summary: Facility Evaluation

raw_content:
Narrative:
On April 30, 2025, Licensing Program Analysts (LPAs) Miriam Flores and Olivia Medrano traveled to Fresno Youth Weldon House to conduct a case management inspection to discuss the updates for the Fresno Youth Program Statement and Plan of Operation. LPAs met with Direct Care Staff, Gina Cappelletty and Interim Administrator, Deaja Randles participated via phone. LPAs discussed pending updates for the Plan of Operation and Program Statement. Copies of PINS and LIC9106A were provided for reference via email. No deficiencies are being cited. LPAs conducted an exit interview with Direct Care staff and Interim Administrator. A copy of this report was left at the facility.

met_with: Gina Cappelletty and Deaja Randles


state: CA

facility_name: FRESNO YOUTH - WELDON HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
On May 16, 2025, Licensing Program Analyst (LPA), Miriam Flores met with Interim Administrator, Daeja Randles to discuss Fresno Youth Program Statement and Plan of Operation Update via Microsoft Teams Meeting . The LIC9106A(9/24) form was reviewed during this meeting. Interim Administrator has agreed to resubmit the Program Statement and Plan of Operation Update by June 30, 205. No deficiencies were cited. Exit interview was completed with Daeja Randles. Copy of this report was forwarded via email with a request for signature and the form to be returned by Daeja Randles.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Daeja Randles


summary: Facility Evaluation

raw_content:
Narrative:
On July 8, Licensing Program Analysts (LPA) Miriam Flores and Angelica Borja conducted a case management inspection at Fresno Youth Weldon STRTP and met with Facility Manager, Mandy Perez to discuss, Interim Licensing Standards (ILS) - Personal Rights and incident reports submitted to CCL for C1. Facility has agreed to update their Program Statement, Sections Personal Rights and AWOL searches procedure by 7/31/2025 to reflect New ILS Version 5 for Facilities: Fresno Youth Weldon and Fresno Youth Palo Alto. Licensee will submit their updated sections to LPA by 7/31/2025. LPAs followed up on the missed medications reports submitted to CCL for C1 (See LIC 811). No citations given on this date. Exit interview was completed with the Facility Manager and a copy of this report was left at the facility.

met_with: Mandy Perez


summary: Facility Evaluation

raw_content:
Narrative:
On October 28, Licensing Program Analysts (LPA) Miriam Flores conducted a case management inspection at Fresno Youth Weldon STRTP and met with Facility Manager, Mandy Perez and Jordan Lett to follow-up on incident report submitted to CCL. LPA discussed the incident report dated 10/08/25 for C1 and collected supportive documentation that reflect that facility is meeting C1's food services needs. LPA received a copy of the LIC500 and fingerprints were verified. A Technical Violation was given on the ILS 87068.2(c)Needs and Services. Facility has agreed to email the assigned LPA copies of their meeting summary reports for C1 by 10/29/25. Exit interview was completed with the Facility Manager and a copy of this report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On May 6, Licensing Program Analyst (LPA) Miriam Flores traveled to Fresno Youth Weldon House to conduct a case management inspection and met with Assistant Manager, Jordan Lett. The purpose of the inspection was to discuss incident report sent to Community Care Licensing (CCL) dated 04/06/2025, regarding direct care staff blocking the exit door for C1 (see LIC811). The Department determined this to be an immediate risk to health and safety at this time, therefore California Code of Regulations are being cited on ILS Version 5, Personal Rights 87072(22)(A) on the attached LIC809D. LPA conducted an exit interview and a copy of this report and appeal rights were left with Assistant Manager, Jordan Lett.

met_with: Jordan Lett


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Miriam Flores traveled to Fresno Youth Weldon House to conduct a case management inspection and met with Assistant Manager, Jordan Lett. Interim Administrator, Daeja Randles participated via phone. The purpose of the inspection was to discuss incident report sent to Community Care Licensing (CCL) dated 01/02/2026, regarding a restraint report submitted for C1 (see LIC811). The Department determined this to be an immediate risk to health and safety at this time, therefore California Code of Regulations are being cited on 809D, Health and Safety Code HSC 1180.55(a)(1). S2 debriefed with C1 on this incident report; C1 did not receive notification of their personal rights the following day after the incident. LPA reviewed with Assistant Manager and Interim Administrator documentation requirements for restraint reports. LPA conducted an exit interview and a copy of this report and appeal rights were left with Assistant Manager, Jordan Lett.

met_with: Jordan Lett and Daeja Randles


summary: Facility Evaluation

raw_content:
Narrative:
On March 24, 2026 an unannounced annual inspection was conducted by Licensing Program Analyst (LPA), Miriam Flores at Fresno Youth - Weldon House STRTP. LPA met with Facility Manager, Jordan Lett. At 8:20AM, LPA arrived at the facility and met with facility staff. LPA informed staff the purpose of this visit to conduct an annual inspection of the facility and record reviews. The facility has capacity for six male clients, ages 12-17 years of age. Currently the facility has three youth in placement. The home has three bedrooms and one bathroom accessible to clients. There is a kitchen, a game room, and a living room. All smoke detectors were tested and were in working order. The following was observed during the facility inspection: At 8:20AM, LPA completed three file reviews for youth in placement. At 10:15AM, LPA completed an interview with youth in placement. At 10:30PM, The inspection began in the kitchen area of the home. Sharps and toxic chemicals are kept locked next to the kitchen. LPA Flores observed that the thermostat is maintained at 71 degrees Fahrenheit. The kitchen, game room, and living room were clean and well lit. Postings were easily accessible to clients in the living room area. Perishable and nonperishable foods were observed. Food menus were posted in the refrigerator. Facility Manager reported that the food menus are posted monthly. LPA measured the water temperature from bathroom faucet and measured at 115.4 degrees Fahrenheit. Continues from page There is a door in the kitchen area which gives youth access to the backyard. LPA observed cameras in shared living areas (kitchen, living room, game room, hallway). There are cameras in the front entrance, backyard, and side of the house. There are no cameras in client's bedrooms. Fire extinguisher was last services on 3/5/2026. At 11:10AM, LPA conducted file reviews. Personnel files are kept off-site in their main office. At 12:30PM, the facility vehicle was inspected. Their vehicle is in working condition. At 12:50PM, LPA completed staff interviews. Youth in placement were present at the facility. Mental Health Program Approval expires on 2/24/27. On 1/14/26, the facility had their annual fire clearance inspection completed. CARF certification is pending approval; CARF survey was held on 2/25/2026. There were no deficiencies to be cited on this date. At 1:50PM, an exit interview was conducted with the facility manager and a copy of this report was left at this facility.

visit_type: Annual


facility_name: FUTURE STARS YOUTH SERVICES

summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
threatened C1. Specifically, it was reported that S1 threatened to hit C1 and also called C1 "bitch". While two witnesses maintain this is true, S1 denies calling C1 "bitch" and also denies threatening C1. Confidential interviews revealed a verbal altercation occurred between S1 and C1 at the facility. A couple of witnesses report hearing S1 call C1 a "bitch" and also verbally threaten C1, saying something along the lines of, "You must not know who you're talking to. I'm about to slap those glasses off your face!" and "Shut the fuck up before I choke you!" to C1 during verbal altercation between S1 and C1. A witness maintains this was said by S1 as S1 was about 1-2 inches from C1's face. Another party states though they did not visually witness this occur, they heard S1's comments and remarks which corroborate what was reported. A couple of witness observed C1 being emotionally distraught due to the verbal altercation involving S1 and what was allegedly said by S1. S1 denies getting loud or yelling at C1. Several other statements corroborate this did occur. S1 was unable to articulate what trauma informed care/service was provided to C1 during this incident, S1 simply denied both allegations. Based on interviews conducted and information obtained, the allegations that S1 spoke inappropriately to C1 and S1 threatened C1 are SUBSTANTIATED because the preponderance of evidence standard has been met for the allegations. This poses a potential health, safety, or personal rights risk to clients in care. The facility is being cited under Interim Licensing Standards section Personal Rights. An exit interview was conducted and a copy of this report, LIC 811, and appeal rights, were provided to Facility Manager, Iyonna Matthews, for signature.

