summary: Facility Evaluation

raw_content:
Narrative:
On January 21st, 2026, at 11:00AM Licensing Program Analysts (LPAs) Hanako Primer and Celeste Aparicio conducted a scheduled prelicensing inspection at the facility site. LPAs met with Rhonda Jones, Chief Operating Officer and Lanesha Morris, staff member. There no clients at the facility. LPA conducted a tour of the facility site, reviewed operating requirements with applicant representatives, and discussed the pending items to be completed prior to licensure. LPAs discussed Technical Support Program and provided informational pamphlet. Facility was clean and in good repair. LPAs inspected three bedrooms and three bathrooms. Bedrooms had storage space and beds with sheets and linens, with extra linens/towels in upstairs cabinet. Lights were functioning. LPAs observed two days of perishable foods and seven days of non-perishable foods. There are kitchen utensils, silverware, and dishes in the kitchen cabinets. The trashcans have tight-fitting lids. The backyard is clean and free of hazards. LPAs observed client rights, grievance procedures, activity schedule, and food menu posted in the facility. There are locked storage areas for medications, sharps, and toxic substances. Cleaning compounds were stored separately from food supplies. Client files and staff files will be stores in the staff office. The following items need to be completed prior to licensure. Office of the Foster Care Ommbudsperson Client Rights poster will be ordered. Licensee will send photo to LPA. Disaster and Emergency Preparedness Plan should include medication procedures and storage of refrigerated medication during an emergency. Licensee will send updated plan to LPA. Updated administrator qualifications exception request. Lanesha Morris's CPR/first aid certificate. Complete and submit to LPA the following program statement revisions. (see notice of incomplete application for details) 1. Revise staff training plan chart (pg. 77) to reflect trainings described in body paragraphs (pg. 74). On-hire trainings should be labeled. 2. Revise staff qualifications in job descriptions (pgs. 19-53) to reflect qualifications described in body paragraphs (pg. 55 and on). 3. Policies regarding security cameras per PIN 24-09-CRP. 4. Revised LIC200, LIC401, LIC500, LIC9165. 5. Revise intake policies/procedures section. 6. Include agreements with other agencies in core services and supports section. 7. Population to be Served: clarify, and keep consistent with LIC200. 8. Needs and Services Plan: Include listed elements. 9. Update components of centrally stored medication records. 10. Ensure allowance disbursements day is consistent throughout application. An exit interview was conducted with Rhonda Jones, Chief Operating Officer, and a copy of this report was provided to applicant representatives.

visit_type: Prelicensing


state: CA

facility_name: OPEN LINE - THE OAKS

summary: Complaint Investigation - Unsubstantiated - 1 allegation

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

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

report_type: Complaint Investigation

met_with: Debi Nunes, Administrator

complaint_status: unsubstantiated


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
Three clients reported a staff member solicited nude photos from one client who was Absent Without Leave (AWOL) from the facility. The facility was informed of the alleged solicitation, and promptly terminated the staff, who was already on leave for other unprofessional conduct. In addition to soliciting nude photos, the clients reported the staff member allowed the clients to use the staff member's cell phone to access social media, which went against facility policy. The staff member also visited a client while the client was AWOL, brought the client food, and took the client to the staff member's home. Per facility administration, the staff member did not notify the facility of being in contact with the AWOL youth, nor was the probation officer contacted regarding the client's location. Based on the preponderance of evidence that was met through interviews, observation, and record review, the allegation of: Staff solicited pornographic images from client is therefore SUBSTANTIATED. Facility is issued one citation from Interim Licensing Standards, Article 06. Section 87072 (C )(11): Personal Rights: (c) The licensee shall ensure that each child... is accorded the personal rights specified in Welfare and Institutions Code Section 16001.9, as applicable. In addition, the licensee shall ensure that each child is accorded the following personal rights: 11) To be free of physical, sexual, emotional, or other abuse, and from corporal or unusual punishment, exploitation, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature..." A signed copy of this LIC-9099, LIC-9099C, and LIC-9099D were provided to the facility. Appeal Rights were given. An exit interview was conducted.

Investigation Findings:
13Licensing Program Analyst (LPA) Misty Valencia arrived at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Orion Vasilas, Administrator. LPAs Hillary Hall and Misty Valencia conducted the complaint investigation. LPA Hall was assigned the complaint on 9/14/22, after the initial 10 day due date. LPA Valencia opened the investigation with the facility on 9/15/2022. During the course of the investigation, LPAs Hall and Valencia interviewed five current and former clients, three staff, two social workers, and a Probation Officer. LPA Hall reviewed records including: Employee termination report, Staff training log, Placement Roster, Serious Incident Reports, Prior Complaints, and Needs and Service Treatment Plans for clients. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Daniel Allmon LICENSING EVALUATOR NAME: Misty Valencia 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: OPEN LINE - THE OAKSFACILITY NUMBER: VISIT DATE: 11/17/2022

met_with: Orion Vasilas, Administrator

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Two Serious Incident Reports were documented by the facility, regarding two separate incidents within one week. One incident report documented an assaultive altercation between three clients. Staff attempted to de-escalate the clients using Emergency Intervention procedures. Law enforcement was called and responded. The events outlined in the law enforcement report correspond to the events in the report from the facility. The second Serious Incident Report documented verbally inappropriate behavior by one client toward another client. The staff responded to the clients by providing counsel, support, and additional supervision. Confidential interviews determined inconsistent information regarding the level of staff supervision during these two incidents. Based on LPA's observations, interviews which were conducted, and records reviewed, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. A signed copy of this LIC-9099 report, the LIC-9099C, and appeal rights were provided to the facility. An exit interview was conducted.

Investigation Findings:
13Licensing Program Analyst (LPA) Misty Valencia and MIndy Pope arriveded unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Leanna Montgomery, Facility Manager. LPA McKinley conducted the complaint investigation. LPA opened the investigation with the facility on 8/22/2023 and the administrator and two staff were interviewed. LPA conducted a health and safety check of the facility on 8/22/2023 and no deficiencies were observed. During the course of the investigation, LPA Lyta Vue interviewed one client. LPA McKinley interviewed one client, two County Social Workers, and conducted three additional confidential interviews. LPA reviewed relevant records from the facility including, Placement Roster, Serious Incident Reports, Needs and Services Plans, CFT notes, Staff schedules, staff training log, and law enforcement reports. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Misty Valencia 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: OPEN LINE - THE OAKSFACILITY NUMBER: VISIT DATE: 11/17/2023

met_with: Leanna Montgomery, Facility Manager


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
Based on IB findings, interviews conducted, and records reviewed, the preponderance of evidence standard has been met, therefore the above allegations, staff had inappropriate interactions with client in care and staff absconded with client across state lines are SUBSTANTIATED, Facility is cited per Health and Safety code 1558 (a)(2) Conduct Inimical. A signed copy of this LIC-9099 report, the LIC-9099C, and LIC 9099D were provided to the facility, along with appeal rights. An exit interview was conducted.

Investigation Findings:
13On 2/16/ Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint allegations. LPA met with Rachel Gale- Residential Director. LPA McKinley opened the complaint on 8/18/23. The Investigation Branch (IB) conducted the investigation. LPA McKinley conducted a Health and Safety Inspection of the facility, and no deficiencies were observed. During the course of the investigation, IB conducted 14 confidential interviews and reviewed documentation, video, photos, texts and law enforcement records. One staff absconded from the facility with a minor in care, across state lines. Interviews were consistent that a staff was found behind closed doors with a client, which is against facility policy. Other behaviors were reported that corroborate an inappropriate relationship between the staff and client at the facility. continued on 9099-C page SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: OPEN LINE - THE OAKSFACILITY NUMBER: VISIT DATE: 02/16/2024

met_with: Rachek Gale- Residential Director


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
the minor to drive the staff's vehicle during the crime, while the staff was still employed at the facility, contributing to the delinquency of the minor. The minor was arrested. When the facility was notified of the incident two days later , the staff was terminated. Based on IB investigators interviews which were conducted and records reviewed, the preponderance of evidence standard has been met, therefore the above allegations are found to be Substantiated. A Citation is being issued for violating Interim Licensing standards Section # Personal Rights (c) (16). A signed copy of this LIC-9099 report, the LIC-9099C, and LIC-9099D were provided to the facility. An exit interview was conducted. Appeal rights were provided.

