raw_content:
Narrative:
Confidential interviews reported that S2 and C1's authorized representative agreed that C1 could have a cell phone to be used as an incentive for good behavior. Confidential interviews and documentation show that S2 ordered and set the phone up on C1's behalf. A confidential interview was also reported when the cell phone was set up; due to the C1's age, parental controls were automatically installed on the phone. Confidential interviews disclosed that parental controls were installed unknowingly, and when S2 became aware of the situation, C1's cell phone was factory reset. In addition, information obtained as part of the investigation shows that in order for the parental control application to be effective, S2 would need to install the application on their personal cellular device to monitor C1's cell phone activity. Moreover, a confidential interview denied that S2 had parental control applications installed on their (S2's) personal or business cell phones. Based on inconsistent confidential interviews and pertinent documentation, the allegation that staff (S2) is not allowing the client (C1) to have confidential telephone calls is unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of evidence to prove that the alleged violations occurred. An exit interview was conducted. A copy of this report and appeal rights were explained and given to Head of Service Tabitha Lopez. This is an amended report of a report that was originally issued on 01/12/2024

Investigation Findings:
13This is an amended report of a report that was originally issued on 01/12/ On January 12, 2024, at 9: 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 09/12/2023, LPA Peete inspected the physical plant, and no immediate safety hazards were observed. During the investigation, LPA obtained documents pertinent to the investigation. LPA also interviewed clients (C1-C6), staff (S1 -S3), and the County Social Worker. On 09/11/2023, Community Care Licensing received an allegation that staff (S2) is not allowing the client (C1) to have confidential telephone calls. It was alleged that S2 installed a parental control application on C1's cell phone, allowing S2 to monitor C1's cell phone usage. (Contineued on LIC 9099-C) 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: 01/12/2024

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

met_with: Head of Service Tabitha Lozez


state: CA

facility_name: FUTURE STARS YOUTH SERVICES

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Another confidential interview denied staff verbally or physically abused clients in care and reported all staff and client interactions are professional and trauma-informed. The department also received an allegation that staff (S1) had inappropriate conversations with a minor (C2), and staff did not safeguard a minor's (C2) personal belongings. It was reported that C4 took C2's cell phone and found phone calls between S1 and C2. More specifically, it was alleged that the phone calls between S1 and C2 were exchanged outside of S1's regular working hours. A confidential interview witness interview reported C4 found text messages exchanged between S1 and C2. The confidential witness did not see the text messages and learned, second hand, from C4 that S1 offered C2 money to spy on other clients and a STRTP staff. LPA received inconsistent information to support the alleged misconduct. Although it was reported that S1 had inappropriate phone conversations with C2, LPA did not obtain additional statements from those who saw the text messages or witnessed the phone calls between S1 and C2. Other confidential interviews either denied the allegation or denied having any knowledge of S1 contacting C2 or other clients after hours to spy on clients and staff. In addition, confidential interviews disclosed that C1 did have S2's phone number. However, conversations between C1 and S2 were not inappropriate. C2 only contacted S1 when C2's roommate was "upset," or other clients were "out of control." Information from confidential interviews also reported that S2 was a good employee, and there were no concerns about S1's interaction with clients. Regarding the allegation, the staff did not safeguard C2's belongings, and LPA again received conflicting information to prove the allegation. A confidential interview denied that C2's cell phone was taken by C4 or any other clients in care. Another confidential interview reported that clients stole from each other but did not recall the alleged theft of C2's cell phone. Other confidential interviews reported clients could keep their items in the staff office and had access to personal lockers to store their property. Furthermore, a confidential interview reported that at the time C2 was in care, there were no reports of theft. Based on inconsistent confidential interviews, the allegations Staff (S2) yelled at minor (C3), staff (S1) had inappropriate conversations with minor (C2), and staff did not safeguard minors (C2's) personal belongings are unsubstantiated. The allegations may have happened or are valid, but there is not a preponderance of evidence to prove that the alleged violations occurred. An exit interview was conducted. A copy of this report and appeal rights were explained and given to Facility Manager, Iyonna Matthews. This is an amended report of a report that was originally issued on 03/28/2024

Investigation Findings:
13This is an amended report of a report that was originally issued on 03/28/ On March 28, 2024, at 1: 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 allegations listed above. LPA obtained documents pertinent to the investigation and interviewed clients (C1,and C2), staff (S1-S4) and one resource parent (RP). LPA attempted to interview C3 and C4; however, C3 was not available to interview and C4's location is unknown. On 12/18/2023, Community Care Licensing received an allegation that staff (S2) yelled at a minor (C3). It was reported that S2 was witnessed yelling in C3's face. A confidential interview reported that S2 and C3 were screaming at each other, and C3 put their (C3's) finger in S2's face. A confidential interview also reported that S2 did not interact with clients in a professional manner. Other confidential interviews denied the alleged incident occurred and noted that S2 established a good rapport with the clients and did not have any disciplinary actions while employed at the STRTP. (Continued on LIC 9099-C) 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: 03/28/2024

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

report_type: Complaint Investigation

met_with: Facility Manager, Iyonna Matthews

complaint_status: unsubstantiated


raw_content:
Narrative:
the two took place. Confidential interviews provided conflicting information as to where and when the alleged incident may have occurred. Confidential interviews and record review could not confirm or dispute the two allegations. Based on record review and confidential interviews the allegations alleging lack of supervision resulted in inappropriate interactions between youths (C1 and C4) in care and lack of supervision resulted in youths (C1 and C4) drinking while in care may have occurred, however they are not supported or proven by 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 Youth Services, Facility Manager (FM), Iyonna Matthews.

Investigation Findings:
13On June 21, 2024 at 1:00pm Licensing Program Analyst (LPA), Nicole Strickland met with Future Stars Youth Services, Facility Manager (FM), Iyonna Matthews, to deliver the findings for the above stated allegations. A Health and safety inspection of the facility was conducted on May 10, 2024, and no immediate hazards were observed. The investigation included interviews with four foster children (C2-C4, C6), two staff (FM and S1), and two county social workers (CSW1 and CSW3). C1 was unable to be contacted and therefore was unable to be interviewed. In addition, county records, and facility records were reviewed. On April 30, 2024, Community Care Licensing (CCL) received two allegations alleging lack of supervision resulted in inappropriate interactions between youths (C1 and C4) in care and lack of supervision resulted in youths (C1 and C4) drinking while in care. Specifically, it was reported sometime in March, on an unknown date C4 had been drinking and provided alcohol to C1, after an inappropriate interaction between 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 RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 06/21/2024

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

met_with: Iyonna Matthews


raw_content:
Narrative:
review revealed conflicting statements as to threats being made towards C1 during and after the incident. Confidential interviews could not confirm or dispute the allegation. Based on record review and confidential interviews the allegation alleging staff did not provide a safe environment for the minor (C1) may have occurred, however it is not supported or proven by 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 Youth Services, Facility Manager (FM), Iyonna Matthews.

Investigation Findings:
13On June 21, 2024 at 12:27pm Licensing Program Analyst (LPA), Nicole Strickland met with Future Stars Youth Services Facility Manager (FM), Iyonna Matthews, to deliver the findings for the above stated allegation. A Health and safety inspection of the facility was conducted on March 22, 2024, and no immediate hazards were observed. The investigation included interviews with five foster children [Child #1 (C1), Child #2 (C2), Child #5 (C5), Child #6 (C6) and Child #7 (C7)], two staff [Staff #1 (S1) and Staff #3 (S3)], and two county social workers (CSW1 and CSW2). In addition, county records, and facility records were reviewed. On March 20, 2024, Community Care Licensing (CCL) received an allegation alleging staff did not provide a safe environment for the minor (C1). Specifically, it was reported C1 had a behavior episode after which other residents in the facility allegedly made threats of harm to C1. Confidential interviews and record 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 RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 06/21/2024