Investigation Findings:
13On January 19, 2021 at 3: PM, Licensing Program Analyst (LPA) Carmen Escobar conducted an unannounced inspection at the Short Term Residential Therapeutic Program (STRTP) in order to issue the investigative findings for the above allegations. During the investigation, LPA requested documents from client 1 (C1's) file including placement agreement, copy of most recent needs and service plan, and special incident reports involving the allegation reported. LPA also obtained a copy of STRTP client roster and staff roster. LPA Escobar conducted interviews with staff 1 (S1), staff 2 (S2), C1, client 2 (C2), client 3 (C3), San Bernardino County Investigator, and another involved party. LPA Escobar completed the initial ten-day inspection at the facility to initiate the complaint on 09/29/21 at 11: AM. No safety concerns were observed. It was alleged that on or around 09/23/21, S1 spoke inappropriately to C1 and S SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Carmen Escobar LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 01/19/2022

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

report_type: Complaint Investigation

met_with: Facility Manager, Iyonna Matthews

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
allegations with a preponderance of evidence. IB investigator and LPA Mena obtained conflicting information during interviews. Confidential interviews denied allegations that staff do not intervene in physical altercations, and that they did not safeguard Child # 1's (C1) belongings. According to confidential interviews, staff always intervenes and tries to prevent any arguments or physical altercation between minors in care. Confidential interviews also denied having any knowledge of C2 allegedly inappropriately touching C1 while in care. According to confidential information, although there was an incident of inappropriate communication and use of Facility's Ipad device, interviews denied that any inappropriate touching had occurred between C1 and C2 during this incident. While other confidential information received by Licensing Office stated that these allegations had occurred, and that C2 also had a habit of taking snacks and other belongings from other clients in care. There were no other known witnesses to these allegations. Based on confidential information obtained during the course of this investigation, the allegations that Facility Staff do not intervene in physical altercations between minors in care, do not safeguard minor's personal items, and that Child # 2 (C2) had inappropriately touched Child #1 (C1) while in care, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Mental Health Specialist, Ronnie Lusk to discuss the investigative findings for the above stated allegations. LPA Daniel Mena conducted an inspection to the facility on June 24, 2022 at 12:45pm, and on December 08, 2022 at 12:10pm. No immediate hazards observed. Special Investigator (SI), Charlotte Jackson and LPA Mena interviewed Four Staff (S1, S2, S3 & S4), Four of Five clients (C1, C3, C4 & C5), as well as reviewed client and facility records. LPA Mena was unable to interview Child # 2 (C2), due to C2's parent/legal guardian not being responsive to LPA Mena's attempts to interview them regarding allegations. Community Care Licensing received information on June 21, 2022, alleging that Facility Staff do not intervene in physical altercations between minors in care, do not safeguard minor's personal items, and that Child # 2 (C2) had inappropriately touched Child #1 (C1) while in care. Information obtained in confidential interviews did not corroborate the UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 01/18/2023

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

met_with: Ronnie Lusk

complaint_status: unsubstantiated


raw_content:
Narrative:
S1 or C4's Instagram account as the screen shots show the name on screen as Instagram user. CCL reviewed additional screenshots of text messages that had been obtained which show messages sent to a phone number that was saved under S1's name. These messages appear to be between S1 and another staff but could not be confirmed as to which staff. Confidential interviews and record review could not confirm or dispute S1 had inappropriate text messages with C4. Based on LPA observation of screenshots obtained by CCL, record review and confidential interviews the allegation of facility staff member (Staff #1 [S1]) had inappropriate text messages with group home minor (Child #4 [C4]), may or may not have occurred, however it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights to Future Stars Facility Manager, Iyonna Matthews

Investigation Findings:
13On March 20, 2023 at 1:23pm Licensing Program Analyst (LPA), Nicole Strickland, met with Future Stars Facility Manager-Iyonna Matthews, to deliver the finding for the above stated allegation. LPA conducted an inspection of the facility on April 4, 2022 at approximately 3:20 pm and no immediate deficiencies were observed. The investigation included interviews with three staff (Staff #1 [S1], Staff #3 [S3] and Staff #4 [S4]), three foster youth (Child #1 [C1], Child #2 [C2], Child #4 [C4]), and two County Social Workers (CSW#3, and CSW#4). One confidential witness did not respond to LPA's request for an interview and therefore was not interviewed. In addition, county records and facility records were reviewed. On March 25, 2022, Community Care Licensing (CCL) received an allegation alleging facility staff member (Staff #1 [S1]) had inappropriate text messages with group home minor (Child #4 [C4]). Specifically it was reported over 30 inappropriate text messages between S1 and C4 were obtained. CCL obtained and reviewed the copies of text messages and Instagram messages allegedly sent between S1 and C4. Confidential interviews and review of the Instagram messages provided to CCL could not confirm or dispute they were from UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 03/20/2023

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

met_with: Facility Manager-Iyonna Matthews


raw_content:
Narrative:
record review could not confirm or dispute this allegation. CCL received three allegations alleging staff (Staff #2 [S2]) caused injuries to a client (Child #1 [C1]) while in care, staff (S2) slapped a client (C1) while in care, and staff (S2) spits at a client (C1) while in care. Specifically it was reported C1 had bruises caused by S2. Confidential interviews provided conflicting statements as to S2, causing injuries, slapping and spitting at C1. At least one confidential witness provided statements confirming these allegations but was unable to provide any specific information as to when, where, or other details of the alleged incident or incidents, or when C1 was observed to have bruising caused by S2. Record review revealed a confidential interview acknowledged hearing of staff (unknown who) hitting C1 but not witnessing the incident. Additional confidential interviews deny these allegations reported feeling safe and not being harmed while in care. CCL also received an allegation alleging staff (Staff #2 [S2]) isolated a client (Child #1 [C1]) while in care. Confidential interviews provided conflicting statements regarding C1 being isolated. Confidential interviews stated C1 would often be sent to C1's room so staff would not have to deal with C1. Additional confidential interviews stated that C1 would only be sent to C1's room as a time-out to help redirect C1 when C1 was having behavior issues. Confidential interviews and record review could not confirm or dispute C1 being isolated. An additional allegation alleging staff (Staff #2 [S2]) financially abuses a client (Child #1 [C1]) while in care was received by CCL. Specifically it was reported that S2 takes money from C1's account. Confidential interviews reported that C1 is unaware of how much money is in C1's account and therefore does not realize when S2 uses money from C1's account for personal purposes. Additional confidential interviews reported that C1 needs assistance with managing C1's money and therefore S2 helps when C1 is purchasing items using C1's money. Record review revealed C1 was provided with both weekly and clothing allowances which were documented. Confidential interviews and record review could not confirm or dispute that the money used from C1's account was not also used by S2 for personal purposes. CCL received an allegation alleging staff (unnamed) do not properly supervise minors while in care. Confidential interviews and record review provided conflicting reports of supervision in the facility. Confidential interviews were not able to provide specific details or a date of any instance where there was a lack of ****** supervision by staff however reported that residents come and go from the facility without being reported as AWOL. Additional confidential interviews reported residents are supervised and any absence from the facility is reported to all appropriate and required parties. Confidential interviews reported that staff check on residents throughout the day at various times. Additional confidential interviews reported staff seldomly check on the residents. Confidential interviews could not confirm or dispute this allegation. Based on record review and confidential interviews the allegations alleging Staff (Staff #2 [S2]) inappropriately touched a client (unknown which client) while in care, staff (S2) caused injuries to a client (Child #1 [C1]) while in care, staff (S2) slapped a client (C1) while in care, and staff (S2) spits at a client (C1) while in care, staff (S2) isolated a client (C1) while in care, staff (S2) financially abuses a client (C1) while in care, and Staff (unnamed) do not properly supervise minors while in care, may or may not have occurred, however they are not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of the report was provided along with appeal rights to Future Stars Facility Manager-Iyonna Matthews.

