summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
preponderance of evidence of C1 being sexually abused by S1 by S1 bribing C1 to participate in sexual activities. Based on record review and confidential interviews the allegations alleging Staff (S1) sexually abused a minor (C1) in care and staff (S1) bribed minor are substantiated. The complaint allegations are valid because the preponderance of evidence standard has been met. Facility is cited for two violations of Interim Licensing Standards (ILS) v.4 standard PERSONAL RIGHTS (c)(11) To be free of physical, sexual, emotional, or other abuse, and from corporal or unusual punishment, exploitation, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature including, but not limited to, interference with the daily living functions of eating, sleeping, or toileting, or withholding of shelter, clothing, or aids to physical functioning which posed an immediate Health, Safety or Personal Rights risk to children in care. The facilities violation of ILS v.4 standard PERSONAL RIGHTS (c)(11) which resulted in C1 being sexually abused by S1 requires the facility to be assessed an immediate civil penalty per Health and Safety Code 1548(c)(1). An Enhanced Civil Penalty (ECP) determination is pending. If an ECP is assessed a Community Care Licensing (CCL) representative will return to the facility to deliver the penalty assessment. A copy of the report was discussed and provided along with Civil Penalty assessment and appeal rights to Trinity-Yucaipa Teresa Valles, Administrator.

Investigation Findings:
13On October 20, 2023 pm Licensing Program Analyst (LPA), Nicole Strickland met with Trinity-Yucaipa Administrator Tersesa Valles, to deliver the findings for the above stated allegations. The investigation was conducted by Special Investigator (SI) Dennis Seng and LPA N. Strickland and included interviews with Assistant Campus Director, five residents (Child #1 [C1], Child #2 [C2], Child #3 [C3], Child #4 [C4], and Child #5 [C5]), and four staff (Staff #1 [S1], Staff #2 [S2], Staff #3 [S3] and Staff #4 [S4]). In addition, county records and facility records were reviewed. On June 16, 2023, Community Care Licensing (CCL) received two allegations alleging Staff (S1) sexually abused a minor (C1) in care and staff (S1) bribed minor (C1). Specifically, it was reported when C1 resided at the facility, S1 propositioned C1 for sexual activities in exchange for items including drugs, candy, and things unavailable at the facility. Consistent confidential interviews and record review provided a SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: TRINITY - YUCAIPAFACILITY NUMBER: VISIT DATE: 10/20/2023

met_with: Teresa Valles, Administrator


state: CA

facility_name: TRINITY HOUSE 2

summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Reported information received alleged that S1's inappropriate conduct towards a minor, not associated with the facility, poses a risk to minors in care. Based on gathered information, including inconsistent statements and a lack of corroborating evidence, the allegation is deemed unsubstantiated. Although the allegation may have happened or may be valid, there is not a preponderance of the evidence to prove S1's conduct poses a risk to minors in care. The finding is Unsubstantiated. There are no deficiencies cited at this time. Facility is no longer operating; no children in placement. On March 30, 2022, Licensing Program Analyst (LPA) Regina Martin mailed certified a copy of this report and confidential name form LIC811, to Facility Representative, CEO for signature.

Investigation Findings:
On June 22, 2021, an allegation regarding conduct inimical by Staff Member #1 (S1), was investigated by Community Care Licensing Division (CCLD) Investigations Bureau, Investigator Lorraine Patterson (see LIC811, dated 3/17/2022). On June 29, 2021, LPA Martin conducted the initial complaint inspection, spoke with Facility Administrator and obtained staff schedules. The investigation further included interviews with pertinent parties, including but, not limited to, complainant, alleged victim, alleged victim's parent, two residents, two staff members, S1 and review of related reports from the Oxnard Police Department revealed a lack of evidence to support alleged conduct inimical by S1. (Continued on page LIC9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Regina Martin LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: TRINITY HOUSE 2FACILITY NUMBER: VISIT DATE: 03/17/2022

report_type: Complaint Investigation

met_with: Facility Representative, CEO

complaint_status: unsubstantiated


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Investigation Findings:
13On May 10, 2022, Licensing Program Analyst (LPA) Enrique Hernandez sent by certified mail the findings of the complaint to the P.O Box on file due to facility closure. On November 20, 2020, the Department received a complaint alleging: Staff are sleeping during the evening shifts, Staff failed to properly supervise minors while in care and Staff inappropriately transports minors while in care. During the investigation process, LPA Hernandez conducted confidential interviews and gather information about the allegations. S2 confirmed falling asleep while working with the clients, which was corroborated by the clients and S3. Also, C2 confirmed to have thrown water on S4's face, due to S4 sleeping during the night shift. Although S4 denied falling asleep, this was confirmed during confidential interviews. In addition, S2 confirmed transporting the clients in his personal vehicle, which was confirmed by S3 and the clients. Based on LPA interviews and record reviews, the preponderance of evidence standard has been met, therefore the above allegations of Neglect/Lack of supervision are found to be SUBSTANTIATED. Deficiencies were cited to the facility for Neglect/Lack of supervision A copy of this report was sent by certified mail to the P.O. Box on file for the licensee's signature. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Enrique M Hernandez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: TRINITY HOUSE 2FACILITY NUMBER: 565801787

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

met_with: Sent to Cleo Anderson

complaint_status: SUBSTANTIATED


raw_content:
Narrative:
Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has decided that the allegations are unsubstantiated but if any additional information is received this complaint can be amended and finding can be changed. A copy of this report was sent by certified mail to the P.O. Box on file for the licensee's signature.

Investigation Findings:
13On May 10, 2022, Licensing Program Analyst (LPA) Enrique Hernandez sent by certified mail the findings of the complaint to the P.O Box on file due to facility closure. On November 20, 2020, the Department received a complaint alleging: Facility has inadequate record keeping and Facility is lacking the necessary resources to operate. During the investigation process there were contradictory statements from the parties involved. S3 stated that none of the notes have been change regarding incidents with the clients. Other statements also corroborated that they do not change any of the notes, although one statement says otherwise, there is not enough evidence of the facility changing the notes of incidents that happened with the clients.Confidential interviews revealed that the facility has the funds to operate and the reason the card was declined once was because the card has protection that when you go over a certain amount the card is declined. C1 stated that they told RP not to go over the $500 budget and RP still did. Continue on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Enrique M Hernandez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: TRINITY HOUSE 2FACILITY NUMBER: VISIT DATE: 05/10/2022