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


raw_content:
Narrative:
It was specifically reported to CCL that an incident involving client #1 (C1) resulting in law enforcement contact occurred at the facility and the facility did not follow the reporting requirements. During the investigation, LPA Urena received consistent information that indicates the allegation is true. Confidential interviews reported that C1 left the facility on a continuous basis while in care and facility staff were not aware that the information had to be reported to CCL within 24 hours. Record review corroborates these statements showing that C1 left the facility multiple times however, LPA was unable to obtain any evidence that these unauthorized absences were reported to CCL. Confidential interviews further reported that an incident involving a law enforcement contact occurred when C1 attempted to return to the facility from a runaway status on or about June 9, 2024. Record review conducted indicated that facility staff did not report this incident to CCL. Another confidential interview also reported that facility staff did not notify C1's authorized representative of C1's runaway status thus, indicating that a violation of reporting requirements occurred while C1 was in care. Based on confidential interviews and record review the preponderance of evidence standard has been met, and the allegation that facility did not follow reporting requirements is supported and proven by evidence, therefore the allegation is substantiated at this time. The STRTP is being cited for California Code of Regulations (CCR) SECTION: 80061(b)(1)(E) REPORTING REQUIREMENTS. (b) Upon the occurrence, during the operation of the facility, of any of the events specified in (1) below, a report shall be made to the licensing agency within the agency's next working day during its normal business hours. In addition, a written report containing the information specified in (2) below shall be submitted to the licensing agency within seven days following the occurrence of such event. (1) Events reported shall include the following: (E) Any unusual incident or client absence which threatens the physical or emotional health or safety of any client. An exit interview was conducted, a copy of this report, LIC D, along with appeal rights were provided to Future Stars Youth Services Mental Health Specialist, Ronnie Lusk. facility staff discharged client #1 (C1) from the facility resulting in staff refusing to allow C1 access to the facility following a runaway return. During the investigation, LPA received inconsistent information that would support or dispute the allegation. Confidential interviews denied that facility staff did not follow discharge procedures and reported that C1 was discharged from the facility in collaboration with C1's county social worker. Other confidential interviews reported that C1 attempted to return to the facility from their runaway status but staff #3 (S3) refused to allow C1 into the facility resulting in law enforcement contact. While some confidential interviews reported that facility staff did not follow discharge procedures involving C1 in care other confidential interviews maintained that facility staff followed discharge procedures and C1 was allowed access to the facility following clarification from the placing county. Based on confidential interviews and record review the allegation that facility did not follow discharge procedures for minor, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report along with the appeal rights was provided to Mental Health Therapist, Ronnie Lusk.

Investigation Findings:
13On October 3, 2024, at 9: AM, Licensing Program Analyst (LPA), Cynthia Urena met with Future Stars Youth Services Short Term Residential Therapeutic Program (STRTP) Mental Health Specialist, Ronnie Lusk to deliver the investigative finding for the above stated allegation. On June 20, 2024, at 1: PM, Licensing Program Analyst (LPA), Cynthia Urena initiated the investigation at the STRTP and collected pertinent documents from the STRTP staff and client files. Interviews were conducted with a county staff member, three STRTP staff members (S1, S2, S3), four clients, (C1, C2, C3, C4) and a Sheriff Deputy. Additionally, LPA Urena conducted a comprehensive record review to further assist with the investigation process. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Nicole Strickland 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 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 10/03/2024

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: Mental Health Specialist, Ronnie Lusk


raw_content:
Narrative:
Confidential interviews revealed conflicting statements that staff are not intervening any altercations when it happens. Confidential interviews revealed that staff would break-up the altercations by standing in between or verbally redirecting the youths in the home. Other statements indicated that staff stand there and watch the incidents. Based on confidential interviews, the allegation that facility staff are not properly intervening in altercations between youths, may have occurred, however, is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with appeal rights was provided to Future Stars Youth Services Short Term Residential Therapeutic Program (STRTP), Facility Manager, Iyonna Mathews.

Investigation Findings:
13On December 11, 2024, at 2: PM, Licensing Program Analyst (LPA) Sarah Lo met with Facility Manager, Iyonna Matthews, to deliver the finding for the above complaint allegation at Future Stars Youth Services Short Term Residential Therapeutic Program (STRTP). On 08/29/24, LPA inspected the facility's physical plant, and no immediate health and safety hazards were observed. The investigation included interviews with two staff (S1, S2), six clients (C1, C2, C3, C4, C5, C6) and three County Social Workers (CSW1, CSW2, CSW3). Clients' Needs and Services Plans and County Investigation Narrative were reviewed. On August 26, 2024, Community Care Licensing received an allegation that facility staff are not properly intervening in altercations between youths. Specifically, it was reported C6 was observed falling asleep multiple times in the classroom due to a fight breaking out every night and the staff do not intervene. (continued on LIC 9099c) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Sarah Lo LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 61-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE N CRP RO, MAIN ST., SUITE FACILITY NAME: FUTURE STARS YOUTH SERVICESFACILITY NUMBER: VISIT DATE: 12/11/2024

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


summary: Facility Evaluation

raw_content:
Narrative:
On May 06, 2026, at 10:30 am Licensing Program Analysts (LPAs) Gilbert Marquez and Sarah Lo arrived unannounced to Future Stars Short Term Residential Therapeutic Program (STRTP) to conduct an annual inspection. LPAs met with Facility Manager Iyonna Matthews. LPAs began a tour of the physical plant at 10:45 am. A physical plant inspection was completed and included the following checks: kitchen, dining room, living room, two staff offices, three client bedrooms, and two bathrooms. There is adequate indoor and outdoor activity space. Facility grounds are clean and free of debris and observable hazards. Books, games and art supplies were observed for clients' recreation time. All facility smoke detectors and carbon monoxide detectors were tested and in working order; fire extinguishers are properly charged and serviced. Licensee maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. All required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster. All hazardous items have been properly made inaccessible to areas where clients will have access. Sharp knives, medications, and a complete first aid kit are kept locked and secure in the entry way hall closet. Cleansers and chemicals are locked in the hallway cabinet next to mental health staff office. Bedrooms are arranged so that no more than two clients share a room. Each bedroom has two beds with one client per bed. There is adequate shelf and closet space for client's belongings. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. The facility has two bathrooms for clients' use. **Continued on LIC809C** **Continued from LIC809** The bathrooms were in working order. The hot water measured 105.8 degrees Fahrenheit in the kitchen and bathroom #1. There are no guns or weapons in the facility as stated by Facility Manager Iyonna Matthews. During time of inspection LPAs reviewed five client records and conducted three staff and two client interviews. All client files are stored and locked in the file cabinet in the Facility Manager's office. LPAs reviewed five client files (C1 - C5, see Confidential Names List LIC811) to ensure clients had all required documents per Title 22. Client files had education records, physical examinations, Needs and Services plans, and mental health notes. LPAs also reviewed two client medication records; three other clients did not have medications. LPAs reviewed five staff files (S1 - S5) to ensure staff had all required documents such as criminal record clearance or exemption, health screening and TB test, driver's license, personnel record LIC501 or job application. Due to time constraints, LPAs were not able to complete the review of staff training logs. LPAs will return to review the staff training on another date. A copy of this report was reviewed and given to Facility Manager Iyonna Matthews, along with the confidential names list (LIC 811).

report_type: Facility Evaluation

visit_type: Annual

met_with: Facility Manager Iyonna Matthews


summary: Facility Evaluation

raw_content:
Narrative:
On May 11, 2026, Licensing Program Analysts (LPAs) Gilbert Marquez and Sarah Lo arrived unannounced at the facility to continue the annual inspection that began on May 8, 2026. LPAs met with Iyonna Matthews, Facility Manager. LPAs reviewed five staff training records (S1 - S5, see Confidential Names List LIC811). An exit interview was conducted with Facility Manager Iyonna Matthews, and Chief Executive Officer Danette Thomas. A copy of this report, LIC811, and Appeal Rights were given to Facility Manager.

visit_type: Case Management


facility_name: GATEWAY RESIDENTIAL PROGRAM-FAIR OAKS HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Jean Stidman at 9:00 am. During the inspection, LPA met with Cat Matthews, Executive Director and inspected all files, medication documentation and conducted a medication count on this date. LPA met with Jamie Taylor Child Care Worker and inspected the facility inside and out. LPA reviewed two child's records on site at the facility at 9:00am. LPA reviewed three staff personnel files on site at the facility at 11:00am. LPA interviewed three staff on site at 1:30pm. LPA interviewed two children currently taking psychotropic medication at 1:00pm. No deficiencies being cited at this time. LPA conducted exit interview with Jamie Taylor Child Care Worker at 1:30pm. LPA provided the Summary Report to Jamie Taylor Child Care Worker upon completion.