Investigation Findings:
13On March 20, 2023 at 1:50pm Licensing Program Analyst (LPA), Nicole Strickland, met with Future Stars, Facility Manager-Iyonna Matthews, to deliver the findings for the above stated allegations. LPA conducted an inspection of the facility on April 4, 2022 at approximately 3:20 pm and no immediate deficiencies were observed. The investigation included interviews with three staff (Staff #1 [S1], Staff #3 [S3] and Staff #4 [S4]), three foster youth (Child #1 [C1], Child #2 [C2], Child #4 [C4]), and two County Social Workers (CSW#3, and CSW#4). One confidential witness did not respond to LPA's request for an interview and therefore was not interviewed. In addition, county records and facility records were reviewed. On March 25, 2022, Community Care Licensing (CCL) received an allegation alleging Staff (Staff #2 [S2]) inappropriately touched a client (unknown which client) while in care. CCL did not receive any specific details regarding this allegation. Record review noted at least one confidential witness observed S2 hitting Child #1 (C1) on the butt. It is unknown if this was the inappropriate touch of concern. Additional confidential interviews denied any inappropriate touch occurring at the facility and reported feeling safe. Confidential interviews and UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Nicole Strickland LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 03/20/2023

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


raw_content:
Narrative:
Regarding the allegation that staff yells at minors, at least one confidential witness provided statements that the allegation was true. Other interviews provided information that confirmed the allegation was true but was unable to provide any specific information as to when, where, or other details of the alleged incident or incidents. Other confidential interviews and evidence gathered revealed that staff does not yell at minors in care but will use redirection when situations with clients escalate while other interviews did not witness or hear staff yelling at minors in care. Regarding the allegation that staff was rough with minors in care, one confidential witness provided statements confirming these allegations but was unable to provide any specific information as to when, where, or other details of the alleged incident or incidents. Other confidential interviews stated that they had not witnessed or heard of any minors being handled roughly in care. Regarding the allegation that youth are doing drugs and drinking at the facility, confidential interviews provided statements that minors may use substances when they are absent from care, but that alcohol and drugs are not used within the facility premises by minors in care. Other interviews provided information that confirmed the allegation was true but was unable to provide any specific information as to when, where, or other details of the alleged incident or incidents. Regarding the allegation that staff encourages minors to physically fight at least one confidential witness provided statements and evidence confirming these allegations. Other interviews provided information that confirmed the allegation was true but were unable to provide any specific information as to when, where, or other details of the alleged incident or incidents. While other interviews did not witness or hear staff encouraging minors in care to physically fight. Regarding the allegation to that staff call minor names, at least one confidential witness provided statements and evidence confirming these allegations. Other interviews provided information that confirmed the allegation was true but were unable to provide any specific information as to when, where, or other details of the alleged incident or incidents. Other confidential interview denied that staff calls minors in care names. Next page... Based on record review and confidential interviews the allegations alleging that staff yells at minors, staff was rough with minors in care, youth are doing drugs at the facility, youth are drinking alcohol at the facility, staff encourages minors to physically fight, and staff call minor names, may or may not have occurred. However, it is not supported or proven by the evidence. Confidential interviews could not confirm or dispute these allegations; Therefore, the allegations are unsubstantiated at this time. Exit interview was conducted, appeal rights were discussed and provided. A copy of the report was given to Future Stars Facility Manager, Iyonna Matthews.

Investigation Findings:
13On March 21, 2023 at 12:25 pm Licensing Program Manager (LPM), Natasha Dunlap, and Licensing Program Analyst (LPA), Emina Preciado, met with Future Stars Short Term Residential Therapeutic Program (STRTP), Facility Manager, Iyoanna Matthews to deliver the findings for the above stated allegations. LPA's Carmen Escobar and Erika Lopez conducted an inspection of the facility on April 7, 2022 at approximately 2:50 pm and no immediate deficiencies were observed. The investigation included interviews with three staff (S1, S2, and S3) and two out of four foster youth (C1, C2, C3, C4). LPA was unable to obtain statements from C3 and C4 due to whereabouts are unknown at this time. Two confidential witnesses and county social workers did not respond to LPA's request for an interview and therefore were not interviewed. In addition, county records and facility records were reviewed. On March 28, 2022, Community Care Licensing (CCL) received six allegations alleging that staff yells at minors, staff was rough with minors in care, youth are doing drugs at the facility, youth are drinking alcohol at the facility, staff encourages minors to physically fight, and staff call minor names. Next page... UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Emina Preciado LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 03/21/2023

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

met_with: Iyonna Matthews, Facility Manager


raw_content:
Narrative:
Confidential interviews also reported that hospital staff called the facility the evening C1 was released and informed staff (S3) that C1 should have been picked up at 3: PM from the hospital. Additionally, a confidential witness interview reported that C1 was driven to the facility by hospital staff at 10: PM and dropped off at the facility. Confidential documents obtained as part of the investigation show that C1 was discharged and transported back to the facility by the hospital. Per review of the facility Program Statement/Plan of Operation regarding transportation arrangements, it states the following: "Future Stars Youth Services Inc stipulates that the staff on duty and that is on call are mainly responsible for children and non-minor dependents transportation when needed." Additionally, a confidential interview reported that the facility vehicle was on site the night C1 was returned to the facility by hospital staff and confirmed that C1 was not picked up by facility staff. The preponderance of evidence standard has been met based on confidential interviews and document reviews. Staff did not provide transportation to a minor (C1), resulting in the minor (C1) being left at the hospital. Therefore, the allegation is substantiated. The Department has determined that the licensee did not follow their program statement, specifically the terms regarding the transportation arrangements for clients in care. The facility is cited for violation of California Code of Regulations Title 22, Division Plan of Operation, 80022(a)(b)(10)(k). (a) Each licensee shall have and maintain on file a current, written, definitive plan of operation. (b) The plan and related materials shall contain the following (10) Transportation arrangements for clients who do not have independent arrangements (k) The facility shall operate in accordance with the terms specified in the Plan of Operation and may be cited for not doing so. The facility did not ensure C1 was provided transportation when C1 was discharged from the hospital. An exit interview was conducted. A copy of this report, LIC 811, and appeal rights were given and explained to Iyonna Matthews. and C2 trying to hit S1 with a stick when they (C1 and C2) returned. Confidential interviews reported that clients are allowed to have cell phones unless the use of a cell phone is prohibited by the County Social Worker ( CSW) or court order. Confidential interviews reported at the time of the incident; C2 did not have cell phone privileges. Confidential interviews reported that S1 took a cell phone away from C2. C2 then hit S1 in the head and placed their arm around S1's neck. Confidential interviews reported that C1 and C2 hit S1 and threw multiple items at S1, striking S1 in the left arm. A confidential interview reported that C1 hit S1 after S1 hit C1 on the hand. Confidential interviews reported that staff (S1 and S2) did not hit C1 or C2. A confidential interview reported that S2 tried to de-escalate the situation. LPA received conflicting information regarding the use of restraints. A confidential interview disclosed that restraints are used at the facility as a last resort, and any use of restraints is documented on a Special Incident Report. A review of the incident report and another confidential interview did not mention the use of restraints on C1 or C2. It was unclear whether the staff (S1 and S2) used or did not use restraint, and rather the incident report that the Department received was missing some information regarding restraint. Community Care Licensing also received an allegation that staff speaks inappropriately to minors in care. It was alleged that S1 threatened C1 during the incident on 02/09/2023. Confidential interviews reported hearing loud voices and staff yelling, but the interviews did not reveal what was said. A confidential interview reported that S1 threatened to hurt C1 physically. A confidential interview also noted that S1 could not speak because C2 had their arm around S1's neck. Confidential interviews also reported that S1 and S2 did not threaten, curse, or say anything inappropriate to C1 and C2. Based on inconsistent confidential interviews and document review, the allegations that staff engaged in a physical altercation with minors in care and staff speaks inappropriately to minors in care may have occurred. However, the allegations are not supported or proven by the evidence. Therefore, the allegations are unsubstantiated. An exit interview was conducted. A copy of this report, LIC 811, and appeal rights were given and explained to Iyonna Matthews Facility Manager

Investigation Findings:
13On March 27, 2023, at 09: AM, Licensing Program Analyst (LPA) Jessica Peete conducted an unannounced visit to Future Stars Youth Services Short Term Residential Therapeutic Program (STRTP) to deliver the investigative findings for the allegation listed above. On 02/21/2023, LPA Peete LPA inspected the physical plant, and no immediate safety hazards were observed. During the investigation, LPA obtained documents pertinent to the investigation. LPA conducted interviews with clients (C1, C2, C3, C4, C5, and C6) and Staff (S1, S2, S3, and S4), and confidential witnesses (CWs) On 02/16/2023, Community Care Licensing received an allegation that staff did not provide transportation to the minor(C1), resulting in the minor (C1) being left at the hospital. Confidential interviews reported that staff was at the facility when the hospital dropped off C1. A confidential witness interview reported that the hospital discharge plan involves the hospital contacting the facility before the client's release and giving the facility a two-hour window to pick up the client. A Confidential interview reported that staff at the facility spoke with hospital staff at 9: PM the day C1 was released. A confidential witness interview reported that the County Social Worker (CSW) contacted the facility at 2: PM to inform the facility that C1 could be picked up at 3: PM. LPA was unable to confirm with the CSW due to CSW being unavailable. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Jessica M Peete LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 03/28/2023

