raw_content:
Narrative:
It was reported that staff were trying to keep C1 safe and it was observed that S1 punched C1 after C1 kicked another staff. It was also reported that C1 wrestled with S1, during which S1 punched C1 and C1 punched S1 back. There were no corroborating witnesses. Confidential interview indicated C1 was new to the facility and went out of area with S1 following. According to confidential interview, C1 and S1 walked a couple blocks from the facility, and S1 didn't intervene due to C1 not showing unsafe behaviors. Confidential interview indicated C1 crossed in the middle of the street and was advised by S1 to use a crosswalk next time. Confidential interview indicated S2 and S3 arrived for support and took over to process with C1. Confidential interview indicated C1 attempted to cross the street with S2 and S3 and all were almost hit by a car. Confidential interview indicated S1 engaged in an unapproved one person hold by grabbing C1 by the collar of C1's shirt and walking C1 backwards onto the sidewalk. Confidential interview indicated C1 became aggressive towards S1, and, in an effort to keep C1 safe, S1 bent over and picked up one of C1's legs causing C1 to fall on the ground and S1 to fall as well. Confidential interview indicated S1 locked legs with C1 while on the ground, and S1 held on to C1 by one of their ankles, to prevent C1 from running into oncoming traffic, until law enforcement arrived. According to the investigation, S1 may have handled C1 in a rough manner; however, based upon information obtained, actions taken on S1's part were reportedly taken in an effort to protect and keep C1 safe. Based on the foregoing, the allegation that facility staff handled youth in a rough manner, may have occurred, however, the allegation is not supported or proven by evidence. Therefore, the allegation is unsubstantiated. An exit interview was conducted, and a copy of this signed report and appeal rights were provided to Anneka Adame, Lead Shift Supervisor.

Investigation Findings:
13On September 5, 2024, at 12: PM, Licensing Program Analysts (LPA's) Lucero Jauregui and Abby Saeteurn arrived at the facility unannounced and met with Anneka Adame, Lead Shift Supervisor to discuss the investigative findings for the allegation noted above. LPA Jauregui conducted an inspection of the facility on April 16, 2024, and no deficiencies were noted. During the investigation, LPA Jauregui interviewed two staff (S1, S4). LPA attempted to interview two staff (S2-S3), however, after numerous attempts LPA was unsuccessful. LPA obtained Special Incident Report dated 11/12/23 and Witness Statement Forms for S1- S3. On April 11, 2024, it was reported to Community Care Licensing (CCL) that facility staff handled youth in a rough manner. It was reported that while C1 was placed at the facility, on an unknown date, C1 ran away from the facility. Reportedly, C1 was making suicidal statements, trying to go into the street, and was assaultive to staff. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: LUCERO JAUREGUI 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 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # FACILITY NAME: SAN DIEGO CENTER FOR CHILDRENFACILITY NUMBER: VISIT DATE: 09/05/2024

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


state: CA

facility_name: SAN PASQUAL ACADEMY

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Based on confidential interviews and records reviewed that C1 and C2 are engaging in inappropriate interactions due to lack of supervision, which may or may not have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Rich Boyer. Due to printer malfunction, a copy of this report, LIC 811, and appeal rights will be emailed to the Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On 07/21/2023, at 10:00 am, Licensing Program Analyst's (LPA) Charmaine Linley and Jacob Salem arrived unannounced at the facility and met with Rich Boyer, Program Director, to discuss the investigative finding for the allegation noted above. LPA Linley conducted an inspection of the facility on 04/20/2023 at 9:45 am and no deficiencies were observed. LPA Linley interviewed three clients (C1-3), and eight staff (S1-8). LPA reviewed the following documents during the investigation: Client Roster, C1 and C Needs and Services Plan, and Employee Roster. LPA Linley requested a copy of the April staff schedule multiple times and did not receive a copy of the schedule. On 04/18/2023, Community Care Licensing (CCL) received an allegation that minors in care are engaging in inappropriate interactions due to lack of supervision. It was reported that C1 is being taken advantage of by C2 in a sexual nature. Confidential interviews did not corroborate the allegation with a preponderance of evidence. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FACILITY NAME: SAN PASQUAL ACADEMYFACILITY NUMBER: VISIT DATE: 07/21/2023

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

report_type: Complaint Investigation

met_with: Rich Boyer

complaint_status: unsubstantiated


raw_content:
Narrative:
allegations with a preponderance of evidence. Based on confidential interviews and records reviewed that staff are not supervising minors leading to physical altercations and inappropriate behaviors, staff did not intervene when minor made inappropriate comments towards C1, staff did not safeguard C1's personal belongings, minor's room has pests, which may have occurred, however, it is not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Rich Boyer. Due to printer malfunction, a copy of this report, LIC 811, and appeal rights will be emailed to the Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On 11/02/2023, at 10:05 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Rich Boyer, Program Director, to discuss the investigative finding for the allegations noted above. LPA Linley and Salem conducted an inspection of the facility on 07/21/2023 at 10:15 am and no deficiencies were observed. LPA Linley and Salem interviewed four clients (C1-4), and six staff (S1-6). LPA reviewed the following documents during the investigation: Client Roster, Special Incident Reports, July Schedule, Student Handbook, and Control Invoices. On 07/19/2023, Community Care Licensing (CCL) received allegations that staff are not supervising minors leading to physical altercations and inappropriate behaviors, staff did not intervene when minor made inappropriate comments towards C1, staff did not safeguard C1's personal belongings, minor's room has pests. Confidential interviews revealed conflicting statements. Confidential interviews did not corroborate the UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-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, FACILITY NAME: SAN PASQUAL ACADEMYFACILITY NUMBER: VISIT DATE: 11/02/2023

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


raw_content:
Narrative:
may have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Rich Boyer. Due to printer malfunction, a copy of this report, LIC 811, and appeal rights will be emailed to the Facility Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On 12/04/2023, at 12:45 pm, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Rich Boyer, Program Director, to discuss the investigative finding for the allegation noted above. LPA conducted an inspection of the facility on 08/18/2023 at 1:20 pm and no deficiencies were observed. LPA Linley interviewed one client (C1), and three staff (S1-3). LPA reviewed the following documents during the investigation: C1's Child-Family-Team Meeting Notes, C1's Health and Education Passport, C1's Needs and Services Plan, and C1's School Enrollment Forms. On 08/17/2023, Community Care Licensing (CCL) received an allegation that staff are refusing to transport C1 to school. Confidential interviews revealed conflicting statements. Confidential interviews did not corroborate the allegation with a preponderance of evidence. Based on confidential interviews and records reviewed that staff are refusing to transport C1 to school, which UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-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, FACILITY NAME: SAN PASQUAL ACADEMYFACILITY NUMBER: VISIT DATE: 12/04/2023

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


raw_content:
Narrative:
Conflicting interviews reported that the hole was fixed within two weeks. Confidential interviews reported that a verbal request was made to fix the hole in the bedroom, however, the facility did not have written documentation of the repair request. Confidential interviews reported that one of the bedrooms had ants for several days. Conflicting information reported that ants were not observed in the bedroom. Per LPA's observation, one of the bedrooms had ants and a call was made to pest control to spray the house during LPA's visit, however it was unknown if clients had brought the concern of the ants to the staff's attention prior to the inspection. Thus, confidential interviews did not corroborate the allegations with a preponderance of evidence. Based on confidential interviews and records reviewed the allegations, that the licensee does not ensure the facility is in good repair and the licensee does not ensure the facility is free from pests, which may have occurred, however, it is not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Wayne Ferguson. Due to printer malfunction, a copy of this report, LIC 811, and appeal rights will be emailed to the Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On 12/19/2023, at 8:00 pm, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Wayne Ferguson, Deputy Director, to discuss the investigative finding for the allegations noted above. LPA conducted an inspection of the facility on 11/02/2023 at 10:30 am and no deficiencies were observed. LPA Linley interviewed two clients (C1, C2) and LPA interviewed four staff (S1-4). LPA reviewed the following documents during the investigation: Pest control invoices and August and September Compliance Review Reports. On 10/23/2023, Community Care Licensing (CCL) received allegations that the licensee does not ensure the facility is in good repair and the licensee does not ensure the facility is free from pests. It was reported that one of the bedrooms has a hole in the wall, has bugs, and the outlets do not work. It was reported that staff are aware of the condition of the room and have not been willing to fix it. Confidential interviews revealed conflicting statements. Some interviews reported the hole in the bedroom was not fixed for several months. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-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, FACILITY NAME: SAN PASQUAL ACADEMYFACILITY NUMBER: VISIT DATE: 12/19/2023

