summary: Facility Evaluation

raw_content:
Narrative:
On 4/23/2025 at 9: AM Licensing Program Analyst (LPA) Tatyana Shulz made an unannounced visit with the purpose of conducting an annual inspection to the above facility. LPA met with Administrator, Kelli Fellows, and a walk through of the interior and exterior was completed. Physical Plant Room 1 is the clients bedroom with 2 twin hospital beds, 1 wardrobe and 1 dresser. Room 2 is the spare living room with a couch, recliner chair and TV. Leading towards Room 3 is the clients half bathroom with a working sink and toilet with a water temperature of 105 degrees Fahrenheit. Room 3 is a spare bedroom with a locked door, queen size bed, and full bathroom. Weapons are kept in the closet and ammunition is stored separately. Room 4 is the living room with a couch, 2 chairs and a TV. Room 4 is the kitchen area that has a working stove top, 2 dish washers, refrigerator, First Aid Kit, Fire Extinguisher, an oven, an office corner, and a kitchen table with enough seating for clients with medication stored in a locked cabinet. Room 5 is a bedroom with a full bed, dresser, closet and an attached Jack and Jill bathroom. Room 5 is a bedroom with a queen bed, 2 dresser and closet. Room 6 is a bedroom with a bed, dresser and closet. Room 7 is an additional bedroom occasionally utilized by the adult daughter with a dresser, closet and an attached Jack and Jill bathroom. Room 8 is the master bedroom with a nursery, seating area, fire place, closet, private bathroom and two exit doors. Room 9 is the laundry room with a washer and dryer, detergent, cleaning supplies which is kept out of reach of the client, with clean linens and towels readily available. Room 10 is a workout/ game room that has a microwave, fish tank, games, boxing bag, foosball table and a piano. Room 11 is the dining room with a dining table with 8 chairs, a cabinet and a piano. There are 4 bathrooms, each bathroom is equipped with a working toilet, and running warm water with a temperature of 105 degrees. The home has sufficient activities, including books, age-appropriate toys, arts/craft materials and all furniture is in good repair. Continue to 809-C. The backyard is gated, with ample space for the clients to move about with lawn furniture, a grill and a grassy area. The facility has a Jeep to be used to transport clients that is in good working condition. There is a garage with storage space and a spare refrigerator for overflow food. The following required documents were posted by the licensee in the common area, Emergency Disaster Plan, Personal Rights, Complaint contact numbers and License. Disinfectants/cleaning solutions are inaccessible to children in care and kept in a nook. Refrigerator temperature is at or below 45 degrees F. With nonperishable foods one week and fresh perishable foods three days minimum. There are plates, cups and cooking supplies ready for clients. Each client has their own cellphone and can use it as they wish. Smoke detectors and carbon monoxide are in working order. Hot Water between 105-120-degree F. Fire Extinguishers are up to date and in working order, the facility plans on obtaining a new fire extinguisher as of tomorrow, 4/24/2025. Toilets, wash basins and shower fixtures in good repair, no leaks and there is hot water accessible. Soap and Paper towels are available to clients. Bedroom-required linen and furnishings are fully stocked. The facility is free of vermin. The following domains were also reviewed during today's inspection, Physical Plant, Operations, Disaster Preparedness, Staffing, Client Records. A total of 2 staff files, 1 client file was reviewed. LPA also conducted 1 staff interviews and 0 client interviews during todays inspection, due to the client not being present at the facility during the inspection. LPA was also informed that the client is nonverbal. No concerns for follow up was noticed. A review of the Licensing Information System indicates the facility is up to date on their facility fees and all the staff were fingerprint cleared and associated to the facility. An exit interview was conducted with Kelli Fellows, Administrator and a copy of this report, was provided to the facility.

met_with: Kelli Fellows- Administrator


state: CA

summary: Facility Evaluation

raw_content:
Narrative:
On April 13, 2026 at 10: AM Licensing Program Analyst (LPA) Tatyana Shulz made an unannounced visit with the purpose of conducting an annual inspection at the above facility. LPA met with Administrator, Kelli Fellows, and a walk through of the interior and exterior was completed. Physical Plant Room 1 is the clients bedroom with 2 twin beds, 1 wardrobe and 1 dresser. Room 2 is the spare living room with a couch, recliner chair and TV with a dining room directly across with a dining table with 8 chairs, a cabinet and a piano. Leading towards Room 3 is the clients half bathroom with a working sink and toilet with a water temperature of 110 degrees Fahrenheit. Room 3 is a spare bedroom with a locked door, queen size bed, and full bathroom. Room 4 is the living room with a couch, 2 chairs and a TV. Room 4 is the kitchen area that has a working stove top, 2 dish washers, refrigerator, an oven, an office corner, and a kitchen table with enough seating for clients. There is a pantry that houses extra food and the First Aid Kit and Fire Extinguisher, with medication stored in a locked cabinet. Room 5 is a bedroom with a full bed, dresser, closet and an attached Jack and Jill bathroom. Room 6 is a bedroom with a queen bed, 2 dresser and closet. Room 7 is a bedroom with a bed, dresser and closet. Room 8 is an additional bedroom occasionally utilized by the adult daughter with a dresser, closet and an attached Jack and Jill bathroom. Room 9 is the master bedroom with a nursery, seating area, fire place, closet, private bathroom and two exit doors. Room 10 is the laundry room with a washer and dryer, detergent, cleaning supplies which is kept out of reach of the client, with clean linens and towels readily available. Room 11 is a workout/ game room that has a fish tank, games, boxing bag, foosball table and a piano. There are 4 bathrooms, each bathroom is equipped with a working toilet, and running warm water with a temperature of 110 degrees. The home has sufficient activities, including books, age-appropriate toys, arts/craft materials and all furniture is in good repair. Continue to 809-C. The backyard is gated, with ample space for the clients to move about with lawn furniture, a grill and a grassy area. The facility has a Jeep to be used to transport clients that is in good working condition. There is a garage with storage space and a spare refrigerator for overflow food. The following required documents were posted by the licensee in the common area, Emergency Disaster Plan, Personal Rights, Complaint contact numbers and License. Refrigerator temperature is at or below 45 degrees F. With nonperishable foods one week and fresh perishable foods three days minimum. There are plates, cups and cooking supplies ready for clients. Each client has their own cellphone and can use it as they wish. Smoke detectors and carbon monoxide are in working order. Hot Water between 105-120-degree F. Fire Extinguishers are up to date and in working order. Toilets, wash basins and shower fixtures in good repair, no leaks and there is hot water accessible. Soap and Paper towels are available to clients. Bedroom required linen and furnishings are fully stocked. The facility is free of vermin. The following domains were also reviewed during today's inspection, Physical Plant, Operations, Disaster Preparedness, Staffing, Client Records. A total of 2 staff files, 1 client file was reviewed. LPA also conducted 1 staff interviews and 0 client interviews during todays inspection, due to the client not being present at the facility during the time of the inspection. LPA was also informed that the client is nonverbal. No concerns for follow up was noticed. A review of the Licensing Information System indicates the facility is up to date on their facility fees and all the staff were fingerprint cleared and associated to the facility. No deficiencies were cited during today's visit but a Technical Assistance was given. (See LIC 9102TA for further details). An exit interview was conducted with Kelli Fellows, Administrator and a copy of this report, will be provided to the licensee.

report_type: Facility Evaluation

visit_type: Annual

met_with: Kelli Fellows-Adminisrator


facility_name: FLORENCE MWANGI SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On 4/08/2025 at 2: PM, Licensing Program Analyst (LPA) Aleza Ruiz and Licensing Program Manager (LPM) Hillary Hall conducted an in person office meeting with Florence Mwangi. The purpose of the meeting was to continue the small family home application process by conducting the Component II orientation. LPA Ruiz explained the purpose of the meeting. Documents discussed during time of meeting were the following: I. Application Instructions for a facility License. II. Personnel Record (required education documentation) (LIC 501) III. Personnel report (LIC 500) IV. Surety Bond (LIC 400) V. Facility Sketch (LIC 999) (Camera locations) VI. Application (LIC 200) VII. Control of Property documentation VIII. Program Statement- Policy and Procedures discussed during time of meeting were the following I. Program Purpose and Intake Procedures. II. Intake Process and Admission Polices III. Facility Forms IV. The Applicant has stated they will do the following and submit updated Program Statement and requested documentation by DATE. Education document submitted to CCLD by 5/8/ Program Statement: Applicant will submit to LPA Ruiz when it has been updated. To be updated by 5/8/ LPA Ruiz will do the following: Pre-licensing inspection scheduled for DATE: Will continue to follow up with Florence throughout the application/licensing process. An exit interview was conducted, and a copy of this report was provided to the Applicant.

met_with: Florence Mwangi, Applicant


summary: Facility Evaluation

raw_content:
Narrative:
On 06/27/25 at 10:30 am, Licensing Program Analyst, (LPA) Aleza Ruiz conducted a Pre-Licensing inspection at the Florence Mwangi Small Family Home. LPA Ruiz met with the licensee Florence Mwangi. The facility will be licensed to care for 2 ambulatory children ages 6-17 year and 2 non ambulatory clients ages 0-5. LPA toured the facility inside and outside. The facility is a one-story family home and consists of 2 bedrooms and 1 bathroom for clients. The home has a master bedroom and bathroom for the licensee. The home has a living room, kitchen, dining room, garage and backyard. The home has a dedicated area in the backyard for a garden growing vegetables and fruits. The room temperature was comfortable, and no odor was detected. There were Fire alarms and 1 carbon monoxide detectors. A First aid kit was checked and complete and kept in a central location. The Medication kit is in a locked box. Care Tool was completed. No staff interview was conducted. There were no youths in placement. An exit interview was conducted with the Licensee Florence Mwangi. A copy of this report was left with the Licensee.

