raw_content:
Narrative:
Confidential interviews indicated that the administrator informed S1 not to be alone with C1 to prevent an allegation. Confidential interviews revealed that C1 was not inappropriately touched at the facility and that the alleged incident occurred at C1's previous placement. Confidential interviews stated that it was never witnessed that S1 or any other staff member attempted to touch C1 or any other clients residing at the facility. The Department also received a second allegation that the staff spoke inappropriately to the minor (C1). Confidential interviews indicated that facility staff did not speak to the clients inappropriately and spoke to them with respect. Confidential interviews stated that C2, C3, and C4 never heard staff speaking inappropriately to C1. The Department also received a third allegation that a staff allowed a minor (C1) to leave the facility. Confidential interviews indicated that the facility staff would encourage C1 to leave the facility. Confidential interviews revealed that a C1 was unhappy at the facility and wanted to be transferred to a different program. Confidential interviews revealed that C1 was directed to call their parents and inform them of C1's disappointment with the facility. Confidential interviews indicated that C1 walked out of the facility. Confidential interviews disclosed that the program director (PD) and milieu coordinator (MC) followed C1. Other confidential interviews indicated that the program director allowed C1 to leave the facility. Confidential interviews revealed that PD and MC encouraged C1 to make a better choice and return back to the facility. The Department also received a fourth allegation that the staff did not properly report incidents involving minor (C1) to an authorized representative. Confidential interviews stated that the facility staff did not properly report incidents to C1's authorized representative. Confidential interviews revealed that the administrative staff, management, and therapist report all incidents to C1's authorized representative. Confidential interviews stated that the administrative staff, management, and therapist instruct the facility staff to report an incident to the client's parents if they are off-site or after hours. In addition, confidential interviews also stated that the milieu coordinator (MC) reports all incidents to the client's authorized representative after hours. Based on inconsistent confidential interviews and facility record review, the allegations that staff (S1) inappropriately touched the minor (C1), staff spoke inappropriately to the minor (C1), staff allowed minor (C1) to leave the facility, and staff did not properly report incidents involving the minor (C1) to an authorized representative are unsubstantiated.****CONTINUED on LIC 9099C**** The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, appeal rights were explained, and a copy of this report was provided to Discovery Mood & Anxiety Program Riverside and met with Milieu Manager (MM) Marcus Gitchuway.

Investigation Findings:
13On October 18, 2024, at 11:00 am, Licensing Program Analyst (LPA) Jose Gonzalez conducted an unannounced visit and met with Discovery Mood & Anxiety Program Riverside Milieu Manager (MM) Marcus Gitchuway to deliver the findings for the above-stated allegations. LPA Jessica Peete inspected Discovery Mood & Anxiety Program Riverside Group Home at 10:55 am on May 14, 2024; no health and safety hazards were observed. LPA reviewed four client's records (C1, C2, C3, and C4). During the investigation, interviews were conducted with three clients (C1, C2, and C3), the Educational Liaison (EL), the Milieu Coordinator (MC), and the Interim Program Administrator/ Milieu Manager (MM). Due to C1's continual behavioral issues, it was determined that in C1's best interest, an interview with C1 would not be conducted during the investigation. On May 10, 2024, the Department received an allegation that the staff (S1) inappropriately touched a minor (C1). Confidential interviews indicated that staff (S1) never touched C1 inappropriately. *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: DISCOVERY MOOD & ANXIETY PROGRAM RIVERSIDEFACILITY NUMBER: VISIT DATE: 10/18/2024

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

met_with: Milieu Manager (MM) Marcus Gitchuway


state: CA

summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
This is an amended LIC9099C to the original issued on February 20, 2025. In addition, confidential interviews affirmed that S1 was suspended from working at the group home pending an investigation. Further, additional information indicated that S1 was detained for inappropriate sexual contact with C1. Based on confidential interviews and documentation, the allegation that a minor (C1) was inappropriately touched by staff (S1) while in care is substantiated. The preponderance of evidence standard has been met. The Group Home is cited for violation of Title California Code of Regulations (CCR) Personal Rights 84072 (d)(19) which states (d) The licensee shall ensure that each child, regardless of whether the child is in foster care, is accorded...personal rights (19) To be free of physical, sexual, emotional, or other abuse...exploitation ...coercion...or other actions of a punitive nature including, but not limited to, interference with the daily living functions of eating, sleeping. An Enhanced Civil Penalty (ECP) determination is pending. If an ECP is assessed a CCL representative will return to the facility to deliver the penalty assessment. The Program Administrator approved the assessment of this Enhanced Civil Penalty. Therefore, an ECP was issued to this facility in the amount of $5,000 on the {LIC809 and LIC421} An exit interview was conducted and a copy of this report, LIC 811, LIC 809D, and appeal rights were provided to Administrative Director Kaydeese Washington.

Investigation Findings:
13On February 20, 2025, at 9: AM, Licensing Program Analyst (LPA) Jessica Peete conducted an unannounced visit to Discovery Mood and Anxiety Program Group Home and met with Administrative Director, Kaydeese Washington to deliver the investigative findings for the allegation listed above. On 09/20/ LPA Peete initiated the investigation at the Group Home and collected pertinent documents to assist with the investigation process. The investigation was conducted by Special Investigator Dennis Douglas of the Community Care Licensing (CCL). The investigation included interviews with group home clients (C1-C3), staff (S1-S5), and Law Enforcement. On September 14, 2024, Community Care Licensing (CCL) received an allegation that a minor (C1) was inappropriately touched by staff (S1) while in care. It was alleged that S1 had separate instances of inappropriate contact with C1, including, but not limited to, the touching of C1's private areas over the clothes. During the investigation investigator Douglas obtained information that revealed C1 provided consistent statements regarding the alleged misconduct perpetrated by S1. (Continued on LIC 9099C) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Jessica M Peete 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 PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: DISCOVERY MOOD & ANXIETY PROGRAM RIVERSIDEFACILITY NUMBER: VISIT DATE: 02/20/2025

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

report_type: Complaint Investigation

met_with: Kaydeese Washington Administrative Director

complaint_status: SUBSTANTIATED


facility_name: DISCOVERY MOOD & ANXIETY PROGRAM RIVERSIDE

summary: Facility Evaluation

raw_content:
Narrative:
On November 03, 2022 at 9: AM, Licensing Program Analysts (LPA) Jessica Peete, and Licensing Program Manager (LPM), Cheraki Davis, conducted an unannounced annual inspection at Discovery Mood and Anxiety Program Group Home. LPA and LPM were met at the facility by Program Director Sylvia Parron at 9: AM. LPA and LPM began a physical plant inspection at 9: AM assisted by the Program Director and Milieu Manager Stephanie Rosales. The physical plant inspection included the following checks: A physical plant inspection was completed and included the facilities formal entry, kitchen area, dining room, refrigerator/freezers, food storage areas, two group rooms, two staff bathrooms, and two staff offices. There are three client wings (Green Wing, Blue Wing and Yellow Wing) All wings, except for the Yellow Wing, have three client bedrooms, one therapy office and one client bathroom. The Yellow wing had three client bedrooms, two client bathrooms and one therapy office. The facility grounds are clean and free of debris and observable hazards. Per Program Director there are no guns or weapons on facility grounds. Cleansers, chemicals, and cooking knives are inaccessible to clients. Cleaners and chemicals are locked in the front closet near the front door. Sharps are in a lock box located in the milieu (common area) and the cooking knives are locked in a cabinet in the kitchen. Licensee maintains an adequate supply of perishable and non-perishable foods and the food menus are posted. LPA observed the following postings: the facility license, Grievance Procedures, Visitation Policies and Personal Rights form. Age appropriate toys, games and books were observed for client's recreation time. There is adequate indoor and outdoor activity space, and all exits were free from obstruction. LPA observed the facility pool in the backyard to be inaccessible clients. The fence around the pool has a self-latching gate that swings outward and measured over five feet tall. The pool is clean and well maintained. (Continued on LIC C) All facility smoke detectors and carbon monoxide detectors are in appropriate working order and located throughout the facility. Fire extinguishers are properly charged and serviced and located throughout the facility. Medications are centrally stored inside the nurses' office and locked in a portable medication cart. The washer and dryer are located inside the facility near the Green Wing. All detergents are kept locked in a cabinet and are inaccessible to clients. All bedrooms have individual beds, the facility ensures that there are two client per bedroom, with appropriate linens, pillows, comforters, and mattresses in good repair. There is adequate drawer space for each client's belongings. The hot water in the client's bathroom was measured in each wing and were within 105-120 degrees Fahrenheit. At 9: AM LPA observed that the licensee did not comply with California Code of Regulations (CCR) 84072(a) Each facility licensed to provide foster care for six or more children shall post a listing of a foster child's rights. The licensee did not have the foster child's rights posted. At 10: AM LPA observed that licensee did not comply with (CCR) 80088(f)(1). (f) Solid waste shall be stored, located, and disposed of in a manner that will not transmit communicable diseases or odors.... (1) All containers, including movable bins, used for storage of solid wastes shall have tight-fitting covers kept on the containers; shall be in good repair, shall be leakproof and rodent-proof. LPA observed the trash can in the kitchen and bathrooms did not have lids. The facility has a total of three vehicles, labeled V#1, V#2 and V#3. All are used to transport clients to appointments and recreational activities. At 11: AM LPA observed that V#2 had a crack in on the passenger side windshield violating CCR 80074(c) Motor vehicles used to transport clients shall be maintained in a safe operating condition. At 11: AM LPA began the review Disaster Preparedness with the Program Director and Milieu Manager. All the documentation pertaining to this area of the inspection was provided, and no deficiencies were noted. At 12: PM LPA began the review of the Operational Requirements assisted by the Program Director and Milieu Manager. At 1: PM LPA observed the licensee was not in compliance with CCR 80020(a). All facilities shall secure and maintain a fire clearance approved by the city or county fire department, the district providing fire protection services, or the State Fire Marshal. (Continued on LIC C) The licensee could not provide proof of fire clearance for the garage that was converted into a group room. Due to time constraints, LPA's will return to complete the inspection at a later date. An exit interview was conducted, and a copy of this report and appeal rights were provided to Program Director Sylvia Parron. This is an amended report of a report that was originally issued on 11/03/2022.