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

met_with: Wayne Ferguson


raw_content:
Narrative:
Some interviews reported that C1 was offered first aid and an ice pack. Conflicting interviews reported that C1 was not offered medical attention and had to call emergency services for an ambulance to take them to the Emergency Room. Thus, confidential interviews did not corroborate the allegation with a preponderance of evidence. Based on confidential interviews and records, the allegation that staff did not seek C1 medical attention, which may have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Rich Boyer, Program Director. Due to printer malfunction, a copy of this report, LIC 811, and appeal rights was emailed to the Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On February 27, 2024 at 11:20 am, Licensing Program Analyst (LPA) Charmaine Linley conducted an unannounced complaint inspection at the above facility. LPA Linley met with Rich Boyer, Program Director. The purpose of the inspection was to deliver the findings of the complaint investigation. LPA Linley conducted an inspection of the facility on 10/11/2023 at 2:05 pm and no deficiencies were found. LPA Linley interviewed four clients (C1-4), one Protective Services Worker and Supervisor (PSW, PSS), and five staff (S1-5). During the investigation, the following documents were reviewed: Client Roster, Personnel Report, C1's Needs and Services Plan, C2's Needs and Services Plan, Special Incident Report, C1's visitation paperwork, Van mileage log, and photos of C1 and C2. On 10/09/2023, Community Care Licensing (CCL) received an allegation that staff did not seek youth medical attention. Confidential interviews revealed conflicting statements. It was reported that C1 was involved in a physical altercation and had injuries to their face and staff did not offer C1 medical attention. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-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, FACILITY NAME: SAN PASQUAL ACADEMYFACILITY NUMBER: VISIT DATE: 02/27/2024

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


raw_content:
Narrative:
Based on confidential interviews and record review the allegation that S6 spoke to C1 in an inappropriate manner is substantiated. The preponderance of evidence standard has been met. The facility is cited for violation of the California Code of Regulations, Title Division Six, regulation 84072(d)(10) Personal Rights. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Rich Boyer. Due to printer malfunction, a copy of this report, LIC 811, and appeal rights were emailed to Rich Boyer. A copy of this report will be placed in the facility file. indicated that sometimes the facility does not have enough staff to open the gym and supervise the clients in the gym or recreational areas. Confidential interviews indicated the facility is trying to hire additional employees to work on the weekends. Confidential interviews did not corroborate the allegation with a preponderance of evidence. Based on confidential interviews and records reviewed the allegation that staff are not meeting the needs of youth in care, which may have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Rich Boyer. Due to printer malfunction, a copy of this report, LIC 811, and appeal rights were emailed to Rich Boyer. A copy of this report will be placed in the facility file.

Investigation Findings:
13On March 20, 2024, at 11:55 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility and met with Rich Boyer, Program Director, to discuss the investigative finding for the allegation noted above. LPA conducted an inspection of the facility on January 24, 2024, at 2:30 pm and no deficiencies were observed. LPA interviewed eight clients (C1-8) and five staff (S1-5). LPA reviewed the following documents during the investigation: Special Incident Report, Client Roster, Staff Schedules, and Recreational Activity Schedules. On January 18, 2024, Community Care Licensing (CCL) received an allegation that S6 spoke to C1 in an inappropriate manner. It was reported that C1 made inappropriate comments to S6 and S6 responded, "hoe-ass staff hates you too." Confidential interviews confirmed that S6 responded to C1 with inappropriate comments. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-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, FACILITY NAME: SAN PASQUAL ACADEMYFACILITY NUMBER: VISIT DATE: 03/20/2024

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:


summary: Complaint Investigation - Unsubstantiated - 3 allegations

raw_content:
Narrative:
.... CONTINUED During the investigation, LPA Saeteurn interviewed clients (C1 -C9), staff (S2-S6), one witness (W1) and reviewed pertinent facility records. Confidential interviews revealed that staff at the facility are instructed to perform walk troughs of the homes to ensure everything is in operating condition. Confidential interviews indicated that on September 9, 2024, S3 was performing a walk through of the facility to ensure that everything was in proper working order and if any repairs or maintenance were needed. Confidential interviews revealed that S3 was checking on the condition of the restroom located next to C1's room when S3 observed a candle and burnt matches on the restroom sink area. Confidential interviews revealed that when S3 found the candle inside the restroom, S3 called S4 to inquire who the candles belonged to. Confidential interviews revealed that staff were unaware who the candle and matches in the restroom belonged to, but staff also found two candles in C1's bedroom. Confidential interviews revealed that the candles that belonged to C1 were located on a dresser/vanity that is placed next to the restroom door and were found in plain sight. A walk through inspection of the facility performed by LPA Saeteurn revealed that in order to access the restroom where the candle and matches were found by S3, the restroom would need to be accessed from entrances located inside client rooms. The restroom can be accessed through an entrance located in front of C1's bedroom area. A review of pertinent records show that students are notified through their student handbook that staff are to "visually inspect student rooms to ensure student safety and cleanliness." The handbook also details that "staff do not conduct invasive inspections of student's personal items without reasonable cause, but staff have the right to clean and organize a student's bedroom in order to meet state guidelines and regulations". Confidential Interviews confirmed that staff are instructed to check minor's rooms daily to ensure they are "clean" and free of debris or hazards. Confidential Interviews indicated that after the candles were found in C1's room, S3 had a conversation with S4 and requested that staff remind C1 and all other minors in care that burning candles in the facility is not allowed for safety reasons. Continued... Confidential interviews revealed the candles were left where they were found and S3 disposed of the matches. Confidential interviews revealed that C1 was informed that lighting candles in the facility is not allowed, but a conflicting confidential interview disclosed that only C1 was asked to stop lighting candles. A confidential interview revealed staff did not discuss the matter with other clients in the facility. Due to refusal of interviews from clients, LPA was unable to confirm if S4 discussed the information with any other minors other than C1. Based on LPA observation and confidential interviews conducted, the allegations that facility staff unreasonably searched a minor's personal belongings and staff were not treating the minor with dignity are unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted with Richard Boyer, Program Director. A copy of this report and appeal rights were provided and reviewed with Richard Boyer, Program Director, whose signatures on this report confirm receipt of these documents.

