summary: Facility Evaluation

raw_content:
Narrative:
On 09/18/2024 at 11: AM, Licensing Program Analyst (LPA) Jasmine Cardeno and LPA Celeste Aparicio conducted an unannounced visit to the facility Paradise Home. The purpose of this visit was to conduct the psychotropic medications inspection. LPAs met with Shift Supervisor, Ava Ballard and Manager, Ashaki Gregory. LPAs conducted a walk-through of the facility facilitated by Shift Supervisor, Ava Ballard and Manager, Ashaki Gregory. LPAs observed the three client bedrooms, one bathroom, the kitchen and living room area, garage area, and one staff office room. LPAs observed the facility to be clean and the walkways to be free from obstructions. During the inspection, LPAs obtained an updated LIC500, client roster, and list of clients currently prescribed psychotropic medications. The current census of the home is four clients. Three clients were prescribed psychotropic medications. Of those three clients, none of the clients were eligible for psychotropic medications inspection review. LPAs reviewed three staff files and conducted two confidential staff interviews. At this time, no deficiencies were observed or cited. An exit interview was conducted and a copy of this report was given to Shift Supervisor, Ava Ballard, whose signature on this form confirms receipt.


state: CA

facility_name: PARADISE HOME

summary: Facility Evaluation

raw_content:
Narrative:
On 11/22/ Licensing Program Analyst (LPA) Jonathan Medina conducted a case management visit to follow-up on a submitted incident report (IR). LPA met with Shift Supervisor Ava Ballard and informed of the purpose of the visit. An IR was submitted for an incident that occurred on 11/13/2024. According to the IR, it was reported that two clients, C1 and C2, got into an altercation at school. As a result, C2 made a threat to C1, instructing them not to talk about what happened. This incident is related to CSEC. The Shift Supervisor further explained that both clients were brought back in separate car rides and when they got back home they seemed fine. In the following days, an emergency CFT meeting was planned and conducted on 11/18/2024. During the meeting, the clients' behaviors were discussed, as well as their problems with CSEC. C1's mother confirmed that she had been involved with CSEC prior to arriving at the facility, and not because of the other client. Additionally, a safety plan has been created, and discussed several rules that C1 signed and has to abide by. On Monday, MeeChell Williams, a Human Trafficking Case Specialist from Community Violence Solutions, will begin providing ongoing support for C1. LPA reviewed the safety plan and conducted a confidential interview with Shift Supervisor. At this time, no deficiencies were observed or cited. An exit interview was conducted and a copy of this report was given to Shift Supervisor, Ava Ballard, whose signature on this form confirms receipt.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Shift Supervisor - Ava Ballard


summary: Facility Evaluation

raw_content:
Narrative:
Control Number - 0001328 - FN On 12/20/ Licensing Program Analyst (LPA) Jonathan Medina conducted a case management visit to follow-up on a submitted incident report (IR). LPA met with Shift Supervisor, Ava Ballard and informed of the purpose of the visit. An Incident Report (IR) was submitted for an event that occurred on December 6, 2024. According to the IR, a client did not attend school that day due to a fight with another student. During today's visit, the Shift Supervisor provided additional details about the incident and the follow-up actions taken by staff when the client returned to the facility. Through a confidential interview, the Shift Supervisor explained that the client has moved past the incident and advised LPA not to bring it up again to avoid causing unnecessary distress. As the client appears to be doing well and has resumed attending school, no further action is required at this time. Please refer to LIC812 for interview with Shift Supervisor. An exit interview was conducted and no deficiencies cited during today's inspection. A copy of the report was left with the Shift Supervisor.

met_with: Ava Ballard - Shift Supervisor


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Jonathan Medina conducted a follow-up inspection at Paradise Home and spoke with Ava Ballard, Shift Supervisor. The purpose of the inspection was to obtain additional information regarding concerns raised during confidential interviews. LPA Medina conducted a walk-through of the home and observed that the facility maintains at least a one-week supply of nonperishable food and a two-day supply of perishable food. Additional food supplies are stored in the garage. The garage is kept locked due to the presence of clients' personal valuables. The home was observed to be clean and in good repair. LPA Medina conducted a confidential interview with Shift Supervisor Ava Ballard. At this time, no deficiencies were cited. An exit interview was conducted, and a copy of this report was provided to Shift Supervisor Ava Ballard. Her signature on this form acknowledges receipt of the report.


summary: Facility Evaluation

raw_content:
Narrative:
On June 18th 2025 at 10AM, Licensing Program Analysts (LPA) Hanako Primer and Brenda Rodriguez conducted an unannounced Annual Inspection at listed facility. LPAs met with Evette Watts, Direct Care Counselor and Melissa Saidak, Head of Service. The Short-term Residential Therapeutic Program is licensed to serve six clients. Present during the inspection were two staff and three clients. LPAs reviewed three client files. LPAs conducted two client and two staff interviews. One client declined. LPAs toured the facility. LPAs observed one bedroom and one bathroom. LPA observed facility license, personal rights, facility sketch, meal menu, and other forms posted on the walls throughout the facility. LPA tested the water temperature and found it to be 117 degrees which is in range. The thermostat read 71 which is within range. Sharps were locked and chemicals were safely stored. There were two days of perishable foods and seven days non-perishable foods present. The medication was also stored and locked in staff office. The facility is in good repair and clean. LPA toured the backyard. There were no open bodies of water. LPAs observed back door screen removed from door frame and placed on the side of the facility. Staff provided work order to repair screen. Based on record review, head of Service stated that roommate compatibility agreements are done verbally, and there is no documentation. LPAs cited one Technical Violation under STRTP ILS 87087(e) Buildings and Grounds. An exit interview was conducted and a copy of this report was given to Evette Watts, Direct Care Counselor.

visit_type: Annual

met_with: Evette Watts - Direct Care Counselor


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Lisette Valenzuela made an unannounced case management inspection at the above agency on 07/01/2025 at 11:10AM. LPA Valenzuela met with Ava Ballard, Shift Supervisor who assisted with the visit. The purpose of the visit was to conduct an interview with a current youth in placement. Interview was conducted with youth. Exit interview was conducted with Ava Ballard, Shift Supervisor. A copy of the report was printed, and left with Ava Ballard, Shift Supervisor whose signature on this form confirms receipt. Report will also be emailed to facility email address at paradiseadolescenthome@gmail.com

met_with: Ava Ballard


summary: Facility Evaluation

raw_content:
Narrative:
On July 1st 2025 at 10:35AM, Licensing Program Analysts (LPAs) Hanako Primer and Brenda Rodriguez conducted an unannounced annual inspection - continuation at the above licensed facility. LPA met with Ava Ballard, Shift Supervisor. The short term therapeutic residential program is licensed to serve six clients. Present during the inspection were one staff and three clients. One client was at school. LPAs inspected five staff files, previous licensing reports, and emergency disaster plan. LPAs observed staff training certificates, health screening reports, CPR certificates, and personnel record in five out of five staff files. There were no deficiencies cited at this time. LPAs will return at a later date to continue the inspection. An exit interview was conducted and a copy of this report was given to Ava Ballard, Shift Supervisor.


summary: Facility Evaluation

raw_content:
Narrative:
On July 1st 2025 at 10:35AM, Licensing Program Analysts (LPAs) Hanako Primer and Brenda Rodriguez conducted an unannounced case management - incident inspection to follow up on an previously submitted incident report. LPA met with Ava Ballard - Shift Supervisor. The Short-Term Residential Therapeutic Program is licensed to serve six clients. Present during the inspection were one staff and four clients. LPAs conducted one confidential staff interview. There were no deficiencies cited at this time. An exit interview was conducted and a copy of this report was given to Ava Ballard, Shift Supervisor.


summary: Facility Evaluation

raw_content:
Narrative:
On July 14th 2025 at 10: AM, Licensing Program Analysts (LPAs) Hanako Primer and Brenda Rodriguez conducted an unannounced annual inspection - continuation at the above licensed facility. LPA met with Ava Ballard, Shift Supervisor. The short term therapeutic residential program is licensed to serve six clients. Present during the inspection were two staff and three clients. One client was not initially present but returned during the inspection. LPAs inspected staff emergency intervention plan training and facility mass casualty and disaster plan. LPA Primer communicated with administrator, Biana Jones, over the telephone. Administrator stated that the facility did not conduct trainings on emergency medical assistance and injections. Administrator and shift supervisor stated that there was currently one client in care with an allergy who carries an epipen. Based on interview and record review, LPA cited one Type B deficiency under STRTP ILS 87075.1(a): Emergency Medical Assistance, Injections, and Self-Administration of Medication. LPAs inspected staff emergency intervention training plan and cited one Technical Assistance under STRTP ILS 87095.65(b): Emergency Intervention Staff Training. An exit interview was conducted, appeal rights discussed, and a copy of this report was given to Ava Ballard, Shift Supervisor.


summary: Facility Evaluation

raw_content:
Narrative:
On August 18th, Licensing Program Analyst (LPA) Hanako Primer made an unannounced Case Management - Incident inspection to the above licensed facility. LPA Primer met with Melissa Saidak, Head of Service and informed them of the purpose of the visit. At the time of the inspection, there was one client present at the facility. Two clients were on AWOL. Two clients were at school. LPA inspected agreements on day passes, and requested staff email client safety plan and behavioral contracts. LPA conducted two confidential interviews. No deficiencies were cited at this time. An exit interview was conducted and a copy of this report was given to Melissa Saidak, Head of Service.

