raw_content:
Narrative:
In regard to the allegations; it was specifically reported that FC1 had bruising and scratches on her vaginal area. During investigation, a confidential interview disclosed to not have witnessed any bruising or scratching on FC1. Other confidential interview did not indicate any information regarding the allegations. Confidential interviews denied observing bruising and scratches on FC1, however, licensee stated that they observed marks on FC1's upper right hip area which occurred prior to placement, and the mark looked similar to a rash or birth mark. LPA obtained a photo of FC1's hip area showing a discoloration. Based on interview and record review, the allegations that FC1 sustained unexplained bruising and scratches while in care may have occurred, however, there was not a preponderance of evidence to support the alleged violations, therefore, these allegations are unsubstantiated at this time. An exit interview was conducted. A copy of this report and appeal rights were explained and given to licensee Memory Beaumier.

Investigation Findings:
13On 05/10/2024, at 9:20AM, Licensing Program Analyst (LPA) Maya Chavez arrived at Memorable Small Family Home (SFH) and met with Licensee Memory Beaumier to deliver the investigative finding regarding the allegations involving foster child 1 (FC1) and the facility. On June 15, 2023, Community Care Licensing (CCL) received a complaint alleging that child sustained unexplained bruising and child sustained unexplained scratches while in care. Lpa B. Aborchie met with Staff 1 (S1) Gretta Chikakai who granted LPA access into the home. On June 22, 2023, at 3:51PM, LPA Aborchie arrived unannounced to Memorable SFH to initiate the investigation. LPA conducted a safety inspection with (S1). There were no immediate safety hazards observed at this time of inspection. In addition, LPA M. Chavez obtained photographic image of FC1's vaginal area from licensee and interviewed foster children 1-3 (FC1-FC3), staff 1 (S1) and Licensee/Foster Mother (FM) as listed on the Confidential Names List (LIC 811) LPA was unable to interview FC1 due to FC1's developmental age and FC1's being non-verbal. (See LIC9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Maya Chavez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: MEMORABLE SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 05/10/2024

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

met_with: Licensee-Memory Beaumier


state: CA

facility_name: MEMORABLE SMALL FAMILY HOME

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
During investigation, confidential interview didn't provide any relevant information regarding the allegation. A confidential witness denied that FC1 engaged in any inappropriate interaction with another child. Licensee disclosed that FC1 was hiding in the restroom when the other child went to use the restroom and FC1 attempted to inappropriately interact with the other child, however, the child walked away and refused the interaction. The licensee stated that after the attempted interaction, FC1 reported to everyone that the other child sexually touched FC1 in the bathroom. There was no other witness to the event. Based on interview and record review, the allegation that licensee did not adequately supervise FC1 and another child resulting in inappropriate interactions between the children in care may have occurred, however, there was not a preponderance of evidence to support the alleged violation, therefore, this allegation is unsubstantiated at this time. An exit interview was conducted. A copy of this report and appeal rights were explained and given to licensee Memory Beaumier.

Investigation Findings:
13On 05/10/2014, at 9:20AM, Licensing Program Analyst (LPA) Maya Chavez arrived at Memorable Small Family Home (SFH) and met with Licensee Memory Beaumier to deliver the investigative finding regarding the allegations involving foster children (FC1-FC4) and the facility as listed on the Confidential Names List (LIC 811) dated 05/9/2024. On July 5,2023, Community Care Licensing (CCL) received a complaint alleging that license did not adequately supervise minors resulting in inappropriate interactions between minors in care. On July 14, 2023, at 12:32PM, LPA Aborchie arrived unannounced to Memorable SFH to initiate an investigation and conducted a safety inspection with staff. No immediate safety hazards observed at this time of inspection. In addition, LPA M. Chavez arrived at the facility to conduct investigation. LPA interviewed licensee/Foster Mother (FM) and staff (S1). Furthermore, LPA conducted collateral interviews with FC2, FC3 and FC4. LPA was unable to interview FC1 and another child. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Maya Chavez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: MEMORABLE SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 05/10/2024

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

report_type: Complaint Investigation

complaint_status: unsubstantiated


facility_name: MEMORABLE SMALL FAMILY HOME 2

raw_content:
Narrative:
** continued from LIC 9099-C** On October 25, 2023, at 2: PM, LPA Karen Beal arrived at Memorable Small Family Home (SFH) to continue an investigation regarding the above allegation. LPA met with Licensee and LPA collected copies of needs and services plans, incident reports, and placement agreements. LPA conducted an interview with the licensee. On October 30, 2023, a confidential interview was conducted with the resource grandmother (RG), October 31, 2023, a confidential interview was conducted with CSW. On November 1, 2023, LPA conducted a collateral interview with FC1, November 8, 2023, confidential interview was conducted with FC2. Regarding the allegation foster parent locked foster child out of the home, confidential interviews stated FC1 was never locked out of the home. FC1 did not allow time for the door to be opened. Once opened FC1 chose not to enter the home. It was stated that FC1 was having an emotional outburst due to FC1 didn't want to leave RG home. The police were called and deemed that FC1 did not meet the requirements to be placed on a 5150 hold. In regard to foster parent hitting foster child and another child in the home, confidential interviews stated there was never any kind of physical abuse occurring in the home. Children in the home are disciplined by taking their electronics away and restricting television time. LPA didn't receive additional information. Lastly regarding foster parent did not provide adequate supervision for foster child(ren) and foster child sustained multiple injuries while in care due to lack of supervision, confidential interview disclosed that there was supervision provided for the children in care. When the licensee needed to attend to other business, care for the children was provided by the grandmother confidential interviews stated that the children would get into fights and would receive scratches from the fights. LPA received conflicting information. Based on confidential interviews, the allegations that foster parent locked foster child out of the home, foster parent hit foster child and another child in the home, foster parent did not provide adequate supervision for foster child(ren), foster child sustained multiple injuries while in care due to lack of supervision may have occurred, however, there was not a preponderance of evidence to support or deny the allegations. Therefore, the above allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with the appeal rights were reviewed and provided to the S1..

Investigation Findings:
13On November 17, 2023, at 12: PM Licensing Program Analyst (LPA) Karen Beal met with Memorable Small Family Home #2, Tafadzwa "Ivette" Chikakayi, Licensee to deliver the investigative finding for the above stated allegations. On April 12, 2023, Community Care Licensing received a complaint alleging that foster parent locked foster child out of the home, foster parent hit foster child and another child in the home, foster parent did not provide adequate supervision for foster child(ren), and foster child sustained multiple injuries while in care due to lack of supervision. On April 19, 2023, at 03: PM, LPA Babatunde Aborchie conducted an unannounced complaint inspection to the Small Family Home (SFH) and met with licensee to initiate an investigation for the above allegations. LPA conducted a health and safety inspection with the licensee. LPA observed no immediate deficiencies. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Karen Beal LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: MEMORABLE SMALL FAMILY HOME 2FACILITY NUMBER: VISIT DATE: 11/29/2023

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

met_with: Angela Tom, Staff 1


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
****Continued from LIC 9099**** Regarding the allegation that foster parents do not prevent physical altercations between minors, it was specifically alleged that FC2 punched FC1 numerous times in the face while in the car. Confidential interviews stated FC1 taps or hits other children in care to get their attention. Another confidential interview indicated that FC1 tapping or hitting can be perceived as aggressive. Confidential interview disclosed that while the foster children were in the car, they started engaging in altercations and staff pulled over to separate them, and staff resolved the issue to prevent another altercation. Based on confidential interviews and file reviews, the allegation that foster parents do not prevent altercations between minors may have happened or are valid, however, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is unsubstantiated at this time. Exit interview was conducted. A copy of this report, LIC 811, and appeal rights were explained and provided to Memory Beaumier.

Investigation Findings:
13On October 28, 2024, Licensing Program Analyst (LPA) Karen Beal arrived at Memorable Small Family Home and met with staff Memory Tom Beaumier to issue the finding for the above stated allegation involving the Small Family Home and foster children (FC1, FC2 and FC3) as listed on the Confidential Names List (LIC 811) dated October 28, 2024. On April 19, 2024, the Department received a complaint that alleged foster parent do not prevent physical altercations between minors. On April 29, 2024, LPA Beal initiated the complaint, conducted health and safety inspection at the facility and there were no noted concerns. Additionally, LPA obtained and reviewed copies of the placement agreements and needs and services plans. During the investigation, interviews were conducted with foster Child (FC1), foster Child 2 (FC2), foster Child 3 (FC3) and direct care staff 1 (S1). Moreover, a phone interview was conducted with the licensee. County Social Worker (CSW) for FC1 was interviewed. County Social workers for FC2 and FC3 were not able to be contacted. R- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: MEMORABLE SMALL FAMILY HOME 2FACILITY NUMBER: VISIT DATE: 10/28/2024