Investigation Findings:
13Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Tyson Poso- COO. IB investigator Juan Barajas conducted the complaint investigation. LPA opened the investigation with the facility on 8/30/24 and conducted a Health and Safety Inspection. During the course of the investigation, IB investigator Barajas interviewed two current and one past staff , four clients, a parent, one past and one current administrators, the probation officer, and a police detective. IB investigator reviewed records from the facility including: Placement Roster, staff schedules, client mental health assessments, Needs and Services plan, staff and client files, progress notes, complaint history, and law enforcement reports. A staff member confirmed being involved in an incident in which a client in care engaged in criminal activity. Law enforcement reports detail the staff's involvement in the incident. The staff member allowed SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: OPEN LINE - THE OAKSFACILITY NUMBER: VISIT DATE: 11/14/2024

met_with: Tyson Poso - Chief Operating Officer


raw_content:
Narrative:
Based on interviews which were conducted, and records reviewed, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. A signed copy of this LIC-9099 report, the LIC-9099C, and appeal rights were provided to the facility. An exit interview was conducted. Appeal Rights were given at the time of the delivery.

Investigation Findings:
13Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Tyson Poso COO. IB investigator Juan Barajas conducted the complaint investigation. LPA opened the investigation with the facility on 8/30/24 and conducted a Health and Safety Inspection. During the course of the investigation, IB investigator Barajas interviewed two current and one past staff , four clients, a parent, one past and one current administrators, the probation officer, and a police detective. IB investigator reviewed records from the facility including: Placement Roster, staff schedules, client mental health assessments, Needs and Services plan, staff and client files, progress notes, complaint history, and law enforcement reports. Fourteen out of fifteen interviews did not report knowledge of, or information about, a romantic relationship between a client and a staff member. Both the client and the staff member denied having any romantic relationship. No evidence was obtained through the record review regarding the alleged romantic relationship. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: OPEN LINE - THE OAKSFACILITY NUMBER: VISIT DATE: 11/14/2024

met_with: Tyson Poso- Chief Operating Officer


raw_content:
Narrative:
this incident or any other similar incidents involving staff vaping with the client. The staff observed in the incident did have a history of vaping, and staff and clients confirmed many of the clients smoke or vape. However, all interviewed agreed that clients obtain contraband from school or friends and never from staff at the facility. Both the client and the staff observed by the witness in the incident, denied sharing a vape or interacting inappropriately with each other. The staff has since resigned from employment at the facility. Based on LPA's observations, interviews which were conducted, and records reviewed, although the allegations may have happened, or are valid, there is not a preponderance of evidence to prove the violations did, or did not, occur. Therefore, the allegations are UNSUBSTANTIATED. A signed copy of this LIC-9099 report, the LIC-9099C, and appeal rights were provided to the facility. An exit interview was conducted.

Investigation Findings:
13Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA McKinley met with Mike Hernandez Administrator. LPA McKinley conducted the complaint investigation. LPA Wendy Brown opened the investigation with the facility on 9/10/24, met with Kalina McCarty- Facility Manager and conducted a Health and Safety Inspection. During the course of the investigation, LPA McKinley interviewed two clients and attempted to interview two other clients, who declined. LPA interviewed an administrator, a former staff, and the Chief Operating Officer. LPA Lyta Vue interviewed the reporting parties, a program director, facility manager, and the clinical director. LPA reviewed relevant records from the facility including: Training logs, staff schedules, a staff file, complaint history, Serious Incident Reports, CFT notes, and Needs and Service Plans for foster youth. It was alleged that a staff member engaged in inappropriate interaction and shared a vape with a client in care. One witness reported observing a staff member stand close to a client and vape with the client on one occasion, away from the facility. Subsequent staff and client interviews indicated no knowledge of continued on 9099-C page UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: OPEN LINE - THE OAKSFACILITY NUMBER: VISIT DATE: 11/22/2024

met_with: Mike Hernandez Administrator


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
An incident report was submitted to the Department indicating a staff member had been horseplaying with a client. The staff member meant to tap the client on the arm with a rubber ruler, but the ruler instead made contact with the side of the client's face. The staff apologized to the client. Interviews and documentation support that the incident was accidental on staff's part. No medical treatment was necessary for the client. The facility immediately responded by suspending, then terminating, the staff. The client was provided with additional staff support after the incident. Based on LPA's interviews which were conducted, and records reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. No citation issued due to prompt response by the facility with corrective action already completed. A signed copy of this LIC-9099 report, the LIC-9099C, and appeal rights were provided to the facility. An exit interview was conducted. A copy of the Appeal right was given.

Investigation Findings:
13Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Tyson Poso, CEO. LPA McKinley conducted the complaint investigation. LPA initiated the investigation with the facility on 4/30/25 and met with Rachel Underwood- Residential Director, and conducted a Health and Safety Inspection. During the course of the investigation, LPA interviewed five clients, a County Social Worker, three past and current staff and one outside service provider. LPA reviewed records including: Placement Roster, staff file, prior complaint history, Serious Incident Reports, Child Welfare Records, staff schedule, and the Needs and Service Plans for clients. continued on 9099-C page SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: OPEN LINE - THE OAKSFACILITY NUMBER: VISIT DATE: 05/29/2025

met_with: Tyson Poso- Chief Executive Officer


facility_name: OPEN LINE - WESTGATE

summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
Continued from Based on LPA's observations, interviews which were conducted, and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. This report will be sent to the facility via email. Appeal rights offered.

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


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


summary: Facility Evaluation

raw_content:
Narrative:
9/17/ Licensing Program Analyst (LPA's) Kellie McKinley and Stephanie Whitlow met with Mike Hernandez at Westgate house for an annual inspection. A walk through of the house inside and out was conducted. The dry good were observed in the cupboard and fresh foods in the refrigerator and on the counter which were being prepared for a later meal. Fresh fruit was available for snack on the counter top in the kitchen. The expiration date were checked with dates reflecting 2022 and 2023. The pool was observed to have fences at the appropriate height and locked with a chain and large master lock. Older and brand new fence posts are in place around the perimeter of the back yard area. Fencing is in good repair. Smoke alarm and carbon monoxide detectors were tested and in functioning order. Each child has their own personal care items in separate enclosed bin which are accessible to them at any time. Each client has their own towels which are laundered regularly. Bedroom were observed to be fairly clean and organized with clean linens, pillows, dressers, and closets with hangers fro clothes. Each room had a laundry basket for soiled clothing. Water temperature in the bathroom was check and within the standard temperature. House van was checked for safety, logs of outings, and maintenance supplies. Seat belts were checked and are in functioning order. Interview were conducted with two staff members and two clients in the STRTP facility. Due to time constraints LPA's McKinley and Whitlow will return to complete annual inspection with Administrator/Human Resource Administrator.

report_type: Facility Evaluation

visit_type: Annual

met_with: Mike Hernandez - Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 9/20/ Licensing Program Analyst (LPA), Kellie McKinley and Stephanie Whltlow, met with Administrator, Debi Nunes to complete annual inspection and review 809 and CARES tool. The CARES tool and advisory note was discussed with Administrator. Appeal rights were not explained as no citations were given. LIC 809 was signed and sent electronically to Administrator.

visit_type: Case Management

met_with: Debi Nunes - Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Visual confirmation made of 7 day assessment. Advised Administrator to document assessments after 7 days following initial 8 hour training and within 30 day of completion of 16 hour training.


facility_name: OPEN LINE - WOODCLIFF

investigation_findings: UnsubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
Continued from Based on the information above, it is determined the preponderance of evidence had been met therefore the allegation that S1 smoked marijuana with minor is substantiated. The Agency is cited under the Health and Safety code 1550 (c) Conduct Inimical: Conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or people of this state. An exit interview was conducted and a copy of this report and appeal rights were provided to the Administrators

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

met_with: Debi Nunes and Tyson Poso, Administrators


raw_content:
Narrative:
positive interactions and relationships with staff. Interviews and records reviewed determined staff utilize talking or attempting to redirect the clients from AWOLing. Staff policy is to follow the client and attempt to direct them back to the facility. Once the staff lose sight of the client, policy is to contact local law enforcement for reporting purposes and assistance locating the client. Record review determined a significant decrease in AWOL's since two clients were terminated from the program. Additionally, Needs and Service plans for clients described individualized goals and interventions. Engaging activities were offered to clients on a daily basis. Based on interviews and documentation reviewed the preponderance of evidence has not been met, therefore the allegations are Unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation occurred. An exit interview was conducted. The appeal rights were electronically sent at the time of delivery. A copy of this report was electronically emailed at the time of delivery.