met_with: Melissa Saidak - Head of Service


summary: Facility Evaluation

raw_content:
Narrative:
On January 8th, 2026 at 10:00AM, Licensing Program Analyst (LPA) Hanako Primer and Licensing Program Manager (LPM) Joel Segura conducted a Microsoft Teams Meeting with Paradise Home management. In attendance were Ava Ballard, Shift Supervisor, Khadijah Muhammad, Direct Care staff, of Paradise Home and Shamika Payne, Health Program Specialist, Hong Luu, Health Program Specialist, and Marjana Jackson, Licensing Program Manager from Systems of Care Branch. Administrator, Biana Jones, was not in attendance and attendees will reschedule the informal meeting to include the administrator. LPA Primer conducted an exit interview with Ava Ballard, Shift Supervisor and Kadijah Muhammad, Direct Care Staff. This document is sent for virtual signature.


summary: Facility Evaluation

raw_content:
Narrative:
On January 15th at 2:00PM, Licensing Program Analyst (LPA) Hanako Primer and Licensing Program Manager (LPM) Joel Segura conducted a Microsoft Teams Meeting with Paradise Home management. In attendance were Biana Jones, Administrator, Melissa Saidak, Head of Service, Nattaly Valenzuela-Meza Clinical Director, Ava Ballard, Shift Supervisor, Khadijah Muhammad, Direct Care Staff, and Maritza Jefferson, Executive Director of Paradise Home. Shamika Payne, Health Program Specialist, and Marjana Jackson, Staff Services Manager from Systems of Care Branch also attended the meeting. During the meeting, attendees discussed the facility's 2024 complaint compliance history. In 2025, there were two unsubstantiated complaints (February and April) and no further incidents have occurred. In 2024, seven complaints were received by the department. Out of thirty-one total allegations received, eight were substantiated. Attendees discussed facility's actions to increase supervision and training. Systems of Care Branch joined the meeting with the purpose of introducing themselves to the facility. LPA Primer conducted an exit interview with Biana Jones, Administrator. This document is sent for virtual signature.

met_with: Biana Jones - Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On March 9th, 2026 at 11: AM Licensing Program Analyst (LPA) Hanako Primer made an unannounced Case Management Inspection at the above licensed facility. LPA met with Ava Ballard, Shift Supervisor, and explained the purpose of the visit. At the time of the inspection, there were six clients in care. LPA conducted one confidential staff interview and a walkthrough of the facility. During the visit, LPA requested staff contact sheet. No deficiencies were issued at this time. An exit interview was conducted and a copy of this report was given to Ava Ballard, Shift Supervisor.


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. Therefore, the allegation is unsubstantiated. No deficiencies were cited at this time. An exit interview was conducted and a copy of this report was left with Ava Ballard, Shift Supervisor whose signature on this form confirms receipt.

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

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

report_type: Complaint Investigation

complaint_status: unsubstantiated


facility_name: PARADISE OAKS - ANTELOPE

summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
One of the individuals involved in the incident provided different details than the reporting party and the other person involved in the incident only spoke with the reporting party about the incident in question. Not having consistent information or corroboration, the allegations are determined to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted, and a copy of the report and appeal process was provided.

Investigation Findings:
13On 08/04/2022 at 11:15am, Licensing Program Analyst (LPA), Tana Kinder conducted an unannounced inspection for the purpose of delivering findings with the Facility Administrator. Prior to the meeting, LPA Kinder reviewed the agency's file at the licensing office, including the complaint history, criminal background check, incident reports and facility personnel report summary. LPA Shelton conducted an inspection of the facility inside and out on 5/2/22 and no citations were issued. LPA Kinder conducted 5 confidential interviews between 7/25/22-7/26/22. LPA attempted to conduct an additional 3 interviews but they were either declined or calls not returned. LPA obtained and reviewed the following documents: Needs and services Plan for 1 client, Treatment Plan for 1 client, Case Notes, Placement History, Staff Training Records, and a staff/client roster. Based on 5 confidential interviews conducted, there is conflicting information provided by the reporting party who heard about the alleged concerns second hand. It is unclear as to the nature of comment as whether the comment was misheard. Regarding staff being verbally argumentative, again there is a difference of interpretation about the tone of the conversation. Continue.... UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Tana Kinder 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 23-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, NATOMAS PARK DR., STE FACILITY NAME: PARADISE OAKS - ANTELOPEFACILITY NUMBER: VISIT DATE: 08/04/2022

met_with: Facility Administrator


raw_content:
Narrative:
On the allegation that staff failed to keep youth safe following a youth brandishing a weapon and threatening other youth, corroborating statements and documentation detail staff doing a search of the suspected youth's room immediately after the first verbal threat by that youth was reported by another youth to staff. Additionally, a search of the youth's person was conducted where the youth was asked to empty their pockets-no "pat-down" search is allowed in the facility. Law enforcement was also called and responded-this first search yielded no discovery of a weapon. After a second time that the threat was purportedly made again and upon this being reported to staff, another search was conducted with the involvement of law enforcement, at which time a folding knife was found on the suspected youth's person-that youth was then detained by the responding officers. No other youths interviewed attested to seeing the suspected youth actually brandishing the weapon, nor did any of the interviewed staffers state that they saw the weapon before it was discovered. Beyond threats made by the suspected youth, no other youths were actually harmed due to this ordeal. On the allegation that there are Altercations between youths at the facility, though physical fights sometimes took place in the facility, no youths interviewed reported non-action on the part of the staff. The youths corroborated that staff do intervene when a physical fight breaks out between youths. Reviewed training records show that staff are educated on de-escalation techniques and, when needed, application of restraints. It is not a reasonable expectation that no altercations between youths happen in the facility-only that facility staff attempt to de-escalate situations or intervene when a physical fight does occur. Corroborating statements by youths indicate that staff do their part in this regard. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur; therefore, the allegations are UNSUBSTANTIATED. No citations are being issued as a result of this investigation; a copy of this report along with a copy of the Appeal Rights are being provided to the facility.

Investigation Findings:
13On 10/21/ Licensing Program Analyst (LPA) Chad Cabigon communicated with this facility's administrator, Jovan Metoyer, to deliver the findings of the complaint investigation. On 06/22/ LPA opened the investigation and conducted an onsite inspection of this facility's physical plant. At this time, LPA also requested the Needs & Services Plans for youths; the following records were also obtained and reviewed as part of this complaint investigation: a client roster with County Social Worker names and numbers, the clients' dates of birth, corresponding school and/or summer school information, all staffs' names, titles, personal contact numbers, the and staff training documents for the past full calendar year plus year-to-date. Confidential interviews were conducted by LPA with five Paradise Oaks Youth Services (POYS) staffers, four foster youths (all interviewed off the facility's premises), one case-carrying County Social Worker, and a youth's adoptive grandparent. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Chad Cabigon 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 23-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, NATOMAS PARK DR., STE FACILITY NAME: PARADISE OAKS - ANTELOPEFACILITY NUMBER: VISIT DATE: 10/21/2022

met_with: Jovan Metoyer, Facility Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 06/18/21 at 1: PM, the second collaborative a quarterly meeting with Paradise Oaks Youth Services (POYS) was held to provide technical assistance and collaborative support to assist with and ensure POYS operates a successful program. The first meeting was held on March 19, 2020. POYS consists of nine locations: Olivine, Rosa Vista, Hazel, Hickory, Antelope, Mariposa, Old Auburn, Madison, and Sunset. The current census at all locations is 28. Two locations have closed, Linda Creek on 2/3/21 and Violets on 5/11/21. The following were present on an MS Teams virtual meeting: · CCL: Margo Castaneda, Regional Manager, Jodean Hall, Licensing Program Manager, Robin Sullivan, Licensing Program Analyst. · System of Care (SOC): Marjana Jackson, Stacie Kinney. · Sacramento County: Linda Abdelbaki · Department Health Care Services (DHCS): Brian Keefer · POYS: Robert Pye, CEO, Laynee Kuhn, Executive Director, Stephanie Fisher, Program Director, Thomas Harrer, Clinical Director POYS provided a status update of the CARF evaluation stating the accreditation approval is over two months out due to backlogs from covid. An extension of approval is in effect. The Mental Health review by Dept. of Health Care Service (DHCS) was completed in April 2021 and at this time POYS is working with DHCS in providing the plan of corrections. POYS reports numerous clients recently graduated from high school. Some graduates are enrolled in community college, some are working, some are seeking transitional housing programs, and some are still figuring things out. Distance learning challenges were reported to be with band-width issues both from the schools and at the facilities. Distance learning was embraced by about half of the clientele, with the other half preferring in-person learning. CCL reported a decrease in complaints and incident reports. POYS attribute the decline to a more deliberate intake process and screening for better compatibility with the current clients. They also reported they were revamping their level system. In addition, POYS is training house staff to participate more closely with each client and their overall treatment plan. Staff are eliciting more input from youth on what is working/not working with the program. Youth have responded with more engagement. POYS reported they are resuming a higher level of training for staff as more in-person training become available. They have contracted with Relias Learning for staff training. When asked about the status of overnight staff, POYS reported, they have two roamers that are assigned to three homes each. They also have one floater that helps out as needed or if someone calls out. This model is used both for the day shift and nighttime shift. The roamers and floaters meet regularly with staff to discuss client behaviors and needs. Sacramento County had no specific areas of concern. They complimented the discussed areas of change and the graduation of youth. DHCS discussed the pros/cons of the virtual Mental Health review and was appreciative for POYS' feedback on the process. Clarification on mask wearing requirements for POYS clients and staff will be provided as the Department receives details. POYS will submit an electronic Program Statement to include recent revisions. They next meeting is scheduled for September 17, 2021. A copy of this report will be emailed for signatures to Laynee Kuhn.