Investigation Findings:
13On November 5, 2024 at 3: PM, Licensing Program Analyst (LPA) Abby Saeteurn made an unannounced visit to San Pasqual Academy and met with Richard Boyer, Program Director to deliver the findings for the above-stated allegations. On September 11, 2024, Community Care Licensing (CCL) received a complaint alleging staff (S3) unreasonably searched a minor's (C1) personal belongings and staff (S3) were not treating the minor (C1) with dignity. The complaint specified that on September 9, 2024, staff searched a minor's belongings and touched their things while the minor was not present. It was reported that the minor was not notified of this search and there was no reason for the search to have been performed. It was also reported that staff falsely accused the minor of having matches due to staff finding candles in the minor's possession which appeared to have been lit previously. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: Abby Saeteurn 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 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # San Diego, CA Facility Name: San Pasqual Academyfacility Number: Visit Date: 11/05/ Narrative 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32.... CONTINUED During the investigation, LPA Saeteurn interviewed clients (C1 -C9), staff (S2-S6), one witness (W1) and reviewed pertinent facility records. Confidential interviews revealed that staff at the facility are instructed to perform walk troughs of the homes to ensure everything is in operating condition. Confidential interviews indicated that on September 9, 2024, S3 was performing a walk through of the facility to ensure that everything was in proper working order and if any repairs or maintenance were needed. Confidential interviews revealed that S3 was checking on the condition of the restroom located next to C1's room when S3 observed a candle and burnt matches on the restroom sink area. Confidential interviews revealed that when S3 found the candle inside the restroom, S3 called S4 to inquire who the candles belonged to. Confidential interviews revealed that staff were unaware who the candle and matches in the restroom belonged to, but staff also found two candles in C1's bedroom. Confidential interviews revealed that the candles that belonged to C1 were located on a dresser/vanity that is placed next to the restroom door and were found in plain sight. A walk through inspection of the facility performed by LPA Saeteurn revealed that in order to access the restroom where the candle and matches were found by S3, the restroom would need to be accessed from entrances located inside client rooms. The restroom can be accessed through an entrance located in front of C1's bedroom area. A review of pertinent records show that students are notified through their student handbook that staff are to "visually inspect student rooms to ensure student safety and cleanliness." The handbook also details that "staff do not conduct invasive inspections of student's personal items without reasonable cause, but staff have the right to clean and organize a student's bedroom in order to meet state guidelines and regulations". Confidential Interviews confirmed that staff are instructed to check minor's rooms daily to ensure they are "clean" and free of debris or hazards. Confidential Interviews indicated that after the candles were found in C1's room, S3 had a conversation with S4 and requested that staff remind C1 and all other minors in care that burning candles in the facility is not allowed for safety reasons. SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: Abby Saeteurn LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: LIC9099 (FAS) - (06/04)Page: 3 of Control Number 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # San Diego, CA Facility Name: San Pasqual Academyfacility Number: Visit Date: 11/05/ Narrative 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32continued... Confidential interviews revealed the candles were left where they were found and S3 disposed of the matches. Confidential interviews revealed that C1 was informed that lighting candles in the facility is not allowed, but a conflicting confidential interview disclosed that only C1 was asked to stop lighting candles. A confidential interview revealed staff did not discuss the matter with other clients in the facility. Due to refusal of interviews from clients, LPA was unable to confirm if S4 discussed the information with any other minors other than C1. Based on LPA observation and confidential interviews conducted, the allegations that facility staff unreasonably searched a minor's personal belongings and staff were not treating the minor with dignity are unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted with Richard Boyer, Program Director. A copy of this report and appeal rights were provided and reviewed with Richard Boyer, Program Director, whose signatures on this report confirm receipt of these documents. SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: Abby Saeteurn LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: LIC9099 (FAS) - (06/04)Page: 2 of 3

Allegations:
- UnsubstantiatedEstimated Days of Completion:
- Unsubstantiated Estimated Days of Completion:
- Unsubstantiated Estimated Days of Completion: 0

met_with: Richard Boyer, Program Director


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
During the investigation, LPA Saeteurn interviewed clients (C1 - C4, C6-C10), staff (S1-S7), and one witness (W1). Pertinent facility records were also reviewed during the process of the investigation. Confidential interviews and record review indicated that the facility hosted various activities for clients to participate in early summer into late September. Some of the activities included the use of the pool for recreational activity. Confidential interviews revealed that during the summer, clients participated in a summer pool event in which both clients and staff were present. Confidential interviews confirmed S1 was present and supervising clients when S1 jumped into the pool while clients were swimming. Confidential interviews revealed that S1 took off their shirt and left their pants on to jump into the pool. Confidential interviews revealed that clients believed it was "weird" and it made them feel "uncomfortable". One confidential interview revealed that S1 was swimming near a client, and it made them feel "scared". Confidential interviews revealed that clients requested S1 get out of the pool, and some confidential interviews revealed that S1 remained in the pool despite clients requesting S1 to get out. A confidential interview with S1 confirmed their presence in the pool with clients. A confidential interview revealed that staff are allowed to swim with clients at the facility however, other confidential interviews reveal that there is no set policy. Confidential interviews revealed that the facility does not have a policy regarding staff entering the pool to swim with clients, but some confidential interviews reveal that staff do not believe it is allowed. During the process of the investigation confidential interviews also revealed that both S2 and S4 have supervised clients while at the pool, however contradicting confidential interviews revealed that there have been no situations in which clients reported feeling uncomfortable with other staff while at the pool. A confidential interview revealed that S2 once transported C1 and made an uncomfortable comment stating "I save the best for last" while transporting the client in care. A confidential interview revealed that there were times in which S2 was transporting clients alone, however, contradicting confidential interviews reveal there have not been any complaints or reports by clients regarding S2 while transporting clients. Continued... Based on LPA observation, record review and interviews conducted, the preponderance of the evidence standard has been met, therefore the above allegation that facility staff interact inappropriately with minors in care is found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 6, Chapter 5, Section 84072 (d)(1) is being cited (see attached LIC 9099D). An exit interview was conducted with Wayne Ferguson, Deputy Director. A copy of this report and appeal rights were provided and reviewed with Wayne Ferguson, Deputy Director, whose signature on this report confirms receipt of these documents.

Investigation Findings:
13On November 27, 2024 at 09: AM, Licensing Program Analyst (LPA) Abby Saeteurn made an unannounced visit to San Pasqual Academy and met with Wayne Ferguson, Deputy Director to deliver the findings for the above-stated allegations. LPA Saeteurn initiated a complaint inspection at the facility on September 19, 2024, at 2: PM and no immediate deficiencies were observed. On September 17, 2024, Community Care Licensing (CCL) received a complaint alleging that facility staff interact inappropriately with minors in care. It was reported that S1 once jumped in the swimming pool while clients were in the pool and was swimming near clients. It was also reported that S2 and S4 look at clients in their bathing suits and give them the creeps. Additionally, it was reported that S2 flirts with clients and S4 offered to take a client if they "ever wanted to AWOL". Continued on Lic 9099c... SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: Abby Saeteurn 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 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # FACILITY NAME: SAN PASQUAL ACADEMYFACILITY NUMBER: VISIT DATE: 11/27/2024

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

met_with: Wayne Ferguson, Deputy Director

complaint_status: SUBSTANTIATED


raw_content:
Narrative:
participated in a mediation conducted by the facility regarding the alleged incident, during which time S1 stated S1 did not recall placing S1's hands on C1 but did apologize for making C1 feel uncomfortable. Based on confidential interviews and record review, although the allegation of minor (Child #1 (C1) was inappropriately touched by staff (Staff #1 (S1), may or may not have occurred, however it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report was provided along with appeal rights San Pasqual Academy Residential Director, Beth Hyde.

Investigation Findings:
13On June 3, 2021 at 2:26pm, Licensing Program Analyst (LPA), Nicole Strickland, met with San Pasqual Academy Residential Director, Beth Hyde, to deliver the finding for the above stated allegation. The investigation was conducted by Special Investigator, Ernestina Bellucco with Community Care Licensing's (CCL) Investigations Branch Bureau. The investigation included interviews with Resident Director, Child #1 (C1), Child #2 (C2), Child #3 (C3), Staff #1 (S1), Staff #2 (S2), Staff #3 (S3), C1's Court Appointed Advocate (CASA). In addition, county records and facility records were reviewed. On May 5, CCL received an allegation of Minor (Child #1 (C1) inappropriately touched by staff (Staff #1 (S1). Specifically, it was reported C1 disclosed C1 was "sexually assaulted" by C1's boss. Confidential interviews revealed details of the "sexual assault" to be an incident where S1 allegedly placed S1's hands on C1's waist for an extended period of time. Confidential interviews could not confirm or dispute that S1 put S1's hands on C1 for any period of time. Confidential interviews and record review revealed C1 and S 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 08-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, FACILITY NAME: SAN PASQUAL ACADEMYFACILITY NUMBER: VISIT DATE: 06/03/2021

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

met_with: Residential Director, Beth Hyde


raw_content:
Narrative:
Specifically, it was reported that C1 was "sexually assaulted" by S1. Confidential interviews revealed details of the "sexual assault" to be an incident where S1 allegedly touched C1's buttocks in the kitchen. Confidential interviews could not confirm or dispute that S1 touched C1's buttocks or that S1 touched C1's buttocks purposely as the spacing in the kitchen is tight. There were no witnesses to the alleged incident. Based on confidential interviews and record review, although the allegation of Child #1 (C1) was inappropriately touched by staff (S1), may or may not have occurred, however it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report was provided along with appeal rights San Pasqual Academy Campus Director, Tia Moore

