summary: Facility Evaluation

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Narrative:
On March, 2025, at 9: AM Licensing Program Analyst (LPA) Miguel Gomez arrived at Martinez Family Care for the purpose of conducting an annual/random visit. LPA Gomez met with Licensee Britney Martinez who granted access into the home. The facility is licensed to provide care and supervision for ambulatory developmentally disabled children ages 6-17. The census on the date of this visit is one The home is set-up as follows: The home contains garage, living room, dining area, kitchen, three bedrooms, two bathrooms, den,laundry room, front yard and backyard. Kitchen The kitchen is an open kitchen with an island sink. Cabinets are clean and stored with food, chemicals are stored properly. Alcohol is locked and secure in kitchen cabinet. Kitchen has two refrigerators with sufficient food. Dinning Area Dining area contains a table with four chairs. Foster poster is placed on the wall. Living Room The living room contains couches, TV, fire place with cover and working fire extinguisher. Smoke detector is properly working. The area is clean and sanitary. Den The den contains couches, TV and fish tank. The area is clean and sanitary. Licensee sleeps in the den area for the most part. Room 1- Licensee's Room Licensee's room has a queen size bed, baby crib, TV, closet space and cabinet space. Smoke detector is properly working. The area is clean and sanitary. Assistant caregiver and child reside in the room. Room 2- Client Bedroom is contains two twin beds, TV, cabinets and closet space. The room is designed for clients ages (6-17). Smoke detector is properly working. The area is clean and sanitary. Room 3- Daughters Room (Age 5) Room contains a twin bunk bed, cabinets and closet space. Two small dogs were observed in the room with gate enclosed. Smoke detector is properly working. The area is clean and sanitary. Bathroom Bathroom contains a shower, tub, toilet and sink. The bathroom is clean and sanitary. The bathroom is working properly. Bathroom 2- Not is use Licensee stated that the half bathroom is not being used and not available for use. Front Yard Front is clean and debri free. Back Yard Front is clean and debri free. Two large (Great Dane) dogs were observed in the backyard. Dogs are placed in a gated area. Shed with the enclosed gate is used as a dog house for the two large dogs. Garage Garage contains a laundry room and is used for storage. Detergent and chemicals are stored and locked. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit Interview was conducted, and a copy of this report will be provided to Britney Martinez.


state: CA

facility_name: MARY AND HARRISON MAKAU SMALL FAMILY HOME

summary: Facility Evaluation

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Narrative:
On 01/06/2026, Licensing Program Manager (LPM) Abdoulaye Traore and Licensing Program Analyst (LPA) Maya Chavez conducted an in office Component II meeting with Mary and Harrison Small Family Home (SFH) applicants, Mary and Harrison Makau. LPM and LPA went over revisions needed for the application prior to licensure. LPA provided a copy of the LIC809, LIC184 and Letter of Application Revisions to applicants. A copy of this report was provided to applicants. Mary and Harrison Makau.

report_type: Facility Evaluation

met_with: Applicants- Mary & Harrison Makau


facility_name: MARY SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On December 29, 2023, at 10: AM Licensing Program Analyst (LPA) Babatunde Aborchie began a Pre-Licensing inspection for a Small Family Home license. LPA met with applicant Mary Juma who led a tour of the home. The facility was toured both inside and out with the applicant. The applicant was applying a license to serve 3 ambulatory clients. The home consisted of: Downstairs: Bedroom #1, It was furnished with a full-sized bed. It was used as guest room - vacant. There was also, a family room, a living room, two dining areas, a pantry, a kitchen and one bathroom. Upstairs: Bedroom #2, The room was furnished with one full-sized bed. It was vacant. Bedroom #3, The room was furnished with one queen-sized bed. It was vacant. Bedroom #4, The room was furnished with one queen-sized bed. It was vacant. Bedroom #5, Master bedroom. The room consisted of one king sized bed. It sleeps the applicant. Bedrooms were arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. The smoke detectors were checked and were working properly. Inside the facility there was no fireplace. Telephone service and appliances were in a working order. All hazardous items have been properly made inaccessible to areas where children will have access. The medication will be locked in the kitchen cabinet area by the refrigerator. Cleansers/chemicals were locked and stored in the laundry room cabinet. Sharp knives were inaccessible and stored in a locked kitchen cabinet under the sink. There were no guns or weapons as stated by the applicant at this time. The hot water temperature was tested and noted to be 110 degrees. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. First Aid kit was accessible with all required items, and it was in the family room bookshelf. A Fire extinguisher was observed and properly charged. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. The backyard where children will have access to play was completely fenced and free of hazards. There are no deficiencies to be cited at this time. The request for a small family home license will be forwarded to the Licensing Program Manager for final approval. LPA conducted a component III orientation with applicant Mary Juma. An exit interview was conducted. A copy of this report was provided to applicant.

visit_type: Prelicensing

met_with: Mary Juma


summary: Facility Evaluation

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Narrative:
On 04/14/ Licensing Program Analysts (LPAs) Maryjane Perez and Claudia Aguilera conducted an annual/random inspection and met with Licensee Mary Juma. The home is a two-story family home with five-bedrooms, three bathrooms, and three car garage. The downstairs floor consists of a formal living room, formal dining room, kitchen, family room, one-bedroom, and one-bathroom. The kitchen consisted of a dining table with adequate seating, all sharps locked, fire extinguisher, first aid kit with all required elements. There was also adequate amount of perishable and non-perishable foods. The family room consisted of chairs, television, piano, and books. Bedroom number one consisted of one-queen size bed and was fully furnished. In the hallway there was a coat closet for storage. Bathroom number one was also located downstairs and was fully functioning with water temperature of 118 degrees F. The garage consisted of two parked vehicles and stored household items. The upstairs consisted of bedroom number two that had a full size bed which was utilized as a guest bedroom. Bathroom number two was also located upstairs and was fully functioning. Bedroom number three consisted of two twin beds and two dressers with two drawers each, the bedroom is currently vacant and will be utilized for two clients. Bedroom number four consisted of a queen size bed, dressers, desk, and chair currently occupied by minor placed in the home. The fifth bedroom consisted of a queen size bedroom and bathroom number three and is currently occupied by licensee. The upstairs area also includes a loft with a television, books, desk, chair, and computer accessible to the client currently in the home. The laundry room was upstairs storing detergents and was locked at all times. The outdoor grounds were also inspected, and no hazards or obstructions were observed. During inspection LPAs inspected the client file and licensee file. 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. There was a telephone land line service available in the home. LPAs interviewed licensee and the client. During the visit. there were no deficiencies observed, however, LPAs issued one technical advisory (TA) that was explained and given to licensee. An exit interview was conducted, and a copy of this report along with a TA were reviewed and provided to Licensee Mary Juma.