met_with: Executive Management


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPAs) Marla Horne and Tamara Hill conducted an unannounced annual inspection on 7/26/21 at 10: AM. LPAs toured the facility inside and out and observed that the facility has three dual occupancy rooms and two bathrooms accessible to clients in care. LPAs observed the facility license and foster youth rights posted in a prominent area. Medications were locked in a box in a file drawer in the staff office. LPAs observed and tested the smoke/carbon monoxide detector. LPAs observed the refrigerators and freezers to be well stocked with perishable and non-perishable items. Fresh fruit was observed on the kitchen counter, a menu was posted on the refrigerator. LPAs observed the bedrooms to have required furniture and bedding. LPAs observed cleaning supplies and chemicals in a locked closet. The fire extinguisher was last serviced June 2021. The water in the kitchen and bathroom sinks warmed up to a required temperature. The shower and toilets functioned properly. Soap and paper towels were observed in the kitchen and hallway bathroom. The back bathroom was observed during the inspection as well but was not clean although it was cleaned prior to LPAs leaving the facility. Facility was cited for 80087(a) Buildings and Grounds as the facility shall be clean, safe, sanitary and in good repair and LPAs observed that the back client bathroom was not clean during the inspection but was cleaned while LPAs were present in the facility. An exit interview was conducted with Jovan Metoyer.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPAs) Marla Horne and Tamara Hill conducted and unannounced annual inspection at the administrative offices for Paradise Oaks Youth Services located at Sunrise Vista Drive, Citrus Heights 95610. LPAs reviewed staff files during the inspection and the required documents were observed in the files reviewed although LPAs were unable to complete the file review. A continuation of the file review is needed to conclude the annual inspection. No citations were issued during this inspection. Exit interview conducted with Executive Director, Laynee Kuhn.

met_with: Laynee Kuhn, Executive Director


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Marla Horne conducted an unannounced annual inspection at the Paradise Oaks Youth Services administration office located at Sunrise Vista Drive at 10: AM on 7-29-21. The inspection was a continuation on the inspection from 7-26-21. LPA completed the file reviews for the Antelope location. All required documents were observed to be in the files. No citations were issued during this inspection. An exit interview was conducted with Human Resources Director, Lisa Garceau.


summary: Facility Evaluation

raw_content:
Narrative:
On 09/17/21 at 1: PM, the third collaborative quarterly meeting with Paradise Oaks Youth Services (POYS) was held to provide technical assistance and collaborative support to assist with and ensure POYS operates a successful program. POYS consists of nine locations: Olivine, Rosa Vista, Hazel, Hickory, Antelope, Mariposa, Old Auburn, Madison, and Sunset. The current census at all locations is 27. Three locations: Madison, Sunset and Old Auburn currently have no foster youth placed. The following were present on an MS Teams virtual meeting: · CCL: Jodean Hall, Licensing Program Manager, Robin Sullivan, Licensing Program Analyst (LPA), Cindy Johnson, LPA, Tammy Hill, LPA · System of Care (SOC): Marjana Jackson, Stacie Kinney. · Sacramento County: Linda Abdelbaki · Department Health Care Services (DHCS): Brian Keefer · POYS: Robert Pye, CEO, Laynee Kuhn, Executive Director, Stephanie Fisher, Program Director POYS reported a staff and family moved into Sunset after their home burned down approximately 2 weeks ago. Annual inspections were completed for all their facilities in June and July, resulting in Technical Advisory/Advisory Notes and no deficiencies cited. CCL will provide the electronic program statement revisions to System of Care. Program statement revisions for the SAY population was submitted but still needs to be reviewed and approved. LPA Marla Horne will review by October 20, 2021. Incident reports regarding smoking on grounds was discussed. Both trauma-informed practices and harm reduction protocols were discussed. Harm reduction practices have not been approved by the Department. POYS is reminded that incident reports should document interventions including staff discouraging youth from smoking. CCL pointed out youth smoking in the backyard is still smoking on grounds which may require additional case management inspections. CCL requested program statement revision to Transportation services to add details of exceptions to provide transportation to youth when extreme weather, youth not feeling well or after hours. CCL requested incident reports be typed due to the difficulty of reading the handwritten reports. At this time there are multiple POYS staff that still hand write reports. This has been an ongoing conversation between POYS and CCL. CCL requests all reports be typed by November 1, 2021. POYS declined this request. CCL requested all youths' names be included in one incident report rather than referring to other involved youth as "peer". CCL recommended using a legend to submit the report to CCL and redacting the names for POYS purposes. POYS declined the request due to confidentiality. The CCL request was requested and approved through upper management and noted not to be a HIPPA violation. CCL requested incident reports and time-frames be more specific. Antecedent information is specific and thorough, yet more follow up details or resolution information is needed and requested. CCL recommended POYS to Technical Support Program (TSP) for incident report writing. POYS approved the recommendation. Sacramento County had no specific areas of concern. DHCS had no specific areas of concern. Due to the upcoming impact of FFPSA on program statements, a deadline for the revisions was not determined and will be included at the time of the FFPSA changes. No further meetings are scheduled.

met_with: Robert Pye, CEO, Laynee Kuhn, Executive Director, Stephanie Fisher, Program Director,


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Tamara Hill made an unannounced collateral inspection on 9/24/21 at 12: PM to the administrative office location for the agency located at Sunrise Vista Drive, Suite 2100, Citrus Heights 95610 and met with Laynee Kuhn, Chief Executive Officer for the agency. LPA made the visit to discuss the following incident reports for this facility: On 6/27/ C1 left to the store while staff was in the kitchen. While at the store youth was asking for cigarettes and customer called law enforcement who then returned youth to the facility. LPA inquired as to whether staff were even aware of youth's absence prior to law enforcement returning youth to the facility. Ms. Kuhn states that she believed On 5/5/ C2 threw a bowl of cereal at staff's back after one staff denied having a conversation C2 claimed to have had with C2. The incident appeared to possibly be confrontational between the C2 and staff. LPA learned that C2 has a history of being confrontation and volatile with staff and facility is working with C2 on tempers and reactiveness to situations as C2 could have responded the same if staff had not responded about the alleged conversation. Agency did not see this as confrontational or out of line for staff during this incident. On 4/23/21, C3 was playing with fire while in the facility living room. LPA asked Ms. Kuhn about contacting law enforcement following incidents of this nature and Ms. Kuhn states that they have historically contacted law enforcement but are typically told that they will not respond unless there is an active fire in progress. If staff are successful in putting out the fire, there is no need to respond. This was discussed during C3's child and family team meeting and youth is currently no longer in this placement. Facility typically will not accept youth with fire starting behaviors. LPA discussed with Ms. Kuhn the additional clarification needed on the reports to ensure all details including antecedents and follow up are captured appropriately. No citations were issued as a result of this inspection. Document provided to Ms. Kuhn.

met_with: Laynee Kuhn, Chief Executive Officer


summary: Facility Evaluation

raw_content:
Narrative:
On 3/10/22 at 12: PM, Licensing Program Analyst (LPA) Tina Rivera made an unannounced visit to conduct a case management regarding an incident report received by The Department on 2/15/2022 regarding an incident report which mentions a possible violation of personal rights of a client. LPA met with Ulyous Ingram who assisted with the investigation. The STRTP was overall clean and in good repair. There were more than 7 days' of perishable and nonperishable foods. The toilets and showers were functioning. The dining table was broken due to a client engaging in property damage and a repair request has been put in with the maintenance team. There was a fire extinguisher, fully functioning smoke detectors and carbon monoxide detector. Each room had bedding, beds, dressers, and sufficient storage space. No citations were issued. LPA Rivera conducted interviews with the Administrator, Facility Managers, Case Manager, and 3 clients and gathered information on staff and clients.. An exit interview was conducted with Ulyous Ingram and a copy of this report was emailed to Jovan Metoyer at JMetoyer@paradiseoaks.com. Signature on file. This case management investigation needs further investigation.

met_with: Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On January 27, Licensing Program Manger (LPM) Dara Campos, Regional Office Manager Margo Castaneda, and Licensing Program Analyst (LPA) Stephannie Verna held an Informal Conference Meeting from 1: PM to 2: PM to discuss concerns. The meeting was facilitated by LPM Campos. Attendees included (in-person) Paradise Oaks Youth Services staff, Laynee Kuhn (Executive Director), Stephanie Fischer (Administrator), Amanda Lee (administrator) and Board Member Al Werner, as well as (Via Teams Meeting), Shawn Wade Fresno County Social Worker, Julie Leong, Case Manager Mateo County Behavioral Health, Khoa Nguyen Stanislaus County Social Worker, and Tia Carter Sacramento County Social Worker. The topics discussed included: Absent without Permission Temporary Release (TR) Communication with local law enforcement Cancelling Missing Person reports Incident Report details No deficiencies were cited during today's meeting. A copy of this report was provided to Laynee Kuhn, Executive Director.