report_type: Facility Evaluation

visit_type: Annual

met_with: Sylvia Parron Progam Director , Stephanie Rosales Milieu Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 11/04/2022, at 9: AM, Licensing Program Analysts (LPA) Jessica Peete and Licensing Program Manager (LPM), Cheraki Davis, conducted an unannounced Annual Continuation visit at Discovery Mood and Anxiety Program Group Home. LPA Peete was met by the facility by Program Director Sylvia Parron at 9:40am. LPA Peete and LPM Davis visited the facility on 11/03/2022 to complete inspection of the Physical Plant, Operational Requirements and Disaster Preparedness. At 10: AM LPA began the review of the Emergency Interventions assisted by Milieu Manager Stephanie Rosales. All the documentation pertaining to this area of the inspection was provided, and no deficiencies were noted. At 10: AM LPA began the review of the Client Records assisted by Milieu Manager Stephanie Rosales. Five client records were reviewed (C1-C5) . At 12: LPA observed licensee did not comply with California Code of Regulations (CCR) 80069(c)(1). The regulation is stated as follows: (c) The medical assessment shall include the following: (1) The results of an examination for communicable tuberculosis and other contagious/infectious diseases. The licensee did not have the results of a tuberculosis examination for #C1, C3, and C4. As part of the Plan of Correction the licensee will provide tuberculosis results for the clients noted above. At 12: PM LPA observed the licensee did not comply with CCR 84069.1(a). The regulation is stated as follows: (a) A child for whom vaccination against the following diseases cannot be verified shall receive the first doses of the appropriate vaccines within 30 calendar days of placement in the facility and shall receive follow-up doses as recommended by the physician who administered the first doses. (Continued on LIC C) The licensee did not have the immunization record #C2, #C3, and an incomplete immunization record for #C4. As part of the plan of correction the licensee will provide the immunization records to include proof of immunization for the following: Poliomyelitis, Diphtheria., Pertussis,i.e.,whooping cough, Tetanus, Measles. Rubella, i.e., German measles, and Mumps for the clients noted above. At 1: PM LPA began the review of the Staff Records assisted by Milieu Manager Stephanie Rosales and Human Resource Compliance Specialist Sima Fotoohi. Five staff records were reviewed (S1-S5). All the documentation pertaining to this area of the inspection was provided, and no deficiencies were noted. Due to time constraints, LPA's will return to complete the inspection at a later date. An exit interview was conducted, and a copy of this report and appeal rights was provided to Milieu Manager Stephanie Rosales

visit_type: Case Management

met_with: Stephanie Rosales Milieu Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 11/09/2022, at 9: AM, Licensing Program Analysts (LPA) Jessica Peete conducted an unannounced annual continuation visit at Discovery Mood and Anxiety Program Group Home. LPA Peete was met by Milieu Manager Stephanie Rosales 9: AM. LPA visited the facility on 11/03/2022 and 11/04/2022 to complete inspection of the physical plant, operational requirements, disaster preparedness, client records and staff records. At 9: AM LPA interviewed three clients (C1,C5,C6). At the time of today's inspection C3 was not available for interviews, C2 and C4 were not on facility grounds. At 11: AM LPA conducted five staff interviews (S1,S3,S6,S7,S8). During today's inspection S2 and S5 were not on site. At 12: PM LPA continued with staff file reviews assisted by the by Milieu Manager. All required documentation pertaining to this area of the inspection was provided and no deficiencies were sited. Based on observations made during the inspection, no deficiencies were observed during today's visit an exit interview was conducted and a copy of this report and appeal rights were given to Milieu Manager Stephanie Rosales.


summary: Facility Evaluation

raw_content:
Narrative:
On April 13, 2023, at 9: AM, Licensing Program Analysts (LPAs) Jose Gonzalez and Joon Choi, conducted an unannounced annual inspection at Discovery Mood and Anxiety Program Group Home. LPAs were met at the facility by Program Director Sylvia Parron at 9: AM. LPAs began a physical plant inspection at 9: AM assisted by the Program Director and Milieu Manager Stephanie Rosales. The physical plant inspection included the following checks: A physical plant inspection was completed and included the facilities formal entry, kitchen area, dining room, refrigerator/freezers, food storage areas, two group rooms, two staff bathrooms, and two staff offices. There are three client wings (Green Wing, Blue Wing and Yellow Wing) All wings, except for the Yellow Wing, have three client bedrooms, one therapy office and one client bathroom. The Yellow wing had three client bedrooms, two client bathrooms and one therapy office. The facility grounds are clean and free of debris and observable hazards. Per Program Director there are no guns or weapons on facility grounds. Cleansers, chemicals, and cooking knives are inaccessible to clients. Cleaners and chemicals are locked in the front closet near the front door. Sharps are in a lock box located in the milieu (common area) and the cooking knives are locked in a cabinet in the kitchen. Licensee maintains an adequate supply of perishable and non-perishable foods and the food menus are posted. LPAs observed the following postings: the facility license, Grievance Procedures, Visitation Policies and Personal Rights form. Age-appropriate toys, games and books were observed for client's recreation time. There is adequate indoor and outdoor activity space, and all exits were free from obstruction. LPAs observed the facility pool in the backyard to be inaccessible clients. The fence around the pool has a self-latching gate that swings outward and measured over five feet tall. The pool is clean and well maintained. *********Continued Lic 809c******** All facility smoke detectors and carbon monoxide detectors are in appropriate working order and located throughout the facility. Fire extinguishers are properly charged and serviced and located throughout the facility. Medications are centrally stored inside the nurses' office and locked in a portable medication cart. The washer and dryer are located inside the facility near the Green Wing. All detergents are kept locked in a cabinet and are inaccessible to clients. All bedrooms have individual beds, the facility ensures that there are two client per bedroom, with appropriate linens, pillows, comforters, and mattresses in good repair. There is adequate drawer space for each client's belongings. The hot water in the client's bathroom was measured in each wing and were within 105-120 degrees Fahrenheit. All required forms are posted including the Grievance Procedures, Visitation Policies, and Foster Youth Bill of Rights poster in main entrance of the facility. LPAs observed all containers, including movable bins, used for storage of solid wastes have tight-fitting covers kept on the containers are in good repair, be leakproof and rodent-proof. LPAs observed the licensee's garage was converted into a staff lounge/ staff training room. The facility has a total of three vehicles, labeled V#1, V#2 and V#3. All are used to transport clients to appointments and recreational activities. All three vehicles used to transport clients are maintained in a safe operating condition. LPAs began the review Disaster Preparedness with the Program Director. All the documentation pertaining to this area of the inspection was provided, and no deficiencies were noted. LPAs reviewed three staff personnel files with the assistance of the Administrator and three client files with the assistance of the Assistant Administrator An exit interview was conducted, and a copy of this report was provided to Program Director Sylvia Parron.

met_with: Sylvia Parron Progam Director


summary: Facility Evaluation

raw_content:
Narrative:
On September 25, 2025, at 1: PM Licensing Program Analyst (LPA) Jessica Peete conducted an unannounced visit to the facility to issue an immediate exclusion order for staff (S1). LPA advised the facility to adhere immediately to the exclusion order. Copies of the exclusion order were provided to the Administrative Director for Discovery Mood & Anxiety Program Riverside Group Home #336428089. A copy of the exclusion letter was mailed out and/or delivered in person to S1. An exit interview was conducted. A copy of this report,the LIC 811 and the appeal rights with the exclusion order were provided to the Administrative Director.

