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Narrative:
activity and Staff (S1) allowed minor (C1) to visit with unauthorized adult (Adult #1 [A1]). Specifically, it was reported S1 allowed C1 to leave the facility to meet with A1 who was known to participate in CSEC activities. Confidential interviews provided conflicting statements regarding the allegations. Confidential interviews reported that residents would often leave the facility without permission (AWOLing) and return to the facility prior to resident being considered AWOL according to facilities AWOL protocol of two hours which is when authorities would be notified. Confidential interviews reported staff would attempt to discourage this behavior by reminding residents of consequences of leaving without permission and the safety concerns staff had for the residents. Conflicting confidential interviews reported S1 allowed C1 to leave with A1 as long as C1 brought S1 food when C1 returned without considering C AWOL. Confidential interviews and record review could not confirm or dispute these allegations. Community Care Licensing (CCL) received an additional allegation alleging Staff (Staff #1 [S1]) assisted minors (Child #1 [C1] and other youth [youth's names unknown]) with purchasing illegal substances. Specifically, it was reported S1 had taken C1 and other youth at the facility to purchase illegal drugs and alcohol. Confidential interviews reported conflicting statements regarding the allegation. Confidential interviews and record review revealed S1 had been disciplined for taking residents on unapproved outings. Confidential interviews could not confirm or dispute these outings were to purchase illegal drugs and alcohol. Based on record review and confidential interviews the allegations alleging Staff (Staff #1 [S1]) did not prevent minor (Child #1 [C1]) from engaging in Commercial Sexual Exploitation of Children (CSEC) activity, Staff (S1) allowed minor (C1) to visit with unauthorized adult (Adult #1 [A1]), and Staff (S1) assisted minors (C1 and other youth [youth's names unknown]) with purchasing illegal substances, may or may not have occurred, however they are not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights to Our House Administrator, Devin Baze.

Investigation Findings:
13On January 27, 2023 at 2:27pm Licensing Program Analyst (LPA), Nicole Strickland, met with Our House Administrator, Devin Baze to deliver the findings for the above stated allegations. LPA conducted an inspection of the facility on March 14, 2022 at approximately 10:30 am and immediate safety hazards and deficiencies were addressed and corrected. The investigation was conducted by LPA Strickland and included interviews with four current and former staff (Staff #1 [S1], Staff #2 [S2], Staff #3 [S3], and Staff #4 [S4]), three former foster youth (Child #1 [C1], Child #2 [C2], Child #4 [C4]), and one Court Appointed Special Advocate (CASA) worker. One confidential witness did not respond to LPA's request for an interview and therefore was not interviewed. In addition, county records and facility records were reviewed. On March 4, 2022, Community Care Licensing (CCL) received two allegations alleging Staff (Staff #1 [S1]) did not prevent minor (Child #1 [C1]) from engaging in Commercial Sexual Exploitation of Children (CSEC) UnsubstantiatedEstimated 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: OUR HOUSEFACILITY NUMBER: VISIT DATE: 01/27/2023

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

met_with: Devin Baze


state: CA

facility_name: OUR HOUSE

summary: Complaint Investigation - Unsubstantiated - 1 allegation

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Narrative:
The interviews that were provided to the LPA were not consistent and did not provide any specific details regarding C1 having access to drugs while placed at this facility. Based on interviews and record reviews the allegation that C1 had access to drugs while placed at this facility, may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Erik Juarez.

Investigation Findings:
13On February 28, 2023 at 11:25am , Licensing Program Analyst's (LPA's) Darlene Almaraz-Oseguera and Emina Preciado conducted an unannounced inspection to the facility to deliver the findings of the above allegations. LPA met with Erik Juarez. LPA Linda Haynes conducted an inspection of the facility on March 09, 2022 at 12:45 pm and no immediate deficiencies were observed. Two of three clients (C1, C2, C3), four staff and facility administrator were interviewed. It was reported to Community Care Licensing (CCL) that C1 had access to drugs while placed at this facility. Confidential staff interviews reported that C1 was in placement at this facility for three weeks. Confidential interviews reported that throughout C1's placement at this facility, C1 left the facility without permission and C1 was involved in numerous incidents. Confidential staff interviews reported that C1 had returned from an absent without leave (AWOL) and possibly under the influence. Confidential interviews reported that while at the facility C1 did not have any access to drugs other than the medication that was prescribed to C1. LPA attempted to interview C1 but was unsuccessful after several attempts. 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 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: OUR HOUSEFACILITY NUMBER: VISIT DATE: 02/28/2023

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

report_type: Complaint Investigation

met_with: Erik Juarez

complaint_status: unsubstantiated


summary: Complaint Investigation - Substantiated - 1 allegation

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During investigation a confidential interview stated that there were multiple incidents of verbal and physical altercations that were initiated by C3 towards C1. Confidential interview stated that C3 used C2 as a look out to attack C1 when staff were not present. Confidential further stated that C3 threatened to shoot and kill C1 after C1 surrendered drug paraphernalia to program staff that belonged to C3. Another confidential interview stated hearing the threats that C3 made against C1's safety and observed injuries on C1. Confidential interview also stated witnessing C3 teasing and instigating fights with C1 and on one occasion attempted to stop a physical altercation between C3 and C1. LPA received consistent confidential information regarding C3 making threatening remarks and body language gestures to "kill" and "shoot" C1. Based on confidential interviews, the preponderance of evidence standard has been met, and the allegation that C3 threatened C1 while in care, is supported and proven by evidence, therefore the allegation is substantiated at this time. The facility is cited for violation of Title 22, Division Chapter 5 section 84072(d) which posed a potential health and safety risk to clients in care. Exit interview was conducted. A copy of this report, along with LIC D, LIC 811, and appeal rights were explained and provided to. Our House STRTP Shelter Manager, Joseph Mendoza

Investigation Findings:
13On March 3, 2023, at 1: PM, Licensing Program Analyst (LPA) Cynthia Urena met with Our House Group Home Shelter Manager, Joseph Mendoza to deliver the investigative finding for the above stated allegation. On February 22, 2022, at 11: AM, Licensing Program Analyst (LPA) Val Wilson initiated an investigation at the Group Home. At 12: PM, LPA Wilson conducted a Health and Safety Inspection, and no deficiencies were observed. Additionally, LPA interviewed two staff members (S1, S2) and two clients (C1, C2). on February 23, 2022, LPA Wilson interviewed a County Social Worker (CSW). Attempts were made to interview Client #3 (C3), however; C3 is currently absent without permission and cannot be located. On February 17, 2022, Community Care Licensing received a complaint alleging that a minor threatened another minor in care. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Cynthia Urena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: OUR HOUSEFACILITY NUMBER: VISIT DATE: 03/03/2023

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

met_with: Shelter Manager, Joseph Mendoza

complaint_status: SUBSTANTIATED


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(Continued from page 1) confidential interviews denied any knowledge of the alleged incident occurring and stated S3 does not have a history of poor boundaries. Additionally, a confidential interview stated that C1 never went on an outing to a creek or lake with S3 or changed clothes in C3's presence. Other information states the allegation occurred. Regarding the allegation that staff threatened minors while in care, confidential interviews deny clients were ever being threatened about making complaints. Other information states the allegation occurred. Based on confidential interviews, the allegations that facility staff engaged in inappropriate behavior with minors while in care and facility staff threatened minors while in care may have occurred, however they 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 Joseph Mendoza, Jr.

Investigation Findings:
13On March 16, 2023, Licensing Program Analyst (LPA), Val Wilson, met with Shelter Manager, Joseph Mendoza, Jr, to issue the findings for the above stated allegations. LPA inspected the facility at 8:30AM on March 22, 2022, reviewed facility files, and two client files [Client 1(C1) and Client 2 (C2)]. LPA also obtained and reviewed copies of needs and services plans and face sheets. During the investigation, interviews were conducted with (C1), Administrator (ADM), Staff 1(S1), and Staff 2(S2). LPA was unable to interview C2 due to whereabouts unknown. LPA was unable to interview Staff 3 (S3) due to whereabouts unknown. On March 18. 2022, the Department received a complaint that alleged facility staff engaged in inappropriate behavior with minors while in care and facility staff threatened minors while in care. Specifically, it was alleged that S3 took C1 and an unknown client to the creek nearby and was trying to look at the clients while they were changing and S3 threatened the clients not to tell about the incident. Regarding the allegation staff engaged in inappropriate behavior with minors while in care, (Continued) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Valerie Wilson 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: OUR HOUSEFACILITY NUMBER: VISIT DATE: 03/16/2023

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

met_with: Joseph Mendoza, Jr.