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: Iyonna Matthews


raw_content:
Narrative:
Regarding the allegation that staff inappropriately touched a minor, all interviewed parties denied any inappropriate touching and have not seen staff touch any client inappropriately. Other confidential information received reported that the allegation was true. LPA received inconsistent information regarding the allegation. Regarding the allegation that staff encouraged other minors to fight a minor while in care, one confidential witness provided statements confirming this allegation but was unable to provide any specific information as to when, where, or other details of the alleged incident or incidents. Other confidential interviews stated that they had not witnessed or heard of staff encouraging other clients to fight a minor while in care. Regarding the allegation that staff caused injuries to a minor while in care, two confidential witnesses provided statements confirming this allegation but was unable to give the exact date and time of when the incident occurred. Other confidential interviews with staff and other clients stated that they have not seen or witnessed injuries to minor in care. Regarding the allegation that staff demonstrated inappropriate forms of discipline, all interviewed parties confirmed that staff does not use inappropriate forms of discipline. During a file review and based on confidential interviews, client has a history of client and destructive behaviors and often goes to their room to regulate. Staff assist uses appropriate de-escalation techniques. Regarding the allegation to that staff made inappropriate comments towards a minor, three confidential witnesses provided statements and evidence confirming these allegations but were unable to provide any specific information as to when, where, or other details of the alleged incident or incidents. Other confidential interviews denied that staff makes inappropriate comments towards a minor. Regarding the allegation to that staff spit on a minor, all interviewed parties confirmed that they have not seen or heard staff spit on a minor. Other confidential information received reported that the allegation was true. LPA received inconsistent information regarding the allegation. (Next Page..) Regarding the allegation that staff mishandled a minor's personal funds, all interviewed parties stated that they have not seen or heard a staff mishandle a minor's personal funds. During a record review of the allowance logs, all clients receive weekly allowances and are signed with both staff and client signatures upon receiving or removal of funds. Regarding the allegation that staff mishandled a minor while in care, two confidential witness provided statements confirming this allegation but was unable to give the exact date and time of when the incident occurred. Other confidential interviews with staff and other clients stated that they have not seen staff mishandle a minor while in care. Regarding the allegation that staff are denying minors access to food, all interviewed parties stated that staff did not deny minors access to food. After a review of documents and interviews, staff had to lock up snacks due to a client throwing food at the facility but never denied snacks to clients in care. On April 4th, 2023, LPA Ng did a walkthrough of the facility and observed sufficient snacks and food. Regarding the allegation that facility does not have comfortable accommodations, all interviewed parties stated that facility would remove small picture frames and the TV remote due to client's property destruction. All interviewed clients stated that the facility had comfortable accommodations. On April 4th, 2023, LPA Ng did a walkthrough of the facility and facility to have comfortable accommodations. Regarding the allegation that staff choked a minor while in care, one confidential witness provided statements confirming this allegation but was unable to give the exact date and time of when the incident occurred. Other confidential interviews with staff and other clients stated that they have not seen staff choke a minor while in care. Regarding the allegation that staff threatened a minor while in care, two confidential witness provided statements confirming this allegation but was unable to give the exact date and time of when the incident occurred. Other confidential interviews with staff and other clients stated that they have not seen staff threaten a minor while in care. (Next page..) Although, the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that staff inappropriately touched a minor, staff encouraged other minors to fight a minor while in care, staff caused injuries to a minor while in care, staff demonstrated inappropriate forms of discipline, staff made inappropriate comments towards a minor, staff spit on a minor, staff mishandle a minor's personal funds, staff mishandled a minor while in care, staff are denying minors access to food, facility does not have comfortable accommodations, staff choked a minor while in care, and staff threatened a minor while in care. Confidential interviews could not confirm or dispute these allegations; Therefore, the above allegations are unsubstantiated at this time. Exit interview was conducted, appeal rights were discussed and provided. A copy of the report was given to Future Stars Facility Manager, Iyonna Matthews.

Investigation Findings:
13On 4/6/2023 at 1: PM, Licensing Program Analyst (LPA), Alyssa Ng, met with Future Stars Short Term Residential Therapeutic Program (STRTP), Facility Manager, Iyonna Matthews to deliver the findings for the above stated allegations. LPA's Carmen Escobar and Erika Lopez conducted an inspection of the facility on May 18th, 2022, at approximately 10:15 am and no immediate deficiencies were observed. The investigation included interviews with three staff (FM, S1, and S2) and three out of five foster youth (C1, C2, C3, C4, and C5). On April 3rd, 2023, LPA Alyssa Ng interviewed four out of six current foster youth placed (C6, C7, C8, and C9). LPA was unable to obtain statements from C1 and C5 due to whereabouts are unknown currently. County social workers did not respond to LPA's request for an interview and therefore were not interviewed. In addition, county records and facility records were reviewed. On May 16 2022, Community Care Licensing (CCL) received twelve allegations alleging that staff inappropriately touched a minor, staff encouraged other minors to fight a minor while in care, staff caused injuries to a minor while in care, staff demonstrated inappropriate forms of discipline, staff made inappropriate comments towards a minor, staff spit on a minor, staff mishandled a minor's personal funds, staff mishandled a minor while in care, Staff are denying minors access to food, Facility does not have comfortable accommodations, Staff choked a minor while in care, and staff threatened a minor while in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Christina Barnes LICENSING EVALUATOR NAME: Alyssa Ng LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 04/06/2023

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

met_with: Facility Manager - Iyonna Matthews


raw_content:
Narrative:
During investigation confidential interviews stated that C1 instigate fights with other clients in care that result in verbal altercations and staff intervention. Confidential interviews further stated that there have been multiple verbal and physical altercations involving C1 where C1 is identified as the person who starts fights with peers. Confidential interviews also stated that staff intervene and redirect all clients specifically C1 due to ongoing behaviors. Another confidential interview supported the statements that C1 initiates fights with other clients and added that C1 has been physically aggressive towards staff, and social workers as well. Confidential interview added that CSW is aware of C1's behaviors but CSW does not know when C1's statements about C1's current placement are true or not true due to C1's history. Another confidential interview stated that C2 hit C1 multiple times in the head with a closed fist and when C1 asked for help staff did not stop C2 from hitting C1. C2 could not be reached for comment regarding the allegations. Other confidential interviews maintained that staff intervene and stop fights among clients in care and there were no concerns reported. LPA received inconsistent information regarding the allegations. Based on confidential interviews, and record review the allegation that minors engaged in a physical altercation with C1 in care, and that staff did not intervene in a physical altercation between C1 and other clients in care, may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report along with the appeal rights will be emailed to Head of Service, Tabitha Lopez.

Investigation Findings:
13On April 26, 2023, at 11: AM, Licensing Program Analyst (LPA) Cynthia Urena conducted an unannounced visit at Future Stars Short Term Residential Therapeutic Program (STRTP) to deliver the finding of the above stated allegations. LPA was met by Head of Service, Tabitha Lopez . LPA Carmen Escobar conducted an inspection of the facility on October 27, 2022, at 4: PM and no immediate deficiencies were observed. Additionally, LPA Escobar collected pertinent documents from the STRTP's program staff and client files. LPA Escobar interviewed a staff member (S1). Additionally, LPA Urena interviewed a Facility Manager, one staff member (S2), three clients (C1, C3, C4), and a County Social Worker (CSW). Client #2 (C2) could not be reached for an interview due to an absence without leave (AWOL) status and unknown whereabouts. On October 21, 2022, Community Care Licensing (CCL) received a complaint alleging that minors engaged in a physical altercation with another minor in care, and that staff do not intervene in physical altercations between minors in care. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Cynthia Urena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 04/26/2023

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

met_with: Head of Service, Tabitha Lopez


raw_content:
Narrative:
The interviews that were provided to the LPA were not consistent regarding the allegations that staff scratched, choked, and pushed C1. Furthermore, confidential interviews did not provide any additional specific details regarding staff supervision. Based on interviews and record reviews the allegations that staff #1 (S1) scratched C1 and S1 and staff #2 (C2) choked and pushed C1, may have occurred, however is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Tanicki Wallace.