visit_type: Annual

met_with: Licensee- Mary Juma


facility_name: MCCARNS KELLEY FAMILY HOME

summary: Facility Evaluation

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Narrative:
On November 21, Licensing Program Analyst (LPA) Maryjane Perez met with applicant Stephanie McCarns 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 Stephanie McCarns

met_with: Applicant- Stehanie McCarns


summary: Facility Evaluation

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Narrative:
On December 31, 2025, Licensing Program Analyst (LPA) Maryjane Perez arrived at McCarns Kelley Family Home Small Family Home (SFH) for a pre-licensing inspection for an initial license. LPA met with applicant Stephanie McCarns who led a tour of the entire home inside and outside. The applicant is applying to serve two ambulatory clients ages 6-17 years old. Currently there is one resource family approval (RFA) child placed in the home but no other clients. The home is a two story building with five bedrooms and five bathrooms. The downstairs consisted of an entry way with a living room with couches and a formal dining room with adequate seating arrangement. There was a hallway closet that stored an overstock of snacks. Bathroom #1 had a toilet and sink. Hot water temperature was measuring 98.6 degrees Fahrenheit. Applicant understands that the water temperature needs to be between 105-120 degrees Fahrenheit. The family room had couches, TV, and a screened fire place. The kitchen had an office area that had all required postings such as clients personal rights, visitation policy, emergency disaster plan, monthly menu and facility sketch. The office desk had a locked medication box for storing clients medication, a first aid kid with all required elements, and a locked cabinet for storing clients files/ personnel records. There was a functioning telephone service and a fire extinguisher that was operable. The pantry/ refrigerator were fully stocked with perishable and non-perishable foods. There was a cabinet that stored knives/ sharp objects in a locked box and a dining table with adequate seating. Bathroom #2 had a shower/ bathtub, sink, and toilet. Bedroom #1 was utilized as a guest bedroom and had king size bed with dresser/ closet space and was locked at all times. The upstairs had a loft area with a couches, TV, movies, an emergency escape ladder and a fake fire place that was screened. Bedroom #2 was the master bedroom for applicant and had a king size bed with an office area, a locked closet that stored a locked safe with one firearm and bathroom #3 that had two sinks, a toilet, bathtub and shower. The bedroom was locked at all times. There was bedroom #3 that had a bunk bed with railings on the upper tier and had two twin size beds that was utilized for one client and one of applicants legal guardians. The bedroom also had dresser/ closet space, a TV, lighting, all required bedding and bathroom #4 that had a shower/ bathtub, dual sinks, and a toilet. There was hallway cabinets that stored extra lines, blankets, and bored games. There was a locked laundry room that stored extra linens, towels, laundry detergents/ essentials, paper towels/ toilet paper and cleaning supplies. Bedroom #4 had two twin size beds that was utilized for one client and one of applicants legal guardians. The bedroom had a TV, dresser/ closet space, lighting and all required bedding. Bedroom #5 had a bunk bed with only the bottom bed being used and a twin size bed that was utilized for applicants legal guardian and one RFA client. Bathroom #5 had a toilet, shower/bathtub, and dual sinks all 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. All appliances were in working order and all trash cans for storage of solid waste had tight fitting lids. The garage stored one parked vehicle, extra house hold items such as holiday decorations, and a locked locker that stored ammunition. There was a separate small garage that was locked at all times and stored tools, gardening tools and a deep freezer for extra 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 bodies of water. Based on this inspection of the home, the facility will need the following corrections: Water temperature to measure between 105-120 degrees Fahrenheit. After corrections are completed, the applicant will notify LPA so that another inspection can be completed. Component III orientation was also completed this day of December 31, 2025. An exit interview was conducted and a copy of this report was provided to applicant Stephanie McCarns.

met_with: Applicant- Stephanie McCarns


summary: Facility Evaluation

raw_content:
Narrative:
On April 6, 2026, Licensing Program Analyst (LPA) Maryjane Perez made an unannounced visit to McCarns Kelley Family Home Small Family Home (SFH) for a post-licensing inspection and met with licensee Stephanie McCarns who led a tour of the entire home inside and outside. The facility was approved to serve two ambulatory clients ages 6-17 years old. Currently there is one client 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 living room with couches and a formal dining room with adequate seating arrangement. There was a hallway closet that stored an overstock of snacks. Bathroom #1 had a toilet and sink with hot water temperature measuring 116.2 degrees Fahrenheit. The family room had couches, TV, and a screened fire place. The kitchen had an office area that had all required postings such as clients personal rights, visitation policy, emergency disaster plan, facility license and facility sketch. The office desk had a locked medication box for storing clients medication, a first aid kit with all required elements, and a locked cabinet for storing clients files, personnel records, and clients cash resources. There was a functioning telephone service and a fire extinguisher that was operable. The pantry/ refrigerator were fully stocked with perishable and non-perishable foods. There was a cabinet that stored knives/ sharp objects in a locked box and a dining table with adequate seating. Bathroom #2 had a shower/ bathtub, sink, and toilet. Bedroom #1 was utilized as a guest bedroom and had king size bed with dresser/ closet space and was locked at all times. The upstairs had hallway cabinets that stored games and blankets. There was a laundry room that was locked at all times and stored laundry detergents, laundry essentials, towels, and linen. Bedroom #2 was utilized for one of licensees legal guardians and had two twin size beds and was fully furnished. Bedroom #3 was utilized for one client and one of licensees legal guardians. The room had twin size bunk beds with railings on the upper tier and the top bunk being occupied by a client, the bottom being vacant (not to be in use), and there was another twin size bed that was currently occupied by licensees legal guardian. Bathroom #3 had a toilet, shower/bathtub, and dual sinks all fully functioning. Bedroom #4 had twin size bunk beds with railings on the upper tier that was utilized for one client and one legal guardian. The bedroom had a TV, dresser/ closet space, lighting and all required bedding and bathroom #4 that had a shower/ bathtub, dual sinks, and a toilet. There was hallway cabinets that stored extra blankets and another first aid kit. The loft area had couches, TV, and emergency escape ladder. Bedroom #5 was the master bedroom for licensee and had a king size bed with an office area, a locked closet that stored a locked safe with one firearm and bathroom #5 that had two sinks, a toilet, bathtub and shower. The bedroom was locked at all times. Bedrooms were arranged so that no more than two children share a room, and there is one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. The smoke detectors and carbon monoxide detectors were checked and are working properly. All hazardous items have been properly made inaccessible to areas where children will have access. All appliances were in working order and all trash cans for storage of solid waste had tight fitting lids. The garage stored one parked vehicle, extra house hold items such as holiday decorations, and a locked locker that stored ammunition. There was a separate small garage that was locked at all times and stored tools, gardening tools and a deep freezer for extra 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 bodies of water. LPA reviewed one client file and two personnel records as well as attempted to interview 1 client, 3 legal guardian children and interview two staff members. An exit interview conducted and a copy of this report, and two technical assistances were provided to licensee Stephanie McCarns.

met_with: Licensee- Stephanie McCarns


summary: Facility Evaluation

raw_content:
Narrative:
On April 6, 2026, Licensing Program Analyst (LPA) Maryjane Perez conducted an unannounced case management inspection at McCarns Kelley Family Home Small Family Home (SFH). LPA met with licensee, Stephanie McCarns. The purpose of the inspection was to follow up on an incident report received by the Department on April 1, 2026, regarding Child 1 (C1) sustaining a black eye. During the inspection, LPA obtained and reviewed pertinent documentation, conducted interviews with the licensee and one staff member (S1), and completed a health and safety inspection of the facility. No health and safety hazards were observed at the time of inspection. Due to the need for additional information, the case management investigation is being extended at this time. A copy of this report was provided to licensee, Stephanie McCarns.

visit_type: Case Management


facility_name: MCKAY'S SMALL FAMILY HOME LLC

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
also reported that S2 hit C1 with a belt resulting in a mark on their arm and made rude remarks. Confidential interviews revealed conflicting statements. Some interviews indicated ice cream was used an incentive for a good week in school and C1 did not have a good week, as they received a dress code violation. Some interviews indicated C1 was offered other options for a dessert, such as pudding or Jell-O. While other interviews could not recall C1 wearing a crop top to school or not being allowed to eat ice cream. Regarding the allegation that S2 hit C1 with a belt, some interviews indicated S2 hit C1 with a belt and conflicting interviews denied S2 hit C1 with a belt. Lastly, it was reported that S1 said they were fed up with C1 and C1 did not belong in their home. Some confidential interviews denied hearing these statements. Thus, confidential interviews did not corroborate the allegations with a preponderance of evidence. Based on confidential interviews and records reviewed the allegations that S2 hits minor and S1 does not treat minor with respect, which may have occurred, however, they are not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report, LIC 811, and appeal rights were provided to Kym McKay. A copy of this report will be placed in the facility file.