Investigation Findings:
13On 5/5 /2023 at 10: AM Licensing Program Analyst (LPA) Kellie McKinley met with Tyosn Poso- COO for the purpose of delivering the complaint findings into the allegation listed above. LPA delivered findings in person to the main office located at Mountain Lakes Blvd, Redding, CA 96003. On 2/13/2023, Licensing Program Manager (LPM) Hillary Hall conducted an unannounced ten-day complaint investigation and interviewed Tyson Poso, Chief Operating Officer. LPM also interviewed three additional facility staff. LPM conducted a facility inspection. LPM did not observe any deficiencies and no citations were given at the time of the visit. LPA Lyta Vue conducted six client interviews. LPA Kellie McKinley conducted a records review, and interviewed one administrator. Interviews and record review determined Emergency Intervention Plan Strategies were used by staff to deter Absence Without Leave behaviors (AWOL). All clients interviewed reported UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: OPEN LINE - WOODCLIFFFACILITY NUMBER: VISIT DATE: 05/05/2023

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

met_with: Tyson Poso - Chieff Operating Officer


raw_content:
Narrative:
Interviews and documents were inconsistent with the allegation. Interviews determined client has trouble respecting personal boundaries and was often too close to people. Staff admitted to only hugging clients sideways and never from the front, nor often, and only by their initiation. Based on interviews, documentation and records reviewed, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. An exit interview was conducted with Rachel Gale - Residential Director. This report was given at the time of the delivery of findings. A copy of the Appeal Rights was given at the time of the delivery.

Investigation Findings:
13On 7/19/2023 at 2: PM Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced and met with Rachel Gale - Residential Director for the purpose of delivering the complaint findings into the allegation listed above. LPA delivered findings in person to Mountain Lakes Blvd, Redding, CA 96003. On 4/27/ LPA McKinley conducted an unannounced complaint investigation. LPA stated the allegations as Personal Rights. LPA stated the Department Investigation Bureau (IB) would be conducting the investigation. LPA requested the following documents: Staff roster, client roster, staff schedules for the past six months, all related SIR's while client was present, Needs and Services plans and Case Notes for all clients, related staff records, related staff training logs, facility floor plan. IB may request additional documents at a later date. IB conducted 11 confidential interviews. A records review was conducted by LPA McKinley and by IB investigator Balerie. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: OPEN LINE - WOODCLIFFFACILITY NUMBER: VISIT DATE: 07/19/2023

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

met_with: Rachel Gale- Residential Director


raw_content:
Narrative:
Based on LPA's observations, interviews which were conducted, and records reviewed, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. A signed copy of this LIC-9099 report, the LIC-9099C, and appeal rights were provided to the facility. An exit interview was conducted.

Investigation Findings:
13Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Tyson Poso- COO. LPA McKinley conducted the complaint investigation. LPA opened the investigation with the facility on 7/25/24. LPA conducted a Health and Safety Inspection. During the course of the investigation, LPA interviewed six clients, three direct care staff, one administrator, one Residential Director, one Behavioral Health Director, three County Social Workers (CSW), and the reporting party. LPA reviewed records from the facility including Placement logs, Staff schedules, Incident reports, Needs and Services plans, and CFT notes for foster youth. It is alleged clients are engaging in inappropriate sexual interactions due to lack of supervision. Interviews and documentation provided insufficient evidence to support the allegation. Documentation and interviews determined an increase in staffing for behavior issues with clients. In additional to regular staff there are Mental Health specialist who are also in the homes regularly. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: OPEN LINE - WOODCLIFFFACILITY NUMBER: VISIT DATE: 09/26/2024


raw_content:
Narrative:
Based on LPA's observations, interviews which were conducted, and records reviewed, although the allegations may have happened, or are valid, there is not a preponderance of evidence to prove the violations did, or did not, occur. Therefore, the allegations are UNSUBSTANTIATED. A signed copy of this LIC-9099 report, the LIC-9099C, and appeal rights were provided to the facility. An exit interview was conducted.

Investigation Findings:
13Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Tyson Poso COO. LPA McKinley conducted the complaint investigation. LPA opened the investigation with the facility on 7/16/24 and conducted a Health and Safety Inspection. During the course of the investigation, LPA interviewed six clients, three direct care staff, one administrator, one Residential Director, One Behavioral Health Director, three County Social Workers (CSW), and the reporting party. LPA reviewed records from the facility including Placement logs, Staff schedules, Incident reports, Needs and Services plans, and CFT notes for foster youth. Interviews and documentation provided insufficient evidence to support the allegations of staff yelling or staff speaking inappropriately to clients. Inconsistent statements were made about what words staff yelled at clients, and if they did so. One client reported some staff cussed and said hurtful things, but the remaining clients said staff did not yell or cuss but may occasionally raise their voice to get the client's attention or redirect them. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: OPEN LINE - WOODCLIFFFACILITY NUMBER: VISIT DATE: 09/26/2024

met_with: Tyson Poso- COO


raw_content:
Narrative:
response was timely. A contracted worker with over 40 years' experience inspected the spot in question. When accessing the attic space above it, there was no indication of water or a water spot on the sheetrock, verifying that the spot was not the result of a water leak causing mold to grow. The contractor determined the spot to be soot. Photographs were provided of the spot prior to being painted over. LPA also took photographs of spots on the ceiling and now painted over. Photographs are retained in file. Based on LPA's observations, interviews, and record reviews, although the allegation may have happened, or is valid, there is not a preponderance of evidence to prove the violation did, or did not, occur. Therefore, the allegation is UNSUBSTANTIATED. An exit interview was conducted and a copy of the report was provided along with appeal rights.

Investigation Findings:
13Licensing Program Analyst (LPA2) Kellie McKinley arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Tyson Poso- COO. LPA Brown (LPA) and Licensing Program Analyst (LPA1) Yesenia Vallejo conducted the complaint investigation. LPA opened the investigation with the facility administrator on 09/10/2024 and conducted a Health and Safety Inspection. During the course of the investigation, LPA interviewed one client, one independent contractor, and three staff. LPA1 interviewed one county social worker. LPA reviewed relevant records including: placement roster, facility sketch, Internal Complaint Procedure form, grievance form, complaint procedures (Client Policies 5.02), and the maintenance work order. The facility also provided the following documents (although not requested) and these were also reviewed: Signed personal rights, house rules, Non-Violent Practices, Code of Ethics, Prudent Parenting Standards, Shasta County's Grievance Form, Your Personal Belongings, and Intake Discharge Summary. Interviews and records were inconsistent on when suspected mold was reported and if the Continued on 9099- C page UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: OPEN LINE - WOODCLIFFFACILITY NUMBER: VISIT DATE: 09/26/2024


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
Based on LPA's interviews which were conducted, and records reviewed, the preponderance of evidence standard has been met, therefore the above allegations are found to be Substantiated. No citation is being issued as the facility addressed the violation in a timely manner and fulfilled a Plan of Correction prior to the LPA completing the investigation. One of the staff involved is no longer employed with the facility. A signed copy of this LIC-9099 report, the LIC-9099C were provided to the facility. An exit interview was conducted. Appeal rights were provided.