met_with: Memory Beaumier, Staff 2


summary: Facility Evaluation

raw_content:
Narrative:
On October 26, 2021, Licensing Program Analyst (LPA) Sarah Smith, and Licensing Program Manager (LPM) Natasha Dunlap conducted an unannounced Annual inspection to the Memorable Small Family home. LPA Smith met with licensee Tafadzwa Chikakayi who led an inspection of the home. The facility was inspected inside and out at 1:33 p.m. There are currently two clients in the home. The home is four bedrooms and three bathrooms. The home is set up as follows: • Bedroom One Master bedroom has king bed and crib - sleeps licensee • Bedroom Two has two twin beds - sleeps two clients • Bedroom Three has two twin beds - sleeps adoptive child • Bedroom Four has a queen bed and crib - bedroom not in use Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate drawer and closet space for children's belongings. The fireplace is properly screened. All hazardous items have been properly made inaccessible to areas where children will have access. Currently, none of the clients are taking any medications. Cleansers/chemicals are locked and stored in the laundry room and under the kitchen sink with locks. The first aid kit contains all required items. Sharp knives are inaccessible and stored in the kitchen cabinet. Licensees had current CPR/ First Aid certificates. Licensee provided proof of 8 hours of continued education training. see continuation page There are no guns or weapons as stated by licensee at this time. Water temperature was tested and is safe and within regulation requirements. Smoke detectors & carbon monoxide detector in hallways are all rooms were tested and operable. Proper storage of all food was noted. Trash cans for storage of solid waste have tight fitting lids. The Emergency Disaster Plan with exit map was posted and available for view. Title Personal Rights, and visitation policies are posted at this time. Toys are safe, clean, and age appropriate for the age group of children being cared for. Two children files and one staff file were reviewed. Children records are organized and up to date. A review of staff records on this date indicates that all facility staff have received criminal record and child abuse index check clearances. The back yard was inspected. LPA observed and photographed a hole in the fence. Per LPA observation a review of records indicated that there is no fire drill documentation. However, Licensee stated that fire drills are conducted every six months. See LIC9099D page. Based on LPA observation and record review, facility is cited for Title 22 80087(a) Buildings and Grounds, and 80023(d)(2) Disaster and Mass Casualty Plan which poses a potential health and safety risk to clients in care. Exit interview conducted and copies of this report, appeal rights given and explained to the licensee. Due to technical difficulties, original signatures have been placed in the facility file.

report_type: Facility Evaluation

visit_type: Annual

met_with: Tafadzwa Chikakayi, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On August 16, 2023, Licensing Program Analyst (LPA) Toni Castillo conducted an unannounced annual random inspection to the Memorable Small Family home. LPA Castillo met with licensee Tafadzwa Chikakayi who led an inspection of the home. The facility was inspected inside and out. There is currently one client in the home. The home is four bedrooms and three bathrooms. The home is set up as follows: • Bedroom One Master bedroom has king bed and crib - sleeps licensee • Bedroom Two has two twin beds - sleeps two clients • Bedroom Three has two twin beds - sleeps adoptive child • Bedroom Four has a queen bed and crib - bedroom not in use Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate drawer and closet space for children's belongings. The fireplace is properly screened. All hazardous items have been properly made inaccessible to areas where children will have access. Currently, none of the clients are taking any medications. Cleansers/chemicals are locked and stored in the laundry room and under the kitchen sink with locks. The first aid kit contains all required items. Sharp knives are inaccessible and stored in the kitchen cabinet. Licensees had current CPR/ First Aid certificates. Licensee provided proof of 8 hours of continued education training. (continue on next page) There are no guns or weapons as stated by licensee at this time. Water temperature was tested and is safe and within regulation requirements. Smoke detectors & carbon monoxide detector in hallways are all rooms were tested and operable. Proper storage of all food was noted. Trash cans for storage of solid waste have tight fitting lids. The Emergency Disaster Plan with exit map was posted and available for view. Title Personal Rights, and visitation policies are posted at this time. Toys are safe, clean, and age appropriate for the age group of children being cared for. One child file and one staff file were reviewed. Child's records are organized and up to date. A review of staff records on this date indicates that all facility staff have received criminal record and child abuse index check clearances. The back yard was inspected, LPA did not observe any health and safety issues or concerns. LPA's review of records indicated that the fire drill documentation is up to date. At this time there are no deficiencies observed. Exit interview conducted and copies of this report, appeal rights given and explained to the licensee.


summary: Facility Evaluation

raw_content:
Narrative:
On October 5, 2023 at 12:15pm, Licensing Program Analyst (LPA) Karen Beal arrived at Memorable Small Family Home 2 to conduct an annual inspection. Licensee informed LPA that the annual was already completed.


summary: Facility Evaluation

raw_content:
Narrative:
On December 8, 2025, Licensing Program Analyst (LPA) Maryjane Perez made an unannounced visit to Memorable Small Family Home 2 for an annual inspection and met with licensee Angela Tom who led a tour of the entire home. The home was approved to serve four ambulatory clients ages 0-17 years old. There are currently two clients in care. The home is a two-story building with four bedroom and three bathrooms. The downstairs consisted of an entry way with a formal dining room, a family room with and a living room with couches, TV, and a screened fire place. The kitchen had a table with adequate seating, a locked cabinet for storing medications and a locked kitchen sink cabinet that stored knives/ sharp objects and cleaning supplies. The refrigerator and pantry were fully stocked with perishable and nonperishable foods. there was a storage closet that stored extra house hold items such as paper towels and overstock beverages. Bedroom #1 was utilized as a guest bedroom and had a queen size bed, closet/dresser space and was currently vacant. Bathroom #1 was fully functioning with a toilet and walk in shower. The water temperature was measuring 120 degrees Fahrenheit. The laundry room was accessible to clients but had a locked cabinet for storing laundry detergents and laundry essentials. The laundry room also had an office area where all required postings such as emergency disaster plan, facility license, and personal rights were posted. Client files were in a locked cabinet in the laundry/office room as well as a first aid kit with all required elements. The upstairs had bedroom #2 that was utilized for one client and had two twin size beds, closet/dresser space, all required bedding and lighting. Bedroom #3 was utilized for one client and had two twin size beds, closet/dresser space, all required bedding and lighting. There was a loft that had a desk, couches, and gaming console for clients use. There was bathroom #2 that had dual sinks a shower/bathtub, and a functioning sink. The upstairs hallway stored extra towels and linens. Bedroom #4 was the master bedroom for licensee. The bedroom had a king size bed and bathroom #3 that was fully functioning. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. All bedrooms were arranged for one child per bed. The backyard where children will have access to play was completely fenced and had a shed that stored extra items. The garage was locked at all times and had a parked vehicle and stored extra household items. As stated by licensee, there were no weapons/firearms and there were no pools or other bodies of water. The smoke and carbon monoxide detectors were checked and were working properly. There was a telephone service and appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients/children will have access. LPA reviewed two client files and two personnel files as well as interviewed two staff and two clients. During inspection of client files there was missing documentation of written consent that authorizes licensee to obtain other than ordinary medical and dental care in emergency for both clients. An exit interview was conducted and a copy of this report and one technical violation were discussed and provided to licensee Angela Tom.

met_with: Licensee- Angela Tom


facility_name: MENIFEE HILLS HOME

summary: Facility Evaluation

raw_content:
Narrative:
On July 30, 2024, Licensing Program Analyst (LPA) Rafael Enriquez met with applicant Babatope Opadotun & Adedayo Adebisi for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the notification of incomplete application (LIC 184), letter of Incomplete Application, and additional correspondence to assist with the revisions needed to the application. Copy of this report was emailed to applicant and a signed copy will be placed in the facility file.

met_with: Applicant Babatope Opadotun & Adedayo Adebisi


summary: Facility Evaluation

raw_content:
Narrative:
On September 23, 2024, at 9: AM, Licensing Program Analyst (LPA) Rafael Enriquez began a pre-licensing inspection for Menifee Hills Home Small Family Home for an initial license. LPA met with applicant Babatope Opadotun who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there are no children placed in the home. The applicant was approved to serve two bedridden children ages 0 to 17. The home is a Two-story building with five bedrooms and three bathrooms which is set up as follows: Downstairs: · Bedroom #1 will sleep two foster children, It was furnished with two twin sized beds. It was vacant. · There was also a living room, a dining area, a kitchen, a pantry, a study room, a bathroom, and a coat closet. Upstairs: · Bedroom #2 is a guest room; it was furnished with a queen-sized bed. It was vacant. · Bedroom #3 is a guest room; it was furnished with a queen-sized bed. It was vacant. · Bedroom #4, sleeps applicant's two daughters, it was furnished with two twin sized bed. · Bedroom #5, the master bedroom, it was furnished with a king-sized bed, it had a bathroom and a walk-in closet. It sleeps the applicant and his spouse. · There was also a study nook, a loft, a laundry room and a bathroom. Bedrooms were arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. The smoke detectors and carbon monoxide detectors were checked, and they were working properly. Telephone service and appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients/children will have access. Sharp knives and sharp objects were locked in a cabinet in the kitchen. Cleansers/chemicals were inaccessible and stored in a locked storage outside. There was adequate food storage space and a supply of three days of perishable foods and a week of non-perishable food. A proper storage of all food was discussed. Trash cans for storage of solid waste had tight fitting lids. The water temperature was observed to be at 114.0 degrees. First Aid kit was accessible with all required items, and it was in the client's room. A Fire extinguisher was observed and properly charged. All the appropriate forms were posted in view of facility clients. As stated by applicant, there were no weapons/firearms and there were no pools or other bodies of water. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request for licensure will be forwarded to Licensing Program Manager for final approval. Applicant was advised to contact the department within 30 days of their first placement. An exit interview was conducted. A copy of this report was provided to applicant Babatope Opadotun.