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(Continued) Regarding the allegation lack of supervision resulting in minors AWOLing, confidential interviews, special incident reports noted that C1 and C2 never absconded on the same date from the facility together. Confidential interviews denied any knowledge of the alleged incident occurring with C1 and C2 and stated there were no reports of a man showing C1 or C2 a gun. Confidential interviews noted C1 would abscond while out on 15-minute walks. Additionally, C1 would return from absconding with new items, but a confidential interview denied C1 had a phone, and C1 has a history of stealing items from the store. Other information states the allegation occurred. Regarding the allegation that minors engaged in inappropriate behavior while in care, confidential interviews and client file reviews noted C1 consumed pills requiring hospitalization on 03/04/22. A confidential interview revealed cold medication was stolen and ingested while clients absconded from the facility. Confidential interviews deny drugs were stored at the facility. Specifically, another confidential interview stated safety checks of a minors or their belongings is conducted if a minor appears under the influence or smells of drugs or alcohol. If drugs are found they are disposed of by staff. Other information states the allegation occurred. Based on confidential interviews, the allegations that lack of supervision resulting in minors AWOLing and minors engaged in inappropriate behavior while in care may have occurred, however they are not supported, or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, LIC 811, appeal rights explained, and a copy of this report was emailed to Joseph Mendoza.

Investigation Findings:
13On March 22, 2023, Licensing Program Analyst (LPA), Val Wilson, met with Shelter Manager, Joseph Mendoza, to issue the findings for the above stated allegations. LPA inspected the facility at 10:46AM on March 22, 2022, reviewed facility files, and three client files [Client 1(C1) Client 2 (C2) and Client 3 (C3)]. LPA also obtained and reviewed copies of incident reports and shift notes. During the investigation, interviews were conducted with Client 3 (C3), Staff 1(S1), Staff 2(S2), and Staff 3 (S3). LPA was unable to interview C2 due to aging out of foster care and whereabouts unknown. On March 21. 2022, the Department received a complaint that alleged lack of supervision resulting in minors AWOLing and minors engaged in inappropriate behavior while in care. Specifically, it was alleged that C1 and C2 absconded from the facility with an adult male in his 30's that offered to provide C1 a cellphone for leaving with him. Additionally, the male showed C1 and C3 a gun they had with them. Lastly, a confidential interview stated that an unknown staff and C1 walked in on C2 masturbating C3 under the covers. Confidential interviews deny reports of C2 masturbating C3. Other information states the allegation occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Valerie Wilson 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: OUR HOUSEFACILITY NUMBER: VISIT DATE: 03/22/2023

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

met_with: Joseph Mendoza, Jr


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(Continued from page 1) was caught attempting to have sexual relations with unknown female client. Regarding the allegation staff did not prevent client from AWOLing while in care, a confidential interview and documentation stated that staff are not permitted to lock the doors or restrain clients that want to leave. Additionally, staff followed the facility runaway plan to persuade C2 to stay. Confidential interviews reported staff would attempt to discourage this behavior by reminding clients of consequences of leaving without permission and the safety concerns staff had for the clients. Other information states the allegation occurred. In regard to the allegation client is being bullied by other clients while in care, confidential interviews and documentation revealed C1 instigated altercations with other clients that resulted in those clients engaging in verbal or physical altercations with C1, requiring staff intervention. However, staff ensure the client are separated after altercations. An interview and documentation review revealed staff are not permitted to physically restrain clients, but rather intervene with verbal redirection. Other confidential interviews denied bullying occurs at the facility. Other information states the allegation occurred. Regarding the allegation clients are engaging in inappropriate behavior while in care, confidential interviews revealed sexual health may be a topic discussed at group therapy and client participation is voluntary. Confidential interviews revealed C1 did not participate in the sexual health group. None of the confidential interviews disclosed sexual interactions between clients. Other information states the allegation occurred Based on confidential interviews, the allegations that staff did not prevent C2 from AWOLing while in care, C1 is being bullied by other clients while in care, and clients are engaging in inappropriate behavior while in care may have occurred, however they are not supported, or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, a copy of this report, and LIC 811 was provided to Joseph Mendoza, Jr., and Devin Baze, Administrator.

Investigation Findings:
13On April 5, 2023, Licensing Program Analyst (LPA), Val Wilson, met with Shelter Manager, Joseph Mendoza Jr., and via phone, Administrator, Devin Baze, to issue the findings for the above stated allegations. LPA inspected the facility at 2:00PM on April 15, 2022, reviewed facility files, and two client files [Client 1(C1) and Client 2 (C2)]. LPA also obtained and reviewed copies of the facility roster, client roster, program statement, county report, individual child/young adult characteristics and behaviors, Health and Education Passport, shift notes, and special incident reports (SIR's). During the investigation, confidential client and staff interviews were conducted by LPA Wilson and Katherine McGill, Supervising Social Services Practitioner (SSP), with (C1), (C2), Staff 1 (S1), and C1's biological mother (BM). On April 8, 2022, the Department received a complaint that alleged staff did not prevent client from AWOLing (absence without leave) while in care, client is being bullied by other clients while in care, and clients are engaging in inappropriate behavior while in care. Specifically, it was alleged C2 was observed absconding through an open door, C1 was bullied and "jumped" by three clients, staff are unable to physically intervene during altercations, C1 is being talked to about sex and birth control, and an unknown male client (Continued) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Valerie Wilson 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: OUR HOUSEFACILITY NUMBER: VISIT DATE: 04/05/2023

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

met_with: Joe Mendoza and vai phone, Devin Baze


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(unknown) do not ensure a minor (C1) takes medications as prescribed, and staff (unknown) do not prevent a minor (C1) from engaging in self harming activities, may or may not have occurred, however thet are not supported or proven by the evidence. therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights to Our House Shelter Manger, Joseph Mendoza, Jr., Confidential interviews provided conflicting statements regarding how C1 obtained the alcohol and how staff responded when C1 was observed having possession of alcohol. Confidential interviews reported it was common practice for C1 to leave the facility without permission in order to obtain alcohol and bring it back to the facility. Confidential interviews report that when staff observed contraband including alcohol it is confiscated from the residents. Conflicting statements were also reported to say that if and when residents are observed to have possession of alcohol or other contraband staff may or may not say something to the resident about the contraband not being allowed but nothing further is done by staff. Confidential interviews could not confirm or dispute how and when C1 would obtain C1's alcohol nor could they confirm or dispute C1 being allowed to drink alcohol while in care. An additional allegation alleging Staff (unknown) do not ensure a minor (C1) takes medications as prescribed. Specifically, it was reported C1 was observed to have 30 pills in C1's possession which had been allegedly "cheecked" (provided by staff as part of medication routine but placed in cheek in order to avoid ingesting the medication). Confidential interviews provided conflicting statements as to how medications are provided to residents and if staff check residents for cheeking. Confidential interviews could not confirm or dispute the pills found in C1's possession were obtained through "cheecking." CCL received an additional allegation alleging Staff (unknown) did not prevent a minor (C1) from engaging in self harming activities. Specifically, it was reported C1 was left in a room by self with the door closed while C1 was having suicidal ideation. Confidential interviews provided conflicting statements as to how C1 was supported during C1's crisis. Confidential interviews reported staff followed safety plan that had been created for C1 which included taking C1 for walks, drives in facility vehicle and giving space to C1 based upon staff's interactions with C1. Confidential interviews could not confirm or dispute when C1 was given space that C1 was left in room with door closed. Confidential interviews reported when C1 was given space staff would either be outside of the room or conduct more frequent room checks additional confidential interviews reported that C1 would be left for long periods with little to no interaction with staff when C1 was in crisis. Based on record review and confidential interviews the allegations of staff (unknown) allows a minor (Child #1 (C1) to drink alcohol while in care, staff (unknown) encourage a minor (C1) to steal alcohol, staff ******