met_with: Kaydeese Washington Administrative Director, Arlene Ledesma Milieu Manager


summary: Facility Evaluation

raw_content:
Narrative:
On October 22, 2025, at 10: AM, Licensing Program Analyst (LPA) Jessica Peete met with Discovery Mood and Anxiety Program Group Home, Administrative Director,Kaydeese Washington in order to assess an Enhanced Civil Penalty (ECP). On February 20, 2025, LPA Peete delivered an Complaint Investigation Report to the facility; substantiating the allegation that a minor (C1) was inappropriately touched by staff (S1) while in care. The initial investigation provided sufficient evidence that S1 had separate instances of inappropriate contact with C1, including, but not limited to, the touching of C1's private areas over the clothes. Therefore, the facility was cited from Title California Code of Regulations (CCR) Personal Rights 84072 (d)(19). The Department's continued investigation into S1's conduct at the group home revealed that S1 had inappropriate sexual contact with another minor (C2) while in care. The corroborating information was similar to C1's statement about multiple incidents of inappropriate sexual contact by S1. Based on an analysis of confidential interviews and documentation, the Department has determined that an ECP is warranted for the facility not ensuring that the minors (C1and C2) personal rights were protected, resulting in S1 engaging in sexual acts with minors (C1 and C2) in care. The Penal Code section 11165.1 defines sexual abuse as "lewd and lascivious acts upon a child." This section describes a number of more or less direct and (always) willful acts that constitute sexual abuse. Therefore, pursuant to the Enhanced Civil Penalty Law, Health, and Safety Code section 1548(f)(1)(C) the Department will be issuing an immediate Civil Penalty of $5,0000 ($2,500 per victim). An exit interview was completed, and the appeal rights were discussed. A copy of this report, the Confidential Names List dated, October 22, 2025, and the Civil Penalty Assessment Serious Bodily Injury/Sexual Abuse (Form 421-D) were provided to the Administrative Director,Kaydeese Washington. The signed copy will be retained in the facility file.


summary: Facility Evaluation

raw_content:
Narrative:
On November 10, 2025, Licensing Program Analyst (LPA) Babatunde Aborchie began an annual/required inspection for Discovery Mood & Anxiety Program Riverside Short Term Residential Therapeutic Program (STRTP). LPA met with administrator (AD), Kaydeese Washington, who led a tour of the home. The facility was toured both inside and out with AD. There were nine children in placement at the home; The residence is a single story-house with ten rooms and five and a half bathrooms. The area consists of a living room, a kitchen, dining area, break room nursing station, Milieu, laundry room, storage, garage, and the backyard. The facility serves male and female clients. The living spaces were divided into three parts named: the Green Hall, the Blue Hall and the Yellow Hall. Green Hall is the female hall; it comprised of four rooms. Room #1 was furnished with two twin beds; it sleeps one client. Room #2 was furnished with two twin-sized beds, it had two clients. Room #3 was furnished with two twin-sized beds, it sleeps one client. Room#4 was fully furnished and, it was used as a session room. Blue Hall is a female hall; it comprised of four rooms. Room #1 was furnished with two twin-sized beds, it had one client. Room #2 was furnished with two twin-sized beds, it had one client. Room #3 was furnished with two twin-sized beds, it had one client. Room #4 was fully furnished and, it was used as a session room. Yellow Hall is a male hall; it comprised of four rooms. Room #1 was furnished with two twin-sized beds, it had one client. Room #2 was furnished with two twin-sized beds, it was vacant. Room #3 was furnished with two twin-sized beds, it was vacant. Room #4 was fully furnished and, it was used as a session room. In addition to the rooms, there was an observation room, it was furnished with one twin-sized bed, it sleeps one client. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawers and closet space for children's belongings. The smoke detectors and carbon monoxides were checked and were working properly. The fireplace was in the living room area, and it was properly screened. Telephone service and appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients would have access. The medications were locked and stored in the med cabinet in the nursing room. Sharp objects/knives were locked and stored in a storage box in the kitchen cabinet. Cleansers/chemicals were locked and stored in the laundry room. The first aid kit was in office area, accessible and contained all required items. There were no guns or weapons as stated by the administrator at this time. The hot water temperature was tested and noted to be 105 degrees. There was adequate food storage supply of two days of perishable foods and a week of non-perishable food. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. Five staff, and five clients files were reviewed and met requirements. The home had a pool that was appropriately fenced. The fence was 5-foot-tall and surrounded the pool. The pool gate opens outward away from the pool with safe latching mechanism located on the gate. The backyard where clients have access to play was completely fenced and free of hazards. All requirements were met at this time. Based on this annual/required inspection of the home, no deficiencies were found during this inspection. An exit interview was conducted, and a copy of this report was provided to the administrator, Kaydeese Washington.

met_with: Director


summary: Facility Evaluation

raw_content:
Narrative:
On November 30th, 2022, at 9:35 am, Licensing Program Analyst (LPA) Jessica Peete met with Discovery Mood and Anxiety Program Group Home Program Administrator Sylvia Parron to deliver a case management deficiencies report. According to information obtained by Community Care Licensing (CCL), Administrator #1 (A1) was employed on 10/03/2022, and Administrator #2 (A2) was employed on 10/09/2019. A1 meets the education and experience qualifications but does not have a Group Home Administrator Certificate. A2 meets the education and has a Group Home Administrator Certificate but does not meet the experience qualification. Based on the record review, the Group Home could not provide documents for A1 and A2 to show they are qualified and currently certified administrators; this is a violation of California Code Regulations 84064(b). The facility is being cited for violation of California Code Regulations 84064(b). Administrator Qualifications and Duties (b) Effective January 1, 2000, all group homes shall have a qualified and currently certified administrator. A copy of the report was discussed and provided along with appeal rights and LIC 811 to Discovery Mood and Anxiety Program Administrator Sylvia Parron.

met_with: Program Administrator Syliva Parron


summary: Facility Evaluation

raw_content:
Narrative:
On June 19, 2024, at 12:50 pm, Licensing Program Analysts (LPAs) Jose Gonzalez and Jessica Peete and Licensing Program Manager Cheraki Davis met with Vice President of Western Region of Operations (VP) Robert Thomas. The purpose of today's visit is to conduct a plan of correction (POC) visit to clear a Type B deficiency cited on 04/29/2024. The deficiency, initially cited during the visit on 04/29/2024, has not been cleared. The facility is being cited for violation of the California Code Regulations Title Division Chapter Article Continuing Requirements, section Personal Rights (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... Based on confidential witness statements, facility staff continue to violate the clients' personal rights during the intake process, do not treat clients with dignity and respect, and do not provide a safe and comfortable environment for the clients, which poses a potential Health, Safety, or Personal Rights risk to children in care. Exit interviews were conducted. A copy of this report and appeal rights was provided to Vice President of Western Region of Operations (VP) Robert Thomas.


summary: Facility Evaluation

raw_content:
Narrative:
On June 19, 2024 at 9: AM Licensing Program Analysts (LPA) Jose Gonzales, Jessica Peete and Licensing Program Manager (LPM) Cheraki Davis arrived unannounced to Discovery Mood and Anxiety Group Home (GH). At 9: AM, assisted by facility staff Diedre Barriger, LPA's and LPM completed a health and safety inspection of the facility which included the facilities formal entry, kitchen area, dining room, refrigerator/freezers, food storage areas, two group rooms, two staff bathrooms, and two staff offices. There are three client wings (Green Wing, Blue Wing and Yellow Wing) All wings, except for the Yellow Wing, have three client bedrooms, one therapy office and one client bathroom. The Yellow wing had three client bedrooms, two client bathrooms and one therapy office. The facility grounds are clean and free of debris and observable hazards. All facility smoke detectors and carbon monoxide detectors are in appropriate working order and located throughout the facility. Medications are centrally stored inside the nurses' office and locked in a portable medication cart. All detergents and other cleaning products are securely locked and inaccessible to clients. All bedrooms have individual beds, the facility ensures that there are two client per bedroom, with appropriate linens, pillows, comforters, and mattresses in good repair. There is adequate drawer space for each client's belongings. At 10: AM LPA's toured the yellow wing and observed one dead insect in bedroom 3. Per staff statement the facility receives bi-monthly pest control services to manage and prevent insects. At 10: AM LPA's inspected the observation room, located off the milieu. LPA's observed two dead flies in the windowsill and observed the bedroom wall had paint damage. At 10: AM LPA's toured the Blue wing and observed the bottom left bathroom cabinet needed repair. At 10: LPA's toured the Green wing and observed bedroom had writing on the wall and paint damage. Based on observations the licensee is not incompliance with Title California Code of Regulations (CCR) 80087(a) (1) deficiencies are being cited; see LIC D. ***CONTINUED on LIC C*** An exit interview was conducted, and a copy of this report and appeal rights was provided to Vice President of Western Region of Operations (VP) Robert Thomas.


facility_name: DREAM HOME RESIDENTIAL

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Evidence obtained revealed that RP & Staff denied that Staff hit youth in care. Also, confidential interviews with Child 1 stated Staff did not hit him and he felt safe. Child 2 denied that Staff hit child in care. Child 3 was not able to answer questions due to to disability. Based on the interviews conducted and documentary evidence obtained the information did not produce corroborating evidence to support the above said allegations. Due to inconsistent statements LPA Phillips was not able to determine if the above said allegations occurred, therefore the allegations are found to be Unsubstantiated meaning that although the allegation may have happened or is valid there is not a preponderance of evidence to prove that the alleged incidents occurred. No deficiencies cited at the time of this investigation. Exit interview was conducted, and copy of this report was left with facility administrator.