met_with: Jamie Taylor Child Care Worker


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced annual inspection on 3/7/22 at 9: AM and met with, Catherine Matthews, Executive Director, Jeffrey Beesley, Deputy Director and Ramzy Shehadeh, Program Director. All Gateway properties were inspected by LPA on 3/1/22. LPA did advise the agency that the inspection is being completed with the use of the CARE Tool. LPA Shelton conducted a walk-through of the facility inside and out. There were no clients present during the inspection due to school. LPA observed four bedrooms with both single and double beds in each room. Two bathrooms with soap, paper towels hygiene products and towels. LPA Shelton inspected and/or reviewed the following: · Postings of facility license and Personal Rights Poster were appropriately posted · Disinfectants/Cleaning solutions were inaccessible and locked as required · Nonperishable Foods for one week and fresh perishable for foods two days minimum were present · Menu was present and posted · LPA observed a working telephone on the premises · Carbon monoxide detectors and Smoke Detectors were present and functioning · First Aid Kit was present and fully stocked as required · Common Room (living room) was available as was a separate room in each wing for privacy · Dining area with enough seating for clients in care was present and in good condition · Medication was centrally stored, locked/inaccessible. Centrally stored medication and log reviewed. · LPA's reviewed five (5) client files. One interview was conducted · Motor Vehicle was not present during inspection due to school. · LPA observed that the facility appeared to be free of vermin · LPA observed Locked Facilities included a shed with lawn equipment · LPA reviewed complaint procedures for clients. · Board Minutes were reviewed · Disaster Preparedness was updated and available for review, quarterly drills are completed and logged in a binder and there are disaster preparedness supplies available and verified by LPA · Staff training was in compliance · Criminal record clearances were verified by LPA and in compliance · Certified Administrators certificate was valid and current · Staff job titles/qualifications were verified along with the required Hours of initial training. LPA verified that for staff that have been here longer than a year, the Hours of annual training was also present · Trauma informed practices are implemented as needed (including specialty mental health services and extracurricular activities and social supports) per discussion with the administrator. The following items were reviewed for compliance in the regional office prior to the facility inspection: Administrator Certificate for Catherine Matthews is current and verified Fees have been paid and documentation was provided No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.

met_with: Catherine Matthews, Executive Director


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced Case Management - Annual Continuation inspection on 4/17/2024 and met with Jeffrey Beesley, Deputy Director and Ramzy Shehadeh, Program Director, who assisted with the inspection. LPA Shelton conducted a walk-through of the home inside and out. There are currently no clients or staff living or working in the home. LPA did advise that today inspection was done using the Care Tools. LPA observed that the facility was clean and maintained during the inspection No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.

met_with: Ramzy Shehadeh, Program Director


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Jean Stidman and Janie Davis on 12/15/23 at 9:15am. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9(a)(2). During the inspection, LPAs Stidman and Davis met with Jeffrey Beesley, Executive Director and inspected the facility inside and out. LPAs reviewed two child's records and three staff personnel files on site at the facility. LPAs reviewed two child's psychotropic medications and medication records. LPAs interviewed three staff on site to discuss the facilities policies and procedures of operation. LPAs interviewed two children currently prescribed psychotropic medication. LPAs provided a copy of this licensing report to Jeffrey Beesley, Executive Director. LPAs observed the deck in the backyard has a broken board. Facility cited 80087(a) Buildings and Grounds. LPAs conducted exit interview with Jeffrey Beesley, Executive Director.

met_with: Jeffrey Beesley, Executive Director


facility_name: GATEWAY RESIDENTIAL PROGRAMS-GINGER BLOSSOM HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
On December 8, Licensing Program Analysts (LPAs) Mary Shelton and Connie Goldie made an announced case management to the home and met with Catherine Matthews, Executive Director. The reason for the visit was to conduct an inspection of the home after the home changed the occupancy from six to five clients. LPAs observed that there are currently no residents residing in this house. As such there are no staff working their now either. There are five bed's in the home for residents and the home is in compliance.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced annual inspection on 3/1/22 at 2: PM and met with, Catherine Matthews, Executive Director, Jeffrey Beesley, Deputy Director and Ramzy Shehadeh, Program Director, who assisted with the inspection. LPA Shelton conducted a walk-through of the facility inside and out. There is currently no clients or staff at the home and it is not being occupied. . LPA did advise the agency that the inspection is being completed with the use of the CARE Tool. LPA Shelton inspected and/or reviewed the following: · Postings of facility license and Personal Rights Poster were appropriately posted · Disinfectants/Cleaning solutions were inaccessible and locked as required · Carbon monoxide detectors and Smoke Detectors were present and functioning · First Aid Kit was present and fully stocked as required · Common Room (living room) was available as was a separate room in each wing for privacy · Dining area with enough seating for clients in care was present and in good condition · LPA observed that the facility appeared to be free of vermin A file review was conducted at the office prior to the visit. No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On June 27, 2022, Licensing Program Analysts (LPA) Mary Shelton made an announced case management to the home and met with Jeff Beesley, Executive Director. The reason for the visit was to conduct an inspection of the home after the home changed the occupancy from five to six clients. LPA observed there to be six beds in the home. LPA conducted an exit interview.

met_with: Jeff Beesley, Executive Director.


summary: Facility Evaluation

raw_content:
Narrative:
On 2/21/2023 at 1: PM Licensing Program Analyst (LPA) Mary Shelton made an announced case management to the home and met with Jeff Beesley, Executive Director. The reason for the visit was to conduct an inspection of the home after the home suffered fire damage on 8/8/2022. LPA observed that there are currently no residents residing in this house. As such there are no staff working their now either. LPA observed that all fire damage has been repaired and the home is in compliance.

met_with: Jeff Beesley, Executive Director


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced annual inspection on 4/12/2024 at 9: AM and met with Ramzy Shehadeh, Program Director. LPA did advise the agency that the inspection is being completed with the use of the CARE Tool. LPA Shelton conducted a walk-through of the office. LPA Shelton inspected and/or reviewed the following: · LPA reviewed client files. · LPA Interviewed (3) clients. · Client Records/Client Checklist using CARE Tool. · Clients with special health care needs using CARE Tool. · Emergency Intervention using CARE Tool. · Board Minutes were reviewed. · Disaster Preparedness was updated and available for review, quarterly drills are completed and logged in a binder and there are disaster preparedness supplies available and verified by LPA. The following items were reviewed for compliance in the regional office prior to the facility inspection: Administrator Certificate for Jeffrey Beesley is current and verified. Fees have been paid and documentation was provided. No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.

met_with: Ramzy Shehade, Program Director


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced Case Management - Annual Continuation inspection on 4/17/2024 and met with Jeffrey Beesley, Deputy Director and Ramzy Shehadeh, Program Director, who assisted with the inspection. LPA Shelton conducted a walk-through of the home inside and out. LPA did advise that today inspection was done using the Care Tools. LPA Shelton inspected and/or reviewed the following: · Postings of facility license and Personal Rights Poster were appropriately posted. · Disinfectants/Cleaning solutions were inaccessible and locked as required. · Carbon monoxide detectors and Smoke Detectors were present and functioning. · First Aid Kit was present and fully stocked as required. · LPA observed the Grievance/Complaint Policy is posted as required. · Allowance binder was in compliance. · Common Room (living room) was available as was a separate room in the home for privacy. · Dining area with enough seating for clients in care was present and in good condition. · Clients bedrooms/bathroom. · LPA observed that the home's water was at required temperatures at all faucets within the home. · LPA inspected the Medication Log and the Controlled Medication Log for clients in care. · LPA observed that the facility was clean and maintained during the inspection and meal menu displayed. A staff file review was conducted at the office prior to the visit. No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.

met_with: Jeffrey Beesley, Deputy Director


summary: Facility Evaluation

raw_content:
Narrative:
On 1/15/2025, Licensing Program Analyst (LPA) Mary Shelton, conducted an unannounced inspection for the purpose of conducting a case management regarding an incident that occurred on 12/27/2024. LPA met with staff, C1's Probation Officer and one client, and obtained information regarding the incident. LPA conducted a walk through to observe the facility. The case management is closed. No follow-up investigation is required. An exit interview was conducted and a copy of this report was provided to the Program Director.


summary: Facility Evaluation

raw_content:
Narrative:
On April 25, 2025 at 11: AM, Licensing Program Analyst (LPA) Michelle Silvas made an unannounced visit to Gateway Residential Programs - Ginger Blossom House, to conduct a case management inspection. LPA met with Ramzy Shehadeh, Administrator who assisted with the inspection. 0 clients and 1 staff were present. LPA conducted an inspection of the facility inside and outside. The purpose for today's inspection is to issue a citation for 2 uncleared staff working at the facility. While conducting an inspection at one of the other Gateway homes, it was determined that multiple staff in every location did not have a criminal record clearance to work at the facility. A civil penalty of $100.00 per day for five days is being assessed for the two uncleared staff. An exit interview was conducted, and appeal rights were discussed. A copy of this report along with the appeal rights were given to Ramzy Shehadeh, Administrator.

