S1], Staff #2 [S2]). In addition, county records and facility records were reviewed. On March 5, 2021, CCL received an allegation alleging lack of supervision resulting in minors (C1, C2, and C3) getting into an altercation with another minor in the home. Specifically, it was reported a video sent by an anonymous party showed five minors stomping on the head of another minor. Record review of SI's observation of the video noted an altercation did occur in the facility and no staff members were observed. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland 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: ALPHA CONNECTION-ANOKA RANCH, THEFACILITY NUMBER: VISIT DATE: 07/29/2021

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

met_with: Administrator Evonnda Hull


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and a busted lip. Record review revealed on June 13, C1 became escalated and aggressive towards S1, alleging S1 had called C1 an idiot. Confidential interviews reported instead of S1 deescalating C1, S1 was arguing with C1, which escalated the situation. Confidential interviews reported Staff #2 (S2) and Staff #3 (S3) were attempting to de-escalate both C1 and S1, as S1 and C1 continued to argue. Confidential interviews reported during the entire time S2 was attempting to de-escalate the situation, S1's actions of arguing and pushing C1 away in an aggressive manner, continued to escalate the situation resulting in S1 coming from the side/behind of C1, and knocking C1 to the ground. S1's action of knocking C1 to the ground caused C1's face and stomach to land on the gravel driveway where the incident occurred. Additionally, the manner in which S1 took C1 to the ground resulted in S2 to also falling to the ground as S2's arm was trapped between S1 and C1. Confidential interviews reported once C1 was on the ground S1 then jumped on top of C1's back landing with S1's torso on top of C1 and began banging C1's head on the rocks/gravel beneath him. Confidential interviews reported after the incident S1 contacted Program Director (PDir) informing PDir that S1 "took C1 down." Confidential interviews and photographs revealed as a result of this incident and the manner in which S1 "took C1 down," C1 sustained injuries to C1's nose, arms, and lip. Based on record review and confidential interviews the allegation staff member (Staff #1 [S1]) physically assaulted resident (Child #1 [C1]) is substantiated. The preponderance of evidence standard has been met. Facility is cited for violation of Interim Licensing Standards (ILS) standard Personal Rights 87072(d) The licensee shall ensure that each child, regardless of whether the child is in foster care is accorded the personal rights specified in Welfare and Institutions Code Section 16001.9 as applicable. In addition, the licensee shall ensure that each child is accorded the following personal rights. An Enhanced Civil Penalty (ECP) determination is pending. If an ECP is assessed a Community Care Licensing (CCL) representative will return to the facility to deliver the penalty assessment. A copy of the report was discussed and provided along with appeal rights to Alpha Connection - Anoka Ranch, Administrator Evonnda Hull.

Investigation Findings:
13On November 16, 2021 at 6:09pm Licensing Program Analyst (LPA), Nicole Strickland, met with Apha Connection - Anoka Ranch, Administrator Evonnda Hull to deliver the findings for the above stated allegation. The investigation was conducted Community Care Licensing (CCL) Investigation Branch Special Investigator (SI) Marlon William. The investigation included interviews with Program Director (PDir), Administrator (ADM), County Social Worker (CSW), two of six residents (Child #1 [C1] and Child #2 [C2]), four staff members (Staff #1 [S1], Staff #2 [S2], Staff #3 [S3], and Staff #4 [S4]) and San Diego County Social Worker from the Open Case Investigations Unit (OHI). In addition, county records, medical records and facility records were reviewed. On June 30, 2021, Community Care Licensing (CCL) received an allegation alleging staff member (Staff #1 [S1]) physically assaulted resident (Child #1 [C1]). Specifically, it was reported S1 and C1 got into an argument resulting in S1 jumping on top of C1 causing C1 to sustain a bloody nose, scratches to C1's arms, ***CONTINUED ON PAGE 2*** SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland 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: ALPHA CONNECTION-ANOKA RANCH, THEFACILITY NUMBER: VISIT DATE: 11/16/2021