Investigation Findings:
13On May 25, 2023, at 12:07pm Licensing Program Analyst (LPA), Nicole Strickland, met with Our House Shelter Manger, Joseph Mendoza, Jr., to deliver the finding for the above stated allegations. A health and safety inspection of the facility was conducted on May 23, 2022 and no immediate safety hazards were observed. The investigation included interviews with three of seven current and former foster youth (Child #1 [C1], Child #2 [C2], and Child #7 [C7]) San Bernardino County Social Worker (CSW), three staff (Staff #1 [S1], Staff #2 [S2], and Shelter Manager [SMgr]). Three confidential witness' whereabouts were unknown and therefore were not interviewed. In addition, county records and facility records were reviewed. On May 18, 2022, Community Care Licensing (CCL) received an allegation alleging staff (unnamed) allows a minor (Child #1 [C1]) to drink alcohol while in care and staff (unnamed) encourages a minor (C1) to steal alcohol. Specifically, it was reported C1 would be encouraged by nighttime staff to leave the facility to steal alcohol and upon C1's return, C1 was allowed to consume the alcohol in the presence of the staff. UnsubstantiatedEstimated 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: OUR HOUSEFACILITY NUMBER: VISIT DATE: 05/25/2023

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

met_with: Joseph Mendoza, Jr.,


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Narrative:
(continued) Regarding the allegation C1 self-harmed while in care, confidential interviews and documentation revealed C1 confronted C2, which resulted in aggression towards C2. During the investigation it was revealed S1 and S2 intervened when C1 threatened to kill C2, then threatened to kill themself, all while destroying dinnerware in the kitchen and attempting to self-harm with the broken dinnerware. Corroborating interviews shared that staff were immediately picking up pieces of the broken dinnerware and removing the pieces from C1 that were picked up. C1 sustained red marks on their arm that did not break the skin. Additionally, S1 and S2 followed the program statement and contacted law enforcement. C1 then told the sheriff they had intention to kill themselves and the sheriff transported C1 for a mental health evaluation. Other information states the allegation occurred. Based on record review and confidential interviews, the allegation C1 self-harmed while in care may have occurred, however they are not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, a copy of this report, and LIC 811 was provided to facility.

Investigation Findings:
13On June 22, 2023, at 3: PM, Licensing Program Analyst (LPA), Val Wilson, was greeted by Gailine Lee, lead youth advocate, and granted entry. LPA met with shelter manager, Joe Mendoza, and on the phne Administrator, Devin Baze, to issue the findings for the above stated allegation involving the Our House Group Home (GH) and clients listed on the confidential Names List, LIC 811, dated June 22, 2023. LPA inspected the facility at 3:20PM on July 14, 2022, reviewed facility files, and two client files [Client 1(C1) and Client 2 (C2)]. LPA also obtained and reviewed copies of the facility roster, client roster, program statement, county report, Health and Education Passport, shift notes, and special incident report (SIR). During the investigation, confidential client and staff interviews were conducted by LPA Wilson with (C1), (C2), staff 1 (S1), and the shelter manager (SM). Staff 2 (S2) was unable to be interviewed due to whereabouts unknown. On July 8, 2022, the Department received a complaint that alleged minor self-harmed while in care. Specifically, it was alleged C1 attempted to stab and cut themself with a pencil, throw butter knives, and threatened to hit their head with a frying pan while in care. However, when the emergency department inquired into suicidal ideations, C1 shrugged and did not provide clear answers. (Continued) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Valerie Wilson 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: OUR HOUSEFACILITY NUMBER: VISIT DATE: 06/22/2023

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


raw_content:
Narrative:
observed putting a hand on C7. The video obtained does not show if there was any physical interaction between DIR and C7 prior to DIR putting a hand on C7. Record review and Confidential interviews provided conflicting statements regarding DIR putting DIRs hand on C7. Confidential interviews reported DIR put DIRs hand on C7 after being hit by C7 to push C7 away and defend self. Additional confidential interviews reported that DIR had put hands on C7 first which instigated C7 then hitting DIR. Record review and confidential interviews could not confirm or dispute the allegation. Based on record review and confidential interviews the allegation of Staff (Director [DIR]) physically assaulted minor(s) (Child #7 [C7]) in care, 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 a copy of the report was provided along with appeal rights to Our House Administrator Devin Baez. occurring on the morning of July 14, 2022, led to the DIR arriving to the facility and allegedly being disrespectful to the minor(s) and making threats to the minors. Record review and confidential interviews reported DIR was overheard making statements that DIR was going to drop off the minors in the desert. Confidential interviews also report hearing DIR telling residents they were going to be kicked out of the facility. Confidential interviews also reported DIR was heard calling the residents (C7, C8, C9, and C10) "dumb bitches," and was not using the correct gender pronouns to which the residents identified with. Based on confidential interviews and record review the allegations of staff (Director [DIR]) threatened minor(s) (Child #7 [C7], Child #8 [C8], Child #9 [C9] and Child # [C10]) in care and staff (DIR) spoke inappropriately to minor(s) (C7, C8, C9, and C10) in care are substantiated. The preponderance of evidence standard has been met. Facility is cited for violation of California Code of Regulations (CCR) Regulation 84072(d)(10) PERSONAL RIGHTS (d)(10) to be accorded dignity in his or her personal relationships with staff and other persons. A copy of the report was discussed and provided along with appeal rights to Our House Administrator, Devin Baze.

Investigation Findings:
13On July 5, 2023 at 1:18 pm Licensing Program Analyst (LPA), Nicole Strickland, met with Our House Group Home Administrator, Devin Baze to deliver the finding for the above stated allegation. The investigation was conducted by LPA Strickland and included interviews with four current and former foster youth (Child #6 [C6], Child #7 [C7], Child #10 [C10], and Child #12 [C12]), two staff (Staff #1 [S1] and Staff #2 [S2]), Director, and San Bernardino County Social worker. Additional interviews were either declined or responses to LPA's request for interviews were not responded to. In addition, county records, and facility records were reviewed. On July 15, 2022, Community Care Licensing (CCL) received two allegations alleging staff (Director [DIR]) threatened minor(s) (Child #7 [C7], Child #8 [C8], Child #9 [C9] and Child # [C10]) in care and staff (DIR) spoke inappropriately to minor(s) (C7, C8, C9, and C10) in care. Specifically, it was reported an incident 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: OUR HOUSEFACILITY NUMBER: 366428048

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:


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(Continued) personal belongings by intentionally ripping and/or hitting the items against hard surfaces in addition to pouring various liquids on C1's personal belongings. Confidential interviews and documents revealed S1 removed clients from C1's bedroom area, S2 and S3 locked themselves in the back office, law enforcement was contacted, and SM attempted to de-escalate C1, who was crying loudly and redirected by SM from re-entering their bedroom. C2 and C3 finished damaging C1's belongings while C1 continued to cry and object to C2 and C3's destroying C1's remaining belongings. C1 was not accorded dignity in relations with staff or peers. Based on confidential interviews, document review, and video recordings, the preponderance of the evidence standard has been met. The allegations staff failed to implement emergency intervention plan while C2 had a physical altercation with C1 while in care and due to staff neglect, minor's personal belongings were damaged by another minor while in care are substantiated at this time. The facility is cited for violation of Title 22, Division 6, Chapter 5, Subchapter 3. Emergency Intervention in Group Homes, Section General Provisions and Title 22, Division 6, Chapter 5, Section Personal Rights. An exit interview was conducted, appeal rights explained, a copy of this report, 9099D, and LIC 811 was provided to Joe Mendoza (Continued) alleged staff failed to implement emergency intervention plan while minor had a physical altercation with another minor while in care and, due to staff neglect, minor's personal belongings were damaged by another minor while in care. Specifically, it was alleged video captured C1 dragged through the street by C2 with several onlookers that included staff and clients, and clients did not allow staff to intervene. Additionally, it was captured on video that C2 and C3 intentionally destroyed C1's personal property. Regarding the allegation staff failed to implement emergency intervention plan while C2 had a physical altercation with C1 while in care, confidential interviews, documents, and recorded video revealed a verbal altercation between C1 and C2 escalated into C2 following C1 outside of the GH and C2 dragging C1 by their hair and arms on the street in front of the GH while C4 recorded the events on their phone. S2 and S3 did not physically intervene. However, S1 is seen on video verbally intervening and moving between C1 and C2 while a neighbor physically intervenes by touching C2's arm and asking C2 to stop. S1 was then able to to separate and de-escalate the physical altercation. Corroborating interviews and documents revealed S2 and S3 were also present outside observing the physical altercation and neither S2 or S3 removed all other clients from the area of the altercation. In addition, neither S2 or S3 used a continuum of interventions while C2 continued to present an imminent danger for injuring or endangering C1. Lastly, confidential interviews and video revealed that C2 and C3 cornered S2 and S3 in while looking to find household items to destroy C1's personal property. Review of the program statement revealed the following: "No one is allowed to use physical force in the shelter for any behavior enforcing reason at any time", "Restraint of any client may be used only in a life threatening emergency", "If a child is threatening themselves or others, the police will be contacted and the youth removed from the property. Shelter staff will remove all other children from the area until law enforcement arrive and remove the child", "Physical assault will not be tolerated. In the case of physical assault, 911 will be called immediately. The perpetrator will be removed from the program and the victim will be given the opportunity to press charges", and "If there is any sign that staff or client is in danger from someone outside or inside the facility, 911 will be contacted immediately". Confidential interviews reveal the emergency intervention plan was not followed and staff did not use a more restrictive intervention when less restrictive techniques were not effective. Regarding the allegation, due to staff neglect, minor's personal belongings were damaged by another minor while in care, corroborating interviews, documents, and recorded video revealed C1 witnessed C2 and C3 destroy C1's personal property while C4 took video and staff did not consistently use a continuum of more restrictive interventions. Confidential interviews and video note C2 and C3 damaged C1's (Continued)