visit_type: Prelicensing

met_with: Applicant- Babatope Opadotun


summary: Facility Evaluation

raw_content:
Narrative:
On May 19, 2025, Licensing Program Analyst (LPA) Maryjane Perez made an unannounced visit to Menifee Hills Home to conduct a post licensing inspection. LPA met with licensee Babatope Opadotun who led a tour of the entire home inside and out. Currently there is one child in placement. The licensee was approved for a capacity of two bedridden children ages 0 to 17. The home is a two-story building with five bedroom and three bathrooms. The downstairs consisted of a kitchen, living room, study, bathroom, and a bedroom. The kitchen was clean and sanitized with locked sharps/ knives, an operable fire extinguisher, refrigerator and pantry with three days of perishable and seven days of non-perishable foods as well as a locked cabinet storing medication. The water temperature was measuring 115.8 degrees Fahrenheit. The living room consisted of a couch, television, and toys. There was a study that had books, a desk, printer, and all required postings such as emergency disaster plan, visitation policy, facility sketch and facility license. There was bathroom #1 that was fully functioning, with adequate space and a trash can with a lid. There was also bedroom #1 that had a hospital bed for one bedridden client that was currently occupied, a twin size bed- currently vacant, and dresser/closet space for personal belongings and a locked cabinet storing clients medications and client files. The bedroom also stored the first aid kit with all required elements. The home was missing a telephone land line service. The upstairs consisted of bedroom #2, bedroom #3, bedroom #4, bathroom #2, a loft, a laundry room, and bedroom #5 that was considered master bedroom with bathroom #3. Bedroom #2 was utilized for storage, storing extra house hold items. Bedroom #3 was utilized as a guest bedroom with a queen size bed and closet space. Bedroom #4 was utilized for licensee's biological children and had two twin size beds, toys, and closet space. Bathroom #2 was fully functioning and had two side by side sinks, a trash can with a lid, and locked cabinets storing cleaning products. The loft had a couch, television, and toys. The laundry room was accessible and had laundry detergents stored away from children's reach. Bedroom #5 was considered master bedroom that was utilized for licensee and had a cal- king size bed, fully furnished, and had fully functioning bathroom #3. Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. The garage stored an extra freezer with extra food, extra items for client such as diapers/bedding, and a wheel chair. The backyard where children will have access to play was completely fenced and free of hazards. There was no pool or other body of water. There were no firearms as stated by licensee. One client and two staff files were reviewed as well as two staff and one client were interviewed. The smoke detectors and carbon monoxide detectors were checked, and they were working properly. Appliances were in working order. Trash cans for storage of solid waste had tight fitting lids. Exit interview conducted and a copy of this report, 3 technical assistances, and 1 technical violation were discussed and provided to licensee Babatope Opadotun.

met_with: Licensee- Babatope Opadotun


summary: Facility Evaluation

raw_content:
Narrative:
On May 15, 2026, Licensing Program Analyst (LPA) Maryjane Perez made an unannounced visit to Menifee Hills Home Small Family Home (SFH) and met with licensee Babatope Opadotun who led a tour of the entire home inside and outside. The facility is licensed to serve two bedridden clients ages 0-17 years old, however, licensee prefers to severe clients ages 6-17 years old. Currently there is no client in placement. The home is a two story building with five bedrooms and three bathrooms. The downstairs consisted of an entry way with bedroom #1 that was utilized for two bedridden clients. The bedroom had one twin bed and one hospital bed, dresser/ closet space, and lighting. Currently the hospital bed is occupied by one legal guardian child meanwhile the twin size bed is vacant. There was locked drawers in the bedroom that stored clients records, cash resources, and client medication. There was a storage closet for shoes/coats. Bathroom #1 was fully functioning with a toilet, shower/bath tub, and sink. Water temperature was 116.2 degrees Fahrenheit. There was a study area that had a desk, books, telephone service, facility sketch and emergency disaster plan posted. The living room had couches and TV. The kitchen was clean and sanitary with a locked cabinets for storing cleaning supplies, medication, and sharps/ knives. The refrigerator and pantry were stocked with perishable and non-perishable foods. The fire extinguisher was located in the kitchen and was operable. The upstairs had bedroom #2 that was utilized as a guest bedroom and had a king size bed. There was a loft with couches, TV, and toys. Bedroom #3 was the master bedroom for licensee and had a king size bed and bathroom #2 that was fully functioning. There was a laundry room that was accessible to clients. Bathroom #3 was fully functioning with a toilet, shower/ bath tub and dual sinks. Bedroom #4 was utilized for licensees biological daughters and had two twin size beds and toys. Bedroom #5 was utilized as a guest bedroom and had a queen size bed- currently vacant. The garage was clear of hazards and had a deep freezer for extra frozen goods. The backyard where children will have access to play had a swing set, a locked shed for storing extra household supplies, was completely fenced and had a gate with a latch. Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was no pool or other body of water and no firearms as stated by licensee. Two staff files were reviewed as well as two staff were interviewed. The smoke detectors and carbon monoxide detectors were checked, and they were working properly. Appliances were in working order. Trash cans for storage of solid waste had tight fitting lids. Exit interview conducted and a copy of this report, six technical assistances, and one technical violation were discussed and provided to licensee Babatope Opadotun.


facility_name: MICHELLE SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On Wednesday May 18, 2022, at 1: PM Licensing Program Analyst (LPA) Linda Haynes conducted a pre licensing inspection of the facility. At time of inspection LPA met with applicant Michelle Covarrubias. The facility was toured inside and out with applicant Michelle Covarrubias. The home is a one-story residence with two bedrooms and two bathrooms. Bedroom # 1 is furnished with two twin beds Bedroom # 2 is furnished with one king bed and two cribs. Bedrooms are arranged so that no more than two clients are in a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. The bathrooms were clean and in good repair. Hot water in bathroom number one measured to be 111.9 and bathroom number two is the master bathroom to which clients will not have access. All hazardous items have been properly made inaccessible to areas where clients will have access. The medications will be stored in a locked cabinet in the hallway. Cleansers/chemicals are stored in a locked cabinet under the kitchen sink and in the garage. Sharp knives are inaccessible and stored in a locked box on top of the refrigerator . The First Aid Kit is located in the hallway and contained all required supplies. The facility's smoke detectors and carbon monoxide detectors in each bedroom were checked and were operable. There are guns located in the facility as stated by applicant Michelle Covarrubias. LPA observed the gun stored in a locked safe in the applicants closet and the ammunition stored in a locked cabinet in the garage. The following required posted items will be made accessible to clients: Grievance Procedures, Personal Rights, and Visitation policies. () The facility outside grounds was also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. There is no pool or other body of water. The applicant will be scheduled for a Component III prior to licensure. The request of License will be forwarded to Licensing Program Manager for final approval. Exit interview conducted and a copy of this report was discussed and provided to applicant Michelle Covarrubias on this date.

met_with: MIchelle Covarrubias


summary: Facility Evaluation

raw_content:
Narrative:
On Friday July 28, 2023, at 1: PM Licensing Program Analyst (LPA) Linda Haynes conducted aa annual inspection of the facility. At time of inspection LPA met with Licensee Michelle Covarrubias. The facility was toured inside and out with Licensee Michelle Covarrubias. The home is a one story home with two bedrooms and two bathrooms. Bedroom # 1 is has one twin bed and sleeps the bio daughter Bedroom # 2 is the master bedroom it sleeps the Licensee and two clients. Bedrooms are arranged so that no more than two clients are in a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. The bathrooms were clean and in good repair. Hot water in bathroom number one measured to be 106.7 degrees Fahrenheit and in bathroom number two 106.4. All hazardous items have been properly made inaccessible to areas where clients will have access. The medications are stored in a locked cabinet in the hallway. Cleansers/chemicals are stored in a locked cabinet under the sink. Sharp knives are inaccessible and stored in a locked draw in kitchen. The First Aid Kit is located in the hallway and contained all required supplies. The facility's smoke detectors in each bedroom were checked and were operable. The carbon monoxide detector was located in the hallway and is operable. There are guns in the facility as stated by Licensee Michelle Covarrubias. LPA observed that the guns are locked in a cabinet in a safe in the garage and the ammunition is locked in a separate cabinet in the garage. The following required posted items are accessible to clients: Grievance Procedures, Personal Rights, and Visitation policies. The facility outside grounds was also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. There is now pool or other body of water. Based on this inspection the facility is being given a technical assistance note for having two infants sleeping the room with them. Exit interview conducted and a copy of this report was discussed and provided to Licensee Michelle Covarrubias on this date.