visit_type: Prelicensing

met_with: Florence Mwangi, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On 02.04.26 at 9:00 am, Licensing Program Analyst, (LPA) Tina Thorn conducted a Post-Licensing inspection at the Florence Mwangi Small Family Home. LPA Thorn met with the licensee Florence Mwangi. The facility is licensed to care for 2 ambulatory children ages 6-17 and 2 non-ambulatory children ages 0-5. The single-family home consists of 2 client bedrooms and 1 master bedroom for the licensee. There is a two (2) car garage. There is one client currently residing in the home. LPA completed a Health and Safety Inspection of the facility. All toilets, showers, and sinks were functioning properly. The living area is furnished and the home was clean and organized. The room temperature was comfortable and no odor was detected. Smoke alarms/carbon monoxide detectors were in working order, fire extinguisher was current, and a first aid kit was fully stocked. Disinfectants and medications are in locked cabinets. LPA observed the kitchen to have at least 3 days of perishable food and 7 days of non-perishable food on hand. Client's bedroom had clean bedding, along with a dresser and closet which provided ample storage space for personal belongings. There is no swimming pool or other body of water on the premises. There are no firearms or other weapons in the facility. LPA reviewed 1 client file. The client had a current Individual Education Plan (IEP) on file. The Client was current on medical exams and dental exams. LPA reviewed licensee and staff files. Staff files contained sufficient training hours and CPR and First Aid was current. Client was not present so no interview was conducted. LPA interviewed licensee. No citations were given on this date. An exit interview was conducted and a signed copy of this 809 was given to licensee.


facility_name: FLORENCE SMALL FAMILY HOME

summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Regarding the allegation that FC1 sustained unexplained injury in care, it was specifically stated that "FC1 must have gotten stuck in the crib''. During the investigation, a confidential interview stated FC1 had a habit of stumping foot against the crib and FC1 was always redirected when observed. The confidential interview added that FC1 was always being supervised and was never left to stay in the crib without supervision. Another confidential interview was not sure blister-like injury was caused by FC1 being left unattended in the crib, but they believed it might be from FC1's shoes. A confidential witness did not observe FC1 being left in the crib unsupervised during routine visit at the SFH. The confidential witness does not believe LS left FC1 in the crib without supervision. Based on confidential interviews, the allegation that FC1 sustained unexplained injury in care may have occurred, however, there was not a preponderance of evidence to prove that the violation occurred. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted and a copy of this report LIC 9099 was discussed and provided to LS.

Investigation Findings:
13On August 15, 2025, Licensing Program Analyst (LPA) Babatunde Aborchie arrived at Florence Small Family Home (SFH) and met with SFH representative Florence Kagwanja to deliver the investigative finding for the above stated allegation involving the Small Family Home and foster child listed on the confidential list (LIC811) dated August 15, 2025. On February 6, 2025, a complaint report was referred to Community Care Licensing (CCL) alleging foster child sustained unexplained injury in care. On February 12, 2025, LPA Babatunde Aborchie arrived at the SFH to initiate investigation, conducted a safety inspection and interviewed licensee (LS), county social worker (CSW). In addition, LPA Babatunde Aborchie interviewed a biological daughter (BD). LPA was unable to interview foster child 1 (FC1) due to FC1's developmental age. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FLORENCE SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 08/15/2025

report_type: Complaint Investigation

met_with: Licensee

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On April 27, 2023 at 1: PM, Licensing Program Analyst (LPA) Linda Haynes began a pre-licensing inspection for Florence Small Family Home license. LPA met with applicant Florence Kaguanja who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there is no client in the home. The applicant is applying to serve 3 client ages 0 to 17. The home is a two-story building with four bedrooms and three and one half bathrooms which are set up as follows: · Bedroom #1 (Master) has one bed sleeps the applicant and has a master bathroom · Bedroom #2 (Client's) was vacant has one twin bed over full Bunk beds, it will sleep two clients. · Bedroom #3 (Daughters) has one Full bed, it sleeps the daughter. · Bedroom #4 (Clients) vacant has one full and one crib it will sleep one client · A great room/living room, kitchen, dining area, three- and one-half bathrooms, a sitting room, an attached two car garage, laundry room, and the backyard. The Client's bedrooms were arranged so that no more than two clients will be in the room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There was a smoke detector in every bedroom. The six smoke detectors were checked, and they were working properly. There is a carbon monoxide detector in the hallway upstairs and one in the sitting room downstairs. The Carbon monoxide detectors were checked and are working properly. There is a dedicated phone line. The home's central air conditioning module was located in the back yard on the porch. The home's hot water heater was located inside the garage. The appliances were in working order. The client's files will be locked inside a cabinet in the dinning room. There was adequate food storage space and a supply of two days of perishable foods and a week of non-perishable foods. A proper storage of all food was discussed. A trash can for storage of solid waste had a tight-fitting lid and was present. The sharp knives are in a locked kitchen drawer. The medications are located in a locked cabinet in the kitchen. The hot water in bathroom one measured to be 128.8 degrees Fahrenheit. The hot water in the master bathroom measured to be 128.6 degrees Fahrenheit. The hot water in bathroom two measured to be 128.4 degrees Fahrenheit and the hot water in bathroom three measured to be 127.6 degrees Fahrenheit. The home's First Aid kit was accessible and is located in pantry and has required supplies. Two fire extinguishers were present in the home one is located in the kitchen and one is located upstairs. They were observed to be properly charged and inspected by the fire department. There is no firearm in the home as stated by the applicant. There is no pool or other body of water.. The backyard where clients will have access to play is fenced. The following items need to be corrected · Hot water Temperature needs to be between 105 and 120 degrees Fahrenheit · Post complaint hotline phone number · Tags on fire extinguishers. The request for a license will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to Florence Kaguanja.

met_with: Florence Kaguanja


summary: Facility Evaluation

raw_content:
Narrative:
On May 23, 2025, at 12: PM, Licensing Program Analyst (LPA) Karen Beal began an announced inspection for Florence Small Family Home. LPA met with licensee Job Kuria, who led a tour of the home. The facility was toured both inside and out with the licensee. The licensee is applying for a change of capacity from 3 developmentally disabled and/or mentally disabled ambulatory clients, to two children ages 0-5 and two children ages 6-17 developmentally disabled and/or mentally disabled ambulatory clients. Downstairs: There is a family room, a living room, a dining area, a kitchen, and half bathroom. Upstairs: Bedroom #1, Master Bedroom with a king bed and two cribs. One baby in care currently. Bedroom #2, Client Bedroom one full bed and one twin bed. It is currently occupied by one client. Bedroom #3, Bio daughter room with one full size bed. Bedroom #4, It is furnished with one queen bed. It is currently vacant. There are three full bathrooms upstairs. One in located in the master bedroom, one in the hallway, and a Jack and Jill bathroom located between bedroom 3 and 4. Bedrooms are arranged so that no more than two children share a room, and one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawer and closet space for the children's belongings. The smoke detectors were checked and were working properly. ***Continued to LIC 809-C*** ****Continued from LIC 809-C**** Inside the facility there is a fireplace properly screened. Telephone service and appliances were in a working order. Medications, cleansers/chemicals, and sharp items will be locked in Kitchen Cabinets. There will no weapons in the home as stated by licensee. The hot water temperature was tested and noted to be 118.7 degrees. Perishable and non-perishable food was available for at least seven days. Trash cans for storage of solid waste have tight-fitting lids. First Aid kit was accessible with all required items. A Fire extinguisher was observed and properly charged. There is a fire extinguisher located upstairs in the hallway and one downstairs by the living room. The Facility Sketch, Emergency Disaster Plan, and License was posted in the entry of the home. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request for capacity change will be forwarded to the Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to the licensee.

visit_type: Case Management

met_with: Job Kuria, Licensee


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On December 8th, 2025, Licensing Program Analyst (LPA) Claudia Aguilera conducted a two-year required inspection at Florence Small Family Home (SFH). The home is licensed to serve three ambulatory clients and one bedridden client. Currently, the facility has placement of two ambulatory clients. The facility was toured inside and out with the Licensee, Florence Wangui Kaguanja. The home is a two-story residence with 5 bedrooms and 3.5 bathrooms. During the inspection, LPA observed that the downstairs consisted of the kitchen with formal dining room, pantry, living room, half bathroom, a closet, and garage. Bedroom #1 was vacant with one queen size bed, closet, and dresser, it would sleep one bedridden client, it has an exit door to the outside. LPA observed trash cans to have tight fitting covers. The kitchen was observed to be organized and clean, no sharp/knives were accessible to clients, soaps and toxins were also stored and locked. LPA observed a minimum of seven-day nonperishable supply of food and three-day perishable supply of food, and plenty of snacks. The medications were locked in a kitchen cabinet inaccessible to clients. The fist aid kit was inspected to be in compliance with all the necessary items. The garage was also inspected, LPA observed two vehicles, storage containers, and one refrigerator for additional food. The second level of the home consisted of bedroom #2 which consists of two beds one full size bed that is vacant and one twin bed that is occupied by 5-year old client. The room included a television, closet, and storage for clothing. Bedroom #3 was vacant with one full size bed, closet and dresser space. Bedroom #4 is occupied by licensee's 17-year old biological daughter which includes bathroom #1. ... The upstairs area also included bathroom #2 in the hallway which was fully functioning. Bedroom #5 is occupied by the licensee and spouse; it also includes bathroom #3, two cribs one is occupied by 3-year old medically fragile client. Per licensee, no weapons are kept in the home. LPA observed a full laundry room that included a washer and dryer and locked detergents/toxics. The water temperature was tested and measured at 118 degrees F. LPA observed all windows and screens to be in good repair. The smoke and carbon monoxide detectors were tested and operable. Two fire extinguishers were observed to be operable, one located downstairs and one upstairs. The following required posted items were observed to be accessible to clients, personal rights and current menu. The backyard was also inspected; there were no hazards or obstructions observed. There is one outdoor camera which meet the Title 22 camera policy. Based on today's inspection and observations, LPA issued two technical advisory (TAs) that was explained and given to licensee. Additionally, on a review of staff records, S1 did not have a criminal record clearance prior to working at the facility; therefore, the facility is being cited for violation of Title 22, Division California Code of Regulations (CCR) 80019(e)(2) Criminal Record Clearance which states (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility (2) Obtain a California clearance or a criminal record exemption as required by the Department. An immediate civil penalty in the amount of $500.00 has been assessed for allowing S1 to work before a criminal background clearance was filed. A copy of this report, the LIC 421BG Civil Penalty Assessment Background Check, was discussed and provided to Licensee, along with appeal rights..