Investigation Findings:
13On April 16, 2025, at 11:45 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Kym McKay, Staff, to discuss the investigative finding for the allegations noted above. LPA Adaleyci Caballero conducted an inspection of the facility on October 29, 2024, at 2:30 pm and no deficiencies were observed. LPA Caballero interviewed one Client (C2) and one Staff (S2). LPA Charmaine Linley interviewed two Clients (C1, C3), three Staff (S1, S5, S6), one County Social Worker (CSW1), one Staff refused to be interviewed (S3), and LPA was unable to interview one Staff (S4), and two County Social Workers (CSW2-3), despite multiple attempts to contact them. LPA reviewed the facility documents during the investigation. On October 23, 2024, Community Care Licensing (CCL) received allegations that adult in home hits minor and licensee does not treat minor with respect. It was reported that C1 got in trouble for wearing a crop top to school and upon returning to the facility, C1 was not allowed to eat ice cream with the other clients. It was UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 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: MCKAY'S SMALL FAMILY HOME LLCFACILITY NUMBER: VISIT DATE: 04/16/2025

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

report_type: Complaint Investigation

met_with: Kym McKay

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On October 04, 2023 at 9: AM, Licensing Program Analyst (LPA) Linda Haynes began a pre-licensing inspection for McKay's Small Family Home license. LPA met with applicant Bethanee McKay who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there are no clients in the home. The applicant is applying to serve 4 clients ages 3 to 17. The home is a one-story building with three bedrooms and 2 bathrooms which are set up as follows: · Bedroom #1 (Master) has one bed sleeps the applicant · Bedroom #2 (Client's) was vacant has two twin beds, it will sleep two client's. · Bedroom #3 (client's) was vacant has one twin over full bunk beds, it will sleep two client's · A great room/living room, kitchen, dining area, 2 bathrooms, and the backyard. The Client's bedroom was arranged so that no more than two clients will be in the room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There was a smoke detector / Carbon Monoxide Detector in every bedroom. The five smoke detectors / Carbon Monoxide Detectors were checked, and they were working properly. There is a dedicated phone line. The home's central air conditioning module was located on the roof. The home's tank less hot water heater was located outside on the wall by the back door. The appliances were in working order. The client's files will be locked in a file cabinet in the dinning room. There was adequate food storage space. There was a two day supply of perishable foods and a week of non-perishable foods. A proper storage of all food was discussed. A trash can for storage of solid waste had a tight fitting lid. The sharp knives are in a locked drawer in the kitchen. The medications is located in a locked cabinet in the laundry room. The hot water in bathroom one measured to be 115 degrees Fahrenheit and in bathroom two 114.5 degrees Fahrenheit. The home's First Aid kit was accessible and is located in the kitchen it had all required supplies but the thermometer. Two fire extinguishers were present in the home one is located in a cabinet in the kitchen and one was located in the laundry room. They were observed to be properly charged and inspected by the fire department. There is no firearm in the home as stated by the applicant. There is no pool or other body of water. The backyard where clients will have access to play was fenced. The following items need to be corrected · Post the following documents, personnel rights, and complaint hot line · Thermometer needed for first aid kit · Kitchen drawer needs to be repaired The request for a license will be forwarded to Licensing Program Manager for final approval. An exit interview was conducted. A copy of this report and appeal rights was provided to Bethanee McKay.

met_with: Bethanee McKay


summary: Facility Evaluation

raw_content:
Narrative:
On October 4, Licensing Program Analyst (LPA) Linda Haynes met with Applicant Bethanee McKay to complete the Component III of the application process.


summary: Facility Evaluation

raw_content:
Narrative:
On April 16, 2025, at 12:00 pm, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Kym McKay, Staff, to discuss information that was reported to the Department and records reviewed by LPA on March 17, 2025. LPA Charmaine Linley conducted confidential interviews with one Client (C1), four Staff (S1, S2, S5, S6), one County Social Worker (CSW1), one Staff refused to be interviewed (S3), and LPA was unable to interview one Staff (S4), despite multiple attempts to contact them. LPA reviewed the facility documents during the investigation. On March 17, 2025, while reviewing C1's Medication Administration Records, LPA observed C1's MAR medication sheets for March 2024-February 2025 had two psychotropic medications listed on the same medication sheets. In addition, there are multiple boxes that are left blank for the months of April, June, and September 2024-February 2025, which did not indicate if C1 took their prescribed medications or if C1 refused the medication. Lastly, on the Centrally Stored Medication and Destruction Record, there are eight blank boxes on the dates started for the medications, the prescription numbers are not filled out for two medications, one medication is logged in and does not have any additional information, and one medication does not have the expiration date listed. Confidential interviews indicated C1 refused their medication on several dates and that Incident Reports were completed and sent to the Department. Records reviewed did not indicate any Incident Reports were sent to the Department for C1 not taking their prescribed medication. Based on confidential interviews and records reviewed, the facility is being cited for violating California Code of Regulations Title 22, Division 6, Chapter 4, Article 06 83070(b)(12) Child's Records (refer to LIC 809D). An exit interview was conducted, appeal rights explained, and a copy of this report, LIC 811, and appeal rights were provided to Kym McKay. A copy of this report will be placed in the facility file.


summary: Facility Evaluation

raw_content:
Narrative:
On February 19, 2025 at 1:15PM, Licensing Program Analyst (LPA) Adaleyci Caballero completed a pre-licensing inspection of McKay's Small Family Home (SFH). LPA met with Licensee Bethanee McKay who led a tour of the home. The facility was toured both inside and out with the licensee. There are two clients in placement. The home is a one-story building with four bedrooms and two full bathrooms which are set up as follows: Bedroom #1- It consisted of bunks beds. The beds had linen, comforters, and pillows. It will sleep two clients. Bedroom #2- It consisted of a single bed. The bed had linen, comforters, and pillows. It will sleep one client. Bedroom #3- It consisted of one single bed. The beds had linen, comforters, and pillows. It will sleep one client. Bedroom #4- It consisted of a single bed. The bed will sleep licensee and husband. A living room, dining area, kitchen, two car garage, and a backyard. The garage will be utilized for storage. The clients' bedrooms were arranged so that no more than two clients will be in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the clients' belongings. There was six smoke detectors in every bedroom. The six smoke detectors were checked and working properly. Smoke Detector and Carbon Monoxide detectors are combined. The home's central air conditioning module was in the backyard. The water heater is in a closet inside the home. The appliances were in working order. The staff and clients' files will be locked inside a filing cabinet in the kitchen area. There was adequate food storage space and a supply of perishable food and non-perishable food. The home had a trash can for storage of solid waste with a tight-fitting lid. The sharp knives were locked in a lock box in the licensee's bedroom. Medications will be locked in a locked container in the licensee's bedroom. Chemicals will be stored in a locked cabinet inside the licensee's bedroom. The hot water was at a temperature of 132.4 degrees Fahrenheit. The First Aid kit was accessible and was placed on the kitchen counter. There were two fire extinguishers present in the home located in the kitchen and in licensee's bedroom. It was observed to be properly charged and inspected by the fire department. There are no firearms in the home. There is no pool or other bodies of water at the home. The backyard is fully fenced and free of debris. There are no cameras at the home. Corrections: Food Menu, telephone service, tweezers for First-Aid kit, and water temperature must be between 105 and 120 degrees Fahrenheit. A copy of this report was provided to Licensee Bethanee McKay. Application will be forwarded to Licensing Program Manager Jennifer Smith for licensure.