met_with: Michelle Covarrubias


summary: Facility Evaluation

raw_content:
Narrative:
On Wednesday August 9, 2023 at 11: AM Licensing Program Analyst (LPA) Linda Haynes conducted day two of the annual inspection. At time of inspection LPA met with Licensee Michelle Covarrubias. At 11: AM LPA conducted a review of two of two client files. The following document was missing from one of two client files. Written consent which authorizes the licensee to obtain other than ordinary medical and dental care in an emergency if the authorized representative cannot be located. A Technical Assistance note will be issued. Licensee has no staff so there are no staff files to review. LPA verified the expiration date on First Aid and CPR cards they expire in 1/2024. At 11: LPA interviewed Licensee see staff interview sheet. Based on this inspection the Licensee is being given one technical assistance note for missing document in client file. Exit interview conducted and a copy of this report was discussed and provided to Licensee Michelle Covarrubias on this date.

visit_type: Case Management


raw_content:
Narrative:
Regarding the allegation that licensee left child unattended for an extended period of time it was alleged that licensee brought a portable playpen to a family friend's home and left foster child #1(FC1) in there for six consecutive hours. Incident date is unknown. It was reported that licensee and (A) will leave the children in the car for three to four hours at a time. It is unknown when the incidents occurred. A confidential interview reported that (FC1-FC3) are not left in soiled diapers for long period of time. The same interview reported that FC2 is left in the playpen for a maximum of one or two hours. Another confidential interview stated that licensee is teaching FC2 to not always want to be held and is learning to self-soothe; therefore, the playpen is used for those purposes. The same interview reported that FC1 is not placed in the playpen because FC1's age is not appropriate for playpen. FC2 is in the playpen for a maximum of four hours throughout the day. If FC2 is not in the playpen or in the highchair for feeding FC2 is in therapy. County Social Worker stated not having concerns on the care and supervision from SFH. Other information states the allegation occurred. Regarding the allegation that licensee left child in a soiled diaper it was alleged that licensee left FC1 in the playpen for six hours without changing FC1's diaper. No further details. A confidential interview stated all foster children are not left in soiled diapers for long periods of time. Another confidential interview stated foster children are changed immediately. County Social Worker stated not having concerns that FC1-FC3 are not changed in a timely manner. Other information states the allegation occurred. Based on confidential interviews, the allegation that the licensee left child unattended for an extended period of time, licensee left child in a soiled diaper, may have occurred, however, there was not a preponderance of evidence to support or deny the alleged violations. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, a copy of this report, LIC 811, and appeal rights were given to Licensee Michelle Rivero. In regard to the allegation that licensee does not ensure firearms are secured properly it was specifically alleged that (A) carries a gun in the presence of foster children in the home. It was further reported that (A) carries a firearm in a fanny pack and in the vehicle when driving with the children. It was reported that (A) keeps his firearm loaded. Confidential interviews stated (A) obtained a Carry Concealed Weapon License for the handgun in the fanny pack (A) carries. Confidential interviews stated (A) always carries the handgun in (A)'s fanny pack inaccessible to foster children in care. Confidential interviews reported that (A) did not have the handgun locked in a safe during the nighttime hours. The handgun was placed on a shelf inside (A)'s bedroom's closet. Based on confidential interviews, the preponderance of evidence standard has been met, therefore, the allegation that licensee did not ensure firearms are properly secured is substantiated. The facility is being cited for the violation of General Licensing Requirements 80087 (g)(1) Building and Grounds on the attached LIC 9099D. An exit interview was conducted and a copy of this report, appeal rights, and LIC811 was provided to licensee Michelle Rivero.

Investigation Findings:
13On June 27, 2024, at 09:00AM, Licensing Program Analyst (LPA) Adaleyci Caballero met Michelle Small Family Home (SFH) Licensee Michelle Rivero to discuss the investigation finding for the above stated allegations involving foster children #1-#3 (FC1-FC3) listed on the Confidential Names List (811) dated 06/27/24. On May 8, 2024, at 1:00PM, LPA initiated the investigation at the SFH, and a safety inspection was conducted. There were no immediate hazards observed. During the investigation, LPA interviewed licensee, Adult (A), staff, and County Social Worker. LPA obtained pertinent documents from SFH and foster children's files. On May 1, 2024, Community Care Licensing received information alleging that the licensee left child unattended for an extended period of time and licensee left child in a soiled diaper. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Adaleyci Caballero LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: MICHELLE SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 06/27/2024

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

met_with: Licensee-Michelle Rivero


raw_content:
Narrative:
On June 6, 2024, Community Care Licensing received information alleging that an adult in the home yells at minors in care. It was alleged that an adult in the home does not have patience when the foster children cry or fight with one another. A confidential interview reported that Adult #1 (A1) does not yell or scream at foster children but scolds them. Another confidential interview stated (A1) does not yell or scream at foster children, but voices are raised towards FC1 because FC1 has mild hearing loss. One confidential interview reported not witnessing yelling or screaming at the SFH, but scolding is used to redirect foster children #1 and #3. Other information states the allegation occurred. Based on confidential interviews, the allegation that Adult #1(A1) yells at minors in care, may have occurred, however, there was not a preponderance of evidence to support or deny the alleged violation. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, a copy of this report, LIC 811, and appeal rights were given to Licensee Michelle Rivero.

Investigation Findings:
13On September 11, 2024, at 1:02PM, Licensing Program Analyst (LPA) Adaleyci Caballero met Michelle Small Family Home (SFH) Licensee Michelle Rivero to discuss the investigation finding for the above stated allegation involving foster children #1-#3 (FC1-FC3) listed on the Confidential Names List (811) dated 09/11/24. On June 12, 2024, at 2:38PM, LPA initiated the investigation at the SFH, and a safety inspection was conducted. There were no immediate hazards observed. During the investigation, LPA interviewed licensee, Adult #1(A1), and youth #1(Y1). Foster children #1-#3 were not interviewed due to their developmental ages. County Social Workers were not interviewed due to LPA making several attempts to interview County Social Workers and was unsuccessful. LPA obtained pertinent documents from SFH and foster children's files. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Adaleyci Caballero 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 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: MICHELLE SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 09/11/2024

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


summary: Facility Evaluation

raw_content:
Narrative:
On April 18, 2024 at 12: PM, Licensing Program Analyst (LPA) Linda Haynes completed a pre-licensing inspection of Michelle Small Family Home. LPA met with Applicant Michelle Rivero who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there are three clients in placement. The home is a one story building with four bedrooms and two and 1/2 bathrooms which are set up as follows: · Bedroom #1 (Applicants) has one bed will sleep the applicant. · Bedroom #2 (Client's) has two cribs, it will sleep two client's. · Bedroom #3 (Client's and daughters) has two bed, it will sleep one client and the daughter. · Bedroom #4 (Client's) has two bed's, it will sleep two client's. · A great room/living room, kitchen, dining area, two and one half bathrooms, laundry room, two car garage and the backyard. The Client's bedrooms were arranged so that no more than two client's will be in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There was a smoke detector in every bedroom. The four smoke detectors were checked, and they were working properly. The Carbon Monoxide detector is located in the hallway and was checked and working properly. The home's central air conditioning module was located on the side of the house. The home's hot water heater was located in the garage. The appliances were in working order. The client's files will be locked inside a filing cabinet in the office. There was adequate food storage space and a supply of two days of perishable foods and a week of non-perishable foods. A trash can for storage of solid waste had a tight-fitting lid and was present. The sharp knives are in a locked drawer in the kitchen. The medications are located in a locked cabinet in the hallway. The hot water in bathroom one measured to be 104.7 degrees Fahrenheit, bathroom two was 104.6 degrees Fahrenheit, and in bathroom three 104.8 degrees Fahrenheit. The home's First Aid kit was accessible and is located in a cabinet in the hallway and contained all required supplies. There was one fire extinguisher present in the home it is located in the kitchen by the kitchen cabinets. It was observed to be properly charged and inspected by the fire department. There are fire arms in the home they were unloaded and locked in a safe in the garage and the ammo is locked and stored in a separate safe. There is no pool or other body of water at the home. The backyard where clients will have access to play is fenced. The following correction needs to be made The hot water needs to be between 105 degrees Fahrenheit and 120 degrees Fahrenheit An exit interview was conducted. Application will be forwarded to the Licensing Program Manager for Licensing.