Investigation Findings:
13On May 3, 2023 at 9:00am, Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an unannounced inspection to the facility to deliver the findings of the above allegations. LPA met with Tanicki Wallace. LPA Carmen Escobar conducted an inspection of the facility on May 04, 2022, at 01:00 pm and no immediate deficiencies were observed. Three clients (C1, C2, C3), three staff and facility administrator were interviewed. It was reported to Community Care Licensing (CCL) that facility staff #1 (S1) scratched C1 it was also reported that S1 and staff #2 (S2) choked and pushed C1. Confidential staff interviews reported that since C1's was placed at the facility, C1 has very disruptive behaviors towards staff. Confidential staff interviews reported that C1 has been involved in numerous incidents' destroying property and attacking staff. Confidential staff interviews reported that staff has contacted law enforcement for assistance. Confidential staff interviews that when C1 attempted to kick S2, S2 blocked C1's kicks. Staff deny any choking, scratching, or kicking C1. Other information obtained from confidential interviews reported that the allegations were true. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Darlene Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 05/03/2023

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

met_with: Tanicki Wallace


raw_content:
Narrative:
Based on interviews and record reviews the allegations that staff #1 (S1) verbally threatened C1 and S1 pulled C1 by the sweater, may have occurred, however is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Tanicki Wallace.

Investigation Findings:
13On May 3, 2023, at 9:41 am, Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an unannounced inspection to the facility to deliver the findings of the above allegations. LPA met with . LPA Carmen Escobar conducted an inspection of the facility on May 04, 2022, at 01:00 pm and no immediate deficiencies were observed. Three clients (C1, C2, C3), three staff and facility administrator were interviewed. It was reported to Community Care Licensing (CCL) that staff #1 (S1) verbally threatened C1 and S1 pulled C1 by the sweater. Confidential staff interviews reported that since C1's was placed at the facility, C1 has very disruptive behaviors towards staff. Confidential staff interviews reported that C1 has been involved in numerous incidents' destroying property and attacking staff. Confidential staff interviews reported that staff has contacted law enforcement for assistance. Confidential staff interviews reported that staff did not verbally abuse C1 by threatening C1 nor did S1 pull on C1 sweater. There were no other witnesses to these alleged incidents. Other information obtained from confidential interviews reported that the allegations were true. The interviews that were provided to the LPA were not consistent regarding the allegations that staff is violating C1's personal rights and did not provide any further specific details regarding the allegations listed above. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Darlene Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 05/03/2023

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


raw_content:
Narrative:
A Confidential interview reported that client room checks are completed four to five times an hour. Confidential interviews reported that C1 and C2 would leave without permission from the facility and refused safety checks upon their return. Confidential interviews indicated that facility staff is present when C1 and C2 leave without permission. LPA received conflicting information regarding the staff's response to C1 and C2's absence from the facility without permission. A confidential interview reported that staff does not follow C1 and C2 when they leave the facility or intervene to encourage clients to return to the facility. Other confidential interviews reported that when C1 and C2 leave without permission from the facility, they are shadowed by facility staff. Confidential interviews denied staff not intervening in physical altercations between clients. Confidential interviews reported that C1 and C2 assaulted C3. Confidential interviews reported that staff was present and intervened quickly to separate the clients. As a result of the altercation, a safety plan was put in place; that included increased supervision and C3 not being in the presence of C1 and C2 without staff present. According to other confidential interviews, staff always intervene and prevent arguments or physical altercations between clients. In addition, staff would make several attempts to redirect client behavior and counsel C1 and C Based on inconsistent confidential interviews and document review, the allegation that staff do not provide adequate supervision to minors (C1 and C2) in care. may have occurred. However, the allegation is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated. An exit interview was conducted. A copy of this report, LIC 811, and appeal rights were given and explained Head of Services, Tabitha Lopez.

Investigation Findings:
13On June 9, 2023, at 10: PM, Licensing Program Analyst (LPA) Jessica Peete conducted an unannounced visit to Future Stars Short-Term Residential Therapeutic Program ( STRTP) to deliver the investigative findings for the allegation listed above. On 03/07/2023, LPA Peete inspected the physical plant, and no immediate safety hazards were observed. During the investigation, LPA obtained documents pertinent to the investigation. LPA conducted interviews with clients (C1, C2, C4, C5, C6, and C7) and Staff (S1, S2, and S3). LPA was unable to interview C3, due to C3's refusal to be interviewed. On 03/06/2023, Community Care Licensing received an allegation that staff do not provide adequate supervision to minors (C1 and C2) in care. It was alleged that C1 and C2 were absent without permission from the facility, engaging in substance use, and assaulted C3. Confidential interviews reported that facility staff are always present at the facility, and the clients are not left without supervision. Confidential interviews reported that two staff are assigned to work the morning shift, two staff work the day shift, and one staff works the night shift. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Jessica M Peete LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 06/09/2023

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

met_with: Head of Services, Tabitha Lopez


raw_content:
Narrative:
C1 then verbally threatened S2 and struck S2's left arm. The incident report states S2 covered their (S2's) upper body and told C1 to stop. A Confidential witness reported hearing loud voices; the confidential witness reported hearing S2 say "don't touch me" and saw C1 attack S2. The confidential witness also reported seeing S2 pull C1's hair but did not see S2 hit C1. Another confidential interview reported C1 hit S2 in the face and head, S2 tried to block the hit with their hand, and pulled C1's hair. A confidential interview reported that S2 used one hand to pin C1 to the wall. A confidential interview also reported S3 was able to intervene and separate C1 and S2. A confidential interview reported that C1 hit and pulled S2's hair. S2 used their (S2's) arms to block C1 and C1's hair may have been pulled while S2 was blocking C1. A confidential interview further reported that S2 did not hit C1 but placed their (S2's) hand on C1's shoulder to hold C1 to the wall for less than 10 seconds. Further confidential interviews reported that C1 has a history of assaulting staff and hitting S2. Additional confidential interviews reported not seeing staff hit C1 or other clients in care. Based on inconsistent confidential interviews and document review, the allegation that facility staff engaged in an altercation with minor (C1) while in care may have occurred. However, the allegation is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated. An exit interview was conducted. A copy of this report, LIC 811, and appeal rights were given and explained to Head of Service, Tabitha Lopez.

Investigation Findings:
13On June 9, 2023, at 11: AM, Licensing Program Analyst (LPA) Jessica Peete conducted an unannounced visit to Future Stars Short Term Residential Therapeutic Program ( STRTP) to deliver the investigative findings for the allegation listed above. On 03/28/2023, LPA Peete inspected the physical plant, and no immediate safety hazards were observed. During the investigation, LPA obtained documents pertinent to the investigation. LPA conducted interviews with clients ( C2, C3, C4, C5, C6, and C7) and Staff (S1, S2, S3, and S4.) LPA Peete attempted to interview Client 1(C1) but was unsuccessful due to C1's refusal to be interviewed. On 03/23/2023, Community Care Licensing received an allegation that Facility staff engaged in an altercation with minor (C1) while in care. The incident report provided to the Department reported that on 03/18/ C1,was involved in an aggressive act against staff ( S2) The incident report states that C1 was speaking with S3 and became upset when S2 entered into the conversation. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Jessica M Peete LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 06/09/2023

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

met_with: Head of Service Tabitha Lopez


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
standard has been met and the Department has determined the allegations that Staff # 1 (S1) was providing drugs and alcohol to minors in care is substantiated. The facility is issued a citation for the staff's actions, which posed an immediate health and safety or personal rights risk to the children placed in care. These actions are in violation of the California Health and Safety Code , Section 1550(c), Conduct Inimical. See attached LIC 9099D for cited deficiency. An exit interview was conducted, and a copy of the report and appeal rights were provided. stated that C1 had been home all day and had refused to do their laundry throughout the day when prompted by staff, but later decided that they wanted to wash their laundry when it was already past 8:00pm; which was said to be the time that the clients start getting ready for bed. According to confidential interviews, by the time that C1's clothing would have been washed and dried it would have been well past bedtime hours. According to confidential interviews, all clients are assigned at least two dates per week on which to do their laundry but can wash their clothing on any date, as long as the washer and drying machines are not in use. While other confidential information received by Licensing Office stated that these allegations had occurred. There were no other known witnesses to these allegations. Based on confidential information obtained during the course of this investigation, the allegations that Staff did not treat Foster Child # 1 (C1) fairly, as well ad did not allow C1 to do laundry, may have occurred, however is not supported or proven by evidence. Therefore, the above allegations are unsubstantiated at this time.