Investigation Findings:
13On October 27, 2021 at 3:30PM Licensing Program Analyst (LPA), Zena Phillips conducted a follow-up complaint investigation visit to Dream Home Residential and met with Leah Hawkins, Administrator. The purpose of the visit was to deliver findings for the above complaint allegations. During the course of investigating the allegations: Facility staff hit youth. Facility staff handled youth in a rough manner. LPA Phillips conducted confidential interviews with related parties, reviewed facility records and Incident Reports. Based on the interviews conducted and statements obtained during the investigation the above allegations cannot be substantiated because LPA Phillips obtained inconsistent statements from RP, staff and residents in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Zena Phillips LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: DREAM HOME RESIDENTIALFACILITY NUMBER: VISIT DATE: 10/27/2021

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

met_with: Leah Hawkins/ Administrator

complaint_status: unsubstantiated


summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On March 18, 2021, Licensing Program Analyst (LPA) Bernice Karnsrithong arrived at the facility to conduct a follow-up complaint inspection. LPA met with Leah Hawkins, Administrator. The purpose of the visit was to deliver findings for the above complaint allegation. During the investigation of the allegation that minor was hit by another minor while in care, LPA Karnsrithong conducted confidential interviews and reviewed documentary evidences. Confidential interviews indicated that although an incident occurred between clients while in care resulting to minor injuries, staff provided appropriate emergency intervention and first aid. The facility provides one-on-one direct care staff that supervises clients who have special needs while they are in the facility to support when such incidents occur. Authorized parties were notified in a timely manner regarding the incident and appropriate behavior intervention plans were administered at the time of the incident. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. Therefore, the allegation is unsubstantiated. There are no deficiencies cited at this time. Exit interview was conducted with administrator and copy of the report will be provided. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Bernice Karnsrithong LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Leah Hawkins,Administrator


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Investigation Findings:
13On April 27, 2023 at 11: AM, Licensing Program Analyst (LPA) C. White conducted an unannounced visit to the above facility for the purpose of delivering findings on the above allegations. LPA met with Facility Manager, Tammy Eldridge and discussed the findings. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Staff denied the allegations. Staff stated clients bathe each morning prior to getting dressed for school. Staff stated Client #1 attended school in short pants once and that the client is sent to school in uniform pants regularly. Staff stated appropriate clothing is provided for the clients in care. Staff stated Client #1 has a history of self injurious behavior and that the client's mother is aware of this. Staff stated clients in care are not neglected or abused by any staff. Client interviews did not produce corroborating evidence to support the allegations. LPA was unable to obtain a statement from Client #1 as the client is non-verbal. 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 at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Charmetha White LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

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

met_with: Facility Manager - Tammy Eldridge


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Investigation Findings:
13On 10/30/2024 at 8:30 am, Licensing Program Analyst (LPA) Justine Armstrong and Regional Manager Bernice Karnsrithong concluded the investigation of the above complaint allegations. LPA Armstrong met with with Greg Lilly Direct Staff Provider at the facility and Facility Manager Tammy Eldridge. During the investigation of the allegations, Staff member physically abused minor in care. LPA Justine Armstrong conducted confidential interviews and reviewed documentary evidence. Confidential interviews indicated that staff hit the minor while in care during a visit to the hospital. The staff did not follow emergency and crisis intervention procedures at the time the incident occurred. Facility cited for violation of California Code of Regulations, Title Division Six, regulation 80072(a)(3) Personal Rights. The exit interview was conducted with Gregory Lilly and a copy of this report was provided to the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Bernice Karnsrithong LICENSING EVALUATOR NAME: Justine Armstrong 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 EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: DREAM HOME RESIDENTIALFACILITY NUMBER: 198209661

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

met_with: Gregory Lilly


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Investigation Findings:
13On 10/30/ Licensing Program Analyst (LPA) Justine Armstrong and Regional Manager Bernice Karnsrithong arrived at Dream Home Residential for the purpose of delivering findings for the allegation Child ingested a battery due to lack care & supervision LPA met with Greg Lilly Direct Staff Provider and Facility Manager Tammy Eldridge. at the facility. A Health and safety risk assessment was conducted upon arrival.During the investigation, the LPA conducted confidential interviews and reviewed several documents, including the staff crisis intervention training certificate, clients' personal summary logs, clients' behavior support plans, and shift duty expectations. Staff members denied the allegation. The LPA determined that the allegations were unsubstantiated based on the confidential interviews and documentary evidence. There is not enough evidence to establish a preponderance of the evidence to prove the alleged violation did or did not occur. There were no deficiencies cited. An exit interview was completed, and a copy of this report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Bernice Karnsrithong LICENSING EVALUATOR NAME: Justine Armstrong 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


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Investigation Findings:
13On 11/22/2024, at 3: PM, Licensing Program Analyst (LPA) Kim Dear and Licensing Program Manager, (LPM), Enrique Hernandez, arrived at the facility to deliver findings for complaint investigation 34-CR-20240808123404. LPA met with Licensee, Leah Hawkins. and a health and safety assessment was conducted. During the investigation, LPA conducted confidential interviews and reviewed documentary evidence. Statements that were inconsistent and did not produce corroborating evidence to support staff physically abused minor in care. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegations are UNSUBSTANTIATED. There were no deficiencies cited. An exit interview was completed, and a copy of this report will be emailed to Lisensee. There were no deficiencies cited. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Enrique M Hernandez LICENSING EVALUATOR NAME: Kim Dear LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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


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Narrative:
The investigation further included review of client file, incident reports and review of facility file history as well as, review of medical forensic exam report, and Los Angeles Police Department (LAPD) investigative report. In addition, confidential interviews were conducted with two youth, two staff members, Administrator, and contacts with, assigned Quality Assurance Specialist-South Central Los Angeles Regional Center, LAPD, and Department of Children and Family Services (DCFS) assigned Emergency Response Social Worker. Record review revealed C1 resided at Dream Home Residential from December 2024 through 2/25/2025. The investigation uncovered several inconsistencies with the allegations. Documentary evidence from medical records and confidential interviews revealed inconsistencies as interviews found conflicting answers to questions asked by medical staff concerning specific accounts and dates of alleged sexual abuse. Confidential interviews by Investigator Santana also revealed inconsistencies. Statements obtained denied seeing any form of abuse or any opportunities for staff to engage in abuse. Confidential statement further revealed recantation of abuse to assigned social worker on 3/03/2025 but reaffirmed alleged abuse to others since leaving placement. Records reviewed found no indication of any trauma during C1's forensic examination. Confidential interviews with staffs and resident further denied the allegation, denied witnessing or other residents being subjected to sexual abuse. Information obtained found that C1 maintains that S1 threatened C1 with a gun to instill fear to sodomize C1. Interviews found that staff members denied there are firearms on the property, and witnesses also denied observing S1 handling a firearm at the facility. Information from interviews found that C1 maintains that S1 gave C1 marijuana on several occasions. Facility staff members reported that C1 sometimes asked for marijuana, but witness statements maintain denial of giving C1 any marijuana or that C1 smoked at the facility. Statements determined denial and no witness observations of S1 smoking at the facility. Based on gathered information, the allegations that S1 sexually abused C1; S1 threatened C1 with a gun and S1 provided marijuana to C1 is therefore determined unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. There are no deficiencies cited per California Code of Regulations, Title 22, at this time. A copy of this report is provided to Administrator by email.

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: Shamecka Powell, DSP


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Investigation Findings:
13On 07/10/2025 at 1:50PM Licensing Program Analyst (LPA) Justine Armstrong and Licensing Program Analyst (LPA) Aimee Mortatalla arrived at Dream Home Residential for the purpose of delivering findings for the allegation(s) 1.Staff hit minor in care 2. Staff injured minor in care. Supervision. LPA met with Leah Hawkins at the facility Administrator. A Health and safety risk assessment was conducted upon arrival. During the investigation, the LPA conducted confidential interviews with various staff members and reviewed a range of documents, including the detailed Unusual Incident Report. Throughout these interviews, staff members denied the allegations. The LPA determined that while the statements posed some concerns, they lacked sufficient evidence or testimony. Although the incident may have occurred or be valid, there was not a preponderance of evidence to prove that the alleged violation took place. The Department has decided that the allegations are Unsubstantiated; however, if any additional information is received, this complaint can be amended, and the finding can be changed. No deficiencies were cited. An exit interview was conducted, and a copy of this report was provided to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Enrique M Hernandez LICENSING EVALUATOR NAME: Justine Armstrong LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Leah Hawkins