met_with: Michelle Rivero


summary: Facility Evaluation

raw_content:
Narrative:
On April 16, 2025 at 09:00AM, Licensing Program Analyst (LPA) Rachel Vanegas arrived unannounced to the facility listed above to complete an annual/post-licensing inspection. LPA met with the Licensee - Michelle Rivero who led a tour of the home. The facility was toured both inside and out with the Licensee. The home is a one story building with five bedrooms and two and 1/2 bathrooms which are set up as follows: Bedroom #1 (Licensee) has a King Bed, sleeps the Licensee and Spouse. It has 1 crib and sleeps 1 infant client. Bedroom #2 (Clients') has 1 crib and 1 cubby bed. It sleeps 2 clients. Bedroom #3 (Daughter's) has 1 single and sleeps the Licensee's daughter. Bedroom #4 (Client's) has 1 bed and sleeps the Licensee's minor sibling. Bedroom #5 (Office) is used as a storage/office space. A great room/living room, kitchen, dining area, two and 1/2 bathrooms, laundry room, attached two car garage and the backyard. The client's bedrooms are arranged so that no more than two client's will be in a room. No room commonly used for other purposes is used as a bedroom and no bedroom serves as a passageway to another room. There was adequate closet and drawer space for the client's belongings. There are spare linens located in each bedroom. There were combination carbon monoxide and smoke detectors in every bedroom and hallway. The combination carbon monoxide/smoke detectors were checked and in working order at the time of this visit. The home's central air conditioning module is located on the side of the house. The home's hot water heater was located in the garage. **** The hot water temperature was measured in the kitchen and registered at 109.4 degrees Fahrenheit. The client's files are locked inside a filing cabinet in the office. There was adequate food storage space and a supply of two days of perishable foods and seven days of non-perishable foods. A trash can for storage of solid waste had a tight-fitting lid and located in the kitchen. The sharp knives are in a locked drawer in the kitchen. Cleaning chemicals are stored in a locked cabinet under the kitchen sink. The medications are located in a locked cabinet in the hallway. Laundry detergent is located in a locked cabinet in the laundry room. The home's first aid kit was accessible and is located in a cabinet in the hallway and contained all required supplies. There were two fire extinguishers present in the home one is located in the kitchen by the kitchen cabinets and one is located by the laundry room. They were observed to be properly charged and inspected. There are fire arms in the home, they were unloaded and locked in a safe in the garage and the ammunition is locked and stored in a separate safe. The backyard was observed to be clean and free of hazards. The backyard contains play wagons and a play set available for outdoor activities for the children in care along with additional recreation games. There is no pool or other body of water at the facility at this time. LPA conducted three client file reviews for Client 1 (C1), Client 2 (C2), and Client 3 (C3) and observed the needed documents in the files including, needs and services plans, consent to medical treatment authorization forms, placement agreements, medical clearance forms, etc. LPA conducted four staff file review for Staff 1 (S1), Staff 2 (S2), Staff 3 (S3), and Staff 4 (S4) and observed that files contained needed documents including CPR/First Aid certificates, Drivers License, Health Screening, Statement Acknowledging Requirement to Report Child Abuse, etc. LPA discussed with the Licensee the requirements for submitting an exception request for a cubby bed in bedroom #2 for FC1. Based on observation and record review, there are no deficiencies cited at this time. An exit interview was conducted and a copy of this report, LIC 811, and appeal rights were reviewed and provided to the Licensee - Michelle Rivero.

met_with: Licensee - Michelle Rivero


raw_content:
Narrative:
Although the Department received detailed information and due to it being a historical complaint, LPA was not able to obtain a preponderance of evidence regarding neglect/lack of supervision. Confidential interviews conducted did not provide sufficient evidence to corroborate the allegations and there were no witnesses to the said allegations. Additionally, C1 was unable to communicate to obtain an interview. Based on confidential interviews, the allegations that due to neglect/lack of supervision, C1 received injuries while in care and C1 was left in a soiled diaper, may have occurred, however, is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with appeal rights was given to Michelle Small Family Home (SFH), Licensee, Eric Rivero.

Investigation Findings:
13On January 15, 2026, at 08: AM, Licensing Program Analyst (LPA) Sarah Lo met with Michelle Small Family Home (SFH), Licensee, Eric Rivero, to deliver the finding for the above-stated allegations. On 06/25/25, LPA Rachel Vanegas inspected the SFH, and no immediate health and safety hazards were observed. The investigation included interviews with the two Staff (S1, S2), Out of Home Investigator (IN), Respite Caregiver (RC) and County Social Worker (CSW). Client #1 (C1) was not interviewed due to C1's communicative skills. In addition, the Clients' file and Special Incident Report (SIR) were reviewed. On June 24, 2025, Community Care Licensing (CCL) received a complaint alleging that due to neglect/lack of supervision child (C1) received injuries while in care and child (C1) was left in a soiled diaper. Specifically, it was reported that in July of 2024, C1 had a busted lip and in October of 2024, C1 was examined by a doctor who noticed C1's buttock had scarring from being left in a diaper for too long. (continued on LIC 9099c) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Sarah Lo 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 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: MICHELLE SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 01/15/2026

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

met_with: Licensee, Eric Rivero


facility_name: MILLER'S CARE HOME #1

summary: Facility Evaluation

raw_content:
Narrative:
On 08/10/2021, at approximately PM, Licensing Program Analyst (LPA) Chad Cabigon attempted to conduct an unannounced on-site inspection of this facility to follow up on a report that the Regional Office received via phone of a COVID-19 outbreak in the facility. LPA was met at the door by staffer Kim Miller. Three individuals from this facility have been hospitalized due to COVID-19 symptoms (all three tested positive for COVID-19). The one client the facility had cannot come back to the facility for the time being--the County Case Worker and North Bay Regional Center have been informed of recent developments. There is a hold on facility operations at the moment. No citations were issued as a result of this inspection.

met_with: Kim Miller, Staff


summary: Facility Evaluation

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Narrative:
On 02/14/2022, at approximately PM, LPA Chad Cabigon conducted an unannounced inspection of this facility. LPA collected the Home's physical Community Care licenses as part of the process of formally closing the facility--the closure is brought on by the licensee passing away. LPA met with Rhonda Levias, facility caregiver and daughter of the licensee, who confirmed that there were no clients under the facility's care; LPA observed no indication of placements being on the premises. Ms. Levias does have an adopted child living in the home. No citations were issued, and this inspection effectively closes Miller's Care Home #1 without contingency; a copy of this report is being provided to the facility.

met_with: Rhonda Levias


facility_name: MILLER & MILLER RESIDENTIAL CARE HOME

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Tamara Hill met with Edward Miller, Licensee applicant at the Community Care Licensing office to conduct a Component II, face to face meeting with Edward Miller, Licensee, to discuss the facility application. LPA Hill and licensee discussed the application and went over the document provided to the applicant regarding the application review. LPA Hill did receive a copy of the facility sketch of the property indicating a fence around the pool located at the facility. LPA Hill discussed the need for water safety certificate(s) for all staff using the pool with the youth in care. LPA Hill also received a copy of the facility deed as proof of ownership of the home. Some topics discussed during the inspection included positive discipline, emergency interventions, being clear about the clientele to be admitted to the facility, ages of clients to be served (differing ages and the LIC200 indicates they would accept children ages 0 to 5). LPA Hill also discussed medication administration policies, activities, admission policies, exit criteria, complaints and grievances, needs and services plans for children in care, family involvement, and all licensing forms that need to be updated. LPA Hill discussed with Mr. Miller that the updated documents need to be provided to this LPA by 5/31/25. Exit interview was conducted with Mr. Miller and the document was provided.

met_with: Edward Miller, Licensee


facility_name: MITCHELL SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On this date Licensing Program Analyst (LPA), Daniel Mena conducted an annual inspection at the facility. The home was toured inside and out with licensee, Heidi Mitchell. The home is a one story residence with 6 bedrooms and 3 bathroom. The home is set up as follows: Bedroom #1 - is the master bedroom, contains a king size bed and sleeps the licensees. Bedroom #2 - is designated as a sewing/storage room. Bedroom #3 - is designated for the licensee's biological child. The room contained one twin size bed and had adequate drawer and closet space for child's belongings. Bedroom #4- is designated for two foster children. The room contained two cribs and had adequate drawer and closet space for child's belongings. Bedroom #5 - is designated for the licensee's biological children. The room contains two-twin sized beds at this time and had adequate drawer and closet space for child's belongings. Bedroom #6 - is utilized as a school room. The room contained desks, cubbies, and additional storage space. Bedrooms are arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawer and closet space for children's belongings. The smoke detectors were checked and were working properly. There was also a plenty of space for children to play. The fireplace was located in the family room area and it was properly screened. Telephone service and appliances were in a working order. All hazardous items have been properly made inaccessible to areas where children will have access. Cleansers/chemicals were locked and stored in the laundry rooms. Sharp knives were inaccessible and stored in a locked cabinet in the kitchen area. The hot water temperature was tested and noted to be 108 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit was accessible and contained all required items. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. Licensee's stated that there are no weapons in the home. There were no pool or other bodies of water. Home has several farm animals which are properly fenced and separated in the backyard area. The backyard where children will have access to play was completely fenced and free of hazards. Facility is licensed to care for medically fragile/developmentally disabled children 0-17 years of age, ambulatory only. Licensee prefers to serve medically fragile children ages 0-2 years old. The Licensee's meet the requirements for the 8 hours of annual foster care training. Licensee's First Aid and CPR cards expire on February 02, 2023. A review of staff records on this date indicates that all adults residing in the home or providing care and supervision to children have received fingerprint and child abuse index check clearances. Exit interview conducted and a copy of this report was discussed and provided this date. There were no deficiencies cited on this date.