met_with: Ramzy Shehadeh, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On May 20, 2026, at 9: AM, Licensing Program Analyst (LPA) Michelle Silvas and Analyst II Arianna Manabat, made an unannounced visit to the facility for the purpose of an annual inspection. LPA met with Janine Coleman/Resident care coordinator/house director and Norma Leon Romero, Executive Director. LPA and Analyst II conducted a walk through of the facility inside and outside and observed a living room, game area, dining room, kitchen, office, laundry room, four bedrooms and two bathrooms. Outside is a large gated backyard. LPA and Analyst II observed the following: Postings of facility license and Personal Rights Poster were appropriately posted Disinfectants/Cleaning solutions were inaccessible and locked as required A working telephone on the premises Carbon monoxide detectors and Smoke Detectors were present and functioning Dining area with enough seating for clients in care was present and in good condition Medication was centrally stored, locked/inaccessible Enough perishable and nonperishable foods were available Bedrooms had enough storage space for the clients Continue LIC 809-C LPA reviewed five staff files and five resident files. LPA conducted two staff interview. No citations were issued today. An exit interview was conducted and a copy of this report was provided.


facility_name: GATEWAY RESIDENTIAL PROGRAMS-PALM HOUSE

raw_content:
Narrative:
while playing a boxing game. C1 missed the punching bag and punched the medal post behind the bag and fractured his hand. S6 was present at the time of the incident and had asked if C1 was OK, which he replied yes. S1, S4, S5 and C2 state that C1 refused to go to the ER because he did not want to wait for a long time. Staff called S4 who was the Resident Care Coordinator, and the on-call emergency contact that day. She asked to speak to C1 and asked how he was doing and if he wanted to go to the ER? S4 states that C1 did not want to go to the ER because of the wait so S4 advised staff to give him Ibuprofen and to use the first aid kit and put a splint on his hand. Staff did keep asking him throughout the weekend if he needed more Tylenol for the pain. That following Monday, March 13, 2023, S4 called C1s pediatrician to make an appointment, the soonest they could get him in was March 15, 2023. S4 states that C1 felt content knowing he would have an appointment with his doctor. C1 was seen on March 15, 2023, and had X-rays done which showed his right hand to be fractured. His hand was splinted up and a week later he had a cast put on. Regarding the allegations staff did not seek medical attention for minor in a timely manner, staff did not treat minor with dignity and respect and staff did not address a change in minor's health condition, four out of nine confidential interviews stated that C1 refused to go to the ER because he did not want to wait for a long time. Seven out of nine confidential interviews stated that staff always show concern when it comes to client's health and safety and if a client would insist on going to the ER, they would take them immediately. C2 states that staff treat all the clients with dignity and respect and take good care of them. He states that, "if C1 wanted to go to the ER, staff would have taken him." C2 also states that he heard staff ask C1 if he wanted to go to the ER and C1 refuse to go. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. An exit interview was conducted and appeal rights were discussed. A copy of this report along with a copy of the appeal rights were provided to Ariana Gomez, Residential Counselor.

Investigation Findings:
13On May 5, 2025 at 4: PM, Licensing Program Analyst (LPA) Michelle Silvas initiated an unannounced complaint investigation inspection at the above listed facility. LPA met with Ariana Gomez, Residential Counselor, who assisted with the inspection. The purpose of the inspection was to deliver findings for the above listed allegations. On January 27, 2025, LPA initiated a 10-day initial complaint investigation inspection and conducted one staff interview. LPA obtained copies of face sheets and needs and services plan for C1, C2, C3, C4. Between 1/27/25 and 3/27/25, LPA conducted nine confidential interviews. The Department received a complaint on January 23, 2025, regarding C1 being injured and not receiving medical attention in a timely manner. C1 was a client at Gateway-Palm house in 2023. While his time there, he had gone on a group outing on March 10, 2023, to an arcade where C1 sustained an injury UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Michelle Silvas LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: GATEWAY RESIDENTIAL PROGRAMS-PALM HOUSEFACILITY NUMBER: VISIT DATE: 05/05/2025

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

met_with: Ariana Gomez, Residential Counselor


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Jean Stidman at 1:30 pm. During the inspection, LPA met with Cat Matthews, Executive Director and inspected all files, medication documentation and conducted a medication count on this date. LPA met with Albertina Johnson, Case Manager and inspected the facility inside and out. LPA reviewed two child's records on site at the facility at 1:30pm. LPA reviewed three staff personnel files on site at the facility at 1:30pm. LPA interviewed three staff on site at 2:30pm. LPA interviewed two children currently taking psychotropic medication at 1:30pm. No deficiencies being cited at this time. LPA conducted exit interview with Albertina Johnson, Case Manager at 3:15pm. LPA provided the Summary Report to Albertina Johnson, Case Manager upon completion.

met_with: Albertina Johnson, Case Manager


summary: Facility Evaluation

raw_content:
Narrative:
On December 22, 2021, Licensing Program Analysts (LPA's) Connie Goldie and Mary Shelton made an announced case management visit to the home and met with Catherine Matthews, Licensed Social Worker. The reason for the visit was to conduct an inspection of the home after the home reduced occupancy from six to five clients. LPA's Goldie and Shelton observed that there are three single resident bedrooms and one dual resident bedroom with a total of five beds available for clients. The home was clean, safe and compliant. LPA's conducted an exit interview.

met_with: Catherine Matthews / Licensed Social Worker


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced annual inspection on 3/1/22 at 10: AM and met with, Catherine Matthews, Executive Director, Jeffrey Beesley, Deputy Director and Ramzy Shehadeh, Program Director, who assisted with the inspection. All Gateway properties were inspected by LPA on 3/1/22. LPA did advise the agency that the inspection is being completed with the use of the CARE Tool. LPA Shelton conducted a walk-through of the facility inside and out. There were no clients present during the inspection due to school. LPA observed four bedrooms with both single and double beds in each room. Two bathrooms with soap, paper towels hygiene products and towels. LPA Shelton inspected and/or reviewed the following: · Postings of facility license and Personal Rights Poster were appropriately posted · Disinfectants/Cleaning solutions were inaccessible and locked as required · Nonperishable Foods for one week and fresh perishable for foods two days minimum were present · Menu was present and posted · LPA observed a working telephone on the premises · Carbon monoxide detectors and Smoke Detectors were present and functioning · First Aid Kit was present and fully stocked as required · Common Room (living room) was available as was a separate room in each wing for privacy · Dining area with enough seating for clients in care was present and in good condition · Medication was centrally stored, locked/inaccessible. Centrally stored medication and log reviewed. · LPA's reviewed four (4) client files. No interviews were conducted · Motor Vehicle was not present during inspection due to school. · LPA observed that the facility appeared to be free of vermin · LPA observed Locked Facilities included a shed with lawn equipment · LPA reviewed complaint procedures for clients. · Board Minutes were reviewed · Disaster Preparedness was updated and available for review, quarterly drills are completed and logged in a binder and there are disaster preparedness supplies available and verified by LPA · Staff training was in compliance · Criminal record clearances were verified by LPA and in compliance · Certified Administrators certificate was valid and current · Staff job titles/qualifications were verified along with the required Hours of initial training. LPA verified that for staff that have been here longer than a year, the Hours of annual training was also present · Trauma informed practices are implemented as needed (including specialty mental health services and extracurricular activities and social supports) per discussion with the administrator. The following items were reviewed for compliance in the regional office prior to the facility inspection: Administrator Certificate for Catherine Matthews is current and verified Fees have been paid and documentation was provided No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On August 18, 2022, Licensing Program Analysts (LPA) Mary Shelton made an announced case management to the home and met with Ramzy Shehadeh, Program Director. The reason for the visit was to conduct an inspection of the home after the home changed the occupancy from five to six clients. LPA observed there to be six beds in the home. LPA conducted an exit interview and a report was provided.