Investigation Findings:
13Licensing Program Analyst (LPA), Daniel Mena met with Facility Manager, Iyonna Matthews and Mental Health Specialist Ronnie Lusk to issue the finding for the above stated allegations. An investigation was conducted by Special Investigator (SI), Georgina Tallagua and LPAs Carmen Escobar and Daniel Mena regarding allegations. LPAs Escobar and Mena conducted investigations to the Short Term Residential Therapeutic Program (STRTP) on September 01, 2022, May 03, 2023 and on May 09, 2023. SI Tallagua and LPAs Escobar and Mena interviewed four of four clients (C1, C2, C3 & C4), Facility Manager (FM), four staff (S1, S2, S3 & S4), County Social Worker (CSW), as well as reviewed client and facility information. Community Care Licensing received information on September 01, 2022, alleging that Staff # 1 (S1) was providing drugs and alcohol to minors in care. Confidential interviews conducted by LPAs Escobar and Mena corroborated allegations with a preponderance of evidence. According to confidential interviews, Staff # 1 (S1) purchased marijuana from a dispensary for C2, C3 & C4 during a trip to the beach. Confidential interviews also stated that on another occasion, S1 purchased small bottles of alcohol at a liquor store for C2, C3 & C4 on a separate outing to a local park. Based on interviews and information gathered during the investigation, the preponderance of evidence SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 06/28/2023


raw_content:
Narrative:
Confidential interviews reported that C1 was transferred to a new facility without their medications. Confidential interviews further revealed that the medications were over nighted the next day to the new facility as there was no transportation available. However, document review reveals that the medications were not received at the new facility until 7/7/2022. Based on the confidential interview and document review, the allegation that facility did not provide C1 medication upon the transfer of new facility may have occurred. However, the allegation is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. A copy of this report and LIC 811 was reviewed and provided to Youth Counselor / Assistant Manager Lisa Brooks, along with the Appeal Rights.

Investigation Findings:
13On July 28, 2023, Licensing Program Analyst (LPA) Linda Haynes met with Future Stars Youth Services STRTP Youth Counsler / Assistant Manager Lisa Brooks to deliver the complaint investigative findings for the above-stated allegation. On 7/12/2022, LPA conducted a health and safety inspection at the STRTP, and no immediate health and safety hazards were observed. During the investigation, LPA obtained documents pertinent to the investigation. LPA Haynes interviewed the Case Manager (CM). LPA attempted to interview the Client 1 (C1) however C1 is unreachable for interview. LPA attempted to interview C1's County Social Worker (CSW), however was unable to contact CSW. On July 06, 2022, the Department received an allegation that facility did not provide minor medication upon the transfer of new facility. The allegations that facility did not provide minor with medication upon the transfer of new facility specifically refers to C1 being transferred to a new facility on 6/30/2022 without their medication. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Linda Haynes LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 07/28/2023

met_with: Lisa Brooks


raw_content:
Narrative:
Details from confidential interviews stated that C1 was experiencing negative side effects and had concerns regarding a medication. Confidential interviews stated that staff did not address the concerns with C1. Other confidential interviews denied staff did not address a concern with medication and that staff was unaware that C1 had concerns regarding the medication. Details from confidential interviews stated that while staff cannot force clients to take medications, staff will encourage clients to continue their medications. When clients refuse to take their medication they will sign a medication refusal form. When C1's behaviors became a danger to staff and other clients, staff contacted appropriate parties such as law enforcement and mental health services to ensure the safety of C1. Based on record review and confidential interviews the allegation mentioned, may or may not have occurred. However, it is not supported or proven by the evidence. Confidential interviews could not confirm or dispute these allegations; Therefore, the allegations are unsubstantiated at this time. Exit interview was conducted, appeal rights were discussed and provided. A copy of the report was given to Future Stars Youth Services Mental Health Specialist, Ronnie Lusk.

Investigation Findings:
13On August 4th, 2023 at 12:35 pm pm Licensing Program Analyst (LPA), Emina Preciado, met with Future Stars Youth Services Short Term Residential Therapeutic Program (STRTP) Mental Health Specialist, Ronnie Lusk, to deliver the findings for the above stated allegation. LPA Carmen Escobar conducted an inspection of the facility on August 11, 2022 at approximately 1 pm and no immediate deficiencies were observed. The investigation included interviews with one Facility Manager (FM), one Mental Health Specialist, and five out of five foster youth (C1, C2, C3, C4, and C5). Four out of five county social workers did not respond to LPA's request for an interview and therefore were not interviewed. In addition, county records and facility records were reviewed. On August 8th, 2022, Community Care Licensing (CCL) received one allegation alleging that staff did not ensure child's anxiety regarding medication was addressed. Regarding the allegation mentioned above, confidential interviews alleged that staff did not address a concern with a medication for C1. *Continued on LIC 9099-C* UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Emina Preciado LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 08/04/2023

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

met_with: Ronnie Lusk, Mental Health Specialist


raw_content:
Narrative:
information from confidential interviews alleged that staff did not prevent C1 from engaging in self-harming behaviors which resulted in C1 breaking a facility window with a brick and being put on a 51/50 hold. Details from confidential interviews allege that C1 sustained an injury from the broken window. Details from other confidential interviews alleged that C1 used a rock to break the window. Confidential witnesses could not confirm if C1 intended to self-harm themselves on purpose and there were no additional witnesses. Regarding the allegation that minor brought drug paraphernalia onto the facility grounds, information from confidential interviews alleged that upon a return from an unauthorized absence, C1 brought drug paraphernalia into the facility. There were no witnesses to confirm that C1 brought drug paraphernalia into the facility. Details from confidential interviews detail that staff has procedures in place to ensure that clients do not bring drug paraphernalia into the facility. Staff will communicate expectations with clients, and clients are aware that drugs are not allowed on facility grounds. Regarding the allegation that staff did not report an incident involving a minor, information from confidential interviews alleged that staff did not report an incident involving a minor at the facility who was absent from care. Confidential interviews detailed that C1 was at the facility for less than a month but was known to be chronically absent without permission or be out on 51/50 holds. Confidential interviews detailed that staff would contact law enforcement when a client is absent from care. Details from confidential interviews stated that staff will report incidents involving minors by documenting on incident reports or making law enforcement contacts. Records reviewed showed that incident reports involving minors were submitted. Based on record review and confidential interviews the allegations that staff did not prevent a minor from engaging in self-harming behavior, minor brought drug paraphernalia onto the facility's grounds, and staff did not report an incident involving a minor, may or may not have occurred. However, it is not supported or proven by evidence. LPA received inconsistent information and varying details regarding the above allegations. Confidential interviews could not confirm or dispute these allegations; Therefore, the allegations are unsubstantiated at this time. Exit interview was conducted, appeal rights were discussed and provided. A copy of the report was given to Future Stars Facility Manager, Iyonna Matthews.

Investigation Findings:
13On August 18, 2023 at 1:50 pm, Licensing Program Analyst (LPA), Emina Preciado, met with Future Stars Facility Manager, Iyonna Matthews, to deliver the findings for the above stated allegations. LPA Carmen Escobar conducted an inspection of the facility on September 1, 2022 at approximately 3:55 pm and no immediate deficiencies were observed. The investigation included interviews with three staff (S1, S2, and S3) and four out of four foster youth (C1, C2, C3, C4). In addition, county records and facility records were reviewed. On August 23, 2022, Community Care Licensing (CCL) received three allegations alleging that staff did not prevent a minor from engaging in self-harming behavior, minor brought drug paraphernalia onto the facility's grounds, and staff did not report an incident involving a minor. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Emina Preciado LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 08/18/2023

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


raw_content:
Narrative:
There was lack of witnesses and information received to support the allegation that C1 was inappropriately restrained. The interviews that were provided to the LPA were not consistent regarding the allegation of a personal rights violation. Based on interviews and record reviews the allegation that staff (unknown name) inappropriately restrains C1, may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Ronnie Lusk.