met_with: Cleo Anderson


summary: Facility Evaluation

raw_content:
Narrative:
On 10/27/2021 at 9:30AM Licensing Program Analyst (LPA) Olivia made an unannounced to Trinity House 2 for the purpose to conduct the Annual/Required licensing Inspection. LPA Rosas met with Staff#1(S1) who granted access to the facility and an inspection of the facility was conducted together. Individuals mention in this report are identify on the Confidential Names List (LIC811) dated 10/28/21. Temperature and health checks are conducted at the entrance in the sign-in area. LPA met with Staff#1 (S1), who granted access into the home, and who provided a tour of the entire physical plant. This facility has a provisional licensed to provide care and supervision for six (6) children ages 12-17 years old, Ambulatory only. The facility also provides services to non-minor dependents. The facility is in the process of obtaining Accreditation with Joint-Commission. They are in the process obtaining Mental Health Approval. There are no bodies on water on the premises. Staff confirmed that there are no firearms or dangerous weapons in the facility. The facility is current with their annual fees. LPA Rosas inspected the following: This is a one (1) story (STRP) Short Term Residential Therapeutic Program, located in a residential neighborhood. There are three (3) bedrooms, two (2) bathrooms, a living room, dining room, kitchen, staff office, backyard, and an attached garage for storage. There is one (1) facility vehicle parked outside inspected to be in good operating condition. Outdoor Area: There was no swimming pool or bodies of water on the premises. The activity space is free of hazard materials and debris. LPA observed a staff displayed the utility shut-off valves. The facility is surrounded by wooden fence and is observed to be good condition. Report continues on LIC 809-C Page 1 of Garage: The attached garage is used as storage and is kept locked. Laundry Room: The laundry room is located inside of the garage. The laundry is equipped with a washer and dryer unit that was observed to be in good condition. The laundry detergent is made inaccessible to the children and is disputed according the load of the laundry. Disinfectants and chemicals are locked in cabinets made inaccessible. Living Room: There is adequate furniture which appears to be in good condition. There is a television and fireplace that is non-operable. Staff Office: It is equipped office furniture (i.e desk, computers, printers). The medication is triple locked inside of the staff office. All the children prescribed medications are locked in the staff office and children files are kept in a lock cabinet. Staff office is located inside the main facility. The First Aid kit has the required items inside (age-appropriate, and scissors, tweezers, thermometer, and gauzes, antiseptic and First Aid Manual Guide. Dining Area: One table with six chairs is next to the Kitchen: There is a gas stove/oven with four (4) burners, all operating. There is a microwave, refrigerator/freezer and a toaster oven. LPA's observed adequate perishable/nonperishable food supplies. Sharp knives, disinfectants/cleaning solutions made inaccessible to the children locked in cabinets. Water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Bedroom # 1: Occupied by two (2) clients, the bedroom is equipped two (2) twin sized beds, comfortable mattresses, linen, blankets and pillows; adequate drawer and one (1) wall closet. There is adequate lighting and the windows have horizontal slide locked with curtains observed to be in good condition. This bedroom was a bathroom. Bedroom # 2: Currently occupied by two (2) clients, has two (2) twin sized beds and comfortable mattresses, linen, blankets and pillows; adequate drawer and one (1) walk in closet. There is adequate lighting and the windows have horizontal slide locked with curtains observed to be in good condition. Bedroom # 3: Currently occupied by two (2) clients. The bedroom has two (2) twin sized beds and comfortable mattresses, linen, blankets and pillows; adequate drawer and one (1) walk in closet. Report continues on LIC 809-C Page 2 of Bathrooms: There are two (2) bathrooms. Bathroom #1 is the common bathroom for the clients. It is a full-sized bathroom with a toilet, sink, and tub/showers. Bathroom #2 is located inside of Bedroom#1 is full-sized bathroom with a toilet, sink, and shower. Water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. LPA observed a key locked closet that stored hygiene supplies, and cleaning solutions. All windows were in good condition with screens and blinds. There were no security bars on the windows. LPA observed ample towels and linen closet. The passageways and porches are unobstructed. All posting requirements were met, (food menu, regulations, licenses, emergency disaster plan, Children's Personal Rights, and Ombudsman). The facility has a working telephone and youths can use the telephone unless restricted by court order. The Emergency Evacuation Plan is posted on the walls throughout the facility. The Facility operates within license conditions and limitations including capacity limitations. Facility has a current, written plan of operation. Facility personnel are instructed to report violations of personal rights. Licensee will report changes in the plan of operation affecting service to youths. Licensee will report youth injuries requiring medical treatment. A review of Facility's Personnel Report Summary on 10/28/2021 indicates that all personnel have criminal record clearance has obtain the necessary clearances with DOJ, FBI, and Child Abuse Response. LPA Rosas was not able to review youth or staff files during this visit and will return to continue with the annual inspection. Youth were in school during the inspection. LPA Rosas by email the following PINS to S PIN 20-17-CRP: New Background Check Requirements, Assembly Bill 819 (Chapter 777, Statutes of 2019), PIN 21-20-CRP: Statewide Launch of New Inspection Tools for Children's Residential Licensees, PIN 21-05-CRP: The Family Urgent Response System (FURS), Medications Guide TSP 2017-03 (version 08/23/21). There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was email to S1 for signature.

report_type: Facility Evaluation

visit_type: Annual

met_with: Staff#1 (S1)


summary: Facility Evaluation

raw_content:
Narrative:
On 01/13/2022 at 10:00AM Licensing Program Analyst (LPA) Olivia made an unannounced to Trinity House 2 for the purpose to verify facility closure. LPA Rosas, knocked the door and waited for response. LPA Rosas, waited and walked around the outdoor perimeter of the home (facility). LPA did not see or hear anyone at the facility. LPA Rosas, contacted CEO via phone and call went to voice mail. LPA, left a voice mail to return phone call to LPA Rosas. LPA Rosas will mail copy of report to the facility mailing address for signature.

visit_type: Case Management

met_with: CEO


facility_name: TRINITY HOUSE I

raw_content:
Narrative:
Staff video recorded resident without permission Confidential interviews revealed that no one has seen any member of staff recording clients. Although during the interviews someone said that staff was recording a client, no name of the staff was provided. Staff do not treat resident with respect Confidential interviews indicated that clients are treated with respect, and no one is disrespectful to the clients at the facility. This was corroborated by the social worker. Facility has mold Confidential interviews indicated that they are always cleaning the facility due to COVID. This was corroborated by the social worker. Staff did not ensure facility is free from insects Confidential interviews indicated that in the past there were ants in the facility, but not anymore and pest control comes every month to spray for any kind of bugs. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has decided that the allegations are unsubstantiated but if any additional information is received this complaint can be amended and finding can be changed. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 4.0, there are no deficiencies to be cited at this time. A copy of this report will be mailed to the mailing address we have on file for the licensee's signature

Investigation Findings:
13On March 9, 2022, Licensing Program Analyst (LPA) Enrique Hernandez sent by certified mail the findings of the complaint due to facility closure. On October 14, 2020, the Department received a complaint alleging Staff hit resident, Staff video recorded resident without permission, Staff do not treat resident with respect, Facility has mold and Staff did not ensure facility is free from insects. Confidential interviews were conducted, and the following information was obtained during the course of the investigation: Confidential interviews revealed conflicting statements about staff hitting a client. Information from the interview revealed that although a confidential interview claims to have been hit by staff, no one saw, and during the interview the name of the staff was not provided. Other interviews revealed that they have not seen marks or bruises on the client's body. This was corroborated by the social worker. Continue On LIC9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Enrique M Hernandez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: TRINITY HOUSE IFACILITY NUMBER: VISIT DATE: 03/09/2022

met_with: Licensee


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
The Department has decided that the allegations are unsubstantiated but if any additional information is received this complaint can be amended and finding can be changed. A copy of this report was sent by certified mail to the P.O. Box that we have on file for the licensee's signature.

Investigation Findings:
13On April 14, 2022, Licensing Program Analyst (LPA) Enrique Hernandez sent by certified mail the findings of the complaint due to facility closure. On November 30, 2021, the Department received a complaint alleging Minor was sexually abused by another minor in care and Staff did not prevent abuse of minor. The following information was obtained during the course of the investigation: During the investigation process there were contradictory statements from the parties involved. It was reported that C1 was often bother by other clients in the facility. C1 does not recall telling staff about being bother by the other clients. Other statements said that staff are always supervising them, and did not hear or see anyone bother or touching C1 inappropriately. Regarding the sexual abuse, C1 stated that it was mutual and occurred after the staff checked the rooms every 15 to 30 minutes. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Enrique M Hernandez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: TRINITY HOUSE IFACILITY NUMBER: VISIT DATE: 04/14/2022

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


raw_content:
Narrative:
The allegations may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. LPA Rosas and AGPA Barnes-Woodard conducted interviews with clients and facility staff that provided information on staff schedules and care and supervision. On 05/12/2021, reviewed a copy of LIC Personnel Report and found facility's staffing ratio in compliance. Site inspections on 05/22/2021, and 10/28/2021 had sufficient staffing ratio the clients in placement. Confidential interviews had consistent statements that clients were never left unsupervised, and staff was always present. Interviews did state during the COVID-19 pandemic staff had have longer shifts and staff had to wait long period of times for shift change. On 04/17/22, the Department received Special Incident Report (SIR) stating that office door was damage by a client running and jump kicking the office door. Staff#2 (S2) reported the door was repaired and confidential information was kept locked. On 05/12/2022, LPA Rosas received repair pictures of the office door. On 10/28/2022, LPA Rosas conducted Annual Required visit to the facility and inspected the facility office door. The facility door was able to open and close. Inside of the facility office the confidential files were kept in locked metal file cabinet and only authorized staff had access to them. LPA Rosas also observed medication to be centrally stored, locked and inaccessible to clients and unauthorized staff members. Interviews stated that clients did not have access to the facility office. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has decided that the allegations of Personal Rights are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies observed or cited at this time. A copy of the report was sent to S1 for signature to the facility P.O Box on file, due to facility closure on December 31, 2021.