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Misty Valencia on 01/18/2023 at 8:30 am. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Valencia met with Jeffrey Beesley, Executive Director, and inspected the facility inside and out. LPA reviewed 0/5 child's records and 2/6 staff personnel files on site at the facility. LPA reviewed 0/5 of child's psychotropic medications and medication records. LPA interviewed 2/6 of staff on site to discuss the facilities policies and procedures of operation. LPA interviewed 0/5 of children currently prescribed psychotropic medication. No children in care qualified as they all were private placement's. LPA provided a copy of this licensing report to Jeffrey Beesley, Executive Director. No deficiencies are being cited at this time. LPA conducted exit interview with Jeffrey Beesley, Executive Director.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced annual inspection on 4/12/2024 at 9: AM and met with Ramzy Shehadeh, Program Director. LPA did advise the agency that the inspection is being completed with the use of the CARE Tool. LPA Shelton conducted a walk-through of the office. LPA Shelton inspected and/or reviewed the following: · LPA reviewed client files. · LPA Interviewed (3) clients. · Client Records/Client Checklist using CARE Tool. · Clients with special health care needs using CARE Tool. · Emergency Intervention using CARE Tool. · Board Minutes were reviewed. · Disaster Preparedness was updated and available for review, quarterly drills are completed and logged in a binder and there are disaster preparedness supplies available and verified by LPA. · The following items were reviewed for compliance in the regional office prior to the facility inspection: Administrator Certificate for Jeffrey Beesley is current and verified. Fees have been paid and documentation was provided. No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.


summary: Facility Evaluation

narrative: Licensing Program Analyst (LPA) Mary Shelton made an unannounced Case Management - Annual Continuation inspection on 4/17/2024 and met with Jeffrey Beesley, Deputy Director and Ramzy Shehadeh, Program Director, who assisted with the inspection. LPA Shelton conducted a walk-through of the home inside and out. LPA did advise that today inspection was done using the Care Tools. LPA Shelton inspected and/or reviewed the following: · Postings of facility license and Personal Rights Poster were appropriately posted. · Disinfectants/Cleaning solutions were inaccessible and locked as required. · Carbon monoxide detectors and Smoke Detectors were present and functioning. · First Aid Kit was present and fully stocked as required. · LPA observed the Grievance/Complaint Policy is posted as required. · Allowance binder was in compliance. · Common Room (living room) was available as was a separate room in the home for privacy. · Dining area with enough seating for clients in care was present and in good condition. · Clients bedrooms/bathroom. · LPA observed that the home's water was at required temperatures at all faucets within the home. · LPA inspected the Medication Log and the Controlled Medication Log for clients in care. · LPA observed that the facility was clean and maintained during the inspection and meal menu displayed. A staff file review was conducted at the office prior to the visit. No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.


facility_name: GATEWAY RESIDENTIAL PROGRAMS-WINDING HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced annual inspection on 3/2/22 at 1: PM and met with, Catherine Matthews, Executive Director, Jeffrey Beesley, Deputy Director and Ramzy Shehadeh, Program Director. All Gateway properties were inspected by LPA on 3/1/22. LPA did advise the agency that the inspection is being completed with the use of the CARE Tool. LPA Shelton conducted a walk-through of the facility inside and out. There were no clients present during the inspection due to school. LPA observed four bedrooms with both single and double beds in each room. Two bathrooms with soap, paper towels hygiene products and towels. LPA Shelton inspected and/or reviewed the following: · Postings of facility license and Personal Rights Poster were appropriately posted · Disinfectants/Cleaning solutions were inaccessible and locked as required · Nonperishable Foods for one week and fresh perishable for foods two days minimum were present · Menu was present and posted · LPA observed a working telephone on the premises · Carbon monoxide detectors and Smoke Detectors were present and functioning · First Aid Kit was present and fully stocked as required · Common Room (living room) was available as was a separate room in each wing for privacy · Dining area with enough seating for clients in care was present and in good condition · Medication was centrally stored, locked/inaccessible. Centrally stored medication and log reviewed. · LPA's reviewed four (4) client files. No interviews were conducted · Motor Vehicle was not present during inspection due to school. · LPA observed that the facility appeared to be free of vermin · LPA observed Locked Facilities included a shed with lawn equipment · LPA reviewed complaint procedures for clients. · Board Minutes were reviewed · Disaster Preparedness was updated and available for review, quarterly drills are completed and logged in a binder and there are disaster preparedness supplies available and verified by LPA · Staff training was in compliance · Criminal record clearances were verified by LPA and in compliance · Certified Administrators certificate was valid and current · Staff job titles/qualifications were verified along with the required Hours of initial training. LPA verified that for staff that have been here longer than a year, the Hours of annual training was also present · Trauma informed practices are implemented as needed (including specialty mental health services and extracurricular activities and social supports) per discussion with the administrator. The following items were reviewed for compliance in the regional office prior to the facility inspection: Administrator Certificate for Catherine Matthews is current and verified Fees have been paid and documentation was provided No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced visit to the home and agency office on 4/7/2022 at 1: PM and met with Jeff Beesley and Ramzy Shehadeh. LPA made the visit to discuss an incident report for C1 (see LIC811 dated 3/28/2022) that occurred on 3/27/2022. In this incident C1 was trying to self-harm and attempt suicide. · What was staff's knowledge of C1's background and needs. · What type of calming techniques are used on clients and the training involved. · What issues were staff working on with C1 before and after the incident. · Who contacted and informed C1's Probation Officer/Bio Grandmother and when? While at the facility on 4/7/2022, LPA discussed the importance of ensuring the facility has knowledge and prepared to handle the behavior of new clients upon arrival. LPA requested C1's folder and reviewed all documents. LPA requested a timeline in which to address the time each incident occurred on 3/27/2022 with C1 and when Law Enforcement/Paramedics were contacted. LPA requested that this timeline be provided to Licensing by 4/22/2022. No citations were issued on this date and exit interview conducted. Documentation was provided.

met_with: Jeff Beesley, Deputy Director


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Jean Stidman on 12/6/2022 at 5pm. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Stidman met with Shawna Mason Residential Care Coordinator and inspected the facility inside and out. The facility does not currently have any clients or staff and has been vacant since June 2022. LPA did not review any child's records or staff personnel files on site at the facility. LPA did not interview any staff or children currently prescribed psychotropic medication. LPA observed the facility is a single story home with four bedrooms and two bathrooms with no clients in placement. No deficiencies are being cited at this time. LPA conducted exit interview with Shawna Mason Residential Care Coordinator. LPA will email a copy of this licensing report to Shawna Mason Residential Care Coordinator due to technical difficulties.


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
The Department has investigated the complaint that a child was restrained inappropriately. Gateway's Program Statement repeatedly establishes that they are a "hands off" program due to the residents needs to feel physically safe. Gateway does not train staff in the use of restraints nor allow staff to restrained clients. The staff involved in the incident was terminated. C1 stated that C1 keep pushing S1 to S1's limits, trash talking, and one thing led to another. C1 ran up to S1 and put his shoulder into S1. S1 then placed C1 in a headlock lock like you're getting a knuckle noogie. C1 picked up the staff and then release the staff and the incident ended at that point. As a result of the interviews conducted, documentation reviewed and investigation conducted, the allegation that a child was restrained inappropriately is SUBSTANTIATED at this time meaning that the allegation is valid because the preponderance of the evidence standard has been met. Facility cited for violations of California Code of Regulations, Title Division Six, regulation 87095.00(d) General Provisions: All children placed in a Short Term Residential Therapeutic Program have the right to be free from the use of restraints. An exit interview was conducted with Jeff Beesley and copy of the report and appeal right were provided. No title 22 regulations were cited during today's inspection.

Investigation Findings:
13Licensing Program Analyst (LPA) Mary Shelton conducted a visit on 8/18/2022, and LPA spoke with Jeff Beesley, Executive Director to deliver findings of the investigation on the complaint allegation that a child was restrained inappropriately. LPA Shelton informed the complaint investigation included a tour of the home on 5/25/2022. The initial 10-day complaint inspection was conducted by the LPA, at the home on 5/25/2022 and LPA, requested Needs and Service Individual Treatment Plan, facility sketch and training records. Interviews were conducted by LPA Mary Shelton, which included C1, C2, C3, C4, C5, S1, S2 and the agency social worker between 5/25/2022 and 8/5/2022. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Mary Shelton LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, NATOMAS PARK DR., STE FACILITY NAME: GATEWAY RESIDENTIAL PROGRAMS - HICKORY HOUSEFACILITY NUMBER: VISIT DATE: 08/18/2022

complaint_status: SUBSTANTIATED


facility_name: GATEWAY RESIDENTIAL PROGRAMS - HICKORY HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced annual inspection on 3/3/22 at 1: PM and met with, Catherine Matthews, Executive Director, and Ramzy Shehadeh, Program Director. All Gateway properties were inspected by LPA on 3/1/22. LPA did advise the agency that the inspection is being completed with the use of the CARE Tool. LPA Shelton conducted a walk-through of the facility inside and out. One staff was interviewed. There were no clients present during the inspection due to school. LPA observed four bedrooms with both single and double beds in each room. Two bathrooms with soap, paper towels hygiene products and towels. LPA Shelton inspected and/or reviewed the following: · Postings of facility license and Personal Rights Poster were appropriately posted · Disinfectants/Cleaning solutions were inaccessible and locked as required · Nonperishable Foods for one week and fresh perishable for foods two days minimum were present · Menu was present and posted · LPA observed a working telephone on the premises · Carbon monoxide detectors and Smoke Detectors were present and functioning · First Aid Kit was present and fully stocked as required · Common Room (living room) was available as was a separate room in each wing for privacy · Dining area with enough seating for clients in care was present and in good condition · Medication was centrally stored, locked/inaccessible. Centrally stored medication and log reviewed. · LPA's reviewed two (2) client files. No interviews were conducted. · Motor Vehicle was not present during inspection due to school. · LPA observed that the facility appeared to be free of vermin · LPA observed Locked Facilities included a shed with lawn equipment · LPA reviewed complaint procedures for clients. · Board Minutes were reviewed · Disaster Preparedness was updated and available for review, quarterly drills are completed and logged in a binder and there are disaster preparedness supplies available and verified by LPA · Staff training was in compliance · Criminal record clearances were verified by LPA and in compliance · Certified Administrators certificate was valid and current · Staff job titles/qualifications were verified along with the required Hours of initial training. LPA verified that for staff that have been here longer than a year, the Hours of annual training was also present · Trauma informed practices are implemented as needed (including specialty mental health services and extracurricular activities and social supports) per discussion with the administrator. The following items were reviewed for compliance in the regional office prior to the facility inspection: Administrator Certificate for Catherine Matthews is current and verified Fees have been paid and documentation was provided No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.