Investigation Findings:
13On July 13, 2023, at 4: PM, Licensing Program Analyst (LPA), Val Wilson met with Our House Group Home (GH) Shelter Manager, Joe Mendoza, to issue the findings for the above stated allegation involving the GH and clients listed on the confidential Names List, LIC 811, dated June 22, 2023. On June 27, 2022, at 12: PM, a safety inspection was conducted at the GH and there were no noted concerns. LPA reviewed facility files, three staff files [staff 1 (S1), staff 2 (S2), staff 3 (S3)], and four client files [client 1 (C1), client 2 (C2), client 3 (C3), and client 4 (C4)]. During the investigation, LPA obtained and reviewed copies of the client roster, staffing roster, shift notes, placement agreement, face sheets, GH timeline of events, county report, police report, declarations, and C4's video recordings. During the investigation, confidential client and staff interviews were conducted by LPA Wilson with C1, C2, C3, C4, S1, S2, administrator (ADM), shelter manager (SM), county social worker(CSW), and facility social worker (FSW). LPA was unable to interview S3 due to current whereabouts being unknown. On July 18, 2022, Community Care Licensing (CCL) the Department received a complaint that alleged that (Continued) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Valerie Wilson 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: OUR HOUSEFACILITY NUMBER: 366428048

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

met_with: Joe Mendoza, Jr.


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belongings whenever they return to the facility from school, from an AWOL or a home pass when staff suspect contraband. According to confidential interviews, staff will also attempt and prevent clients from AWOLing by counseling them, giving them options, as well as by telling them about the consequences and dangers of them leaving the facility without permission. According to confidential information, staff cannot physically restrain or prevent clients from leaving and will follow them as much as possible, get a description of the direction headed or the vehicle, and will notify law enforcement and other pertinent agencies of the client's AWOL. Confidential interviews also stated that C1 was not sexually assaulted by C2, and that sexual interactions between C1 and C2 were consensual. While other allegations received by Licensing Office stated that these allegations had occurred. There were no other known witnesses to these allegations. Based on interviews and confidential information obtained during the course of this investigation, the allegations that staff do not adequately supervise minors resulting in AWOL (Absence Without Official Leave), that Child # 1 (C1) was sexually assaulted while in care by Child # 2 (C2), and that minors have access to alcohol while in care, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided. standard has been met and the Department has determined the allegation that Staff are not preventing inappropriate sexual interactions between minors in the facility is substantiated. This posed an immediate health, safety or personal rights risk to the child placed in care. The facility is being cited for violation of the Title Regulations Division 6, Chapter 1, Article 6, Section 80078(a) Responsibility for Providing Care and Supervision. See attached LIC 9099D for cited deficiency. An exit interview was conducted, and a copy of the report and appeal rights were provided.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Facility Manager, Tanajah Steen to discuss the investigative findings for the above stated allegation. LPA Mena conducted an inspection of the Facility on February 24, 2023, at 10: AM. No immediate hazards were observed. Special Investigator (SI), Georgina Tallagua interviewed three foster children (C1, C3 & C4), six staff (S1, S2, S3, S4, S5 & S6), County Social Worker (CSW), as well as reviewed facility and client records. SI Tallagua was unable to interview C2 and C3 due to their current whereabouts being unknown. Community Care Licensing received information on February 23, 2023, alleging that staff are not preventing inappropriate sexual interactions between minors in the facility, more specifically that Client # 1 (C1) had engaged in sexual intercourse with C2 while in care. Confidential interviews corroborated allegation with a preponderance of evidence. Confidential information obtained confirmed allegation that C1 and C2 had engaged in sexual intercourse inside one of the facility's bathrooms. According to confidential interviews, C1 and C2 turned on the bathroom's shower in order to prevent staff from catching them. Based on interviews and information gathered during the investigation, the preponderance of evidence SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena 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: OUR HOUSEFACILITY NUMBER: 366428048

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: Tanajah Steen


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(Continued from page 1) attention for injuries sustained while in care, and facility staff did not ensure safety of minor's personal possessions while in care. Specifically, it was alleged that S1 and S2 did not intervene in an altercation involving C1 and C2, medical attention was not offered to C1, C1's possessions were stolen, and C1 absconded the GH. Regarding the allegation that the facility staff did not prevent C1 from AWOLing while in care, confidential interviews reported the facility protocol is for staff to verbally redirect the clients from leaving the facility. Confidential interviews reported staff did attempt to redirect C1 from leaving. Other information states the allegation occurred. Regarding the allegation that S1 and S2 did not prevent C1 and C2 from engaging in a physical altercation resulting in C1's injuries while in care, confidential interviews reported the facility protocol during incidents involving physical altercations is for staff to redirect the clients verbally; Law enforcement is contacted if staff are unable to redirect the clients during the altercations. Confidential interviews reported S1 and S2 verbally redirected and separated C1 and C2. Other information states the allegation occurred. Regarding the allegation that S1 and S2 did not offer C1 medical attention for injuries sustained while in care, confidential interviews revealed first aid was provided and C1 was offered the opportunity to go to urgent care. Other information states the allegation occurred. Regarding the allegation that facility staff did not ensure safety of C1's personal possessions while in care, confidential interviews revealed C1's possessions remained safe and secure without report of missing items. Other information states the allegation occurred. Based on confidential interviews, the allegations that facility staff did not prevent C1 from AWOLing while in care, S1 and S2 did not prevent C1 and C2 from engaging in a physical altercation resulting in C1's injuries while in care, S1 and S2 did not offer C1 medical attention for injuries sustained while in care, and facility staff did not ensure safety of C1's personal possessions while in care, may or may not have occurred; However, they are not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, a copy of this report, and LIC 811 was provided to the Shelter Manager.

Investigation Findings:
13On February 1, 2024, at 11: AM, Licensing Program Analyst (LPAs), Cynthia Velasquez and Val Wilson, met with Shelter Manager, Joe Mendoza, Jr., at Our House Group Home (GH), to issue the findings for the above stated allegations involving the GH and clients listed on the confidential Names List, LIC 811, dated February 1, 2024. On February 10, 2023, at 12: PM, LPA Belinda Torres arrived at the GH and a safety inspection was completed without any health and safety concerns observed. On February 28, 2023, LPA Wilson reviewed client files, facility documents, and obtained copies of Special Incident Reports (SIRs) and shift notes. During the investigation, interviews were conducted with staff 1 (S1), staff 2 (S2), shelter facility manager (SM), client 2 (C2), client 3 (C3), and the county social worker (CSW). LPA was unable to interview Client 1 (C1) due to aging out of foster care and whereabouts unknown. On February 2, 2023, the Department received a complaint that alleged the facility staff did not prevent minor from AWOLing while in care, facility staff did not prevent minors from engaging in a physical altercation resulting in injuries while in care, facility staff did not offer minor medical *R- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: OUR HOUSEFACILITY NUMBER: VISIT DATE: 02/01/2024

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


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

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.*****Continued***** facility with food from S2's home, and S2 conveyed there would be no consequences for lack of professional boundaries due to their friendship with LYA. Additionally, S2 called C1 nicknames, S2 showed favoritism to C1, and S2 twerked in front of C1. Regarding the allegation that S2 has engaged in an inappropriate relationship with C1, confidential interviews confirmed S2 brought C1 to their residence for a home cooked meal but documented a mall trip in the client file. Confidential interviews revealed that S2 never took C1 to the mall. Confidential interviews and documents reveal the community outing was approved for the mall and GH policy does not permit taking clients to an employee residence. Confidential interviews also revealed that S2 would only engage with the male clients, had danced in front male clients, and showed preferential treatment to C1. Regarding the allegation that S2 has spoken inappropriately to C1, confidential interviews confirmed S2 showed C1 favoritism and would call C1 handsome, cute or pretty eyes. Based on confidential interviews, the preponderance of evidence standard has been met, and the allegation that S2 has engaged in an inappropriate relationship with C1 and S2 has spoken inappropriately to C1 is supported and proven by evidence, therefore the allegations are substantiated at this time. The facility is cited for violation of Title Regulations Division 6, Chapter 5, Article 6, 84072 (d)(10) Personal Rights. An exit interview was conducted, appeal rights explained, a copy of this report, D, and LIC 811 were provided to the facility representative.