Investigation Findings:
13Licensing Program Analyst (LPA) Kellie McKinley arrived unannounced at the facility on this date for the purpose of delivering findings for the complaint investigation. LPA met with Rachel Underwood- Residential Director. LPA McKinley conducted the complaint investigation. LPA opened the investigation with the facility on 9/26/24 and conducted a Health and safety inspection of the facility. During the course of the investigation, LPA interviewed five minors, a Head of Services, an administrator, a Facility manager, direct care staff, a residential director, a county social worker and the reporting party. LPA reviewed records from the facility including: Staff schedules, Placement Roster, Serious Incident Reports, CFT notes, and Needs and Service Plans for foster youth. It was alleged that staff speak inappropriately to minors and were involved in a verbal altercation in the presence of minors in care. Interviews and documentation were consistent that one evening, staff were overheard arguing and swearing with each other and to the youth. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Hillary Hall LICENSING EVALUATOR NAME: Kellie McKinley 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 25-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHICO - RESIDENTIAL, COHASSET RD., STE. FACILITY NAME: OPEN LINE - WOODCLIFFFACILITY NUMBER: VISIT DATE: 12/11/2024

met_with: Rachel Underwood- Residential Director


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward met arrived at the facility to conduct the Annual Required Inspection. LPA was met by Renon Hodge and the inspection began at 10: AM. Facility Manager Terence Nowlin joined in later and completed the inspection. LPA inspected the following items carbon monoxide and fire alarms, storage, food supply, vehicle safety, facility exterior, kitchen and bathroom fixtures, required postings. medication storage and available client records. The Staff records and the bulk of client records are kept at the main campus. Mr. Nolan was informed that client records are to be kept on site. LPA interviewed two clients. A third client refused to be interviewed. LPA will review client and staff records at the main facility. There were no deficiencies cited on this date.

met_with: Renon Hodge, Youth Care Care


facility_name: OPTIMIST EAGLE ROCK

raw_content:
Investigation Findings:
13Licesning Program Analyst Connie Jones-Steward investigated the above allegations. LPA spoke to several staff members and reviewed the DCFS Investigations report. LPA was not able to interview Client #1 due to inability to make contact with the client. Per her last placement, Client #1 was discharged to her parents. LPA tried to contact the social worker, but received a fax machine. Based on information received via interviewing the staff and reviewing the DCFS report, the allegation of Lack of Supervision was resolved as "unsubstantiated". A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


raw_content:
Narrative:
On February 23, 2022, LPA Martin, conducted the initial complaint inspection and obtained information including, client rosters and placement histories for the past year. A review of documentary evidence and confidential statements found no knowledge of said incident or abuse being reported. Attempts to interview Youth #1 was unsuccessful as their whereabouts are unknown. Documentary evidence indicates Youth #2 was placed at Optimist Eagle Rock on August 9, 2021 for approximately 4 hours at which time, Youth #2 was reported to have run away from the facility. Confidential statement obtained concerning Youth #2 revealed a lack of evidence to prove Staff did not provide a comfortable environment for minors. Based on documentary evidence and confidential statements, LPA is not able to determine if the allegations occurred; therefore, the allegations are deemed unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. There were no deficiencies cited at this time.

Investigation Findings:
13On November 1, 2022 at 10: AM, Licensing Program Analyst (LPA), Regina Martin spoke with Facility Representatives, Ken Garcia and Maria Bhattachan for the purpose of discussing and delivering findings for alleged sexual abuse and general neglect by unspecified Optimist Eagle Rock staff. On February 8, 2022, Community Care Licensing received allegations that Youth #1 (see LIC 811, dated 11/1/2022) was sexually assaulted by an unidentified staff member while in care. Specific details regarding the sexual assault, identification of perpetrator, date of incident, and location is not known. Further, it was reported that Youth #2 felt uncomfortable in the presence of unidentified male staff members while in care. (Continued on page 2 - LIC9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Regina Martin LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: OPTIMIST EAGLE ROCKFACILITY NUMBER: VISIT DATE: 11/01/2022

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

met_with: Facility Representatives


raw_content:
Investigation Findings:
13Licensing Program Analyst Connie Jones-Steward investigated the above allegation. LPA spoke to Client #1 (alleged victim), staff (including the accused asailaint) and witnesses. LPA reviewed the Outcome Report created by the Residential Program Monitoring & Investigations Unit (RPMI). The staff stated that Client #1 threatened them with a knife that she took from a restaurant. Staff stated that another client informed him that she had seen Client #1 take the knife from the restaurant. However, when inteviewed by this LPA, Client #3 denied that she saw Client #1 steal the knife. Based on conflicting stories, it is unknowable how Client #1 obtained the knife with which she theartened the staff. Therefore the allegation that a physical plant violation enabled her to do so was resolved as unsubdtantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Connie Jones-Steward LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 2 of 2

met_with: Ken Garcia, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward commenced the annual /required inspection on this date. The inspection began at 10: AM and LPA was assisted by administrator Kenneth Garcia and facility manage Silvia Hernandez. The following was observed. A physical plant inspection was completed and included the following checks: This is a three bedroom, two story home with 2.5 bathrooms. The facility grounds are free of observable hazards. There are no security bars on windows. There are no swimming pools on the premises. The fireplace is decorative only There are carbon monoxide detectors in all bedrooms and a centralized fire panel downstairs. All knives, medications household cleaners and other hazardous items are safely stored in locked areas. The kitchen and bathroom fixtures are clean and in good working order. There is food to meet the requirements of two days for fresh food and one week of non-perishable food. The hot water was tested at 101 degrees. All trash containers, both inside and out, were covered as required. All bedrooms have two twin beds with mattresses and coverings in good condition. All clients have storage space in accordance with Title 22 regulations. All clients have locked storage lockers for their personal belongings. The menu, floor plan, employee work schedule, and other required documents were posted as required LPA will complete the necessary file reviews and client and staff interviews at a later date No deficiencies were cited today.

met_with: Kenneth Garcia/Silvia Hernandez


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward continued the annual inspection on this date. LPA completed the file review for staff and clients. LPA interviewed 2 of three clients. The other three clients were not available due to having to attend their treatment programs. LPA also interviewed two staff. LPA Jones-Steward issued no citations as a result of this inspection.

met_with: Ken Garcai/Sylvia Hernandez


facility_name: OPTIMIST MISSION HILLS

summary: Facility Evaluation

raw_content:
Narrative:
On August 20, 2021 at 9am Licensing Program Analyst (LPA) Donald Martin and Licensing Program Manager JoAunne Griffin arrived at the above facility, for the purpose of conducting an Annual/Required inspection on the home. LPA met with Theresa Nunez, Residential Director who granted access into the home. The home was toured both inside and out. Currently residing in the facility is one client. The facility is licensed to care for six male children ages 13-17 years and non-minor dependents, ambulatory only. The home is located in a residential area and was set as follows: four bedrooms; two single-occupancy and two double-occupancy, all equipped with twin beds. Bedroom doors were observed to lock from the outside, however clients are able to open from the inside. There is ample closet and adequate drawer space is available. There are three bathrooms, observed in good repair and working order, living room/dining area, kitchen, and an attached garaged which has been converted into a rec room and laundry/storage area. There is an outdoor area including basketball court that is free of obstructions. The second floor of the facility is used as a staff area and includes the therapist's office, staff bathroom, and a storage room. The home was inspected and the following was observed: Facility is clean, safe, sanitary, and in good repair. There are no swimming pools or bodies of water on the premises. Knives, disinfectants, cleaning solutions, and poisons are inaccessible to clients. Cleaning solutions are stored in hall closet and sharp knives are stored in staff office on first floor. Clients in care are supervised and protected at all times. Four cameras were observed on the exterior of the home. Cameras view is of the front right, left, center and left rear of home. Fire escape ladder is located on second floor exterior of home. Facility has ample perishable and non-perishable food. Three refrigerators and pantry were observed in garage converting into storage area. Facility provides nutritious between meal and snacks. Menu observed posted in kitchen area. Medications are locked/accessible only to employees Continued on LIC 809C responsible for stored medications. Psychotropic medicine is tripled locked in staff office. Facility personnel are instructed to report violations of personal rights. Child's rights, grievance process and emergency disaster plan observed posted at entry door. Mental Health certification effective March 23, 2021 - March 22, 2022. Accreditation effective through May 31, 2025. Clients are not restricted in telephone use except by court order. Clients accorded dignity in personal relationships with staff and others. Clients live in a safe, healthy, comfortable facility and are treated with respect. Clients can contact the licensing agency or Foster Care Ombudsman person in confidence without threats or punishment for making complaints. Clients attend school, extracurricular, cultural, and personal enrichment activities. Facility reports changes in the plan of operation affecting service to clients. Facility reports client injuries requiring medical treatment. Emergency Disaster Mass Casualty Plan: Current and available for review. Designation/staff assignments current. Facility operates within license conditions & limitations including capacity limitations. Smoke detectors and carbon monoxide detectors were working properly in the home. Fire extinguisher was available and last serviced September 9, 2020. There were no bars on the windows at the time of the visit. All posting requirements were met. The facility has a Ford Transit - 150XL van and Hyundai passenger vehicle to transport clients. Current automobile insurance is with Riverport Insurance Co. LPA will return at a later date to complete Annual Inspection. There were no deficiencies cited at this time. Exit Interview was conducted with Teresa Nunez and a copy of this report was left at the facility.