Investigation Findings:
13On October 6, 2022, at 09:00am, Licensing Program Analyst (LPA) Olivia Rosas concluded the investigation on the above allegations for Trinity House 1 and sent complaint findings to Staff#1 (S1). LPA Rosas sent by certified mail the delivery of findings of the completed complaint to the facility P.O Box on file, due to facility closure on December 31, 2021. On 05/12/2021, contacted the facility to begin the investigation process and conduct interviews. During the investigation process, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted inspection and conducted interviews on 05/22/2021. In addition, LPA Rosas interviewed witnesses and pertinent parties related to the investigation. Individuals mention in this complaint are identify on the Confidential Names List (LIC811) dated October 6, 2022. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the Personal Rights allegations that facility is operating out of ratio and facility is not safeguarding minors' confidential information. Report continues LIC-9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Olivia Rosas LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: TRINITY HOUSE IFACILITY NUMBER: VISIT DATE: 10/06/2022

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


raw_content:
Narrative:
The allegations may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the findings are unsubstantiated. LPA Rosas and AGPA Barnes-Woodard conducted interviews with clients and facility staff that provided information on staff schedules, allowance and care and supervision for clients. Facility denied the allegations of Personal Rights and Neglect/Lack of Supervisor. Staff#2(S2) and Staff#3(S3) reported that on August 8, 2022, Client#1 (C1) was taken to Arroyo Verde Park in Ventura. C1 and S3, preceded to hike at the park. A couple minutes into the hike C1 walked off the trail and did not want to finish the hike. S3 lost visual of C1 and S3 walked to the end of the trail to wait for C3. S3 observed C1 walking towards the facility vehicle, and both returned to the facility. S3 denied intimidating clients or handling clients in a rough manner. S3 reported, the facility was trained to use verbal prompts to redirect clients during crisis. S3 reported that on August 12, 2021, Client#2 (C2) became escalated when requesting a snack and S3 attempted to calm him down verbally. C2 was unreceptive and attempted to breach the office by jumping over the half open door. S3 reported, using his body to block the door and preventing C2 from breaching the office. Results from the Department's investigation, consisting of interviews with related parties, inspections, and review of records. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. The Department has decided that the allegations of Personal Rights and Neglect/Lack of Supervision are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed. There were no deficiencies observed or cited at this time. A copy of the report was sent to S1 for signature to the facility P.O Box on file, due to facility closure on December 31, 2021.

Investigation Findings:
13On October 12, 2022, at 09:00am, Licensing Program Analyst (LPA) Olivia Rosas concluded the investigation on the above allegations for Trinity House 1. The delivery of findings of the completed complaint investigation was sent by certified mail to Staff#1 (S1) due to facility closure on December 31, 2021. During the investigation process, Associate Governmental Program Analyst (AGPA) Tonya L. Barnes-Woodard conducted inspection and conducted interviews on September 25, 2021. In addition, LPA Rosas interviewed witnesses and pertinent parties related to the investigation. Individuals mention in this complaint are identify on the Confidential Names List (LIC811) dated October 12, 2022. Based on the confidential interviews conducted during the investigation process, record review, statements obtained, LPA Rosas concluded the Personal Rights and Neglect/Lack of Supervision allegations that facility staff left youth unsupervised, staff intimidates youth, and staff handle youth in a rough manner. Report continues LIC-9099C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Olivia Rosas LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: TRINITY HOUSE IFACILITY NUMBER: VISIT DATE: 10/12/2022

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


summary: Facility Evaluation

raw_content:
Narrative:
On 10/27/2021 at 9:30AM Licensing Program Analyst (LPA) Olivia made an unannounced to Trinity House I for the purpose to conduct the Annual/Required licensing Inspection. LPA Rosas met with Staff#1(S1) who granted access to the facility and an inspection of the facility was conducted together. Individuals mention in this report are identify on the Confidential Names List (LIC811) dated 10/28/21. Temperature and health checks are conducted at the entrance in the sign-in area. LPA met with Staff#1 (S1), who granted access into the home, and who provided a tour of the entire physical plant. This facility has a provisional licensed to provide care and supervision for six (6) children ages 12-17 years old, Ambulatory only. The facility also provides services to non-minor dependents. The facility is in the process of obtaining Accreditation with Joint-Commission. They are in the process obtaining Mental Health Approval. There are no bodies on water on the premises. Staff confirmed that there are no firearms or dangerous weapons in the facility. The facility is current with their annual fees. LPA Rosas inspected the following: This is a one (1) story (STRP) Short Term Residential Therapeutic Program, located in a residential neighborhood. There are three (3) bedrooms, two (2) bathrooms, a living room, dining room, kitchen, staff office, backyard, and an attached garage for storage. There is one (1) facility vehicle parked outside inspected to be in good operating condition. Outdoor Area: There was no swimming pool or bodies of water on the premises. The activity space is free of hazard materials and debris. LPA observed a staff displayed the utility shut-off valves. The facility is surrounded by wooden fence and is observed to be good condition. Report continues on LIC 809-C Page 1 of Garage: The attached garage is used as storage and is kept locked. Laundry Room: The laundry room is located inside of the garage. The laundry is equipped with a washer and dryer unit that was observed to be in good condition. The laundry detergent is made inaccessible to the children and is disputed according the load of the laundry. Disinfectants and chemicals are locked in cabinets made inaccessible. Living Room: There is adequate furniture which appears to be in good condition. There is a television and fireplace that is non-operable. Staff Office: It is equipped office furniture (i.e desk, computers, printers). The medication is triple locked inside of the staff office. All the children prescribed medications are locked in the staff office and children files are kept in a lock cabinet. Staff office is located inside the main facility. The First Aid kit has the required items inside (age-appropriate, and scissors, tweezers, thermometer, and gauzes, antiseptic and First Aid Manual Guide. Dining Area: One table with six chairs is next to the Kitchen: There is a gas stove/oven with four (4) burners, all operating. There is a microwave, refrigerator/freezer and a toaster oven. LPA's observed adequate perishable/nonperishable food supplies. Sharp knives, disinfectants/cleaning solutions made inaccessible to the children locked in cabinets. Water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. Bedroom # 1: Occupied by two (2) clients, the bedroom is equipped two (2) twin sized beds, comfortable mattresses, linen, blankets and pillows; adequate drawer and one (1) wall closet. There is adequate lighting and the windows have horizontal slide locked with curtains observed to be in good condition. This bedroom was a bathroom. Bedroom # 2: Currently occupied by one (1) client, has two (2) twin sized beds and comfortable mattresses, linen, blankets and pillows; adequate drawer and one (1) walk in closet. There is adequate lighting and the windows have horizontal slide locked with curtains observed to be in good condition. Bedroom # 3: Currently occupied by two (2) clients. The bedroom has two (2) twin sized beds and comfortable mattresses, linen, blankets and pillows; adequate drawer and one (1) walk in closet. Report continues on LIC 809-C Page 2 of Bathrooms: There are two (2) bathrooms. Bathroom #1 is the common bathroom for the clients. It is a full-sized bathroom with a toilet, sink, and tub/showers. Bathroom #2 is located inside of Bedroom#1 is full-sized bathroom with a toilet, sink, and shower. Water temperature measured within safe temperatures, at not less than 105 and did not exceed 120 degrees Fahrenheit. LPA observed a key locked closet that stored hygiene supplies, and cleaning solutions. All windows were in good condition with screens and blinds. There were no security bars on the windows. LPA observed ample towels and linen closet. The passageways and porches are unobstructed. All posting requirements were met, (food menu, regulations, licenses, emergency disaster plan, Children's Personal Rights, and Ombudsman). The facility has a working telephone and youths can use the telephone unless restricted by court order. The Emergency Evacuation Plan is posted on the walls throughout the facility. The Facility operates within license conditions and limitations including capacity limitations. Facility has a current, written plan of operation. Facility personnel are instructed to report violations of personal rights. Licensee will report changes in the plan of operation affecting service to youths. Licensee will report youth injuries requiring medical treatment. A review of Facility's Personnel Report Summary on 10/28/2021 indicates that all personnel have criminal record clearance has obtain the necessary clearances with DOJ, FBI, and Child Abuse Response. LPA Rosas was not able to review youth or staff files during this visit and will return to continue with the annual inspection. Youth were in school during the inspection. LPA Rosas by email the following PINS to S PIN 20-17-CRP: New Background Check Requirements, Assembly Bill 819 (Chapter 777, Statutes of 2019), PIN 21-20-CRP: Statewide Launch of New Inspection Tools for Children's Residential Licensees, PIN 21-05-CRP: The Family Urgent Response System (FURS), Medications Guide TSP 2017-03 (version 08/23/21). There were no deficiencies observed or cited at this time. Exit interview was conducted with S1 and a copy of this report was email to S1 for signature.