Investigation Findings:
13On March 12, 2024, at 2: PM, Licensing Program Analysts (LPA), Jason Dalton and Val Wilson, met with Shelter Manager, Joe Mendoza., at Our House Group Home (GH), to issue the findings for the above stated allegations involving the GH and youth listed on the confidential Names List, LIC 811, dated March 12, 2024. On March 16, 2023, at 2: PM, LPA Wilson arrived at the GH and a safety inspection was completed without any health and safety concerns observed. LPA Wilson reviewed client files, facility documents, and obtained copies of the client roster, LIC 500, face sheets, shift notes, employee handbooks, and admission agreements. During the investigation, interviews were conducted with client 1 (C1), shelter manager (SM), Lead Youth Advocate (LYA), staff 1 (S1), staff 2 (S2), and staff 3 (S3). LPA was unable to interview client 2 (C2) due to aging out of foster care and whereabouts unknown. On March 13, 2023, the Department received a complaint that alleged a facility staff has engaged in inappropriate relationships with residents and facility staff has spoken inappropriately to residents. Specifically, it was alleged that S2 brought C1 to their home, C1 returned to the ***Continued*** SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Valerie Wilson 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 Riverside, CA Facility Name: Our Housefacility Number: Visit Date: 03/12/ Narrative 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32.*R- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: OUR HOUSEFACILITY NUMBER: 366428048

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

Deficiencies:
61621: Our Housefacility Number: 366428048 Visit Date: 03/12/2024 Narrative 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32.*****Continued*****

facility with food from S2's home, and S2 conveyed there would be no consequences for lack of professional boundaries due to their friendship with LYA.  Additionally, S2 called C1 nicknames, S2 showed favoritism to C1, and S2 twerked in front of C1.

Regarding the allegation that S2 has engaged in an inappropriate relationship with C1, confidential
interviews confirmed S2 brought C1 to their residence for a home cooked meal but documented a mall trip in the client file.  Confidential interviews revealed that S2 never took C1 to the mall.  Confidential interviews and documents reveal the community outing was approved for the mall and GH policy does not permit taking clients to an employee residence.  Confidential interviews also revealed that S2 would only engage with the male clients, had danced in front male clients, and showed preferential treatment to C1.

Regarding the allegation that S2 has spoken inappropriately to C1, confidential interviews confirmed S2 showed C1 favoritism and would call C1 handsome, cute or pretty eyes.

Based on confidential interviews, the preponderance of evidence standard has been met, and the allegation that S2 has engaged in an inappropriate relationship with C1 and S2 has spoken inappropriately to C1 is supported and proven by evidence, therefore the allegations are  substantiated at this time.

met_with: Joe Mendoza

title:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., Suite 600 Riverside, CA 92501 Facility Name


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*****Continued***** Regarding the allegation that S1 and S2 did not adequately supervise C1 and C2 in care, confidential interviews revealed C1 and C2 were outside the GH. S1 and S2 were unsuccessful at encouraging the clients to return into the GH. S1 and S2 remained inside the GH while the clients outside in the darkened areas of the GH yard remained unsupervised. Confidential interviews noted S1 and S2 observed condoms and other contraband in the darkened area of the GH yard. However, record review of the SIR dated June 10, 2023, states "When staff went to check on them, they noticed they were having sex. The staff told them to stop and go to their rooms". Confidential interviews confirmed C1 reported sexual activity. Record review and confidential interviews revealed both S1 and S2 received written counseling in regard to clients are not permitted to be outside the GH unsupervised during the overnight shift, lack of documentation, and constant supervision is required when clients are out of their rooms any time past bedtime. Based on confidential interviews and record review, the preponderance of evidence standard has been met, and the allegation that S1 and S2 did not adequately supervise C1 and C2 in care is supported and proven by evidence, therefore the allegation is substantiated at this time. The facility is being cited for violation of the Title Regulations Division 6, Chapter 5, Article 6, Section 84065.2(b)(1) Personnel Duties. An exit interview was conducted, appeal rights explained, a copy of this report, 9099D, and LIC 811 was provided to the facility representative.

Investigation Findings:
13*****This is an amended report of the report issued June 17, 2024*****On June 17, 2024, at 2: PM, Licensing Program Analysts (LPAs), Rachel Vanegas and Val Wilson, met with Joseph Mendoza, Lead Facility Manager at Our House Group Home (GH), to issue the findings for the above stated allegation involving the GH and clients listed on the confidential Names List, LIC 811, dated June 17, 2024. On June 22, 2023, at 4: PM, LPA Wilson arrived at the GH and a safety inspection was completed without any health and safety concerns observed. LPA Wilson reviewed client files, facility documents, and obtained copies of the client roster, LIC 500, individual child/young adult characteristics and behaviors, health education passport, face sheets, parent/guardian contract, child and family team meeting notes, serious incident report (SIR), and staff files. During the investigation, interviews were conducted with client 1 (C1), client 2 (C2), facility shelter manager (FM), and staff 1 (S1). LPA was unable to interview staff 2 (S2) due to no longer working at the GH. On June 19, 2023, the Department received a complaint that alleged facility staff did not adequately supervise minors while in care. *R- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: OUR HOUSEFACILITY NUMBER: 366428048

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

met_with: Joseph Mendoza


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*****Continued***** Specifically, it was alleged C1 had been coughing up blood, group home staff and C1's county social worker (CSW) was made aware, but no medical attention was provided until C2 called 911. Regarding the allegation that staff did not seek medical care for C1 in a timely manner, confidential interviews and record review revealed C2 contacted the paramedics for C1 even when staff consistently offered first aid medical attention, and the opportunity to go to urgent care and/or to go to the emergency room, but each of these opportunities was declined by C1. Other information states the allegation occurred. Regarding the allegation that staff did not treat minor with dignity or respect, confidential interviews and record review reveal facility staff recognize and appropriately respond with the necessary supports and services to meet C1's individualized needs. Other information states the allegation occurred. Based on confidential interviews, the allegations that staff did not seek medical care for C1 in a timely manner staff did not treat C1 with dignity or respect, may or may not have occurred; However, they are not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, a copy of this report, LIC 811, and appeal rights were explained and provided to the facility representative.