met_with: Licensee-Bethanee McKay


summary: Facility Evaluation

raw_content:
Narrative:
On February 18, 2026 at 10:00AM, Licensing Program Analyst (LPA) Rachel Vanegas, arrived unannounced at McKay's Small Family Home (SFH) for the purpose of conducting a post licensing/annual inspection. LPA met with the licensee Bethanee McKay who led a tour of the SFH both inside and outside. Due to time constraints, Licensee left during the inspection and authorized Support Staff - Kamaya Marks to receive and sign this report on the Licensee's behalf. There is one client in placement. The home is a one-story building with four bedrooms and two bathrooms which are set up as follows: Bedroom #1- Contained single bed bunk beds. It sleeps one client and one bed is vacant. Bedroom #2- Contained one single bed. It will sleep one client and is currently vacant. Bedroom #3- Contained one single bed. It will sleep one client and is currently vacant. Bedroom #4- Contained one single bed and sleeps the Licensee and Spouse. The SFH also contains a living room, dining area, kitchen, two car garage, and a backyard. The garage is utilized for storage. The clients' bedrooms were arranged so that no more than two clients will be in a room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate closet space for the client's belongings. There were smoke/carbon monoxide detectors in every bedroom, hallway, and living room. The combo detectors were checked and in properly functioning order at the time of this inspection. The water heater is located in a closet inside the home. **Continued on the next page** The home's central air conditioning module was located outside of the home in the backyard. The appliances were in working order at the time of this inspection. The hot water temperature was measured in the kitchen and registered at 118.2 degrees Fahrenheit. LPA observed a seven day supply of non-perishable food and two day supply of perishable food. There was adequate amount of food storage space. Cleaning chemicals are securely locked in a closet in the Licensee's bedroom which is locked and inaccessible to clients in care. The sharp knives and medications are securely stored in the closet in the Licensee's bedroom which remains locked and inaccessible to clients in care. The home's First Aid kit was accessible and is located in the kitchen area and contained all required supplies. There was one fire extinguisher present in the home located in the kitchen near the sink. The fire extinguisher was observed to be properly charged and inspected by the fire department. There are no firearms or weapons in the home as stated by the Licensee. The backyard where clients have access to play is fenced. The home has two security cameras one is located on the outside perimeter of the home (backyard) and one is located inside of the home in the living room. The Client and Staff files are located in a locked file cabinet in the kitchen. LPA reviewed one client file for Client 1 (C1). LPA observed required documents including signed placement agreements, Health and Education Passport, etc. C1's file did not contain documentation of Tuberculosis Screening on health screening documents. LPA reviewed six of six staff files for Staff 1 (S1), Staff 2, Staff 3, Staff 4, Staff 5, and Staff 6. LPA observed that six of six files reviewed contained needed documents including CPR/First Aid certificates, Drivers License, Criminal Background Clearance Forms, etc. Three out of six staff files reviewed did not contain documentation/verification of tuberculosis (TB) screening. Based on observation and record review, the facility is issued two Type B violations in accordance with California Code of Regulations (CCR) Section 80069(c)(1) for not having the results of Tuberculosis examination screening for C1 and CCR Section 80066(a)(11) for not having results of Tuberculosis examination screening for Staff 3, Staff 4, and Staff 6. An exit interview was conducted and a copy of this report, LIC 809D, LIC 811, and appeal rights were reviewed and provided to the Support Staff - Kamaya Marks.

met_with: Licensee - Bethanee McKay


facility_name: MEMORABLE SMALL FAMILY HOME

raw_content:
Narrative:
During investigation, confidential interview stated GC was treated as a biological child and denied hitting GC or any of the foster children at any time. Another confidential interview stated that FM did not hit any child while in care and FM was very nice to all the children including GC. A confidential interview believed FM would not hit GC or any other child in care. A confidential witness did not observe FM hitting, throwing shoes, or yelling at GC. Confidential witness always observed FM provide great care and support for all children in the home. Based on the confidential interviews, the allegation that foster parent hit minor in care, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. A copy of this report and LIC 811 was provided to Memory SFH.

Investigation Findings:
13On December 7, 2022 at 11:02, Licensing Program Analyst (LPA) Babatunde Aborchie met Memorable Small Family Home staff, to deliver the investigative finding for the above stated allegation involving the Small Family Home and foster children. On July 20, 2022 at 09: AM, Licensing Program Analyst (LPA) Babatunde Aborchie arrived at the small family home to initiate the investigation and conducted interviews with foster mother (FM), interviewed three of three foster children (FC1, FC2, and FC3). LPA was unable to interview guardianship child (GC) due to the child being non-verbal. On July 12, 2022 a complaint report was referred to Community Care Licensing (CCL) alleging foster parent hit minor in care. It was specifically stated that FC1 witnessed FM hitting, throwing shoes at GC. A confidential interview denied ever hitting GC. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: MEMORABLE SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 12/07/2022

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

met_with: Staff


raw_content:
Narrative:
During investigation, confidential interview interviewed denied that foster children were not adequately supervised while in care. Confidential interview stated that all children were adequately supervised in the home while in care. Confidential interviews denied making out when no one was looking. An additional confidential interview stated that everyone was at home, and it would be difficult to make out. Furthermore, a confidential witness did not witness children not being adequately supervised while in care. Confidential witness stated that FC1 made up story in the past and believed the allegation may not be true. Based on the confidential interviews, the allegation that foster parent did not adequately supervise FC1 and FC2 while in care, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. A copy of this report and LIC 811 was provided to Memory SFH.

Investigation Findings:
13On June 2, 2023 at 1: PM Licensing Program Analyst (LPA) Babatunde Aborchie met Memorable Small Family Home Licensee Memory Beaumier to deliver the investigative finding for the above stated allegation involving the Small Family Home and foster children. On December 7, 2022, Licensing Program Analyst (LPA) Babatunde Aborchie arrived at the small family home to initiate the investigation and conducted a safety inspection. On April 21, 2023, LPA interviewed foster mother (FM) and staff 1 (S1). On April 26, LPA interviewed two Foster Children (FC1 and FC2). On June 1, 2023, LPA interviewed County Investigator (CI). On November 30, 2022, a complaint report was referred to Community Care Licensing (CCL) alleging Foster parent did not adequately supervise foster children while in care. It was specifically indicated that FC1 and FC2 made out when no one was looking. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: MEMORABLE SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 06/02/2023