Investigation Findings:
13On August 17, 2021 at 10:20 am, Licensing Program Analyst (LPA), Danielle Garcia and LPA Carol Anderson, met with San Pasqual Academy Campus Director, Tia Moore, to deliver the finding for the above stated allegation. The investigation was conducted by Special Investigator, Hector Quintanar with Community Care Licensing's (CCL) Investigations Branch Bureau. The investigation included interviews with Clients Social Worker (SW1), San Diego County Sheriff Department (SD1), San Pasqual Academy School Counselor (SC1), Social Worker #2 (SW2), San Diego County Children's Welfare Services Protective Services Supervisor (CWS1), and San Pasqual Academy staff (S1). In addition, county reports and facility records were reviewed. On March 22, 2021, CCL received an allegation of Minor Child #1 (C1) was inappropriately touched by staff (S1). UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Danielle Garcia 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 08-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, METROPOLITAN DR. # FACILITY NAME: SAN PASQUAL ACADEMYFACILITY NUMBER: VISIT DATE: 08/17/2021

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

met_with: Tia Moore


raw_content:
Narrative:
Based on confidential interviews and information gathered during the investigation the allegation that S1 is making inappropriate comments to C1 is substantiated. The preponderance of evidence has been met. This poses an immediate Health and Safety, or personal rights violation. The facility is being cited for California Code of Regulations, Title 22, Division Six, regulation 84072(d)(10) Personal Rights. An exit interview was conducted, appeal rights discussed, and a copy of this report was provided to Program Director Tia Moore.

Investigation Findings:
13On March 21, 2023, at 2:10PM, Licensing Program Analyst (LPA) Carol Anderson completed the investigation on the above allegation. During the complaint investigation, LPA reviewed Client 1 (C1) file. LPA interviewed four of four Staff (S1 - S4), and one of three Clients (C1 - C3). One client (C4) was unavailable to be interviewed. LPA reviewed FC1's Appraisal Needs, and Services Plans, County of San Diego Health and Human Services report as well as Special Incident Report. The Department received a complaint on April 27,2022, that staff are making inappropriate comments towards minor. Confidential interviews reported that S1 admitted using the word prostitution towards C1 instead of the trauma inform approach Commercial Sexual Exploitation Children (CSEC) during a meeting with County Social Worker. Confidential interviews revealed that S1 was directed to use more appropriate trauma inform language. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Carol Anderson 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 08-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, METROPOLITAN DR. # FACILITY NAME: SAN PASQUAL ACADEMYFACILITY NUMBER: VISIT DATE: 03/21/2023

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


raw_content:
Narrative:
Based on confidential interviews and documents reviewed during the investigation, the allegation that staff did not safeguard C1's personal belongings, may have occurred, however, is not supported or proven by evidence. Therefore, the allegation is unsubstantiated. An exit interview was conducted, appeal rights discussed, and a copy of this report was provided to Program Director Tia Moore.

Investigation Findings:
13On March 21, 2023, at 2:52PM, Licensing Program Analyst (LPA) Carol Anderson completed the investigation on the above allegation. During the complaint investigation, LPA reviewed Client 1 (C1) file. LPA interviewed four of four Staff (S1 - S4), and three of four Clients (C1 - C3). One client (C4) wase unavailable to be interviewed. LPA reviewed FC1's Appraisal Needs, and Services Plans, County of San Diego Health and Human Services report as well as Special Incident Report. The Department received a complaint on April 27,2022, that staff did not safeguard minor's personal belongings. Confidential interviews revealed that when C AWOLed from the facility, C1's full-length mirror was missing, one full-length mirror broken, and C1'strip lights were missing. However, confidential interviews revealed when C Awoled staff packed up C1's personal belongings, and staff observed C1's full-length mirror was cracked, and C1's strip lights were not attached to the wall and had been broken. There were conflicting statements to weather the items were previously broken and if they were replaced when C1 returned to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Carol Anderson 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 08-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, METROPOLITAN DR. # FACILITY NAME: SAN PASQUAL ACADEMYFACILITY NUMBER: VISIT DATE: 03/21/2023

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


raw_content:
Narrative:
sitting outside the door. It is unknown how long C1 and C2 were alone and if any sexual acts occurred. Based on confidential interviews and records reviewed that C1 was sexually abused by C2 while at the facility, due to lack of supervision, which may or may not have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Beth Hyde. Due to printer malfunction, a copy of this report will be emailed to the Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On May 5, 2023, at 11:05 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at W Valley Pkwy, Escondido, California and met with Beth Hyde, Residential Director, to discuss the investigative finding for the allegation noted above. LPA Charmaine Linley and LPM Ann Valenzuela conducted an inspection of the facility on 02/23/2023 at 8:00 am and no deficiencies were observed. LPM Valenzuela interviewed two clients (C1, S2), one staff (S1) and LPA Linley interviewed one staff (S2). LPA reviewed the following documents during the investigation: Special Incident Reports. On 02/14/2023, Community Care Licensing (CCL) received an allegation that a Minor was sexually abused by another minor at the facility due to lack of supervision. It was reported that C2 asked C1 to give them oral sex and C1 agreed. Confidential interviews revealed conflicting statements to whether the act occurred. Furthermore, confidential interviews indicated that the C2 and C1 were being supervised by staff that was UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-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, FACILITY NAME: SAN PASQUAL ACADEMYFACILITY NUMBER: VISIT DATE: 05/05/2023

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

met_with: Beth Hyde


raw_content:
Narrative:
fighting, and called for additional staff. Conflicting interviews reported that staff stood by the doorway and called for additional staff to intervene. Confidential interviews did not corroborate the allegation with a preponderance of evidence. Based on confidential interviews and records reviewed that staff did not intervene in an altercation between C1 and C2, which may or may not have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Tia Moore. Due to printer malfunction, a copy of this report, LIC 811, and appeal rights will be emailed to the Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On September 26, 2023, at 9:55 am, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the facility's FFA Office and met with Tia Moore, Facility Administrator, to deliver the investigative finding for the allegation noted above. LPA Meza-Gonzalez conducted an inspection of the facility on 03/02/2023 at 9:45 am and no deficiencies were observed. LPA Linley interviewed two clients (C1, C2) and four staff (S1-4). LPA reviewed the following documents during the investigation: Special Incident Report, House Roster, C1 and C2's Emergency and Identification forms, and C1 and C2's Needs and Services Plan. On February 24, 2023, Community Care Licensing (CCL) received an allegation that staff did not intervene in an altercation between minors. It was reported that C1 and C2 were involved in a physical altercation and staff told the minors "they did not get paid enough to intervene." Confidential interviews revealed conflicting statements. Some interviews reported that staff stood in between C1 and C2, redirected them to stop UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-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, FACILITY NAME: SAN PASQUAL ACADEMYFACILITY NUMBER: VISIT DATE: 09/26/2023

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


raw_content:
Narrative:
Confidential interviews revealed conflicting statements. Confidential interviews did not corroborate the allegation with a preponderance of evidence. Based on confidential interviews and records reviewed that staff did not prevent C1 from having access to a lighter while in care and staff did not prevent C1 from causing harm to C2, which may have occurred, however, it is not supported or proven by the evidence. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, appeal rights explained, and a copy of this report was reviewed with Beth Hyde. Due to printer malfunction, a copy of this report, LIC 811, and appeal rights will be emailed to the Administrator. A copy of this report will be placed in the facility file.