summary: Facility Evaluation

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Narrative:
On 11/17/ Licensing Program Analyst, Bernice Karnsrithong arrived at the said facility to conduct an annual inspection. LPA Karnsrithong met with Administrator, Leah Hawkins and Direct Care Staff, Shantal Manabat, who provided a tour of the facility. This facility is licensed to provide care and supervision to five (5) children, ages 13-17 years old, ambulatory only. There are no bodies of water on the premises. This home is located in a residential neighborhood. The home has with three (3) bedrooms, one (1) bathroom, living room, dining area, kitchen, two (2) detached units in the backyard. LPA Karnsrithong conducted one (1) client and two (2) staff interviews. LPA Karnsrithong reviewed three (3) client and three (3) staff files. LPA Karnsrithong has observed the following during the time of inspection: Living Room/Common Area: There is broom closet next to the door which has the broom, vacuum, and mops for the facility. There is a locked cabinet which stores cleaning supplies and knives. There is a fireplace in the living room but is covered and non-operable. There is a sectional sofa, ottoman, television and two (2) small tables in the living room. The reward chart, children's personal rights, and facility sketch plan and emergency disaster plan are also posted in the living room area. Dining Area: One table with two (2) chairs and a one (1) bench. This is currently being used as the COVID-19 sign in area and not being used during meal time. Clients are eating in the common room or in their respective bedrooms. Laundry Area: This area is next to the kitchen. There is a operable washer and dryer. There is a shelf and counter top as well. Emergency Supply bins are stored in the laundry area. (Page 1 of 3) Kitchen: There is a stove/oven with four (4) gas burners. There is a microwave, refrigerator, toaster, blender and Instapot. There is enough supply of perishable and non-perishable food supplies. There are cups, plates, utensils, pots, and pans accessible to use. There is a dish drying rack as well to use. Sample menus for breakfast, lunch, snack, and dinner are posted in the refrigerator. Kitchen cleaning schedule is also posted in the kitchen area. Office Area: This area is located next to the kitchen. It has two (2) desks, two (2) chairs, a filing cabinet, computer, printer, facility documentation and records for the (Medication Records, Consumer Notes, Clients Records, Staff Records). Labor law and licensing postings, client and staff schedules are also in the office area. First Aid kit is also located in the office area. Bedroom #A: This room is equipped with one twin size bed. The room has a closet, drawers, laundry basket, and television. There is currently one (1) client staying in this room. There is adequate lighting in this room as well. Bedroom #B: The room is equipped with two twin size beds. There are adequate drawers, closet space, and lighting in this room. There is a television in this room. There is only one (1) client staying in this room. Bedroom #C: The room is equipped with two twin size beds. There are two (2) closets. There is adequate lightning, an entertainment table, television, and video game console. This room has a door that leads to the side of the house but is kept locked at all times. There are currently two (2) clients staying in this room. Bathroom: There is one (1) bathroom in the facility. It has a toilet, sink, bathtub, and shower. There is also closet space for toiletries. Backyard: The backyard is fenced in and is clean and free of any debris. There are two detached units in the backyard that is locked and not being used by the facility. (Page 2 of 3) Facility is clean, safe, sanitary and in good repair. Clients medications are locked and stored. Medication log is updated regularly client's photo is also posted on the binder for easier identification. Clients records are stored in binders and can be accessed for audit or inspection. Staff document client reports on separate individual binders. The electric, water and gas utility shut off valves are located outside the home. Hallways and pathways inside and outside the facility are unobstructed and free of debris. There is a fire and carbon monoxide alarm in the hallway. There is a controlled thermostat to maintain safe and appropriate temperature throughout the facility. The facility provides extra-curricular activities to clients such as yoga, visiting the park, and shopping at the store. Clients are provided with clothing allowance and staff take them to the store to purchase supplies as needed. Each bedroom has a nightly check log for each client to be monitored and conducted by staff. The facility also has a certified Behavior Intervention Analyst that provides services of a minimum of 16 hours a month per client. (Page 3 of 3)

met_with: Administrator


summary: Facility Evaluation

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Narrative:
On 12/19/2022, Licensing Program Analyst, C. White arrived made an unannounced visit to Dream Home Residential for the purpose of conducting a Required Inspection. LPA met with Facility Manager, Tammy Eldridge who granted access to the facility. LPA met with Administrator, Leah Hawkins and together toured the interior and exterior of the facility. The facility is licensed to provide care and supervision to five (5) children, ages 13-17 years old, ambulatory only. The current census is four (4). There are no bodies of water on the premises. This is a three (3) bedroom, one (1) bathroom single story home located in a residential area and is set up as follows: living room, dining room, kitchen, laundry area, office area, and a backyard which includes two (2) detached units. Living room: is furnished with a sectional sofa, a chair, a mounted TV, and two (2) tables. The area has a covered non-operable fireplace, a locked cabinet, and a locked broom closet. Dining room: Currently this area is not furnished as it is used to COVID check in. Client's eat in the living room or their respective bedrooms. Kitchen: is equipped with refrigerator/freezer, microwave, air fryer, and a four (4) burner gas stove/oven. All burners were tested and found to be working at the time of this inspection. The facility was found to have the required amount of perishable and non-perishable food supplies. LPA observed the facility to have ample plates, cups, and eating utensils. Laundry area: is located inside the kitchen. The area contains a washer and dryer, shelf, and a locked cabinet. The area also stores the facility's emergency supplies bins. There is an exit door off the laundry area which leads to the backyard. Report continued on LIC 809C (page 1 of 3) Office area: is set up in the breakfast nook of the kitchen. The area is equipped with two (2) desks, three (3) chairs, a locked filing cabinet, a built-in cabinet with a security latch lock, computer, and a printer. Client records, Staff records, Facility logs, Medication logs, Consumer Notes, and First Aid Kit are stored in this area. Medication requiring no refrigeration is stored in the locked file cabinet in this area. The facility does not contain any medication which required refrigeration. Backyard: The backyard is fenced in and is clean and free of any debris. There are two detached units in the backyard that is locked and not being used by the facility. Bedroom #1: is equipped with one (1) twin size bed. The room has a closet, drawers, a working light, and a window. The room is occupied by one (1) client. Bedroom #2: is equipped with two (2) twin size beds. The room has a closet, drawers, a working light and a window. The room is occupied by two (2) clients. Bedroom #3: is equipped with two (2) twin size beds. The room has closets, drawers, a working light, a window, and a door leading to the side of the house; this door is kept locked at all times. The room is occupied by one (1) client. Bathroom: There is one (1) bathroom in the facility. It has a toilet, sink, bathtub, and shower. There is also closet space for toiletries. Clients medications are locked and stored. Medication log is updated regularly. Clients records are stored in binders and can be accessed for audit or inspection. Staff document client reports on separate individual binders. The electric, water and gas utility shut off valves are located outside the home. Hallways and pathways inside and outside the facility are unobstructed and free of debris. Smoke alarm and carbon monoxide detector was tested and found to be in working order. The facility has a regulation fire extinguisher located in the kitchen. Hot water was tested and found to be between 105-120 degrees (F). The facility temperature is controlled by a thermostat and the temperature is maintained between 68-85 degrees (F). Report continued on LIC 809C (page 2 of 3) Overall LPA observed the facility to be clean, safe, sanitary and in good repair. Disinfectants and cleaning solutions are stored in a locked in living room cabinet and made inaccessible to clients. The facility does not maintain any sharps on the premises. The facility operates within license conditions and limitations including capacity limitations. LPA discussed and advised the Licensee to ensure the following: 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. 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. Personal Rights, menus, and activities were posted in the facility. (page 3 of 3)

met_with: Administrator - Leah Hawkins


summary: Facility Evaluation

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Narrative:
On 01/25/2023, Licensing Program Analyst, C. White made an unannounced visit to Dream Home Residential for the purpose of discussing overdue fees. LPA met with Administrator, Leah Hawkins, who granted access to the facility. When LPA arrived the facility was being inspected by two (2) Regional Center Representatives. LPA discussed the overdue annual fess to the Administrator. The Administrator reported that the fees will be paid by Friday, 01/27/2023. PER California Code Regulations, TITLE 22, the facility is within regulation standards at this time. A copy of this report was left with Facility Administrator.