Deficiencies:
80019(e): Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility

met_with: Licensee, Florence Wangui Kaguanja


facility_name: FOUNT OF PEACE HOME

summary: Facility Evaluation

raw_content:
Narrative:
On January 5, 2024, at 10: AM Licensing Program Analyst (LPA) Babatunde Aborchie began a Pre-Licensing inspection for a Small Family Home license. LPA met with applicants Dorcas Karanja and Elijah Makau who led a tour of the home. The facility was toured both inside and out with the applicants. The applicants were applying a license to serve 3 ambulatory clients. The home consisted of: Downstairs: Loft: It was furnished with an office desk and chair. It was used as an office. There was also, a living room, a dining area, a pantry, a kitchen, and a half bathroom with a storage. Upstairs: Bedroom #1, Master bedroom. The room consisted of one king sized bed and a crib. It sleeps the applicants and a foster child. Bedroom #2, The room was furnished with one full-sized bed. It sleeps biological daughter, aged 12 years. Bedroom #3, The room was furnished with one queen-sized bed and a twin bed.It will sleep two client It was vacant. Bedrooms were arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. The smoke detectors were checked and were working properly. Inside the facility the fireplace was properly screened. Telephone service and appliances were in a working order. All hazardous items have been properly made inaccessible to areas where children will have access. The medication will be locked in the kitchen cabinet. Cleansers/chemicals were locked and stored in the kitchen and laundry room cabinets. Sharp knives were inaccessible and stored in a locked kitchen cabinet by the dishwasher. There were no guns or weapons as stated by the applicants at this time. The hot water temperature was tested and noted to be 111 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit was accessible with all required items, and it was in the kitchen cabinet. A Fire extinguisher was observed and properly charged. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request for a small family home license will be forwarded to the Licensing Program Manager for final approval. LPA conducted a component III orientation with applicants Dorcas Karanja and Elijah Makau. An exit interview was conducted. A copy of this report was provided to applicants.

met_with: DORCAS KARANJA AND ELIJAH MAKAU


summary: Facility Evaluation

raw_content:
Narrative:
On May 13, Licensing Program Analyst (LPA) Maryjane Perez met with applicants Dorcas Karanja and Elijah Makau this date for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the LIC 184, Notice of Application Revision, and additional correspondence to assist with the revisions needed to the application. A copy of this report was provided to applicants Dorcas Karanja and Elijah Makau.

met_with: Applicants- Dorcas Karanja and Elijah Makau


summary: Facility Evaluation

raw_content:
Narrative:
On July 7, Licensing Program Analyst (LPA) Maryjane Perez arrived at Fount of Peace Home Small Family Home (SFH) for a pre-licensing inspection for an initial license. LPA met with applicants Dorcas Karanja and Elijah Makau who led a tour of the entire home inside and out. Currently there are no children placed in the home. The applicant are applying to serve three ambulatory children ages 0 to 17 years old. The home is a two-story building with three bedrooms and three bathrooms. The downstairs consisted of an entry way with all required postings such as emergency disaster plan, facility sketch, personal rights, and visitation policy. There was a living room that was fully furnished with couches, television, and a screened fireplace. The kitchen was clean and sanitary and had a fully stocked pantry and refrigerator that had perishable and nonperishable foods. The kitchen also has a cabinet with locked sharps/ knives, a locked cabinet storing medications, and a locked sink cabinet storing cleaning supplies. There was also a dining table with adequate seating, fire extinguisher #1 that was operable and a first aid kit with all required elements. Bathroom #1 was located downstairs fully functioning with water temperature measuring 114.6 degrees Fahrenheit . There was a hallway closet that stored extra house hold items such as toilet paper, waters, diapers, and wipes. There was an office that had couches, television, computer, desk and books/games. The upstairs consisted of bedroom #1 which was the master bedroom and had a crib for an infant currently occupied by applicants adopted child as well as bathroom #2 that was fully functioning. There was a locked laundry room with laundry detergents and cleaning supplies stored away. There was a hallway closet that consisted of extra towels and linens. Bedroom #2 was also upstairs and had one twin size bed and one full size bed, dresser/closet space, a light fixture, and all required bedding that will utilized for two clients and is currently vacant. Bedroom #3 was fully furnished with one queen size bed currently occupied by applicants biological daughter and one twin size bed that will be utilized for one client which was currently vacant. Bathroom #3 was clean and sanitary had a trash can with a tight fitting lid and was fully functioning. Fire extinguisher #2 was in the upstairs hallway and was operable. The garage was free of hazards and stored two deep freezers with extra food items and a locked cabinet that stored paints and tools. The backyard where children will have access to play was completely fenced, had a gate with a latch and was free of hazards. There were no pools or other bodies of water and no weapons/firearms as stated by applicants. Bedrooms were arranged so that no more than two children share a room, and there is one child per bed. No room that is commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. The smoke detectors and carbon monoxide detectors were checked and are working properly. There was no land- line telephone service but appliances were in working order, and all trash cans had tight fitting lids. All hazardous items have been properly made inaccessible to areas where children will have access. Based on this inspection of the home, the facility will need the following corrections: Applicants to obtain a telephone land line service Applicants to obtain a lock box to store client cash resources After corrections are completed, the applicant will notify LPA so that another inspection can be completed. Component III orientation was also completed this day of July 7, 2025. Exit interview conducted and a copy of this report was discussed and provided to applicants Dorcas Karanja and Elijah Makau.


summary: Facility Evaluation

raw_content:
Narrative:
On 12/09/2025 at 10: AM, Licensing Program Analyst (LPA) Andrew Upshaw and Licensing Program Manager (LPM) Kevin Sauk conducted a Component II office meeting which was held at the El Segundo Children's Residential Regional Office in El Segundo, CA. LPA Upshaw and LPM Sauk met with Applicant, Sherry Frazier. Application forms and Program Statement was reviewed and discussed. Licensing staff requested revisions to application forms and program statement to be submitted by 01/12/2026. Pre-Licensing Inspection is scheduled for 12/11/2025, A copy of this report was issued to the Applicant, Sherry Frazier.

met_with: Applicant- Sherry Frazier


summary: Facility Evaluation

raw_content:
Narrative:
On 12/11/2025, at 9: AM, Licensing Program Analyst (LPA) Andrew Upshaw and Licensing Program Manager (LPM) Kevin Sauk arrived at Frazier Small Family Home LLC for the purpose of conducting a Pre-Licensing Inspection. LPA Upshaw and LPM Sauk were met by Applicant, Sherry Frazier, who granted access to the facility. At 9:35am, a health and safety assessment and inspection was conducted. The residence is a two-story 4 bedroom, 3 bathroom home. On the first floor of the home there is a front yard, living room, dining room, kitchen, family room, laundry room, backyard, and attached garage, one bedroom and a bathroom. The second floor has a family room and three bedrooms and two bathrooms including a master bedroom with its own bathroom. Front yard: Grass lawn, gas meter and electrical power shutoff located on side of yard. Living room and Dining area: equipped with a two-piece sofa set, and coffee table. Dining area includes dining table with six chairs and cabinet filled with glassware. A camera is located in the living room dining area. The camera located in this room has audio capability, but does not have recording capability. Kitchen and Family room: is equipped with a refrigerator/freezer, a five burner gas stove/oven (all burners were operational at the time of this inspection), and a microwave. Sharps and knives are locked up in a separate location. The kitchen is connected to a family room which is equipped with a sectional couch and TV mounted to the wall. A fire extinguisher is mounted to the wall facing the backyard and was last inspected in April of 2025. -Continued on 809-C, Page 2 (Page 2) Backyard: is equipped with a hot tub which is covered, barbecue, a shed, and trampoline with safety net and stairs. Shed contains a lawnmower, vacuum, a rake, an electrical cord, and pictures that are stored. Applicant plans to keep the shed locked. Bedroom number 1: located downstairs and equipped with a queen size bed and a dresser. Applicants reported that room is unoccupied and used when guests stay over. A working smoke detector is located in the bedroom. A working carbon monoxide detector is located near the staircase downstairs. Bathroom number 1: located next the bedroom number 1. The bathroom is equipped with a toilet, a sink, and a combination shower/tub. Laundry room: located near bathroom 1 and is equipped with a washer, dryer, and storage shelves. Laundry detergent and cleaning supplies for the home are kept in a locked cabinet above the washer and dryer. Garage: The laundry room has a door to access the garage. A freezer with additional food is located in the garage. An unlocked cabinet with hazardous items such as lighter fluid, charcoal, and paint is located in the garage. Hairdresser/salon materials is located in the garage. Bedroom 2/Master bedroom and bathroom: located upstairs and is occupied by the Applicant. The room is equipped with a king-size bed, two dressers, one night stand, a window, working lights and connects to the master bathroom which has a toilet, shower/bath, and a large closet filled with clothes. Upstairs hallway: Working carbon monoxide detector in on the hallway wall. Medications will be stored in a locked box in a cabinet in the hallway. Hallway cabinet also includes a fully equipped first aid kit. Hallway has a rug which is not secured to the ground which may pose as a tripping hazard. Bedroom number 3: is unoccupied and will be utilized by any future clients. It is equipped with twin bunk beds, empty plastic dresser, an empty closet, a window, and a working smoke detector. -Continued on 809-C, Page 3- (Page 3) Bedroom 4: Occupied by the applicant's 15 year old daughter. The room is equipped with twin beds with a dresser, a mounted TV, a lamp, a window, and a closet with clothes and shoes. Bathroom 3: located along the hallway near bedrooms 3 and 4. The bathroom is equipped with a toilet, a sink, and a combination shower/tub. Family room: equipped with three mounted TVs, and extra twin trundle bed, an empty dresser, and two cameras. One camera points outside to the street and one points inside this room. The hot water was tested and found to be under 120 degrees (F). LPA Upshaw observed the passageways, stairways, and open porches to be unobstructed. The front and backyard were free of debris. There are no firearms or dangerous weapons in the home. There are no animals on site. Vehicle: Applicant will transport children in a Nissan Rogue. LPA observed the vehicle to have working seat belts, horns, and lights. Applicant has current registration valid until 08/02/2026 and insurance which expires on 06/20/2026. Fire clearance has already been granted. Prior to being licensed the following is required: -Applicant will lock all hazardous material in a locked cabinet or locked storage shed. -Applicant will secure upstairs hallway rug to the ground so it does not pose as a tripping hazard. -Applicant will complete other documents requested during component II meeting. Exit Interview was conducted, and a copy of this report was emailed to Applicant.