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

met_with: Licensee


raw_content:
Narrative:
While other confidential information received by Licensing Office stated that these allegations had occurred. There were no other known witnesses to these allegations. Based on confidential information obtained during the course of this investigation, the allegation that Staff sexually abused minor while in care, more specifically that Adult Assistant (A1) had inappropriately touched C1's private parts while bathing, may have occurred, however is not supported or proven by evidence. Therefore, the above allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Licensee's Sister, Greta Chikakai to discuss the investigative findings for the above stated allegation. Licensing Program Analyst (LPA), Daniel Mena conducted an inspection to the Small Family Home (SFH) on March 01, 2023, at 3:20pm and on May 26, 2023, at 9:03am. No immediate hazards observed. Special Investigator (SI), Marlon Williams and LPA Daniel Mena interviewed Resource Mother (RM), three children (C1, C2 & C3), Adult Assistant (A1), as well as reviewed client interview, facility and client records. Community Care Licensing received information on February 27, 2023, alleging that Staff sexually abused minor while in care, more specifically that Adult Assistant (A1) had inappropriately touched C1's private parts while bathing. Information obtained in confidential interviews did not corroborate the allegation with a preponderance of evidence. LPA Mena and SI Williams obtained conflicting information during confidential interviews. Confidential interviews denied that A1 or anyone else in the home had ever inappropriately touched or sexually abused C1 during the time that they had lived in the home. According to confidential information obtained, C1 did not like to bathe on a daily basis and suffered from poor hygiene. According to confidential interviews A1 did assist C1 in bathing, including their private parts on at least two occasions, but denied any sexual abuse or inappropriate touching by A1 during the bathing. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: MEMORABLE SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 06/06/2023

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

met_with: Greta Chikakai


raw_content:
Narrative:
In regard to the allegation that FM hit FC1 with an object while in care, it was specifically alleged the foster mother (FM) hit FC1 with a shoe. During investigation, confidential interviews denied that FC1 was hit by FM. A confidential interview stated that FM never spanked or hit any of the children in the SFH. However, another confidential interview maintained that FM hit FC1 with a shoe after FC1 hitting S1 with a shoe. Other confidential interviews stated no reports of corporal punishment used. Regarding the allegation that foster parent demonstrated inappropriate form of punishment, it was specified that foster mother grounded FC1 for three weeks because FC1 got in to trouble for hitting a staff. Confidential stated that FM uses time out and taking electronics away as a form a discipline and the timeout would last two to three hours. A confidential stated FC1 will be grounded for a longtime. LPA received conflicting information regarding the allegation. Based on confidential interviews and file review, the allegations that foster mother fit FC1 with a shoe and foster mother demonstrated inappropriate form of punishment may have happened or may be valid, there was not a preponderance of evidence to support or deny the allegations, therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report and appeal rights were reviewed and provided to the licensee, Memory Tom Beaumier

Investigation Findings:
13On March 21, 2024, at 2: PM, Licensing Program Analyst (LPA) Karen Beal arrived at Memorable Small Family Home (SFH) and met with Licensee Memory Tom Beaumier to deliver the finding for the allegations stated above involving foster child (FC1) as listed on the Confidential Names List (LIC 811) dated 03/21/2024. On September 11, 2023, Community Care Licensing (CCL) received a complaint alleging foster parent hit a minor with an object while in care and foster parent demonstrated inappropriate form of punishment. a On September 15, 2023, at 3: PM, Licensing Program Analyst (LPA) Babatunde Aborchie arrived unannounced at Memorable Small Family Home (SFH) to initiate an investigation of the above stated allegations. LPA Aborchie conducted a safety inspection and there were no immediate safety hazards observed. Licensing Program Analyst (LPA) Beal conducted an inspection at the SFH and collected the following documents: Placement Agreement and Needs and Case Plan Summary. LPA conducted interviews with FM, FC1, staff (S1), County Social Worker (CSW), and Social Services Practitioner (SSP). 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 HOMEFACILITY NUMBER: VISIT DATE: 03/21/2024

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


raw_content:
Narrative:
In regard to the allegation, It was specifically alleged the foster mother (FM) was not preventing physical contact between FC1, FC2, and FC3 which was causing FC1, FC2, and FC3 to obtain bruises. Confidential interviews stated FC1, FC2, and FC3 played with each other in a rough manner and would fight each other. The children would hit themselves, bump against the wall and tables. FC3 would have tantrums and fall onto the floor. A confidential interview stated that most of the bruising on FC1 occurred while attending school. A confidential interview stated FC1, FC2 and FC3 were constantly monitored due to engaging in physical altercations and self-harm. Based on confidential interviews and file review, FM does not provide adequate supervision resulting in FC1, FC2 and FC3 engaging in physical altercations may have happened or may be valid, there was not a preponderance of evidence to support or deny the allegations, therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report and appeal rights were reviewed and provided to the licensee, Memory Tom Beaumier

Investigation Findings:
13On March 21, 2024, at 10: AM, Licensing Program Analyst (LPA) Karen Beal arrived at Memorable Small Family Home (SFH) and met with Licensee Memory Tom Beaumier to deliver the finding for the allegation stated above involving foster children (FC1, FC2, and FC3) as listed on the Confidential Names List (LIC 811) dated 03/21/ On September 18, 2023, Community Care Licensing (CCL) received a complaint alleging foster mothers does not provide adequate supervision resulting in minors engaging in physical altercations. On September 27, 2023, at 1: PM, Licensing Program Analyst (LPA) Babatunde Aborchie arrived unannounced at Memorable Small Family Home (SFH) to initiate an investigation of the above stated allegation. LPA Aborchie conducted a safety inspection. There were no immediate safety hazards observed at this time of inspection. Licensing Program Analyst (LPA) Beal conducted an inspection at the SFH, collected the following pertinent documents and interviewed staff (S1). Additionally, LPA Beal interviewed foster mother (FM) and FC1. LPA was unable to contact the County Social Worker (CSW). FC2 and FC3 were not interviewed due their development ages. 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 HOMEFACILITY NUMBER: VISIT DATE: 03/21/2024

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

met_with: Licensee Memory Tom Beaumier


raw_content:
Narrative:
. Licensing Program Analyst (LPA) Beal conducted an inspection at the SFH, collected the following pertinent documents and interviewed staff (S1) and foster mother (FM). LPA was unable to contact the County Social Worker (CSW). FC2 and FC3 were not interviewed due their development ages. FC1 refused to be interviewed. Regarding foster children sustained unexplained injuries while in care, it was specifically alleged the foster children had bruises and rashes on their bodies. During investigation, confidential interviews stated the children would play rough with each other, have tantrums, and engage in self-harm. A confidential interview stated the children would have rashes around their mouths due to having fevers. FC2 was being cared for by a dentist for decaying teeth. LPA was unable to gather additional information. In regard to the allegation that licensee does not provide foster children appropriate clothing and shoes, it was specifically alleged that the children were wearing clothing too small or too big and the clothing was not gender appropriate or shoes were too small. A confidential interview stated the bio mother did not like the clothing the children were wearing and wanted the children to wear designer clothing. A confidential interview stated the children clothing was appropriate for their ages; the children wore clothing sized for their bodies and shoes were sized for the children's feet. LPA didn't observe FC1 wearing inappropriate clothing during the interview. Based on confidential interviews and file review, the allegations that FC1, FC2 and FC3 sustained unexplained injuries while in care and licensee does not provide foster children appropriate clothing and shoes may have happened or may be valid, there was not a preponderance of evidence to support or deny the allegations, therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report and appeal rights were reviewed and provided to the licensee, Memory Tom Beaumier