summary: Facility Evaluation

raw_content:
Narrative:
On 2/27/23, Licensing Program Analyst (LPA) Stephanie Lor conducted an announced annual inspection at the above facility. LPA Lor met with the Administrator who provided a tour of the interior and exterior of the facility. There is currently no clients or staff associated to this facility. LPA conducted 1 interview with the Administrator. LPA reviewed 5 staff files. LPA toured the facility inside and out and observed that the facility has three dual occupancy rooms and two bathrooms accessible to clients in care. Posters were posted in the back room of the entrance. There is a storage for medication in the staff office. LPA observed smoke/carbon monoxide detector. LPA observed working refrigerators, freezers, and can goods in the classroom. LPA observed the bedrooms to have required furniture and bedding. LPA observed cleaning supplies and chemicals in a locked closet. The shower and toilets were functioning properly. A laundry room with a washer and dryer is available to the clients. LPA observed the outdoor area to be clear of clutter and debris. A Technical Assistant was provided for the outdoor fence. No defienceies cited. An exit interview was conducted with Administrator.

met_with: Jovan Metoyer, Administrator


summary: Facility Evaluation

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Narrative:
On 04/03/ Licensing Program Analyst (LPA) Chad Cabigon met with Paradise Oaks Youth Services Executive Director Laynee Kuhn and Chief Executive Officer Robert Pye for Component II of the application process for this location's reversion to a Group Home. The Program Statement was reviewed, and revisions are to be sent by Ms. Kuhn by 04/14/2023.

met_with: Laynee Kuhn, Robert Pye


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) Cindy Johnson arrived at Paradise Oaks Youth Services (POYS) Administrative Office on 7/27/2021 at 4: PM. LPA Johnson spoke with Laynee Kuhn, Executive Director to discuss the conclusion of this investigation initiated from incident reports and previous case management visits. LPA Johnson informed Ms. Kuhn this case was investigated by the Department's Investigator Jami Eaton and LPA Cindy Johnson. The investigation included: on 12/19/2019, POYS provided initial notification to the Department, via email of an allegation obtained on 12/13/2019 that Non-Minor Dependent (NMD) has a "girlfriend" that is a staff person and provided three incident reports (see LIC 811 dated 7/27/2021). On 12/20/2019, POYS provided additional documentation including: an Internal Investigation (summary concluded on 12/20/2019) and one incident report concluding S1's boundaries were inappropriate with NMD and S1 was terminated for providing inconsistent statements about an iPad (see LIC 811 dated 7/27/2021). Licensing Program Analyst (LPA) Cindy Johnson conducted a Case Management- Incident visit at POYS Administrative Office on 12/31/2019 with Laynee Kuhn, Executive Director and Thomas Harrer, Clinical Director. Two staff (S2 and S3) were interviewed (see LIC 811 dated 7/27/2021). S1's file was reviewed and copies obtained, including: LIC 501, Employee Address Change Form, Child Abuse Reporting Policy, Statement Acknowledging Requirement to Report Suspected Child Abuse, Allegation of Abuse and Social Media, Training Logs, S1's Statements dated 12/13/2019 and 12/20/2019, two photos of S1's iPad, email dated 12/20/2019, Communication Notes dated 12/18/2019 and 12/19/2019, and S4's Statement dated 12/18/2019 (see LIC 811 dated 7/27/2021). LPA Johnson conducted another Case Management visit on 2/12/2020 with Stephanie Fisher, Program Director and obtained copies of two incident reports of staff witnessing S1 return to two POYS facilities and transporting NMD, after being terminated, three Communication Notes dated 1/28/2020 and 2/10/2020 (see LIC 811 dated 7/27/2021). On 3/4/2020, POYS provided notification that when a former staff resigned, he alleged that NMD is having a sexual relationship with S1 and S1 is pregnant. A Suspected Child Abuse Report was made on 3/12/2020 and Investigator Jami Eaton was assigned to investigate this case on 3/16/2021. Interviews were conducted from 12/31/2020-6/2/2020 with S1, Probation Officer Winifred Temple, NMD and six current or former POYS staff (see LIC811 dated 7/27/2021). The allegation is whether S1 had a sexual relationship with NMD when NMD was a minor client of POYS. NMD was placed on 8/26/2019, turned 18 years old on 10/4/2019, and S1 was terminated on 12/20/2019. Both S1 and NMD denied there was a sexual relationship. Two staff directly heard statements from NMD admitting to having a sexual relationship with S1, however the statements did not indicate when the relationship began. So it is not possible to determine if the relationship occurred while S1 was employed by POYS (See LIC811 dated 7/27/2021). Based on the investigation, interviews conducted and records reviewed, the complaint allegation is UNSUBSTANTIATED at this time meaning that the allegation is meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted. Facility signature is on hard copy. A copy of all reports and appeal rights were provided to the facility via email.


facility_name: PARADISE OAKS - HAZEL

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Narrative:
three to five days to receive the results. The facility did not attempt to obtain results until August 16, 2021. Documentation obtained during the investigation indicates that youth were tested August 12, 2021, and their results were ready as of August 14, 2021. Test results were obtained verbally from the clinic. Until a subsequent visit to the facility on January 27, 2022, the facility did not have any documentation of the test results in question. Facility Administrator went to the clinic during the LPA's visit and obtained the documentation because it was not obtained previously. Amongst the results, there was one positive youth and two youth's results indicate that COVID was "Not Detected" and the narrative of the results states "re-testing should be considered" but these two youth were not re-tested. During the time from the date of the test to the date of the receipt of the COVID results these youth were not isolating in their rooms and were potentially exposing staff and other youth. The youth that was in the hospital for another reason returned to the facility on August 15, 2022, was retested but was in isolation in their room until their test results were received August 17, 2022 indicating they were negative. As a result of the information obtained, interviews conducted and documentation received, the allegation that the facility did not obtain the youths' COVID test results in a timely manner is SUBSTANTIATED at this time meaning that the "preponderance of the evidence" standard has been met. Facility was cited for violation of California Code of Regulations, Title Division Six, regulation 80070(b)(9) Client Records. Licensees are required to maintain a separate, complete, and current record in the facility for each client that also includes, but is not limited to, record of any illness or injury requiring treatment... The facility took four youth for COVID testing on August 12, 2021, but did not obtain the written documentation of the COVID testing results as necessary to meet the intent of this regulation. The written documentation was not obtained from the clinic until January 27, 2022. Facility obtained the COVID testing results via phone on August 16, 2022, but the results of the verbal contact with the clinic was not documented in client files. Exit interview was conducted with Ms. Kuhn and documents provided along with appeal rights. When LPA interviewed staff about COVID-19 protocols, it was discussed that staff were not sure what part they play in mitigating the spread of COVID outside of cleaning multiple times throughout the facility and following Centers for Disease Control and Prevention (CDC) guidelines and protocols. Staff also confirmed that they feel that COVID is so new and ever-evolving that they aren't confident that they could be trained in a thorough manner either. Confidential interviews revealed that while staff some have been trained to clean, maintain social distancing, wear masks and wash their hands often, they feel that the agency could provide additional training on how all of these measures are helpful and what other things they could do. Some staff insisted that they have not received any training related to COVID mitigation and prevention at the facility. The allegation that the facility is not following their emergency plan to protect clients and staff is related to staff feeling that Paradise Oaks administrative staff asked at least one staff to return to work once their quarantine and/or isolation period was over regardless of still being symptomatic. LPA attempted to speak to this staff person about the circumstances but staff refused to be interviewed. Other confidential interviews revealed that a staff person reported to other staff that they were cleared to return to work regardless of still being symptomatic. This situation made staff question facility's policies to mitigate the spread of COVID, further creating the potential for additional spread of COVID. Confidential interviews revealed that said staff did not return to work and forfeited their position with the agency. Other interviews revealed that staff are trained and constantly reminded and trained that they are not to return to work if they are experiencing any COVID-related symptoms. As a result of the investigation, interviews conducted, and documentation reviewed, the allegations that facility staff are not properly training on COVID protocols, facility is not following their emergency plan, and facility failed to implement mitigating factors that created additional exposure to clients and staff are UNSUBSTANTIATED at this time meaning that the allegations may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Exit interview was conducted with Ms. Kuhn and documents provided along with appeal rights.