met_with: Catherine Matthews


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Misty Valencia on 03/03/2023 at 9: AM . This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPA Valencia met with Ramzy Shehadeh, Program Director and inspected the facility inside and out. LPA reviewed no child records and four (4) staff personnel files on site at the facility. LPA reviewed no child's psychotropic medications or medication records. LPA interviewed four (4) of staff on site to discuss the facilities policies and procedures of operation. LPA did not interview any children that were under eighteen (18) or a ward of the courts that are currently prescribed psychotropic medication. LPA provided a copy of this licensing report to Ramzy Shehadeh, Program Director. No deficiencies are being cited at this time. LPA conducted exit interview with Ramzy Shehadeh, Program Director.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced annual inspection on 4/12/2024 at 9: AM and met with Ramzy Shehadeh, Program Director. LPA did advise the agency that the inspection is being completed with the use of the CARE Tool. LPA Shelton conducted a walk-through of the office. LPA Shelton inspected and/or reviewed the following: · LPA reviewed client files. · LPA Interviewed (3) clients. · Client Records/Client Checklist using CARE Tool. · Clients with special health care needs using CARE Tool. · Emergency Intervention using CARE Tool. · Board Minutes were reviewed. · Disaster Preparedness was reviewed, quarterly drills are completed and logged in a binder and there are disaster preparedness supplies available and verified by LPA. The following items were reviewed for compliance in the regional office prior to the facility inspection: Administrator Certificate for Jeffrey Beesley is current and verified. Fees have been paid and documentation was provided. No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Mary Shelton made an unannounced Case Management - Annual Continuation inspection on 4/17/2024 and met with Jeffrey Beesley, Deputy Director and Ramzy Shehadeh, Program Director, who assisted with the inspection. LPA Shelton conducted a walk-through of the home inside and out. LPA did advise that today inspection was done using the Care Tools. LPA Shelton inspected and/or reviewed the following: · Postings of facility license and Personal Rights Poster were appropriately posted. · Disinfectants/Cleaning solutions were inaccessible and locked as required. · Carbon monoxide detectors and Smoke Detectors were present and functioning. · First Aid Kit was present and fully stocked as required. · LPA observed the Grievance/Complaint Policy is posted as required. · Allowance binder was in compliance. · Common Room (living room) was available as was a separate room in the home for privacy. · Dining area with enough seating for clients in care was present and in good condition. · Clients bedrooms/bathroom. · LPA observed that the home's water was at required temperatures at all faucets within the home. · LPA inspected the Medication Log and the Controlled Medication Log for clients in care. · LPA observed that the facility was clean and maintained during the inspection and meal menu displayed. A staff file review was conducted at the office prior to the visit. No citations were issued at the conclusion of the inspection. Exit interview was conducted and documents were provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 02/06/2025 at 2: PM, Licensing Program Analyst (LPA), Michelle Silvas arrived unannounced at Gateway - Hickory House for the purpose of initiating a case management- incident Inspection. LPA met with Mable Logo, Residential Care Counselor, who assisted with the inspection. About 40 minutes later, House Director, Simon Ballout and Program Director Ramzy Shehadeh arrived. During the inspection, LPA discussed the Incident Report received by the Department on 02/04/2025. LPA conducted a walk through of the facility inside and out. LPA Silvas Reviewed Psychotropic Medication Administration Records (paper PMAR) for C1 and conducted two staff and one client interview. An exit interview was conducted at time and a copy of this report was provided.

met_with: Mable Logo, Residential Care Couselor


summary: Facility Evaluation

raw_content:
Narrative:
On April 25, 2025 at 11:00AM, Licensing Program Analyst (LPA) Michelle Silvas made an unannounced visit to Gateway Residential Programs - Hickory House, to conduct a case management inspection. LPA met with Ramzy Shehadeh, Administrator who assisted with the inspection. 0 clients and 1 staff are present. LPA conducted an inspection of the facility inside and outside. The purpose for today's inspection is to issue a citation for 3 uncleared staff working at the facility. While conducting an inspection at one of the other Gateway homes, it was determined that multiple staff in every location did not have a criminal record clearance to work at the facility. A civil penalty of $100.00 per day for five days is being assessed for the three uncleared staff. An exit interview was conducted, and appeal rights were discussed. A copy of this report along with the appeal rights were given to Ramzy Shehadeh, Administrator.

met_with: Ramzey Shehadeh, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced Case Management inspection at the facility and met with staff Brian Perrott and Program Director Ramsay Shehadeh, Executive Director Jeff Beesley who assisted with the inspection. CCL received an incident report dated 8/21/2023 concerning an allegation made by a client that a staff member (S1 - See Confidential Names List dated 8/29/2023) purchased one vape device for two clients, let them vape in the facility vehicle, and the staff vaped in the vehicle as well. The incident report stated a meeting with the staff would be held on 8/24/2023. LPA is conducting this Case Management inspection to learn what the outcome of this investigation is and to conduct additional investigation if necessary. LPA spoke with staff, Program Director, Executive Director and found that they conducted an internal investigation which consisted of them interviewing all clients. On 8/29/ S1 was terminated for this incident. Administration attempted to call S1 in on 8/23/2023, but S1 did not come in. S1 offered to do Zoom, and Administration accommodated this on 8/24/2023, however S1 did not attend. Administration asked S1 to come in again on 8/25/2023, S1 did not appear. Today, 8/29/2023, Administration sent out a Job Abandonment and Termination Letter. On this date, the facility is being cited for a violation of the Health and Safety Code Section 1558(a)(2), Conduct Inimical, which is detailed on the attached LIC809-D page. An exit interview was conducted with ED and PD and a copy of this report and appeal rights was left with them.

met_with: Brian Perrott & Ramsay Shehadeh


facility_name: GIRLS REPUBLIC

raw_content:
Narrative:
It was alleged that staff did not inform client of notice of removal, staff requested client's removal prior to updating the Needs and Services Plan and staff prevented authorized persons from communicating with client. Confidential interviews reveal that an emergency CFT Meeting was held on 10/3/22 to preserve client's placement. Client was in attendance and the emergency CFT meeting notes state in part that, "the identified client continues to meet criteria for placement in an STRTP and the level of care provided." However, a 14-day notice of request for removal was submitted by the facility on the same day, without client's knowledge. Staff explained that client was not informed of the removal request for client's own safety and that it's the policy of the facility not to inform clients of any planned removal for safety reasons. Staff explained that client was unable to commit to safety. There was no record found of any incident or safety issues involving the client during and after the CFT meeting to indicate the need for a removal request. There was no record found that the removal request was discussed with the client. The client's NSP was not updated prior to the removal request. There was no record found showing that the client was offered an opportunity in the development of any transfer plan. The client became aware of the removal request after being informed by the client's legal team during a scheduled court hearing. The client's legal team informed staff of the need to speak to the client prior to the scheduled court hearing. The client's legal team made several attempts to speak to the client, by phone calls and emails to staff, before and after the client's court date. All attempts to speak to the client, through staff and the facility, were unsuccessful. There was no record found that client refused to speak to the legal team. Based on information obtained from confidential interviews and records obtained, the allegations are substantiated, based on the preponderance of evidence. The following deficiency citations are issued under STRTP Interim Licensing Standards - 87068.4(e)(2)(E)(1) and 87068.4(e)(2)(D) Removal and/or Transfer Procedures and 87072(c)(4) Personal Rights. These violations pose an immediate and/or potential Health, Safety, or Personal Rights risk to clients in care. A Plan of Correction was discussed with the facility representative. Copies of the following were provided at the conclusion of the inspection: LIC 9099, LIC 9099-C, LIC 9099-D and LIC Confidential Names dated 5/4/23. Appeal rights forms were provided and explained. It was alleged that staff did not ensure sharp objects were inaccessible to client and staff did not provide client's record to authorized person. Confidential interviews reveal that client had access to a compact mirror, which was an age and developmentally appropriate personal item used for grooming and make up. Although client has a history of self injurious behavior, there was no record found that such item was prohibited. Client used the compact mirror to engage in self injurious behavior while inside the bathroom, resulting in hospitalization. The client's safety/crisis intervention plan was updated after the incident. Regarding the request for client's record, the document not immediately provided by staff who explained to the requestor that information was being added to the document. The document was provided after a week. There was no evidence found that the facility refused to provide or was withholding client's record. Based on information obtained, the allegations are unsubstantiated. Although the allegations may have happened or are valid, the preponderance of evidence to prove the allegations was not met. A copy of this report and the LIC Confidential Names Form dated 5/4/23, were provided to the facility representative. Appeal rights forms were provided and explained.