met_with: Sherry Frazier- Applicant


summary: Facility Evaluation

raw_content:
Narrative:
On 01/21/2026, at 9: AM, Licensing Program Analyst (LPA) Andrew Upshaw arrived at Frazier Small Family Home LLC for the purpose of conducting a Pre-Licensing Inspection. LPA Upshaw was met by Applicant, Sherry Frazier, who granted access to the facility. At 9: AM, a health and safety assessment and inspection was conducted. The residence is a two-story 4 bedroom, 3 bathroom home. On the first floor of the home there is a front yard, living room, dining room, kitchen, family room, laundry room, backyard, and attached garage, one bedroom and a bathroom. The second floor has a family room and three bedrooms and two bathrooms including a master bedroom with its own bathroom. Front yard: Grass lawn, gas meter and electrical power shutoff located on side of yard. Living room and Dining area: equipped with a two-piece sofa set, and coffee table. Dining area includes dining table with six chairs and cabinet filled with glassware. A camera is located in the living room dining area. The camera located in this room has audio capability, but does not have recording capability. Kitchen and Family room: is equipped with a refrigerator/freezer, a five burner gas stove/oven (all burners were operational at the time of this inspection), and a microwave. Sharps and knives are locked up in a separate location. The kitchen is connected to a family room which is equipped with a sectional couch and TV mounted to the wall. A fire extinguisher is mounted to the wall facing the backyard and was last inspected in April of 2025. Backyard: is equipped with a hot tub which is covered, barbecue, a locked shed, and trampoline with safety net and stairs. Shed contains a lawnmower, vacuum, a rake, an electrical cord, paint, and pictures that are stored. -Continued on 809-C, Page 2 (Page 2) Bedroom number 1: located downstairs and equipped with a window, queen size bed and a dresser. Applicants reported that room is unoccupied and used when guests stay over. A working smoke detector is located in the bedroom. A working carbon monoxide detector is located near the staircase downstairs. Bathroom number 1: located next the bedroom number 1. The bathroom is equipped with a toilet, a sink, and a combination shower/tub. Laundry room: located near bathroom 1 and is equipped with a washer, dryer, and storage shelves. Laundry detergent and cleaning supplies for the home are kept in a locked cabinet above the washer and dryer. Garage: The laundry room has a door to access the garage. A freezer with additional food is located in the garage. An unlocked cabinet stores tools. Hairdresser/salon materials is located in the garage. Bedroom 2/Master bedroom and bathroom: located upstairs and is occupied by the Applicant. The room is equipped with a king-size bed, two dressers, one night stand, a window, working lights and connects to the master bathroom which has a toilet, shower/bath, and a large closet filled with clothes. Upstairs hallway: Working carbon monoxide detector in on the hallway wall. Medications will be stored in a locked box in a cabinet in the hallway. Hallway cabinet also includes a fully equipped first aid kit. Bedroom number 3: is unoccupied and will be utilized by any future clients. It is equipped with twin bunk beds, empty plastic dresser, an empty closet, a window, and a working smoke detector. Bedroom 4: Occupied by the applicant's 15 year old daughter. The room is equipped with twin beds with a dresser, a mounted TV, a lamp, a window, and a closet with clothes and shoes. Bathroom 3: located along the hallway near bedrooms 3 and 4. The bathroom is equipped with a toilet, a sink, and a combination shower/tub. -Continued on 809-C, Page 3- (Page 3) Family room: equipped with three mounted TVs, and extra twin trundle bed, an empty dresser, and two cameras. One camera points outside to the street and one points inside this room. The hot water was tested and found to be under 120 degrees (F). LPA Upshaw observed the passageways, stairways, and open porches to be unobstructed. The front and backyard were free of debris. There are no firearms or dangerous weapons in the home. There are no animals on site. Vehicle: Applicant will transport children in a Nissan Rogue. LPA observed the vehicle to have working seat belts, horns, and lights. Applicant has current registration valid until 08/02/2026 and insurance which expires on 06/20/2026. Fire clearance has already been granted. Prior to being licensed the following is required: -Applicant will complete other documents requested during component II meeting. Exit Interview was conducted, and a copy of this report was emailed to Applicant.


summary: Facility Evaluation

raw_content:
Narrative:
On 04/17/2026 at 10: AM, Licensing Program Analyst (LPA) Andrew Upshaw and Licensing Program Manager (LPM) Kevin Sauk conducted a Component III office meeting which was held at the El Segundo Children's Residential Regional Office in El Segundo, CA. LPA Upshaw and LPM Sauk met with Applicant, Sherry Frazier. LPA Upshaw conducted Component III presentation to familiarize applicant with general rules and regulations, prepare applicant to maintain and operate their facility, provide information to avoid potential problem areas, provide clear description of Licensing Program Analyst's (LPA) role in operation of facility, and provide clear description of Civil Penalties. LPA Upshaw and LPM Sauk went over required forms with applicant Sherry Frazier. Applicant's Application and Program Statement is pending approval. Exit interview was conducted and a copy of this report was provided to applicant.


facility_name: FRENCH ABODE

summary: Facility Evaluation

raw_content:
Narrative:
On June 17, 2021 at 10: AM Licensing Program Analyst (LPA) Linda Haynes conducted an unannounced required annual inspection. LPA met with Licensee Gemma French. There is one client in the home however, client was at school at time of the inspection. The facility is licensed for two non-ambulatory client ages 0-17yrs old. There are three bedrooms, living room, dining room and family room, and two bathrooms. One bathroom is in the hallway. One bathroom is in the Licensee's bedroom. One bedroom is arranged for one client and Licensee's biological child share a bedroom. with two twin beds. One bedroom is arranged for licensee's biological children with two twin beds. LPA measured the hot water temperature at 105.8 degrees. The medications are in the kitchen in a locked cabinet that is inaccessible to children. Disinfectants, cleaning solutions were stored and located underneath the kitchen cabinet and inaccessible to children. The first aid kit was checked and found to be complete. Client #1 is fed Nutren Jr. w/Fiber through a G-Tube. LPA observed facility license, emergency disaster plan, facility sketch, menu and personal rights posted. LPA observed in the Licensee's bedroom a gun safe were weapons are stored was locked. LPA observed ammunition are stored in a locked cabinet in the garage. A review of the Licensing Information System on June 14, 2021 indicates that all individuals are associated to the facility had DOJ, FBI and child abuse index check clearances. The front and backyard were inspected and found clear of hazards. There were no pools and/or bodies of water on at the facility. Based on the facility inspection and file reviews this date, there are no deficiencies found at this time.