summary: Facility Evaluation

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Narrative:
On 12/07/2023, Licensing Program Analyst, C. White arrived at Dream Home Residential for the purpose of conducting an Annual/Required Inspection. LPA met with Facility Manager, Tammy Eldridge who granted access to the facility. LPA met with Administrator, Leah Hawkins and together toured the interior and exterior of the facility. The facility is licensed to provide care and supervision to five (5) children, ages 13-17 years old, ambulatory only. The current census is four (4). There are no bodies of water on the premises. The home is set up as follows: three (3) bedrooms, one (1) bathroom, living room, dining room, kitchen, laundry area, office area, and a backyard with two (2) detached units. Living room: is equipped with the following: a sofa, a chair, mounted TV, and two (2) tables. The room also includes a non-operable fireplace, a locked storage cabinet, and a closet that remains locked. Dining room: is equipped with a table and four (4) chairs. Kitchen: is equipped with refrigerator/freezer, four (4) burner gas stove/oven (all burners were operational at the time of this inspection), microwave, air fryer, toaster, and a trash can with a fitted lid. LPA observed the home to have the required amount of perishable and non-perishable food supplies, ample plates, cups, and eating utensils. This area also has a small breakfast nook. Laundry area: is located at the back of the kitchen and has a door leading out to the backyard. The area has is one (1) washer, one (1) dryer (both operational at the time of this inspection), a locked cabinet, and emergency storage supplies bins. Office area: is set up in the kitchen breakfast nook. It is equipped one (1) desk, one (1) chair, a locked filing cabinet, a built-in cabinet with a security latch lock, computer, and a printer. Report continued on LIC 809C Backyard: The backyard is fenced in and is clean and free of any debris. There are two detached units in the backyard which are not used by the facility. Bedroom #1: is equipped with one (1) twin size bed. The room is occupied by one (1) client. Bedroom #2: is equipped with two (2) twin size beds. The room is occupied by two (2) clients. Bedroom #3: is equipped with two (2) twin size beds. The room has a door leading to the side of the house which is kept locked at all times. The room is occupied by one (1) client. All bedrooms have a closet, drawers, a working light, and windows. Bathroom: is equipped with a toilet, sink, bathtub/shower combination and a closet. LPA observed client records, staff records, facility logs, medication logs, and First Aid Kit are stored in the office area. Medication requiring no refrigeration is stored in a locked file cabinet. The water shut off valve is located outside of the home near street curb. The gas shut off valve is located outside in the back of the home. The electricity shut off valve is located inside the home in the laundry area. The facility does not maintain any sharps on the premises. Disinfectants, cleaning solutions. and detergents are kept locked in the living room storage cabinet and made inaccessible to clients. Smoke alarm and carbon monoxide detector was tested and found to be in working order. The facility has a regulation fire extinguisher located in the kitchen. Hot water was tested and found to be between 105-120 degrees (F). The facility temperature is controlled by a thermostat and the temperature is maintained between 68-85 degrees (F). Overall LPA observed the facility to be clean, safe, sanitary and in good repair. The facility operates within license conditions and limitations including capacity limitations. LPA discussed and advised the Licensee to ensure the following: 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. 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. Personal Rights, menus, and activities were posted in the facility. PER California Code Regulations, TITLE 22, DIVISION 6, CHAPTERS 5 no deficiencies were cited. An exit interview was conducted and a copy of this report was left with the Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/30/ Licensing Program Analyst, Justine Armstrong and Regional Manager Bernice Karnsrithong arrived at Dream Home Residential facility to conduct an annual inspection. LPA Armstrong met with Facility Manager, Tammy Eldridge and Direct Care Staff, Gregory Lilly, who granted access and tour of the facility. This facility is licensed to provide care and supervision up to five (5) children, ages 13-17 years old, ambulatory only. There are no bodies of water on the premises. This home is located in a residential neighborhood in Los Angeles, California. The home has three (3) bedrooms, one (1) bathroom, living room, dining area, kitchen. LPA Armstrong conducted 2 client and two staff interviews. LPA Armstrong has observed the following during the time of inspection: Dining Area: One table with two (2) chairs. Clients are eating in the common room or in their respective bedrooms. Laundry Area: This area is next to the kitchen. There is an operable washer and dryer. There is a shelf and countertop as well. Kitchen: There is a stove/oven with four (4) gas burners. There is a microwave, refrigerator, toaster, blender and Air Fryer. There is enough supply of perishable and non-perishable food supplies. There are cups, plates, utensils, pots, and pans accessible to use. There is a dish drying rack as well to use. Sample menus for breakfast, lunch, snack, and dinner are posted in the refrigerator. Kitchen cleaning schedule is also posted in the kitchen area. (Page 1 of 2) Office Area: This area is located next to the kitchen. It has two (1) desk, two (2) chairs, a filing cabinet, computer, printer, facility documentation and records for the facility (Medication Records, Consumer Notes, Clients Records). Labor Law and licensing postings, client and staff schedules are also in the office area. First Aid kit is located in the office area. This area is being used by staff only. Bedroom #A: This room is equipped with one twin size bed. The room has a closet, drawers, laundry basket, and television. There is currently one (1) client staying in this room. There is adequate lighting in this room as well. Bedroom #B: The room is equipped with two twin size beds. There are adequate drawers, closet space, and lighting in this room. There is a television in this room. There is only one (1) client staying in this room. Bedroom #C: The room is equipped with one twin size bed. There are two (2) closets. There is adequate lightning. This room has a door that leads to the side of the house but is kept locked at all times. There are currently two (1) client staying in this room. Bathroom: There is one (1) bathroom in the facility. It has a toilet, sink, bathtub, and shower. There is also closet space for toiletries. There were no deficiencies cited. An exit interview was completed, and a copy of this report was provided to the facility. (PG 2 of 2)

met_with: Tammy Eldridge Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 10/31/ Licensing Program Analyst, Justine Armstrong and Regional Manager arrived at Dream Home Residential facility to continue the annual inspection. LPA Armstrong met with Facility Director Leah Hawkins who granted access and tour of the facility. LPA Armstrong reviewed 3 client files and two staff files. Living Room/Common Area: Upon entering the facility, there is common area that is used by clients for relaxation and meetings. The living room has couches, television and rug. There is utility closet next to the door which has the broom, vacuum, and mops for the facility. There is a locked cabinet next to it which stores cleaning supplies. There is a fireplace in the living room but is covered and non-operable. There is another locked cabinet close to the fireplace which stores extra hygiene products, diapers, and bed pads. The grievance chart, children's personal rights, and facility sketch plan are also posted in the living room. Backyard: The backyard is fenced in and is clean and free of any debris. There are two detached units in the backyard that is locked and not being used by the facility. The facility is clean, safe, sanitary and in good repair. Client's medications are locked and stored. Medication log is updated regularly client's photo is also posted on the binder for identification. Clients' records are stored in binders and can be accessed for audit or inspection. Staff document client reports on separate individual binders. The electric, water and gas utility shut off valves are located outside the home. Staff are aware of the location of utility shut off valves. Hallways and pathways inside and outside the facility free of debris. There is a controlled thermostat to maintain safe and appropriate temperature throughout the facility. The facility provides extra-curricular activities to clients such as trying new food restaurants, visiting the park, and shopping at store. Clients are provided with clothing allowance and staff take them to the store to purchase supplies as needed. There were no deficiencies cited. An exit interview was completed, and a copy of this report was provided to the facility.

met_with: Leah Hawkins Facility Director


summary: Facility Evaluation

raw_content:
Narrative:
On June 27, 2025 at 9:30am Licensing Program Analyst (LPA) Justine Armstrong, License Program Anaylst (LPA) Aimee Moratalla and Licensing Program Manager (LPM) Enrique Hernandez conducted an Informal Meeting with the Licensee Leah Hawkins from Dream Home Residential. The meeting was conducted at El Segundo Local Unit Children Residential Regional Office located at Continental Blvd El Segundo, CA 90245. The purpose of the meeting was to discuss the facility concerns. El Segundo Children Residential has concerns on the following things: Complaint allegations 7 within 10 months License responsibilities and required presence Supervision and Training Mandated Reporting Responsibilities Document incident with Staff Protection of Child Personal Rights Facility Manager Concerns Staff Policy and Procedure (LIC Continued on 809C) Recommendations: The department recommends that the Licensee document instances when staff do not adhere to policies and procedures. It is important to update staff policies and procedures regularly. Additionally, staff should receive further training on supervision techniques, personal rights, and crisis management. Continuing to ensure the safety and well-being of all minors in the facility is essential. The Facility Manager or Licensee should arrive at the facility during unannounced visits from Community Care Licensing. The Licensee must comply with Title 22 regulations and Community Care Licensing (CCL) requirements. A copy of this report was provided to the Licensee.


summary: Facility Evaluation

raw_content:
Narrative:
On 12/10/2025, Licensing Program Analyst, C. White arrived at Dream Home Residential for the purpose of conducting an Annual/Required Inspection. LPA met with Facility Manager, Jason Watson who granted access to the facility and together toured the interior and exterior of the facility. The facility is licensed to provide care and supervision to five (5) children, ages 13-17 years old, ambulatory only. The current census is two (2). There are no bodies of water on the premises. The home is set up as follows: three (3) bedrooms, one (1) bathroom, living room, dining room, kitchen, laundry area, office area, and a backyard with two (2) detached units. Living room: is equipped with the following: a sofa, a chair, mounted TV, and two (2) tables. The room also includes a non-operable fireplace, a locked storage cabinet, and a closet that remains locked. Dining room: is equipped with a table and two (2) chairs. Kitchen: is equipped with refrigerator/freezer, four (4) burner gas stove/oven (all burners were operational at the time of this inspection), microwave, air fryer, toaster, and a trash can with a fitted lid. LPA observed the home to have the required amount of perishable and non-perishable food supplies, ample plates, cups, and eating utensils. This area also has a small breakfast nook. Laundry area: is located on the service porch at the back of the kitchen and has a door that exits to the back side yard. Report continued on LIC 809C (Page 1 of 3) The area has one (1) washer, one (1) dryer (both operational at the time of this inspection), a locked cabinet, and emergency storage supplies bins. Office area: is set up in the kitchen breakfast nook. It is equipped with one (1) desk, two (2) chairs, a locked filing cabinet, a built-in cabinet with a security latch lock, computer, and a printer. Facility documentation and records (Medication Records, Consumer Notes, Clients Records) are kept in the locked filing cabinets. Labor Law, licensing postings, client and staff schedules are also in the office area. First Aid kit is located in the office area. This area is used by staff only. Backyard: The backyard is fenced in and is clean and free of any debris. There are two detached units in the backyard which are not used by the facility. Bedroom #1: is occupied by one (1) client and is equipped with one (1) twin size bed. The room has a closet, drawers, a laundry basket, a television, and adequate lighting. Bedroom #2: is not currently occupied and is equipped with two (2) twin size beds. There are adequate drawers, closet space, a television, and adequate lighting. Bedroom #3: is equipped with one (1) twin size bed, two (2) closets, drawers, a laundry basket, a television, and adequate lighting. The room also has a door leading to the side of the house which is kept locked at all times. Bathroom: is equipped with a toilet, sink, bathtub/shower combination and a closet. LPA observed client records, staff records, facility logs, medication logs, and First Aid Kit are stored in the office area. Medication requiring no refrigeration is stored in a locked file cabinet. The water shut off valve is located outside of the home near street curb. The gas shut off valve is located outside in the back of the home. The electricity shut off valve is located inside the home in the laundry area. The facility does not maintain any sharps on the premises. Disinfectants, cleaning solutions. and detergents are kept locked in the living room storage cabinet and made inaccessible to clients. There is another locked cabinet close to the fireplace which stores extra hygiene products, diapers, and bed pads. The grievance chart, children's personal rights, and facility sketch plan are also posted in the living room. Smoke alarm and carbon monoxide detector were tested and found to be in working order. The facility has two (2) regulation fire extinguishers. The hot water was tested and found to be between 105-120 degrees (F). The facility temperature is controlled by a thermostat, and the temperature is maintained between 68-85 degrees (F). Report continued on LIC 809C (Page 2 of 3) Overall LPA observed the facility to be clean, safe, sanitary and in good repair. The facility operates within license conditions and limitations including capacity limitations. LPA discussed and advised the Licensee to ensure the following: 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. 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. Personal Rights, menus, and activities were posted in the facility. PER California Code Regulations, TITLE 22, DIVISION 6, CHAPTERS 5 no deficiencies were cited. An exit interview was conducted, and a copy of this report was emailed to the Administrator. (Page 3 of 3)