Investigation Findings:
13On March 21, 2024, at 03: PM, Licensing Program Analyst (LPA) Karen Beal arrived at Memorable Small Family Home (SFH) and met with Licensee Memory Tom Beaumier to deliver the findings for the allegations stated above involving foster children (FC1, FC2, and FC3) as listed on the Confidential Names List (LIC 811) dated 03/21/ On November 15, 2023, Community Care Licensing (CCL) received a complaint alleging foster children sustained unexplained injuries while in care and licensee does not provide foster children appropriate clothing and shoes. November 17, 2023, Licensing Program Analyst (LPA) Babatunde Aborchie arrived unannounced at Memorable Small Family Home (SFH) to initiate an investigation of the above stated allegation. LPA Aborchie conducted a safety inspection. There were no immediate safety hazards observed at this time of inspection. 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 Riverside, CA Facility Name: Memorable Small Family Homefacility Number: Visit Date: 03/21/ Narrative 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32. Licensing Program Analyst (LPA) Beal conducted an inspection at the SFH, collected the following pertinent documents and interviewed staff (S1) and foster mother (FM). LPA was unable to contact the County Social Worker (CSW). FC2 and FC3 were not interviewed due their development ages. FC1 refused to be interviewed. Regarding foster children sustained unexplained injuries while in care, it was specifically alleged the foster children had bruises and rashes on their bodies. During investigation, confidential interviews stated the children would play rough with each other, have tantrums, and engage in self-harm. A confidential interview stated the children would have rashes around their mouths due to having fevers. FC2 was being cared for by a dentist for decaying teeth. LPA was unable to gather additional information. In regard to the allegation that licensee does not provide foster children appropriate clothing and shoes, it was specifically alleged that the children were wearing clothing too small or too big and the clothing was not gender appropriate or shoes were too small. A confidential interview stated the bio mother did not like the clothing the children were wearing and wanted the children to wear designer clothing. A confidential interview stated the children clothing was appropriate for their ages; the children wore clothing sized for their bodies and shoes were sized for the children's feet. LPA didn't observe FC1 wearing inappropriate clothing during the interview. Based on confidential interviews and file review, the allegations that FC1, FC2 and FC3 sustained unexplained injuries while in care and licensee does not provide foster children appropriate clothing and shoes may have happened or may be valid, there was not a preponderance of evidence to support or deny the allegations, therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report and appeal rights were reviewed and provided to the licensee, Memory Tom Beaumier 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: LIC9099 (FAS) - (06/04)Page: 2 of 2

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

met_with: Licensee, Memory Tom Beaumier


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


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:


raw_content:
Narrative:
In regard to the allegation that foster children sustained unexplained injuries, it was specifically alleged that the children have bite marks and bruises on them. FC2 has a bruise near FC2's eye the size of a quarter and a large bruise on FC2's forehead. FC2 has bruising on FC2's left arm from the elbow to the hand that almost look like grab marks. During investigation, licensee and staff disclosed that FC1, FC2, and FC3, would self-inflict injuries as well as hurt one another which were all documented when occurred. Confidential interviews didn't provide any information regarding the allegations. A confidential witness was unable to recall incident involving FC1, FC2 and FC3. CSW stated that many of the injuries the siblings sustained were self-inflicted and that they would often hurt each other as well. Regarding the allegation that licensee did not prevent minor's hair from getting matted, licensee and staff stated that FC2 had curly hair and did not like for it to be brushed and even when brushed FC2 would mess their hair up when they lost their temper. Confidential interviews didn't provide any information regarding the allegations. A confidential witness was unable to recall incident involving FC1, FC2 and FC3. A confidential interview stated that one time during a visit, FC1 had on an adult sized diaper but other than that, they can't recall another time foster children were improperly dressed. LPA received a conflicting information. In regard to the allegation that licensee did not ensure minors in care were properly dressed, licensee and staff stated that FC1, FC2, and FC3 had plenty of clothes and were always properly dressed but they would often take their own clothes off during tantrums. A confidential witness was unable to recall incident involving FC1, FC2 and FC3. LPA received a conflicting information. Another interview disclosed that foster children have access to clothes and there has never been a time, foster child have been inappropriately dressed. Based on interview and record review, the allegations FC1, FC2, and FC3 sustained unexplained injuries while in care, licensee did not prevent FC1, FC2, and FC3 hair from getting matted, and licensee did not ensure FC1, FC2, and FC3 in care were properly dressed may have occurred, however, there was not a preponderance of evidence to support the alleged violations, therefore, this allegation 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), foster child 2 (FC2), foster child 3 (FC3), and the facility. On September 25, 2023, Community Care Licensing (CCL) received a complaint alleging that the foster children sustained unexplained injuries while in care, licensee did not prevent minor's hair from getting matted, and licensee did not ensure foster children in care were properly dressed. On September 27, 2023, at 2: PM, LPA Aborchie arrived unannounced to Memorable SFH to initiate an investigation of the above stated allegations. LPA Aborchie conducted a safety inspection with S1. There were no immediate safety hazards observed at this time of inspection. LPA Chavez conducted the investigation and interviewed Licensee, a staff, and foster children (FC4, FC5, and FC6). Additionally, LPA Chavez requested copies of Unusual Incident Reports and School Injury Reports from licensee. LPA conducted a telephone contact with the County Social Worker for FC1, FC2 and FC3. A confidential individual stated that all three siblings would not be able to be interviewed due to young age and not being comfortable. 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:


raw_content:
Narrative:
In regard to the allegation, it was specifically reported that FC1 appears to be losing weight FC's pants fall off on FC1) and FC1 has not been eating at school because FC1 was refusing to drink the vanilla Ensure that foster mother provided, however, FC1 would only drink the chocolate flavored Ensure and licensee said the insurance will only cover the vanilla flavored. During investigation, licensee stated that FC1 was prescribed Ensure as a meal replacement, the insurance provided only the vanilla flavored Ensure due the chocolate flavored being unavailable and it was noted that FC1 didn't like the vanilla and preferred chocolate as a result, FC1 did not want to consume the Vanilla Ensure that FM sent to the school. Based on interview and record review, the allegation that licensee did not ensure foster child was adequately fed 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 05/10/2024, 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 child 1 (C1) and the facility. On November 2, 2023, Community Care Licensing (CCL) received a complaint alleging that licensee did not ensure foster child was adequately fed. Lpa B. Aborchie met with Staff 1 (S1) Gretta Chikakai who granted LPA access into the home. LPA conducted a safety inspection with (S1). There were no immediate safety hazards observed at this time of inspection. In addition, LPA Chavez received medical record and weight log 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 C1 due to C1's developmental age and C1's being non-verbal. LPA Chavez interviewed FC1's County Social Worker via telephone. 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:


raw_content:
Narrative:
On November 13, 2023, at 1:53PM, LPA B. Aborchie arrived unannounced to Memorable SFH to initiate the investigation, interviewed licensee (LS) and conducted a health and safety inspection with licensee (LS). There were no immediate safety hazards observed at this time of inspection. In addition, LPA M. Chavez interviewed foster children (FC1, FC2, FC3 and FC4) and obtained copies of Needs and Services Plan, and a summary of Optometrist visit. LPA Chavez conducted additional interviews with licensee (LS), staff #1 (S1). Lpa M. Chavez was unable to contact County Social Workers. In regard to the above allegation that licensee made numerous threats to evict minor as a mean of discipline, it was specifically reported that foster mother was always threatening to put in a 14-day notice to kick FC1 out if FC1 did not behave or listen to her in the way she expected or being disrespected by FC1. During investigation, a confidential interview disclosed that the threats to be evicted only occurred when FC1 was first placed at the SFH. Another confidential interview disclosed that evicting FC1 was not a threat or means of discipline but rather a conversation. Confidential interview explained that the conversation was to explain FC1 their rights to be placed elsewhere and that FC1 would have their support regardless of FC1's decision. The confidential interview continued explaining that it was later mutually decided between LS and FC1 that FC1 would stay at SFH. Regarding licensee did not get prescription glasses for minor, a confidential interview disclosed that FC1 did not receive glasses for two to three months after losing them. In another confidential interview, it was disclosed that FC1 did not inform LS that FC1 lost their glasses until two to three months later, but when LS was informed about the glasses, she immediately made an appointment for FC1 to get new glasses. A confidential interview stated that LS had to pay out of pocket for glasses due to FC1's insurance only covering new glasses every two years. (See LIC9099-C) In regard to the allegations that licensee yelled at minor and did not treat minor with dignity nor respect, it was specifically alleged that foster mother has blown up and yelled at FC1 at least four times causing FC1 to cry. A confidential interview disclosed that LS would yell a lot when FC1 was first placed at the SFH, but then later LS got the yelling under control and eventually stopped. In another confidential interview, it was disclosed that LS and S1 both have loud voices, and their tones often are perceived as yelling. A confidential interview disclosed that they have not witnessed LS treating or dis-respecting FC1 or any other foster children. LPA didn't receive any additional information. In regard to the above allegation that licensee does not pick up FC1 from school in a timely manner and it was reported FC1 has had to wait up to two hours for a ride during hot summers and cold winters repeatedly. During investigation, a confidential interview disclosed that the longest FC1 has ever waited for a ride was at the most, thirty minutes but was informed ahead of time. Another confidential interview disclosed that when LS is running late to pick up FC1 that LS always gives FC1 the option to wait, get an uber, or arrange for someone else to pick FC1 up. LPA received a conflicting information. In regard to the above allegation that LS did not provide FC1 with hygiene products specially soap. A confidential interview disclosed that FC1 does not like to shower nor brush their teeth and FC1 used falsehood during a meeting that soap was not available. Another interview disclosed that the facility has plenty of hygiene products that are unlocked. Another confidential interview indicated that when they run out of hygiene products, they just have to ask LS or S1 to provide hygiene products. LPA received a conflicting information. Based on interview, inspection, and record review, the allegations that licensee made numerous threats to evict FC1 as a means of discipline; licensee did not get prescription glasses for FC1; licensee yelled at FC1 and does not treat FC1 with dignity or respect; licensee did not pick FC1 up in a timely manner from school, and licensee does not provide FC1 with hygiene products (soap) 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 Staff #1.

Investigation Findings:
13On 07/24/2024, at 9:15AM, Licensing Program Analyst (LPA) Maya Chavez arrived at Memorable Small Family Home (SFH) and met with Staff # Gretta Chikakai to deliver the investigative finding regarding the allegations involving foster child #1 (FC1) and the facility. On November 07, 2023, Community Care Licensing (CCL) received a complaint consisting of the following allegations: Licensee made numerous threats to evict minor as a means of discipline; licensee did not get prescription glasses for minor; licensee yelled at minor; licensee does not treat minor with dignity or respect; licensee did not pick minor up in a timely manner from school; and licensee does not provide minor with hygiene products (soap). 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: 07/24/2024

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

met_with: Staff #1- Gretta Chikakai


raw_content:
Narrative:
On July 25, 2024 at 09: AM, Licensing Program Analyst (LPA) R. Enriquez arrived at Memorable SFH to initiate the complaint and conducted a safety inspection with (S1). There were no immediate safety hazards observed at this time of inspection. In addition, LPA M. Chavez conducted a visit to Memorable SFH. LPAs conducted interviews with child 1 and 3 (C1 & C3) staff 1 (S1), licensee (LS), and C1's county social worker (CSW) as listed on the Confidential Names List (LIC 811). LPAs were unable to interview child 2 and 4 (C2 & C4) due to C2 and C4 being non-verbal. In regard to the allegations that licensee does not prevent a minor from walking around nude while in care and licensee does not prevent a minor from engaging in inappropriate interaction with another minor. It was specifically reported that C2 walks around the SFH late at night nude and one-night C2 tried to get in to bed with C3 while nude. Multiple confidential interviews disclosed that after C2 goes to bed for the night that C2 will then take their clothes off and walk to the restroom during the night naked. In addition, confidential interviews disclosed that C2 now has one on one supervision to ensure C2 doesn't leave their room naked and there are now doorbells on C2's bedroom door which make a sound when C2 leaves their room during the night. Multiple confidential interviews disclosed that C1 and C3 lock their door at night to avoid C2 from going in their room. In addition, multiple interviews stated that C2 has never harmed any clients and the time C2 went into C1 and C3's room was an accident. Regarding the allegation that licensee does not provide adequate transportation for a minor, it was specifically reported that LS does not pick up C1 from school and that LS has C1 take Uber home. During confidential interview, it was disclosed that C1 had to take an uber home on a few occasions where LS was running late to pick up but as of November 2024, C1 has not had to take Uber home and that LS is on time to pick up C1 from school. In addition, a confidential interview disclosed that during a child family and team meeting LS disclosed that during situations where LS was not able to get C1 on time from or to school then LS would use Uber and C1's social worker nor any other participants in the meeting stated Uber was unacceptable. In regard to the allegation that licensee screams at a minor, it was specifically reported that LS screams at C1 for falling asleep on the couch. During multiple confidential interviews, it was disclosed that LS does not scream at C1 or any other clients in care. Other multiple confidential interviews disclosed that LS has a naturally loud voice but does not yell at C1. LPA did not receive any further details. Based on interview and record review, the allegations that licensee does not prevent C2 from walking around nude while in care; licensee does not prevent C2 from engaging in inappropriate interaction with another minor; licensee does not provide adequate transportation for C1; licensee screams at C1 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 11/22/2024, at 1:20PM, 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 child 1 (C1) and the facility. On July 17, 2023, Community Care Licensing (CCL) received a complaint alleging that licensee does not prevent a minor from walking around nude while in care; licensee does not prevent a minor from engaging in inappropriate interaction with another minor; licensee does not provide adequate transportation for a minor and licensee screams at a minor. 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: 11/22/2024

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

met_with: Licensee- Memory Beaumier


raw_content:
Narrative:
In regard to the allegation that a foster child is being neglected while in care it was specifically reported that LC pointed to their private parts saying "hurt" and there was suspicion that LC may be pregnant. During multiple confidential interviews, it was disclosed that LC will point to body parts and communicate that LC is in pain. In addition, confidential interviews added that this a tactic LC used to gain attention because LC is attention seeking. Furthermore, the confidential interviews disclosed that LC is not sexually active and is on birth control because LC does not know how to deal with menstruation. Regarding licensee did not meet foster children's medical needs allegation, multiple confidential interviews disclosed that LS takes LC to doctor's appointments and urgent care as needed/ frequently. Another confidential interview disclosed that LS will share LC's medical documents with county social worker and LS does take LC to their medical appointments. A confidential interview disclosed that when LC is not receiving attention, LC will communicate that LC is sick or in pain to LS, teacher, or school nurse. Another confidential interview disclosed that children in LC's class often go to the nurse's office to get their medication daily and it has been brought to LS's attention that when classmates are leaving the class to the nurse's office, LC will suddenly report to the teacher that LC is in pain or sick. LPA was unable to gather additional interviews whether the foster children were being neglected. Based on interview and record review, the allegations that a foster child is being neglected while in care and licensee did not meet children's medical needs may have occurred, however, there was not a preponderance of evidence to support the alleged violation, 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 staff 1, Gretta Chikakai.