Investigation Findings:
13On May 4, 2023 at 9:30AM, Licensing Program Analyst (LPA) Irene Yamamoto conducted a complaint inspection at the facility. LPA met with the facility representative named above. The purpose of the inspection is to deliver the findings for the above allegations. The investigation was conducted by LPAs Heriberto Perez and the undersigned LPA. On 11/2/22, LPA Perez conducted the initial complaint inspection at the facility and obtained the staff and client rosters, Needs and Services Plan (NSP), Incident Reports (IR) and Request for Removal. LPA Yamamoto conducted interviews with former and current staff on 3/6/23, 3/30/23, 4/11/23, 4/12/23, 4/26/23 and 4/28/23. Placement agency staff was interviewed on 4/24/23. Current clients in placement were interviewed on 4/11/23. LPA attempted to obtain statements from other related parties on 3/2/23, 4/10/23, 4/24/23 and 5/1/23; those attempts were unsuccessful. Additional records were obtained and reviewed by LPA Yamamoto on 3/2/23, 3/6/23, 4/24/23 and 4/28/23 which include, but not limited to the Child and Family Team (CFT) Meeting notes, Discharge Summary, Safety/Crisis Intervention Plan, Student Chronological Record, Behavior Report, Intake Report and Admission Agreement. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Irene Yamamoto 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 32-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, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: GIRLS REPUBLICFACILITY NUMBER: VISIT DATE: 05/04/2023

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: Danielle Lopez, Assistant Residence Director


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Continue from page 1 . . . The staff stated that during a group meeting an altercation took place with clients in the facility. The staff stated that the meeting was to discuss an argument between two clients at school. The staff stated that one client became aggressive toward the other client and the staff was redirecting the client but the client was not receptive to the staff redirection. The staff stated that the client left the room where the meeting was taken place and went to the kitchen but was followed by one of the staff, the staff stated that the client got a fork and attempted to use it against other clients. The staff stated that they were redirecting the client to give up the fork and creating space between the clients. One staff stated that she attempted to take the fork from the client but the client got loose from the staff grasp. The staff stated that the fork was obtained from the client when another client grabbed and restraint the aggressor client. The staff stated that the Law Enforcement was called when the incident was getting out of control. The confidential interviews indicated that the clients were having a group meeting to discussed the altercation between two clients at school but one of the client became upset and began to hit others in the facility. The confidential interviews indicated that the staff was redirecting the aggressive client and was creating space between the clients. The confidential interviews revealed that the aggressive client went to the kitchen and got a fork while the other clients went outside the facility to create space. The confidential interviews revealed that the aggressive client was being follow by one of the staff and was being redirected to give up the fork but the aggressive client went outside. The aggressive client was used the fork against another client and resulted in injuries (scratches) on the client. The confidential interviews revealed that another client help to restraint the aggressive client and the staff was able to get the fork from the aggressive client before law enforcement got to the facility. The confidential interviews indicated that the staff was always with the clients and were redirecting the aggressive client and attempted to take away the fork from the client. Based on the interview and records reviewed the allegation is found unsubstantiated. Although the allegation have happened or is valid, there is not a preponderance of the evidence to prove the allegation was due to neglect or lack of supervision. Appeals rights were provided and discussed with the facility representative mention above. There were no deficiencies cited.

Investigation Findings:
13On May 10, 2023, Licensing Program Analyst (LPA) Heriberto Perez conducted a follow-up complaint inspection to the above facility and met with Danielle Lopez, Assistant Supervisor. The purpose of the inspection was to deliver the finding for the above complaint allegation. During the course of the investigation, LPA interviewed two staff and three clients on 01/24/23, LPA interviewed one client via telephone on 04/14/23, LPA interviewed one staff via telephone on 04/18/23, LPA interviewed one staff and probation officer (PO) via telephone on 04/20/23 and LPA interviewed one probation officer (PO2) via telephone on 04/21/23 (see Confidential Names Form LIC 811 dated May 10, 2023). LPA also reviewed documents including but not limited to Client's Need and Service Plans, Special Incident Reports (SIR) and Law Enforcement investigation report. It was alleged Minors engaged in a physical altercation with each other at the facility resulting in injuries. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Heriberto Perez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-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, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: GIRLS REPUBLICFACILITY NUMBER: VISIT DATE: 05/10/2023

met_with: Danielle Lopez, Assistant Supervisor


summary: Facility Evaluation

raw_content:
Narrative:
On February 7, 2022, Licensing Program Analyst (LPA's) Nicolette David and Winston Moroney conducted an unannounced Annual inspection at the facility at 10: AM. LPA met with Lisa Denbo Facility Administrator. The purpose of the inspection was to conduct an Annual/Required inspection of the facility. The STRTP's Mental Health Program Application is approved. The STRTP has CARF accreditation that expires on 08/31/2024. This STRTP is licensed to serve up to six (8) ambulatory children ages 13-17 years of age. Currently, there are two (2) clients in placement. The facility is a 3- story house located in a residential neighborhood. It consists of 5 bedrooms (1 bedroom is located adjacent to staff office and is for Relief Staff). There are 4 1/2 bathrooms (2 bathrooms are located in the staff office), living room, dining room, kitchen, TV room, staff office and a clinician's office. The 3rd floor is an attic which is used for a computer Lab and arts craft. The living, dining, kitchen and TV room are located on the first floor, along with outside laundry area and downstairs basement which is used for storage. LPA observed the facility license, facility sketch, COVID signage posters, Grievance Procedures, Personal Rights, Ombudsman Poster, visitation policies, emergency disaster plan and activity calendar posted by the front entrance of the facility. The following sleeping arrangements were noted: Bedroom # 1, two twin beds, two dressers and closet Bedroom # 2 sleeps C-1, two twin beds, two dressers and closet Bedroom # 3, two twin beds, two dressers and closet. Bedroom # 4 sleeps C-2, two twin beds, two dressers and closet. All beds are clean and in good repair. Bedding and sheets were sufficient. There is adequate supply of perishable and non -perishable food. There is 2 refrigerator being used and one freezer in the laundry room. The kitchen utensils, glasses and dishes were found to be in good condition Medications, first aid kit, all cleaning supplies and laundry detergent, sharp knives and client files are kept in a locked storage room inside the locked staff office. Hot water was tested and found to be within regulatory guidelines at 120' degrees Fahrenheit. Fire/earthquake drills are conducted once a month and kept in a log. The carbon monoxide/smoke detectors were tested and found to be in good working condition. The facility is equipped with a fire alarm system which is tested annually by local fire department. In the backyard of the facility, (LPAs) observed a pool with a locked fence surrounding it, and patio furniture. There is a separate detached structure in the backyard area that is being temporary use by an employee that works at the Boys Republic site. Interviews: LPA's interviewed 3 staff that included the Administrator , Supervisor and HR . There are currently 17 staff working at the facility. LPA interviewed Clients. File Review: A review of 2 client flies and 6 staff files was conducted. Client files contained an original admission agreement. There are 2 clients currently taking medication. Files for clients currently taking prescribed medication contained all the required documentation such as the medical consent forms and authorizations. Overall, clients are provided adequate services in accordance with their needs and services plan and are being updated. Staff files contained criminal record clearances or exemptions and child abuse index check, job descriptions (except for the Administrator's file), required training and work evaluations. All documents were complete and signed by employee. All staff requiring training, including Mandated Reporter, Emergency Intervention, initial and annual training, was current. all adult individuals who require caregiver background checks have received criminal record and child abuse index check clearances or exemption. Operations Facility maintains a current, written plan of operation that meets licensing standards. Facility maintains a register of clients and the register is available upon request. The board of directors regularly conducts meeting to review and discuss the STRTP's operation. Disaster Preparedness Plan Facility maintains a current, written disaster and mass casualty plan of action. Facility conducts disaster drill at least every month for each shift. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan, register of clients, Needs and Services Plan for each client, medication records, and contact information for each client's responsible party and physician. Core/Therapeutic Services Facility provides core services and supports to children as appropriate or necessary that are trauma informed, culturally relevant, age and developmentally appropriate and include the following: Medi-Cal specialty mental health services; transition port services; educational and physical, behavioral, and mental health supports; activities to support children with services to achieve permanency. On today's inspection, there are no citations assessed during this inspection. LPA was provided with Board Minute Meetings and staffs schedule/personnel report An exit interview was completed, and a signed copy of this report was provided to the facility representative. .