met_with: Theresa Nunez-Residential Director


summary: Facility Evaluation

raw_content:
Narrative:
On August 25, 2021 at 12pm Licensing Program Analyst (LPA) Donald Martin arrived at the above facility, for the purpose of conducting an Annual/Required inspection Continuation on the home. LPA then went to the main office at N. Figueroa St. Los Angeles, CA 90042 to inspect the staff and client files. LPA met with Maria Bhattachan, Chief Compliance Officer and began my inspection of the files. LPA inspected staff file for Maggie Williams, House Supervisor hired 5-16-2011. File contained all the necessary documents which include Criminal Record Clearances, Personnel Records, Employee Actions, Child Abuse Clearances, Training, Education and medical requirements. Maggie also has a Conditional Certificate for the STRTP Administrator Certification Program. LPA inspected Client file for Takato Fortune DOB 6/10/2002. The client file had all Medical/Immunization Records available. The client had a complete and current Needs and Services Plan as well as current Mental Health and medication documentation. Staff interview was conducted with Theresa Nunez, Residential Director. The interview went very well and all questions were answered completely. LPA was unable to interview a client at this time. There were no deficiencies to report at this time.

met_with: Maria Bhattachan-Chief Compliance Officer


facility_name: OPTIMIST VAN NUYS

summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On 06/30/2021 at 10:10AM (LPA) Licensing Program Analyst Rosslyn Gray made an unannounced visit to OPTIMIST VAN NUYS for the purpose to conduct Annual Required facility inspection. LPA-Gray met with facility residential Counselor who granted access to the facility and provided a tour of the entire physical plant both inside and out. The facility is licensed to care for six (6) clients, ages 13-17 years, ambulatory only; as well as three (3) 18-year-old non-minor dependents. S1 states that there is no weapons or guns on the premises. There is no pool or bodies of water on the premises. There are no security bars on the windows. There is an active alarm system, which notifies staff when any doors are open. The facility is a two story STRTP in a residential neighborhood. This is a two story home with three (3) bedrooms and four (4) bathrooms, living room, dining room, 1 staff office and 1 therapy office located down (downstairs) the living room has a non-operable fireplace with a secure screen attached. Bedrooms: All bedrooms are located upstairs, and furnished with enough lighting, drawer and closet space, comfortable mattresses, and clean linen, blankets, and pillows, all in good repair. Bedroom#1: Is occupied by Client#1 and Client#2; (one (1) minor and one (1) (NMD) Non-Minor dependent). It has two twin beds, adequate drawer adequate lighting, comfortable mattresses, clean linen, blankets, and pillows. Bedroom #2 (upstairs): Is occupied by two (2) minors Client#3 and Client#4. It has two twin beds, adequate drawer adequate lighting, comfortable mattresses, clean linen, blankets, and pillows. Bedroom #3(upstairs): Is occupied by Client#5 and Client#6; two (2) (NMD) Non-Minor dependents (. It has two twin beds, adequate drawer adequate lighting, comfortable mattresses, clean linen, blankets, and pillows. There is a full-size walk-in bathroom, walk-in closet, a balcony with and fire escape. [See Confidential Names (form LIC811), dated 06/30/2021 for names] (Continued on LIC-809C) There are four (4) Bathrooms: LPA observed one (1) staff bathroom located downstairs and three (3) full-size bathrooms upstairs; All were observed to be clean and in working order. Hot water temperatures were within safe temperatures. There is adequate linen and hygiene items. Living room: LPA observed needed repairs in the living room LPA observed several broken and missing blinds in the living rooms that need to be replaced. Kitchen and Dining area: with a six (6) chair dining table There is a microwave and refrigerator/freezer; electric stove/oven with (4) burners were operable. There is an ample supply of perishable and non-perishable food in the facility. The facility ensures three nutritious meals, snacks, and special diets. Cleaning solutions, disinfectants, and sharp knives are inaccessible to the clients (stored in a locked cabinet in the dining room on locked cabinet). The weekly menu is current and posted on the refrigerator. LPA observed covered trash cans in the dining are, kitchen, bathroom and staff office. Observed deficiency: LPA observed the refrigerator had pad locks on the upper freezer door. All smoke/ carbon monoxide detectors were tested and operable at the time of inspection. LPA-Gray observed three (3) fire extinguishers throughout the facility that were operable at the time of inspection. There is locked door that leads the laundry area equip with a Washer and dryer unit, all chemicals were locked in the upper cabinet. There is locked door that leads to the garage. LPA observed a full-size pool table, exercise equipment, two (2) additional refrigerators, one (1) freezer, pantry and storage cabinets with ample nonperishable food supplies. Staff office: All client's files and medications are stored in key locked staff office, in locked cabinets and are inaccessible to clients. All posting requirements were met and posted on the wall in the staff (regulations, licenses, emergency disaster plan and personal rights). LPA's reviewed the Clothing Inventory Log, Food Menu, and the Weight Log for all clients. LPA observed two (2) the First aid kits that in compliance. The passageways and porches are unobstructed. Backyard: The front yard and portions of the back yard were free and clear of debris. Clients can use the telephone unless restricted by court order. Clients in care are always supervised and protected. Clients are accorded dignity in personal relationships with staff and others. Clients live in a safe, healthy, comfortable facility and are treated with respect. Clients attend school, extracurricular, cultural, and personal enrichment activities. Clients can contact Community Care Licensing or Foster Care Ombudsman office in confidence without threats or punishment. Facility operates within license conditions and limitations including capacity limitations. Facility has a current, written plan of operation. Facility personnel are instructed to report violations of personal rights. Licensee will report changes in the plan of operation affecting service to clients. Licensee will report client injuries requiring medical treatment. A review of Facility's Personnel Report Summary on 06/30/2021, indicates that all personnel have criminal record clearance has obtain the necessary clearances with DOJ, FBI, and Child Abuse Response. PER California Code Regulation, TITLE 22, DIVISION 6, CHAPTERS 1, General Licensing Regulations, and Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Chapter 7. Version 3, There was deficiency observed and cited (see D page). Exit Interview was conducted with S1 and a copy of this report was left with S1

Deficiencies:
80076: 1
2
3
4
5
6
7Facility will ensure that the refrigerator in not locked and is available for clients to be able to access food at alll times.