Investigation Findings:
13On June 25, 2024, at 8: AM, Licensing Program Analysts (LPAs), Jason Dalton and Val Wilson, met with Lead Facility Manager, Tanajah Steen, at Our House Group Home (GH), to issue the findings for the above stated allegations involving the GH and clients listed on the confidential Names List, LIC 811, dated June 24, 2024. On June 30, 2023, at 2: PM, LPA Wilson arrived at the GH and a safety inspection was completed and case management was completed for an observed health and safety concern. LPA Wilson reviewed client files, facility documents, and obtained copies of the client roster, LIC 500, face sheets, individual child/young adult characteristics and behaviors, behavior agreements, health education passports, shift notes, special incident report (SIR), and county reports. During the investigation, interviews were conducted with client 1 (C1), client 2 (C2), staff 1 (S1), staff 2 (S2), county social worker (CSW), and facility manager (FM). On June 26, 2023, the Department received a complaint that alleged staff did not seek medical care for minor in a timely manner and staff did not treat minor with dignity or respect. *R- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: OUR HOUSEFACILITY NUMBER: VISIT DATE: 06/25/2024

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


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*****Continued***** On July 21, 2023, the Department received a complaint that alleged staff do not prevent minors from engaging in sexual activity and staff do not prevent minors from drinking alcohol. Specifically, it was alleged C1 wanted to report to staff they had sex with C2, but the staff told C1 they did not want to hear about it 'if it was something they had to report". Additionally, staff are aware of sexual activity and drinking at the GH. Regarding the allegation that staff do not prevent C1 and C2 from engaging in sexual activity, confidential interviews and record review deny C1 and C2 had sexual relations while placed at the facility or that it was reported there was sexual relations to any of the facility staff. Interviews revealed the level of supervision is eyes on each client every 15 minutes. Staff immediately intervene when clients room visit and redirect the visit to a common area. Other information states the allegation occurred. Regarding the allegation that staff do not prevent minors from drinking alcohol, confidential interviews deny staff do not prevent minors from drinking alcohol. Interviews reveal searches for any contraband is conducted based on reasonable and prudent parenting. If alcohol or any contraband is suspected or reported in the home, a search can be conducted. If a client is found to have contraband, the contraband is removed, the client is assessed, documentation is made in the client record and facility logbook, and the afterhours response center (ARC) is contacted for client removal. Other information states the allegation occurred. Based on confidential interviews, the allegations that staff do not prevent C1 and C2 from engaging in sexual activity and staff do not prevent minors from drinking alcohol, may or may not have occurred; However, they are not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, a copy of this report, LIC 811, and appeal rights were explained and provided to the facility representative.

Investigation Findings:
13On June 26, 2024, at 2: PM, Licensing Program Analysts (LPA), Val Wilson, met with Administrator, Joe Mendoza, at Our House Group Home (GH), to issue the findings for the above stated allegations involving the GH and clients listed on the confidential Names List, LIC 811, dated June 26, 2024. On July 24, 2023, at 1: PM, LPA Wilson arrived at the GH and a safety inspection was completed and no immediate health and safety hazards were observed. LPA Wilson reviewed client files, facility documents, and obtained copies of the client roster, LIC 500, face sheets, individual child/young adult characteristics and behaviors, dynamic development, health education passports, shift notes, special incident report (SIR), and county reports. During the investigation, interviews were conducted with client 1 (C1), client 2 (C2), client 3 (C3), staff 1 (S1), staff 2 (S2), staff 3 (S3), staff 4 (S4), county social worker (CSW), and facility manager (FM). LPA was unable to interview Client 4 (C4) due to whereabouts unknown. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Valerie Wilson LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: OUR HOUSEFACILITY NUMBER: VISIT DATE: 06/26/2024

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


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

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Narrative:
***Continued*** Regarding the allegation that S1 is not qualified. Specifically, it was alleged that S1 did not meet the education and experience for the job description. Confidential interviews confirmed what the personnel records revealed; S1's personnel records did not contain documentation of S1's education and experience to satisfy the GH's Plan of Operation (POO) regarding "Education and Experience" for Social Worker which state "A Master's Degree from an accredited or state approved graduate school... In addition to the degree specifications, all of the following coursework and field practice or experience shall be required... (c) Social work personnel who do not meet the Master's Degree requirements specified above may apply for an exception provided he/she completes the coursework and field practice or experience requirements specified in above..." HR and H2 reviewed S1's personnel record with LPA Wilson, in person, and confirmed documents applicable to satisfying the GH's own requirements were not in S1's personnel record. Based on interviews, record review and observation, the preponderance of evidence standard has been met, and the allegation that the S1 is not qualified is supported and proven by evidence, therefore the allegation is substantiated at this time. The facility is cited for violation of Title Regulations Division 6, Chapter 1, Article 3, 80022 (k) Plan of Operation. An exit interview was conducted, and a copy of the appeal rights were provided and explained. A copy of this report, LIC 809D, and LIC 811 was provided to the facility representative. ***Continued*** Regarding the allegation that facility staff are engaging in inappropriate activities, specifically it was stated that facility credit cards are declined for client activities, fuel for facility vehicles, or groceries. Additionally, Chief Executive Officer/administrator (CEO) yells, blames, throws objects, and makes unreasonable demands, contributing to staff turnover. Confidential interviews and record review noted shopping and activities are cancelled when the credit cards are declined. Interviews shared that historically, alternative activities took place, and the activity or grocery shopping was rescheduled to a later time or date; client services were not impacted. Other information noted the DYS implemented protocol for staff to proactively check the credit card balance prior to attending client related service or activities, and there are three credit cards assigned to the GH for staff use. Additionally, confidential interviews instances where they received phone calls from CEO and/or in-person visits that included being blamed and yelled at for not meeting an unreasonable demand; however, these instances did not occur in the presence of clients. Other interviews noted staff turnover was due to ineffective communication and "barking orders", and each instance was brought to HR's attention. HR confirmed notification, but record review did not reveal documentation in personnel records. Other information revealed the GH satisfies requirements, and staff are satisfied with communication and leadership. LPA received inconsistent information regarding this allegation. Regarding the allegation that the POO is not being followed, it was specifically alleged the CEO does not ensure direct care staff are trained on how to intervene with various situations that occur at the facility. Confidential interviews noted the CEO admonishes staff that follow the POO/program statement when calling 911, direct police line, or ARC (after hours response center), because these behavioral events are no longer internal and result in financial loss due to reduced census. Interviews also revealed that historically, implementation of the staff training program and emergency intervention plan is inconsistent. Other information notes a new human resources director and administrator has been appointed. The DYS has been working with the current administrator and human resources to update, where needed, the POO/program statement, plan for tracking orientation, development, and training of staff, including competency. Other information revealed the GH satisfies plan of operation requirements, and staff are satisfied with communication and leadership. LPA received inconsistent information regarding this allegation. Based on confidential interviews, the allegations that facility staff are engaging in inappropriate activities and the POO is not being followed, may or may not have occurred; However, they are not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, a copy of this report, and LIC 811 was provided to the facility representative.

Investigation Findings:
13On August 19, 2024, at 11: AM, Licensing Program Analyst (LPA), Val Wilson, met with Administrator, Joseph Mendoza and Director of Youth Shelters, Sylvia Steinhart regarding Our House Group Home (GH), to issue the findings for the above stated allegations involving the GH and those listed on the confidential Names List, LIC 811, dated August 19, 2024. On August 23, 2023, at 1: PM, LPAs Wilson and Sarah Lo arrived at the GH, and a safety inspection was completed without any health and safety concerns observed. LPAs reviewed facility documents, and obtained copies of the client roster, LIC 500, staff files, staff statements, plan of operation, and the program statement. During the investigation, interviews were conducted with shelter manager (SM), staff 1 (S1), staff 2 (S2), staff 3 (S3), staff 4 (S4), staff 5 (S5), staff 6 (S6), staff 7 (S7), staff 8 (S8), staff 9 (S9), staff 10 (S10), client 1 (C1), client 2 (C2), human resources (HR), human resources 2 (HR2), executive assistant (EA), and director of youth shelters (DYS). On August 15, 2023, the Department received a complaint that alleged that facility staff are engaging in inappropriate activities and the Plan Of Operation (POO) is not being followed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Valerie Wilson 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE This is an official report of an unannounced visit/investigation of a complaint received in our office on 08/15/2023 and conducted by Evaluator Valerie Wilson PUBLICCOMPLAINT CONTROL NUMBER: 19-CR- FACILITY NAME:OUR HOUSEFACILITY NUMBER: ADMINISTRATOR:DEVIN BAZEFACILITY TYPE: ADDRESS: JASPER AVENUETELEPHONE: (760) 985- CITY:MENTONESTATE: CAZIP CODE: CAPACITY:12CENSUS: 2DATE: 08/19/ UNANNOUNCEDTIME BEGAN: 11: AM MET WITH:Joe MendozaTIME COMPLETED:12: PM 9Staff is not qualified. INVESTIGATION FINDINGS: 13On August 19, 2024, at 11: AM, Licensing Program Analyst (LPA), Val Wilson, met with Administrator, Joseph Mendoza and Director of Youth Shelters, Sylvia Steinhart regarding Our House Group Home (GH), to issue the findings for the above stated allegation involving the GH and those listed on the confidential Names List, LIC 811, dated August 19, 2024. On August 23, 2023, at 1: PM, LPAs Wilson and Sarah Lo arrived at the GH, and a safety inspection was completed without any health and safety concerns observed. LPAs reviewed facility documents, and obtained copies of the client roster, LIC 500, staff files, staff statements, plan of operation, and the program statement. During the investigation, interviews were conducted with shelter manager (SM), staff 1 (S1), human resources (HR), human resources 2 (HR2), executive assistant (EA), and director of youth shelters (DYS). On August 15, 2023, the Department received a complaint that alleged that staff is not qualified. Specifically, it was alleged that S1 was not licensed and/or qualified. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Valerie Wilson 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: 3 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: OUR HOUSEFACILITY NUMBER: VISIT DATE: 08/19/2024