met_with: Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On April 24, 2023 at 9:40 am, Licensing Program Analyst, (LPA) Uchenna Ajaero conducted a Pre-Licensing inspection at the Heidi Mitchell Small Family Home. LPA Ajaero met the Licensee, Heidi Mitchell. The following domains were completed: physical plant, operations, staffing records, Special Health Care Needs (SHCN), and client records. LPA toured the facility inside and outside. Facility is a single home and consists of two levels, with five bedrooms, two bathrooms, a living room, kitchen, dining room, family room, laundry room and backyard. Fire alarms and carbon monoxide were tested. First aid kit was checked and complete. Medication kit was in a locked cabinet and was inspected. Licensee had only vitamins and OTC medications. Licensee has 2 standby staff currently being cleared. Care Tool was completed. No staff interview was conducted. There were no youths in placement. An exit interview was conducted with the Licensee, Heidi Mitchell. A coy of this report was left with the Licensee, Heidi Mitchell.

met_with: Heidi Mitchell


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Tina Thorn arrived unannounced at the facility on 04.16.24 and met with Heidi Mitchell, administrator. The purpose of the visit was to complete an Annual Inspection using the CARE tool. The facility has 1 staff and two on-call staff. Staff and on-call staff have complete Criminal Record Clearances on file. The facility has 1 client in placement. LPA completed a Health and Safety Inspection of the facility. The facility is a home with 25 acres of land. Half of an acre is properly fenced for client use with supervision. There was space in living area for seating, baskets with toys and free of hazards with room for toddlers to walk or crawl around. There are two bedrooms downstairs and two bedrooms upstairs.There are two bathrooms, One for clients and children and one for administrator. All toilets, showers, and sinks were functioning properly. The living area is spacious. The home was clean and organized. The room temperature was comfortable and no odor was detected. There are seven smoke alarms and five carbon monoxide alarms that were in working order. Fire extinguishers were current, and a first aid kit was fully stocked. Disinfectants and medications are locked in two cabinets.LPA observed the kitchen to have at least 2 days of perishable food and 7 days of non-perishable food on hand.Client's bedroom had clean bedding, along with a dresser and closet which provided ample storage space for personal belongings. There is no swimming pool or other body of water on the premises. There are no firearms or other weapons in the facility. LPA reviewed one client file. Client had a comprehensive physical and developmental discharge summary. LPA reviewed one staff file. Staff file contained sufficient training hours and CPR and First Aid was current. LPA was not able to interview client because client was an infant. Client is G-tube fed and was feeding when LPA arrived. Client was clean and had clean clothes and babbling a lot. LPA interviewed one staff. No citations were given on this date. A signed copy of LIC-809 report was provided to adminstrator. An exit interview was conducted.

met_with: Heidi Mitchell, administator, licensee


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPAs) Tina Thorn and Yesenia Vallejo arrived unannounced at the facility on 04.09.25 and met with Heidi Mitchell, Licensee. The purpose of the visit was to complete an Annual Inspection using the CARE tool. The facility is licensed to care for 2 ambulatory/ non-ambulatory children ages 0-6 years. The facility has 1 staff. Licensee has complete Criminal Record Clearances on file. The facility has 1 client in placement. LPA completed a Health and Safety Inspection of the facility. The facility is a home with 25 acres of land. Half of an acre is properly fenced for client use with supervision. There was space in living areas for seating and many toys and books available for the client in care. There are two bedrooms downstairs and two bedrooms upstairs.There are two bathrooms, One for clients and one for Licensee. All toilets, showers, and sinks were functioning properly. The living area is spacious. The home was clean and organized. The room temperature was comfortable and no odor was detected. There are seven smoke alarms and five carbon monoxide alarms that were in working order. Fire extinguishers were current, and a first aid kit was fully stocked.Disinfectants and medications are locked in two cabinets.LPA observed the kitchen to have at least 2 days of perishable food and 7 days of non-perishable food on hand.Client's bedroom had clean bedding, along with a dresser and closet which provided ample storage space for personal belongings. There is no swimming pool or other body of water on the premises. There are no firearms or other weapons in the facility. LPA reviewed 1 client file. Client is currentwith medical exams and dental exams. LPA reviewed 1 staff file. Staff file contained sufficient training hours and CPR and First Aid was current. LPA interviewed 1 staff. Client in the home is too young to be interviewed. No citations were given on this date. An exit interview was conducted. A copy of this LIC 809 was given to the Licensee.

met_with: Heidi Mitchell, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPAs) Misty Valencia and Lyta Vue arrived unannounced at the facility on 04/09/2026 and met with Heidi Mitchell, Licensee. The purpose of the visit was to complete an Annual Inspection using the CARE tool. The facility is licensed to care for 2 ambulatory/ non-ambulatory children ages 0-6 years. The facility has 1 staff. Licensee has complete Criminal Record Clearances on file. The facility has no clients in placement. LPAs completed a Health and Safety Inspection of the facility. The facility is a home with 25 acres of land. Half of an acre is properly fenced for client use with supervision. There was space in living areas for seating and many toys and books available for any clients in care. There are two bedrooms downstairs and three bedrooms upstairs. There are two bathrooms, One for any clients in care and one for Licensee. All toilets, showers, and sinks were functioning properly. The living area is spacious. The home was clean and organized. The room temperature was comfortable and no odor was detected. There are eight smoke alarms/carbon monoxide alarms that were in working order. Fire extinguishers were current, and a first aid kit was fully stocked. Disinfectants and medications are locked in two cabinets. LPA observed the kitchen to have at least 2 days of perishable food and 7 days of non-perishable food on hand. Client's bedroom had clean bedding, along with a dresser and closet which provided ample storage space for personal belongings. There is no swimming pool or other body of water on the premises. There are no firearms or other weapons on the facility property. LPAs reviewed 0 client file. There are currently no clients in care, last placement exited September 2025. LPAs reviewed 1 staff file. Staff file contained sufficient training hours and CPR and First Aid was current. LPAs interviewed 1 staff. No citations were given on this date. An exit interview was conducted. A copy of this LIC 809 was given to the Licensee.


facility_name: MO ROCKHAVEN CARE

summary: Facility Evaluation

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Narrative:
On May 20, 2025 at 10:30AM, Licensing Program Analyst (LPA) Shikya Belfield met with Licensee Mutiu Okolodana for the purpose of conducting the second component of the licensing process. Present during this meeting is LPA Shikya Belfield and Licensee Mutiu Okolodana. The following was discussed: LPA discussed discipline policies and procedures, medication procedures, Visitation policies, Therapeutic programs/services / supports and transportation. Licensee was able to describe information regarding their Small Family Home Program design and the support they will provide for the clients in their care. LPA discussed circumstances surrounding individualized support provided for each client in care and special health care conditions that may be presented during discussions of placement referrals. LPA asked questions regarding supervision and the home schedule as well as individuals in the home were discussed. Licensee was very knowledgeable and understands the procedures for medication as they are currently a registered Nurse and was able to describe this information regarding prescription and LPA discussed documentation.. Experience was also discussed as the Licensee has mainly experience working with adults with developmental disabilities however, they have began taking training courses that cover safety and supervision of children as well as child development. Licensee has support in the home from two other adults. All revisions have been completed and submitted to the department and the revisions were discussed. LPA gave Licensee time to ask any questions or make request for any supportive information. Licensee took time to ask questions regarding special health care needs and next steps for the licensing process. Licensee also asked clarifying questions regarding medication and it was discussed. The meeting was concluded.

met_with: Mutiu Okolodana


summary: Facility Evaluation

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Narrative:
On 6/4/25 at 10: AM, Licensing Program Analyst (LPA) Paul Simien conducted an announced visit to the above facility. The purpose of this visit was to conduct the required Prelicensing inspection. LPA met with Mutiu Okolodana, Licensee at the above facility to conduct the required annual inspection. LPA reviewed two staff files and completed the staff, client, operations, and disaster preparedness sections of the SFH prelicensing CARE tool. LPA discussed the following with licensee: Driver's license and job duties/descriptions need to be added to staff files. Staff training requirements. Register of clients requirements (when client placement are made). MAR needed for clients medication (when client placement are made). Adding a copy of the Admissions Agreement and facility sketch in Plan of Operations. Disaster drill requirements/disaster and mass casualty plan of action. At this time, the inspection is complete. LPA conducted an exit interview with Mutiu Okolodana, Licensee

met_with: Mutiu Okolodana, Licensee


facility_name: MONARCH HOME

summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) David Hiett conducted an unannounced inspection to the facility for the purpose of conducting an Annual/Required inspection. LPA Hiett met with Dennis Opp and toured the facility. 1 of the 3 clients was present and no other staff than Mr. Opp. The home is clean, safe, sanitary, and in good repair. All passageways are unobstructed. There are no bodies of water on the property. No room commonly used for other purposes is used as a bedroom. There is an adequate supply of formula for clients in care. The facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The home is maintained at a comfortable temperature. Firearms are kept locked and inaccessible in the garage. Licensee understands ammunition is kept locked separately. Facility has one first-aid kit located client bathroom. Applicant understands that the hot water temperature must be maintained within the regulation range of 105 - 120 degrees. Currently in placement are three clients, one girl and two boys. The home operates within the capacity and limitations of the license. LPA Hiett reviewed client files and they had the necessary forms. Staff files showed were reviewed and complete. No Title 22 deficiencies cited this date. Exit interview conducted a copy of the report was sent to the facility. Current forms and Title Regulations can be obtained through the internet at www.ccld.ca.gov

met_with: Dennis Opp


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) David Hiett conducted an unannounced inspection to the facility for the purpose of conducting an Annual/Required inspection. LPA Hiett met with Travis Opp and toured the facility. 2 clients were present and no other staff than Mr. Opp. The home is clean, safe, sanitary, and in good repair. All passageways are unobstructed. There are no bodies of water on the property. No room commonly used for other purposes is used as a bedroom. There is an adequate supply of formula for clients in care. The facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The home is maintained at a comfortable temperature. Firearms are kept locked and inaccessible in the garage. Licensee understands ammunition is kept locked separately. Facility has one first-aid kit located client bathroom. Applicant understands that the hot water temperature must be maintained within the regulation range of 105 - 120 degrees and was measured at 111F. Currently in placement are 2 clients, one girl and one boy. The home operates within the capacity and limitations of the license. LPA Hiett reviewed client files and they had the necessary forms. Staff files were reviewed and complete. No Title 22 deficiencies cited this date. Exit interview conducted a copy of the report was sent to the facility.