Investigation Findings:
13On 01/03/2025, at 10:30AM, Licensing Program Analyst (LPA) Maya Chavez conducted an unannounced visit to Memorable Small Family Home (SFH) to deliver the investigative finding for the allegations listed above involving the Small Family Home (SFH) and foster children (FC1, FC2, FC3 & FC4), and legal child (LC) as listed on the Confidential Names List (LIC 811) dated 01/03/2025. On 08/22/2024, Community Care Licensing (CCL) received a complaint that a foster child is being neglected in care and licensee (LS) did not meet children's medical needs. On 08/30/2024, LPA M. Chavez conducted a health and safety inspection at the SFH, and no immediate health and safety hazards were observed. In addition, LPA M. Chavez obtained pertinent documents to the investigation, interviewed foster children (FC2 & FC3), licensee, staff 1 (S1), and LC's County Social Worker. Additionally, LPA M. Chavez attempted to conduct interviews with legal child (LC), and foster children (FC1 & FC4) whom were all unable to be interviewed due to being non-verbal. 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: 01/03/2025

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

met_with: Staff 1- Gretta Chikakai


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Another confidential interview stated that C1 was being sneaky and hiding in places, so staff could not see exactly what C1 was doing. Confidential interviews corroborated that multiple staff were in the home during this allegation and no sexual interactions occurred. However, another confidential interview maintained that there was a sexual interaction between C2 and C1 in the bathroom. LPA received conflicting information. Based on confidential interviews and a review of pertinent documents, the allegation that staff did not provide adequate supervision resulting in C1 engaging in sexual behavior with C2 in care may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted and a copy of this report was provided to caregiver Winnie Abiute.

Investigation Findings:
13On September 10, 2025, Licensing Program Analyst (LPA) Maryjane Perez conducted an unannounced visit to Memorable Small Family Home (SFH) and met with caregiver Winnie Abiute to deliver the finding for the above stated allegation. On June 27, 2025, Community Care Licensing received a complaint alleging that staff did not provide adequate supervision resulting in minor engaging in sexual behavior with another minor in care. On July 1st, 2025, LPA M. Perez conducted a health and safety inspection of the facility, and no hazards were observed. Lpa M. Perez also obtained pertinent documents and interviewed licensee (LS), staff 1 (S1), staff 2 (S2), staff 3 (S3), client 1 (C1), client 2 (C2), client 3 (C3), and client 4 (C4). In regard to the allegation, it was reported that during the holiday season of 2021- LS' family would get together and celebrate thanksgiving at LS' house, during the holiday celebration, C1 and C2 were engaging in sexual behaviors where C2 allegedly raped C1. During confidential interviews, it was reported that there was no sexual interaction between C2 and C1. Another confidential interview stated that once staff were aware of this allegation law enforcement was called and the two clients were separated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: MaryJane Perez 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: 09/10/2025

met_with: Winnie Abiute- Caregiver


summary: Facility Evaluation

raw_content:
Narrative:
On November 3, 2022 at 10: AM, Licensing Program Analyst (LPA) Karen Beal and Licensing Program Manager (LPM) Abdoulaye Traore arrived at the Memorable Small Family to conduct an annual Inspection. LPA met with staff Greta Chikakai who granted LPA/LPM access to the home. At 10: 30 am, LPA/LPM began a tour both inside and out with the staff and Licensee Memory. There were 4 children in the home at the time of this inspection. The home has currently 5 children in placed. 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 was 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 fireplace was properly screened. All hazardous items have been properly made inaccessible to areas where children will have access. The medications were locked and stored in upstairs locked hallway cabinet by master bedroom. Cleansers/chemicals were locked and stored in a locked cabinet under kitchen sink. Sharp knives were inaccessible and stored also under the kitchen sink. There was 7 days of non-perishables and 3 days of fresh perishable foods observed in the pantry, refrigerator and freezer. The hot water temperature was tested and noted to be at 110 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. As stated by Licensee, there were no weapons/firearms. 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 on the premises. Toys were safe, clean, and age appropriate for the age group of children being cared for. CPR and the First Aid cards expires on 10/30/23. Children and staff records are organized. Administrative records included. A review of two staff and two client's records on this date indicates that all facility. Staff have received criminal record and child abuse index check clearances and required documents. Based on this annual inspection, the home was operating within a capacity of 5 foster children and guardian child. In accordance with Title 22, Division 6, Chapters 1 & 4, there were no deficiencies being cited at this time. Exit interview conducted and a copy of this report and confidential names List (LIC 811) were given and explained to the licensee


summary: Facility Evaluation

raw_content:
Narrative:
On March 20, 2025, Licensing Program Analyst (LPA) Maryjane Perez arrived at Memorable Small Family Home to conduct annual required inspection. LPA met with licensee Memory Tom Beaumier who granted access into the home. Currently, there were 3 ambulatory clients placed in the home and it is licensed for a capacity of 6. The Facility was toured both inside and out with the licensee. The home is a two story building with 6 bedrooms and 3 bathrooms. The downstairs consisted of dining room with adequate seating, living room #1 with couches and television, bathroom #1 that was fully functioning but the trash can needs a lid. The kitchen was clean and sanitary with a fully stocked pantry and refrigerator with perishable/ non-perishable foods and a lock box storing medication. There was a fire extinguisher that was up to date. The knives were in a kitchen locked cabinet as well as client medication. There was living room #2 that had more couches, television, and games. There was bedroom #1 downstairs that was vacant and used as a guest room with a twin size bed. The hallway had a first aid kit with all required elements. There was a storage closet that was locked and stored extra household items. Bedroom #2 was also downstairs and had a full size bed for licensee's family member. The upstairs had a loft that was used as a family play area as there was couches, television, toys and a desk. There was a locked laundry room that stored washer and dryer as well as soaps and detergents. Bedroom #3 was for foster children and had one full size bed and one twin size bed with dressers and closet space. Bedroom #4 had two full size beds with dresser and closet space- both beds occupied one for foster child and one for licensee's child. There was bathroom #2 was fully functioning with dual sinks and water temperature reaching 110.4 degrees Fahrenheit. There was bedroom #5 that had one full size bed and one twin size bed being occupied by one foster child and fully furnished. The hallway stored client files and personnel files locked in a cabinet. There was bedroom #6 that was for licensee and had a king size bed with bathroom #3 fully functioning. During inspection of staff files LPA found there to be missing required training's for licensee and staff members. During inspection of client files there was missing documentation of the consent medication authorization form for one client and Tuberculosis Test for all clients. Based on these observations, the facility is cited for violation of California Code of Regulations Title 22, Division Chapter 1 section 80069(c)(1) Client Medical Assessment (c) The medical assessment shall include the following: (1) The results of an examination for communicable tuberculosis and other contagious/infectious diseases. The backyard was free of hazards and had a gate with a latch for emergency exit. There was no pool or other body of water. There was no firearms in the home as stated by licensee. All bedrooms were arranged for one child per bed. There were adequate drawer and closet space for children's belongings. The smoke and carbon monoxide detectors were checked and were working properly. LPA interviewed 2 staff and 1 client. LPA reviewed 4 staff files and 3 client files. During the visit there was 1 deficiency and 8 technical violations , an exit interview was conducted, and a copy of this report along with an LIC809D form and technical assistances were reviewed and provided to Licensee Memory Tom Beaumier.

met_with: Licensee- Memory Tom Beaumier


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