Investigation Findings:
13Licensing Program Analyst (LPA) Tamara Hill made an unannounced visit on 1/27/22 at 11: AM and met with Laynee Khun, Executive Director to discuss the complaint allegations as stated for this facility. LPA informed Ms. Kuhn that the investigation included an initial inspection at the facility on 8/26/2021 by LPA Robin Sullivan where documents were requested via email. LPA Hill made a subsequent visit to the facility on 10/19/2021 where LPA Hill requested that the agency provide a copy of the COVID training plan for staff, protocols for youth and any other cleaning, sanitizing or other COVID protocols established for the mitigation of the spreading COVID within the facility. Another subsequent visit was conducted on 1/27/22 to the facility to obtain additional documentation. LPA Hill conducted interviews with clients and staff from 10/19/21 to 1/20/22. At least one staff did not respond to repeated requests for interview. The allegation that the facility did not obtain COVID test results in a timely manner is related to an incident on August 10, 2021, where one youth was taken to the hospital for another reason and was COVID tested. The hospital alerted the facility staff that youth had tested positive so all the remaining youth were taken to a clinic for tests on August 12, 2021. According to the administrator, the clinic's policy on testing is that the tests can SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Tamara Jensen-Hill 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 23-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, NATOMAS PARK DR., STE FACILITY NAME: PARADISE OAKS - HAZELFACILITY NUMBER: VISIT DATE: 01/28/2022

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

met_with: Laynee Khun, Executive Director


raw_content:
Narrative:
S1 contacted S2 to inform S2 that the school was requesting that C1 be picked up due to illness. S2 contacted the school to discuss reasons for C1 needing to be picked up. During that discussion, school personnel were not able to confirm seeing or hearing C1 vomiting. S2 informed the school that because there was no physical evidence of C1 being ill, the facility would not pick up C1. C1 then contacted their probation officer to inform them that they were walking home since the facility would not pick them up. C1 then walked off the school campus and walked home. Upon arrival to the facility, C1 was taken to urgent care. While C1 had reported being ill, the facility is aware that C1 has a history of lack of attendance in school due to unauthorized absences at school or leaving the school grounds after being dropped off by facility staff. Upon the school personnel not being able to confirm C1's illness, facility staff refused to pick up C1 as a tactic to encourage C1 to stay in school. As a result of the interviews conducted, the allegation that staff abandoned minor at school is UNSUBSTANTIATED meaning the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted with Carla Izzarelli, Facility Manager and documents were provided. S1 contacted S2 to inform S2 that the school was requesting that C1 be picked up due to illness. S2 contacted the school to discuss reasons for C1 needing to be picked up. During that discussion, school personnel were not able to confirm seeing or hearing C1 vomiting. S2 informed the school that because there was no physical evidence of C1 being ill, the facility would not pick up C1. C1 then allegedly contacted their probation officer to inform them that they were walking home since the facility would not pick them up. School personnel indicated that they had spoken to the probation officer and was told that they were aware of C1 walking home. CEO states that she has proof via email that the probation officer would not have allowed C1 to leave the school grounds to walk to the facility. C1 then walked off the school campus and walked to the facility. Upon arrival to the facility, C1 was taken to urgent care. While C1 had reported being ill, the facility is aware that C1 has a history of lack of attendance in school due to unauthorized absences at school or leaving the school grounds after being dropped off by facility staff. Upon the school personnel not being able to confirm C1's illness, facility staff refused to pick up C1 as a tactic to encourage C1 to stay in school. As a result of the interviews conducted, the allegation that staff abandoned minor at school is UNSUBSTANTIATED meaning the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted with Ms. Kuhn and documents were provided.

Investigation Findings:
13Licensing Program Analyst (LPA) Uchenna Ajaero conducted an unannounced complaint inspection on 6/3/22 at 12: PM and met with Laynee Kuhn, Chief Executive Officer to discuss the allegation as stated. LPA Ajaero informed Ms. Kuhn that the complaint investigation included a facility health and safety inspection conducted on 5/9/22. C1's client file (see LIC 811 dated 5/9/22) was obtained on 5/9/22. Interviews were conducted with reporting party on 5/9/22, three school personnel 5/9/22, agency staff (S1, S2) on 5/9/22 and 5/19/22, client (C1) on 5/9/22. During interviews conducted with school personnel, C1 reported that they were not feeling well while in school and C1 requested that the school contact the facility to be picked up on 5/3/22. School personnel contacted the facility to request that facility staff pick up C1 as it had been reported that other youths in the classroom heard C1 tell a teacher that they had vomited and was ill. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Uchenna Ajaero 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 23-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, NATOMAS PARK DR., STE FACILITY NAME: PARADISE OAKS - HAZELFACILITY NUMBER: VISIT DATE: 05/31/2022

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


raw_content:
Narrative:
before the altercations escalate. Interview with RP and FFY both stated FFY was not treated with respect while at the house. As a result of the investigation and interviews conducted regarding the staff allowing minors to engage in physical altercations with another minor, this allegation has been found to be UNSUBSTANTIATED meaning that allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. During the investigation LPA Baca investigated the complaint that staff did not safeguard minors personal property. Interviews with A1 and S1 both stated that when a youth comes into the facility a safeguard property list is given to list all the youths belongings. LPA observed this document for FFY. Interview with FY1 and FY2 both stated that there has not been an issue with their belongings being taken or messed with at the facility. Due to the FFY being discharged from the facility quickly and a relative putting FFY belongings in multiple bags to take, staff was unable to conduct a safeguard of property form during discharge. Interview with FFY stated that a staff had accidentally dropped a fidget spinner that belonged to the FFY. As a result of the investigation and interviews conducted regarding the allegation that staff did not safeguard minors personal property, this allegation has been found to be UNSUBSTANTIATED meaning that allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. During the investigation LPA Baca investigated the complaint that staff did not treat minor with respect. During interviews with FY1 and FY2, both stated they feel they are treated with respect by staff at the house. S1 and A1 both stated they do their best to treat all clients with respect and try to teach the clients respect as well. Interviews with FFY and RP both stated that FFY was not treated with respect while at the facility. As a result of the investigation and interviews conducted regarding the allegation that staff did not treat minor with respect, this allegation has been found to be UNSUBSTANTIATED meaning that allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. End of report.

Investigation Findings:
13On 4.11..2023 at 1:45 p.m. Licensing Program Analyst (LPA) Monica Roberts arrived at the agency to conduct an unannounced complaint inspection. LPA Roberts spoke with Carla Izzarelli, Administrator to discuss the findings of the complaint investigation and allegations stated above. LPA informed agency staff this case was investigated by LPA Baca. The initial 10-day complaint investigation inspection was conducted at the agency on 3.20.2023. Documents obtained on 3.20.2023 included trainings, facility sketch, staff schedule and Incident reports pertaining to complaint allegations. and the foster youth's needs and services. Interviews were conducted with Reporting Party (RP) on 3.16.2023, Former Foster Youth (FFY) 3.16.2023, Foster Youth 1 (FY1) on 3.20.2023, Foster Youth 2 (FY2) on 3.16.2023, Staff 1 (S1) on 3.16.2023, Administrator (A1) on 3.20. 2023. LPA Baca investigated the complaint that staff allowed minors to engage in physical altercations with another minor. Interview with FY1 and FY2 stated that staff will stop any altercations that happen between the youths in the house. S1 stated that when he sees any altercation that he will separate the youths. Interview with A1 stated that staff are to break up any altercations that they see with the youths UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Monica Roberts 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION NO. Cal Cr/res., Natomas Park Dr., STE FACILITY NAME: PARADISE OAKS - HAZELFACILITY NUMBER: VISIT DATE: 04/11/2023

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


raw_content:
Narrative:
LPA Crass investigated the above allegations. Based on video footage provided by the reporting party, LPA Crass observed staff member (S2) casually eating and on their cell phone, while clients had put a chair on a table, to climb on to an awning, to get on to the roof. While the children were on the roof, the staff member was looking down at their cell phone, and then was watching a youth on the roof, while eating. The staff member did not appear to be preventing the child from being on the roof, or verbalizing for them to get down. The staff member eventually walks back inside the house. Additionally, two youth can be seen vaping in the video, one of which vaped right in front of the staff member, with no intervention from S2 being observed. Based on record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Interim Licensing Standards, Article 6, 87065.2(b)(1) is being cited on the attached LIC 9099D. An exit interview was conducted with Carla Izzarelli. A copy of this report and appeal rights were given. It was reported that sometime in 2021 or 2022, youth in care were hiding from the fire department at night, and that staff had locked the back door so the youth could not enter the facility. LPA Crass investigated the above allegation. Based upon information obtained during the investigation, LPA received conflicting statements from interviews, and was not able to observe youth being locked out of the home in video footage, therefore this allegation has been found to be UNSUBSTANTIATED meaning that the allegation may have happened or is valid, but there is not a preponderance of evidence to prove that the alleged violation occurred. An exit interview was conducted with Carla Izzarelli. A copy of this report and appeal rights were given.