summary: Facility Evaluation

raw_content:
Narrative:
On 01/13/2022 at 10:00AM Licensing Program Analyst (LPA) Olivia made an unannounced to Trinity House 1 for the purpose to verify facility closure. LPA Rosas, knocked the door and waited for response. LPA Rosas, waited and walked around the outdoor perimeter of the home (facility). LPA did not see or hear anyone at the facility. LPA Rosas, contacted CEO via phone and call went to voice mail. LPA, left a voice mail to return phone call to LPA Rosas. LPA Rosas will mail copy of report to the facility mailing address for signature.


facility_name: TUOLUMNE INN

raw_content:
Investigation Findings:
13On October 20, 2021, Licensing Program Analyst (LPA) Eduardo Barragan conducted a complaint inspection at Tuolumne Inn and met with Ramsina Oushana. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the above complaint allegations. LPA Barragan spoke with staff, clients, a Probation Officer and reviewed other predominant documents. Based on documents reviewed, an inspection, and conversations with staff and clients, all the information that was gathered was conflicting. "Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED." An exit interview was conducted with Ramsina Oushana. A copy of this report and appeal rights were provided to Ramsina Oushana. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Juanita Arroyo LICENSING EVALUATOR NAME: Eduardo Barragan LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 2

met_with: Ramsina Oushana


raw_content:
Investigation Findings:
13Licensing Program Analysts (LPAs) Lidia Tinoco and Briana Placencia conducted an unannounced visit to the Tuolumne Inn STRTP in order to deliver the findings of the above allegations and met with Monica Alexander. The above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, interviews, and a review of facility and foster children's records. 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 discussed and provided along with appeal rights at the conclusion of the inspection. 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 3

met_with: Monica Alexander


summary: Facility Evaluation

raw_content:
Narrative:
On 09/03/21, Licensing Program Analysts (LPAs) Eduardo Barragan and Jessica Rodriguez travelled to the above facility to conduct an Annual inspection. LPAs were met by Ramsina Oushana, Administrator. An inspection of the facility was conducted and the following was observed: There are currently four clients in placement. LPAs toured the facility indoors and outdoors. Fire extinguisher charged and up to date. Hot water temperature last measured at 109 degrees. LPAs observed adequate supply of non-perishables. Observed adequate supply of furnishings, linen and storage space for clients. Cleaning chemicals inaccessible to clients. Medication area centrally stored and locked. There are no pets at the facility. Per the Administrator, there are no weapons at the facility. There are no bodies of water at the facility. There have been no deficiencies in the prior 12 months. LPAs will return to the facility at a later date and time in order to complete the annual inspection. No deficiencies cited on this date. LPAs conducted and exit interview with Ramsina Oushana.


summary: Facility Evaluation

raw_content:
Narrative:
On 09/08/21, Licensing Program Analyst (LPA) Eduardo Barragan travelled to the above facility to continue an Annual Inspection that began on 09/03/2021. LPA Barragan was met by Ramsina Oushana, Administrator. LPA Barragan interviewed two staff members and three clients at the facility. LPA Barragan is going to go to the corporate office to finish the file review today (09/08/2021). LPA Barragan is going to go to one of the clients schools to complete his interview as well today (09/08/2021). There have been no deficiencies in the prior 12 months. No deficiencies cited on this date. LPA Barragan conducted and exit interview with Ramsina Oushana.


summary: Facility Evaluation

raw_content:
Narrative:
On 09/08/21, Licensing Program Analyst (LPA) Eduardo Barragan travelled to the corporate office to continue an Annual Inspection that began on 09/03/2021. LPA Barragan was met by Brandi Boehme. LPA Barragan went to the corporate office to finish the staff file review today (09/08/2021). No deficiencies were cited on this date. LPA Barragan conducted and exit interview with Brandi Boehme.

met_with: Brandi Boehme


summary: Facility Evaluation

raw_content:
Narrative:
On December 1, 2021, Licensing Program Analyst (LPA) Eduardo Barragan stopped at Tuolumne Inn in order to review a few a client files. LPA Barragan met with Ramsina Oushana. No deficiency were noted on todays visit.


summary: Facility Evaluation

raw_content:
Narrative:
On December 13, 2021, an unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Tamara Melikian at 10:00AM. During the inspection, LPA met with Ramsina Oushana , Administrator and Monica Alexander, Assistant Program Director and inspected the facility inside and out. LPA reviewed seven children's records and reviewed two staff personnel records for the facility at 10:30AM. A medication count was conducted at 12:00PM. LPA interviewed two staff at 12:30PM. LPA interviewed two children. The remainder of the children were not interviewed as they were at school and will be interviewed at a later date. No deficiencies to be cited at this time. LPA conducted exit interview with Ramsina Oushana, Administrator and Assistant Program Director Monica Alexander at 1:00PM. LPA provided the summary report upon completion.

met_with: Monica Alexander, Ramsina Oushana


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Tamara Melikian and Vanessa Galvan on March 2, 2023 at 9:00AM. This case management inspection is conducted pursuant to Health and Safety Code 1538.9(a)(2). During the inspection, LPAs met with Monica Alexander, Administrator and inspected the facility inside and out. LPAs reviewed 3 child's records and 2 staff personnel files on site at the facility. LPAs reviewed 3 child's psychotropic medications and medication records. LPAs interviewed 2 staff on site to discuss the facilities policies and procedures of operation. LPAs interviewed one child currently on psychotropic medication as the other children were in school at this time. LPAs provided a copy of the licensing report to Administrator, Monica Alexander. No deficiencies are being cited at this time. LPA conducted exit interview with Monica Alexander, Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco arrived at the Tuolumne Inn STRTP for the purpose of conducting an Annual Inspection. LPA Tinoco met with Administrator, Dawn Lee and inspected the facility, inside and out. Administrator, is present at the facility a minimum of 20 hours a week. The facility employs Social Worker, Head of Service, Clinician, 3 facility supervisors and 12 direct care staff. The STRTP has obtained Mental Health Certification Including the following: Mental Health Program Approval valid through September 24,2026. The STRTP has obtained National Accreditation through CARF. The Accreditation is valid through September 30, 2026. Centrally stored medications are maintained in a locked cabinet. Sharps and Toxic chemicals are kept locked. The facility has a written emergency disaster plan and provided a copy to LPA. A fire department inspection was conducted on 11/03/2025 and marked as passed as verified by documentation reviewed. 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. No firearms or weapons are allowed in the facility. A guardian check conducted on 5/4/26 verified that all staff listed on the LIC500 are cleared and associated to the agency. Continued on LIC809-C... records of clients were reviewed. Staff files will be reviewed at a later date. Client and Staff interviews will be conducted on a later date. No deficiencies were observed or cited on this date. A copy of this report along was provided at the conclusion of the inspection.

met_with: Dawn Lee


raw_content:
Narrative:
Confidential interviews reported that law enforcement was called for assistance. C1 was taken to a hospital for assessment and discharged from the hospital on May 8, 2021. On May 10, 2022, C1 was observed with several cuts on the left wrist, which were self-inflicted. However, LPA was unable to determine if the cuts were done while at the facility or at the hospital. The interviews that were provided to the LPA were not consistent regarding the allegation of lack of supervision and interviews did not provide any further specific details. Based on interviews and record reviews the allegation that staff did not adequately supervise C1, may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Diana Bustamante.