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


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Confidential witnesses denied the allegations. Additional confidential witness statements indicate that C1 was possibly injured during a physical altercation between C1 and C4. Confidential witness statements also revealed that C1 and C2 were involved in a physical altercation because C1 had destroyed C2's personal TV. Additional confidential witness statements indicate that C1 was the aggressor towards the other clients at the facility. Confidential witness statements revealed that C1 was bulling the other clients at the facility. Additional confidential witness statements indicate that no clients were making sexual advances towards C1 and that the clients are all teenagers and they make inappropriate comments. Confidential witness statements revealed that C1's cell phone was destroyed by C2 because C1 had destroyed C2's personal TV and the house TV. Additional confidential witness statements indicate that C1 did sustain injuries while at the STRTP home. Confidential witness statements revealed that C1 was being physically abused by the clients at the home. Additional confidential witness statements indicate that C4 was making sexual advances towards C1. Confidential witness statements revealed that C1's cell phone was destroyed by C2 and that the other clients had destroyed C1's personal property. FM stated that C1 had destroyed C2's TV and the facility living room TV. FM also stated that he attempted to deescalate C1 prior to C1 destroying C2's and the house TV's. FM stated that C1 and C2 were involved in a physical altercation (wrestling) and that FM had intervened and separated C1 and C2. FM stated that he had observed redness around C1 and C2's neck and arms. FM states that the clients jokingly make inappropriate sexual comments to one another and that the comments are not made in a serious manner in making sexual advances. FM stated that he verbally redirects the clients to stop making inappropriate comments. AD stated that C1 was not being physically abused by the clients and that it was C1 bullying and intimidating the other clients at the home. AD stated that the clients did not make sexual advances towards C1. CSW states that it was C1 bullying the other clients CSW went on to add that C1 was also destroying the facility property. CSW was unaware of the client's making sexual advances towards C1, and that the clients were destroying C1's property. Based on confidential interviews, the allegation that alleged client #1 (C1) sustained injuries while in care, C1 is being physically abused by other clients in the home, clients are making sexual advances towards C1, and that the clients are destroying C1's property., may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Facility Manager (FM), Tyler Frankland.

Investigation Findings:
13On December 17, 2021 at 8:57AM, Licensing Program Analyst (LPA) Jose Gonzalez met with Alpha Connection Anoka Ranch Facility Manager (FM), Tyler Frankland, to deliver the findings for the above stated allegations. LPA conducted a safety inspection at the facility at 9:57am on August 13, 2021 and no safety hazards were observed. LPA also reviewed seven of seven client's records. During the investigation, interviews were conducted with four of the seven clients, Facility Manager (FM), Facility Administrator (A), and County Social Worker (CSW). An interview with client's #3, #4, and #5 (C3, C4, C5) was attempted but the clients refused to be interviewed. The Department received a complaint on August 10, 2021, that alleged client #1 (C1) sustained injuries while in care, C1 is being physically abused by other clients in the home, clients are making sexual advances towards C1, and that the clients are destroying C1's property. *R- 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: ALPHA CONNECTION-ANOKA RANCH, THEFACILITY NUMBER: VISIT DATE: 12/17/2021

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

met_with: Facility Manager (FM), Tyler Frankland


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Confidential witness statements also revealed that the clients have the option to turn in their money to be secured in a lock box inside of a locked file cabinet located in the staff office. Confidential witness statements indicate that no money was found in C1's bedroom and that C1 never turned in C1's money for safeguarding. Additionally, witness statements indicate that the facility administrative staff does not condone such behavior and that the administrative staff did not pay C1 to physically assault other clients in care. Witness statements also revealed that it was not observed that staff paid C1 to assault the other clients. Witness statements indicate that the facility staff do supervise the clients throughout the milieu and that the facility monitors the client's interactions. Additional confidential witness statements indicate that the facility staff had removed C1's money from a black lock box located in C1's bedroom. Witness statements also revealed that C1 was paid by facility administrative staff to assault other minors in care. Additionally, witness statements indicate that the facility administrative staff would pay C1 $200.00 a week to assault the other clients that were not following the STRTP house rules. Witnesses further stated, that the facility staff did not supervise the clients and that the facility staff were not monitoring the client's interactions. Confidential witness statements also revealed that the facility administrative staff condone such behavior. Based on confidential interviews, the allegation that alleged the facility staff did not safeguard client #1 (C1) money, facility staff paid C1 to physically assault other clients in care, and that the facility did not supervise clients, may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Facility Administrator (FA), Evonda Hull.