Investigation Findings:
13On 10/12/2023, at 10: AM, Licensing Program Analyst (LPA) Charmaine Linley arrived unannounced at the organization's FFA Office and met with Beth Hyde, Student and Alumni Success Coordinator, to discuss the investigative finding for the allegations noted above. LPA Carol Anderson conducted an inspection of the facility on 02/14/2023 at 10: AM and no deficiencies were observed. LPA Linley interviewed four clients (C1-4), and eight staff (S1-2, 4-9), and was unable to interview one staff (S4), despite multiple attempts to contact them. LPA reviewed the following documents during the investigation: Special Incident Reports, San Marcos Sheriff's Department Incident Report, Overnight Supervision Logs, Communication Logs, Housing Roster, and C1 and C2's Needs and Services Plan. On 02/09/2023, Community Care Licensing (CCL) received allegations that staff did not prevent a minor from having access to a lighter while in care and staff did not prevent a minor from causing harm to another minor. It was reported that C2 set C1's bed on fire while C1 was sleeping in the bed on two separate occasions. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Charmaine Linley LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-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, FACILITY NAME: SAN PASQUAL ACADEMYFACILITY NUMBER: VISIT DATE: 10/12/2023

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


summary: Facility Evaluation

raw_content:
Narrative:
On June 24, 2021 at 4:03pm Licensing Program Analyst (LPA) Nicole Strickland returned to the facility to follow-up on a Plan of Correction (POC) that has not been received by Community Care Licensing (CCL). LPA Strickland met with San Pasqual Academy Supervisor, Tia Moore. The facility was cited on June 3, 2021 at 3:01pm for a type B Personal Rights violation, FFA Interim Licensing Standards (ILS) 84072(d). CCL requested a POC that the Residential Director acknowledged and signed be submitted to CCL by June 18, 2021. The POC was to include a signed memorandum of understanding (MOU) by Staff #1 (S1) regarding appropriate trauma informed communication between all staff and residents and S1 will participate in a individual training regarding appropriate trauma informed communications. Residential Director will provided LPA proof of completion of training and a copy of the MOU by POC date 6/18/2021. As of today's date CCL has not received the POC. Academy Supervisor informed LPA that S1 has been out sick and therefore they were unable to complete the POC. LPA issued a Technical Advisory LIC 9102. A copy of this report along with the LIC 9102 were provided to San Pasqual Academy Supervisor, Tia Moore

report_type: Facility Evaluation

met_with: Academy Supervisor, Tia Moore


facility_name: SANWAL GROUP HOMES INC.

summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Based on interviews conducted throughout the investigation process, 5 out of 8 interviews stated that no one has observed any form of aggression from any staff towards any clients in care at the facility. However, 2 out of 8 people of interest could not be interviewed due to a disability diagnosis. LPA conducted facility visits on 7/31/2025 and 8/28/2025, LPA did not observe any marks or bruises on any youths placed at the facility; LPA also observed youth to remain in close proximity of staff without signs of fear. Although the allegation may have happened or is valid there is not a preponderance of evidence to prove the alleged violation did occur therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted, and Appeal Rights were discussed with Gurjit Dhaliwal, Facility Manager. A copy of this report and Appeal Rights were left at the facility.

Investigation Findings:
13On 10/30/ Licensing Program Analyst (LPA) Sara Luman-Gonzalez conducted an unannounced visit to the above agency to deliver the findings of a complaint investigation. LPA met with Gurjit Dhaliwal, Facility Manager and was granted entry. During the investigation, LPA conducted the 10-day inspection of the facility on 7/31/2025. LPA obtained Incident Reports for last month, Needs and Services Plan for 1 client, 3 months of Case Notes for 1 client, Staff Roster, Staff Contact information, Client Roster, and Staff Schedule for June and July. Eight confidential interviews were conducted between July 2025 and October 2025 by LPA Luman-Gonzalez. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Connie Goldie LICENSING EVALUATOR NAME: Sara Luman-Gonzalez 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: SANWAL GROUP HOMES INC.FACILITY NUMBER: VISIT DATE: 10/30/2025

met_with: Gurjit Dhaliwal, Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 04/03/2024 ,at 02: PM, Licensing Program Analyst (LPA) Connie Goldie made an announced pre-licensing inspection at the facility and met with Administrator, Gaganjit Sandhu and Licensee, Harvir Dhaliwal, who assisted LPA with the inspection. During the pre-licensing inspection, LPA Goldie toured the facility inside and out and observed that the facility was clean inside and safe. The outside of the facility is free of debris and has adequate space for client use. The home was a comfortable 71 degrees. LPA Goldie observed four single occupancy client rooms equipped with appropriate furniture, bedding and supplies. LPA observed light blankets for beds currently not in place. Licensee agreed to place a blanket on each resident's bed. LPA observed three bathrooms in the facility that are accessible to client use and equipped with soap and towels. LPA observed that the medication cabinet is located in the kitchen/dining area and is locked and inaccessible to clients in care. LPA observed that the kitchen area is equipped with an adequate number of utensils, dining supplies, and cups for clients. LPA observed that the dishwasher is working. LPA advised licensee that non-perishable foods need to be obtained. LPA observed that there is office space as required that is locked and inaccessible to clients in care. LPA observed nine smoke/carbon monoxide detectors which were tested and functional during the inspection. LPA observed one fire extinguisher located in the pantry that were last inspected on 10/12/2023. LPA observed a first aid kit in the kitchen area as required. Licensee advised to obtain a first aid guide per regulation. The water temperature initially measured 131 degrees. The water heater was adjusted and measured 109 degrees within acceptable compliance range. The laundry room has an operating washer and dryer and secured cabinets for chemicals. The garage is organized and has storage space. . LPA completed Component Three of the licensing process with Ms. Sandhu and Ms. Dhaliwal by reviewing regulation and processes with them. LPA reminded licensees that CCL needs to be notified within five days of a client being placed in the facility and that LIC forms LIC500, LIC308 and LIC610 will need to be updated. An unannounced post licensing inspection will follow within 90 days. LPA explained that any changes to the Board of Directors need to be communicated to the Department within 10 days and board meetings need to occur quarterly. The following topics were discussed: Fingerprint clearances, Guardian, LPA inspections, citation/advisory note process, civil penalty types, CARE tools, CDSS forms and how to find them, exceptions and waivers, ACLs, ACINs, PINs, reporting requirements, inspection authority, POCs, extensions on POC due dates, client access to telephones, and personal rights. LPA Goldie recommends that the facility be licensed upon completion of technical advisories.

visit_type: Prelicensing

met_with: Gaganjit Sandhu Harvir Dhaliwal


summary: Facility Evaluation

raw_content:
Narrative:
On 03/20/2025, Licensing Program Analyst (LPA) Connie Goldie made an unannounced visit to the above facility for the purpose of conducting a Post Licensing Inspection. LPA met with Gaganjit Sandhu. Program Administrator and Harvir Dhaliwal, Licensee who provided LPA with a tour of the interior and exterior of the facility. LPA observed the following: This facility has 4 bedrooms, 2 living rooms, kitchen, backyard and 3 bathrooms. LPA observed fixtures and furniture, equipment, and supplies necessary for this operation. LPA observed locked cabinets personnel files to ensure confidentiality. LPA tested nine combination smoke detectors and carbon monoxide detectors. LPA observed chemicals and sharps to be locked. A first aid kit and fire extinguishers were on site. The water temperature was tested and found to be above a safe temperature in bathroom #2 121.6 degrees. Administrator immediately lowered hot water heater to bring into compliance.. LPA Goldie observed the agency's license posted near the front door, the emergency disaster plan, personal rights poster, menu and activity calendar posted in the dining area. The agency currently employs one Administrator, one Licensee, and Direct Support Professionals. The agency currently has two clients in care. LPA reviewed two client's files with all required documents and four staff files.. During today's inspection two Tittle 22 type B deficiencies are being sited. An exit interview was conducted, and a copy of this report was provided to the Administrator at the conclusion of the inspection.