met_with: STAFF #1 YOUTH CARE COUNSELOR

title: (a) (4)Between meal nourishment or snacks shall be available for all clients unless limited by dietary restrictions prescribed by a physician. This requirement is not met as evidenced by


facility_name: OUR HEALING CENTER

raw_content:
Investigation Findings:
13On 10/15/2024 at 2:00pm Licensing Program Analyst (LPA) Enrique Hernandez made an unannounced inspection to Our healing Center for the purpose of concluding the investigation on the above allegation and deliver the findings. LPA spoke with Facility Administrator, Maricela Romero and together, discussed the investigative finding. During the investigative process by Licensing program Analyst (LPA), Jhane Haynes,all relevant parties have been accounted for. During the investigation LPA Haynes interviewed and accounted for all relevant parties. Based on interviews conducted, Interviews reflect youth struggles with hygiene due to developmental disability that is being addressed in weekly goals. Program provides incentives when prompted to complete hygiene. Youth was observed to meet basic hygiene. LPA Haynes did not obtained statements to corroborate the above allegations. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview was conducted, and due to technical difficulties with the printer, a copy of this report will be emailed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Enrique M Hernandez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Facility Adminstrator/Maricela Romero


raw_content:
Investigation Findings:
13On 11/7/2024 at 1:15pm, Licensing Program Manager (LPM) Enrique Hernandez made an unannounced inspection to Our Healing Center to conclude the investigation on the above allegation and deliver the findings. LPM spoke with Facility Administrator Maricela Romero and discussed the investigative findings together. During the investigation LPA Haynes interviewed and accounted for all relevant parties. Based on the interviews conducted, the facility maintains continuous oversight of the youth under its care. The staff closely monitors the individuals to ensure their safety and well-being when leaving the facility. Additionally, due to the specific behavioral needs exhibited by some of the youth, the facility has even proposed implementing one-on-one supervision for those individuals. This approach aims to provide tailored support and address their unique challenges more effectively. LPA Haynes did not obtained statements to corroborate the above allegations. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview was conducted, and due to technical difficulties with the printer, a copy of this report will be emailed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Enrique M Hernandez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Facility Administrator /Maricela Romero


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

raw_content:
Narrative:
Confidential interviews and documentary evidence revealed several youths at Our Healing Center engage in the use of drugs and alcohol while at the facility. Corroborating statements found the facility has had issues with youth using drugs and alcohol while in care, including marijuana, vaping and on July 7, 2024, facility reported a medical emergency as youth was reported to have overdosed on fentanyl. Confidential interviews and documentary evidence further revealed acknowledgement that a former youth resident engaged in sexual interactions with one or more youth residents while in care. Documentary evidence reveals between May 2024 and July 2024, a former resident engaged in sexual interactions with another resident. On an isolated incident, the youth was allegedly sexually assaulted by another resident while in care. Statements also revealed some residents felt uncomfortable by the former resident's sexual advances towards them. Information obtained indicates the facility Administrator promptly addressed the situation and reported the concerns to mitigate the issues upon discovery. Based on the information obtained during the investigation, claims alleging drug activity and sexual interactions on facility premises is Substantiated. Facility is cited for violation of California Code of Regulations, Title 22, Interim Licensing Standards (ILS) Version 5, Article 06. Continuing Requirements, 87065. Personnel Duties. Exit interview conducted. Appeal Rights issued.

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

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

Deficiencies:
87065.21: Supervision, protection, and care of children at all times, individually and in groups.

met_with: Maricela Romero Rodriguez, Administrator

title:
2
3
4
5
6
7Personnel Duties Direct care staff shall perform the following duties


raw_content:
Investigation Findings:
13On 5/16/25, at 1045 am, Licensing Program Analyst (LPA) Nestor Gomez made an unannounced inspection to the above facility for the purpose of concluding the investigation on the above allegation and deliver the findings. LPA spoke with Facility Adminstrator, Marcela Romero Rodriguez and together, discussed the investigative findings. During the investigative process by Licensing program Analyst (LPA), Nestor Gomez, all relevant parties have been accounted for except LPA could not get in contact with C1. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occu, therefore the allegation is unsubstantiated. No deficiencies are being cited at this time. Exit Interview conducted, and a copy of this report was emailed to FA. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Kevin C Sauk LICENSING EVALUATOR NAME: Nestor Gomez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Monique Flores - Direc Care staff


summary: Facility Evaluation

raw_content:
Narrative:
On 523/23 at 2:30pm, Licensing Program Analyst (LPA) Christine Wilson conducted an announced Office Visit in order to review component II with the Licensee. During the Pre-Licensing Inspection at the above listed facility, Licensing Program Analyst (LPA) Christine Wilson conducted a Face-to-Face, Component Meeting with the applicant, Facility Administrator Marciela Romero, . The purpose of the meeting is to discuss the Our Healing Center, Short Term Residential Theraputic Program (STRTP) application, which had been submitted to Community Care Licensing (CCL) on April 7, 2023. The proposed facility will provide care and supervision for 6 ambulatory only children, ages 12 through 17 years old, and Non Minor Dependents (NMD) ages 18-21 years old. . LPA reviewed/discussed the children/staff forms that are required and to be maintained in the facility so that they are available for inspection. LPA informed licensee that the original Plan of Operation and Program Statement were reviewed and the following revisions will be required prior to the application being approved. The following matters were discussed: Licensing forms that need to be amended and updated (LIC401A, LIC610C, and LIC9016) LPA Wilson provided a detailed overview with feedback on the application, Program Statement and Plan of Operations. LPA Wilson also discussed revisions stated below. The following revisions have been requested: Revisions provided in detail on a separate form to Licensee: Plan of Operation B. Administrative Organization C. Facility Sketch (Continued on 809C) (Continued from 809) D. Staff Plan F. Administrative Policies and Procedures G. Admission Determination Procedures J. Removal and/or Transfer Policies and Procedures L.Handling Money, Personal Property and Valuables N.Trauma Informed Intervention and De-Escalation Techniques Q. Continuous Quality Improvement Program Statement 1. Population to be Served 2. Emergency Disaster Response Services 3. Transportation Arrangements 4. Core Services and Supports 5. Culturally Relevant Interventions, Practices, Services and Supports Other Additional Information Required: -Nursing Services LPA Wilson provided (2) Foster Youth Bill of Rights and (2) Foster Youth Rights Handbooks and (1) Foster Youth Bill of Rights Coloring Book Should this information not be received by June 22, 2023 this application will be considered withdrawn. Exit interview conducted and a copy of this report was emailed to the Applicant.

met_with: Facility Administrator


summary: Facility Evaluation

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Narrative:
On 5/23/23, at 12:20pm Licensing Program Analyst (LPA) Christine Wilson conducted an announced pre-licensing inspection at the above-listed facility. Licensing staff was met by Facility Administrator, Maricela Romero. The facility is one-story home which contains three (3) bedrooms, and two (2) bathrooms. The home has a fully equipped kitchen and a spacious living room, and sun room, that can be utilized as a multipurpose room. The front yard, and backyard was observed to be secure with a cinder-block fence 5.5ft in height , free of obstructions, and neat. The facility maintains one facility vehicle, Toyota Sienna LE, that seats 8 people and insurance/registration were observed to be current. All seat belts are in working order.. There is one (1) charged fire extinguisher through the facility. (2) Carbon monoxide and (4) smoke detectors were tested and fully functioning. Detergents and cleaning supplies were observed to be locked and inaccessible to minors. Medication closet was observed to be secured and inaccessible to minors. Facility files will be maintained within the staff office. LPA observed the following during inspection: Kitchen: equipped with a stove, microwave, oven, refrigerator, plenty of cabinet space, and enough plates/cups/utensils for all clients. Trash cans are covered. Dishwashing machine is not in working order and will not be used. Dining Room: there is a dining table adjacent to the kitchen with enough seating for (6) with cabinet space. Living Room: the living room is a large open space that functions as a area for relaxation, and is attached to a sun room, with plenty of seating for 10+ people, tv, a non-functional fireplace, and access to the backyard. Hallway: The hallway has a (2) linen closets and maintains enough linen and towels for all residents. There is a working smoke detector and a carbon monoxide detector in this space. Bathrooms- there are two (2) bathrooms through the facility, each with operational plumbing and running water that meets temperature requirements. (Continued on 809C) Bedroom #1: will be occupied by two clients with two twin size beds, dressed with clean linens, on each side of the room. There is adequate closet and (2) drawers. There is a functioning smoke alarm. The bedroom does not serve as a passageway to any other part of the facility. Bedroom #2: will be occupied by two clients with two twin size beds, dressed with clean linens, on each side of the room. There is adequate closet and (2) drawers. There is a functioning smoke alarm. The bedroom serves as a passageway to the backyard of the facility through a sliding door, which is indicated on the facility plan as an emergency exit. Bedroom #3 :will be occupied by two clients and maintain two twin beds, There is adequate closet and (2) drawers. There is a functioning smoke alarm., and an attached bathroom. Garage Space- the garage has been converted to a small room that is only large enough for storage. Licensee communicates that it was converted to include the adjacent staff office to a office activity space and provided LPA with a copy of the building permit. Laundry: located in the garage area and equipped with a washer and dryer in working order, and plenty of cabinet space. Laundry detergents and cleaning supplies are kept in locked cabinet adjacent to the laundry appliances and are inaccessible to clients without supervision. This area also functions to hold locked storage space for sharps, cleaning supplies, hygiene supplies and extra linen. Backyard - there is an enclosed cinder-block fence that extends around the perimeter of the facility that meets height requirements. There is no body of water on the premises. The yard appeared clean and orderly with no hazards. Medication station- medications will be stored in a locked cabinet, in a closet in the staff office. The policy for medication administration will be posted on the inside of the door and was reviewed by LPA. Medication boxes were kept locked within the locked cabinet, with a standard key lock and Licensee agrees to obtain and utilize a lock and key for meds. Staff office- this office is located near the kitchen and has computers, desks, chairs. This space will be utilized for staff to conduct administrative duties, and where client records will be stored. LPA observed that door does lock. There is no additional bathroom designated for staff. Licensee indicates that Bathroom #1 will be used by staff and clients. An exit interview was conducted, and a copy of this report was discussed emailed to the licensee.