met_with: Travis Opp


summary: Facility Evaluation

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Narrative:
On 4/19/23 at 10: AM Licensing Program Analyst (LPA) Alyssa Ng made an unannounced annual/required inspection to this location. LPA Ng met with Administrator Jeanine Opp. The facility is licensed for four residents, and currently in placement is 2 clients. LPA observed one client in care who is non-verbal, however client in care was enjoying watching television and seemed to be in good spirits. Safety precautions were taken, including screening call, hand hygiene, and mask-wearing. LPA Ng toured the facility inside and out. Two bedrooms for clients and two for staff and all bedrooms are double occupancy. The water temperature measured 114.8 degrees F. The facility is clean, safe and sanitary. There is an adequate supply of formula for clients in care. The smoke detectors are in working order. No bodies of water on the premises. All walkways were free from debris or hazards. All window screens are in good condition. LPA Ng reviewed 2 client files and 3 staff files. All client and staff records complete with all of the required documentation. Each client has their own separate binder of all required documents. Facility had a centralized staff binder included required training, staff qualifications, employees personal rights, and health screening. LPA Ng interviewed one staff. One client in care is 19 years of age and the other client in care is 16 years of age. Administrator states that she does not want to convert into an Adult Residential Facility. LPA will reach out to her Licensing Program Manager and will follow up with Administrator Jeanine. At this time, no citations were given. An exit interview was conducted, and a copy of this report was given to Administrator Jeanine Opp, whose signature on this form confirms receipt.

met_with: Jeanine Opp


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge made an unannounced case management inspection, and met with Licensee Jeanine Opp. The purpose of the inspection was to retrieve information about a death of a client. The client has been on and off hospice multiple times. Client has been sick his whole life, but this infection has been creeping up. He has been on anitibitocs for about a year to the type of infection. He got picked up from the home by ambulance and taking to Kaiser Vallejo hospital. The client had been at the hospital for about three days. He had an DNR. On the 12th hospital requested to put him on comfort care. Administrator has notified all parties. LPA talked to administrator about sending in an Incident report and administrator stated that it was in the process as well as getting documentation from the hospital. LPA also requested a copy of the clients needs and services plan.

met_with: Jeanine OPP


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge made an unannounced case management inspection, and met with Licensee Jeanine Opp. The purpose of the inspection was to retrieve information about a death of a client. At 6 am clients apnea machine went off, she had vomited. Administrator turned her to the side and suctioned it out. She vomited two more times and her oxygen was low so the administrator called 911 for an ambulance to the hospital. The client passed away the next day at Queen of the Valley Hospital. The client has been sick for months and in hospice care. Administrator has notified all parties. Administrator sent in an Incident to regional center and gave a copy to LPA. LPA also requested a copy of the clients needs and services plan.


summary: Facility Evaluation

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Narrative:
On the above date, Licensing Program Analyst (LPA) Cheyenne McCambridge made an unannounced visit to the facility and met with Administrator Jeanine Opp. The purpose of the visit was to confirm closure of the Small Family Home. The Request for Closure, written confirmation there being no youth remaining, and license were received by CCL. LPA McCambridge inspected the facility at 10:30am and confirmed that no youth were present. Licensee /Administrator would like the closure of the Small Family Home to be effective immediately. An exit interview was conducted with the Administrator to confirm the closure.


summary: Facility Evaluation

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Narrative:
On February 4th, Licensing Program Analyst (LPA) Maryjane Perez met with applicants Monica Mugo and Patrick Muchiri this date for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the LIC 184, Letter of Application Revision, and additional correspondence to assist with the revisions needed to the application. A copy of this report was provided to applicants Monica Mugo and Patrick Muchiri.

met_with: Applcants- Monica Mugo and Patrick Muchiri


summary: Facility Evaluation

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Narrative:
On February 14, 2025, at 9: AM Licensing Program Analyst (LPA) Maryjane Perez arrived at Monica Mugo and Patrick Muchiri Small Family Home (SFH) for a pre-licensing inspection for an initial license. LPA met with applicants Monica Mugo and Patrick Muchiri who led a tour of the entire home inside and out. Currently there is one resource family approval (RFA) child placed in the home but no other clients. The applicants are applying to serve four children ages 0 to 17, 2 ambulatory and 2 non-ambulatory. The home is a two-story building with 5 bedrooms and 4 and a half bathrooms. The downstairs consisted of living room #1 fully furnished with couches, toys, and adequate play space. There was a half bathroom as it has only a sink and toilet with water temperature reaching 111 degrees Fahrenheit. There was a closet that stores extra house hold items such as toilet paper and paper towels. There was living room #2 fully furnished with couches, television, and telephone land line. The fireplace was in the living room area as well and it was properly screened. The kitchen had working appliances and a fully stocked refrigerator and pantry with perishable and non-perishable foods. There was a locked bag to store refrigerated medication if needed. The knives and sharps were locked in a kitchen drawer as well as medication. Under the kitchen sink there was a locked cabinet storing kitchen cleaning supplies. There was a bulletin board in the kitchen with posted personal rights, facility sketch, emergency disaster plan and visitation policy. Fire extinguisher #1 is located in the kitchen as well. There was also a locked cabinet that stores client files and cash resources. The first aid kit sits on kitchen counter with all the required elements. There was a dining room with dining table with adequate seating. Downstairs also had bedroom #1 that will be utilized for two non-ambulatory clients that was fully furnished and had one full size bed and one twin size bed with the appropriate bedding. The full size bed is currently vacant meanwhile the twin bed is occupied by an RFA child who might be removed from the home once licensed. There was full bathroom #1 that was fully functioning with a sink, toilet and shower/ tub. The upstairs consisted of a laundry room that was accessible to clients but had several locked cabinets storing laundry detergents and essentials. There was also cabinets storing extra blankets and linen. There was bedroom #2 that was fully furnished and had a queen size bed that was utilized for applicants biological son. There was also bedroom #3 that had one full size bed and one twin bed currently vacant and fully furnished with closet and drawer space that will be utilized for 2 ambulatory clients. Across from the bedrooms was bathroom #2 that had two sinks, a toilet, and shower/ tub. Bedroom #4 had a queen size bed and was fully furnished with dressers and closet space that will be utilized for one ambulatory client. There was bathroom #3 with two sinks, toilet, and shower/tub. The upstairs hallway had cabinets storing blankets, towels and a locked cabinet for personnel records. Fire extinguisher #2 was placed in upstairs hallway as well. There was a game room that was fully furnished with couch and television with adequate play space. The master bedroom was fully furnished and had a king size bed with a infant crib with required bedding and bathroom #4 fully functioning. Bedrooms were arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. The smoke detectors and carbon monoxide detectors were checked and are working properly. All hazardous items have been properly made inaccessible to areas where children will have access. The garage was spacious and free of hazards with a an extra freezer storing frozen goods. The backyard was fully enclosed with a gate that has a latch and free of hazards and obstruction. There is no pool or other body of water and there are no guns or weapons as stated by both applicants at this time. There are no deficiencies observed at this time. Component III orientation was completed this day with LPA. The request for licensure will be forwarded to Licensing Program Manager for final review and approval. An exit interview was conducted. A copy of this report was provided to applicants Monica Mugo and Patrick Muchiri.