met_with: Gaganjit Sandhu. Program Administrator Harvir Dhaliwal, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On 05/09/2025, at 08: AM, Licensing Program Analyst (LPA) Connie Goldie made an unannounced visit to conduct an Annual/Required inspection. LPA Goldie was greeted at the door by Gurjit Dhaliwal, Direct Support Professional, (S1). S1 stated Program Administrator, Gagangit Sandhu was on her way. S1 stated he is the only staff present. The clients are at school. LPA Goldie provided Administrator the Entrance Checklist and obtained the following documents: LIC500, LIC308, LIC610C,and LIC400. LPA toured facility with Administrator and S1 and observed a 4 bedroom, 3 bath single story home with a large living room that has adequate seating for clients/staff. The temperature was observed to be a comfortable 72 degrees farenheight. Bedrooms had appropriate furnishings and youth's preferred decor. LPA tested combined smoke/carbon monoxide detectors and found them to be in working order, LPA observed kitchen to have a pantry with 5 days of non-perishables and refrigerator/freezer with 2 days of perishables. Refrigerator temperature read 39 degrees Fahrenheit. Dining area has adequate seating for clients. Family room has additional area for activities. LPA observed soap and towels in all bathrooms. The water temperature was observed to be compliant in kitchen and bathrooms. LPA observed hygiene projects to be available to clients. Backyard was clear of debris. LPA observed facility van to be in safe driving condition, headlights working, tire tread appropriate, first aid kit present and all seat belts working. Maintenance log was also reviewed. LPA informed Administrator that annual fees are current. LPA verified that all staff are background cleared. Care Tool domains Staff Records and Client Records were completed during today's inspection. Continued on LIC809C. LPA Goldie conducted 2 client interviews C1, C2 and 3 staff interviews S1, S2, and S3. Client interviews were observations. LPA reviewed 2 client files, medication administration records and 5 staff files. No deficiencies were cited during inspection. Annual inspection is complete.

visit_type: Annual


facility_name: SAVING ANOTHER MANCHILD SERVICE'S SAM'S

raw_content:
Narrative:
Confidential witnesses stated that when the clients returned to the facility, they knocked on the door but staff #1 (S1) did not open the door. Furthermore, it was disclosed that when C1 and C2 were seen at a park by facility staff only C2 was allowed to return to the facility and C1 was not. Other confidential witnesses stated that they did not hear staff tell C1 that he could not return to the facility. Also, it was disclosed in confidential interviews that C1 decided on his own to not return to the facility. LPA received inconsistent information during interviews. Based on confidential interviews and record reviews, the allegation that S2 kicked C1 out of the facility and did not let C1 get C1's belongings may have occurred, however, is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. A copy of this report and appeal rights were explained and provided to Trina Sanford.

Investigation Findings:
13On February 1, 2023, at 9: AM Licensing Program Analyst (LPA) Michael Almaraz arrived at the facility and met with administrator, Trina Sanford, to issue the finding for the above stated allegation. On April 6, 2022, at 11: AM LPA Almaraz arrived at the facility to initiate the investigation and conducted a safety inspection. During the safety inspection, LPA interviewed one facility staff and reviewed four client records. Additionally, LPA conducted interviews with four of four clients (C1, C2, C3, and C4) listed on the confidential names list (LIC 811) dated February 1, 2023, and one staff. On March 30, 2022, the Department received a complaint that alleged staff kicked minor out of the facility. More specifically, it was alleged that after C1 went absent without leave (AWOL) facility staff #2 (S2) did not allow C1 to return to the facility. Confidential witness stated that on the evening March 27, 2022, C1 and C2 went absent without leave (AWOL) from the facility and when they returned to the facility later that evening, they could not gain access and staff was not opening the door. (continued on page 2...) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Michael Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: SAVING ANOTHER MANCHILD SERVICE'S SAM'SFACILITY NUMBER: VISIT DATE: 02/01/2023

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

met_with: Trina Sanford


raw_content:
Narrative:
In regard to the allegation of wrongful eviction, it was specified that Program Administrator wanted client to be removed immediately due to behaviors and refused to keep the client in the home any longer and did not want to give C1 a 14- day notice. During investigation, Staff indicated that client AWOLed and didn't return to the office. Staff continued stating that C1 was bring illegal drugs to the facility which poses a risk to the other clients. Staff also disclosed that the facility was attempting to give a 14-day notice, but client didn't return. Other interview confirmed that C1 was under the influence of marijuana whenever C1 returned from AWOL, but they were not aware of eviction. One interview stated that it was heard from the facility staff that C1 was going to be evicted. Regarding the allegation of facility did not prevent minor from AWOLING, a confidential interview stated that the facility can't prevent a client from AWOL, however, staff would try to convince clients to stay. Another confidential witness reported C1 would AWOL and return under the influence of marijuana. It was added that staff would talk to C1, but C1 never listen and AWOL anyway. LPAs received consistent information regarding AWOL protocols. Based on interviews and record reviews the allegation that C1 was wrongful evicted and staff didn't prevent C AWOLing may have happened or may be valid, there was not a preponderance of evidence to support or deny the allegations. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report and appeal rights was provided to Administrator Trina Sanford

Investigation Findings:
13On March 9, 2023 at 1: PM licensing Program Analyst (LPA) Karen Beal and Licensing Program Manager (LPM) Abdoulaye Traore arrived at Saving Another Manchild Service's Short-Term Residential Therapeutic Program (STRTP) and me with STRTP's Administrator Trina Sanford to deliver the investigative finding regarding the above stated allegations involving the STRTP and a client (C1) as listed in the confidential names (LIC 811). On September 23,2022, Community Care Licensing (CCL) received a complaint alleging a wrongful eviction and facility did not prevent minor from AWOL (Absence without leave) On September 28, 2022, at 11: AM, Licensing Program Analyst (LPA) Almaraz initiated met with facility Administrator Trina Sanford and initiate the allegation. In addition, LPA Almaraz conducted a safety inspection, interviewed one staff, and reviewed four clients' files. There no safety concerns observed. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Karen Beal LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: SAVING ANOTHER MANCHILD SERVICE'S SAM'SFACILITY NUMBER: VISIT DATE: 03/09/2023

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

met_with: Trina Sanford, Administrator


raw_content:
Narrative:
On February 27, LPA K. Beal conducted collateral interview with two clients. LPA wasn't unable to interview two clients due to being in AWOL. During investigation, the Program Administrator stated that she was not aware of a staff threatening a client or staff inciting clients to fight. She added that she comes to the facility daily and she was not told about anything like that. Additionally, the administrator stated that she didn't believe the staff would touch themselves front of you inappropriately. A confidential interview denied using profanity, threatening clients or yelling at clients. It was disclosed that staff will always separate clients and follow protocols. Other confidential interviews disclosed that staff were always nice to clients, and they didn't witness staff threatening clients or using dirty words. Confidential interviews stated that clients didn't hear staff yelling at clients, however, staff will use a stern tone to get the clients' attention. Confidential witness stated when clients get into altercation, staff would redirect them. In the regards to allegation that facility did not prevent minor from AWOLING, a confidential stated that the facility can't prevent a client from AWOL, however, staff would try to convince clients to stay. Other confidential witness reported that they would not AWOL to be out of trouble, however, clients will always AWOL and return under the influence of marijuana. It was added that staff would talk to clients, but clients never listen. LPAs received consistent information regarding AWOL protocols. Based on interviews and record reviews the allegations that staff threatened to hit clients in care with a chair; staff encouraged clients in care to fight; staff touched himself inappropriately in front of clients in care; staff spoke inappropriately in front of clients in care; staff yelled at clients in care; staff spoke inappropriately to clients in care; and staff did not prevent clients in care from AWOLing may have happened or may be valid, there was not a preponderance of evidence to support or deny the allegations. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report and appeal rights was provided to Administrator Trina Sanford

Investigation Findings:
13On March 9, 2023 at 12: PM Licensing Program Analyst (LPA) Karen Beal arrived at Saving Another Manchild Service's Short-Term Residential Therapeutic Program (STRTP) and me with STRTP's Administrator Trina Sanford to deliver the investigative finding regarding the above stated allegations.. On October 24.2022, Community Care Licensing (CCL) received a complaint alleging that staff threatened to hit a client in care with a chair; staff encouraged clients in care to fight; staff touched himself inappropriately in front of clients in care; staff spoke inappropriately in front of clients in care; staff yelled at clients in care; staff spoke inappropriately to clients in care; and staff did not prevent a client in care from AWOLing. On November 1, 2022, at 1: PM, Licensing Program Analyst (LPA), Michael Almaraz initiated the complaint allegations, conducted a safety inspection and interviewed one staff. On February 1, 2023, Licensing Program Analysts (LPAs), Karen Beal and Michael Almaraz arrived at the STRTP to conducted interviews. LPAs interviewed one staff and reviewed two clients' files. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Karen Beal LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: SAVING ANOTHER MANCHILD SERVICE'S SAM'SFACILITY NUMBER: VISIT DATE: 03/09/2023