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

Deficiencies:
80022: 1
2
3
4
5
6
7

met_with: Joe Mendoza & Sylvia Steinhart

title:
Plan of Operation (k) The facility shall operate in accordance with the terms specified in the Plan of Operation and may be cited for not doing so

This requirement is not met as evidenced by

description:
1
2
3
4
5
6
7


raw_content:
Narrative:
transported via ambulance to the Hospital or Emergency Room, the facility contacts the After Hours Crisis Response (ARC) Hotline and they have the ability to send a Social Services Aide (SSA) to sit with the client and transport them back to the facility. Confidential interviews indicated they could not recall if a SSA was present with C1 on April 20-21, 2024, while C1 was at the Hospital. Records reviewed that on April 21, 2024, staff picked up C1 from the Hospital and transported them back to the facility. Thus, confidential interviews did not corroborate the allegation with a preponderance of evidence. Based on confidential interviews and records reviewed the allegation that staff left C1 unattended while receiving medical attention, 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 and appeal rights were provided to the facility. A copy of this report will be placed in the facility file.

Investigation Findings:
13On February 6, 2025, at 12:35 pm, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Joseph Mendoza, Facility Administrator, and Sylvia Steinhart, Program Director, to discuss the investigative finding for the allegation noted above. LPA Linda Haynes conducted an inspection of the facility on May 3, 2024, at 9:29 am and no deficiencies were observed. LPA Linley interviewed one Client, three Staff (S1, S3-5), one County Social Worker (CSW), and LPA was unable to interview one Staff (S2), despite multiple attempts to contact them. The following documents were reviewed during the investigation: facility documents. On April 29, 2024, Community Care Licensing (CCL) received an allegation that staff left a minor unattended while receiving medical attention. It was reported that C1 was sent to the Hospital and there was not a staff that stayed with C1 and when the Hospital called the facility, they could not reach a staff member. Confidential interviews revealed conflicting statements. Some interviews indicated that when clients are 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 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: OUR HOUSEFACILITY NUMBER: VISIT DATE: 02/06/2025

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


summary: Facility Evaluation

raw_content:
Narrative:
On July 14, 2022, Licensing Program Analyst (LPA ), Val Wilson, arrived at Our House to initiate and investigation. Upon entry to the facility it was noted there was a lot of damage done to the facility and a case management was initiated. LPA was met by Shelter Manager, Joseph Mendoza, Jr., who indicated there had been several behavioral incidences at the facility resulting in property damage in various stages throughout the day. LPA took various photos of the damage in the facility and in the recreation/meeting room and offices behind the facility. The shelter manager shared the incidence reports would be sent timely regarding the events of today. During interviews with Darryl Evey (via phone), Administrator, and the Shelter Manager (in person), information was disclosed to LPA Wilson. This morning there were 10 children assigned from San Bernardino County at this facility. The Administrator reached out to CFS after the first incidence to notify that the children would need to be moved due to the events and property damage. Law enforcement was contacted and present at the facility for approximately five hours. Darryl was told by CFS the Regional Director was notified and the San Bernardino County social workers would be in contact to pick up their assigned children. Upon my arrival to the facility at 3:20PM, one child was 5150 and 4 children had already been picked up by their respective social worker, with 5 remaining at the home. These 5 children were outside playing basketball at the hoop in the backyard. Administrator notified this LPA the need for Temporary Closure of the facility for approximately two weeks to fix the property damage and ensure health and safety needs can be met. LPA provided the Administrator PIN 18-03 to document as instructed Our House's Temporary Closure Plan. The plan will need to be submitted to licensing as indicated in the PIN. Both the Administrator and Shelter Manager stated they understood there are no placement's to the facility until licensing is notified and an inspection is conducted. At 7:07PM, 9 children were picked up by their social worker and 1 child remained 5150. An exit interview was conducted and this report was provided to Joseph Mendoza, Jr.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Shelter Manager, Joseph Mendoza, Jr.


summary: Facility Evaluation

raw_content:
Narrative:
On July 27, 2022 at 4:00pm, Licensing Program Analyst (LPA), Val Wilson, met with Shelter Manger, Joe Mendoza Jr., at Our House Group Home for an unannounced case management inspection. The purpose of the case management was to discuss information the Department received. During this inspection LPA completed a safety inspection of the facility with the Shelter Manger. While at the facility, LPA observed several safety concerns. The facility was not cited for the safety concerns at this time due to the temporary closure plan. In addition, LPA completed confidential interviews with staff. Due to the need gather additional information this case management is being extended. No deficiencies to be cited at this time. A copy of this report was reviewed and emailed to Shelter Manager and Administrator.

met_with: Shelter Manger, Joe Mendoza Jr


summary: Facility Evaluation

raw_content:
Narrative:
On August 24, 2022 at 2:22PM, Licensing Program Analyst (LPA) Val Wilson conducted an inspection of the facility. The facility has been temporarily closed since July 14, 2022, requiring repairs. The facility was toured inside and out with Administrator, Darryl Evey, Shelter Manager, Joseph Mendoza, and Program Manager, Devin Baze, from 2:30PM to 4:13PM. No clients are present at time of inspection due to temporary closure. There are nine bedrooms total. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. The bathrooms were clean and in good repair. The hot water in the four client bathrooms was measured to be within regulatory requirements. All hazardous items have been properly made inaccessible to areas where clients have access. The First Aid Kit had all required safety items. The medications isstored in a large two combination locked box which is locked in a large closet near living room area. Cleansers/chemicals and sharp knives are inaccessible and stored in the same locked large closet near living room area. The facility's smoke detectors at each bedroom were checked and were operable. The carbon monoxide detector located in the "five through nine bedroom" hallway areas are operable. The livingroom has two couches and a fireplace. The kitchen was stocked with plenty of plates, cups and utensils. The pantry has sundries, pots and pans in addition to a refrigerator and freezer, both within in regulated temperatures. There are no guns or weapons in the facility as stated by facility representatives. LPA observed a minimum 7-day non-perishable and a 2-day perishable supply of food. There was a variety of snacks available for clients as well. There were plenty of linens in the linen closet. There was a laundry room with an adequate supply laundry soap. During the inspection the repairman was there to fill holes in the wall of the exterior and interior of the home. Additionally, the air conditioner in the large locked closet near the living room will be removed. The administrator will send pictures of the repairs no later than August 29, 20022. The following required posted items were observed accessible to clients: Grievance Procedures, Personal Rights, Ombudsman Poster, Visitation policies, and current menu. The Wi-Fi is up and running and the facility utilizes the Apricot Electronic Records system that all staff are trained on. The facility outside grounds was also inspected and it was observed to need removal of a broken cement block and a gate behind the recreation office room. Otherwise the backyard is clean and well maintained. Emergency exits were free from obstruction. There is a fountain located in the corner of the backyard of the facility that is now used as a flower bed. There is a covered outside patio next to the Office and Recreation Rooms. The Office and Recreation room has three offices, a storage closet, and a large multi-purpose recreation room. Based on the facility inspection the facility is being cited an advisory note- technical violation for the following violations of California Code of Regulations, Title 22, Division Six: Regulation Physical Environment 80087(a) to repair the hole from the air conditioner and holes in the interior/exterior wall. Exit interview conducted. A copy of this report and appeal rights were provided to facility representative, Darryl Evey, Administrator.

met_with: Darryl Evey, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On September 2, 2022, Licensing Program Analyst (LPA), Val Wilson, met with Administrator, Darryl Evey, to conduct an unannounced continuation inspection of the facility. The facility has been temporarily closed since July 14, 2022, requiring repairs. On August 24, 2022, LPA Wilson toured the facility inside and out with Administrator and Shelter Manager and a technical violation was cited. No clients are present at time of today's inspection due to temporary closure. LPA inspected the facility with Joseph Mendoza, Shelter Manager. The large locked closet near the living room where the air conditioner was removed is repaired in the wall on both the exterior and interior. LPA informed the Administrator that the inspection has been completed and to remain in compliance with Group Home Regulations. Exit interview conducted. A copy of this report and appeal rights were provided to facility representative, Darryl Evey, Administrator.