Investigation Findings:
13On Friday, September 20th, 2024 at 12PM, Licensing Program Analyst (LPA) Brittany Crass conducted an unannounced visit at the facility to deliver findings for the investigation of the complaint allegation stated above. LPA Crass met with the Facility Administrator, Carla Izzarelli, who arrived at 12:20PM, and informed them of the purpose of today's visit. The initial 10-day complaint inspection was conducted by LPA Crass and LPA Tamara Hill, at the facility on 8/29/2024. At the facility, LPA Crass and LPA Hill conducted a health and safety tour, interviewed C1, C2, the facility administrator, and reviewed video footage and documentation. On 8/26/24, LPA Crass interviewed the reporting party. On 9/17/24, LPA Crass reviewed additional video footage. (Continued on LIC 9099-C). SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Brittany Crass 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 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: PARADISE OAKS - HAZELFACILITY NUMBER: 347006002

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

met_with: Carla Izzarelli


summary: Facility Evaluation

narrative: On 06/18/21 at 1: PM, the second collaborative a quarterly meeting with Paradise Oaks Youth Services (POYS) was held to provide technical assistance and collaborative support to assist with and ensure POYS operates a successful program. The first meeting was held on March 19, 2020. POYS consists of nine locations: Olivine, Rosa Vista, Hazel, Hickory, Antelope, Mariposa, Old Auburn, Madison, and Sunset. The current census at all locations is 28. Two locations have closed, Linda Creek on 2/3/21 and Violets on 5/11/21. The following were present on an MS Teams virtual meeting: · CCL: Margo Castaneda, Regional Manager, Jodean Hall, Licensing Program Manager, Robin Sullivan, Licensing Program Analyst. · System of Care (SOC): Marjana Jackson, Stacie Kinney. · Sacramento County: Linda Abdelbaki · Department Health Care Services (DHCS): Brian Keefer · POYS: Robert Pye, CEO, Laynee Kuhn, Executive Director, Stephanie Fisher, Program Director, Thomas Harrer, Clinical Director POYS provided a status update of the CARF evaluation stating the accreditation approval is over two months out due to backlogs from covid. An extension of approval is in effect. The Mental Health review by Dept. of Health Care Service (DHCS) was completed in April 2021 and at this time POYS is working with DHCS in providing the plan of corrections. POYS reports numerous clients recently graduated from high school. Some graduates are enrolled in community college, some are working, some are seeking transitional housing programs, and some are still figuring things out. Distance learning challenges were reported to be with band-width issues both from the schools and at the facilities. Distance learning was embraced by about half of the clientele, with the other half preferring in-person learning. CCL reported a decrease in complaints and incident reports. POYS attribute the decline to a more deliberate intake process and screening for better compatibility with the current clients. They also reported they were revamping their level system. In addition, POYS is training house staff to participate more closely with each client and their overall treatment plan. Staff are eliciting more input from youth on what is working/not working with the program. Youth have responded with more engagement. POYS reported they are resuming a higher level of training for staff as more in-person training become available. They have contracted with Relias Learning for staff training. When asked about the status of overnight staff, POYS reported, they have two roamers that are assigned to three homes each. They also have one floater that helps out as needed or if someone calls out. This model is used both for the day shift and nighttime shift. The roamers and floaters meet regularly with staff to discuss client behaviors and needs. Sacramento County had no specific areas of concern. They complimented the discussed areas of change and the graduation of youth. DHCS discussed the pros/cons of the virtual Mental Health review and was appreciative for POYS' feedback on the process. Clarification on mask wearing requirements for POYS clients and staff will be provided as the Department receives details. POYS will submit an electronic Program Statement to include recent revisions. They next meeting is scheduled for September 17, 2021. A copy of this report will be emailed for signatures to Laynee Kuhn.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Tamara Hill made an unannounced annual inspection 7/22/21 at 10: AM using the Compliance and Regulatory Enforcement (CARE) tools and met with Carla Izzarelli, Administrator. LPA toured the facility inside and out during the inspection today. LPA observed three dual occupancy client bedrooms, that had all of the required furniture as required. LPA observed that there are two bathrooms available to clients and that the bathrooms were appropriately equipped with toilet paper and paper towels. LPA observed that the bathrooms had warm water as required. LPA observed that the showers and toilets functioned as required and showers had hot water as required. LPA observed that the facility had an adequate supply of perishable and nonperishable food for the clients in care. LPA observed that there is a fire extinguisher in the facility and it was last inspected in June 2021. LPA observed that there is a carbon monoxide detector in the hallway near the client bedrooms. LPA observed that the smoke detectors functioned as required. LPA observed that the facility appliances, fridge and freezer appeared to be clean and function as required. LPA observed that sharps and disinfectants and cleaning supplies were appropriately stored where not accessible to clients in care. LPA observed a menu posted in the facility. LPA observed that the facility has laundry services available for each youth to complete their own laundry. LPA observed that the facility has a functioning telephone in the facility. LPA observed that the facility vehicles appeared to be in good operating condition. No citations were issued during the inspection today and exit interview was conducted with Ms. Izzarelli and document was provided.

met_with: Carla Izzarelli, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPA) Tamara Hill and Marla Horne made an unannounced annual continuation inspection on 7/27/21 at 9: AM at the administrative offices for Paradise Oaks Youth Services located at Sunrise Vista Drive, Citrus Heights 95610. The purpose of the visit to this location is to review the staff files at the administrative office. LPAs reviewed staff files during this inspection and no citations were issued during the inspection today. Exit interview with Laynee Kuhn, Executive Director.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Tamara Hill made an unannounced annual continuation inspection on 7/30/21 at 10: AM at the facility and met with Misha Scott, Case Manager The purpose of the visit to this location is to review the client files at the facility. LPA reviewed client files during this inspection. No citations were issued but LPA did experience some technical difficulties while in the facility that were ultimately resolved the Department's programmer via telephone. Exit interview with Ms. Scott.

met_with: Misha Scott, Case Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 09/17/21 at 1: PM, the third collaborative quarterly meeting with Paradise Oaks Youth Services (POYS) was held to provide technical assistance and collaborative support to assist with and ensure POYS operates a successful program. POYS consists of nine locations: Olivine, Rosa Vista, Hazel, Hickory, Antelope, Mariposa, Old Auburn, Madison, and Sunset. The current census at all locations is 27. Three locations: Madison, Sunset and Old Auburn currently have no foster youth placed. The following were present on an MS Teams virtual meeting: · CCL: Jodean Hall, Licensing Program Manager, Robin Sullivan, Licensing Program Analyst (LPA), Cindy Johnson, LPA, Tammy Hill, LPA · System of Care (SOC): Marjana Jackson, Stacie Kinney. · Sacramento County: Linda Abdelbaki · Department Health Care Services (DHCS): Brian Keefer · POYS: Robert Pye, CEO, Laynee Kuhn, Executive Director, Stephanie Fisher, Program Director POYS reported a staff and family moved into Sunset after their home burned down approximately 2 weeks ago. Annual inspections were completed for all their facilities in June and July, resulting in Technical Advisory/Advisory Notes and no deficiencies cited. CCL will provide the electronic program statement revisions to System of Care. Program statement revisions for the SAY population was submitted but still needs to be reviewed and approved. LPA Marla Horne will review by October 20, 2021. Incident reports regarding smoking on grounds was discussed. Both trauma-informed practices and harm reduction protocols were discussed. Harm reduction practices have not been approved by the Department. POYS is reminded that incident reports should document interventions including staff discouraging youth from smoking. CCL pointed out youth smoking in the backyard is still smoking on grounds which may require additional case management inspections. CCL requested program statement revision to Transportation services to add details of exceptions to provide transportation to youth when extreme weather, youth not feeling well or after hours. CCL requested incident reports be typed due to the difficulty of reading the handwritten reports. At this time there are multiple POYS staff that still hand write reports. This has been an ongoing conversation between POYS and CCL. CCL requests all reports be typed by November 1, 2021. POYS declined this request. CCL requested all youths' names be included in one incident report rather than referring to other involved youth as "peer". CCL recommended using a legend to submit the report to CCL and redacting the names for POYS purposes. POYS declined the request due to confidentiality. The CCL request was requested and approved through upper management and noted not to be a HIPPA violation. CCL requested incident reports and timeframes be more specific. Antecedent information is specific and thorough, yet more follow up details or resolution information is needed and requested. CCL recommended POYS to Technical Support Program (TSP) for incident report writing. POYS approved the recommendation. Sacramento County had no specific areas of concern. DHCS had no specific areas of concern. Due to the upcoming impact of FFPSA on program statements, a deadline for the revisions was not determined and will be included at the time of the FFPSA changes. No further meetings are scheduled


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
Licensing Program Analyst (LPA) Tamara Hill made an unannounced collateral inspection on 9/24/21 at 12: PM to the administrative office location for the agency located at Sunrise Vista Drive, Suite 2100, Citrus Heights 95610 and met with Laynee Kuhn, Chief Executive Officer for the agency. LPA made the visit to discuss the following incident reports for this facility: C1 (see LIC811 dated 9/24/21) attempted to leave the facility on a bicycle and when youth returned, the bicycle was locked up and it was not clear if that was an attempt to deter youth from leaving or if it was staff locking up the bike because it was being used as a mode of transportation. C2 brought into the facility a bb gun that was not authorized to be with youth in the program. The facility confiscated the weapon and attempted to have law enforcement come and retrieve the weapon as it looked a real. Facility was informed that they were going to need to destroy the weapon themselves and that law enforcement would not take possession. LPA discussed with Ms. Kuhn the additional clarification needed on the reports to ensure all details including antecedents and follow up are captured appropriately. No citations were issued as a result of this inspection. Document provided to Ms. Kuhn.