met_with: Gemma French


summary: Facility Evaluation

raw_content:
Narrative:
On June 2,2022 at 12:30PM, Licensing Program Analyst (LPA) Carol Anderson conducted an unannounced required annual inspection. LPA met with Licensee Gemma French. There is one client in the home. Client is currently in the hospital. The facility is licensed for two non-ambulatory clients ages 0-17yrs old. There are three bedrooms, living room, dining room and family room, and two bathrooms. On June 2, 2022 at 11:10AM, LPA arrived at the facility, no one was at facility. LPA contacted Licensee French. Licensee French stated that they were at the hospital with Client 1 (C1). One bathroom is in the hallway. One bathroom is in the Licensee's bedroom. One bedroom is arranged for two clients and Licensee's biological child share a bedroom, with two twin beds. One bedroom is arranged for licensee's biological children with two twin beds. LPA measured the hot water temperature at 105 degrees. The medications are in the kitchen in a locked cabinet that is inaccessible to children. Disinfectants, cleaning solutions were stored and located underneath the kitchen cabinet and inaccessible to children. The first aid kit was checked and found to be complete. C1 is fed Pediasure via G-Tube. LPA observed facility license, emergency disaster plan, facility sketch, menu and personal rights posted. LPA observed in the Licensee's bedroom a gun safe were weapons are stored was locked. LPA observed ammunition are stored in a locked cabinet in the garage. A review of the Licensing Information System on June 01, 2022 indicates that all individuals are associated to the facility had DOJ, FBI and child abuse index check clearances. The front and backyard were inspected and found clear of hazards. There were no pools and/or bodies of water on at the facility. Based on the facility inspection and file reviews this date, there are no deficiencies.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced inspection was conducted by Licensing Program Analyst (LPA) Carol Anderson on June 8, 2023, at 10:30A.M., to conduct an unannounced required annual inspection. Licensees French were not the facility. LPA contacted Licensee Gemma French via cellphone. She stated that she will be home in 30 minutes. LPA interviewed Licensee Gemma French. LPA was unsuccessful with the interview of Client 1 (C1) due to C1 unable to be interviewed. The facility does not have staff employed at this time. At 11:01A.M., LPA observed three bedrooms, living room, dining room and family room, kitchen, and two bathrooms, one bathroom is in the hallway. One bathroom is in the Licensee's bedroom. One bedroom is arranged for one client and Licensee's biological child share a bedroom, with two twin beds. One bedroom is arranged for licensee's biological children with bunk bed. LPA measured the hot water temperature at 106 degrees. LPA observed, the medications are in the kitchen in a locked cabinet that is inaccessible to children. Disinfectants, cleaning solutions were stored and located underneath the kitchen cabinet and inaccessible to children. The first aid kit was checked and found to be complete. C1 is fed PediaSure via G-Tube. LPA observed facility license, emergency disaster plan, facility sketch, menu and personal rights posted. LPA observed in the Licensee's bedroom a gun safe where weapons are stored, locked. LPA observed ammunition are stored in a locked cabinet in the garage. A review of Guardian on June 08, 2023, indicates that all individuals are associated to the facility had DOJ, FBI and child abuse index check clearances. The front and backyard were inspected and found clear of hazards. There were no pools and/or bodies of water on at the facility. Based on the facility inspection and file reviews this date, there are no deficiencies.

met_with: Licensee Gemma French


summary: Facility Evaluation

raw_content:
Narrative:
On June 11, 2024, at 1:00PM, Licensing Program Analyst (LPA) Carol Anderson conducted an unannounced required annual inspection. LPA met with Licensee Gemma French. Currently one client is residing at this facility.LPA interviewed Licensee Gemma French. LPA was unsuccessful with the interview of Client 1 (C1) due to C1 unable to be interviewed. The facility does not have staff employed at this time. There are three bedrooms, living room, dining room and family room, and two bathrooms. One bathroom is in the hallway. One bathroom is in the Licensee's bedroom. One bedroom is arranged for one client and Licensee's biological child share a bedroom. with two twin beds. One bedroom is arranged for licensee's biological children with bunk beds. LPA measured the hot water temperature at 107 degrees. The medications are in the kitchen in a locked cabinet that is inaccessible to children. Disinfectants, cleaning solutions were stored and located underneath the kitchen cabinet and inaccessible to children. The first aid kit was checked and found to be complete. Client #1 is feed PediaSure w/Fiber through a G-Tube. LPA observed facility license, emergency disaster plan, facility sketch, menu and personal rights posted. LPA observed in the Licensee's bedroom a gun safe where weapons are stored was locked.LPA observed ammunition are stored in a locked cabinet in the garage. A review of the Licensing Information System on November June 11, 2024, indicates that all individuals are associated to the facility had DOJ, FBI and child abuse index check clearances. The front and backyard were inspected and found clear of hazards. There were no pools and/or bodies of water on at the facility. The front and backyard were inspected and found clear of hazards. There were no pools and/or bodies of water on at the facility. Based on the facility pre-licensing inspection and facility records' review, no deficiencies were noted at time of the inspection. An exit interview was conducted, and a copy of this report was left with Licensee Gemma French.


facility_name: GALE SOLUTIONS SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On May 10, 2023 at 11: AM, Licensing Program Analyst (LPA) Linda Haynes began a pre-licensing inspection for Gale Solutions Small Family Home license. LPA met with applicant Reginald Campbell who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there is no client in the home. The applicant is applying to serve 3 client ages 3 to 17. The home is a one-story building with three bedrooms and two bathrooms which are set up as follows: · Bedroom #1 (Master) has one bed sleeps the applicant and has a master bathroom · Bedroom #2 (Client's) was vacant has one full bed, it will sleep one client. · Bedroom #3 (Client's) was vacant has two twin beds, it will sleep two client's. · A great room/living room, kitchen, dining area, two bathrooms, an attached two car garage, and the backyard. The Client's bedroom was arranged so that no more than two clients will be in the room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There was a smoke detector in every bedroom. The three smoke detectors were checked, and they were working properly. The Carbon Monoxide detector is located in the hallway and was working properly. There is a dedicated phone line. The home's central air conditioning module was located in the linen closet. The home's hot water heater was located inside the garage. The appliances were in working order. The client's files will be locked in the hall closet on the top shelf. There was adequate food storage space. There was not a two day supply of perishable foods and a week of non-perishable foods. A proper storage of all food was discussed. A trash can for storage of solid waste did not have a tight fitting lid. The sharp knives are in a locked kitchen drawer. The medications are located in a locked cabinet in the hallway. The hot water in bathroom one (master) measured to be 113.3 degrees Fahrenheit and in bathroom two 112.1 degrees Fahrenheit. The home's First Aid kit was accessible and is located in the closet in the hallway. One fire extinguisher was present in the home and is located on the wall by the sliding glass door. It was observed to be properly charged and inspected by the fire department. There is no firearm in the home as stated by the applicant. There is no pool or other body of water. The backyard where clients will have access to play was fenced. The following items need to be corrected Two day supply of perishable food Seven day supply of non-perishable foods Trash can with a tight fitting lid for the kitchen The request for a license will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to Reginald Campbell.

met_with: Reginald Campbell


summary: Facility Evaluation

raw_content:
Narrative:
On September 30, 2024 at 09:50AM, Licensing Program Analyst (LPA) Rachel Vanegas arrived unannounced to Gale Solutions Small Family Home for the purpose of conducting a post-licensing annual inspection. LPA met with Licensee - Reginald Campbell, who led a tour of the home, both inside and outside. The single story home contains three bedrooms and two restrooms which are set up as follows: Bedroom #1 - is the master bedroom with one bed that sleeps the licensee. It has one master restroom. Bedroom #2 - has one toddler bed and sleeps one client. It has adequate storage for personal belongings in a drawer chest and bedroom closet. There are spare linens and pillows in the bedroom closet. Bedroom #3 - has two single beds and sleeps two clients. There is adequate storage for personal belongings in drawers and the bedroom closet. Bedrooms are arranged so that no more than two clients are in one room. There are no rooms that are commonly used for other purposes used as a bedroom and no bedroom serves as a passageway to another room. There is a living room, kitchen, dining area, full pantry, attached two car garage entry door which remains locked, and one locked storage closet in the hallway that securely stores chemicals, sharps/knives, and medication and the children in care do not have access. There is a patio sliding door that leads to the backyard from the kitchen. The fire extinguisher is properly charged and inspected and is accessibly located in the kitchen near the patio door. The second restroom to the home is located near bedroom #3 and is in good repair at this time. The facility has a fireplace in the living room observed to be properly screened. LPA observed a minimum of 7 days of non-perishable food in the pantry and a 2 day perishable supply of food. A first aid kit was accessible in the living room and contained all required items. **Continued on LIC 809-C** Telephone service and appliances were in working order. The kitchen hot water temperature was measured and registered at 114.8 degrees F. There are no firearms or weapons on the facility grounds as stated by the licensee. Inside the facility there were operable smoke detectors and carbon monoxide detectors located in the hallways to bedrooms and common areas. There are accessible games and toys that were observed to be safe, clean, and age appropriate for the children in care. The backyard was observed to be clean and free of hazards. The backyard has a toddler trampoline, toddler bikes, and a small play yard set-up for outdoor activities for the children in care that are observed to be clean and appropriate. There is no pool or other body of water at the facility at this time. LPA conducted three client file reviews and observed documents in the files including: needs and services plans, consent to medical treatment authorization forms, placement agreements, etc. Three out of three files did not contain documented results of tuberculosis (TB) screening for Client 1 (C1), Client 2 (C2), and Client 3 (C3). LPA conducted five staff file reviews for Staff 1(S1), Staff 2 (S2), Staff 3 (S3), Staff 4 (S4), and Staff 5 (S5) and observed that five out of five staff files contained needed documents including CPR/First Aid certificates, Drivers License, Application for Employment, Job Duties, Background Clearance, Health Screening, etc. The facility is being cited one Type B violation in accordance with California Code of Regulations (CCR) (Title 22) 80069(c)(1) for not having documentation of a medical/TB examination on file for C1, C2, and C3 within 30 days of admission. An exit interview was conducted and a copy of this report, LIC 811, and appeal rights were reviewed and provided to the licensee, Reginald Campbell.

met_with: Reginald Campbell - Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On September 30, 2024, Licensing Program Analyst (LPA) Rachel Vanegas conducted a required annual inspection with the post licensing inspection. Due to technical difficulties, completion of the required annual inspection was not recorded. The purpose of this report is to record the annual inspection that was completed. A copy of this report and appeal rights were reviewed and provided to the Licensee, Reginald Campbell. This report was sent to licensee electronically for signatures and original signatures are in the facility file.