met_with: Jason Watson - Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On December 22, 2025, at 10: AM, a noncompliance meeting was held at the El Segundo Regional Office to address compliance issues related to Dream Home Residential. Attendees included License Program Analyst Justine Armstrong, License Program Manager Enrique Hernandez, Regional Manager Bernice Karnsrithong, and Administrator/Licensee Leah Hawkins. The purpose of the meeting was to discuss compliance concerns due to reporting requirement issues. Plan of Action During the meeting, we discussed the Title Reporting Requirement Regulations 80061 and Community Care Licensing (CCL) and provided you with examples of incidents that need to be reported and outline the steps for reporting them. We provided you with the resource guide on reporting requirements, which includes details on cross-reporting as well as submitting incident reports promptly. We also provided you with the Unusual Incident Report (LIC 624) and Law Enforcement Contact Report (LIC 624LE). (Report Continued on LIC809C ) We also discussed that it is mandatory for administrators to spend at least 20 hours per week at the facility to ensure compliance. Additionally, we have discussed that you will provide comprehensive training that outlines clear expectations on what to report, how to report, and who is responsible for submitting the incident reports to all your facility staff. We also discussed that you will be making updates on the following policies on your program statement: incident reporting policy and personnel/onboarding training by January 20, 2026. Our agency recommends that you participate in our technical support program to assist with the implementation of the compliance plan. The Licensee must comply with Title Reporting Requirement Regulations 80061 and Community Care Licensing (CCL) requirements. Documents reviewed include: - Reporting Requirement Resource Guideline - LIC 624 and LIC 624LE - Reporting Requirement Regulation - Technical Assistance Brochure A copy of this report was provided to the facility administrator/Licensee.


summary: Facility Evaluation

raw_content:
Narrative:
On December 15, 2025, Licensing Program Analyst (LPA) Justine Armstrong and Licensing Program Manager Enrique Hernandez arrived at Dream Home Residential Group Home to conduct a case management incident inspection at the above facility an met with Jason Watson Facility Manager (FM) and Leah Hawkins Facility Administrator (FA) to discuss a Special Incident Report that was received by Community Care Licensing (CCL) on December 12, 2025. This report is regarding the death of a 14-year-old male client (C1), which reportedly occurred on October 28, 2025 at the facility. According to the Special Incident Report, on the day of the incident, at the facility FM observed C1 having a tantrum during which C1 was crying and screaming. FM reported that C1 began to have difficulty breathing and subsequently became unresponsive. S1 called emergency medical services by dialing 911 and FM initiated emergency response measures, including CPR and chest compressions, which continued until first responders arrived. Upon arrival, the Paramedics took over care of C1 and transported C1 via ambulance to the hospital, while FM proceeded to the hospital as well. C1's mother was notified by the FA and also went to the hospital. Hospital medical staff, along with a hospital social worker, informed facility staff and the C1's mother that resuscitation efforts were unsuccessful, and C1 was pronounced deceased. Community Care Licensing did not receive immediate telephone notification of this incident at the time it occurred, nor did the department receive a written incident report within seven (7) days as required by the reporting requirements (Report Continued on LIC809C ) LPA requested a copy of C1 death certificate as soon as it becomes available. The facility administrator acknowledged that the client's death was not reported to Community Care Licensing as required. LPA requested the LIC500, Client Roster, MARS for the past two months (September and October), Incident Report related to C1 for the past 6 months, CPR Training for staff present during incident, and Needs and Service. The administrator will send this via email to LPA by December 19, 2025. During the Case Management incident inspection, the Department obtained information regarding the death of a client while in care at the facility. The circumstances surrounding the incident require further investigation, and no determination regarding the cause of the incident has been made at this time. However, after reviewing the Incident Report and confidential interviews conducted with two staff , statements were consistent, and it was confirmed that The facility did not notify the department in a timely manner preventing Community Care Licensing from promptly accessing the health and safety of clients in care. The facility is being cited regarding Title 22, Division Six, regulation 80061(b)(1)(A) Reporting Requirements. The following deficiency has been cited (see LIC 809-D). An exit interview was conducted, and a copy of this report was provided

met_with: Jason Watson


facility_name: DYER GROUP HOME

summary: Facility Evaluation

raw_content:
Narrative:
On September 27, 2021 at 12:30pm Licensing Program Analyst (LPA) Donald Martin arrive at the above facility for the purpose of conducting an unannounced Annual Inspection. LPA Was greeted by House Manager, Rosie Marie Mexicano (HM) and allowed into the facility. LPA conducted a tour of the facility inside and out. There are four (4) non verbal children residing in the home. Home is set up as follows: Bedroom #1 has a single bed with one client. The room is equip with a dresser and a closet with sufficient clothing space. Bedroom #2 has two beds two dressers and closet space for two clients clothing. Staff #1 resides in Bedroom #3. Bedroom #4 has no residents and is used by Staff #1 as a personal game room. Bedroom 5 has a full bed and sleeps 1 client. The room is equip with a bed, dresser, and ample closet space for the client. Master suite is for house Manager Rosie Marie Mexicano which has an attached bathroom. (HM) reported there are no fire arms or weapons in the home. There is an in-ground pool on premises with a wooden fence. Fencing has a self latching gate that opens outward with latch at the top. Gate is kept locked when the pool is not in use and per Manager children are supervised at all times when in or around the pool by staff members. NOTE: The gate to the pool locks from the inside. HM stated that per Regional Center, the pool must be locked when housing Regional Center clients. LPA will follow up with Regional Center on this matter. The facility is clean, safe, sanitary, and in good repair. There was a broken faucet in bathroom #1. There was a Plummer at the facility when LPA arrived addressing the issue. Disinfectants/poisons and other hazardous items are inaccessible, they are kept locked in the Laundry Room. There is an adequate food supply (4 days perishable and at least 10 days non-perishable). Nutritious snacks are served between meals. Medication is locked in a cabinet located in the kitchen. LPA advised HM to double lock the medication. LPA also advised HM to have a locked refrigerator for possible medication that needs to be chilled. The Children's Personal Rights is posted, upheld and Staff have been instructed to report Personal Rights Violations. Cont 809-C Two client filed were reviewed. There were no missing items in the files of Child #1 or Child #2. Clients Physicals and Dental exams were outdated due to Covid-19. HM stated that all clients are scheduled to have their exams in October 2021. HM will notify LPA when exams are completed. The vehicle is a Cadillac Escalade. The vehicle is in good working condition and the registration and insurance is up to date. There was plenty of extra towels and linen for the clients use. Two Staff files were reviewed. All required documentation was current and in the files. There are no excluded persons on premises and All adults working in the home have Criminal Clearances. Facility has a current Plan of Operation and HM has been instructed to report changes in the plan of operation which affects clients. HM has been reminded to report client injuries requiring medical treatment and other special incidents. There were no deficiencies cited at the time of the visit.

met_with: Rosie Mexicano-House Manager


summary: Facility Evaluation

raw_content:
Narrative:
On October 14, 2022 at 10:00am Licensing Program Analyst (LPA) Donald Martin arrive at the above facility for the purpose of conducting an unannounced Annual Inspection. LPA Was greeted by House Manager, RosieMarie Mexicano (HM) and allowed into the facility. LPA conducted a tour of the facility inside and out. There are four (4) non verbal children residing in the home. Home is set up as follows: Bedroom #1 has a single bed with one client. The room is equip with a dresser and a closet with sufficient clothing space. Bedroom #2 has two beds two dressers and closet space for two clients clothing. Staff #1 resides in Bedroom #3. Bedroom #4 has no residents and is used by Staff #1 as a personal game room. Bedroom 5 has a full bed and sleeps 1 client. The room is equip with a bed, dresser, and ample closet space for the client. Master suite is for house Manager Rosie Marie Mexicano which has an attached bathroom. (HM) reported there are no fire arms or weapons in the home. There is an in-ground pool on premises with a wooden fence. Fencing has a self latching gate that opens outward with latch at the top. Gate is kept locked when the pool is not in use and per Manager children are supervised at all times when in or around the pool by staff members. NOTE: The gate to the pool is kept locked when not in use. HM stated that per Regional Center, the pool must be locked when housing Regional Center clients. The facility is clean, safe, sanitary, and in good repair. Disinfectants/poisons and other hazardous items are inaccessible, they are kept locked in the Laundry Room. There is an adequate food supply (4 days perishable and at least 10 days non-perishable). Nutritious snacks are served between meals. Medication is locked in a cabinet located in the kitchen. The Children's Personal Rights is posted, upheld and Staff have been instructed to report Personal Rights Violations. The vehicle is a Cadillac Escalade. The vehicle is in good working condition and the registration and insurance is up to date. There was plenty of extra towels and linen for the clients use. Cont 809-C The garage was used for storage and also had a weight set. The garage stays locked and is inaccessible to clients. Two client filed were reviewed. Clients Physicals and Dental exams were up to date. Two Staff files were reviewed. All required documentation was current and in the files. Staff interviews were conducted. No Client interviews were conducted because the clients are Non-Verbal. There are no excluded persons on premises and All adults working in the home have Criminal Clearances. Facility has a current Plan of Operation and HM has been instructed to report changes in the plan of operation which affects clients. There were no deficiencies cited at the time of the visit.