Deficiencies:
95610: C1 (see LIC811 dated 9/24/21) attempted to leave the facility on a bicycle and when youth returned, the bicycle was locked up and it was not clear if that was an attempt to deter youth from leaving or if it was staff locking up the bike because it was being used as a mode of transportation.
C2 brought into the facility a bb gun that was not authorized to be with youth in the program.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) David Torres conducted a case management inspection on May 3, 2022 at 9:02 am based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. During this inspection, 5 out of Direct Care Staff and 5 out of 5 youth files were reviewed. 2 out of Direct Care Staff and 2 out of 5 youth were interviewed. (See the Confidential Names List, LIC 811, dated May 3, 2022). The Plan of Operation including policies and procedures were reviewed. Minutes from the board of directors' meetings related to the facility's incidents involving contact with law enforcement were reviewed. Based on the analysis of the confidential interviews and youth file review including the needs and service assessments, youth case plans, quarterly assessments, and crisis intervention plans, the licensee uses trauma-informed and evidence-based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. LPA David Torres observed documentation of completed training on policies and procedures on when and how to involve law enforcement in response to an incident. Training records show staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance to their Emergency Intervention Plan when there is an immediate risk of serious harm to a child or others. There are no deficiencies cited at this time. A copy of this report was discussed and provided to Carla Izzarelli, Administrator.

met_with: Carla Izzarelli, Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst, Uchenna Ajaero and Jodean Hall, LPM, made an unannounced case management inspection regarding incident reports received on 1/22 and 24, 4/8, 4/24, 4/26, 5/23, 2022 involving missed medication of client #1. We met with Administrator Carla Izzarelli, staff Misha Scott, and Melissa Maturino, who assisted with this inspection. The client is currently not at the facility. LPA Ajaero, LPM Hall and Administrator conducted a walk-through of the facility inside and out. There were no clients present during the inspection. LPA, Ajaero and LPM, Hall conducted interviews with staff, and reviewed medication logs for receiving the medications, documenting the medications, and records addressing the errors. LPA Ajaero and LPM Hall collected medication logs and contact information. Further investigation is required in order to resolve this case management. An exit interview was conducted with Administrator and a copy of this report was emailed to her and she confirmed receipt.

met_with: Misha Scott


summary: Facility Evaluation

met_with: Laynee Kuhn, Executive Director.

narrative: On January 27, Licensing Program Manger (LPM) Dara Campos, Regional Office Manager Margo Castaneda, and Licensing Program Analyst (LPA) Stephannie Verna held an Informal Conference Meeting from 1: PM to 2: PM to discuss concerns. The meeting was facilitated by LPM Campos. Attendees included (in-person) Paradise Oaks Youth Services staff, Laynee Kuhn (Executive Director), Stephanie Fischer (Administrator), Amanda Lee (administrator) and Board Member Al Werner, as well as (Via Teams Meeting), Shawn Wade Fresno County Social Worker, Julie Leong, Case Manager Mateo County Behavioral Health, Khoa Nguyen Stanislaus County Social Worker, and Tia Carter Sacramento County Social Worker. The topics discussed included: Absent without Permission Temporary Release (TR) Communication with local law enforcement Cancelling Missing Person reports Incident Report details No deficiencies were cited during today's meeting. A copy of this report was provided to Laynee Kuhn, Executive Director.


summary: Facility Evaluation

raw_content:
Narrative:
On 2/14/ Licensing Program Analyst (LPA) Jean Stidman met with Deanna Davis Facility Social Worker for the purpose of a Plan of Correction inspection. On 5/27/21 an SB Psychotropic Medication Inspection was conducted and the facility was cited for two clients Needs and Services Plans missing signatures of the authorized representative. LPA obtained documentation of one clients Needs and Services Plans (see attached LIC811 confidential names) signed by the authorized representative from April 2021. The facility will review their records for the other client. LPA conducted a walk through of the facility and observed the facility is a single story three bedroom home. Present was one client, one staff supervising the client and the facility social worker was in their office, During the inspection the one client and the one staff supervising the client left the facility to pickup another client.

met_with: Deanna Davis Facility Social Worker


summary: Facility Evaluation

raw_content:
Narrative:
On 3.13. Licensing Program Analyst (LPA) Jennifer Baca arrived at the facility for the purpose of conducting a case management visit. The incident involved FY1 and FY2 having an altercation, where FY2 sprayed FY1 in the face with a cleaning solution. LPA spoke with Assistant Administrator. LPA asked if Assistant Administrator recalled the incident? Assistant Administrator stated he recalled that FY1 had sprayed FY2 with a cleaning solution in the face. LPA asked why did FY2 have the cleaning solution? Assistant Administrator stated that staff were unaware that FY2 had the cleaning solution in their room. LPA asked if staff conduct checks of the bedrooms? Assistant administrator stated that checks are conducted during each shift. LPA asked how are the checks conducted? Assistant Administrator stated that staff will open drawers and look around, however staff are not allowed to dig into the youth belongings, so the spray bottle could have been hidden under clothing, sheets or anything else where it would not have been detected. LPA asked if staff checked the amount of cleaning items that are taken during cleaning time and check again upon the completion of the cleaning? Assistant Administrator stated that the staff should do that , however they do not. LPA asked how this situation could be avoided in the future? Assistant Administrator stated that they could implement a check out and a check in system, with the cleaning supplies ,Assistant Administrator stated that this idea would need to be given to upper management to see if they are able to implement. A copy of this report was left with the Assistant Administrator.

met_with: James Penn, Assistant Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst, Dung Mac, conducted a case management inspection on 4/25/2023 at 10:30am based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. During this inspection, 4 out of Direct Care Staff and 4 out of 4 youth files were reviewed. 3 out of Direct Care Staff and 1 out of 4 youth were interviewed. (See the Confidential Names List, LIC 811, 4/25/2023). The Plan of Operation including policies and procedures were reviewed. Minutes from the board of directors' meetings related to the facility's incidents involving contact with law enforcement were reviewed. Based on the analysis of the confidential interviews and youth file review including the needs and service assessments, youth's monthly safety plan, and crisis intervention plan, the licensee uses trauma-informed and evidence-based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. LPA Mac observed documentation of completed training on policies and procedures on when and how to involve law enforcement in response to an incident. Training records show staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance to their Emergency Intervention Plan when there is an immediate risk of serious harm to a child or others. There are no deficiencies cited at this time. A copy of this report was discussed and provided to Administrator Carla Izzarelli.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Misty Valencia and Tina Thorn on 05/04/2023 at 9:00 am. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPAs Valencia and Thorn met with Carla Izzarelli, Administrator and inspected the facility inside and out. LPAs reviewed two of three (2/3) child's records and two of two (2/2) staff personnel files on site at the facility. LPA reviewed two (2) child's psychotropic medications and medication records. LPA interviewed two (2) staff on site to discuss the facilities policies and procedures of operation. LPA interviewed two (2) of children currently prescribed psychotropic medication. LPA provided a copy of this licensing report to Carla Izzarelli, Administrator No deficiencies are being cited at this time. LPA conducted exit interview with Carla Izzarelli, Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 6/29/ Licensing Program Analyst (LPA) Jean Stidman conducted an unannounced inspection at the facility for the purpose of interviewing a client. LPA met Ben Afisivalu, Assistant Administrator. LPA interviewed one client. This report was reviewed with and a copy was left with Ben Afisivalu, Assistant Administrator.

met_with: Ben Afisivalu, Assistant Administrator


summary: Facility Evaluation

raw_content:
Narrative:
This is an annual inspection but FAS failed to pull up the annual inspection link on the LIC 809 "Type of Visit" link. This case management record is used in the place of the LIC Annual Inspection/CARE Tools records. FAS does not show any annual inspection requirement for this facility. On 8/25/23, Licensing Program Analysts, (LPAs) Uchenna Ajaero and Monica Roberts made an unannounced annual inspection visit to the facility, Paradise Oaks, Hazel, a Group Home. LPAs met the facility Administrator and the inspection commenced. About 10: AM, LPAs toured the facility inside and outside. LPA observed the following: the house has 6-beds, 3-bedrooms and 2-bathrooms. License was hanging in a conspicuous place on the notice board and a copy in the office. Emergency notification/fire drills records. Emergency kit was not in this facility. Administrator explained they have an emergency location where they take the clients to in the case of an emergency. The facility has food, water and emergency requirements at that home in the case of an emergency. Facility sketch posted; youths rights poster; house rules were in the clients files; laundry room; locked chemical for laundry; perishable food to last more than 3-days, non-perishable food that will last for more than 5-days. Emergency food supply; fire extinguisher was last checked on 8/23/23 ; staff unlocked the garage with youths' personal items; trash cans had covers; the bathrooms were lighted; there was one linen closet; evacuation plan posted in a conspicuous area; disaster plan; hygiene closet; activity calendar and water temperature was within the allowed range. LPAs reviewed 2-staff files, 2 youth files, and 3 clients' medication containers against the MAR. LPAs interviewed 3 staff members and 2 youths at school. This concludes the annual inspection. No citation was issued. A copy of this report is issued to the Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 8/25/23 about 1: PM, Licensing Program Analysts, (LPAs) Uchenna Ajaero and Monica Roberts made an unannounced case management visit for a medication error that occurred at the facility. The LPAs met the facility administrator. The LPAs reviewed the medications with the administrator. The administrator explained that the missed dose was because Omni Care pharmacy has been habitual in failing to deliver filled medication. When they call the pharmacy they were totl the medication was en-route to them for delivery but it never came. When they could not wait any longer they went and picked up the medicine by themselves and wrote the incident report. Administrator said they have resolved to bot let that happen anymore. They will endeavor to go and pick their medications before it is time to give it to the client. That way it will not be late.