met_with: Licensee - Reginald Campbell


facility_name: GALLEGOS SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On Wednesday June 9, 2021 at 1: PM Licensing Program Analyst (LPA) Linda Haynes and Licensing Program Manager (LPM) Stephanie Hudak conducted an annual inspection of the facility. The facility was toured inside and out with licensee Nancy Gallegos. The home is a two story residence with five bedrooms and 3 bathrooms. There is currently no placement's at this time. Bedrooms are arranged so that no more than two children share a room and there is one child per bed. There is adequate shelf and closet space. Locks were placed on the closets at this time due to Regional Center recommendation. There were no lights in the bedrooms due to behaviors of children in the bedroom unplugging and plugging light fixtures, but were available in closet. The screen in bedroom number one was torn and had a screw lock on it due to behaviors of children opening the window from 2nd story. Bathroom number 1 upstairs, 2nd sink to right, did not drain; bathtub had broken tile an dead roach. All hazardous items have been properly made inaccessible. Cleaners and chemicals are locked in the garage. The medications are stored in a locked cabinet in the kitchen. Sharp knives are inaccessible and stored in a locked drawer in the kitchen. The facility outside grounds was also inspected and it was observed to be clean and well maintained. There is a swimming pool located at the facility the gate is wrought iron, five foot tall with no more than four inches between the wrought iron bars. The spring on the gate needs to be replaced in order for it to self latch. The back gate has a lock on it that needs to be removed as it is an emergency exit. LPA and LPM reviewed caregivers files. All caregivers have Department of Justice and Child Abuse Index Check clearances, first aid and CPR cards are current. All training records are current. Licensing fees are due on 6/14/21 and still need to be paid. Based on the inspection this date, there are no deficiencies being cited due to no clients in placement. Also, since the licensee now has guardianship over three children and has adopted another, there is only enough space for two placements based on the capacity of 6. Licensee was made aware that CCL will need to obtain a new LIC 200 to decrease capacity to 2. Licensee stated that they will be in discussion with Regional Center to see if she will be keeping her license. If licensee decides to keep license and accept additional placements, licensee will need to contact LPA to complete a health and safety inspection based on possible violations observed today. Exit Interview conducted and a copy of this report provided to licensee Nancy Gallegos.

met_with: Nancy Gallegos


summary: Facility Evaluation

raw_content:
Narrative:
On November 17, 2023 at 9: AM, Licensing Program Analyst (LPA) Linda Haynes began an annual inspection for Gallegos Small Family Home license. LPA met with Licensee Nancy Gallegos who led a tour of the home. The facility was toured both inside and out with the applicant. There are no clients in placement at this time. The home is a two story building with four bedrooms and 3 bathrooms which are set up as follows: · Bedroom #1 (Master) has one bed sleeps the applicant · Bedroom #2 (sons) has two twin beds; it sleeps two son's. · Bedroom #3 (Daughters) has two twin beds; it sleeps two daughters. · Bedroom #4 (Clients) has two twin beds; it will sleep two client's. · A great room/living room, kitchen, dining area, 3 bathrooms, laundry room, a two car garage and the backyard. The Client's bedrooms were arranged so that no more than two client's will be in the room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There was a smoke detector in every bedroom. The four smoke detectors were checked, and they were working properly. The carbon monoxide detector was working properly and is located in the hallway. There are two fire extinguisher's located in the home. One is located in the kitchen and one is located in the upstairs hallway. They were both properly charged and inspected by the fire department. An exit interview was conducted. A copy of this report and appeal rights was provided to Nancy Gallegos.


summary: Facility Evaluation

raw_content:
Narrative:
On May 28, 2025, Licensing Program Analysts (LPAs) Jacob Ortega, Raina Perez, and Licensing Program Mangaer (LPM) Nicole Strickland began an annual inspection for the Gallegos Small Family Home license. LPA's and LPM met with Licensee Nancy Gallegos, who conducted a guided tour of the home. The facility was toured both inside and out. At the time of the visit, there were no clients in placement. The home is a two-story residence containing four bedrooms and three bathrooms. The master bedroom, Bedroom #1, contains one bed and is occupied by the applicant. Bedroom #2, designated for the licensee's sons and has two twin beds to accommodates both children. Bedroom #3, designated for the licensee's daughters, also has two twin beds to accommodates two children. Bedroom #4 is designated for client use and contains twin beds, which will accommodate up to two clients. The home also includes a living room, kitchen, dining area, a laundry room, a two-car garage, and a backyard with a pool that is surrounded by a five foot fence. The client's bedroom are arranged to ensure that no more than two clients will share a room. There was adequate closet space for the clients' belongings. Each bedroom was equipped with a smoke detector. LPA tested all smoke detectors, and they were found to be functioning properly. Additionally, the carbon monoxide detector, located in the hallway, were operational. Two fire extinguishers were observed in the home. One was located in the kitchen and the other in the upstairs hallway. Both fire extinguishers were fully charged and had been inspected by the fire department. At the time of inspection no deficiencies were noted and a copy of this report was given to Nancy Gallegos.


facility_name: GAUTHIER FAMILY CARE

summary: Facility Evaluation

raw_content:
Narrative:
On August 23, 2023 at 1: PM, Licensing Program Analyst (LPA) Linda Haynes began a pre-licensing inspection for Gauthier Family Care Small Family Home license. LPA met with applicant Justin Gauthier who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there is no client in the home. The applicant is applying to serve 2 clients ages 3 to 17. The home is a three-story building with three bedrooms and three bathrooms which are set up as follows: · Bedroom #1 (Master) has one bed sleeps the applicant and spouse and has a master bathroom · Bedroom #2 (Bio Childrens) has two twin beds, it sleeps the bio children. · Bedroom #3 (Client's) was vacant has two twin beds, it will sleep two client's. · A great room/living room, kitchen, dining area, three bathrooms, an attached two car garage, an office,a laundry room, and the backyard. The Client's bedroom was arranged so that no more than two clients will be in the room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There was a smoke detector in every bedroom. The three smoke detectors were checked, and they were working properly. The Carbon Monoxide detector is located in the kitchen and was working properly. There is a dedicated phone line. The home's central air conditioning module was located on the patio. The home's hot water heater was located inside the garage. The appliances were in working order. The client's files will be locked in the office. There was adequate food storage space. There was a two day supply of perishable foods and a week of non-perishable foods. A proper storage of all food was discussed. A trash can for storage of solid waste had a tight fitting lid. The sharp knives are in a locked closet outside the kitchen. The medications are located in a locked closet outside the kitchen. The hot water in bathroom one (master) measured to be 117.4 degrees Fahrenheit and in bathroom two 117.7 degrees Fahrenheit. Bathroom three sink needs to be repaired then can measure the hot water. The home's First Aid kit was accessible and is located in a cabinet in the kitchen and contains all required supplies. One fire extinguisher was present in the home and is located on the wall by the sliding glass door. It was observed to be properly charged and inspected by the fire department. There is no firearm in the home as stated by the applicant. There is no pool or other body of water. The backyard where clients will have access to play was fenced. The following items need to be corrected · Bathroom three sink needs to be repaired then hot water temperature measured. · Screen to sliding glass door needs to be repaired. The request for a license will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report was provided to Justin Gauthier.

met_with: Justin Gauthier


summary: Facility Evaluation

raw_content:
Narrative:
ON August 23, Licensing Program Analyst (LPA) Linda Haynes met with applicant Justin Gauthier for the Component III.


summary: Facility Evaluation

raw_content:
Narrative:
On September 16, 2024 at 02:20PM, Licensing Program Analyst (LPA) Rachel Vanegas arrived to the facility listed above for the purpose of conducting a post-licensing annual inspection. LPA met with Licensee Justin Gauthier who led a tour of the home. The facility was toured inside and outside with the licensee. The home is a two story home that consists of the following: The first floor contains two living rooms, (one of the living rooms contains board games and toys that were observed to be safe, clean, and age appropriate for the children to be cared for and used for visitation) a kitchen, a pantry, a dining table, a locked garage that children in care do not have access to, a locked storage room that contains knives/sharps and medication and chemicals, and one restroom. The first aid kit is stored in a kitchen cabinet and contains the necessary materials. There is a patio door that leads to the backyard that was observed to be clean and free of hazards. The first floor has one properly charged and accessible fire extinguisher located by the patio door near the kitchen. The second floor contains four bedrooms, a laundry room, a storage closet that contains spare linens, bedroom #1, bedroom #2, bedroom #3, bedroom #4, and two additional restrooms. The full bathroom upstairs allows access through a shared door. There is a lock on each door that restricts access to others while it is in use. Bedroom #1 - Is the master bedroom that sleeps the licensee and spouse. Bedroom #2 - Is set up with two single beds and sleeps the licensee biological children. Bedroom #3- Is set up with one single bed and contains adequate storage for personal belongings. Bedroom #4- Is set up with one full bed and contains adequate storage for personal belongings. **Continued on LIC 809-C** Bedrooms were arranged so that no more than two children share a room and have one child per bed. No room commonly used for other purposes is used as a bedroom and no bedroom serves as a passageway to another room. There is a second fire extinguisher charged and accessible in the hallway on the second floor. Inside the facility there were operable smoke detectors located in each bedroom and common areas. There was also an operable carbon monoxide detector located in the hallway. Telephone service and appliances were in working order. All hazardous items such as cleaning products and laundry detergent have been properly made inaccessible to areas where children will not have access. The current census is Zero. The Facility License, Facility Sketch, Emergency Disaster Plan, Personal Rights, meal menus, etc. were posted in the kitchen. There are no guns or weapons on the facility grounds, as stated by the Licensee at this time. The facility is issued one technical violation for California Code of Regulations section 80019(e)(3). LPA observed that Staff 2 (S2) was not associated to the current facility. An exit interview was conducted and a copy of this report and appeal rights were reviewed and provided to Licensee - Justin Gauthier.

met_with: Justin Gauthier - Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On September 16, 2024, Licensing Program Analyst (LPA) Rachel Vanegas conducted a required annual inspection with the post licensing inspection. Due to technical difficulties, completion of the required annual inspection was not recorded. The purpose of this report is to record the annual inspection that was completed. A copy of this report and appeal rights were reviewed and provided to the Licensee, Justin Gauthier. This report was sent to licensee electronically for signatures and original signatures are in the facility file.