Investigation Findings:
13On March 10, 2022 at , Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an unannounced inspection to the facility to deliver the findings of the above allegation. LPA met with Diana Bustamante. LPA Jesus Cervantes conducted a tele-inspection of the facility on May 20, 2021 at 9:30 am and no immediate deficiencies were observed. Four of four children (C1, C2, C3, C4), three staff and facility administrator were interviewed. It was reported to Community Care Licensing (CCL) that staff did not adequately supervise C1. Confidential staff interviews reported that on May 7, 2021, C1 became upset when C1 asked staff to go outside for a walk. Confidential interviews disclosed staff did not allow C1 to go outside because of the time (12:00am). Staff encouraged C1 to stay indoors or stay on the patio. Confidential interviews reported that C1 ignored staff directives and left the facility. Confidential interviews reported that C1 ran towards the main street, as staff followed C1. C1 laid down on the street, into oncoming traffic. Confidential interviews reported that staff attempted to use de-escalation techniques on C1 but was unsuccessful. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Darlene Almaraz 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 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-FEMALEFACILITY NUMBER: VISIT DATE: 03/10/2022

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

met_with: Diana Bustamante


raw_content:
Narrative:
Confidential interviews reported that C4 is not using or getting any drugs from C1, C2 or C3. Staff is following all proper protocols when dealing with the minors using drugs/marijuana and monitoring the minors. The interviews that were provided to the LPA were not consistent regarding the allegations of lack of supervision and minors are not accorded dignity in relationships with other persons. Based on interviews and record reviews the allegations staff is not properly supervising minors, minors used marijuana and minors are not accorded dignity in relationships with other persons, may have occurred, however is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Diana Bustamante.

Investigation Findings:
13On March 10, 2022 at 12:31pm, Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an unannounced inspection to the facility to deliver the findings of the above allegations. LPA met with Diana Bustamante. LPA Jesus Cervantes conducted an inspection of the facility on June 22, 2021 at 10:30 am and no immediate deficiencies were observed. Four of four children (C1, C2, C3, C4), four staff and facility administrator were interviewed. It was reported to Community Care Licensing (CCL) that staff is not properly supervising minors, minors used marijuana and minors are not accorded dignity in relationships with other persons. Confidential staff interviews reported that on June 13, 2021, staff took C1, C2 and C3 on a hike. Confidential staff interviews reported that when they returned to the van from the hike the van had an odor of marijuana. Confidential interviews reported that all three clients denied smoking marijuana. Confidential staff interviews reported that once they arrived to the facility, C1 and C2 handed over a bag of marijuana and a vape pen. Additional confidential interviews reported that C4 awol's (absent without leave) from the facility and has returned to the facility under the influence. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Darlene Almaraz 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 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-FEMALEFACILITY NUMBER: VISIT DATE: 03/10/2022

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


raw_content:
Narrative:
supervision. Specifically, it was reported that S1 grabbed C1 and that there was not enough supervision resulting in C1 going AWOL . It was also reported that C1 was observed with bruising on the forearm and hands due to staff having C1 clean toilets at the facility. During confidential interviews it was revealed that there were no observations made of S1 hitting or grabbing C1. Confidential interviews revealed that the residents are given chores to do but are always offered protective equipment such as gloves to perform these chores if the clients wish to use it. Confidential interviews revealed that the clients are never asked to clean the toilets. Additionally, confidential interviews revealed that when a client is threatening to AWOL the staff tries to will verbally redirect them and convince them to stay at the facility. If the clients leave the facility staff attempts to follow the client and take a description of what they are wearing, then an incident report is filed. No information could be obtained from C1 because their bed was closed due to the AWOL status and current whereabouts are unknown at this time. LPA was unable to obtain additional information regarding the allegations and there were lack of witnesses to the alleged incidents. Based on confidential interviews and record review, the allegations that Resident was sustained bruising while in care, Staff grabbed the resident, and Staff did not provide adequate supervision may have occurred, however they are not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. A copy of this report and Appeals Rights were provided and explained to Facility Administrator, Diana Bustamante.

Investigation Findings:
13On March 23, 2022 at 11:25 a.m. Licensing Program Analyst (LPA) Sarah Smith met with Tustin Family Campus Qualifying House Short Term Residential Therapeutic Program (STRTP) Facility Administrator, Diana Bustamante to deliver the findings of the complaint investigation for the above allegations. LPA Cervantes conducted a health and safety inspection of the facility on 10/25/2021 at 10:15 a.m. and no immediate deficiencies were observed. During the course of investigating the allegations, LPA Smith conducted confidential interviews with two staff, one client (C2), and County Social Worker (CSW). LPA Smith was unable to interview C1 because they never returned from being Absent With Out Leave (AWOL) and C3 refused to be interviewed. LPA Smith reviewed reports and records for the facility and clients (C1, C2, and C3). On October 19, 2021, a complaint was received by Community Care Licensing (CCL) that a Resident was sustained bruising while in care, Staff grabbed the resident, and Staff did not provide adequate UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Sarah Smith 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 22-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, THE CITY DR., SUITE FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-FEMALEFACILITY NUMBER: VISIT DATE: 03/23/2022

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

met_with: Diana Bustamante, Faciilty Administrator


raw_content:
Narrative:
revealed that the client was told they were being recorded as the client charged toward them with an unknown object in their hand. LPA reviewed the video which did show the client picking up an unknown object off the ground, walking towards staff, and hitting staff, and the video recording ended at that point. Based on confidential interviews, the preponderance of evidence standard has been met regarding the allegation that S1 video recorded C1 without minors' consent. This posed a potential Health, Safety, or Personal Rights risk to C1 in care, the facility will be cited for violating Interim Licensing Standards, STRTP, Article 06, 87072(c)(10) Personal Rights. A copy of this report was provided to and reviewed with Diana Bustamante, Facility Administrator, along with the appeal rights and the LIC 811. A signed copy of the report will be kept in the Facility file. Based on interviews that S1 spoke inappropriately to C1 while in care, which may or may not have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Diana Bustamante, Facility Administrator. A copy of the report will be placed in the facility file.