summary: Facility Evaluation

raw_content:
Narrative:
On 5/14/24 abut 12: PM, Licensing Program Analyst (LPA) Uchenna Ajaero made an unannounced visit to this facility for an annual inspection using the Compliance and Regulatory Enforcement (CARE) tools and met with Hans Owhowho, the Facility Manager. LPA toured the facility inside and out. LPA observed the license was posted in an open area, three dual occupancy client bedrooms, that had all of the required furniture as required. LPA observed that there are two bathrooms available to clients and that the bathrooms were appropriately equipped with hand washing soap, toilet paper and paper towels. LPA observed that the bathrooms had warm water as required and the showers and toilets functioned as required. LPA observed that the facility had 4 refrigerators with an adequate supply of perishable food, and the pantry had nonperishable food for the clients in care. LPA observed that there is a current fire extinguisher in the facility. LPA observed that there is a carbon monoxide detector in the hallway near the client bedrooms and the smoke detectors functioned as required. LPA observed that the facility appliances, fridge and freezer appeared to be clean and function as required. LPA observed that sharps and disinfectants and cleaning supplies were appropriately stored where not accessible to clients in care. LPA observed a menu posted in the facility. LPA observed that the facility has laundry services available for each youth to complete their own laundry. LPA observed that the facility has a functioning telephone and the facility vehicles appeared to be in good operating condition. LPA requested all staff updated TB verification due by 6/30/24. No citations were issued during the inspection today and exit interview was conducted with Mr. Hans Owhowho and a copy of this document was provided.

met_with: Hans Owhowho


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Connie Goldie on 08/05/2025 at 08:30 am. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Goldie met with Carla Izzarelli, Administrator and inspected the facility inside and out. LPA reviewed 1 of 1 child's records and 5 of 5 staff personnel files on site at the facility. LPA reviewed 1 of 1 child's psychotropic medications and medication records. LPA interviewed 5 of 5 of staff on site to discuss the facilities policies and procedures of operation. LPA interviewed 1 of 1 child currently prescribed psychotropic medication. During the inspection the LPA observed two type B deficiencies (see attached 809D page). LPA Goldie cited Interim Licensing Standards Article 6 87068.3(a) Modifications to the Needs and Service Plan and 87068.2 (d) Needs and Services Plan. LPA Goldie issued two technical violations. These are not a deficiency. LPA conducted exit interview with Carla Izzarelli, Administrator. LPA discussed and provided a copy of documents and appeal rights.

met_with: Carla Izzarreli Administrator


summary: Facility Evaluation

raw_content:
Narrative:
An announced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Stefanie Whitlow on 5/27/21 at 9:00am. During the inspection, LPA met with Carla Izzarelli, facility administrator, and inspected the facility inside and out. Due to restrictions of COVID-19, this inspection was conducted using Zoom video technology. All files and medication documents were sent to LPA prior to the inspection. A medication count was also conducted using the Zoom platform on this date. LPA reviewed two children's records prior to the inspection. LPA reviewed four staff and administrator personnel files prior to the inspection. LPA interviewed four staff and administrator on site during the inspection. LPA interviewed two children currently taking psychotropic medication. Facility citation violation of California Code of Regulations Short-Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS) 87068.2(d) the licensee shall ensure and document that the child, and his/her authorized representative(s), and the child and family team were offered the opportunity to participate in the development of the needs and services plan (NSP). Facility failed to get the authorized representatives signature for clients NSP. LPA conducted exit interview with Carla Izzarelli, Facility Manager. LPA provided the Summary Report to Carla Izzarelli, Facility Manager, upon completion by email with a request for signature and to scan back with signature.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced case management visit was conducted by Licensing Program Analyst (LPA) Uchenna Ajaero and Licensing Program Manager (LPM) Jodean Hall on 07/01/22 at 02:00 pm. LPA and LPM met with Carla Izzarelli, Administrator, to deliver the licensing report findings of a case management inspection conducted on May 25, 2022 for five special incident reports (SIR) received for medication errors. The facility was toured both inside and out with Carla Izzarelli, Manager. No clients were present during inspection. Interviews were conducted with Misha Scott, Medication Manager and Carla Izzarelli, Administrator. During the investigation three staff records were reviewed, one client record was reviewed (see LIC 811 - Confidential Names List dated 5/25/2022), medications were reviewed, two medications counted, MAR records for April and May were reviewed, training records were reviewed for S3, S4 and S5. · SIR dated May 25, 2022 -C1 was mistakenly given his p.m. prescription medication in the a.m. on May 23, 2022. · SIR dated April 26, 2022 - C1 was two tablets short for two prescription medications. C1 was one 1 tablet short for a prescription medication. Staff are unsure if the pills were dropped or the client was given an extra pill and there was no notation of the missing medication. ·SIR dated April 22, 2022 - C1 was not given a prescription medication because staff replaced the bubble pack prescription with an over the counter bottle due to the prescription not being filled and staff did not read or recognize the new packaging. SIR dated April 8, 2022 - C1 was missing one tablet of a prescription medication. Staff is unclear if he was given a double dose or if one was dropped. · SIR dated April 4, 2022 - C1 was missing one prescription medication. Staff is unsure if C1 was given an extra dose or if one fell on the ground. There was no notation of the missing medication. The medication manager checks the medications and the MARs on Mondays and Fridays. The administrator said they thought the errors could be attributed to the rotation of on call staff, Agency wide, who are not familiar with the houses or clients and the medication distribution process. The administrator also said she was working on a plan to have only permanent staff dispense medications and a plan to improving the medication dispensing process. Facility is cited for California Code of Regulations, Title 22, Division 6, Section 80065 (a) - Personnel Requirements. Record reviews and interviews conducted confirms multiple medication errors were made by means of lack of documentation, dispensing or not properly reading labels. Facility personnel shall be competent to provide the services necessary to meet individual client needs and shall, at all times, be employed in numbers necessary to meet such needs.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Connie Goldie on 04/30/2024 at 09: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Goldie met with Carla Izzarelli, Program Administrator and inspected the facility inside and out. LPA reviewed two child's records. LPA reviewed three staff personnel files on site at the facility. LPA reviewed two child's psychotropic medications and medication records. LPA interviewed three staff on site to discuss the facilities policies and procedures of operation. LPA interviewed two children currently prescribed psychotropic medication. During the inspection the LPA observed three type B deficiencies (see attached 809D pages). LPA Goldie cited Interim Licensing Standards Needs and Services Plan 87068.2(d) and 84068.3(a) and Title 22, Division 6, Chapter Health Related Services 80075 (b)(5)(B). LPA Goldie issued one technical violation. This is not a deficiency. Plan of corrections were discussed and appeal rights were provided. LPA provided a copy of this licensing report to Carla Izzarelli, Program Administrator.

met_with: Carla Izzarelli, Program Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 1/15/2025, Licensing Program Analyst (LPA) Mary Shelton, conducted an unannounced inspection for the purpose of conducting a case management regarding an incident that occurred on 12/27/2024. LPA met with staff and one client, to discuss the incident and obtained information. LPA conducted a walk through to observe the facility inside and outside. The agency is being cited for Title 22, Division 6, Chapter 5, Article 6, Personal Rights 87072(C)(1) An exit interview was conducted where the citation and plan of correction were discussed. Appeal rights were provided and discussed with the facility representative mentioned above.

met_with: Ricky Torres, Residential Counselor


facility_name: PARADISE OAKS - HICKORY

raw_content:
Narrative:
The facility temporarily moved client 2, who was bullying, to another one of their facilities for safety measures. Staff made roommate changes to increase compatibility and safety. Staff members intervened with a restraint to keep physical distance between clients and separate a physical altercation. Based on the information gathered in the interviews with staff and clients, LPA found that bullying was occurring between clients. LPA also found that staff attempted preventions and moved clients when necessary to ensure their safety. Therefore, the allegation that staff did not prevent youth from being bullied by other youths in care is UNSUBSTANTIATED - meaning although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that alleged violation did or did not occur, therefore the allegations is unsubstantiated. An exit interview was conducted and a copy of this report, appeal rights and the LIC811 were discussed and emailed to Carla Izzarelli.

Investigation Findings:
13On 5/18/2021 at 9: AM Licensing Program Analyst (LPA) Robin Sullivan conducted a teleconference call and spoke Carla Izzarelli, Administrator, to deliver findings for the investigation alleging staff did not prevent youth from being bullied by other youths in care. LPA Marla Horne initiated the investigation and interviewed two clients on 2/24/21. LPA Robin Sullivan completed the investigation and interviewed three staff on 5/3/21 and one staff on 5/14/21. Documents reviewed include incident reports, needs and service plans, child and family team meeting notes, house meeting notes and planned activity schedules. The investigation revealed that bullying occurred between clients at the facility. Both clients and staff confirm that client 1 was bullied by two other clients in the facility. LPA found that staff intervened during verbal and physical incidents to protect client 1. Staff made attempts to prevent bullying by holding house meetings with the clients. Clients identified what they considered bullying and discussed solutions. Client 1 stated, "we tried to do a problem solve with client 2 but it did not work." Client 3 stated, "staff did the best they could do. There's not much they can do if it's verbal." UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Robin Sullivan 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 23-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, NATOMAS PARK DR., STE FACILITY NAME: PARADISE OAKS - HICKORYFACILITY NUMBER: VISIT DATE: 05/18/2021