met_with: Licensee - Justin Gauthier


summary: Facility Evaluation

raw_content:
Narrative:
On October 23, 2024 at 12: PM, Licensing Program Analyst (LPA) Rachel Vanegas arrived at Gauthier Family Care for a continuation of an unannounced post licensing annual inspection. LPA was met by the licensee, Justin Gauthier. The Physical Plant and Operation Requirements were inspected on September 16, 2024. LPA continued the inspection by conducting staff file reviews for Staff 1 (S1) and Staff 2 (S2). LPA observed documents in the file(s) including: Drivers License, Background Clearance, signed acknowledgment for child abuse and neglect reporting, etc. Staff files for S1 and S2 did not contain documentation for duties of the employee and current Cardio Pulmonary Resuscitation (CPR) certification. Based on observation and record review, the facility is issued two technical violations in accordance with California Code of Regulations (CCR) Title 22 80066(a)(8) for not having documentation regarding duties of the employees and CCR Title Section 83075(f)(2) for not maintaining current CPR certification. An exit interview was conducted and a copy of this report, LIC 811, LIC 9120, and appeal rights were reviewed and provided to the licensee, Justin Gauthier.


summary: Facility Evaluation

raw_content:
Narrative:
On June 18, 2025 at 10: AM, Licensing Program Analyst (LPA) Rachel Vanegas completed a pre-licensing inspection of Gauthier Family Care Small Family Home (SFH). LPA met with Applicant Justin Gauthier who led a tour of the home. The SFH was toured both inside and out with the applicant. Currently there are no clients in placement. LPA received Surety bond with original seal, Tuberculosis and Health Screening for Spouse in the home, updated LIC 500, updated LIC 420, and updated LIC 999 during this visit. The home is a two story building with five bedrooms and three bathrooms which are set up as follows: Bedroom #1 (Office) this room is the office and is locked and inaccessible to clients in care. Client and staff records are stored in the office. This room will not sleep any residents or clients. Bedroom #2 (Master) has one bed and sleeps the Applicant, Spouse, and infant child. Bedroom #3 (Biological Child) has one bed and sleeps the applicants biological child. Bedroom #4 (Guest) has one bed and will be utilized as needed for guest. It is locked and inaccessible to clients in care. Bedroom #5 (Clients) has two beds and will sleep two clients. There is one dresser and adequate closet storage space for two clients. The rest of the home contains a great room/living room, kitchen, dining area, three bathrooms, access door to the attached garage that remains locked and inaccessible to clients in care, and the backyard. The client's bedrooms were arranged so that no more than two clients' will be in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. ** ** There was a smoke detector in every bedroom and hallway. All smoke detectors were checked and they were working properly. There are two carbon monoxide detectors in the home located in the hallway on the first floor and one in the hallway on the second floor. The carbon monoxide detectors were checked and working properly. The home's central air conditioning module was located in the backyard. The home has a tankless water heater located in the garage and is set at a temperature of 120 degrees Fahrenheit. The hot water measured in the kitchen and registered at 117.2 degrees Fahrenheit. The home appliances were in working order. There was a functioning home phone available in the kitchen. There was adequate food storage space. There was a 2 day supply of perishable and a 7 day supply of non-perishable food in the home. A trash can for storage of solid waste had a tight-fitting lid and was present in the kitchen. The sharp knives are in a locked cabinet in the kitchen. The medications will be located in a locked cabinet in the kitchen and inaccessible to clients in care. Cleaning chemicals are located in a locked storage closet on the first floor and are inaccessible to clients in care. The home's First Aid kit was accessible and located in a kitchen cabinet. It contained all the required supplies. There were two fire extinguishers present in the home. One is located in the Kitchen and one is located near the laundry room. They were observed to be properly charged and inspected by the fire department. There are no firearms in the home as stated by the applicant. There is no pool or other body of water at the home. The backyard where clients will have access to play is fenced and free from hazards. The home has 6 security cameras. 3 are located inside (front door, living room, loft) and 3 are located outside (front yard, door bell, and backyard). The following corrections need to be made for the application review: Add one dresser/drawer to client room Complete Criminal Record Clearance Guardian Transfer Request for spouse residing in the home An exit interview was conducted a copy of this report and appeals rights were reviewed and provided to applicant, Justin Gauthier. Application will be forwarded to the Licensing Program Manager for Licensing.

met_with: Applicant - Justin Gauthier


summary: Facility Evaluation

raw_content:
Narrative:
On January 30, 2026 at 01:07pm, Licensing Program Analyst (LPA) Rachel Vanegas made an announced visit to Gauthier Family Care Small Family Home (SFH) for the purpose of interviewing Witness 2 (W2) and Witness 3 (W3) regarding an incident that occurred at a different facility. LPA conducted an exit interview with Justin Gauthier, Licensee. A copy of this report, LIC 811, and appeal rights were reviewed and provided to Justin Gauthier, Licensee.


facility_name: GENESIS 1 FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On December 16, 2025, Licensing Program Analyst (LPA) Maryjane Perez met with applicant Sheryl Harden this date for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the LIC 184, Letter of Application Revision, and additional correspondence to assist with the revisions needed to the application. A copy of this report was provided to applicant Sheryl Harden.

met_with: Applicant- Sheryl Harden


summary: Facility Evaluation

raw_content:
Narrative:
On March 13, 2026, Licensing Program Analyst (LPA) Maryjane Perez arrived at Genesis Family Home Small Family Home (SFH) for a pre-licensing inspection for an initial license. LPA met with applicant Sheryl Harden who led a tour of the entire home inside and outside. The applicant is applying to serve two ambulatory children ages 3 to 17 years old. Currently there are no clients placed in the home. The home is a two-story building with four bedrooms and three bathrooms. The downstairs consisted of an entry way with a living room that had couches and a screened fireplace,and French doors leading to the side yard. There was a hallway that had all required postings such as emergency disaster plan, personal rights, facility sketch and visitation policy. There was a family room that had couches, a TV, telephone service and a locked storage closet that stored cleaning supplies, laundry detergents, sharp objects/ knives and a locked medication box. The kitchen was clean and sanitary with a refrigerator and pantry fully stocked with perishable and non-perishable foods, a menu, and a refrigerated medication lock box. There was also a dining table/ counter space with adequate seating and a fire extinguisher that was operable. Bedroom #1 was for applicant and had a king size bed, a closet, computer space and French doors leading to the backyard. There was a laundry room that was accessible to clients but had all laundry essentials locked away. Bathroom #1 had a toilet, sink, trash can with a lid and walk in shower all functioning. Water temperature was measuring 107.6 degrees Fahrenheit. The upstairs consisted of a hallway that had cabinets with extra towels, linen, and bedding. There was a first aid kit with all required elements. Bedroom #2 was utilized for two clients and had two twin size beds- currently vacant, dresser/ closet space, lighting, and a sliding door leading to a balcony that is locked at all times. Bathroom #2 was fully functioning with a sink, shower/ bathtub, toilet, and trash can with a lid. Bedroom #3 was utilized for one client and had a full size bed with dresser/ closet space, all required bedding and lighting. There was bedroom #4 that was fully vacant and had a TV, a sliding door leading to the balcony that was locked at all times, and bathroom #3 that was fully functioning with dual sinks, a shower/bathtub. There was an office that stored a locked file cabinet for client records, employee files, and clients cash resources that was locked at all times. Bedrooms were arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. The smoke detectors and carbon monoxide detectors were checked and are working properly. All hazardous items have been properly made inaccessible to areas where children will have access. There was a telephone service, all appliances were in working order, and all trash cans for storage of solid waste had tight fitting lids. The garage had a parked vehicle and was free of hazards. The backyard where children will have access to play was completely fenced, had a gate with a latch and was free of hazards. There were no pools or other bodies of water and no weapons/firearms as stated by applicant. Based on this inspection, there are no corrections needed at this time therefore, the home is appropriate for a capacity of two ambulatory clients. The request for licensure will be forwarded to Licensing Program Manager for final approval. Component III orientation was also completed this day of March 13th, 2026. An exit interview was conducted and a copy of this report was provided to applicant Sheryl Harden.


facility_name: GENESIS FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On September 10, 2024, Licensing Program Analyst (LPA) Rafael Enriquez met with applicant Sharon Green for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the notification of incomplete application (LIC 184), Letter of Application Revisions, and additional correspondence to assist with the revisions needed to the application. Copy of this report was emailed to applicant and a signed copy will be placed in the facility file.

met_with: Applicant- Sharon Green


summary: Facility Evaluation

raw_content:
Narrative:
On October 14, 2024, at 9: AM, Licensing Program Analyst (LPA) Rafael Enriquez began a pre-licensing inspection for Genesis Small Family Home for an initial license. LPA met with applicant Sharon Greene who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there are no children placed in the home. The applicant was approved to serve three children ages 0 to 17. The home is a Two-story building with three bedrooms and three bathrooms which is set up as follows: Downstairs: · Bedroom #1 will sleep one foster child, It was furnished with a full sized bed. It was vacant. · Bedroom #2, the master bedroom, it was furnished with a Cal-king sized bed, it had a bathroom and a walk-in closet. It sleeps the applicant. · There was also a living room area, a dining area, a kitchen, a laundry room, a bathroom, and a storage closet. Upstairs: · Bedroom #3, is a guest room, might be used as a client room in the future, It was furnished with a queen sized bed. It was vacant. · There was also a loft, and a bathroom. Bedrooms were arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. The smoke detectors and carbon monoxide detectors were checked, and they were working properly. Telephone service and appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients/children will have access. Sharp knives and sharp objects were locked in a cabinet in the laundry room. Cleansers/chemicals were inaccessible and stored in a locked cabinet in the laundry room. There was adequate food storage space and a supply of three days of perishable foods and a week of non-perishable food. A proper storage of all food was discussed. Trash cans for storage of solid waste had tight fitting lids. The water temperature was observed to be at 115.8 degrees. First Aid kit was accessible with all required items, and it was under the kitchen sink. A Fire extinguisher was observed and properly charged. All the appropriate forms were posted in view of facility clients. As stated by applicant, there were no weapons/firearms and there were no pools or other bodies of water. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request for licensure will be forwarded to Licensing Program Manager for final approval. Applicant was advised to contact the department within 30 days of their first placement. An exit interview was conducted. A copy of this report was provided to applicant Sharon Greene.