Investigation Findings:
13On June 24, 2022, at 9:50 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced to the facility and met with Diana Bustamante, Facility Administrator, of Tustin Family Campus Qualifying House-Female to discuss the investigative findings for the allegation noted above. LPA conducted an inspection of the facility on June 8, 2022, at 3: PM. No deficiencies were observed. During the investigation, LPA interviewed one of one client (C1) and one of one staff (S1). LPA reviewed video recording. On June 2, 2022, Community Care Licensing (CCL) received an allegation that Staff video recorded minors without minors' consent. Confidential interviews revealed that the client was recorded on a cell phone as they were leaving the facility without permission and was triggered by the recording. Confidential interviews revealed staff was asked not to record the client as the video recording was triggering for the client. Confidential interviews revealed that the video recording started when the client picked up an unknown object on the ground and walked toward the staff. Confidential interviews SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley 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 22-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, THE CITY DR., SUITE FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-FEMALEFACILITY NUMBER: VISIT DATE: 06/24/2022

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


raw_content:
Narrative:
Confidential interviews also revealed that inappropriate noises were heard when S2 was locked in the bathroom or staff office when S2 goes to the bathroom or staff office. Additional, confidential interviews revealed that S2 stands at the foot of the bed staring at the clients, which causes clients to feel uncomfortable. Based on confidential interviews and record review, the preponderance of evidence standard has been met, and the allegations that staff (S2) hit minor (C1) while in care and staff (S2) is engaging in inappropriate behavior are substantiated. The facility is being cited for Interim Licensing Standards (ILS) Version 4, Personal Rights (c) (10). The facility did not ensure their dignity was accorded with staff while in care. An exit interview was conducted, and a copy of this report LIC 9099 and the appeal rights were discussed and provided to Administrator Diana Bustamante. Other confidential interviews denied staff not preventing clients from being absent from care and reported staff communicating the importance of not being absent without permission. Per confidential interviews, the staff is doing all they can to prevent clients from leaving the facility, and if clients do leave, staff will follow the clients to encourage them to return to the facility. Based on confidential interviews and record review, the allegation that there is no prevention made for clients to AWOL may have occurred, however, this is not supported by evidence. Therefore, the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report LIC 9099 and the appeal rights were discussed and provided to Administrator Diana Bustamante.

Investigation Findings:
13On September 30, 2022, Licensing Program Analysts (LPAs) Leslie Covarrubias and Jose Gonzalez met with Administrator Diana Bustamante to deliver the compliant findings to the allegations listed above. LPA Covarrubias conducted a health and safety inspection on 03/23/2022 at 12: PM, and no immediate health and safety concerns were observed. During the course of the investigation, LPA Covarrubias conducted confidential interviews with Staff #1(S1), Staff #3 (S3), and Clients (C1, C3, C5, C6, C7). LPA obtained copies of Special Incident Reports (SIRs), the client roster and staff roster, the night supervision policy, staff investigation documents, and written statements from staff and clients. LPA was unsuccessful in interviewing S2 as S2 was unavailable. On 03/17/2022, Community Care Licensing (CCL) received an allegation that staff #2 (S2) tapped client #1 (C1) hard, and S2 engaged in inappropriate behavior. Some confidential interviews revealed that S2 poked them during night checks to check if clients were physically in bed. Confidential interviews revealed that staff is not to touch the clients physically. (Continue on next page...) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Leslie Y Covarrubias 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 22-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, THE CITY DR., SUITE FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-FEMALEFACILITY NUMBER: VISIT DATE: 09/30/2022

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

met_with: Administrator, Diana Bustamante


summary: Complaint Investigation - Substantiated - 1 deficiency - 1 allegation

raw_content:
Narrative:
Confidential interviews and documents reviewed indicated that C1's belongings were not searched upon returning to the facility which was required per the NSP. Based on confidential interviews and record review, the preponderance of evidence standard has been met regarding the allegations that the Staff allowed C1 to be transported for a visit in an unsafe manner and staff did not follow search protocol., therefore the allegations are substantiated. This poses an immediate Health, Safety, or Personal Rights risk to the children in care. The facility will be cited for violating the California Code of Regulations, Short Term Residential Treatment Program Interim Licensing Standards (ILS) Version 4, 87022(f) Plan of Operation, and 87068.2(c)(1) Needs and Services Plan. An exit interview was conducted, and a copy of this report LIC 9099 and the appeal rights were discussed and provided to Facility Representative Charon Mitchell and Administrator Diana Bustamante.

Investigation Findings:
13On 08/25/2023, Licensing Program Manager (LPM), Ann Valenzuela, Licensing Program Analysts (LPAs), Jacqueline Garcia, and Guadalupe Munoz met with Facility Representative, Charon Mitchell and Administrator Diana Bustamante via telephone to deliver the compliant findings to the allegations listed above. On June 29, 2023, at 11:50 am LPAs conducted a health and safety inspection, and no immediate health and safety concerns were observed. During the investigation, LPA's conducted confidential interviews with five Staff (S1-S5) and Client #1 (C1). LPAs obtained copies of Special Incident Reports (SIRs), the client roster and LIC 500 staff roster, the Needs and Services Plan (NSP), copies of communication logs, and email correspondence. On 06/26/23, Community Care Licensing (CCL) received a complaint that alleges staff allowed C1 to be transported for a visit in an unsafe manner and staff did not follow search protocol. Confidential interviews and documents reviewed revealed that the Facility did not follow its Plan of Operation: C1 left the facility with their mother for an unsupervised visit without providing the required insurance information. **cont'd on next page SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Jacqueline Garcia 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 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-FEMALEFACILITY NUMBER: VISIT DATE: 08/25/2023

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

Deficiencies:
87022(f): Plan of Operation

met_with: Charon Mitchell and Diana Bustamante

title: Plan of Operation


raw_content:
Narrative:
allegations with a preponderance of evidence. Based on confidential interviews and records reviewed the allegations that due to neglect, staff did not prevent C1 from coming into contact with drugs and staff did not seek C1 timely medical attention which may have occurred, however, it is not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Destiny Ledesma. Due to printer malfunction, a copy of this report, LIC 811, and appeal rights were emailed to Destiny Ledesma. A copy of this report will be placed in the facility file.

Investigation Findings:
13On April 8, 2024, at 11:20 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Destiny Ledesma, Facility Administrator, to discuss the investigative finding for the allegations noted above. LPA conducted an inspection of the facility on March 1, 2024, at 4:30 pm and no deficiencies were observed. The investigation was conducted by the Department's Investigations Branch (IB), assigned to Investigator Thomas Smith. Investigator Smith interviewed three clients (C1-3), six staff (S1-6), and one County Social Worker (CSW). During the investigation, Investigator Smith conducted a comprehensive review of C1's hospital medical records. On February 26, 2024, Community Care Licensing (CCL) received allegations that due to neglect, staff did not prevent C1 from coming into contact with drugs and staff did not seek C1 timely medical attention. Disclosures during the interviews were inconsistent with the allegations. The investigation could not determine if C1 had illicit drugs in their system. Thus, confidential interviews did not corroborate the UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley 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 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION ORANGE COUNTY RO, THE CITY DR., SUITE FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-FEMALEFACILITY NUMBER: VISIT DATE: 04/08/2024

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

met_with: Destiny Ledesma


raw_content:
Narrative:
Based on confidential interviews and records reviewed the allegation that S1 smoked marijuana with clients, which may have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Destiny Ledesma. Due to printer difficulties, a copy of this report and appeal rights were emailed to the Facility Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On December 2, 2024, at 11:30 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Destiny Ledesma, Facility Administrator, to discuss the investigative finding for the allegation noted above. LPA conducted an inspection of the facility on October 21, 2024, at 3:28 pm and no deficiencies were observed. LPA interviewed four clients (C1-3, C6), two clients declined to interview (C4-5), and LPA interviewed six staff (S1-6). The following documents were reviewed during the investigation: Staff Roster, Staff Schedule, S1's Employee Application, S1's Training Records, S1's Termination Notice, and Special Incident Reports. On October 14, 2024, Community Care Licensing (CCL) received an allegation that staff smoked marijuana with clients. It was reported that C1, C2, and C3 were at the park smoking marijuana with S1. Confidential interviews revealed conflicting statements. Thus, confidential interviews did not corroborate the allegation with a preponderance of evidence. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley 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 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION ORANGE COUNTY RO, THE CITY DR., SUITE FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-FEMALEFACILITY NUMBER: VISIT DATE: 12/02/2024

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


raw_content:
Narrative:
Confidential interviews and documents obtained revealed the facility staff conducts searches of clients within the scope of the minors Personal Rights. However, conflicting confidential interviews revealed that drugs are still being smuggled into the facility by a minor in care. Confidential interviews and documents reviewed revealed the facility has been proactively addressing the issue of a minor supplying other minors with drugs. Based on confidential interviews and record review, the allegation that a minor is supplying other minors with drugs while in care may have occurred; however, it is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with appeal rights was provided to Diana Bustamante.