Investigation Findings:
13On January 17, 2024, at 9:15 am, Licensing Program Analyst (LPA) Darlene Almaraz-Oseguera conducted an unannounced inspection to the facility to deliver the findings of the above allegation. LPA met with Ronnie Lusk. LPA conducted an inspection of the facility on February 15, 2023, at 8:20 am and no immediate deficiencies were observed. Four of the four children (C1, C2, C3, C4), four staff and facility administrator were interviewed. It was reported to Community Care Licensing (CCL) that staff (unidentified) inappropriately restrains C1. Confidential staff interviews reported that C1 was not inappropriately restrained by any staff. Confidential staff interviews reported that when C1 leaves the facility absent without leave (awol), staff will verbally give C1 directives but C1 refuses to follow verbal directives of staff. Confidential staff interviews reported that no staff has ever placed C1 in a hold to prevent C1 from leaving the facility without permission. Confidential staff interviews reported that when C1 leaves the facility without permission staff will just follow all protocols of a client awol. Other confidential information received stated that the allegation was true. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Darlene Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 01/17/2024

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


raw_content:
Narrative:
altercation. According to confidential information, a video taken by one of the clients that has since been deleted, revealed staff using profanities directed at C2. According to confidential information obtained, S1 admitted to saying "if I did not care about you, I would have let them fuck you up" towards C2. Additionally, S2 was heard saying "you should have kept your fucken mouth shut" towards C2. According to confidential information, S1 and S2 were temporarily suspended as a result of this incident. Based on interviews and information gathered during the investigation, the preponderance of evidence standard has been met and the Department has determined the allegation that staff's behavior posed a risk to a minor while in care, more specifically that Staff # 1 (S1) and Staff # 2 (S2) had cursed and used profanities towards Client # 2 (C2) during an altercation between clients in care is substantiated. This posed an immediate health and safety risk to the child placed in care. The facility is being issued a citation for violations of the Interim Licensing Standards, Chapter 7.5, Version 5, Section 87072(c)(16) Personal Rights. See attached LIC 9099D for cited deficiency. An exit interview was conducted, and a copy of the report and appeal rights were provided.

Investigation Findings:
13This is an amended report to the one issued on 02/27/24: Licensing Program Analyst (LPA), Daniel Mena met with Facility Manager, Iyonna Matthews to discuss the investigative findings for the above stated allegation. Licensing Program Analysts (LPAs) Lisi Leon, Cynthia Urena and Daniel Mena conducted an inspections of the Short Term Residential Therapeutic Program (STRTP). No immediate hazards were observed. The investigation was jointly conducted by LPAs Leon, Urena and Mena. The investigation included interviews with five staff (Staff #1 (S1), Staff #3 (S3), Staff #4 (S4), Staff # 5 (S5) & Staff # 6 (S6), four clients (Client #1 (C1), Client #3 (C3), Client #4 (C4) & Client # (5), as well as a review of client and facility records. LPA Mena was unable to interview Client # 2 (C2) and Staff # 2 (S2) due to C2 & S2 being unresponsive to LPA Mena's attempts to interview them regarding complaint allegations. Community Care Licensing received information on February 02, 2023, alleging that staff's behavior posed a risk to a minor while in care. Information received and confidential interviews corroborated allegations with a preponderance of evidence. Confidential interviews stated that Staff # 1 (S1) and Staff # 2 (S2) had Client # 2 (C2) cornered against the wall while attempting to prevent an altercation and were standing in between C2 and other clients who were attempting to engage C2 in a physical SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Daniel Mena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 02/27/2024

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

met_with: Iyinna Mathews


summary: Facility Evaluation

raw_content:
Narrative:
On June 23, 2021, at 8: AM, Licensing Program Analyst (LPA) Carmen Escobar arrived at Future Stars Short-Term Residential Therapeutic Program (STRTP). The purpose of the inspection was to complete the continuation inspection for STRTP annual inspection that was initiated on June 22, 2021. LPA already completed the physical inspection of the facility and reviewed facility client files on the first day of the annual inspection. During this annual inspection continuation, LPA Escobar reviewed ten personnel files to ensure they contained all required documentation per Title Regulations and Interim Licensing Standards (ILS). Personnel Files are usually maintained in a locked closet by the front door. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. Ten of the ten files that were reviewed were for employees who converted from group home personnel to STRTP personnel. LPA observed the converted staff members were trained according to the STRTP training requirements. Files for staff 5 (S5) and staff 8 (S8) did not have a copy of driver's license. Staff 1 (S1), staff 2 (S2), and staff 10 (S10) did not have proof of TB test. S10 and staff 7 (S7) files did not have education verification. S5 and staff 6 (S6) did not have signed employee rights. S1, S2, and S10, did not have updated job descriptions. S5 and S6 did not have job descriptions. S8 and S10 did not have current job evaluations and S7 did not have one in file. S2, and S4-S10 did not have employer verification form in files. S3 file does not have copy of fingerprint clearance in file. Technical Assistance Advisory Note will be issued for personnel files. Administrator R'Nisha Parker is present at the facility a minimum of 20 hours a week, as verified by staff schedule and interviews. Appropriate staff/client ratios were verified during this inspection. LPA discussed the following with the facility manager: incident reporting, including incidents related to Assembly Bill 388 law enforcement contacts as well as incidents involving emergency interventions. LPA discussed procedures for Child and Family Team (CFT) meetings, including an overview of required Core Services and Supports. Based upon the inspection of facility records and interviews with staff and clients, the Licensee appears to be meeting CFT and Core Services/Supports requirements. Two youth counselors (direct care staff) and one facility manager present during annual inspection were interviewed in regard to their job duties, training, and services provided at the facility. All staff were able to provide sufficient information in relation to the facility's program. Staff have no issues or concerns regarding the facility. Based upon the inspection of facility records and interviews with staff and clients, the Licensee appears to be meeting CFT and Core Services/Supports requirements. LPA requested the recent board meeting minutes be provided via email by June 28, 2021. Additionally, Facility has cameras in common areas of the facility. The facility has an exception on file to use the cameras and are meeting the terms and conditions. A copy of this report, the advisory notices, and appeal rights, were provided to Facility manager, Iyonna Matthews.

met_with: Facility Manager--Iyonna Matthews


summary: Facility Evaluation

raw_content:
Narrative:
On November 6, 2022 at 9: AM, Licensing Program Analyst (LPA) Gloria Meza-Gonzalez conducted an unannounced inspection at the above facility. LPA Meza-Gonzalez met with Facility Manager (FM) Iyonna Matthews. The purpose of the inspection is to conducted a confidential client (see confidential name list, LIC811, dated: November 6, 2022) interview regarding a previous placement. Exit interview was conducted and a copy of this report was left with FM Matthews