summary: Facility Evaluation

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Narrative:
On June 15, 2023 at 9:20 am Licensing Program Analyst (LPA) Christine Wilson, held a TEAMS meeting with Licensee, Our Healing Center for the purpose of conducting a Component III meeting. LPA Wilson virtually met with the Representative Facility Administrator (FA). LPA Wilson reviewed/discussed the children/staff's forms that are required, and to be maintained at the Facility so they are available for inspections. LPA Wilson went over the Child's Records documents, placement appraisal information LIC603, Appraisal/Needs and Service Plan LIC625, Physician Report For Community Care Facilities LIC602, Identification and Emergency Information LIC601, Admission Agreement Guide for Residential Facilities LIC604, Personal Rights Children's Have the Rights LIC613B, Record Of Client's/Resident's Safeguarded Cash Resources LIC405, Client/ Residential Personal Property and Valuables LIC621, Consent For Emergency Medical Treatment Children's Residential Facilities LIC627B, Unusual Incident Report LIC624, Centrally Stored Medication and Destruction Record LIC622. LPA Wilson also reviewed/discussed the Personnel records, Health Screening Report, Facility Personnel LIC503, Personnel Record LIC501, Criminal Record Statement LIC508, Employee Rights LIC 9052, Statement Acknowledging Requirement To Report Child Abuse LIC9108, Child Abuse Central Index Check For State Licensed Facilities LIC198A, Designation Of Facility Responsibility LIC308, Personnel Report LIC500, Criminal Record Exemption Transfer Request LIC9188, Criminal Background Clearance Transfer Request LIC9182, Applicant/Licensee Rights LIC9058, Appeal Procedures For Applicants/Licensee LIC9058, and provided the relevant regulatory reference as questions arose. Facility representative was informed that the license can be obtained within 90 days. Note: Should additional/revised documents be requested, a revised Program Statement will be submitted to LPA-Christine Wilson within a week of the request. Orientation/Application Process Certificate of Completion was signed by licensee, and sent a copy sent to LPA Wilson. A copy of this report was sent to the representative following today's meeting.

met_with: Facility Administrator (FA)


summary: Facility Evaluation

raw_content:
Narrative:
On 03/25/24 at 10: Licensing Program Analyst (LPA) Jhane Haynes and Licensing Program Manager (LPM) Kevin Sauk made an unannounced visit to the above facility for the purpose of conducting a post-licensing inspection. LPA met with Facility Administrator (FA) Maricela Romero Rodriguez who granted access to the facility and provided a tour. This is a three bedroom, two bathroom home is a residential location. LPA and LPM observed the following: Entry contained postings such as personal rights, facility sketch and disaster plan and closet where non-chemical supplies are stored. Hallway contains an empty linen cabinet, thermostat with temperature no more than 80 degrees, cabinet for accessible first aid and first bathroom. Bathroom #1 contains functional toilet, sink and tub/shower combo with additional storage. Bedroom #1 rooms C5 and C2. It is equipped two twin beds, two dressers and closet. Bedroom#2 is the master bedroom and rooms C1 and C4. It is equipped with one twin and one full bed, two dressers and an ensuite bathroom with functioning toilet, sink and stand alone shower. Bedroom #3 rooms C3 and C6. It is equipped with two twin beds, two dressers and closet. It has an exterior exit. Living room is equipped with a TV, two coffee tables and adequate seating for clients. There is a bookshelf with client activities. Activity Room contains two couches, bookshelf, TV and game console. Clients use this room to take private calls or play games. There is an exterior exit. Kitchen/Dining is equipped with adequate dishes for client use, functional appliances. Fridge contains perishables for up to two days, operating at temperature no greater than 40 degrees and 0 degrees in the freezer. Menu is posted with alternative options. Pantry contained non-perishables for up to a week. There are snacks available for in between meals and adequate seating for meal times. (Continue on LIC809-C) Exterior contains three locked storage sheds, outdoor trash cans, recycling and compost bins. There are seating and gazebo for client leisure. The are two company vehicles used for transporting clients. Vehicle insurance and registration are current and vehicles are operating in safe conditions. Staff Office contains seating, secured medicine cabinet, and additional storage room. Storage room is equipped with washer and dryer, staff only fridge, locked cleaning supply cabinet with chemicals. There is a first aid kit equipped with required dressings including but not limited to bandages, tweezers, scissors, and thermometer. There is a secured hygiene cabinet, secured cabinet where sharps and batteries are kept. There are two locked storage cabinets for clients. Staff and client files are secured in a cabinet. There is a half garage storage that is accessible from the exterior that extra clothes, shoes and activities are stored. In addition, LPA observed disaster plan, monthly emergency drill log and medication log. LPA and LPM observed a non-operational camera in the front-left corner of the house. Due to time constraints LPA will return to complete file review. No deficiencies will be cited at this time An exit interview was conducted, and a copy of this report was emailed with facility administrator.

met_with: Maricela Romero Rodriguez Facility Adminstrator (FA)


facility_name: OUR SAFEHAVEN, INC.

raw_content:
Narrative:
The preponderance of evidence standard has been met, and therefore the above allegation is found to be Substantiated. There is one citation, per Short-Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS) Section Personal Rights. See attached LIC 9099-D. An exit interview was conducted, appeal rights provided, and a copy of this report left with Facility Manager Jessica Reyes, whose signature on this form confirms receipt. Although the allegation may have happened or is valid, based on the LPAs' observations and interviews with residents and staff, there is not a preponderance of the evidence to prove the alleged violation(s) did or did not occur. Therefore, the allegation is Unsubstantiated. An exit interview was conducted, appeal rights provided, and a copy of this report left with Facility Manager Jessica Reyes, whose signature on this form confirms receipt.