met_with: Darryl Evey


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On Thursday, November 10, at 10:45am, Licensing Program Analyst (LPA), Val Wilson, conducted an unannounced annual inspection of the facility. LPA was greeted at the door by Youth Advocate (YA), Johnae Perryman, at 10:48am. LPA was told the Administrator would be contacted. LPA signed in and was met by Social Worker (SW), Kendall Sutera, at 10:52am and provided a workspace in their office located in the Recreation Room office behind the main facility. LPA re-entered the main facility and provided the Social Worker with the Group Home Entrance Checklist to initiate the gathering of items and information requested upon entrance. At 11:10am, YA Perryman indicated Facility Manager (FM), Joseph Mendoza would be arriving to the facility shortly. LPA Wilson met with FM Mendoza at 11:32am. FM Mendoza indicated he was gathering the documents and would be ready to tour the home. Facility Manager (FM), Devin Baze, arrived later during the visit at approximately 11:35am. The facility was toured inside and out with facility FM Mendoza and FM Baze from 11:36am to 12:52pm. Four clients were present in the facility at time of inspection. The entrance to the facility has a doorbell. There is a sign-in book, grievance complaint forms, and personal rights posted in the main entry hall. All nine bedrooms were inspected, each room with a 1 or 2 beds, a closet, dresser drawers, and working fire alarm above the door jam. There are two bathrooms located in the hallway; one between bedroom eight and bedroom nine and one between the art room and bedroom 5. There is a bathroom between bedroom four and three and one other bathroom between bedroom two and one. The activity schedule is posted in the art room. The license is hanging in the dining area along with various other flyers and additional rights posters. There is a fire extinguisher in the main front entrance, between bedroom 6 and seven, one between the kitchen and dining room, and one in the recreation room. Continued Continued The facility is required to be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. Based on observation, the backyard shed is not in good repair as evidence by peeling paint, holes, and damaged roof. The facility is issued a B Citation: CCR 80087(a) Buildings and Grounds. Due to time constraints, this annual visit care tool inspection will be continued at a later date. An exit interview was conducted. A copy of this report and appeal rights were provided and explained to facility representative. Continued Facility telephone is accessible to all clients and located in the art room. Carbon Monoxide detectors were tested and working between room two and three and between room six and seven, both located in the hallway. Provision of basic laundry services, including a washer, dryer, and iron are kept in the laundry closet, along with locked detergents. The temperature in the facility is kept at 72 degrees with access to increase or decrease the temperature at any time. Hot water temperature delivered to plumbing fixtures used by clients was 105 degrees F. A set of keys is available with the lead staff on facility grounds for use during an evacuation that provides access to all facility exit doors, all facility vehicles, all facility files, cabinets, cupboards, food supplies, protective shelter supplies, and elements of the emergency and disaster plan. There are three offices and an open workspace located next to the recreation room behind the main facility. The recreation room is available to children for relaxation and visitation with friends and/or relatives. There is a basketball court in the backyard and a ping pong table in the recreation room. The backyard shed is not in good repair as evidence by peeling paint, holes, and damaged roof. There is a front gated parking area on each side of the facility front along with a gated large trash bin. Both side gates from the backyard exit to the front parking lots are kept unlocked. All window blinds and screened windows are in good repair. Sharps, First Aid kit, Medication storage box with double locks, disinfectants, cleaning solutions, poisons, and other items that could pose a danger if readily available to clients are stored in the locked closet next to the living room, inaccessible to clients. Medication that requires refrigeration is kept in the back-office medication refrigerator. Located in the pantry area, the double refrigerator, freezer, and pantry contained safe food and of the quality and in the quantity to meet the needs of each client. Supplies are maintained on the premises of staple nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. Additional supplies of condiments and spices were located next to the kitchen stove cupboards. A weekly menu is posted on the refrigerator with three USDA Basic Food Group Plan-Daily Food Guide meals and two snacks for each day of the week. Each client has input in the menu. Meals are served in a family-like setting and there are two large dining room tables with ample chairs and benches at each table. The solid waste bin in the kitchen was missing a tight-fitting cover. However, this was corrected prior to LPA exiting the inspection. Emergency exits were free from obstruction. There is no swimming pool/bodies of water located on facility premises. Continued

Deficiencies:
80087(b): Buildings and Grounds

(b) All clients shall be protected against hazards within the facility through provision of the following

visit_type: Annual

met_with: Joseph Mendoza and Devin Baze


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced annual inspection was conducted by Licensing Program Analyst (LPA), Val Wilson on November 14, 2022, at 11:53AM, at Our House Group Home (GH). The purpose of the inspection is the continuation for the GH annual inspection that was initiated on November 10, 2022. LPA already completed the Physical Plant, Operations, and Disaster Preparedness inspection of the facility on the first day of the annual inspection. LPA met with Devin Baze, Facility Manager (FM) and Youth Advocate Lead, Tanajah Steen, during time of inspection and four client interviews were conducted in addition to five client records reviewed. Facility Manager (FM), Joseph Mendoza arrived at the facility at 2:30PM. During this annual inspection continuation, LPA reviewed five children files to ensure they contained all required documentation per Title Regulations. Children files are maintained on-site in an electronic file Apricot application. Files were reviewed in the office located in the recreation building with the Youth Advocate Leader and Facility Manager. Five out of the five files were completed. LPA observed no current court order for psychotropic medication for Child 1 or Child 5. The facility did not maintain a document to consider compatibility in every situation where children share a bedroom for Child 3 and Child 4. Staff 1 and Staff 2 confirmed there is no process to maintain this document at the facility. During LPA interviews with Child 2 and Child 5, the children indicated there is no allowance. Interview of Staff 1 and Staff 5 indicated there is not a provision for allowance at this time. Based on LPA observation, record review, and interviews, the facility is issued a Type B: 84070(b)(12) Children's Records and 84087(e) Buildings and Grounds. Additionally, the facility is issued a Technical Violation 84077(a)(2) Personal Services. Due to time constraints, this annual visit care tool inspection will be continued at a later date. An exit interview was conducted. A copy of this report and appeal rights were provided and explained to Joseph Mendoza, FM.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced annual inspection was conducted by Licensing Program Analyst (LPA), Val Wilson, on November 15, 2022, at 10:00am, for Our House, Group Home (GH), at Family Assistance Program's Main Office located at: 15075 7th Street, Victorville, California 92395. The purpose of the inspection was to complete the continuation inspection for GH annual inspection that was initiated on November 10, 2022. LPA completed the Physical Plant, Operations, and Disaster Preparedness inspection of the facility on the first day of the annual inspection. LPA completed client records on the second day of inspection, November 14, 2022. LPA was met by Executive Assistant, Ginger Bedolla, and later, Wendy Walden, Human Resources Manager. During time of inspection, staff records, facility files and Board Meeting Minutes were reviewed. Staff interviews were also conducted. LPA reviewed ten personnel files to ensure they contained all required documentation per Title Regulations. Personnel Files are maintained on-site in the Human Resources office located in the Main Office in Victorville. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances. All personnel files met the annual training requirement and have valid CPR and first aid cards. Ten of ten personnel files were reviewed. A statement signed by the employee that he/she is at least 18 years of age was not available for Staff 8. Duties of the employee were not maintained in each personnel record for Staff 3, Staff 7, Staff 8, Staff 9, and Staff 10. This was corrected prior to LPA exit. There was no training in personnel files to indicate reasonable and prudent standard training has been provided to Staff 1, Staff 2, Staff 3, Staff 4, Staff 5, Staff 6, Staff 7, Staff 8, Staff 9, and Staff 10 for licensee to ensure that a designated staff member remains on site at all times to apply the reasonable and prudent parent standard as specified in Health and Safety Code section 1522.44(c). The licensee was unable to provide a written plan for the training of facility managers. (Continued) (Continued) Based on LPA observation, record review, and interviews, the facility is issued a Type B: 84065(b)(1)(A) and 84065(k) for Staffing Records. Additionally, the facility is issued a Technical Assistance for Staffing Records 80066(a)(4) and 80066(a)(8). An exit interview was conducted. A copy of this report and appeal rights were provided and explained to Fatima Herrera, Facility Manager (FM).

met_with: Fatima Herreera