met_with: Applicants- Monica Mugo and Patrick Muchiri


summary: Facility Evaluation

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Narrative:
On March 28, 2025, Licensing Program Analyst (LPA) Maryjane Perez began a post-licensing inspection for Monica Mugo & Patrick Muchiri Small Family Home (SFH). LPA met with licensee Monica Mugo who led a tour of the home. The facility was toured both inside and out. Currently there is one child in placement. The licensee was approved for a capacity of four children ages 0 to 17. The home is a two- story building with five bedrooms and four and a half bathrooms. The downstairs consisted of a play area with toys and couches, a living room with couch, TV, and a land line service, a half bathroom , a dining room with adequate seating arrangement, a clean/ sanitary kitchen with an abundance of perishable and non-perishable foods, first aid kit, fire extinguisher #1 and all required postings such as disaster plan, visitation policy, facility sketch, menu, and license posted. The kitchen also had locked medications and knives/sharp objects stored in a cabinet. The downstairs also consisted of bathroom #1 that was fully functioning with water temperature measuring 123.8 degrees Fahrenheit- licensee understands the water temperature range must be from 105-120 degrees Fahrenheit. Bedroom #1 had closet/ dresser space with one hospital bed for a client and was currently occupied and one full size bed for another client that was currently vacant. The upstairs had a laundry room with locked cleaning supplies and detergents, bathroom #2 that was fully functioning with dual sinks, bedroom #2 that was fully furnished and was utilized for licensees biological child. There was also bedroom #3 that had one full size bed and one twin size bed, closet and dresser space that would be utilized for two clients and is currently vacant. There was bedroom #4 that was fully furnished and had bathroom #3, a hallway storing extra towels and linens as well as fire extinguisher #2. The upstairs also had bedroom #5 that was licensee's bedroom with bathroom #4, and a loft area with TV and couches. Bedrooms were arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate lighting and drawer/ closet space for children's belongings. All hazardous items have been properly made inaccessible to areas where children will have access. The outdoor grounds were also inspected, and no hazards or obstructions were observed. During inspection LPA inspected one client file and two staff files. There was no pool or other body of water. There was no firearm in the home as stated by licensee. The smoke and carbon monoxide detectors were checked and were working properly. LPA interviewed two staff and one client. During the visit. there were no deficiencies observed, however, LPA issued three technical advisories (TA) which were explained and given to licensee. An exit interview was conducted, and a copy of this report along with three TA's were reviewed and provided to licensee's Monica Mugo and Patrick Muchiri.

met_with: Licensee- Monica Mugo


facility_name: MONICA SMALL FAMILY HOME

summary: Facility Evaluation

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Narrative:
On August 19, 2025, Licensing Program Analyst (LPA) Maryjane Perez met with applicant Monica Mwaniki this date for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the LIC 184, Letter of Application Revision, and additional correspondence to assist with the revisions needed to the application. A copy of this report was provided to applicant Monica Mwaniki.

met_with: Applicant- Monica W. Mwaniki


summary: Facility Evaluation

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Narrative:
On August 29, 2025, licensing program analyst (LPA) Maryjane Perez arrived at Monica Small Family Home (SFH) for a pre-licensing inspection for an initial license. LPA met with applicants Monica Mwaniki and Steve Kibiku who led a tour of the entire home inside and outside. The applicants are applying to serve four clients (2 ambulatory, 1 non-ambulatory, and 1 bed ridden) ages 0 to 17 years old. Currently there are no clients placed in the home. The home is a two-story building with five bedrooms and five bathrooms. The downstairs consisted of an entry way with a table with a visitation log, a storage closet storing extra household items such as water, paper towels, and games. There was bedroom #1 that had one queen size bed for one non-ambulatory/bed ridden client with bathroom #1 that had a walk in shower and had a trash can with a lid. The applicants understand that there needs to be two beds to show there is room for one non-ambulatory and 1 bed ridden client. There was a hallway with all required postings such as facility sketch, personal rights, and emergency disaster plan. There was a living room with couches, a TV, a sliding door leading to the outside, and a formal dining room with adequate seating arrangement and fire extinguisher #1. The kitchen was clean and sanitary with a locked cabinet for storing sharp objects/knives, a locked medication cabinet, the refrigerator and pantry were fully stocked with perishable and non-perishable foods. There was a dining table with adequate seating and a cabinet storing a first aid kit with all required elements. There was another sliding door leading to the backyard. There was a small family room that had couches and a locked refrigerator for storing only medication. Bathroom #2 was fully functioning with water temperature measuring 115.1 degrees Fahrenheit. The upstairs had a hallway that had fire extinguisher #2 that was fully operable. There was a loft that stored client files and staff records in a locked file cabinet. The loft also had couches, a TV with video games, and a desk with a computer. Bedroom #2 was fully furnished with one twin size bed and one full size bed, dresser/ closet space, and all required bedding that will be utilized by two clients currently vacant. Bathroom #3 had dual sinks, shower/bathtub, and a trash can with a fitted lid. Bedroom #3 had two twin size beds, dresser/closet space, and all required bedding that will be utilized for two clients and is currently vacant. Bedroom #4 was for applicants biological son and had a bunk bed with one full size bed at the bottom and one twin size bed at the top. The room was fully furnished and had bathroom #4 with dual sinks, a shower/bathtub, and a trash can with a lid. The laundry room was locked at all times and stored a locked cabinet for laundry detergents, laundry essentials, and cleaning supplies. There was a linen closet that stored extra blankets, linen, and towels. Bedroom #5 was the master bedroom for applicants that will be locked at all times and had a Cal-king size bed, a crib for an infant, and bathroom #5 that was fully functioning with two sinks, a walk-in shower, and a separate bath tub. Bedrooms were arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. The smoke detectors and carbon monoxide detectors were checked and are working properly. All hazardous items have been properly made inaccessible to areas where children will have access. The backyard where children will have access to play was completely fenced, had a gate with a latch and was free of hazards. There were no pools or other bodies of water and no weapons/firearms as stated by applicants. There was a land- line telephone service and all appliances were in working order. The garage stored extra house hold items such as toys for children and a refrigerator for storing extra goods. Based on this inspection of the home, the facility will need the following corrections: bedroom to be arranged for 1 non amb client and 1 bedridden client After corrections are completed, the applicants will notify LPA so that another inspection can be completed. Component III orientation was also completed this day of August 29th, 2025. An exit interview was conducted and a copy of this report was provided to applicant Monica Mwaniki and Steve Kibiku

met_with: Applicant- Monica Mwaniki and Steve Kibiku


summary: Facility Evaluation

raw_content:
Narrative:
On October 22, 2025, Licensing Program Analyst (LPA) Maryjane Perez made an unannounced visit to Monica Small Family Home for a post licensing inspection. LPA met with licensees Monica Mwaniki and Steve Kibiku who led a tour of the entire home. The home was approved for a capacity of four children (2 ambulatory, 1 non-ambulatory, and 1 bed ridden) ages 0 to 17 years old. Currently there are two clients in care. The home is a two-story building with five bedrooms and five bathrooms. The downstairs consisted of an entry way with a table with a visitation log, a storage closet storing extra household items such as water, paper towels, and games. There was bedroom #1 that was utilized for one non-ambulatory and one bed ridden client and had two twin size beds with bathroom #1 that had a walk in shower and had a trash can with a lid and the room is currently vacant. There was a hallway with all required postings such as facility sketch, personal rights, and emergency disaster plan. There was a living room with couches, a TV, a sliding door leading to the outside, and a formal dining room with adequate seating arrangement and fire extinguisher #1. The kitchen was clean and sanitary with a locked cabinet for storing sharp objects/knives, a locked medication cabinet, the refrigerator and pantry were fully stocked with perishable and non-perishable foods. There was a dining table with adequate seating and a cabinet storing a first aid kit with all required elements. There was another sliding door leading to the backyard. There was a small family room that had couches and a locked refrigerator for storing only medication. Bathroom #2 was fully functioning with water temperature measuring 115.3 degrees Fahrenheit. The upstairs had a hallway that had fire extinguisher #2 that was fully operable. There was a loft that stored client files and staff records in a locked file cabinet. The loft also had couches, a TV with video games, and a desk with a computer. Bedroom #2 was utilized for two clients and was fully furnished with one twin size bed and one full size bed, dresser/ closet space, and all required bedding. One bed currently occupied by a one client. Bathroom #3 had dual sinks, shower/bathtub, and a trash can with a fitted lid. Bedroom #3 was utilized for two clients and had one twin size bed and one queen size bed, dresser/closet space, and all required bedding. The room is currently occupied by one client. Bedroom #4 was for applicants biological son and had a bunk bed with one full size bed at the bottom and one twin size bed at the top. The room was fully furnished and had bathroom #4 with dual sinks, a shower/bathtub, and a trash can with a lid. The laundry room was locked at all times and stored a locked cabinet for laundry detergents, laundry essentials, and cleaning supplies. There was a linen closet that stored extra blankets, linen, and towels. Bedroom #5 was the master bedroom for licensee that will be locked at all times and had a Cal-king size bed, a crib for an infant, and bathroom #5 that was fully functioning with two sinks, a walk-in shower, and a separate bath tub. Bedrooms were arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. The smoke detectors and carbon monoxide detectors were checked and are working properly. All hazardous items have been properly made inaccessible to areas where children will have access. The backyard where children will have access to play was completely fenced, had a gate with a latch and was free of hazards. There were no pools or other bodies of water and no weapons/firearms as stated by licensee. There was a telephone service and all appliances were in working order. The garage stored extra house hold items such as toys for children and a refrigerator for storing extra goods. Two client files and two personnel files were reviewed as well as two staff and two clients were interviewed. An exit interview was conducted and a copy of this report was provided to licensees Monica Mwaniki and Steve Kibiku.

met_with: Licensee- Monica Mwaniki