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

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

met_with: Facility Manager Jessica Reyes


raw_content:
Investigation Findings:
13On 1/25/23 at 11: AM, Licensing Program Analyst (LPA) Alyssa Ng conducted a complaint inspection at listed facility and spoke with Carole Blanchard, Administrator. The purpose of the inspection was to deliver the findings for the above complaint allegation. During the investigation, LPA Ng reviewed documents and conducted interviews with clients and staff. Based on the interviews, it was not confirmed whether or not minor was physically assaulted in care. In addition to the confidential interviews, LPA also reviewed facility incident reports and found that facility staff knocked on the door upon entering minors' room. Although, the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that staff physically assaulted a minor in care. Therefore, the above allegations are unsubstantiated. Exit interview was conducted and a copy of the report was given to Carole Blanchard, Administrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Alyssa Ng LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

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

met_with: Carole Blanchard, Jessica Reyes


raw_content:
Investigation Findings:
13On 1/25/23 and 11: AM, Licensing Program Analyst (LPA) Alyssa Ng conducted a complaint inspection at listed facility and spoke with Carole Blanchard, Administrator. The purpose of the inspection was to deliver the findings for the above complaint allegation. During investigation, interviews were conducted, and incident reports were reviewed, and it was determined that staf verbally abused client in care. Based on LPA's interview with staff, client, and record review(s), the preponderance of evidence standard has been met, therefore the above allegation, Staff verbally abused client in care is found to be SUBSTANTIATED. Facility is being cited for violation of California Code of Regulations (CCR), Title 22, Division 6 & Chapter 1: 80072(a)(1) Personal Rights. Please refer to attached 9099D. At this time, one deficiency was given. An exit interview was conducted, appeal rights provided and discussed, and a copy of this report was given to Carole Blanchard, Administrator. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Alyssa Ng LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, TRAEGER AVE., Suite San Bruno, CA Facility Name: Our Safehaven, INC.FACILITY NUMBER: 015650080

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


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Investigation Findings:
13On 2/22/23 at 1: PM, Licensing Program Analyst (LPA) Alyssa Ng conducted a complaint inspection at listed facility and spoke with Jessica Reyes, Facility Manager. The purpose of the inspection was to deliver the findings for the above complaint allegations. During investigation, interviews were conducted, and incident reports were reviewed, and it was determined that minors engaged in inappropriate behavior while in care and had access to alcohol. Based on LPA's interview with staff, clients, and record review(s), the preponderance of evidence standard has been met, therefore the above allegation, Minors engaged in inappropriate behavior while in care and minors had access to alcohol is found to be SUBSTANTIATED. No citations were given due to facility following their emergency intervention protocol and having a safety plan set in place. At this time, no deficiencies was given. An exit interview was conducted, appeal rights provided and discussed, and a copy of this report was given to Jessica Reyes, Facility Manager. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Alyssa Ng LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

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

met_with: Jessica Reyes


raw_content:
Investigation Findings:
13On 9/11/23 at 11: AM, Licensing Program Analyst (LPA) Alyssa Ng conducted a complaint inspection at listed facility and spoke with Jessica Reyes, Facility Manager. The purpose of the inspection was to deliver the findings for the above complaint allegation. During the investigation, LPA Ng reviewed documents and conducted interviews with clients and staff. Based on the interviews, it was not confirmed whether or not facility staff forced youth in care to take drugs. In addition to the confidential interviews, LPA also reviewed medical records and found no evidence of staff handing that youths' medication nor the youth being on medication. Although, the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that facility staff forced youth to take drugs. Therefore, the above allegations are unsubstantiated. Exit interview was conducted and a copy of the report will be emailed to Jessica Reyes, Facility Manager. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Carolyn Flynn LICENSING EVALUATOR NAME: Alyssa Ng LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

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


summary: Complaint Investigation - Unsubstantiated - 3 allegations

raw_content:
Narrative:
Although the allegation may have happened or is valid, the preponderance of evidence has not been met and there is no consistent evidence to support the allegation listed above. Therefore, the allegation is Unsubstantiated, and no deficiencies were observed. An exit interview was conducted and a copy of this report was given to Executive Director, Crystal Landa, whose signature on this form confirms receipt of these documents.

Investigation Findings:
13On 07/31/2024 at 11: AM, Licensing Program Analyst (LPA) Jasmine Cardeno made an unannounced visit to Our Safehaven. The purpose of this visit was to deliver the findings for the allegation listed above. LPA Cardeno met with Executive Director, Crystal Landa, who facilitated the inspection. There were 2 clients present at the facility during the time of the inspection. At 11: AM, LPA did a walk-through of the facility facilitated by Crystal Landa, including a brief peek into client bedrooms and observed the kitchen and refrigerator. During the course of the investigation, LPA Cardeno reviewed documents including incident reports and conducted confidential interviews with C4 and staff from a previous Case Management visit conducted on 07/23/2024. According to confidential interviews and record review, LPA Cardeno concluded the allegation, "Staff did not seek medical attention for child's injuries," is Unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Carolyn Flynn LICENSING EVALUATOR NAME: Jasmine Cardeno LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO RO, TRAEGER AVE., Suite San Bruno, CA Facility Name: Our Safehaven, INC.FACILITY NUMBER: VISIT DATE: 07/31/2024

Allegations:
- UnsubstantiatedEstimated Days of Completion:
- Unsubstantiated Estimated Days of Completion:
- Unsubstantiated Estimated Days of Completion: 0

met_with: Crystal Landa, Executive Director


raw_content:
Narrative:
An exit interview was conducted and a discussion and a copy of this report along with Appeal Rights was given to Facility Manager, Jessica Reyes.

Investigation Findings:
13On 08/15/2024 at 11: AM Licensing Program Analyst (LPA) Jasmine Cardeno made an unannounced visit to Facility Our Safehaven. The purpose of this visit was to inform the facility representative of the findings for the allegation above. LPA met with Facility Manager, Jessica Reyes, who assisted with the inspection. During the course of the investigation, LPA conducted confidential interviews, record review, and walkthroughs of the facility. LPA concluded that the allegations, "Staff do not prevent the minors from having access to vape pens," and "Staff do not prevent the minors from engaging in physical altercations," had inconsistent support. Although the allegations may have happened or is valid, the preponderance of evidence has not been met and there is no consistent evidence to support the allegations listed above. Therefore, the allegations are Unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Carolyn Flynn LICENSING EVALUATOR NAME: Jasmine Cardeno LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO RO, TRAEGER AVE., Suite San Bruno, CA Facility Name: Our Safehaven, INC.FACILITY NUMBER: VISIT DATE: 08/15/2024

Allegations:
- UnsubstantiatedEstimated Days of Completion:
- Unsubstantiated Estimated Days of Completion:
- Unsubstantiated Estimated Days of Completion: 0

met_with: Facility Manager, Jessica Reyes


summary: Complaint Investigation - Unsubstantiated - 5 allegations

raw_content:
Narrative:
At this time, Type B deficiencies were cited, regarding the discussions above. The facility is being cited for Interim Licensing Standards (ILS) 87072(c)(1), 87072(c)(10), and 87072(c)(15) for Personal Rights violations. Refer to LIC 9099-D pages. In addition, LPA issued Technical Assistance as an advisory to conduct more staff training. An exit interview was conducted and a discussion and a copy of this report along with Appeal Rights was given to Facility Manager, Jessica Reyes. At this time, LPA issued Technical Assistance as an advisory to conduct more staff training regarding the allegation, "Staff do not prevent the minors from wandering the facility." Refer to LIC 9102 - Technical Assistance page. An exit interview was conducted and a discussion and a copy of this report along with Appeal Rights was given to Facility Manager, Jessica Reyes.

Investigation Findings:
13On 08/15/2024 at 11: AM Licensing Program Analyst (LPA) Jasmine Cardeno made an unannounced visit to Facility Our Safehaven. The purpose of this visit was to inform the facility representative of the findings for the allegations listed above. LPA met with Facility Manager, Jessica Reyes, who assisted with the inspection. During the course of the investigation, LPA conducted confidential interviews, record review, and walkthroughs of the facility. Based on confidential interviews, record review, and observations the preponderance of evidence standard has been met. LPA concluded that the allegations, "Staff are retaliating against a minor," "Staff are not providing a minor privacy," and "Staff do not prevent a minor from being mistreated while in care," are Substantiated. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Carolyn Flynn LICENSING EVALUATOR NAME: Jasmine Cardeno LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO RO, TRAEGER AVE., Suite San Bruno, CA Facility Name: Our Safehaven, INC.FACILITY NUMBER: 015650080

Allegations:
- SubstantiatedEstimated Days of Completion:
- Estimated Days of Completion:
- UnsubstantiatedEstimated Days of Completion:
- Unsubstantiated Estimated Days of Completion:
- Unsubstantiated Estimated Days of Completion: 0