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

met_with: Trina Sanford, Adminnistrator


raw_content:
Narrative:
During the investigation, confidential witnesses stated that C1 would go AWOL often from the facility. Additionally, it was reported that staffing was always appropriate and staff would attempt to convince C1 not to go AWOL. LPA received other information that the facility may not be following their emergency intervention plan to prevent youth in care from AWOLing. Regarding the allegation that C1's needs could not be met at the facility. Confidential witnesses stated that C1 used drugs and obtained drugs away from the facility. Additionally, LPA was informed that staff did not provide drugs to C1 and he would obtain drugs elsewhere. Another confidential witness stated that they did not feel that the facility was adequate to meet C1's needs. Based on confidential interviews and record reviews, the allegations that C1 went AWOL from the facility due to staffing levels and that C1's needs could not be adequately met at the facility 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, appeal rights explained, and a copy of this report was provided to Ashley Sanford.

Investigation Findings:
13***This is an amended report*** On April 19, 2024, Licensing Program Analyst (LPA) Michael Almaraz met with facility staff, Ashley Sanford, to issue the finding for the above stated allegations. On April 10, 2023, at 1: PM, LPA Almaraz initiated the investigation and conducted a safety inspection, no deficiencies were noted. During the inspection LPA interviewed one facility staff and reviewed three of three client's records (see confidential names list LIC 811 dated April 19, 2024). Additionally, LPA conducted interviews with one additional staff. Two of three clients were unavailable to interview due to one being absent without leave (AWOL) and LPA being unable to locate the other client. On April 10, 2023, the Department received a complaint that staff did not follow their emergency intervention plan to prevent youth in care from AWOLing and minor's needs are not being met while in care. It was specified that client #1 (C1) went AWOL from the facility due to staffing level and that C1's needs could not be adequately met at the facility. (continued on page 2...) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Michael Almaraz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: SAVING ANOTHER MANCHILD SERVICE'S SAM'SFACILITY NUMBER: VISIT DATE: 04/19/2024

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

met_with: Ashley Sanford


raw_content:
Narrative:
Based on the lack of information, the allegation that staff threatened a minor with a knife while in care may have occurred or valid, however, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. An exit interview was not conducted as LPA M. Perez could not contact the facility due to it being closed. A copy of this report and appeal rights will be placed in the facility closed file.

Investigation Findings:
13Licensing Program Analyst (LPA) Maryjane Perez attempted to contact Saving Another Manchild Services Group Home using the last known phone number to deliver the finding of the stated allegation. On November 26, 2024, Community Care Licensing (CCL) received a complaint alleging that staff threatened a minor with a knife while in care. On December 6, 2025, LPA arrived at the closed facility location in attempt to initiate a 10-day visit. LPA did not receive an answer at home; therefore, LPA called the last known telephone number associated with the facility administrator (AD). LPA was unable to contact them or receive responses. The facility has been closed since April 10, 2024. In addition, LPA attempted to locate client 1 (C1) and was unsuccessful. LPA contacted C1's last known placement and spoke to former resource parent (RP) who stated that they had not seen C1 since the beginning of the year 2025 as C1 left the home on an unauthorized absence. LPA attempted to speak with C1's social worker (SW) via phone call but it was unsuccessful. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: MaryJane Perez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: SAVING ANOTHER MANCHILD SERVICE'S SAM'SFACILITY NUMBER: VISIT DATE: 10/17/2025


summary: Facility Evaluation - 6 deficiencies

raw_content:
Narrative:
On August 20, 2021 at 9: AM, Licensing Program Analysts (LPAs) Michael Almaraz, Adaleyci Caballero and Licensing Program Manager (LPM) Abdoulaye Traore conducted an annual inspection. The facility converted from a Group Home to STRTP (Short Term Therapeutic Program) on August 28, 2020. Facility manager Sharon Mayberry granted LPAs and LPM access into the facility. There were one out five clients present during the inspection. A physical plant inspection was completed at 10: AM and included the following checks: Facility grounds were clean and free of debris and observable hazards. There was adequate indoor and outdoor activity space. All facility smoke detectors and carbon monoxide detectors were in appropriate working order; however, one smoke detector was beeping due to a possible low battery. The fire extinguishers were properly charged and serviced. LPA's and LPM observed 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, and Foster Care Ombudsman posters. Medications were locked and centrally stored in a locked closet downstairs. Two Individual beds were missing appropriate clean linens. The hot water temperature was measured, and it was within the range. Facility had cameras in common areas of the facility. The facility has an exception on file to use the cameras and are meeting the terms and conditions. Per facility staff, no firearms or weapons are allowed in the facility. Five of five clients' file reviews were completed. Based on observation and file review, the facility is being cited on the following areas: children record and physical plant. In addition, the facility was unable to provide copies of the Board of Director's meeting minutes. Other deficiencies were observed and cited on 809Ds. (...) A case management inspection will be conducted at a later date to complete the annual inspection. Exit interview was conducted and deficiencies were advised.

Deficiencies:
80088(d): Deficient Practice Statement
1
2
3
4Based on observation, the facility did not comply with the section cited above in three out of three cleint rooms which poses a potential health, safety or personal rights risk to persons in care .
POC Due Date: 09/03/2021
Plan of Correction
1
2
3
4
80026(e): Deficient Practice Statement
1
2
3
4Based on record review, the licensee did not comply with the section cited above in six of six clients which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/03/2021
Plan of Correction
1
2
3
4
80026(j): Deficient Practice Statement
1
2
3
4Based on observation, the licensee did not comply with the section cited above in five out of five clients which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/03/2021
Plan of Correction
1
2
3
4
80026(h): Safeguards for Cash Resources, Personal Property, and Valuables

(h) Each licensee shall maintain accurate records of accounts of cash resources, personal property, and valuables entrusted to his/her care, including, but not limited to the following
87068.3(a): Modifications to The Needs And Services Plan

(a) The needs and services plan specified in Section 87068.2 shall be updated at least every 30 days to determine the following
87068.2: (2)

met_with: Sharon Mayberry

title:
Fixtures, Furniture, Equipment and Supplies

(d) The licensee shall provide lamps or lights as necessary in all rooms and other areas to ensure the comfort and safety of all persons in the facility.

This requirement is not met as evidenced by

title:
Safeguards for Cash Resources, Personal Property, and Valuables

(e) Cash resources, personal property, and valuables of clients shall be separate and intact, and shall not be commingled with facility funds or petty cash.

This requirement is not met as evidenced by

title:
Safeguards for Cash Resources, Personal Property, and Valuables

(j) Cash resources entrusted to the licensee and kept on the facility premises, shall be kept in a locked and secure location.