met_with: Lisa Denbo


summary: Facility Evaluation

raw_content:
Narrative:
On March 30, 2023 at 9: AM, Licensing Program Analysts (LPAs) Ashley Ruacho and Pamela Silva conducted an unannounced case management inspection to the facility and met with Tanya Miller, Administrator. The purpose of the case management was to follow-up on a Special Incident Report (SIR) received by the Department regarding medication error. Per the SIR, on 02/25/23 staff (S1) made an error distributing the wrong medication to client (C1) (see LIC Confidential Names List dated 03/30/23). The nurse advised the staff on shift to monitor C1's behavior and for any possible side effects but did not anticipate any major concerns. C1's authorized representative was informed of the incident. Medication training was provided to all staff on 03/08/23 but S1 was not present during the training. Since this was S1's second error regarding medication distribution a write up was given. S1 will be provided additional medication training and shadow staff for 4-5 months before she can distribute medication again. During the inspection, LPA's reviewed medication log vs medication packets, LPA's also checked JV 220's for all clients on psychotropic medication. No deficiency citation was issued during today's inspection. An exit interview was conducted, and a copy of this report was given to the Administrator.

met_with: Tanay Miller


summary: Facility Evaluation

raw_content:
Narrative:
On September 6th, 2023 at 1:45PM, Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced case management inspection at the above facility and met with the Administrator Tanya Miller. The purpose of the visit was to obtain a copy of the facilities mental health certificate. No citation was issued during today's inspection. An exit interview was conducted and a copy of this report was provided to the Administrator.

met_with: Tanya Miller- Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On December 6th, 2023 at 3: PM, Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced case management inspection at the facility and met with the above representative. The purpose of the case management was to follow-up on a Special Incident Report (SIR) received by the Department which stated a client (C1) had fell down the staircase. (See confidential name list LIC 811). During the visit LPA conducted in person interviews with the Administrator (AD) , Case Worker (CW), and client 2 (C2), and client (C3). LPA also took a tour and checked food supply with AD. LPA needs to conduct additional interviews and document review for this incident. No deficiency citation was issued during today's inspection. Further follow-up is required. An exit interview was conducted, and a copy of this report was given to the Administrator.

met_with: Tanya Miller - Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On January 5th, 2024, at 8: AM, Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced case management inspection at the facility and met with the above representative. The purpose of the case management was to follow up on a Special Incident Report (SIR) received by the Department which stated a client (C1) had fallen down the staircase. (See confidential name list LIC 811). Per the SIR, C1 fell down the stairs and sustained bruises on one of their legs, along with scrapes and swollenness on their cheeks. The injuries were stated to be a result of the extent of the fall. The medical report suggested youth to refrain from skipping any meals, stay hydrated, and to sit in a squat position when they feel like fainting. LPA Ashley Ruacho conducted in person interviews with the Administrator (AD), Case Worker (CW), and client 2 (C2), and client 3 (C3). C1 was on AWOL status and LPA was unable to obtain an interview with them. Proper actions were taken by the facility, and it was revealed that C1 has a medical history of fainting spells. LPA toured the facility and inspected the facilities food supply, there was a surplus of both perishables and non-perishable foods. Based on information provided in interviews LPA observed that the incident was not a result of lack of supervision or lack of food supply. No deficiency citation was issued during today's inspection. No further follow-up is required. An exit interview was conducted, and a copy of this report was given to the Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On February 22nd, 2024, at 9:30AM Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced inspection at the above facility for the purpose of conducting an annual/required inspection. LPA met with Assistant Supervisor, Danielle Lopez. LPA and the Assistant Supervisor toured the facility. LPA obtained and reviewed the following updated documentation: · LIC Personnel and Client Roster · LIC C Emergency Disaster Plan · Board of Directors report and Program Statement · Employee Grievance Policy/ Grievance Procedures · Emergency Preparedness: Disaster and Mass Casualties Drills · Emergency Evacuation Routes · Facility Monthly Activities Calendar · Emergency Intervention Plan · Complaint Procedures The facility was in full compliance with 7 applicable areas of the Compliance and Regulatory Enforcement (CARE) tools for Children's Residential Licenses. Annual compliance review consisted of the following domains: Physical plant, operations, disaster preparedness plan, emergency intervention, staffing, and client records. Community Care Licensing (CCL) focuses its efforts on three priority areas: prevention, compliance, and enforcement. There are two (2) fire extinguishers throughout the facility, all fully charged and all last serviced on November 3, 2023. The facility is a 3- story house located in a residential neighborhood. It consists of 5 bedrooms (1 bedroom is located adjacent to the staff office and is for extra storage space). There are 4 1/2 bathrooms (2 bathrooms are in the staff office), a living room, dining room, kitchen, TV room, staff office and a clinician's office. The 3rd floor is an attic which is used for storage and donations. The living, dining, kitchen, and TV room are located on the first floor, along with the outside laundry area and downstairs basement which is used for storage. LPA observed the facility license, facility sketch, Grievance Procedures, Personal Rights, Ombudsman Poster, visitation policies, emergency disaster plan and activity calendar posted by the front entrance of the facility. The facility has a working telephone that is accessible to clients and staff. All passageways and grounds were free of any obstructions. The medications and cleaning solutions were locked inside the cabinets in separate storage rooms. There was perishable foods enough for 3 days and non-perishable foods enough for client's consumption for more than a week. Each bedroom has two twin beds with clean sheets and linens. There were drawers and closet space in each bedroom for client use. The hot water temperature was tested and was in working order. At the time of this inspection the facility was observed to be clean, safe, and in good repair. The facility has a Honda Odyssey minivan used to transport clients. The vehicle has an active insurance policy. Facility provides core services and supports to children as appropriate or necessary that are trauma informed, culturally relevant, age and developmentally appropriate and include the following: Medi-Cal specialty mental health services; transition port services; educational and physical, behavioral, and mental health supports; activities to support children with services to achieve permanency. For this review, four (4) Los Angeles County placements, and one (1) Riverside County placement clients were selected for the sample to assess the level of care and services they receive. Additionally, LPA reviewed six (6) staff files for compliance with Title Regulations and Interim Licensing Requirements. LPA also conducted an interview with one staff member as they were the only staff at the facility during the time of this inspection. Clients in the facility were unable to be interviewed due to being at a culinary course off site. An exit interview was conducted. LPA provided the facility representative above a signed copy the LIC 809 and LIC 811 reports. There were no deficiencies cited at the time of this inspection.

met_with: Danielle Lopez- Assistant Supervisor


facility_name: GREENACRE HOMES, INC. NO 1 (JOYCE DRIVE)

summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Brian Bertoli made an unannounced complaint investigation at the facility and met with Deputy Director Timothy Dimick, who assisted with the inspection. The purpose of the inspection was to deliver findings on the above allegation. During the course of the investigation LPA Bertoli interviewed 2 staff and the complainant, and reviewed records. The records and the interviews indicated that although the Needs and Services Plan was prepared for client C1 (see LIC 811 form dated 02/03/22), it was not sent for signature of the Authorized Representative until it was requested by them in August 2021. Based on the information obtained, there is a preponderance of the evidence to prove that the facility did not properly complete the Needs and Services Plan. Therefore, the above allegation is substantiated. Title 22 deficiencies were cited and Appeal Rights were provided and discussed with the facility. An exit interview was conducted and a copy of the report was left with Deputy Director Dimick. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: Brian Bertoli 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 21-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, NEOTOMAS AVENUE, STE. Santa Rosa, CA Facility Name: Greenacre Homes, INC. NO 1 (JOYCE DRIVE)FACILITY NUMBER: 490101336

met_with: Tim Dimick