Investigation Findings:
13On February 4, 2022 at 10:23AM, Licensing Program Analyst (LPA) Jose Gonzalez met with Alpha Connection Anoka Facility Administrator (FA), Evonnda Hull, to deliver the findings for the above stated allegations. LPA conducted a safety inspection at the facility at 9:54am on July 16, 2021 and no safety hazards were observed. LPA also reviewed seven of seven client's records. During the investigation, interviews were conducted with five of seven clients, as two clients refused to be interviewed, Executive Director (ED), Assistant Executive Director (AED), Staff #1 (S1) Staff #2 (S2), Staff #3 (S3), and County Social Worker (CSW). The Department received a complaint on July 7, 2021, that alleged the facility staff did not safeguard client #1 (C1) money, facility staff paid C1 to physically assault other clients in care, and that the facility did not supervise clients. Confidential witnesses denied the allegations. Additional confidential witness statements indicate that the facility staff does safeguard the clients' money. R- 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: ALPHA CONNECTION-ANOKA RANCH, THEFACILITY NUMBER: VISIT DATE: 02/04/2022

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


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Confidential interviews indicate that staff #1 (S1) was asleep during the assault. Regarding the allegation, the facility staff did not report the incident to C1s responsible party in a timely manner. Confidential interviews revealed that C1s county social worker (CSW) had emailed Alpha Connection Youth and Family Services Program Director (PD) and Facility Administrator (FA) requesting the incident report of C1 being assaulted and pictures of C1s injuries on 01/31/2022. Additional confidential interviews indicate that C1s CSW also contacted PD on 01/31/2022. Confidential interviews revealed that C1s CSW emailed on PD 02/01/2022 with the summation of their conversation and again requested a copy of the incident report of C1s assault and pictures of C1 injuries. Based on confidential interviews and pictures of C1's injuries that the lack of supervision resulted in client #1 (C1) being assaulted by client #2 (C2) while in care is Substantiated as the preponderance of evidence standard has been met for the allegation. This poses an immediate health, safety, or personal rights risk to clients in care. The facility is being cited under Short-Term Residential Therapeutic Program Interim Licensing Standards (ILS) Chapter 7. Version 4, 87072(11) Personal Rights To be free of physical, sexual, emotional, or other abuse, and from corporal or unusual punishment, *exploitation,* infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature including, but not limited to, interference with the daily living functions of eating, sleeping, or toileting, or withholding of shelter, clothing, or aids to physical functioning. Based on confidential interviews and evidence gathered that the facility staff did not report the incident to C1s responsible party in a timely manner is Substantiated as the preponderance of evidence standard has been met for the allegation. This poses a potential Health, Safety, or Personal Rights risk to children in care. CCR 80061Reporting requirements (a)(1)(D)(G) The facility is being cited under Short-Term Residential Therapeutic Program Interim Licensing Standards (ILS) Chapter 7. Version 4, 87072(11) Personal Rights To be free of physical, sexual, emotional, or other abuse, and from corporal or unusual punishment, *exploitation,* infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature including, but not limited to, interference with the daily living functions of eating, sleeping, or toileting, or withholding of shelter, clothing, or aids to physical functioning. The facility is being cited under CCR 80061Reporting requirements (a)(1)(D)(G)An exit interview was conducted, appeal rights explained, and a copy of this report was provided to CEO, Barron Wilson. Confidential interviews indicate that C1 was not transported to the hospital to receive medical attention. Additional confidential interviews revealed that the clients are not in possession of marijuana. Confidential interviews indicate that marijuana has not been observed by facility staff during perimeter and room searches. Additional confidential interviews revealed that the clients keep the marijuana on their person during room searches. Confidential interviews indicate that the client's AWOL from the facility when room searches are being conducted. Based on confidential interviews, the allegation that alleged facility staff did not seek medical attention for client #1 (C1) and that the clients are in possession of marijuana at the facility, may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to CEO, Barron Wilson.

Investigation Findings:
13On April 11, 2022, at 1:23 pm, Licensing Program Analyst (LPA) Jose Gonzalez and Licensing Program Manager (LPM) Christina Barnes met with Alpha Connection Anoka Chief Executive Officer (CEO), Barren Wilson to deliver the findings for the above stated allegations. LPA conducted a safety inspection at the facility at 11:05 am on February 11, 2022, and no safety hazards were observed. LPA also reviewed six of six client's records. During the investigation, interviews were conducted with six of six clients (C1, C2, C3, C4, C5, C6), Facility Manager (FM), Staff #2, #3 (S2, S3), and County Social Worker (CSW). The Department received a complaint on February 7, 2022, that the lack of supervision resulted in client #1 (C1) being assaulted by client #2 (C2) while in care. Confidential interviews indicate that C2 had assaulted C1. Additional confidential interviews revealed that C2 had hit C1 with two belts in their bedroom behind closed doors. Confidential interviews indicate that C1 had red marks across their upper back, behind both ears, both sides of their face, and neck. Additional confidential interviews revealed that C3 had to intervene and stop C2 from assaulting C1. R- 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: ALPHA CONNECTION-ANOKA RANCH, THEFACILITY NUMBER: 366401649

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