This requirement is not met as evidenced by


summary: Facility Evaluation

raw_content:
Narrative:
On August 26, 2021, at 09: AM, Licensing Program Analyst (LPA's) Michael Almaraz, Adalecyi Caballero and Darlene Almaraz conducted an unannounced inspection. The purpose of the inspection was to complete the continuation inspection for STRTP annual inspection that was initiated on August 20, 2021. LPA's already completed the physical inspection of the facility and reviewed facility client files. During this annual inspection continuation LPA's reviewed nine personnel files to ensure they contained all required documentation per Title Regulations and Interim Licensing Standards (ILS). All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. Personnel files were locked in the staff office. LPA's reviewed the Personnel Report (LIC 500) and schedules to ensure appropriate staffing ratios. Based on observation and file review, the facility is being cited on the following areas: disaster preparedness and emergency intervention. LPA's observed that the training hours for 9 of 9 personnel files reviewed, for 2021 meet the training requirements, per STRTP Interim Licensing Standards (ILS) LPA M. Almaraz conducted interviews with one of one available staff. Staff was able to provide sufficient information in relation to the facility's STRTP Program Statement, Emergency Intervention Plan, clients' Needs and Services plan, and Reporting Requirements. Based on interview with staff, the facility appears to be meeting Core Services/Supports requirements. An exit interview was conducted and a copy of this report, LIC 809-d and appeal rights were provided to Director Trina Stanford.

visit_type: Case Management


summary: Facility Evaluation - 3 deficiencies

raw_content:
Narrative:
On August 31, 2021 at 10: AM, Licensing Program Analysts (LPA) Anne Visaya and Licensing Program Manager (LPM) Abdoulaye Traore conducted a required annual inspection at Saving Another's Man's Child Short-Term Residential Therapeutic Program (STRTP). LPM and LPA met with Director/Administrator Trina Stanford at the Facility entrance. Trina stated that she was leaving, and Staff Maria would grant access LPM and LPA into the home. There were one out of four clients present during the inspection. At 10: AM, LPA and LPM began the facility tour inside and out with the staff Maria. Facility grounds were clean and free of debris and observable hazards. A smoke detector/alarm located in the living room was not operable. LPA and LPM observed bleach under unlocked kitchen accessible to the clients. LPA and LPM observed two sharp objects in an unlocked kitchen drawer. LPA and LPM observed detergent and other chemicals were unlocked and accessible to the children in the laundry room located upstairs. Toilet in the staff bathroom was missing a flushing handle. Based on observation and testing, the fire alarm system of the facility was not operable. The facility is being cited for the violation of the Short-Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS) regulations...sections... An Immediate civil penalty of $500 is assessed. In addition, Sharp objects and chemical were accessible. The facility is cited for violation of the Short-Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS) sections 80087(g) and 87087(d). The facility maintained an adequate supply of perishable and non-perishable foods and appeared to be following the posted menu. All required forms were posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster. Medications were locked and centrally stored in downstairs closet. Individual beds were missing appropriate clean linens. The hot water in the client's bathroom was measured to be 115 degrees. Facility had cameras in common areas of the facility. Per facility staff, no firearms or weapons are allowed in the facility. A Review of staff fingerprint clearance showed that staff (S1, S2 and S3) didn't have a fingerprint clearance. Facility is being cited for a violation of California Code of Regulations Section 80019(e)(2). An immediate civil penalty of $1,500 is assessed for the day of 08/31/2022. Personnel files were reviewed to ensure they contained all required documentation per Title 22 and Short-Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS) regulations. Per record review, personnel files were missing the following information: All staff required orientation for new staff; 8 hours and 16 hours trainings; facility manager additional training; competency assessments; required training documentation; trauma informed care; emergency disaster trainings; staff evaluations; emergency intervention trainings; all required ILS training topics; Administrator designating a person responsible for activities; medication trainings and core therapeutic services. The facility is cited for violation of Title 22 and Interim Licensing Standards: ILS Sections Personnel requirements; ILS Sections 87065. Training Requirements. Citation sections and details on LIC 809D pages. The annual inspection to be continued in a later date. LPM contacted Administrator Trina to give an authorization to staff L. Perry to receive licensing reports including plan of corrections. An exit interview was conducted and a copy of this report, LIC along with the appeal rights were provided to Direct Care Staff.

Deficiencies:
87066(b): Personnel Records

(b) The licensee shall maintain the following personnel records
80066(a): Personnel Records

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information
87065.1(d): Supervision, Evaluation And Training Requirements

(d) Notwithstanding California Code of Regulations, Title 22, Section 80065(f)(1) through (6), new direct care staff shall complete a minimum of 24 hours of initial training comprised of the 8 and 16 hour training as specified in (1) and (2) below

met_with: MARIA LUIS JUAN & JIMMIE PAYTON


facility_name: SECOND HOME, INC. - SAMPLE HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
On November 16, 2021, Licensing Program Analyst (LPA) Les Inouye conducted an annual inspection of the facility indicated above. Met at the agency by Administrator Jennifer Fish. An inspection of the physical plant was conducted. LPA observed adequate food supply, appropriately maintained yard, adequate bedding, storage space, activity space, hot water that measured 118 degrees and lamps, toiletries and a facility that is safe, sanitary and in good repair. Staff files and training records were inspected on this date. At 3: PM, an interview of S1 (see LIC811 dated 11/16/2021) was conducted. The exit interview was conducted at 3:30PM and a copy of this report given to the Administrator.

met_with: Jennifer Fish


summary: Facility Evaluation

raw_content:
Narrative:
On the above date a Case Management evaluation was conducted to review physical plant and operations of the facility. The facility has had a census of 0 since approximately June 2020. The facility has requested to modify the gender accepted to accommodate new clients. A Board resolution and appropriate licensing forms have been submitted to the Fresno CCL office. Approval was given to the facility to accept females on 11/15/21. On inspection, the physical plant was reviewed and in compliance. Each bedroom was furnished appropriately, waiver was reviewed for captains bed and additional bedding and pillows were observed. The facility was stocked with toiletries, towels. Chemicals, laundry and cleaning supplies were secured. The kitchen was supplied with appropriate perishables and non-perishables. The back yard was free of observable hazards hazards. Hot water was measured at 118 degrees. Medication storage area was observed and is inaccessible to clients. 1st aide kit was observed and complete. Appropriate licensing signs was posted including personal rights, evacuation plans, menus.

met_with: Jennier Fish


summary: Facility Evaluation

raw_content:
Narrative:
On this date Licensing Program Analyst (LPA) Les Inouye met with Jennifer Fish at the office to discuss the status of the current application for Second Home Inc STRTP Sample House for a Component II.. The Department agreed to proceed with the application process and license Sample House during the review process due to two currently operating facilities San Jose House and Tenaya House. The current Sample House application was discussed including details of corrections needed for the Plan of Operation (POO) section. The Program Statement (PS) section was not reviewed at this time but a preliminary working copy of the PS review was provided. The hard copy of the application was returned, Due to conflicting schedules by both LPA and Jennifer Fish no return due date was scheduled. It was agreed that the review and corrections would be done in a timely manner.


summary: Facility Evaluation

raw_content:
Narrative:
On the date above a pre licensing visit was conducted at Sample House by Licensing Program analyst (LPA) Les Inouye. Sample House is currently operating Group Home facility transitioning to a Short Term Residential Treatment Program (STRTP) facility. I was met by Administrator Jennifer Fish and Emily Logan. A review of the Physical Plant was conducted including the Indoor Activity Space, Fixtures Furniture Equipment and Supplies and Outdoor Activity Space. Kitchen was clean and non-perishable and perishable items were observed in the kitchen. Bedrooms were observed, 3 single occupancy for a capacity of 3. The house currently preparing to convert to a STRTP and additional furnishings are being stored at the facility. All rooms were appropriately furnished with storage area was observed. All chemicals and cleaning supplies were locked and secured. Smoke Alarms and Carbon Monoxide detectors were observed and operating. Hot water temperature was measured at 119 degrees. Back yard, there is no pool or hot tub, yard consisted of a lawn area with covered patio area. The physical plant review was observed to be clean, safe, and free of hazards. A review of the Program Statement and Plan Of Operation is ongoing by CCL and updates will reviewed. At this time, it is recommended that the facility be licensed as an STRTP.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Corina Carrillo conducted a case management inspection June 22, 2022 at 10:50AM based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. During this inspection, 8 out of Direct Care Staff and 2 out of 2 youth files were reviewed. 2 out of Direct Care Staff and 0 out of 2 youth were interviewed. (See the Confidential Names List, LIC 811, June 22, 2022). The Plan of Operation including policies and procedures were reviewed. Minutes from the board of directors' meetings related to the facility's incidents involving contact with law enforcement were reviewed. Based on the analysis of the confidential youth file review including the needs and service assessments, and crisis intervention plans, the licensee uses trauma informed and evidence based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. LPA Carrillo observed documentation of completed training on policies and procedures on when and how to involve law enforcement in response to an incident. Training records show staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance to their Emergency Intervention Plan when there is an immediate risk of serious harm to a child or others. There are no deficiencies cited at this time. A copy of this report was discussed and provided to Jennifer Fish .