summary: Facility Evaluation

raw_content:
Narrative:
On March 03, 2023, at 8: AM, Licensing Program Analyst (LPA) Jessica Peete arrived at Future Stars Short-Term Residential Therapeutic Program (STRTP). LPA was greeted and granted access by Youth Counselor Lea Cash. The purpose of the visit is to conduct an annual inspection of the facility. Per staff statement FM was off site dropping clients off at school. The facility manager arrived at 9: AM. At 9: AM LPA began a physical plant inspection assisted by the Facility Manager. The physical plant inspection included the following checks: The facility consists of three bedrooms, one staff bathroom and one client bathroom. Per FM statement clients are allowed to use and access the staff bathroom, (toilet and shower) when the client bathroom is in use. LPA observed burned paper in the staff shower. The FM stated they did not know when or who burned the paper. Youth Counselor Lea Cash cleaned the shower at the time if inspection. The facility has a small dining area, kitchen area, living room, open common area, laundry room, and a garage. The facility has a clinician's office for therapeutic services. Additional staff areas are in the open common area as well as a corner of the main living room. Bedrooms are arranged so that there are two clients per a room and one client per bed. There is adequate shelf and closet space for client's belongings. Extra linens are stored in the hall closet. The bathrooms were clean and in good repair. Cleansers, chemicals, and cooking knives are inaccessible to clients. Cleaners and chemicals are locked in the laundry room closet and in the garage. The cooking knives are locked inside of the staff office. Licensee maintains an adequate supply of food and a variety of snacks for clients. LPA observed a minimum seven-day non-perishable and a two-day perishable supply of food. Extra food for stored in the garage, LPA observed moldy strawberries in the garage refrigerator . The FM disposed of the expired food immediately. Additionally, LPA observed the following postings: facility license, grievance procedures, personal rights, Ombudsman poster, visitation policies, and current menu. Continued on LIC C. Age-appropriate toys, games and books were observed for client's recreation time. The facilities outside grounds (front yard, backyard) were also inspected and were found to be clean, well maintained, and free of observable hazards. There is adequate indoor and outdoor activity space; all exits, and walkways were free from obstruction. Per Facility Manager there are no guns or weapons on facility grounds. The facility has an operable smoke detector located throughout the facility. The carbon monoxide detector is operable and located in the kitchen. Fire extinguishers are properly charged, serviced, and located in the kitchen and entry. The medications are centrally stored inside of a locked hall closet. The First Aid Kit is complete and kept in the hall closet. The facility has a one vehicle that is used to transport clients to appointments and recreational activities. The vehicle is operable, good repair , and the registration is current. At 9: AM LPA observed the staff bathroom and client licensee was not in compliance with Title California Code of Regulations (CCR) 80088(e)(1) The regulation is stated as follows: ... (1) Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures used by clients to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C). The water in the staff bathroom measured 129.3 degrees Fahrenheit. The water in the client bathroom measured 126.3 degrees Fahrenheit. The FM adjusted the water temperature during the inspection. LPA tested the water again at 01: PM. The water in the staff bathroom measured 106.1 degrees F. and water in the client bathroom measured 97.7 degrees F. At 9: AM LPA observed the client and staff bathrooms did not have the required trash can lids. The facility will be cited for Title CCR 80088(f)(1) ... All containers, including movable bins, used for storage of solid wastes shall have tight-fitting covers kept on the containers; shall be in good repair... At 10: AM LPA observed client bedroom #3 was not clean. The bedroom was unsanitary, had trash, clothes and various other debris covering the floor dressers. The furniture in the room was stained, the bed linens were observed to be unkempt and pillowcases were missing. The FM stated the room has not been cleaned because the clients will not let staff enter. The FM provided pillowcases at the time of inspection and cleared the debris from the floor. The facility will be cited for Title CCR 80087(a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors; (Continued on LIC C) and Interim Licensing Standards ( ILS) 87088(c)(1). The licensee shall provide and make readily available to each child the following furniture, equipment and supplies necessary for personal care and maintenance of personal hygiene: (1) An individual bed maintained in good repair; equipped with good springs and a clean mattress; and supplied with pillow(s) which are clean and in good repair. LPA also observed portable dresser staked on top of each other creating a safety Hazzard for clients. The FM stated the clients stacked the dressed that way and refused to have the new dresser in the room. LPA observed a new portable dresser in the hallway. The FM removed the stacked dresser from the room at the time of inspection. At 11: LPA observed the facility did not have locked containers in which clients can store their contraceptives. The FM stated the staff lockers will be converted and used for the storage of client contraceptives. The facility will be cited with a technical violation Interim Licensing Standards ( ILS) 87075(b)(1)(A) The licensee shall provide the child with a locked container in which to store their contraceptives and ILS 87075(b)(1)(A)(1) The licensee shall provide the child with a locked container in which to store their contraceptives... Due to time constraints, LPA will return to complete the inspection at a later date. Based on observations made during the inspection, deficiencies are being cited. An exit interview was conducted, and a copy of this report and appeal rights was provided to Facility Manager Iyonna Matthews.

met_with: Facility Manager Iyonna Matthews


summary: Facility Evaluation

raw_content:
Narrative:
On March 6th, 2023 at 10: AM, Licensing Program Analyst (LPA) Jessica Peete, conducted an unannounced annual inspection at Future Stars Short-Term Residential Therapeutic Program (STRTP). LPA was met at the facility by Facility Manager (FM) Iyonna Matthews. LPA Peete visited the facility on 03/03/2023 to complete inspection of the Physical Plant. The FM left the facility at 10: AM to retrieve the staff and client files, that are kept off site. LPA waited off facility grounds for the FM to return. The FM returned at 11: AM and LPA began a review of client records. LPA reviewed five client files (C1-C5) assisted by the FM and Head of Services Tabitha Lopez . At 11: AM it was observed the C3's client intake packet, which covered the facility's policies and procedures regarding the removal and/or transfer; discipline; and complaints. was missing a few signatures and forms were not dated. The FM stated the packet was reviewed with C3's at the time of placement and the required forms will be signed and dated by C3. A technical assistance advisory note was issued from Interim Licensing Standards (ILS) 87070(c)(2).. (c) the following additional information shall be maintained in the child's record. (2) Signed copies of the facility's policies and procedures regarding the child's removal and/or transfer; discipline; and complaints. At 2: PM the licensee was cited with a technical violation of ILS 87068.2(b)(6)... (b) The needs and services plan shall be trauma informed... and shall identify the child's needs in the following areas:(6) Visitation, including the frequency of and any other limitations on visits to the family residence and other visits inside and outside the facility and ILS 87068.2(e) The licensee shall document in the child's needs and services plan how family members are integrated into the treatment process for the child... and how sibling connections are maintained... The needs and services plan or C1-C5 did not include the required information as stated above. (Continued on LIC C) At 2: PM it was observed the medical assessment for C1-C5 did not include the required tuberculosis examination results. The licensee is not in compliance with Title California Code of Regulations 80069(c)(1) The medical assessment shall include the following: (1) The results of an examination for communicable tuberculosis and other contagious/infectious diseases. Due to time constraints, LPA will return to complete the inspection at a later date. Based on observations made during the inspection, deficiencies are being cited. An exit interview was conducted, and a copy of this report, the LIC 811, and appeal rights was provided to Facility Manager Iyonna Matthews.


summary: Facility Evaluation

raw_content:
Narrative:
On March 7th, 2023, at 8: AM, Licensing Program Analyst (LPA) Jessica Peete, conducted an unannounced annual inspection at Future Stars Short-Term Residential Therapeutic Program (STRTP) LPA was met at the facility by Director Danette Seay. LPA Peete visited the facility on 03/03/2023 to complete inspection of the Physical Plant and on 03/06/2023 to complete the review of five client files. Per the Directors statement the Facility Manager (FM) Iyonna Matthews had the keys to the staff files and would not be on site until 10: AM. The FM arrived at the facility at 10: AM. At 10: AM , assisted by the FM, LPA began review of Operations, Disaster Preparedness, and Core Therapeutic Services. All the documentation pertaining to this area of the inspection was provided, and no deficiencies were noted. At 11: AM LPA began review of the Emergency Intervention Plan. Per FM statement staff is trained on assaultive behavior management techniques and restraints are used as a last resort; from least to most restrictive. FM stated training for the year of 2023 has been scheduled for staff. The licensee will provide proof of emergency intervention training to LPA. Licensee did not have a restraint log and will be cited with the following technical violations of Interim Licensing Standards (ILS) : ILS 87095.61(f): The licensee must maintain a monthly log of each use of manual restraints. The log must include: ILS 87095.61(f)(1) The licensee must maintain a monthly log of each use of manual restraints. The log must include:(1) Name of each child. ILS 87095.61(f)(2) The licensee must maintain a monthly log of each use of manual restraints. The log must include:(2) Date and time of the intervention. ILS 87095.61(f)(3) The licensee must maintain a monthly log of each use of manual restraints. The log must include: (3) Duration of the intervention. ILS 87095.61(f)(4) The licensee must maintain a monthly log of each use of manual restraints. The log must include: (4) Name(s) of facility staff member(s) who participated in the manual restraint. ILS 87095.61(f)(5) The licensee must maintain a monthly log of each use of manual restraints. The log must include: (5) Description of the intervention and type used. ILS 87095.61(f)(6) The licensee must maintain a monthly log of each use of manual restraints. The log must include: (6) Result of licensee review. ILS 87095.61(g) The monthly log must be available for review, and subject to reproduction by the Department upon request during normal business hours. At 11: AM LPA began review of five staff files ( S1-S5) assisted by the FM. During file review it was observed the tuberculosis test results were not on file for S1. The licensee will be cited for Tittle California Code of Regulations (CCR) 80066(a)(11) ...The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (11) Tuberculosis test documents... At 12: PM it was observed S1 and S2 did not complete the required 40 hours of annual training for the year 2022. S1 completed 38 hours and S2 completed 32 hours. The licensee will be cited with the technical violation of ILS 87065.1(e)(1) ... all direct care staff shall complete a minimum of 40 hours of annual training... LPA interviewed two clients and staff. Based on observations made during the inspection, deficiencies are being cited. An exit interview was conducted, and a copy of this report, the LIC 811, and appeal rights was provided to Facility Manager Iyonna Matthews.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) N. Strickland arrived to the facility unannounced to deliver an amended report initially delivered April 4, 2022.


summary: Facility Evaluation

raw_content:
Narrative:
On March 28, 2023 at 9:07 am, Licensing Program Analyst (LPA), Jessica Peete met with Facility Manager Iyonna Matthews. The purpose of today's visit is to clear a Type B deficiency cited during an annual inspection on 03/03/2023. The deficiency, initially cited during an annual visit on 03/03/2023, have been cleared. No deficiencies observed or cited during this visit. Exit interviewed conducted. A copy of this report was provided to Facility Manager, Iyonna Matthews.