summary: Facility Evaluation

raw_content:
Narrative:
On July 30, 2024 at 9:30am Licensing Program Analyst (LPA) Donald Martin arrived at the above facility for the purpose of conducting an Annual/Random inspection. LPA was met by House Manager, Rosie Mexicano (S1) and allowed into the facility. The facility capacity is 4 ambulatory, developmentally disabled clients. The house layout is as follows: Bedroom #1 has a single bed. The room is for one client. The room is equip with a dresser and a closet with sufficient clothing space. Bedroom #2 has two beds two dressers and closet space for two clients clothing. Bedroom # Has one queen bed with a dresser and closet space for clothing. Bedroom #4 is a separation room which has a bed, dresser and closet space. Bedroom 5 is currently empty. LPA was informed that the room is being converted to the house office. Master suite is for house Manager Rosie Marie Mexicano which has an attached bathroom. (S1) reported there are no fire arms or weapons in the home. There are two bathroom located in the hallway next to the bedrooms. Both bathrooms are clean and in good working condition. There is an in-ground pool on premises with a white fence surrounding it. Fencing has a self latching gate that opens outward with latch at the top. Gate is kept locked when the pool is not in use and per Manager children are supervised at all times when in or around the pool by staff members. NOTE: The gate to the pool is kept locked when not in use. HM stated that per Regional Center, the pool must be locked when housing Regional Center clients. The water shut off valve is on the side of the home in the backyard. the Electric shut off is on the opposite side of the home in the front. The facility is clean, safe, sanitary, and in good repair. Disinfectants/poisons and other hazardous items are inaccessible, they are kept locked in the Laundry Room. There is an adequate food supply (4 days perishable and at least 10 days non-perishable). Nutritious snacks are served between meals. Cont 809-C There was plenty of perishable and non perishable food accessible to the clients and a menu posted on the refrigerator. Medication is locked in a cabinet located in the kitchen. The living room has three couches and a TV on the wall. The Children's Personal Rights is posted, upheld and Staff have been instructed to report Personal Rights Violations. The vehicle is a Cadillac Escalade. The vehicle is in good working condition and the registration and insurance is up to date. There was plenty of extra towels and linen for the clients use. The garage stays locked and is inaccessible to clients. Two client files were reviewed. Clients Physicals and Dental exams were up to date. Three Staff files were reviewed. All required documentation was current and in the files. Staff interviews were conducted. No Client interviews were conducted because the client is Non-Verbal. There are no excluded persons on premises and All adults working in the home have Criminal Clearances. Facility has a current Plan of Operation and HM has been instructed to report changes in the plan of operation which affects clients. There were no deficiencies cited at the time of the visit.


summary: Facility Evaluation

raw_content:
Narrative:
On January 29, 2026 at 2:30pm Licensing Program Analyst (LPA) Donald Martin arrived at the above facility for the purpose of changing the "Type of visit" to Annual/Required from the Annual/Random inspection I previously conducted on July 30, 2024 at 9:30am. LPA was met by House Manager, Rosie Mexicano (S1) and allowed into the facility. The facility capacity is 4 ambulatory, developmentally disabled clients. The house layout is as follows: Bedroom #1 has a single bed. The room is for one client. The room is equip with a dresser and a closet with sufficient clothing space. Bedroom #2 has two beds two dressers and closet space for two clients clothing. Bedroom # Has one queen bed with a dresser and closet space for clothing. Bedroom #4 is a separation room which has a bed, dresser and closet space. Bedroom 5 is currently empty. LPA was informed that the room is being converted to the house office. Master suite is for house Manager Rosie Marie Mexicano which has an attached bathroom. (S1) reported there are no fire arms or weapons in the home. There are two bathroom located in the hallway next to the bedrooms. Both bathrooms are clean and in good working condition. There is an in-ground pool on premises with a white fence surrounding it. Fencing has a self latching gate that opens outward with latch at the top. Gate is kept locked when the pool is not in use and per Manager children are supervised at all times when in or around the pool by staff members. Cont 809-C NOTE: The gate to the pool is kept locked when not in use. HM stated that per Regional Center, the pool must be locked when housing Regional Center clients. The water shut off valve is on the side of the home in the backyard. the Electric shut off is on the opposite side of the home in the front. The facility is clean, safe, sanitary, and in good repair. Disinfectants/poisons and other hazardous items are inaccessible, they are kept locked in the Laundry Room. There is an adequate food supply (4 days perishable and at least 10 days non-perishable). Nutritious snacks are served between meals. There was plenty of perishable and non perishable food accessible to the clients and a menu posted on the refrigerator. Medication is locked in a cabinet located in the kitchen. The living room has three couches and a TV on the wall. The Children's Personal Rights is posted, upheld and Staff have been instructed to report Personal Rights Violations. The vehicle is a Cadillac Escalade. The vehicle is in good working condition and the registration and insurance is up to date. There was plenty of extra towels and linen for the clients use. The garage stays locked and is inaccessible to clients. Two client files were reviewed. Clients Physicals and Dental exams were up to date. Three Staff files were reviewed. All required documentation was current and in the files. Staff interviews were conducted. No Client interviews were conducted because the client is Non-Verbal. There are no excluded persons on premises and All adults working in the home have Criminal Clearances. Facility has a current Plan of Operation and HM has been instructed to report changes in the plan of operation which affects clients. There were no deficiencies cited at the time of the visit.


raw_content:
Narrative:
Although the allegation may have happened or is valid, based on LPA's observations and interviews, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED. An exit interview was conducted and a copy of this report was provided to Administrator Alyssa Kianidehkian, whose signature on this form confirms receipt.

Investigation Findings:
13This an amended report, original report date of 04/26/ LPA amended report due to making the report Public. On 04/26/24 at 10:45AM, Licensing Program Analyst (LPA) Celeste Aparicio made an unannounced visit to the above facility and met with Administrator, Alyssa Kianidehkian for the purpose of delivering findings for a complaint investigation. The Department received a complaint alleging that facility staff inappropriately touch minor while in care. Part of this investigation was investigated by the Investigations Bureau of the Community Care Licensing Division. LPA reviewed incident reports, the client file, and conducted confidential interviews. After the review of documentation and interviews with relevant parties, it was found that the allegation could not be corroborated due to inconsistent statements obtained. Report continued LIC9099-C... UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Celeste Aparicio LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO RO, TRAEGER AVE., SUITE FACILITY NAME: EDGEWOOD CENTER FOR CHILDREN AND FAMILIESFACILITY NUMBER: VISIT DATE: 04/26/2024

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

met_with: Alyssa Kianidehkian


facility_name: EDGEWOOD CENTER FOR CHILDREN AND FAMILIES

summary: Facility Evaluation

raw_content:
Narrative:
On December 22, 2022 at 9:30am, Licensing Program Analyst (LPA) Monica Pavia conducted an announced pre-licensing inspection of the facility. LPA met and toured the facility with America Grajeda and Augustine Arballo Jr. This facility is transitioning from a Short-Term Residential Therapeutic Program to a Group Home. There are several buildings on the property. The Stow Cottage is utilized as the residential cottage, with a capacity of 12. The Stow Cottage consists of 6 client bedrooms and several client bathrooms, living and dining areas, kitchen, laundry, recreation room and many other rooms for client use. The facility is clean, safe, sanitary, and in good repair. All passageways are unobstructed and all doors open freely. There is no pool on the facility premises. Fire arms are not allowed on the facility premises. At the time of visit, the following was observed: Fire extinguishers are throughout the house. Smoke detectors are throughout the house and operational. Carbon monoxide detectors are located in the hallway. Each bedroom has a bed, clean linens, and adequate drawer/cabinet space. Facility has a fire clearance. First aid kit was observed. Hot water temperature measured at 118 degrees Fahrenheit. Staff records are kept in the Administration building, on the property. Client files are locked in the chart room, in Dimond Cottage. Medications are centrally stored and locked. Disinfectants and other toxic materials are locked. Hygiene products are locked in the hallway closet. Extra bedding and towels are in the hallway closet. Knives and sharps are kept locked in the kitchen. This facility has been approved for licensure as a Group Home with a capacity of 12, as of today, December 22, 2022. LPA Pavia will email a copy of your license.

met_with: America Grajeda