Investigation Findings:
13On November 24, 2021, at 10: AM, Licensing Program Analyst (LPA) Jesus Cervantes made an unannounced visit at the facility. LPA met with Administrator Diana Bustamante, to issue the investigative finding of the allegation listed above. On April 28, 2021, Licensing Program Analyst (LPA), Jesus Cervantes, conducted an unannounced inspection of the facility, and no deficiencies were noted. LPA Cervantes conducted interviews with five of five foster children (C1, C2, C3, C4, C5) and two of two staff (S1 and S2). During the investigation, LPA reviewed facility records and obtained copies of the following documents: Incident Reports and Facility Policy and Procedures. On April 26, 2021, Community Care Licensing received the allegation that a minor is supplying other minors with drugs while in care. Confidential interviews revealed conflicting statements regarding a minor supplying other minors with drugs. SEE PAGE TWO UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Jesus Cervantes 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 22-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, THE CITY DR., SUITE FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-MALEFACILITY NUMBER: VISIT DATE: 11/24/2021

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


raw_content:
Narrative:
facility and attempted to get in through a window and a staff body slammed them and carried them outside of the facility, causing scratches to their forearm. Confidential interviews revealed conflicting statements, some interviews indicate that S3 told C1 they needed to turn in the aerosol cans before entering the facility. Other interviews indicate that staff was waiting for Law Enforcement to arrive and assist as C1 had thrown a patio chair at the window. As far as the allegation of staff mishandling C1, confidential interviews revealed that S1 held C1's arms at their side, walked them out of the facility, and held them in a single-person restraint while waiting for law enforcement to arrive. Conflicting interviews revealed that S1 picked up and slammed C1 to the ground. Other interviews indicated that C1 hit S3 several times and C1 guided them out of the facility to the front porch and while S3 was trying to restrain C1, both individuals fell onto the grass. Based on confidential interviews and records reviewed that staff denied C1 access to the facility and staff mishandled C1 while in care which may or may not have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted and appeal rights explained.. Due to printer malfunction, a copy of this report and appeal rights will be emailed to the Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On August 26, 2022, at 11:05 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced to the facility and met with Vickie Rogers, Facility Manager, to discuss the investigative findings for the allegations listed above. LPA Linley conducted an inspection of the facility on 07/13/2022 at 12:15 pm. No deficiencies were observed. During the investigation, LPA Linley interviewed four out of four clients (C1-4), four out of four staff (S1-4), and one County Social Worker (CSW1). (See LIC 811 for confidential names). LPA Linley also reviewed the following documents: S Resume, application, and training records, Staff Contact list, Client roster, Special Incident Report, dated 07/06/2022, C1 daily progress notes, dated 07/06-07/2022, and copies of the house log, dated 07/06-07/07/2022. On July 8, 2022, Community Care Licensing received allegations that staff denied minor access to the facility and staff mishandled a minor while in care. It was reported that the minor was denied entry to the UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley 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 22-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, THE CITY DR., SUITE FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-MALEFACILITY NUMBER: VISIT DATE: 08/26/2022

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

met_with: Vickie Rogers, Facility Manager


raw_content:
Narrative:
Other confidential interviews revealed that C1 phone calls with the biological parent are monitored per court order. Additional confidential interviews indicated that FS allows C1 to make and receive phone calls. Confidential interviews revealed that FS allows C1 privacy when making calls that FS does not monitor. CSW stated that C1 phone calls with C1's parent are monitored per court order. The Department also received an allegation that client #1 (C1) mental health needs are not being met. Additional confidential interviews indicated that C1 was provided therapy sessions at the facility. Confidential interviews disclosed that C1s refuse to participate in therapy. Other confidential interviews indicated that the home offered C1 different therapeutic groups and therapists. Confidential interviews disclosed that C1 was not receiving therapy. Additional confidential interviews indicated that C1 wanted to participate in therapy with a licensed therapist. It was disclosed that the facility offered C1 a therapist. It was also disclosed that C1 refused to participate in therapy. Confidential interviews reported that CSW provided C1 with an outside therapist and C1 continued to refuse. The confidential witness denied the allegation of mental health needs not being met. The Department received an allegation that Facility Staff (FS) caused client #1 (C1) to miss a scheduled court date. Confidential interviews revealed that C1 and FS arrived late to court. Additional confidential interviews indicated that the judge was upset with C1 for arriving late to court. Other confidential interviews revealed that C1 arrived at court on time. Additional confidential interviews indicated that C1 returned late to the second court session due to C1 still eating C1 lunch. A confidential witness stated that C1 never missed a court date. Additional confidential interviews disclosed that the facility did everything possible to meet C1 needs. Based on inconsistent confidential interviews, the allegations that Facility Staff (FS) are interfering with client #1 (C1) telephone visits, C1's mental health needs are not being met, and FS caused C1 to miss a scheduled court date may have occurred, however, are not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Administrator (AD) Diana Bustamante.

Investigation Findings:
13On September 30, 2022, at 11: 12 am, Licensing Program Analysts (LPAs) Jose Gonzalez and Leslie Covarrubias met with Administrator (AD) Diana Bustamante to deliver the findings for the above-stated allegations. LPA conducted a health and safety inspection on January 14, 2022, at 9:25 am, and no immediate health and safety hazards were observed. LPA also reviewed six clients' records. During the investigation, interviews were conducted with three out of six clients (C1, C5, and C6), Administrator (AD), Staff #1 (S1), Head of Service (HS), and County Social Worker (CSW), clients (C2, C3, and C4) refused to be interviewed. The Department received an allegation on January 10, 2022, that Facility Staff (FS) are interfering with client #1 (C1) telephone visits. Confidential interviews disclosed that FS interfered with C1 phone conversations. Additional confidential interviews indicated that FS listens in on C1 phone conversations. Confidential interviews disclosed that the FS is not allowing C1 privacy during C1 phone calls. Additional confidential interviews indicated that C1 phone calls are not monitored.R- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, THE CITY DR., SUITE FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-MALEFACILITY NUMBER: VISIT DATE: 09/30/2022

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

met_with: Administrator (AD) Diana Bustamante


raw_content:
Narrative:
Confidential interviews disclosed that C1 slept under the covers, and it's the facility policy to ensure that clients are physically seen and that pillows are not placed over clients' faces. Confidential interviews also revealed that S5 retaliated against C1 by demonstrating an attitude toward C1 and treating C1 disrespectfully. Other confidential interviews revealed that S5 treated C1 well by S5 attempting to speak with C1, and C1 would ignore S5 by not communicating back. Confidential interviews stated that the allegations were false. Based on the inconsistent confidential interviews, the allegations that staff inappropriately touched minor (C1) and staff (S5) are retaliating against minor (C1) for making complaints may have occurred, however, this is not supported by evidence. Therefore, the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report LIC 9099 and the appeal rights were discussed and provided to Administrator Diana Bustamante.

Investigation Findings:
13On September 30, 2022, Licensing Program Analysts (LPAs) Leslie Covarrubias and Jose Gonzalez met with Administrator Diana Bustamante to deliver the compliant findings to the allegations listed above. LPA Valerie Wilson conducted a health and safety inspection on 12/29/2021 at 10: AM, and no immediate health and safety concerns were observed. During the course of the investigation, LPA Covarrubias conducted confidential interviews with Staff #1(S1), Staff #2 (S2), Staff #3 (S3), Staff #4 (S4), Staff 6 (S6), Staff 7 (S7), and Clients (C1, C2, C3, C4, C5). LPA obtained copies of Special Incident Reports (SIRs), the client roster and staff roster, and the training record/ documents for one staff. On 12/20/2021, Community Care Licensing (CCL) received an allegation that staff inappropriately touched C1, and the staff (S5) is retaliating against C1 for making complaints. Confidential interviews reported that S5 would poke clients to verify they were physically there. Other confidential interviews revealed that S5 did not poke the clients (C2-C5). (Continue on next page...) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Leslie Y Covarrubias 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 22-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, THE CITY DR., SUITE FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-MALEFACILITY NUMBER: VISIT DATE: 09/30/2022

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


raw_content:
Narrative:
Confidential interviews revealed that S4 talks to the clients and lets them know the importance of them being on good behavior and listening to staff. Community Care Licensing also received an allegation that the facility provides inadequate food services. Confidential interviews revealed that the facility offers healthy snacks. During the inspection on 03/30/2022, LPA observed a board where clients could make their food choices requests. LPA also observed that some C1 food choices were fruits, salad, chicken, and yogurt. Other confidential interviews stated that staff provides healthy snacks for C1. Additional confidential interviews stated that C1 uses a variety of healthy snacks such as yogurt to mix with other snacks, which causes the food to go quicker, and the facility has to restock on C1's favorite snack choices often. Confidential interviews reported that C1 sometimes wants the staff to purchase steak but cannot buy steak because it's unfair if the staff cannot purchase steak for all the clients. Based on confidential interviews and observation, the allegations that S4 physically and verbally abuses C1 and that the facility provides inadequate food services may have occurred; however, this is not supported by evidence. Therefore, the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report LIC 9099 and the appeal rights were discussed and provided to Administrator Diana Bustamante.