met_with: Applicant -Sharon Greene


summary: Facility Evaluation

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Narrative:
On April 17, 2026, at 10: AM Licensing Program Analyst (LPA) Julian Lucas arrived at Genesis Small Family Home to conduct an annual random inspection. LPA met with Administrator Sharon Greene. At 10:25 am, the LPA conducted a walk through of the facility. During the physical plant inspection, LPA observed a two story house with a formal entry. LPA observed downstairs consisted of a hallway closet with first aid kit, a bathroom with water temperature reading at 113.7 degrees Fahrenheit, bedroom one is occupied by one foster child, it consists of a full size bed. Bedroom two is the master bedroom for the administrator. It consists of a bed and a bathroom including a closet. There is a washer, dryer including detergent and cleaning supplies. LPA observed foster child's meds in a locked closet and lock box. There is an L-shaped sofa, a television, and a formal table with four chairs in the living room. The kitchen has a center counter top with three chairs and a sink with water temperature reading at 110.8 degrees Fahrenheit. There is a refrigerator/freezer fully stock with non-perishable food. The cabinets are fully stocked with perishable and non-perishable foods. LPA observed a house telephone with service, knives and sharp objects were locked and not accessible to children. There are postings of the facility sketch, Grievance Procedures, Visitation Policies, Youth Bill of Rights in English and Spanish, and posted on the wall. There is a storage closet, and hallway with fire extinguisher and a locked garage. Continued on LIC 809-C The second floor consists of a bedroom, consisting of one full size bed which is currently vacant, a bathroom in hallway, a small loft with furniture, a hallway closet stocked with linen and towels. All beds have the appropriate linens, pillows, comforters, and mattresses in good repair. There are dressers and closet space for each client's belongings. The smoke detectors and carbon monoxide detectors, and fire extinguishers were checked, and they were working properly. Appliances were in working order. LPA reviewed one client file and two staff files. Based on the annual random inspection on this date, there were no deficiencies found. An exit interview was conducted with the Administrator, Sharon Greene. . Exit interview conducted. A copy of this report and LIC 811 were provided to the Administrator, Sharon Greene.

met_with: Sharon Greene, Administrator


facility_name: GIGI'S NINTH STREET HOUSE

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA), Lidia Tinoco conducted an unannounced visit to the Gigi's Ninth Street House Small Family Home in order to deliver the findings of the above allegations and met with Licensee, Gigi Horn. On July 11, 2025, the above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, confidential interviews, and review of records. Based on the investigation conducted, the department found that there was conflicting information regarding these issues. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the allegations occurred. Therefore, the allegations are Unsubstantiated at this time. A copy of this report was provided at the conclusion of the inspection along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco 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: Gigi Horn


summary: Facility Evaluation

raw_content:
Narrative:
On this date. Licensing Program Analyst (LPA) Lisa Slusher completed a required annual inspection of the small family home locate in Fresno, CA. LPA was met at the facility by Licensee Gigi Horn. LPA toured the facility, inside and out. The home is licensed to serve four clients. There is currently 1 client in placement. Present during the inspection was Licensee . The client was at school during inspection. A review of staff records on October 1, 2021 indicated that all facility staff associated to the facility received fingerprint and child abuse index check clearances. Facility has no active waivers or exceptions. There are no bodies of water and no weapons at the facility, per the Licensee. Hot water measured 120 degrees. Medications were securely stored in locked cabinet in the kitchen area. Licensee's bedroom is locked at all times Furniture was in good repair. Outdoor area free of hazards. There were no deficiencies cited on this date, however, a Technical violation for chemicals (dog washing chemicals) in an area accessible to youth. Exit interview conducted, appeals rights left at the facility and a copy of the report was left at the facility. LPA forwarded link for current Mandated reporter training offered by DSS.


summary: Facility Evaluation

raw_content:
Narrative:
On March 24, 2022, Licensing Program Analyst (LPA) Leslie Inouye conducted an unannounced annual required inspection at the facility. LPA met with Gigi Horn, Licensee. An inspection of the facility was conducted and the following was observed: Client and staff file were inspected on this date. The facility was inspected indoors and outdoors. Hot water temperature measured below 120 degrees. LPA observed adequate supply of perishables and non-perishables. LPA observed adequate supply of furnishings, linen and storage space for clients. Cleaning chemicals inaccessible to clients. Medications centrally stored and locked. There is one pet at the facility. There is no swimming pool or hot tube at the facility. Per Licensee, there are no weapons at the facility. There have been no deficiencies in the prior 12 months. A review of staff records on the above date, indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. No deficiencies were noted on todays visit. LPA left a copy of this report at the facility. The visit was then concluded.


summary: Facility Evaluation

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Narrative:
On April 4, 2023, Licensing Program Analyst (LPA) Wayne Aoki conducted an unannounced annual required inspection at the facility. LPA met with Gigi Horn, Licensee. An inspection of the facility was conducted and the following was observed: Client and staff file were inspected on this date. The facility was inspected indoors and outdoors. Hot water temperature measured 112 degrees in the kitchen sink.. LPA observed supply of perishables and non-perishables. LPA observed supply of furnishings, linen and storage space for clients. Cleaning chemicals inaccessible to clients. Medications centrally stored and locked. There is one pet at the facility. There is no swimming pool or hot tube at the facility. Per Licensee, there are no weapons at the facility. There have been no deficiencies in the prior 12 months. LPA requested the Licensee to provided updated forms for the following by April 30, 2023: LIC 500, LIC 400, LIC 610C A review of staff records on the above date, indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. There were no deficiencies cited during this inspection. LPA left a copy of this report at the facility. The visit was then concluded


summary: Facility Evaluation

raw_content:
Narrative:
On June 28, Licensing Program Analyst (LPA) Wayne Aoki travelled to Gigi's Ninth Street House to continue the Annual Inspection. LPA was met by Licensee, Gigi Horn. Currently Ms. Horn currently has 1 minor in placement. This minor is the same and only minor that was in placement on April 4, 2023 when the Annual Inspection was conducted. LPA conducted a physical Inspection of the home. During today's physical plant inspection there were no firearms observed in the facility. On April 4, 2023, the LIC 809 stated that "Per Licensee, there are no weapons at the facility." This was verified during the physical plant inspection on that date. LPA observed interactions between Ms. Horn and the minor in care. Although the minor is non-verbal, Ms. Horn is able to communicate with the minor as he is receptive but only can carry out no more than 2 basic/simple commands. LPA attempted to interview the minor but due to his non-verbal nature, LPA was unable to complete the interview process with the minor. LPA interviewed Ms. Horn regarding the staff questionnaire. There were no deficiencies cited during this inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On April 26, 2024, Licensing Program Analyst (LPA) Leslie Inouye conducted an unannounced annual required inspection at the facility. LPA met with Gigi Horn, Licensee. An inspection of the facility was conducted and the following was observed: Client and staff file were inspected on this date. The facility was inspected indoors and outdoors. Hot water temperature measured below 120 degrees. LPA observed adequate supply of perishables and non-perishables. LPA observed adequate supply of furnishings, linen and storage space for clients. Cleaning chemicals inaccessible to clients. Client is currently taking no Medications at the facility. There is one pet at the facility. There is no swimming pool or hot tube at the facility. Per Licensee, there are no weapons at the facility. There have been no deficiencies in the prior 12 months. A review of staff records on the above date, indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. No deficiencies were noted on todays visit. LPA left a copy of this report at the facility. The visit was then concluded.


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On the above date, Licensing Program Analysts (LPAs), Lidia Tinoco and Olivia Medrano arrived at Gigi's Ninth Street House Small Family Home for the purpose of conducting an unannounced Annual/Random inspection. LPA met with Administrator, Gigi Horn and inspected the facility, inside and out. Centrally stored medications are maintained in a locked cabinet. Sharps and Toxic chemicals are kept locked. The facility has a written emergency disaster plan. Facility smoke detectors were observed and appear to be in appropriate working order, fire extinguisher is properly charged. Individual beds were observed with appropriate clean linens and are in good repair. There is at least one-week supply of nonperishable and a two-day supply of perishable foods. Facility has cameras in common areas of the facility including outside and living room. Information regarding cameras provided to licensee. No firearms or weapons are allowed in the facility. Administrator is present at the facility a minimum of 20 hours a week, as verified by staff schedule and interviews. Appropriate staff/client ratios were verified during this inspection. 3 records of personnel/staff members were reviewed. Personnel Files are maintained on-site. 1 records of clients were reviewed and 1 client was interviewed. 1 staff was interviewed. 1 type A deficiency is being cited and Technical Violations. Plans of Corrections were reviewed and developed with the Licensee. A copy of this report and appeal rights were provided at the conclusion of the inspection.

Deficiencies:
80019(e): Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst(LPA), Lidia Tinoco arrived at Gigi's Ninth Street House Small Family Home and met with Administrator, Gigi Horn. LPA Tinoco informed the Administrator that the purpose of the visit was to provide an updated Amended report for the Annual Inspection conducted 04/18/25. LPA provided a copy of this report at the conclusion of the inspection.