Investigation Findings:
13On September 30, 2022, Licensing Program Analysts (LPAs) Leslie Covarrubias and Jose Gonzalez met with Administrator Diana Bustamante to deliver the compliant findings to the allegations listed above. LPA Covarrubias conducted a health and safety inspection on 02/16/2022 at 10: AM, and no immediate health and safety concerns were observed. During the course of the investigation, LPA Covarrubias conducted confidential interviews with Staff (S1-S8) and Clients (C1-C5). LPA obtained copies of Special Incident Reports (SIRs), the client roster and staff roster, pictures of the facility fridge, a list of food requests, and the facility menu. On 02/11/2022, Community Care Licensing (CCL) received an allegation that staff #4 (S4) physically and verbally abused client #1 (C1). Confidential interviews revealed that S4 is stern and can have an attitude when mad, while other clients denied that S4 was yelling, cussing, or hitting any client in care. Confidential interviews revealed that S4 is a little stern but does not yell at the clients, and S4 speaks to all clients in the same tone. (Continue on next page...) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Leslie Y Covarrubias 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 22-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, THE CITY DR., SUITE FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-MALEFACILITY NUMBER: VISIT DATE: 09/30/2022

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


raw_content:
Narrative:
Confidential interviews disclosed that C1 refuses to attend medical appointments due to ignoring prompts from staff to either wake up or get up and get ready. Additional, confidential interviews stated that the facility made several attempts for C1 to attend medical schedule appointments, but C1 ignored staff. Per facility record review, the staff has had to reschedule medical apportionments on serval occasions. The medical office has rescheduled C1 appointments due to failing to attend the scheduled appointments due to C1 being late because of C1 ignoring prompts by staff to get up in time to make the appointment. Based on confidential interviews and record review, the allegation that minor (C1) is missing scheduled appointments while in care may have occurred, however, this is not supported by evidence. Therefore, the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report LIC 9099 and the appeal rights were discussed and provided to Administrator Diana Bustamante.

Investigation Findings:
13On September 30, 2022, Licensing Program Analysts (LPAs) Leslie Covarrubias and Jose Gonzalez met with Administrator Diana Bustamante to deliver the compliant findings to the allegation listed above. LPA Covarrubias conducted a health and safety inspection on 04/08/2022 at 12: PM, and no immediate health and safety concerns were observed. During the course of the investigation, LPA Covarrubias conducted confidential interviews with Staff #1(S1), Staff #2 (S2), Staff #3 (S3), and Clients (C1, C2, C3, C4). LPA obtained copies of Special Incident Reports (SIRs), the client roster and staff roster, and C1's documented refusals on the Intensive Care Coordination Progress Note. On 04/6/2022, Community Care Licensing (CCL) received an allegation that C1 was missing scheduled appointments while in care. Confidential interviews stated that staff did not have a facility van available at the time, and this caused the clients to have to wait. Other confidential interviews stated that if clients wake up in time, they have no issue getting them to appoinment. Confidential interviews stated that clients (C2-C4) attend scheduled medical appointments when they are made. (Continue on next page...) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Leslie Y Covarrubias 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 22-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, THE CITY DR., SUITE FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-MALEFACILITY NUMBER: VISIT DATE: 09/30/2022

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


raw_content:
Narrative:
only allowed to make phone calls between the hours of 9: AM- 9: AM. Confidential interviews disclosed that C1 wanted to make a phone call after the hours of 9: AM- 9: AM and didn't want the staff to monitor the phone call. Other confidential interviews revealed that staff does not monitor calls if there are no court-ordered on file to monitor clients' telephone calls. In addition, confidential interviews revealed that clients could take calls anywhere throughout the house. Community Care Licensing also received an allegation that staff is falsifying information regarding C1. Confidential interviews revealed that staff mentioned an individual (C1's bio-parent) was somewhere they weren't or blamed clients for something they did not do. Confidential interviews stated that C1 is telling false information because C1 does not want to be in the facility and wants to be back with their bio-parent. Other confidential interviews revealed that staff are honest and do not share incorrect client information. Based on inconsistent interviews, the allegations that staff are interfering with the minor's (C1) telephone calls and staff are falsifying information regarding C1 may have occurred, however, this is not supported by evidence. Therefore, the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report LIC 9099 and the appeal rights were discussed and provided to Administrator Diana Bustamante.

Investigation Findings:
13On September 30, 2022, Licensing Program Analysts (LPAs) Leslie Covarrubias and Jose Gonzalez met with Administrator Diana Bustamante to deliver the compliant findings to the allegations listed above. LPA Covarrubias conducted a health and safety inspection on 04/13/2022 at 1: PM, and no immediate health and safety concerns were observed. During the course of the investigation, LPA Covarrubias conducted confidential interviews with Staff #1(S1), Staff #2 (S2), Staff #3 (S3), Staff #4 (S4), and Clients (C1, C2, C3, C4). LPA obtained copies of Special Incident Reports (SIRs), the client roster and staff roster, and court-monitored calls document. On 04/08/2022, Community Care Licensing (CCL) received an allegation that staff was interfering with C1's telephone calls. Confidential interviews stated that clients could make phone calls confidentially in private as long as they do not have a court order to have phone calls monitored. Facility records reviews revealed that C1 had a court order for monitoring phone calls with C1's parent and C1's sibling.. Per C1's court order, C1 is (Continue on next page...) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Leslie Y Covarrubias 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 22-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, THE CITY DR., SUITE FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-MALEFACILITY NUMBER: VISIT DATE: 09/30/2022

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


raw_content:
Narrative:
Based on the confidential interviews and records reviewed, the standard of proof has not been met that staff inappropriately shoved C1 while in care. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted and appeal rights explained to Diana Bustamante, Facility Administrator. Due to printer malfunction, a copy of this report, LIC 811, and appeal rights will be emailed to the Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On January 9, 2023, at 10:00 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Diana Bustamante, Facility Administrator, to discuss the investigative finding for the allegation noted above. LPA conducted an inspection of the facility on 11/07/2022 at 12:30 pm and no deficiencies were observed. LPA Linley interviewed three clients (C1-3) and four staff (S1-4). LPA reviewed the following documents during the investigation: S Employee Evaluation, Client Roster, C Cell Phone Videos, C Child-Family-Team Meeting notes, and an email between S2 and C1's CSW. On November 1, 2022, Community Care Licensing (CCL) received an allegation that staff inappropriately shoved C1 while in care. The confidential interviews with staff and clients provided inconsistent details of staff inappropriately shoving C1 while in care and conflicting statements. The record reviews did not provide a preponderance of evidence to prove the alleged violations did or did not occur. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley 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 22-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, THE CITY DR., SUITE FACILITY NAME: TUSTIN FAMILY CAMPUS QUALIFYING HOUSE-MALEFACILITY NUMBER: VISIT DATE: 01/08/2023

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